Calibration-free blood pressure estimation based on a convolutional neural network.

In this study, we conducted research on a deep learning-based blood pressure (BP) estimation model suitable for wearable environments. To measure BP while wearing a wearable watch, it needs to be considered that computing power for signal processing is limited and the input signals are subject to noise interference. Therefore, we employed a convolutional neural network (CNN) as the BP estimation model and utilized time-series electrocardiogram (ECG) and photoplethysmogram (PPG) signals, which are quantifiable in a wearable context. We generated periodic input signals and used differential and thresholding methods to decrease noise in the preprocessing step. We then applied a max-pooling technique with filter sizes of 2 × 1 and 5 × 1 within a 3-layer convolutional neural network to estimate BP. Our method was trained, validated, and tested using 2.4 million data samples from 49 patients in the intensive care unit. These samples, totaling 3.1 GB were obtained from the publicly accessible MIMIC database. As a result of a test with 480,000 data samples, the average root mean square error in BP estimation was 3.41, 5.80, and 2.78 mm Hg in the prediction of pulse pressure, systolic BP (SBP), and diastolic BP (DBP), respectively. The cumulative error percentage less than 5 mm Hg was 68% and 93% for SBP and DBP, respectively. In addition, the cumulative error percentage less than 15 mm Hg was 98% and 99% for SBP and DBP. Subsequently, we evaluated the impact of changes in input signal length (1 cycle vs. 30 s) and the introduction of noise on BP estimation results. The experimental results revealed that the length of the input signal did not significantly affect the performance of CNN-based analysis. When estimating BP using noise-added ECG signals, the mean absolute error (MAE) for SBP and DBP was 9.72 and 6.67 mm Hg, respectively. Meanwhile, when using noise-added PPG signals, the MAE for SBP and DBP was 26.85 and 14.00 mm Hg, respectively. Therefore, this study confirmed that using ECG signals rather than PPG signals is advantageous for noise reduction in a wearable environment. Besides, short sampling frames without calibration can be effective as input signals. Furthermore, it demonstrated that using a model suitable for information extraction rather than a specialized deep learning model for sequential data can yield satisfactory results in BP estimation.

Photocatalytic removal of ceftriaxone from wastewater using TiO2/MgO under ultraviolet radiation.

Pharmaceutical compounds are among the environmental contaminants that cause pollution of water resources and thereby threaten ecosystem services and the environmental health of the past decades. Antibiotics are categorized as emerging pollutants due to their persistence in the environment that are difficult to remove by conventional wastewater treatment. Ceftriaxone is one of the multiple antibiotics whose removal from wastewater has not been fully investigated. In this study, TiO2/MgO (5% MgO) the efficiency of photocatalyst nanoparticles in removing ceftriaxone was analyzed by XRD, FTIR, UV-Vis, BET, EDS, and FESEM. The results were compared with UVC, TiO2/UVC, and H2O2/UVC photolysis processes to evaluate the effectiveness of the selected methods. Based on these results, the highest removal efficiency of ceftriaxone from synthetic wastewater was 93.7% at the concentration of 400 mg/L using TiO2/MgO nano photocatalyst with an HRT of 120 min. This study confirmed that TiO2/MgO photocatalyst nanoparticles efficiently removed ceftriaxone from wastewater. Future studies should focus on the optimization of reactor conditions and improvements of the reactor design to obtain higher removal of ceftriaxone from wastewater.

Full-Color Solar-Heat-Resistant Films Based on Nanometer Optical Coatings.

Nanometer optical coatings with absorbing materials allow the tuning of structured absorption spectra, thus developing ultrathin color devices. However, these coatings are limited by the narrow bandwidth and tunability of wavelength that restrict the chroma and hue characteristics of colors, respectively, apart from imposing adverse thermal problems under sunlight exposure. Here, we demonstrate that inversely designed TiN/ZnS/Ag coatings attain a wide color gamut in the trilayer configuration and efficiently dissipate heat through thermal radiation when transfer-printed on high-emissivity polymers. Daytime experiments reveal that fabricated optical films yield an almost color-independent heat dissipation rate against solar heating. Moreover, they outperform commercial paints of the same color when applied to three-dimensional miniature houses. All magenta, green, cyan, and yellow optical films lower the roof temperature by 10, 6, 8, and 2 °C below one sun irradiance, respectively, compared to their paint counterparts; the temperature gradient increases directly with the level of sunlight.

Synergistically designed antireflective cover for improving wide-angle photovoltaic efficiencies.

We demonstrated that a well-designed nanopatterned cover improves photovoltaic efficiency across a wide range of incident angles (θ). A nanopatterned cover was created using an integrated ray-wave optics simulation to maximize the light absorption of the surface-textured Si photovoltaic device. A hexagonally arranged nanocone array with a 300 nm pitch was formed into a polymer using nanoimprinting, and the nanostructured polymer was then attached to a glass cover with an index-matching adhesive. Angle-resolved current density-voltage measurements on Si photovoltaic devices showed that the nanopatterned glass cover yielded a 2-13% enhancement in power conversion efficiency at θ = 0-60°, which accounted for its broadband antireflective feature. We performed all-season-perspective simulations based on the results of the integrated ray-wave optics simulations and solar altitude database of South Korea, which validated the sustainability of the developed nanopatterned cover during significant seasonal fluctuations.

Molecular Characterization of Estrogen Receptor Agonists during Sewage Treatment Processes Using Effect-Directed Analysis Combined with High-Resolution Full-Scan Screening.

Endocrine-disrupting potential was evaluated during the sewage treatment process using in vitro bioassays. Aryl hydrocarbon receptor (AhR)-, androgen receptor (AR)-, glucocorticoid receptor (GR)-, and estrogen receptor (ER)-mediated activities were assessed over five steps of the treatment process. Bioassays of organic extracts showed that AhR, AR, and GR potencies tended to decrease through the sewage treatment process, whereas ER potencies did not significantly decrease. Bioassays on reverse-phase high-performance liquid chromatography fractions showed that F5 (log KOW 2.5-3.0) had great ER potencies. Full-scan screening of these fractions detected two novel ER agonists, arenobufagin and loratadine, which are used pharmaceuticals. These compounds accounted for 3.3-25% of the total ER potencies and 4% of the ER potencies in the final effluent. The well-known ER agonists, estrone and 17ß-estradiol, accounted for 60 and 17% of the ER potencies in F5 of the influent and primary treatment, respectively. Fourier transform ion cyclotron resonance mass spectrometry analysis showed that various molecules were generated during the treatment process, especially CHO and CHOS (C: carbon, H: hydrogen, O: oxygen, and S: sulfur). This study documented that widely used pharmaceuticals are introduced into the aquatic environments without being removed during the sewage treatment process.

Association Between Sleep Duration and Intelligence Quotient in 6-Year-Old Children.

BACKGROUND: Sufficient sleep during childhood is important for cognitive functions such as learning and successful school performance. This study aimed to investigate the effects of sleep duration on the intelligence quotient (IQ) of 6-year-old children and aimed to analyze whether these effects differed by sex. METHODS: The IQ of 538 6-year-old Korean participants from the cohort study, "The Environment and Development of Children," was measured during follow-up using the Korean Educational Developmental Institute's Wechsler Intelligence Scale for Children. The total, verbal, and performance IQ scores were evaluated. The relationship between sleep duration and IQ scores after adjusting for maternal age, maternal educational level, maternal occupation, maternal IQ, exposure to secondhand smoking, gestational age, and monthly age and birth season was also assessed. RESULTS: Longer sleep duration was significantly associated with improved verbal IQ measures (ß 0.55; p value 0.030). After stratifying participants by sex, a significant association was observed between sleep duration and total, verbal, and performance IQ scores in boys (total IQ 2.49, p value 0.012; verbal IQ 0.75, p value: 0.037; performance IQ 0.73, p value 0.048), but not in girls. CONCLUSIONS: The results indicated that only boys show a significant association between IQ scores and sleep duration. These findings support the hypothesis that sleep duration is associated with IQ, in a sex dependent manner. Future studies are needed for a thorough evaluation of the connection between sleep duration and health outcome in young children.

Cooling Metals via Gap Plasmon Resonance.

We report highly emissive and radiatively cooled metallic surfaces that sustain multiple and high-amplitude gap plasmon cavity modes within the principal thermal radiation spectrum at room temperature (i.e., 8-13 µm). A square-lattice array of Cu/ZnS/Cu gap plasmon cavities with five different widths was designed to avoid the near-field coupling between adjacent cavities and the anticrossing of a cavity mode and the first diffraction mode. The gap plasmon cavities fabricated on a Si substrate exhibited an effective emissivity of >0.62, up to an incidence of 60°. Outdoor solar heating experiments showed that the Cu/ZnS/Cu multicavity array lowered the Si substrate temperature by 4 °C at a maximum solar irradiance of 800 W/m2, which is equivalent to a near-one-sun intensity, relative to a planar Cu/ZnS/Cu multilayer. Such mid-infrared spectrum management of metals enables heat dissipation via radiation, which will be further utilized for designing electrodes that cool optoelectronic devices with the same metal/dielectric/metal configuration.

Nanometer-optical-coating-based visibly tinted films with 24-hour sub-atmospheric passive cooling.

Colored films absorb solar radiation at specific visible wavelengths, and they consequently heat up above atmospheric temperatures when exposed to sunlight. In this Letter, we report nanometer-thick TiN-based multilayers of light cyan, magenta, and yellow colors that can provide 24 h sub-atmospheric cooling when covered with high-emissivity polymers. Outdoor experiments have demonstrated that these visibly tinted films retain sub-atmospheric temperatures during daytime and nighttime. All fabricated films generated almost color-independent cooling powers and even surpassed commercial white paint at TiN thicknesses <5nm. Our work thus highlights the potential of multispectral selective absorbers as esthetic passive coolers.

Environmental and Genetic Risk Factors of Congenital Anomalies: an Umbrella Review of Systematic Reviews and Meta-Analyses.

BACKGROUND: The prevalence of congenital anomalies in newborns in South Korea was 272.9 per 100,000 in 2005, and 314.7 per 100,000 in 2006. In other studies, the prevalence of congenital anomalies in South Korea was equivalent to 286.9 per 10,000 livebirths in 2006, while it was estimated 446.3 per 10,000 births during the period from 2008 to 2014. Several systematic reviews and meta-analyses analyzing the factors contributing to congenital anomalies have been reported, but comprehensive umbrella reviews are lacking. METHODS: We searched PubMed, Google Scholar, Cochrane, and EMBASE databases up to July 1, 2019, for systematic reviews and meta-analyses that investigated the effects of environmental and genetic factors on any type of congenital anomalies. We categorized 8 subgroups of congenital anomalies classified according to the 10th revision of the International Statistical Classification of Diseases (ICD-10). Two researchers independently searched the literature, retrieved the data, and evaluated the quality of each study. RESULTS: We reviewed 66 systematic reviews and meta-analyses that investigated the association between non-genetic or genetic risk factors and congenital anomalies. Overall, 269 associations and 128 associations were considered for environmental and genetic risk factors, respectively. Congenital anomalies based on congenital heart diseases, cleft lip and palate, and others were associated with environmental risk factors based on maternal exposure to environmental exposures (air pollution, toxic chemicals), parental smoking, maternal history (infectious diseases during pregnancy, pregestational and gestational diabetes mellitus, and gestational diabetes mellitus), maternal obesity, maternal drug intake, pregnancy through artificial reproductive technologies, and socioeconomic factors. The association of maternal alcohol or coffee consumption with congenital anomalies was not significant, and maternal folic acid supplementation had a preventive effect on congenital heart defects. Genes or genetic loci associated with congenital anomalies included MTHFR, MTRR and MTR, GATA4, NKX2-5, SRD5A2, CFTR, and 1p22 and 20q12 anomalies. CONCLUSION: This study provides a wide perspective on the distribution of environmental and genetic risk factors of congenital anomalies, thus suggesting future studies and providing health policy implications.

Utilization of Electrical Impedance Spectroscopy and Image Classification for Non-Invasive Early Assessment of Meat Freshness.

This study presents a system for assessing the freshness of meat with electrical impedance spectroscopy (EIS) in the frequency range of 125 Hz to 128 kHz combined with an image classifier for non-destructive and low-cost applications. The freshness standard is established by measuring the aerobic plate count (APC), 2-thiobarbituric acid reactive substances (TBARS), and composition analysis (crude fat, crude protein, and moisture) values of the microbiological detection to represent the correlation between EIS and meat freshness. The EIS and images of meat are combined to predict the freshness with the Adaboost classification and gradient boosting regression algorithms. As a result, when the elapsed time of beef storage for 48 h is classified into three classes, the time prediction accuracy is up to 85% compared to prediction accuracy of 56.7% when only images are used without EIS information. Significantly, the relative standard deviation (RSD) of APC and TBARS value predictions with EIS and images datum achieves 0.890 and 0.678, respectively.

A critical review on strategies for improving efficiency of BaTiO3-based photocatalysts for wastewater treatment.

Barium titanate (BaTiO3) photocatalysts with perovskite structures are promising candidates for the effective removal of hazardous organic pollutants from water/wastewater owing to several advantages, including low cost, non-toxicity, high stability, environmental friendliness, favorable band positions, high oxygen vacancies, multiple crystal phases, rapid migration of charge carriers at the surface, band bending, spontaneous polarization, and easy tailoring of the sizes and morphologies. However, this high dielectric/ferroelectric material is only active in UV light (band gap: 3.2 eV), which reduces the photocatalytic degradation performance. To make barium titanate more suitable for photocatalysis, the surfaces of the powders can be modified to broaden the absorption band. In this paper, various strategies for improving photocatalysis of barium titanate for removing organic pollutants (mostly dyes and drugs) from water/wastewater are critically reviewed. They include modifying the sizes and morphologies of the particles by varying the reaction times and synthesis temperatures, doping with metals/non-metals, loading with noble metal NPs (Ag and Au), and fabrication of heterojunction photocatalysts (conventional type II and Z-scheme). The current challenges and possible future directions of BaTiO3-based materials are also discussed. This comprehensive review is expected to advance the design of highly efficient BaTiO3-based materials for photocatalytic applications in water/wastewater treatment.

Tuning of polarized room-temperature thermal radiation based on nanogap plasmon resonance.

When a one-dimensional (1D) metal array is coupled to a planar metal mirror with a dielectric gap, localized plasmon resonance is excited inside the gap at a specific polarization of light in free space. Herein, we report on the completely polarized, mid-infrared thermal radiation that is released from gap plasmon resonators with a nanometer-thick dielectric. We fabricated nanogap plasmon resonators with 1D Au or Ni array of various widths (w) using laser interference lithography. An atomic layer deposition process was used to introduce a 10 nm-thick alumina gap between a 1D metal array and a planar metal mirror. It was observed that only for the Au nanogap plasmon resonators, high-amplitude absorption peaks that were attributed to gap plasmon modes with different orders appeared at discrete wavelengths in a polarization-resolved spectrum. In addition, all the pronounced peaks were gradually redshifted with increasing w. At w = 1.2-1.6 µm, the fundamental gap plasmon mode was tuned to the main wavelengths (8-9 µm) of thermal radiation at room temperature (e.g., ∼300 K), which led to polarization-selective camouflage against standard infrared thermal imaging. The results of electromagnetic simulations quantitatively agreed with the measured absorbance spectra in both peak wavelength and amplitude. We believe that these experimental efforts towards achieving radiation/absorption spectra tailored at mid-infrared wavelengths will be further exploited in thermal-radiation harnessed energy devices, spectroscopic sensors, and radiative coolers.

Optical Tunneling Mediated Sub-Skin-Depth High Emissivity Tungsten Radiators.

Tailoring the spectrum of thermal radiation at high temperatures is a central issue in the study of thermal radiation harnessed energy resources. Although bulk metals with periodic cavities incorporated into their surfaces provide high emissivity, they require a complicated micron metal etch, thereby precluding reliable, continuous operation. Here, we report thermally stable, highly emissive, ultrathin (<20 nm) tungsten (W) radiators that were prepared in a scalable and cost-effective route. Alumina/W/alumina multiwalled, submicron cavity arrays were fabricated sequentially using nanoimprinting lithography, thin film deposition, and calcination processes. To highlight the practical importance of high-temperature radiators, we developed a thermophotovoltaic (TPV) system equipped with fabricated W radiators and low-bandgap GaSb photovoltaic cells. The TPV system produced electric power reliably during repeated temperature cycling between 500 and 1200 K; the power density at 1200 K was fixed to be approximately 1.0 W/cm2. The temperature-dependent electric power was quantitatively reproduced using a one-dimensional energy conversion model. The symmetric configuration of alumina/W/alumina multiwall together with the presence of a void inside each cavity alleviated thermal stress, which was responsible for the stable TPV performance. The short-current-density (JSC) of developed TPV system was augmented significantly by decreasing the W thickness below its skin depth. A 17 nm thick W radiator yielded a 32% enhancement in JSC compared to a 123 nm thick W radiator. Electromagnetic analysis indicated that subskin-depth W cavity arrays led to suppressed surface reflection due to the mitigated screening effect of free electrons, thereby enhancing the absorption of light within each W wall. Such optical tunneling-mediated absorption or radiation was valid for any metal material and morphology (e.g., planar or patterned).

Fluoride contamination, health problems and remediation methods in Asian groundwater: A comprehensive review.

In low concentration, fluoride is considered a necessary compound for human health. Exposure to high concentrations of fluoride is the reason for a serious disease called fluorosis. Fluorosis is categorized as Skeletal and Dental fluorosis. Several Asian countries, such as India, face contamination of water resources with fluoride. In this study, a comprehensive overview on fluoride contamination in Asian water resources has been presented. Since water contamination with fluoride in India is higher than other Asian countries, a separate section was dedicated to review published articles on fluoride contamination in this country. The status of health effects in Asian countries was another topic that was reviewed in this study. The effects of fluoride on human organs/systems such as urinary, renal, endocrine, gastrointestinal, cardiovascular, brain, and reproductive systems were another topic that was reviewed in this study. Different methods to remove fluoride from water such as reverse osmosis, electrocoagulation, nanofiltration, adsorption, ion-exchange and precipitation/coagulation were introduced in this study. Although several studies have been carried out on contamination of water resources with fluoride, the situation of water contamination with fluoride and newly developed technology to remove fluoride from water in Asian countries has not been reviewed. Therefore, this review is focused on these issues: 1) The status of fluoride contamination in Asian countries, 2) health effects of fluoride contamination in drinking water in Asia, and 3) the existing current technologies for defluoridation in Asia.

Organic carbon source-dependent properties of soluble microbial products in sequencing batch reactors and its effects on membrane fouling.

This study investigated the influence of three different organic carbon sources including sodium acetate (SOD), glucose (GLU), and starch (STAR), on soluble microbial products (SMP), which presumably have dissimilar uptake rates and metabolic pathways, in sequencing batch reactors (SBR) and their subsequent effects on membrane fouling of ultrafiltration (UF). SMP were mainly characterized by fluorescence excitation emission matrix coupled with parallel factor analysis (EEM-PARAFAC) and size exclusion chromatography (SEC). SMP produced in SOD-fed SBR showed higher abundances of protein-like fluorescent component and large sized aliphatic biopolymer (BP) than GLU- or STAR-fed counterpart did, while the STAR-based operation resulted in more SMP enriched with humic-like fluorescence. The differences in SMP exerted marked effects on UF membrane fouling as indicated by the highest fouling potential with reversibility shown for the SMP from the SOD-fed reactor. Regardless of the carbon source, BP fraction and protein-like component exhibited the greatest extent of reversible fouling, suggesting that size exclusion plays a critical role. However, notable differences in the reversible fouling propensity of relatively smaller size fractions among the three SBRs signified the possible involvement of chemical interactions as a secondary fouling mechanism and its dependency on different carbon sources. Our results provide a new insight into the roles of carbon sources in the characteristics of SMP in biological treatment systems and their effects on the post-treatment using membrane filtration, which is ultimately beneficial to the optimization of biological treatment design and membrane filtration operation.

Importance of nutrient availability for soluble microbial products formation during a famine period of activated sludge: Evidence from multiple analyses.

Much remains unknown about compositional variations in soluble microbial products (SMP) with the shift of the substrate condition from a feast to a famine phase in biological treatment systems. This study demonstrated that the formation of SMP could be suppressed by up to 75% during the famine phase with the addition of essential nutrients. In contrast, presence of electron acceptor did not play any significant role during the stress condition, showing the similar amounts of SMP (r = 0.98, p < 0.05) formation between the bioreactors supplied with air and N2. The SMP formed in the famine phase was more bio-refractory in the famine versus the feast phase with a linear correlation shown between the production and their aromatic structures in the composition (R2 > 0.95). The fluorescence excitation-emission matrix coupled with parallel factor analysis (EEM-PARAFAC) revealed the presence of four different fluorescent components, including two protein-like (C1 and C4), fulvic-like (C2), and humic-like (C3) components, in the SMP and bEPS formed at different conditions. Both C1 and C4 showed increasing trends (R2 > 0.95) with the length of starvation in the bioreactors without essential nutrients. Nutrient availability was found to be a key factor to quench the production of large-sized biopolymers. This study provides a wealth of information on operation conditions of activated sludge treatment systems to minimize large sized SMP molecules (particularly proteins), which typically exert many environmental concerns to effluent organic matter quality.

Microstructured void gratings for outcoupling deep-trap guided modes.

Breaking the total internal reflection far above a critical angle (i.e., outcoupling deep-trap guided modes) can dramatically improve existing light-emitting devices. Here, we report a deep-trap guided modes outcoupler using densely arranged microstructured hollow cavities. Measurements of the leaky mode dispersions of hollow-cavity gratings accurately quantify the wavelength-dependent outcoupling strength above a critical angle, which is progressively improved over the full visible spectrum by increasing the packing density. Comparing hollow- and filled-cavity gratings, which have identical morphologies except for their inner materials (void vs. solid sapphire), reveals the effectiveness of using the hollow-cavity grating to outcouple deep-trap guided modes, which results from its enhanced transmittance at near-horizontal incidence. Scattering analysis shows that the outcoupling characteristics of a cavity array are dictated by the forward scattering characteristics of their individual cavities, suggesting the importance of a rationally designed single cavity. We believe that a hollow-cavity array tailored for different structures and spectra will lead to a technological breakthrough in any type of light-emitting device.

Vertical beaming of incoherent quantum emitters via the near-field coupling of Fano resonance.

We report highly collimated radiation from incoherent quantum emitters coupled to photonic dispersion-engineered structures. Two-dimensional free-standing photonic crystal slabs sustained an extremely high density of states for vertically leaky light at discrete frequencies, which results from the constructive interference between directly reflected light and quasi-bound guided modes, referred to as Fano resonance. Electromagnetic simulations showed that an electric dipole that is excited near a photonic crystal slab generates vertically directional radiation at every Fano resonance frequency. The radiation distribution of an electric dipole is strongly correlated with the angular reflectance of a coupled photonic crystal slab. The strategy developed herein will be useful to achieve a vertical beam from quantum emitters such as transition metal dichalcogenide monolayers, facilitating the delivery of light into other external optics.

Effectiveness of pulsed electromagnetic field for pain caused by placement of initial orthodontic wire in female orthodontic patients: A preliminary single-blind randomized clinical trial.

INTRODUCTION: The purpose of this 2-arm parallel trial was to assess the effects of pulsed electromagnetic field (PEMF) on the reduction of pain caused by initial orthodontic tooth movement. METHODS: Thirty-three female patients (mean age, 16.8 ± 3.8 years) who began orthodontic treatment using fixed appliances were examined. In the pilot study, male patients were less likely to use the PEMF device (epatchQ; Speed Dental, Seoul, Korea) and answer a survey consistently, so eligibility criteria were female patients who were periodontally and systemically healthy at the initiation of treatment and had no history of dental pain in the prior 2 weeks or who used no medications (anti-inflammatory or analgesic drugs) during the experiment period. Each patient had brackets bonded on the maxillary teeth, and a 0.014-in nickel-titanium archwire was tied with elastomeric rings. Their maxillary arches were randomly divided into left and right sides in a split-mouth design: a normal PEMF device (experimental group) was used on 1 side, and a PEMF device with an inversely inserted battery (placebo group) was used on the opposite side of the arch for 7 hours on 3 consecutive nights. A Google survey link was sent to the patients' mobile phones via text message, and they were instructed to record their current pain on the survey. The survey was sent a total of 6 times after insertion of the initial archwire at 0 (T0), 2 (T1), 6 (T2), 24 (T3), 48 (T4), and 72 (T5) hours. Patients recorded the degree of pain in resting and clenching states using a numeric rating scale (NRS) from 1 (no pain) to 10 (worst pain). PEMF devices were used after T2. Generalized linear mixed models, along with ancillary pairwise analyses, were used to model and evaluate the differences in pain reported over 72 hours. RESULTS: The NRS scores did not differ across the groups during the before-PEMF phase for resting (mean difference, -0.07; 95% confidence interval [CI], -0.73 to 0.59; P = 0.842) and clenching (mean difference, -0.28; 95% CI, -1.11 to 0.56, P = 0.513). During the after-PEMF phase, NRS scores in the experimental group were significantly lower than those in the placebo group during both resting (mean difference, -1.46; 95% CI, -2.06 to -0.85; P = <0.001) and clenching (mean difference, -1.88; 95% CI, -2.74 to -1.02, P = <0.001). The NRS scores did not differ across the groups during the before-PEMF phase for either state but were significantly lower in the experimental group than in the placebo group at T3, T4, and T5 (P <0.01). The average NRS score in the clenching state was significantly greater than in the resting state. CONCLUSIONS: PEMF was effective in reducing orthodontic pain caused by initial archwire placement. REGISTRATION: The trial was not registered. PROTOCOL: The protocol was not published before trial commencement.

Bone density effects on the success rate of orthodontic microimplants evaluated with cone-beam computed tomography.

INTRODUCTION: The purpose of this study was to evaluate the effect of bone densities on the success rate of orthodontic microimplants with cone-beam computed tomography images. METHODS: We examined 127 orthodontic microimplants implanted into the maxillary buccal alveolar bone of 71 patients (53 female, 18 male; mean age, 19.2 years) with malocclusion. The cortical, cancellous, and total bone densities were measured with Simplant Pro 2011 software (version 13; Materialise, Leuven, Belgium), and the correlations between these measurements and the orthodontic microimplant success rates were evaluated with cone-beam computed tomography. RESULTS: The overall success rate was 85.0% (108 of 127). Sex, age, and side of placement were not significant factors for success in the results (P >0.05). The density of the cortical bone increased apically (3, 5, and 7 mm) from the alveolar crest, but in the cancellous bone it decreased. Whereas the orthodontic microimplant success rates significantly increased as cancellous bone density and total bone density increased (P <0.01), cortical bone density did not have a significant effect on the success rate (P >0.05). CONCLUSIONS: The success rate of orthodontic microimplants significantly increased with higher cancellous and total bone densities, whereas cortical bone density did not have a significant effect.