Priority populations' experiences of isolation, quarantine and distancing for COVID-19: protocol for a longitudinal cohort study (Optimise Study).

INTRODUCTION: Longitudinal studies can provide timely and accurate information to evaluate and inform COVID-19 control and mitigation strategies and future pandemic preparedness. The Optimise Study is a multidisciplinary research platform established in the Australian state of Victoria in September 2020 to collect epidemiological, social, psychological and behavioural data from priority populations. It aims to understand changing public attitudes, behaviours and experiences of COVID-19 and inform epidemic modelling and support responsive government policy. METHODS AND ANALYSIS: This protocol paper describes the data collection procedures for the Optimise Study, an ongoing longitudinal cohort of ~1000 Victorian adults and their social networks. Participants are recruited using snowball sampling with a set of seeds and two waves of snowball recruitment. Seeds are purposively selected from priority groups, including recent COVID-19 cases and close contacts and people at heightened risk of infection and/or adverse outcomes of COVID-19 infection and/or public health measures. Participants complete a schedule of monthly quantitative surveys and daily diaries for up to 24 months, plus additional surveys annually for up to 48 months. Cohort participants are recruited for qualitative interviews at key time points to enable in-depth exploration of people's lived experiences. Separately, community representatives are invited to participate in community engagement groups, which review and interpret research findings to inform policy and practice recommendations. ETHICS AND DISSEMINATION: The Optimise longitudinal cohort and qualitative interviews are approved by the Alfred Hospital Human Research Ethics Committee (# 333/20). The Optimise Study CEG is approved by the La Trobe University Human Ethics Committee (# HEC20532). All participants provide informed verbal consent to enter the cohort, with additional consent provided prior to any of the sub studies. Study findings will be disseminated through public website (https://optimisecovid.com.au/study-findings/) and through peer-reviewed publications. TRIAL REGISTRATION NUMBER: NCT05323799.

Improving Monocular Facial Presentation-Attack-Detection Robustness with Synthetic Noise Augmentations.

We present a synthetic augmentation approach towards improving monocular face presentation-attack-detection (PAD) robustness to real-world noise additions. Face PAD algorithms secure authentication systems against spoofing attacks, such as pictures, videos, and 2D-inspired masks. Best-in-class PAD methods typically use 3D imagery, but these can be expensive. To reduce application cost, there is a growing field investigating monocular algorithms that detect facial artifacts. These approaches work well in laboratory conditions, but can be sensitive to the imaging environment (e.g., sensor noise, dynamic lighting, etc.). The ideal solution for noise robustness is training under all expected conditions; however, this is time consuming and expensive. Instead, we propose that physics-informed noise-augmentations can pragmatically achieve robustness. Our toolbox contains twelve sensor and lighting effect generators. We demonstrate that our toolbox generates more robust PAD features than popular augmentation methods in noisy test-evaluations. We also observe that the toolbox improves accuracy on clean test data, suggesting that it inherently helps discern spoof artifacts from imaging artifacts. We validate this hypothesis through an ablation study, where we remove liveliness pairs (e.g., live or spoof imagery only for participants) to identify how much real data can be replaced with synthetic augmentations. We demonstrate that using these noise augmentations allows us to achieve better test accuracy while only requiring 30% of participants to be fully imaged under all conditions. These findings indicate that synthetic noise augmentations are a great way to improve PAD, addressing noise robustness while simplifying data collection.

Comparing short implants to standard dental implants: a systematic review and meta-analysis of randomized controlled trials with extended follow-up.

PURPOSE: To compare the difference of marginal level changes (MBL), implant failure (IF), biological and prosthetic complications (BC and PC), and prosthetic failure (PF) of short implants (SH) and standard implants (ST). MATERIALS AND METHODS: Electronic searches (PubMed, Web of Science, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) and manual searches were performed to identify all randomized controlled trials (RCTs) evaluating SH to ST. Applying Stata, a meta-analysis was conducted on the weighted mean difference (WMD) and standardized mean difference (SMD) of MBL and the risk difference (RD) of the secondary outcome. RESULTS: Twenty-four articles were involved in the present study. There were statistically significant differences in MBLs, preferring short implants in the maxilla (WMD: -0.147 (CI: -0.224, -0.070), I2: 76.6%; SMD: -0.757 (CI: -1.226, -0.289), I2: 89.2%) and in the mandible (WMD: -0.377 (CI: -0.656, -0.098), I2: 85.8%; SMD: -0.811 (CI: -1.418, -0.204), I2: 78.8%). There were no significant differences in IF (RD: 0.011 (-0.002, 0.023), I2: 0.0%), PF (RD:0.003 (-0.007, 0.014), I2: 0.0%), and PC (RD:0.001 (-0.008, 0.010), I2: 0.0%). There were significantly higher biological complications (RD: -0.071 (-0.106, -0.036), I2: 0.82.9%) for ST compared to SH in both jaws up to a 10-year follow-up. CONCLUSION: SH and ST had comparable overall outcomes, but short implants had less marginal bone loss and lower biological complications. However, more research is needed to confirm these findings.

Dimensional changes of peri-implant tissue following immediate flapless implant placement and provisionalization with or without xenograft in the anterior maxilla: a study protocol for a randomized controlled trial.

BACKGROUND: Dental implant therapy requires the preservation of peri-implant tissue in the cosmetic zone. Various surgical procedures have been presented, including ridge preservation, flapless method, and quick provisionalization. The goal of this research was to assess the buccal bone dimensional changes following immediate flapless implant implantation in the front maxilla, with or without xenografting. METHOD AND DESIGN: Thirty patients who meet the inclusion criteria and have maxillary teeth (numbers 14 to 24) are candidates for the immediate implant with immediate provisionalization. Participants will be assigned randomly to one of two groups: (1) an immediate implant with xenograft and (2) an immediate implant without bone grafting. For 3 months, the temporary prosthesis will be installed shortly before the final restoration. Following temporary prosthesis insertion and 6 months after surgery, a CBCT radiograph will be used to examine bone tissue. Soft tissue will be assessed at three points: baseline, 3 months, and 6 months following implant therapy. Patients' satisfaction, implant failure, prosthesis failure, and complications will be assessed as secondary outcomes after 6 months. DISCUSSION: The outcomes of this randomized clinical research will show if buccal bone augmentation with xenograft reduces vertical bone and gingiva recession. The findings and patient-reported outcomes will aid in the selection of therapy alternatives for implant treatment patients. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20211119053106N1. Registered on 6 December 2021 and Open Science Framework (OSF) on May 20, 2022. Registration DOI https://doi.org/10.17605/OSF.IO/VUGFQ .

Epigenetic effects of graphene oxide and its derivatives: A mini-review.

Graphene oxide (GO), an engineered nanomaterial, has a two-dimensional structure with carbon atoms arranged in a hexagonal array. While it has been widely used in many industries, such as biomedicine, electronics, and biosensors, there are still concerns over its safety. Recently, many studies have focused on the potential toxicity of GO. Epigenetic toxicity is an important aspect of a material's toxicological profile, since changes in gene expression have been associated with carcinogenicity and disease progression. In this review, we focus on the epigenetic alterations caused by GO, including DNA methylation, histone modification, and altered expression of non-coding RNAs. GO can affect DNA methyltransferase activity and disrupt the methylation of cytosine bases in DNA strands, leading to alteration of genome expression. Modulation of histones by GO, targeting histone deacetylase and demethylase, as well as dysregulation of miRNA and lncRNA expression have been reported. Further studies are required to determine the mechanisms of GO-induced epigenetic alterations.

Immediate vs Delayed Restorations of Immediately Placed Single Implants in the Anterior Maxilla: A Nonrandomized Clinical Study.

PURPOSE: This study was conducted to compare the radiographic, esthetic, and patient-reported outcome measures (PROMs) between immediate and delayed restorations of immediately placed single implants in the maxillary esthetic zone. MATERIALS AND METHODS: Forty patients with immediate single dental implants in the anterior maxilla were included in this study. Afterward, they were allocated either for immediate restoration with a provisional restoration (IR: 20 patients) or for a delayed restoration (DR: 20 patients). The evaluations were performed after 1 year of follow-up. RESULTS: No implant and prosthetic failures were observed during the 1-year follow-up. Two minor complications were found in two IR patients; however, no complication was reported in the DR group during the 1 year. Nevertheless, this difference was not statistically significant (P > .05). After 1 year, the mean marginal bone level changes (MBL) were 0.47 ± 0.29 mm and 0.54 ± 0.21 mm for IR and DR, respectively. There was no statistically significant difference between the two groups in terms of MBL (P = .3). Notably, the mean total pink esthetic score (PES) and white esthetic score (WES) after 1 year of follow-up were 11.2 ± 1.1 (PES) and 8 ± 1.02 (WES) for the immediate restoration, and 10.2 ± 0.97 (PES) and 7.65 ± 1.20 (WES) for the delayed restoration. Also, no statistically significant difference was found between IR and DR in terms of esthetic scores (P > .05). The patient satisfaction of these two groups had no statistically significant difference, except for the esthetic factor (P = .04). CONCLUSION: The immediate restoration and preferred esthetic satisfaction had similar outcomes compared with the delayed restoration.

Staged reconstruction of hemimaxillectomy defect: Application of buccal fat pad flap, iliac bone graft and implant-supported dental prostheses.

In order to achieve a fixed implant-supported prosthesis in a posthemimaxilectomy patient, ideal soft and hard tissue rehabilitation is necessary. Here, we present a staged approach for soft tissue reconstruction with local flaps followed by anterior iliac crest bone graft which resulted in a predictable and satisfactory outcome.

Preoperative imaging of the inferior alveolar nerve canal by cone-beam computed tomography and 1-year neurosensory recovery following mandibular setback through bilateral sagittal split ramus osteotomy: a randomized clinical trial.

OBJECTIVES: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO. MATERIALS AND METHODS: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01). RESULTS: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122). CONCLUSION: Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

Enabling Low-Power, Multi-Modal Neural Interfaces Through a Common, Low-Bandwidth Feature Space.

Brain-Machine Interfaces (BMIs) have shown great potential for generating prosthetic control signals. Translating BMIs into the clinic requires fully implantable, wireless systems; however, current solutions have high power requirements which limit their usability. Lowering this power consumption typically limits the system to a single neural modality, or signal type, and thus to a relatively small clinical market. Here, we address both of these issues by investigating the use of signal power in a single narrow frequency band as a decoding feature for extracting information from electrocorticographic (ECoG), electromyographic (EMG), and intracortical neural data. We have designed and tested the Multi-modal Implantable Neural Interface (MINI), a wireless recording system which extracts and transmits signal power in a single, configurable frequency band. In prerecorded datasets, we used the MINI to explore low frequency signal features and any resulting tradeoff between power savings and decoding performance losses. When processing intracortical data, the MINI achieved a power consumption 89.7% less than a more typical system designed to extract action potential waveforms. When processing ECoG and EMG data, the MINI achieved similar power reductions of 62.7% and 78.8%. At the same time, using the single signal feature extracted by the MINI, we were able to decode all three modalities with less than a 9% drop in accuracy relative to using high-bandwidth, modality-specific signal features. We believe this system architecture can be used to produce a viable, cost-effective, clinical BMI.

Cortical Bone Augmentation Versus Nerve Lateralization for Treatment of Atrophic Posterior Mandible: A Retrospective Study and Review of Literature.

PURPOSE: We sought to assess implant success/survival/failure rate following cortical autogenous tenting technique (CATT) versus inferior alveolar nerve transposition (IANT) in the posterior mandible. MATERIALS AND METHODS: Patients who underwent these two procedures between 2007 and 2011 were analyzed. CATT was performed using lateral ramus block graft and implants were inserted simultaneously or after 4 to 6 months. In IANT, implants were placed simultaneously after nerve transposition with or without mental foramen involvement. Data regarding marginal bone level (MBL), pus discharge (PD), neurosensory dysfunction (NSD), implant mobility, and failure were collected. Success rate was measured based on Pisa Consensus. Independent sample t-test with a significance level of 0.05 was used to compare implant dimensions and MBL changes between the two techniques. RESULTS: A total of 118 patients with a mean age of 54.85 years were included. The mean follow-up after CATT and IANT was 37.97 and 18.51 months, respectively. The overall survival and success rates of dental implants in the CATT group were 98.73% and 71.52%, respectively. The corresponding values for IANT subjects were 98.74% and 94.56%, respectively. Implant length and diameter in IANT group were significantly longer and wider than implants used after CATT (p value < .001). MBL changes in both techniques were less than 1 mm (p value = .79). Two cases of NSD, seven PD, and two implant failures were found in the CATT group. For IANT patients, seven permanent NSD, two PD, two implant failures, and one mandibular fracture were documented. CONCLUSION: Both techniques had implant survival rates similar to implants placed in unaltered bone. A higher implant success rate, albeit with higher incidence of long-lasting nerve damage, was observed in the IANT group.

Nerve Retraction During Inferior Alveolar Nerve Repositioning Procedure: A New Simple Method and Review of the Literature.

Nerve repositioning surgery is one of the treatments chosen for the patients with edentulous posterior atrophic mandible. Like any other treatments, this therapy has its advantages and disadvantages, indications and contraindications. The most important complication of this procedure is neurosensory disturbance. This problem may occur at different stages of the treatment. One common time when nerve damage happens is when the nerve is located outside the canal and drilling and insertion of the implant are performed. Accordingly, this report describes a simple and feasible method to retract and protect nerves outside the canal during the treatment of nerve transposition. This will reduce the risk of nerve damage.

Surgical excision of duodenal/pancreatic metastatic renal cell carcinoma.

Renal cell carcinoma (RCC) has a potential to metastasize to almost any site and this may occur many years following nephrectomy. We present six cases with uncommon sites of metastasis: four patients presented with distal pancreatic metastasis and two with duodenal/head of the pancreas metastasis. Time to metastatic disease varied from 1 to 19 years following renal surgery. For patients are alive and two succumbed to their disease. Long-term survival can be achieved with aggressive surgical excision of disease.

Hemangioma of the buccal fat pad.

Hemangiomas are benign vascular neoplasms characterized by an abnormal proliferation of blood vessels. Buccal fat pad (BFP) is a rare place for hemangioma. In this report, clinical, radiographic, and histopathological findings are described in a rare case of hemangioma with phleboliths involving the BFP, and a review is made of the international literature on this subject.

Heminasal proboscis, a rare craniofacial cleft.

Craniofacial clefts are extremely rare congenital anomalies, the importance of which lies in their great range of variety of anatomic forms and their complex management. Proboscis is one of the rare cases of this kind in which half of the nose is separated from the face and it is only pedicled on the right or left medial canthal regions by a nose-like, rudimentary tubular structure. This article reports the case of a 3-month-old infant with left-sided proboscis. Left lower eyelid coloboma was also present. The proboscis was treated with local flaps at the age of 3 months, and at the age of 10 months the coloboma was managed.

Respiratory Tract Infections and its Preventive Measures among Hajj Pilgrims, 2010: A Nested Case Control Study.

BACKGROUND: Respiratory tract infections are very common among the Hajj pilgrims. Some preventive measures including Influenza vaccination, using face mask and salt water gargling have been considered to control these infections and the reports show conflicting results about the effects of each one of these measures. This study is trying to assess the effects of these recommendations on respiratory tract infections. METHODS: According to nested case-control design, in a cohort consisting of 338 Iranian pilgrims, the outcome examined, was all types of respiratory tract infections other than common colds. With occurrence of any patient in convoy, data collection form was completed for that person. On the same day, two people were randomly selected as control group from among pilgrims who have not affected so far. RESULTS: During Hajj, 32 pilgrims (9.5%) were affected by respiratory tract infections other than common colds. In univariable logistic regression analysis, salt water gargling (OR = 2.4, P = 0.08), existence of other patient in the room (OR = 2.14, P = 0.19), age over 60 years (OR = 1.84, P = 0.15) and the education more than or equal to 3 years (OR = 1.93, P = 0.16) were effective in the respiratory tract infections (P < 0.2). However, multivariable logistic regression analysis showed that none of the above mentioned factors are significantly associated with these infections. CONCLUSIONS: This study showed that measures such as seasonal influenza vaccination, use of face masks and personal prayer carpet have no effect on the incidence of respiratory tract infections. However, washing throat and mouth with salt water can be considered the most effective preventive measures.

Freeman-Sheldon syndrome: combined surgical and non-surgical approach.

BACKGROUND: Many Freeman-Sheldon syndrome patients suffer from extensive microstomia resulting in possible inhibition of dental and skeletal development as well as difficulties in eating, speech and dental hygiene. Oral commissure contraction treatments vary from patient education to complicated surgical and/or prosthetic treatments, but recurrence is often described. This article reports on a combined surgical and non-surgical approach in order to increase maximum mouth opening and maintain the result of the surgery. TECHNIQUE: The patient underwent bilateral commissuroplasty using 2 rhomboid flaps for each side. After two steps of intraoral and perioral tissue impression taking, a master cast was poured and a retractor was fabricated from thermoplastic material. The patient was encouraged to wear the retractor the entire day and night except at meal times. RESULTS: After surgery maximum mouth opening was increased from 20 mm to 37 mm and remained the same six months after the surgery. Psychosocial factors were improved and the patient was satisfied with the results of her treatment. CONCLUSION: The use of bilateral commissuroplasty in combination with this customized dynamic oral commissure retractor may be applicable in other syndromic patients with a small oral commissure and also in patients with circumoral burns.

Inferior encephalocele: transpalatal repair using paired costal bone grafts with a 14-year follow-up.

A 2-year-old girl was referred to our hospital because of a pulsating mass in the roof of the mouth. On examination, a mass measuring 4 × 5 cm was found in the roof of the mouth and nose with a secondary palatal cleft. She had hypertelorism, a bifid nose, and a visible cleft over the dorsum and skin of the nose. In 1 stage, the mass was opened, reduced, and repositioned into the cranial cavity, and the defect was repaired with 2 parallel bridges of split costal bone grafts. The bone grafts were placed between 2 layers of soft tissue and the mucosa repaired over it. Palatal cleft was repaired with the Veau-Wardill-Kilner method 1 year later. Fourteen years later, the bifid nose was corrected using a flying-bird incision and a costal cartilage graft for the dorsum of the nose. On follow-up, minimal scar remained on the tip of the nose. There was neither obliteration nor reduction in the size of the bony defect. There were no operative complications, and the shape of the nose improved. The patient and her parents were highly satisfied with the result.

Use of cone beam computed tomography to detect and remove a broken suture needle.

Suture needles can break when they are used to suture the oral mucosa, especially if they have been bent or if excessive force is applied. Several retrieval modalities have been discussed in the literature; these have focused mainly on locating the needle. Although the segment often is found and removed by the surgeon during the procedure, more extensive procedures and paraclinical diagnostics may be necessary. This article presents a case in which a lost suture needle was located using a cone beam computed tomography scan and retrieved via surgery.