Orthodontic correction of anterior open bite using skeletal anchorage: systematic review and meta-analysis.

The purpose of this study was to investigate the scientific evidence on the short- and long-term effects of orthodontic correction of anterior open bite (AOB) using skeletal anchorage (SA). Clinical studies on the use of SA for AOB in patients with permanent dentition, or at least 12 years of age, were searched. Short- and long-term (≥2 years) outcomes were collected. Mean differences were calculated from pooled data. Twenty-four eligible articles with a total of 362 subjects were selected for inclusion in the meta-analysis. There was a significant increase in overbite (3.88 mm, P < 0.001) and maxillary molar intrusion (-2.15 mm, P < 0.001). The mandible showed counterclockwise rotation with anterosuperior chin movement (all P < 0.001). Long term, the decrease in overbite was 19.9% and decrease in molar intrusion was 22.9%. The decrease in the mandibular projection was 14.6% for ANB (A-point-nasion-B-point angle) and 46.2% for mandibular anteroposterior position. The overall risk of bias in the included studies was rated as moderate to high, and publication bias existed for several key variables. SA for maxillary molar intrusion effectively improved dental and skeletal outcomes, but there was a long-term decrease in overbite and maxillary molar position. The variable data quality, heterogeneity, and publication bias in investigated outcomes are limitations in interpreting the findings.

Deep-learning Method for the Prediction of Three-Dimensional Dose Distribution for Left Breast Cancer Conformal Radiation Therapy.

AIMS: An increase in the demand of a new generation of radiotherapy planning systems based on learning approaches has been reported. At this stage, the new approach is able to improve the planning speed while saving a reasonable level of plan quality, compared with available planning systems. We believe that new achievements, such as deep-learning models, will be able to review the issue from a different point of view. MATERIALS AND METHODS: The data of 120 breast cancer patients were used to train and test the three-dimensional U-Res-Net model. The network input was computed tomography images and patients' contouring, while the patients' dose distribution was addressed as the output of the model proposed. The predicted dose distributions, created by the model for 10 test patients, were then compared with corresponding dose distributions calculated by a reliable treatment planning system. In particular, the dice similarity coefficients for different isodose volumes, dose difference and mean absolute errors (MAE) for all voxels inside the body, Dmean, D98%, D50%, D2%, V95% for planning target volume and organs at risk were calculated and were statistically analysed with the paired-samples t-test. RESULTS: The average dose difference for all patients and voxels in body was 0.60 ± 2.81%. The MAE varied from 3.85 ± 6.65% to 8.06 ± 10.00%. The average MAE for test cases was 5.71 ± 1.19%. The average dice similarity coefficients for isodose volumes was 0.91 ± 0.03. The three-dimensional gamma passing rates with 3 mm/3% criteria varied from 78.99% to 97.58% for planning target volume and organs at risk, respectively. CONCLUSIONS: The investigation showed that a deep-learning model can be applied to predict the three-dimensional dose distribution with optimal accuracy and precision for patients with left breast cancer. As further study, the model can be extended to predict dose distribution in other cancers.

Moderate grazing is the best measure to achieve the optimal conservation and soil resource utilization (case study: Bozdaghin rangelands, North Khorasan, Iran).

The study of the variability of physical and chemical factors of soil due to different intensities of livestock grazing can help in the management and maintenance of soil and vegetation. Accordingly, the effect of livestock grazing intensities on soil properties and vegetation in Bozdaghin rangelands of North Khorasan province was investigated. To investigate the effect of different livestock grazing intensities, Three 5-hectare plots in the study area were determined under different treatments (ungrazed (UG), moderate grazing (MG), and heavy grazing (HG)), and the effect of three grazing intensities on vegetation and soil physicochemical and erodibility properties (SPEP) was evaluated. The soil sampling process was performed at depths of 0-15, 15-30 cm and SPEP including soil saturation moisture (SSM), soil texture (percentage of clay, sand, and silt), absorbable potassium (K), electrical conductivity (EC), soil organic matter (SOM), absorbable phosphorus (P), acidity (pH), and bulk density were evaluated, and Soil Erodibility Index (SEI) was calculated by implementing the modified clay ratio relation. To assess the impact of various grazing intensities on all measured characteristics, multivariate analysis of variance (MANOVA) and Duncan tests were utilized to compare the means and their grouping. The results showed that HG compared to MG causes worrying consequences in the first soil depth. Also with increasing grazing intensity, plant production percentage (P < 0.05) and vegetation density (P < 0.01) decreased, and the amount of bare soil (P < 0.01) increased. Also, with increasing grazing intensity, the amount of pH, EC, clay, saturated moisture, and N decreased (P < 0.01), but the amount of silt, sand, K, P, calcium (Ca), lime, and SOM increased (P < 0.01). UG improves soil quality, MG intensity causes optimal conservation and utilization of soil resources, and HG intensity causes severe changes in rangeland soil properties. In areas with MG intensity, due to the increase of the percentage of vegetation (an increase of SOM and prevents the direct impact of raindrops on the soil aggregates) and as a result improvement of soil structure and texture, an increase of water infiltration, and decrease of runoff, and the rate of soil erodibility and water erosion, the rangeland soil decreases and results in sustainable production. This results in optimal conservation and utilization of soil resources. So to sustainably exploit and balance the conservation of biodiversity, livestock production, and soil carbon and nitrogen management, MG is recommended.

Effect of Vitamin E on Serum Levels of Vascular Endothelial Growth Factor and Angiopoietin-1 in Women with Polycystic Ovary Syndrome: A Pilot Randomized, Placebo-Controlled Trial.

BACKGROUND: Angiogenesis disturbances are common in women with polycystic ovary syndrome (PCOS). Vitamin E has antiangiogenic properties. Data on the effects of vitamin E on angiogenesis in PCOS is limited, so the current study was conducted to evaluate its effects on angiogenic indices in PCOS patients. MATERIALS AND METHODS: This randomized, double-blind, placebo-controlled trial was performed on 43 women aged 20-40 years, diagnosed with PCOS (Rotterdam criteria). It was performed at the referral clinic affiliated to Tabriz University of Medical Sciences, Tabriz, Iran, from April 2017 to September 2017. Patients were randomly assigned into two groups to receive either 400 IU/day vitamin E -as alpha tocopheryl acetate- (n=22) or placebo (n=21), for 8 weeks. Anthropometric, and angiogenic parameters including body weight, fat mass and fat free mass, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), angiopoietin-1 (Ang-1), and angiopoietin- 2 (Ang-2) were measured by standard methods at the beginning and at the end of study. Statistical Package for Social Science version 25 was used for statistical analysis and P<0.05 were considered significant. RESULTS: After adjusting for potential confounders, we observed that vitamin E supplementation significantly reduced body weight, fat mass, Ang-1, Ang-1/Ang-2 ratio and VEGF (P<0.01). We did not observe any considerable effect for vitamin E on Ang-2 level or bFGF. CONCLUSION: Vitamin E supplementation for 8 weeks in the PCOS women had beneficial effects on body weight, Ang- 1, Ang-1/Ang-2 ratio, and VEGF level (Registration number: IRCT201610193140N18).

Long-term grazing exclosure: implications on water erosion and soil physicochemical properties (case study: Bozdaghin rangelands, North Khorasan, Iran).

Grazing exclosure (GE) is used to improve rangelands in the dry area of the world, so it is important to investigate its effects on soil physicochemical and erodibility properties. This study was conducted to evaluate the effect of long-term GE on the physicochemical and erodibility properties of soil and vegetation as compared with open grazing (OG) areas in Bozdaghi region of North Khorasan province, Iran. Soil and vegetation data were sampled from two sites in the grazing exclosure and the open grazing in early autumn in a randomized complete block design with three replications. Therefore, in each area (GE and OG), three transects of 500-m length and 200-m intervals) were set up. Along each transect, five soil samples were taken at the depths of 0-15 and 15-30 cm in a random-systematic method (15 soil samples in each area) and transferred to the laboratory. In the laboratory, some soil physicochemical properties such as saturation percentage, soil texture (clay, silt, and sand), bulk density, porosity, percentage of soil organic matter (SOM), total nitrogen (TN), exchangeable sodium, potassium, pH, and electrical conductivity (EC) were measured and Soil Erodibility Index (SEI) was calculated by using the modified clay ratio relation. After installing the transects (with a length of 50 m) in three blocks in each area, the parameters of species composition and canopy cover were investigated by the linear-contact method. Data analysis was performed by using an independent t test on Statistical Package for Social Sciences (SPSS) v. 23 software. The results indicate that the application of GE in the Bozdaghi area has a significant positive effect on soil physicochemical properties (P < 0.05). Also, the application of GE has increased the amount of SOM and TN in the surface layer of the soil by about twice as much as the OG pastures. Due to these changes, during 20 years in the GE area, the effects of GE can be positively assessed. According to the obtained results, especially the positive changes in vegetation and the soil physicochemical and erodibility properties, it is recommended to execute the GE plan in the study area.

Effect of Exercise Training on Heart Rate Variability in Patients with Heart Failure After Percutaneous Coronary Intervention.

BACKGROUND: This study aims to evaluate the effect of exercise training on heart rate variability (HRV) and to determine the correlation between parameters of HRV and the ejection fraction in patients with heart failure after percutaneous coronary intervention. MATERIAL AND METHODS: Fifty patients with left ventricular ejection fraction ≤ 40% undergone percutaneous coronary intervention were randomly allocated in either an exercise training (ET) group or a control group. The ET group performed exercise training for 45 minutes, three times a week for seven weeks. Patients in both groups received a leaflet for daily exercising at home. HRV parameters comprising, the standard deviation of normal R-R intervals (SDNN), the square root of the mean of the squares of successive R-R intervals differences (RMSSD) ,the percentage of successive R-R intervals differing from more than 50 ms (PNN50), using 24-hour Holter electrocardiographic monitoring was measured. RESULTS: After the intervention, the SDNN improved in the ET group (P=0.002), while changes in all remaining HRV indices were insignificant (P≥0.05). The control group showed no significant changes in any HRV parameters (P≥0.05). Changes in SDNN in the ET group were significantly different from the control group (P=0.003). At baseline, our results revealed a significant weak correlation between ejection fraction and SDNN (r =0.279, P=0.047). However, ejection fraction did not correlate significantly with RMSSD and PNN50. CONCLUSION: Exercise training is safe and feasible in post percutaneous coronary intervention patients, even in those with reduced ejection fraction. In a seven-week period, exercise training was effective in improving HRV in heart failure patients after percutaneous coronary intervention.

A Randomized Trial Using 3Mixtatin Compared to MTA in Primary Molars with Inflammatory Root Resorption: A Novel Endodontic Biomaterial.

OBJECTIVES: Novel methods for preserving primary teeth can help to maintain their developmental, esthetic, and functional capabilities. The aim of this study was to assess the success of the repair of bony defects, caused by pre-treatment perforations, with a mixture of three antibiotics combined with simvastatin (3Mixtatin) compared to MTA in hopeless primary molars. STUDY DESIGN: In this randomized clinical trial, 80 teeth from 65 healthy children aged 3-6 years with interradicular or periapical root resorption and/or perforation in primary molars were treated either with 3Mixtatin or MTA before conventional pulpectomy and restoration. The subjects were followed up clinically and radiographically for 4, 6, 12 and 24 months after pulp treatment to evaluate and compare the healing process. The data were compared using chi-square test at a significance level of 0.05. RESULTS: By the end of 24 months in 3Mixtatin group, 31 (96.8%) teeth revealed no clinical signs or symptoms with arrested resorption progress in radiographs. In MTA group, clinical signs and symptoms including pain, mobility and sinus tract were observed in 18 (48.6%) teeth with cessation of root/interradicular radiolucency in 7 (18.9%) teeth without bone repair. CONCLUSIONS: Radiographic and clinical healing occurred more successfully following 3Mixtatin treatment compared to treatment with MTA, it may lead to a paradigm shift in the pulpal treatment of primary teeth in the future.

Use of general anaesthesia in paediatric dentistry: barriers to discriminate between true and false cases.

PURPOSE: The use of general anaesthesia (GA) has shown significant increase in child dental patients. This study aimed to assess whether behaviour management strategies can be the effective methods for decreasing the need for GA and its over-utilisation in paediatric dentistry. METHODS: The patients (n = 240) aged 3-6 years old were selected from referrals by paediatric dentists (PD) or general dentists (GD) for dental treatment under GA. Each child's behaviour during first and subsequent appointments was assessed using the Frankl Behaviour Rating Scale. A first visit included clinical examination and fluoride therapy. In all sessions, a hierarchy of anxiety-reducing behaviour guidance strategies was implemented over nine steps in a logical treatment order. RESULTS: Overall, 47.5% of children referred for dental treatments under GA were retrained to be treated routinely. False referrals were significantly higher in GD compared to PD group. 80.0% of the referred children by PD and 6.7% of those referred by GD were true GA cases and still needed GA. 20.1% of retrained children and 67.4% of true GA cases received conscious sedation. There was no significant change in the frequency of children considered uncooperative as the years of experience increased among GD, while this value was significant for PD. CONCLUSIONS: The findings may highlight the importance of using behaviour management techniques thoroughly prior to referring an uncooperative child for treatment under GA, and may discourage its over-utilisation. Specifically, these skill sets and their efficient practice should be improved among general dentists.

Runoff potentiality of a watershed through SCS and functional data analysis technique.

Runoff potentiality of a watershed was assessed based on identifying curve number (CN), soil conservation service (SCS), and functional data analysis (FDA) techniques. Daily discrete rainfall data were collected from weather stations in the study area and analyzed through lowess method for smoothing curve. As runoff data represents a periodic pattern in each watershed, Fourier series was introduced to fit the smooth curve of eight watersheds. Seven terms of Fourier series were introduced for the watersheds 5 and 8, while 8 terms of Fourier series were used for the rest of the watersheds for the best fit of data. Bootstrapping smooth curve analysis reveals that watersheds 1, 2, 3, 6, 7, and 8 are with monthly mean runoffs of 29, 24, 22, 23, 26, and 27 mm, respectively, and these watersheds would likely contribute to surface runoff in the study area. The purpose of this study was to transform runoff data into a smooth curve for representing the surface runoff pattern and mean runoff of each watershed through statistical method. This study provides information of runoff potentiality of each watershed and also provides input data for hydrological modeling.

Experimental study on tsunami risk reduction on coastal building fronted by sea wall.

This experimental study was conducted to idealize the efficacy of sea wall in controlling the tsunami forces on onshore structures. Different types of sea walls were placed in front of the building model. The tsunami forces and the wave heights were measured with and without the sea wall conditions. Types of sea wall, wall height, and wall positions were varied simultaneously to quantify the force reductions. Maximum of 41% forces was reduced by higher sea wall, positioned closer proximity to the model whereas this reduction was about 27% when the wall height was half of the high wall. Experimental investigations revealed that wall with adequate height and placed closer to the structures enables a satisfactory predictor of the force reduction on onshore structures. Another set of tests were performed with perforated wall placing near the building model. Less construction cost makes the provision of perforated sea wall interesting. The overall results showed that the efficacy of perforated wall is almost similar to solid wall. Hence, it can be efficiently used instead of solid wall. Moreover, overtopped water that is stuck behind the wall is readily gone back to the sea through perforations releasing additional forces on the nearby structures.

Sustainability of rainwater harvesting system in terms of water quality.

Water is considered an everlasting free source that can be acquired naturally. Demand for processed supply water is growing higher due to an increasing population. Sustainable use of water could maintain a balance between its demand and supply. Rainwater harvesting (RWH) is the most traditional and sustainable method, which could be easily used for potable and nonpotable purposes both in residential and commercial buildings. This could reduce the pressure on processed supply water which enhances the green living. This paper ensures the sustainability of this system through assessing several water-quality parameters of collected rainwater with respect to allowable limits. A number of parameters were included in the analysis: pH, fecal coliform, total coliform, total dissolved solids, turbidity, NH3-N, lead, BOD5, and so forth. The study reveals that the overall quality of water is quite satisfactory as per Bangladesh standards. RWH system offers sufficient amount of water and energy savings through lower consumption. Moreover, considering the cost for installation and maintenance expenses, the system is effective and economical.

Storm runoff quality and pollutant loading from commercial, residential, and industrial catchments in the tropic.

Information on the pollution level and the influence of hydrologic regime on the stormwater pollutant loading in tropical urban areas are still scarce. More local data are still required because rainfall and runoff generation processes in tropical environment are very different from the temperate regions. This study investigated the extent of urban runoff pollution in residential, commercial, and industrial catchments in the south of Peninsular Malaysia. Stormwater samples and flow rate data were collected from 51 storm events. Samples were analyzed for total suspended solids, 5-day biochemical oxygen demand, chemical oxygen demand, oil and grease (O&G), nitrate nitrogen (NO3-N), nitrite nitrogen, ammonia nitrogen, soluble reactive phosphorus, total phosphorus (TP), and zinc (Zn). It was found that the event mean concentrations (EMCs) of pollutants varied greatly between storm characteristics and land uses. The results revealed that site EMCs for residential catchment were lower than the published data but higher for the commercial and industrial catchments. All rainfall variables were negatively correlated with EMCs of most pollutants except for antecedent dry days (ADD). This study reinforced the earlier findings on the importance of ADD for causing greater EMC values with exceptions for O&G, NO3-N, TP, and Zn. In contrast, the pollutant loadings are influenced primarily by rainfall depth, mean intensity, and max 5-min intensity in all the three catchments. Overall, ADD is an important variable in multiple linear regression models for predicting the EMC values in the tropical urban catchments.

Investigating the statistical properties of the swallowing sounds.

In this paper the statistical properties of the swallowing sound is discussed. This knowledge is required for the acoustical modeling of the swallowing mechanism as it is important to select an appropriate type of the system (i.e. linear vs. nonlinear) for modeling. The tests of linearity and gaussianity were performed. The results of the statistical test of gaussianity showed a nonGaussian distribution of the swallowing sound signals. Also, the test of linearity exhibited the nonlinear characteristics of the model that represents the swallowing sound generation.

Use of navigator-echo-gated MRI to diagnose a coronary shunt involving an anomalous origin of the right coronary artery from the pulmonary artery.

Origin of the right coronary artery from the main pulmonary artery is an anomaly that can cause formation of a left-to-right coronary shunt, leading to myocardial ischemia and early onset of congestive heart failure. We describe a case in which magnetic resonance imaging was able to show the anomalous origin of the right coronary artery, and magnetic resonance phase velocity mapping was able to demonstrate the presence of a left-to-right shunt through the coronary artery by showing retrograde flow in the right coronary artery.

Contractions move contents by changing the configuration of the isolated cat stomach.

To understand how contractions move gastric contents, we measured, in isolated cat stomachs, the effects of contractions on gastric length, diameters, pressures, and emptying. Movements of the stomach and of gastric contents were monitored by video camera and ultrasound and were related to mechanical events. Based on pressures, we defined the following four phases of contractions: 1) Po, a steady pressure associated with tonic contraction of proximal stomach; 2) P', a pressure wave during which the contraction indents the gastric body; 3) a pressure nadir while the contraction lifts the gastric sinus toward the incisura; and 4) a second pressure wave, P", as the contraction advances through the antrum. In open preparations, liquid output and shortening of the greater curvature are large during Po, stop during P', and resume with P". Contractions generate higher pressures when gastric volume is held steady. Contractions increase wall thickness and decrease gastric diameters at sites they involve and have opposite effects at remote sites. Contractions move the incisura and hence redraw the borders between gastric segments and shift volumes back and forth within the gastric lumen. Contractions furthermore stir up, compress, and disperse particulate beans without moving them to the pylorus. We conclude that gastric contractions 1) reverse changes in gastric length that occur during gastric filling, 2) move gastric contents directly through local contact and indirectly by changing the configuration of the stomach, and 3) interact with structures such as the incisura in retaining and breaking up solid gastric contents.

Gastric contractions, secretions and injury in cold restraint.

The clinical syndrome of stress ulceration has been studied for years using rodent cold restraint stress models, although the pathogenesis of the characteristic focal gastric mucosal lesions produced in these models has been controversial. We used gastric strain gauges to characterize fully the gastric motility effects of a 4-h cold restraint protocol, and we determined the relationship of variations in gastric contents and in gastric contractions to the amount of gastric mucosal injury. Additionally, we examined rat stomachs histologically, and determined the location of focal haemorrhagic mucosal lesions on the mucosal rugae. We found a consistent relationship between force of gastric contractions and gastric mucosal injury, and also a relationship between the initial duration of contractions during restraint and ultimate mucosal injury. Volume, acidity and mucus in the gastric contents were unrelated to mucosal injury. The majority (91%) of the mucosal lesions had some relationship to a rugal fold, with 59% of all lesions at the base of a rugal fold. Thus, the mechanical forces of gastric hypercontractility may contribute to the gastric mucosal injury of rodent cold restraint models.

Volume shifts, unfolding and rolling of haustra in the isolated guinea pig caecum.

The large intestine extracts water from chyme and compacts chyme into faecal conglomerates; it is unclear what role the special pockets known as colonic haustra have in these events. Here we monitored the movements of haustra in isolated preparations of guinea pig caecum using videocamera and ultrasound and related them to contractions of muscle flaps and movements of glass beads in haustral pockets. We found that in partially filled caecal loops localized contractions of taeniae shift volume back and forth between adjacent haustra; volume unfolds haustral walls in a characteristic sweep with sequential intrahaustral folds popping out; cyclic contractions and relaxations of the fold then produce the caterpillar-like movement known as haustral rolling; ultrasound showed that haustral rolling made the haustral flow channel narrower and longer as haustral folds increase their height from 7.5 +/- 1.5 mm to 16 +/- 4 mm and their distance from 4.1 +/- 0.2 mm to 7.9 +/- 0.3 mm; luminal contents were alternatively shaken off the haustral wall, whirled around the lumen or left to settle. We also suspended the row of haustra between two taeniae inside a frame and attached flaps of taeniae and haustral folds to strain gauges to record their mechanical activity; both taeniae and haustral folds produced an undulating baseline tension; during rolling, folds produced phasic contractions at 17 +/- 2 cycles min-1 which propagated distally across haustral septa; rolling constantly shuffled around glass beads placed inside the haustra. When we stimulated the intramural nerves to the caecum through bipolar electrodes, all contractile activity was temporarily inhibited and haustral septa flattened; a rebound contraction then propagated aborally from the caecal pole and swept the glass beads ahead of it. Thus, tonic contractions of taeniae shift caecal contents back and forth across haustral septa; expansion of haustra triggers haustral rolling which shuffles contents; both these movements produce local flow within and between haustra which might enhance the separation of solid and liquid colonic contents.

Role of altered responsiveness of hypertrophic smooth muscle in manometric abnormalities of the obstructed opossum oesophagus.

The movements of the obstructed oesophagus are abnormal, but whether this relates to the disease causing the obstruction, to the altered load conditions or to abnormal neuromuscular functions in hypertrophic smooth muscle is unclear. In an opossum model of chronic oesophageal obstruction, we compared the mechanical responsiveness of hypertrophic smooth muscle in vitro to in vivo manometric function. Related to their greater thickness, strips of hypertrophic muscle generated greater force in response to electrical stimulation and to stretch than control strips. Hypertrophic muscle often generated repetitive contractions; spread of contractions orad from the stimulus site was common in hypertrophic oesophageal bands. On manometry, the obstructed oesophagus generated abnormally high pressures proximally, and highly variable pressure amplitudes in the middle and distally; pressure waves often occurred simultaneously throughout the oesophagus, were repetitive or multi-peaked and led to a lasting rise of oesophageal pressure. Alterations in the intrinsic neuromuscular functions of hypertrophic smooth muscle including generation of greater force, repetitive or spontaneous contractions, and retrograde spread of contractions explain many, but not all, of the manometric abnormalities seen in the chronically obstructed oesophagus.