Photobiomodulation Therapy on the Palliative Care of Temporomandibular Disorder and Orofacial/Cervical Skull Pain: Preliminary Results from a Randomized Controlled Clinical Trial.

The main symptoms of temporomandibular disorders (TMDs) are pain from musculoskeletal and/or joint-in the head and neck region-and complaints of difficulty in mandibular movements. The photobiomodulation therapy (PBMT) has been reported as a promising treatment in the management of these symptoms. The objective of this research was to assess the effect of PBMT immediately after irradiation on TMDs symptoms under a prospective clinical trial, randomized, triple-blinded, placebo-controlled, and with two parallel arms. According to the RDC/TMD, maximum mouth opening (MMO) and pain in the orofacial/cervical muscles and temporomandibular joint (TMJ) were recorded. One hundred forty-five participants (71 placebo and 74 PBMT experimental) were analyzed after irradiation protocols (sham-PBMT or PBMT) at the orofacial/cervical skull musculature and at the TMJ. The results showed a reduction in the total pain score (p = 0.026), a reduction in the number of painful points (p = 0.013), and an increase in the MMO (p = 0.016) in the PBMT protocol group when compared to the placebo protocol (sham-PBMT). The PBMT was shown to be effective in reducing orofacial/cervical skull pain immediately after the irradiation. It is clinically relevant and should be taken into consideration by professionals who are dedicated to treating this pathology because, in addition to bringing comfort to patients who need dental treatment, it also consists of a low-cost and low technical complexity clinical approach.

Implementation of a Pediatric Telemedicine and Medication Delivery Service in a Resource-limited Setting: A Pilot Study for Clinical Safety and Feasibility.

OBJECTIVE: Determine the clinical safety and feasibility of implementing a telemedicine and medication delivery service (TMDS) to address gaps in nighttime access to health care for children in low-resource settings. STUDY DESIGN: We implemented a TMDS called 'MotoMeds' in Haiti as a prospective cohort study. A parent/guardian of a sick child ≤ 10 years contacted the call center (6 PM-5 AM). A nurse provider used decision support tools to triage cases (mild, moderate, or severe). Severe cases were referred to emergency care. For nonsevere cases, providers gathered clinical findings to generate an assessment and plan. For cases within the delivery zone, a provider and driver were dispatched and the provider performed a paired in-person exam as a reference standard for the virtual call center exam. Families received a follow-up call at 10 days. Data were analyzed for clinical safety and feasibility. RESULTS: A total of 391 cases were enrolled from September 9, 2019, to January 19, 2021. Most cases were nonsevere (92%; 361); household visits were completed for 89% (347) of these cases. Among the 30 severe cases, 67% (20) sought referred care. Among all cases, respiratory problems were the most common complaint (63%; 246). At 10 days, 95% (329) of parents reported their child had "improved" or "recovered". Overall, 99% (344) rated the TMDS as "good" or "great". The median phone consultation time was 20 minutes, time to household arrival was 73 minutes, and total case time was 114 minutes. CONCLUSION: The TMDS was a feasible health care delivery model. Although many cases were likely self-limiting, the TMDS was associated with high rates of reported improvement in clinical status at 10 days. TRIAL REGISTRATION: clinicaltrials.gov: NCT03943654.

Distinctive g-Factor of Moiré-Confined Excitons in van der Waals Heterostructures.

We investigated the valley Zeeman splitting of excitonic peaks in the microphotoluminescence (µPL) spectra of high-quality hBN/WS2/MoSe2/hBN heterostructures under perpendicular magnetic fields up to 20 T. We identify two neutral exciton peaks in the µPL spectra; the lower-energy peak exhibits a reduced g-factor relative to that of the higher energy peak and much lower than the recently reported values for interlayer excitons in other van der Waals (vdW) heterostructures. We provide evidence that such a discernible g-factor stems from the spatial confinement of the exciton in the potential landscape created by the moiré pattern due to lattice mismatch or interlayer twist in heterobilayers. This renders magneto-µPL an important tool to reach a deeper understanding of the effect of moiré patterns on excitonic confinement in vdW heterostructures.