Hydrogel morphogenesis induced by force-controlled growth.

Morphogenesis is one of the most marvelous natural phenomena. The morphological characteristics of biological organs develop through growth, which is often triggered by mechanical force. In this study, we propose a bioinspired strategy for hydrogel morphogenesis through force-controlled chemical reaction and growth under isothermal conditions. We adopted a double network (DN) hydrogel with sacrificial bonds. Applying mechanical force to the gel caused deformation and sacrificial bond rupture. By supplying monomers to the gel, the radicals generated by the bond rupture triggered the formation of a new network inside the deformed gel. This new network conferred plasticity to the elastic gel, allowing it to maintain its deformed shape, along with increased volume and strength. We demonstrated that sheet-shaped DN hydrogels rapidly adopted various three-dimensional shapes at ambient temperature when subjected to forces such as drawing and blowing. This mechanism enables morphogenesis of elastic hydrogels and will promote the application of these materials in biomedical fields and soft machines.

Intelligent process monitoring of smart polymer composites using large area graphene coated fabric sensor.

Herein, we report the development of an online process monitoring system for vacuum-assisted resin transfer molding (VARTM) process using large area graphene coated in-situ fabric sensor. Besides imparting excellent mechanical properties to the final composites, these sensors provide critical information during the composite processing including detecting defects and evaluating processing parameters. The obtained information can be used to create a digital passport of the manufacturing phase to develop a cost-effective production technique and fabricate high-quality composites.  The fabric sensor was produced using a scalable dip-coating process by coating 1-, 3- or 5-layers of thermally reduced graphene oxide (rGO) onto glass fabric surface according to the number of dips of the fabrics into GO solution. The electrical resistances from all electrode pairs were simultaneously and continuously recorded during distinct stages of the VARTM process to determine the relative conductance. During the vacuum cycle, the range of relative conductance increased with the number of coated rGO layers, with the 5-layer rGO-coated sensor showing the highest conductance range of 16.9 %. Additionally, it was observed that the 5-layer coated sensor showed a consistent decrease in conductance during the infusion phase due to the fluid flow pressure dominating the resin electrical conductivity.

Melt Compounding of Poly(lactic acid)-Based Composites: Blending Strategies, Process Conditions, and Mechanical Properties.

Polylactic acid (PLA), derived from renewable resources, has the advantages of rigidity, thermoplasticity, biocompatibility, and biodegradability, and is widely used in many fields such as packaging, agriculture, and biomedicine. The excellent processability properties allow for melt processing treatments such as extrusion, injection molding, blow molding, and thermoforming in the preparation of PLA-based materials. However, the low toughness and poor thermal stability of PLA limit its practical applications. Compared with pure PLA, conditions such as processing technology, filler, and crystallinity affect the mechanical properties of PLA-based materials, including tensile strength, Young's modulus, and elongation at break. This review systematically summarizes various technical parameters for melt processing of PLA-based materials and further discusses the mechanical properties of PLA homopolymers, filler-reinforced PLA-based composites, PLA-based multiphase composites, and reactive composite strategies for PLA-based composites.

Efficiently Fabricated Core-Sheath Piezoelectric Sensor Based on PVDF Microfibrillar Bundle.

With the rapid development of information technology (e.g., Internet of Things (IoT) and artificial intelligence (AI)), piezoelectric sensor (i.e., piezoelectric nanogenerator, PENG) receives an increasing number attention in the field of self-powered wearable devices. Taking piezoelectric fiber as an example, it shows promising application for wearable devices owing to its light weight and high flexibility compared with block electronic devices. However, it still remains a challenge to fabricate low-cost and high-performance piezoelectric fiber via a large-scale but efficient method. In this study, via extrusion molding and leaching, a core-sheath piezoelectric sensor is facilely fabricated, whose core and sheath layer are respectively slender steel wire (i.e., electrode) and PVDF microfibrillar bundle (PMB) (i.e., piezoelectric layer). Such piezoelectric sensor shows decent output performance in both pressing (12.3 V) and bending (0.32 V) mode. Meanwhile, it possesses sensitive stress responsiveness when serving for self-powered sensing. Furthermore, such piezoelectric sensors can realize wearable signal transmission and human motion monitoring, showing promising potential for wearable devices in the future. This work proposes a large-scale but efficient method for fabricating high-performance PVDF microfibril based piezoelectric fiber, opening a new pathway to develop self-powered sensors following the concept of polymer "structuring" processing.

Helmet therapy efficacy and its prediction in Japanese infants with positional plagio- and brachycephaly.

PURPOSE: To provide additional information on optimal start times and therapeutic effectiveness based on treatment outcome of Japanese infants with positional plagio- and brachycephaly (PPB) receiving cranial molding helmet therapy (CMHT). METHODS: In this retrospective cohort study, data from a 3D head scanning system was analyzed from 2173 Japanese infants who completed CMHT. Anterior and posterior symmetry ratio (ASR and PSR) and longitudinal to transverse diagonal ratios (LD/TDR) were calculated based on skull shape at helmet design and at completion of therapy. The outcomes were evaluated using the regression analysis and a predictive model using cranial parameters was developed. RESULTS: The earlier the start of therapy, the greater the therapeutic effect on ASR, PSR, and LD/TDR (ASR, -0.134 percent points (ppt)/day; PSR, -0.086 ppt/day; and LD/TDR, -0.131 ppt/day). In the predictive model, in addition to starting age of the therapy, sex (male), the degree of deformity of the head (DoD) (moderate and severe), quadrant volume, PSR, and head circumference at the start of treatment also had a positive effect on changes in ASR, DoD (moderate and severe), ASR, LD/TDR and transverse diameter for PSR, sex (male), DoD (moderate), quadrant volume, PSR, and head circumference for LD/TDR. CONCLUSION: The starting age of therapy had a relatively smaller contribution to outcome effects. Applying the cranial parameter obtained at the start of treatment to the predictive model helps to predict the effect of CMHT and whether PPB can be treated with CMHT in infants of older age.

Effects of nasoalveolar molding on nasolabial aesthetics in patients with cleft lip and palate during pre-adolescence: A systematic review and meta-analysis of retrospective studies.

This study aims to analyze long-term effects of nasoalveolar molding (NAM) as a part of cleft primary management protocols on nasolabial aesthetics for patients with non-syndromic cleft lip and palate by conducting a systematic review and meta-analysis. Six electronic databases and two journals were searched up to July 2023. Studies comparing nasolabial outcomes between NAM and non-NAM protocols were selected for further analysis. Nasolabial aesthetics were the outcome of interest. Data extraction, methodological quality assessment, risk of bias assessment, meta-analysis and subgroup analysis were performed. Seven retrospective cohort studies were selected for a qualitative review and four for a quantitative analysis. The risk of bias assessment was moderate for most studies. Only studies utilizing the Asher-McDade rating (AMR) were included for meta-analyses. The protocols with NAM exhibited a significantly lower AMR score for vermillion border than other protocols. AMR scores for nasal form and nasal symmetry from protocols with NAM were significantly lower than protocols without any pre-surgical infant orthopaedics (PSIO) but not significantly different from protocols with other PSIO techniques. The AMR score for nasolabial profile from protocols with NAM was not significantly different from other protocols. However, subgroup analysis demonstrated that protocol combining NAM and primary rhinoplasty significantly lowered AMR scores for nasal form, nasal symmetry and nasolabial profile. For patients with unilateral cleft lip with or without palate (UCLP), this study found that a protocol combining NAM and primary rhinoplasty improved nasolabial outcomes while a protocol with NAM alone offered only limited benefits. For patients with BCLP, the available evidence remains inconclusive. Performing NAM in combination with primary rhinoplasty improves nasolabial aesthetics in patients with UCLP. PROSPERO (CRD4202128384).

Comparison of craniomaxillofacial morphology in children with unilateral cleft lip and palate treated with/without presurgical nasoalveolar molding - a retrospective study with a mean age of 5 years.

OBJECTIVES: To three-dimensionally assess differences in craniomaxillofacial skeletal development in patients with operated unilateral cleft lip and palate (UCLP) treated with/without presurgical nasoalveolar molding (PNAM) with a mean age of 5 years. MATERIALS AND METHODS: Cone-beam CT radiographs of 30 patients with UCLP who had undergone PNAM and 34 patients with UCLP who did not receive PNAM were analyzed. The data were stored in DICOM file format and were imported into the Dolphin Imaging program for 3D image reconstruction and landmark identification. 33 landmarks, 17 linear and three angular variables representing craniofacial morphology were analyzed and compared by using the Mann-Whitney U tests. RESULTS: The vast majority of linear variables and 3D coordinates of landmark points reflecting craniofacial skeletal symmetry were not significantly different between the two groups. In terms of craniofacial skeletal development, the PNAM group had a significantly smaller anterior nasal spine offset in the midsagittal plane and a greater maxillary length compared to the non-PNAM group. CONCLUSIONS: Evaluations performed in early childhood showed that treatment with/without PNAM in the neonatal period was not a major factor influencing craniomaxillofacial hard tissue development in patients with UCLP; moreover, PNAM treatment showed significant correction of skeletal deviation at the base of the nose. CLINICAL RELEVANCE: Follow-up in early childhood has shown that PNAM treatment administered during the neonatal stage does not impede maxillary development and has benefits in correcting nasal floor deviation. It is a viable option for improving nasal deformity in children with unilateral cleft lip and palate.

Classification of Sand-Binder Mixtures from the Foundry Industry Using Electrical Impedance Spectroscopy and Support Vector Machines.

Molding sand mixtures used in the foundry industry consist of various sands (quartz sands, chromite sands, etc.) and additives such as bentonite. The optimum control of the processes involved in using the mixtures and in their regeneration after the casting requires an efficient in-line monitoring method that is not available today. We are investigating whether such a method can be based on electrical impedance spectroscopy (EIS). To establish a database, we have characterized various sand mixtures by EIS in the frequency range from 0.5 kHz to 1 MHz under laboratory conditions. Attempts at classifying the different molding sand mixtures by support vector machines (SVM) show encouraging results. Already high assignment accuracies (above 90%) could even be improved with suitable feature selection (sequential feature selection). At the same time, the standard uncertainty of the SVM results is low, i.e., data assigned to a class by the presented SVMs have a high probability of being assigned correctly. The application of EIS with subsequent evaluation by machine learning (machine-learning-enhanced EIS, MLEIS) in the field of bulk material monitoring in the foundry industry appears possible.

Compressive modulus, translucency, and irradiance transmittance of clear PVS materials used for resin injection molding technique.

OBJECTIVES: To evaluate the compressive modulus, translucency, and light curing irradiance transmittance of four clear polyvinyl siloxane (PVS) materials used for the injection molding technique at varying thicknesses, and to assess the correlation between color parameters and irradiance transmittance. MATERIALS AND METHODS: Four clear PVS materials (Exaclear, Clear Bite Matrix, Affinity Crystal, and Memosil 2) were used in this study. Compressive modulus was measured by compressing cylindrical PVS specimens (n = 9; d = 10 mm; t = 6 mm) up to 30% strain using a universal testing machine. For the translucency analysis and irradiance transmittance, specimens (n = 5) were fabricated with five different thicknesses (d = 12 mm and t = 2, 4, 6, 8 and 10 mm). The L*, a, *b* values of specimens were obtained using a CIELab spectrophotometer (CMD-700, Konica Minolta) with calibrated white and black tiles; the translucency parameter was calculated. The same specimens were placed onto a spectrophotometer (MARC Light Collector) to measure irradiance transmitted through the specimens from a light curing unit (Valo Corded, Ultradent). Data were analyzed using analysis of variance (ANOVA) with Tukey post hoc test and the correlation between translucency and irradiance transmittance of materials for each thickness was evaluated using Pearson's correlation. RESULTS: Compressive modulus differences in PVS materials were significant (one-way ANOVA: df = 3, F = 76.27, p < 0.001); Affinity and Memosil 2 were highest with no significant difference between them (Tukey: t = -1.62; p = 0.382). Clear Bite was higher than Exaclear (Tukey: t = -3.70; p = 0.004). Exaclear was lowest. Translucency decreased with thickness (Two-way ANOVA: df = 3, F = 586.53, p < 0.001; thickness: df = 4, F = 1389.34, p < 0.001). Exaclear was most translucent at all thicknesses. L*, a*, b* values varied by material and thickness (L*: df = 3, F = 1213.32, p < 0.001; a*: df = 3, F = 10766.8, p < 0.001; b*: df = 3, F = 3260.42, p < 0.001). Memosil 2 had lowest b* values. Irradiance transmittance was affected by material and thickness (Two-way ANOVA: df = 4, F = 2388.86, p < 0.001). Exaclear had highest irradiance transmission, surpassing control at >6 mm. Violet/blue irradiance ratio decreased with thickness; Exaclear maintained a constant ratio, indicating preserved violet irradiance. There was a strong positive correlation between translucency and light irradiance (Pearson's r = 0.97, R2 = 0.86-0.96). Radiant exposure analysis suggests adjusting the curing time based on PVS thickness for optimal exposure (10 J/cm2) is achievable within 13-14 s for <2 mm and 21-30 s for 8-10 mm with Clear Bite, Affinity, and Memosil 2; whereas Exaclear requires less time. CONCLUSIONS: Compressive modulus in clear PVS materials varied by type; Affinity and Memosil 2 demonstrate higher modulus, offering more stability of the clear mold. Translucency and irradiance transmission through clear PVS materials decreased as their thickness increased, yet Exaclear exceled in maintaining high translucency and superior light transmission capabilities. Additionally, there is a strong positive linear correlation between translucency and light irradiance transmittance, offering a method to adjust curing times effectively based on material translucency. CLINICAL SIGNIFICANCE: The light curing time to adequately polymerize composite through clear impression material may need to be increased, particularly with thicker matrices or less translucent materials.

Production of sustainable thermoplastic composites from waste nitrogen fertilizer-grown marine filamentous cyanobacterium Geitlerinema sp.

The global demand for petroleum-derived plastics continues to increase, as does pollution caused by plastic consumption and landfilling plastic waste. Recycling waste plastics by thermomechanical molding may be advantageous, but it alone cannot address the challenges associated with plastic demand and its widespread pollution. A more sustainable and cleaner approach for recycling plastic waste could be to produce thermoplastic composite blends of waste plastic and biobased alternative materials such as marine algal biomass. In this study, Geitlerinema sp., a marine cyanobacterium, was cultivated with waste nitrogen fertilizer as a nitrogen source, resulting in phycocyanin content and biomass density of 6.5% and 0.7 g/L, respectively. The minimum and maximum tensile strengths of thermoplastic blends containing Geitlerinema sp. biomass, recycled glycerol plasticizer, and waste plastic were 0.29-23.2 MPa, respectively. The tensile strength and Young's modulus of thermoplastic composites decreased as the Geitlerinema sp. biomass concentration increased. Furthermore, thermal analysis revealed that thermoplastics containing Geitlerinema sp. biomass have lower thermal onset and biomass degradation temperatures than waste polyethylene. Nevertheless, 35-50% of Geitlerinema sp. biomass could be a sustainable biobased alternative feedstock for producing thermoplastic blends, making the recycling of waste plastics more sustainable and environmentally friendly.

TeleCleft: Development and Evaluation of a Mobile Application for Monitoring Cleft Patients.

OBJECTIVE: Development and evaluation of a mobile application for remote monitoring and guidance of pediatric patients diagnosed with cleft lip and/or palate (CL ± P) and their caregivers. DESIGN: This is a pilot cross-sectional, applied, and quantitative study. SETTING: The study was conducted in two tertiary care treatment centers in Brazil. PARTICIPANTS: The participants included 20 caregivers and infants undergoing treatment with nasoalveolar molding (NAM) for CL ± P. INTERVENTIONS: The intervention involved using the TeleCleft mobile application for remote monitoring and guidance of caregivers and infants during NAM treatment. MAIN OUTCOME MEASURE(S): The main outcome measures included usability and satisfaction of users with the TeleCleft application. RESULTS: The results showed high usability and satisfaction ratings among users of the TeleCleft application. Most participants found remote monitoring to be effective and expressed positive opinions about its convenience and usefulness. CONCLUSION: TeleCleft could be a viable tool for remote monitoring and guidance, reducing the need for patients and caregivers to travel to treatment centers, which could potentially alleviate the burden of care faced by families during the journey of CL ± P treatment.

Helmet Therapy for the Management of Deformational Plagiocephaly in Pediatric Patients with Shunted Hydrocephalus.

OBJECTIVE: To evaluate the safety and efficacy of helmet therapy for deformational plagiocephaly in patients with shunted hydrocephalus. DESIGN: Retrospective chart review. SETTING: Institutional, tertiary-care hospital. PATIENTS: All patients at St. Louis Children's Hospital between 2014 and 2021 with shunted hydrocephalus who underwent helmet therapy for deformational plagiocephaly. INTERVENTIONS: Helmet therapy. MAIN OUTCOME MEASURES: Cranial vault asymmetry (CVA), cranial vault asymmetry index (CVAI), and cephalic index (CI) were measured before and after completion of helmet therapy. RESULTS: There were 37 patients with shunted hydrocephalus and documented deformational plagiocephaly. Twelve were managed with helmet therapy. Average age at helmeting initiation and time between shunt placement and helmeting initiation was 5.8 and 4.6 months, respectively. Average CVA, CVAI, and CI at helmeting initiation and termination was 11.6, 7.98, and 85.2, and 6.95, 4.49, and 83.7, respectively. Average duration of helmeting was 3.7 months. CVA and CVAI were significantly lower after helmeting (P = .0028 and .0021) and 11/12 patients had overall improvement in plagiocephaly. CONCLUSIONS: Helmet therapy appears to be a safe and efficacious management strategy for deformational plagiocephaly in patients with shunted hydrocephalus. Despite the occasional need for additional fittings and surveillance beyond the normal schedule, in all cases appropriately fitting helmets were achieved and no major adverse events occurred. This cohort represents a proof of principle for the safety and efficacy of helmet therapy in patients with shunted hydrocephalus. Further work in larger prospective cohorts is needed to confirm these initial findings.

Gingivoperiosteoplasty in Children with Cleft Lip and Palate: The Need for Alveolar Bone Grafting.

OBJECTIVE: This study aimed to determine the efficacy of gingivoperiosteoplasty (GPP) in preventing alveolar bone grafting (ABG) among children with cleft lip and palate (CLP). DESIGN/SETTING: Retrospective university hospital single center study. PATIENTS: Children with CLP treated with GPP from 2000-2015 were included. Those under eight years of age, without definitive conclusions regarding need for ABG or with incomplete data were excluded. INTERVENTIONS: Included patients were analyzed for demographics, cleft type, age at GPP, associated cleft surgery, use of nasoalveolar molding (NAM), indication for ABG, operating surgeon and presence of residual alveolar fistula. T-tests and Fisher's exact tests were utilized for statistical analysis. MAIN OUTCOME MEASURE: The need for ABG. RESULTS: Of the 1682 children identified with CLP, 64 underwent GPP and met inclusion criteria. 78% of patients with CLP who underwent GPP were recommended for ABG. Those who received GPP at a younger age (P = .004) and at the time of initial cleft lip repair (P = .022) were less likely to be recommended for ABG. Patients with complete CLP were more likely to be recommended for ABG than patients with cleft lip and alveolus only (P = .015). The operating surgeon impacted the likelihood of ABG (P = .004). Patient gender, race, ethnicity, laterality, and NAM were not significantly associated with recommendation for ABG. CONCLUSION: GPP does not preclude the need for ABG. Therefore, the success of ABG after GPP and maxillary growth restriction should be analyzed further to determine if GPP is a worthwhile adjunct to ABG in cleft care.

3-Dimensional Evaluation of Two PNAM Techniques (Modified Grayson & AlignerNAM) on Facial Soft Tissue Morphology: A Randomised Clinical Trial.

OBJECTIVE: Evaluate facial changes after Presurgical Naso-Alveolar Molding (PNAM) in unilateral cleft lip and palate (UCLP) patients treated with Modified Grayson Technique and AlignerNAM (with DynaCleft nasal elevator) using a 3D facial scan. DESIGN: Randomised clinical trial. SETTING: Institutional study. Participants: 20 UCLP patients allocated to two groups (10 patients each). INTERVENTIONS: Group A patients underwent PNAM with Modified Grayson Technique and Group B patients underwent AlignerNAM (with DynaCleft nasal elevator). Their 3D facial scans were obtained by using an iOSbased application (Bellus3D FaceApp) mounted on a novel frame. These .stl files were analysed using 3D software (GOM INSPECT) at three-time intervals; before intervention (T0), after intervention (T1) and one month after lip repair surgery (T2). MAIN OUTCOME MEASURE(S): Changes in facial and nasolabial morphology. RESULTS: Both techniques brought significant improvement in the columellar length, nasal tip projection, columella angle, nasal tip angle and a significant reduction in cleft width. At T1, a statistically significant difference in angular and linear measurements was present in both groups. At T2, no statistically significant difference in linear parameters was observed between the two groups except for the outer lateral height of the non-cleft side, basal lateral height of the non-cleft side, and philtrum width. Similar pattern was observed in angular measurements with no statistically significant difference between the two groups except in nasolabial angle, anterior nasal base triangle III, and anterior nasal root triangle. CONCLUSIONS: Aligner NAM and Modified Grayson technique are equally effective PNAM methods with similar clinical results in nasolabial morphology after lip repair surgery.

Research Trends in Presurgical Infant Orthopaedic Treatment in Patients with Cleft Lip and Palate: A Bibliometric Analysis of 100 Most-Cited Articles.

OBJECTIVE: To assess research trends and publication patterns of literature related to presurgical infant orthopaedics (PSIO) through a bibliometric analysis of the top 100 most-cited articles. MATERIAL AND METHODS: The top 100 most-cited articles were identified in the Web of Science (WoS) database using search terms related to PSIO on April 23, 2024, without any restrictions to study design, publication date and language. Standard information about each study was extracted. Citations from WoS, Scopus and PubMed databases were compared. The level of evidence for each article included was assessed. Association between different variables was calculated using Spearman's correlation coefficient with statistical significance set at p < 0.05. Visual analysis of the author's keyword co-occurrence, co-authorship analysis of authors, and citation analysis of journals and authors were performed using VOSviewer. RESULTS: Top cited articles were published from 1994 to 2020, with total individual database citations being WoS (n = 5378), Scopus (n = 6184) and PubMed (n = 10 450). Eleven articles were considered classic articles. Cleft Palate and Craniofacial Journal (Impact Factor = 1.1) had a maximum number of articles and citations. Two hundred eighty-five individuals contributed to top-cited articles, with 62 corresponding authors from 19 countries. A maximum number of authors were affiliated with universities in the United States. The most common keyword used was "nasoalveolar molding (n = 24)", "cleft palate (n = 16)", and "infant orthopedics (n = 16)". The study design of the majority of articles was retrospective and follow-up studies (level 3; n = 53). A weak negative correlation was observed between citation metrics and both the publication year (P < 0.01) and the level of evidence (P < 0.01). CONCLUSION: This analysis recognises the contributions of experts and offers valuable insights into trends that have shaped the development and evidence related to PSIO research. Future research should focus on integrating advanced technologies, conducting longitudinal studies, fostering collaboration, and emphasizing patient-centred outcomes.

Treatment Outcomes of Lip Taping in Patients with Non-syndromic Cleft Lip and/or Palate: A Systematic Review and Meta-analysis.

OBJECTIVE: To conduct a systematic review of the data in peer-reviewed medical literature and evaluate the effectiveness of lip taping as a pre-surgical naso-alveolar molding (NAM) technique in infants with cleft lip and/or palate. DESIGN: An electronic search of various databases for relevant studies, regardless of date, from inception to June 2023 was carried out and evaluated. After completing the electronic search and applying our inclusion/exclusion criteria, 6 studies-2 randomized control trials, 2 non-randomized studies, and 2 case series-were included. Data extraction of relevant articles was done independently by 2 authors. Quality assessment was done using the JBI prevalence critical appraisal tool and certainty of evidence was carried out by GRADE approach. MAIN OUTCOME MEASURES: Nasolabial Aesthetics, Dentoalveolar Relationship. RESULTS: A total of six studies were included in the current review. Meta-analysis was carried out, and forest plots were obtained for a single mean from the lip-taping group. 3 studies had a low risk of bias, while 3 studies displayed a serious risk of bias. Significant improvement in various outcome measures was noted with lip taping when compared with the control group although the certainty of evidence was very low. CONCLUSION: When compared to no therapy, lip taping appears to ameliorate dentoalveolar measurements and nasolabial aesthetics. To increase our knowledge of lip taping, more research will be needed in the future, as there are not many studies to prove lip taping is better than other treatment approaches.

Presurgical Infant Orthopedic Videos on YouTube™: A Thematic Analysis of Caregiver Narratives.

OBJECTIVE: Information regarding how caregivers cope when using presurgical infant orthopedic (PSIO) appliances is sparse. This study aimed to understand caregivers' perspectives and experiences with contemporary PSIO treatment. DESIGN: PSIO videos shared on the YouTube™ platform were used as the data source. Videos with caregivers were identified (n = 21) and portions with caregiver narratives were transcribed. This was followed by the application of a six-step thematic analysis as conceptualized by Braun and Clarke (2006, 2019). RESULTS: Two themes were identified from the caregiver narratives in the PSIO videos. The Family Journey theme included reaction to diagnosis, choice of center, burden of care, care commitment, coping, and testimonials. The Information theme included PSIO techniques and PSIO benefits. CONCLUSION: Multifaceted challenges and coping strategies were described by caregivers during the PSIO phase. Caregivers remained committed to treatment despite the burden of care, were motivated by an understanding of the benefits of PSIO, and customized care based on their individual strengths and needs. Study results can help providers gain an understanding of what caregivers experience outside the clinical environment.

Effects of nasoalveolar molding on maxillary arch dimensions and malocclusion characteristics in primary dentition patients with cleft lip and palate.

BACKGROUND: Nasoalveolar molding (NAM) is a presurgical orthopedic technique used in the management of cleft lip and palate deformities. Despite the widespread use of NAM therapy, there is a need for further investigation to assess its specific effects on arch dimensions and malocclusion characteristics. AIM: To evaluate the effects of NAM therapy on maxillary arch dimensions and malocclusion characteristics in patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). DESIGN: Patients in primary dentition were referred to the Institutional Department of Orthodontics. The NAM group consisted of 21 patients with UCLP (mean age 4.7 ± 0.7 years) and 12 patients with BCLP (mean age 4.8 ± 0.7 years). Sixteen patients with UCLP (mean age 4.9 ± 0.9 years) and five patients with BCLP (mean age 5.4 ± 1.1 years) were included in the non-NAM group. The plaster models of all patients were digitized. Dental arch dimensions and malocclusion characteristics were analyzed via digital software. One-way ANOVA with Bonferroni correction was used for statistical analysis. RESULTS: Intercanine and intermolar widths showed statistically significant differences according to the cleft type (p < .01). There was no statistically significant effect of NAM therapy on maxillary arch parameters and malocclusion characteristics (p > .05). The prevalence of anterior crossbite was 12.1% in the NAM group and 23.8% in the non-NAM group. CONCLUSION: NAM therapy did not affect the maxillary arch dimensions and malocclusion characteristics in patients with UCLP and BCLP. The cleft type was the main factor, leading to a significant difference in maxillary widths.

Digital denture with mucostatic base and functional borders: A cast-free digital technique.

Digital complete dentures fabricated using a mucostatic impression, like intraoral scans, are desirable for their beneficial effect on long-term residual ridge stability but may have less retention than those fabricated with a mucocompressive impression. Border molding procedure may improve initial retention, thus favoring adaptation to new dentures, especially in cases where neuromuscular dysfunctions may diminish the patient's ability to cope with adapting to existing motor patterns or learn new ones. However, a mucocompressive impression may cause higher residual ridge resorption, thus resulting in a retention decrease over time. A desirable combination would be a digital denture with a mucostatic intaglio surface obtained from intraoral scans and functional borders. A cast-free digital workflow for that is demonstrated in this technical report.

[Molding law of traditional Chinese medicine gel plaster based on physicochemical properties of raw materials and intermediates].

This paper aims to study the correlation between the physicochemical properties of raw materials and intermediates and the molding quality and law of traditional Chinese medicine(TCM) gel plaster by using TCM slices and powder as raw materials. 48 TCM compounds are selected as model prescriptions to prepare gel plasters. The rotational rheometer is used to determine the rheological parameters of the plaster, including storage modulus(G'), loss modulus(G″), yield stress(τ), and creep compliance [J(t)]. The molding quality of the prepared TCM gel plaster is evaluated by subjective and objective measures. Clustering and principal component analysis are conducted to evaluate the physical properties of the plaster. By measuring the rheological properties of the plaster, the molding quality of the TCM gel plaster can be predicted, with an accuracy of 83.72% after seven days of modeling and 88.37% after 30 days of modeling. When the parameters such as G' and G″ of the plaster are large, and the [J(t)] is small, the molding quality of the plaster is better. When the plaster coating point is no less than 3, it is difficult to be coated. In addition, when the proportion of metal ions in the prescription is higher, the 30-day forming quality of the plaster is mainly affected, and the viscosity of the plaster is poor. If the prescription contains many acidic chemical components, the 7-day forming quality of the plaster is mainly affected, with many residuals. The results suggest that the rheological properties of the plaster can be used to predict the molding quality of TCM slice and powder gel plaster. It can provide a reference for the development of TCM gel plaster prescriptions.