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Radiopaque lesions of jaws are innumerable and variable in appearance. There are several radiopaque lesions seen in the periapical region of tooth root which are indistinguishable from other lesions. The diagnosis and management of these lesions from clinical and radiographic features could be challenging to the dentist. Alterations in the bone could be inflammatory cystic odontogenic and non-odontogenic neoplastic reactive vascular traumatic dysplastic or metabolic in origin. As intraoral periapical radiographs IOPA provide the best image resolution they can aid in identifying the subtle changes in the bone architecture periodontal ligament Pdl space and lamina dura. Radiographic analysis of the involvement of adjacent structures using panoramic imaging is not sufficient for diagnosis as it provides 2D imaging of a 3D object. Cone Beam Computed Tomography CBCT provides an accurate 3D image of the involvement of bone and adjacent structures. Systematic radiologic analysis of lesions based on their location size shape borders internal structure effect on surrounding structures and consideration of clinical signs and symptoms enable clinicians to arrive at a reliable diagnosis. Here we present a case report of an asymptomatic radiopaque lesion associated with the root of an unerupted supernumerary tooth which was accidentally detected on an IOPA taken for treating the adjacent tooth.

Existing non-verbal ability tests are typically protected by copyright, preventing them from being freely adapted or computerized. Working towards an open science framework, we provide 80 novel, open-access abstract reasoning items, an online implementation and item-level data from 659 participants aged between 11 and 33 years: the matrix reasoning item bank (MaRs-IB). Each MaRs-IB item consists of an incomplete matrix containing abstract shapes. Participants complete the matrices by identifying relationships between the shapes. Our data demonstrate age differences in non-verbal reasoning accuracy, which increased during adolescence and stabilized in early adulthood. There was a slight linear increase in response times with age, resulting in a peak in efficiency (i.e. a measure combining speed and accuracy) in late adolescence. Overall, the data suggest that the MaRs-IB is sensitive to developmental differences in reasoning accuracy. Further psychometric validation is recommended.

Background and Objectives: In vivo stains are prompt resources, which have emerged, in the recent years, to aid as clinical diagnostic tools in detecting early premalignant and malignant lesions. The aim of the study was to determine the diagnostic efficiency of toluidine blue with Lugol′s iodine in oral premalignancies and malignancies and to evaluate the reliability of in vivo staining with toluidine blue and Lugol′s iodine in the lesions at risk of malignancy. Materials and Methods: The study group comprised 30 subjects with clinically suspicious premalignant lesions and 30 subjects with clinically suspicious malignant lesions. All the lesions were stained consecutively with toluidine blue and Lugol′s iodine and the dye retention were recorded with photographs. Depending on the retention of the dyes, the biopsy site was determined. The biopsy specimens were sent for histological confirmation and results were statistically analyzed. Results: The overall diagnostic accuracy of Lugol′s iodine when used consecutively with toluidine blue stain in distinguishing premalignant lesions and malignant lesions was 90%. As the degree of differentiation of malignant lesions progressed toward more severity, they failed to show the retention of Lugol′s iodine and the result was highly significant statistically, with a P value < 0.001. Interpretation and Conclusion: Lugol′s iodine when used with toluidine blue helped in delineating the inflammatory lesions and was the mean source in determining clinically the degrees of differentiation of malignant lesions as the poorly differentiated malignant lesions without glycogen content failed to show Lugol′s iodine retention. Toluidine blue with Lugol′s iodine can be used as a pretherapeutic assessment of the biologic aggressiveness of the disease.

Background: Leukemia is a fatal disease. The oral manifestations of the leukemias occur early in the course of the disease and these oral features can at times act as a diagnostic indicator. Saliva has been used as a diagnostic aid in a number of systemic diseases. Materials and Methods: In our study, samples of unstimulated saliva of 30 leukemia patients who were not on chemotherapy were collected and analyzed for salivary amylase and total protein. The oral manifestations and radiographic changes (OPG) were recorded. The correlation between the oral manifestations and the salivary components (salivary amylase and total protein) was assessed for prognostic significance. Results: In the present study when the mean values of salivary amylase (1280±754 U/ml) and total protein (647.2±320.7 mg%) were compared with that in control subjects. There was a statistically significant difference for amylase levels (PConclusions: The saliva of leukemic patients demonstrated obvious changes in composition. A rise in salivary amylase and total protein levels was evident, with the increase in amylase levels being statistically significant.

Background and Objectives: Lichen planus is a relatively common chronic inflammatory disease of oral mucosa and skin. Cortisol, also called as "stress hormone", has been used as an indicator in various stress evaluation studies. Salivary cortisol measurement is an indicator of free cortisol or biologically active cortisol in human serum and provides noninvasive and easy technique. Recent studies have been conflicting, and hence, in the present study, evaluation of salivary cortisol levels and psychosocial factors in oral lichen planus (OLP) patients was done. Materials and Methods: A total of 30 patients with clinically and histopathologically proven cases of OLP, along with the age and sex-matched healthy controls were included in the study. Samples of stimulated saliva were collected, centrifuged and analyzed for the level of cortisol with cortisol enzyme linked immunosorbent assay. Psychosocial factors of study and control groups were measured by depression anxiety and stress scale. Student′s t-test was used to compare the psychological factors and salivary cortisol levels between patients with the OLP and the control group. Results: Irrespective of sex, significantly higher depression (83.4 ± 15.4%), anxiety (80.5 ± 11.3%), and stress (94.2 ± 6.2%) scores were observed in OLP patients compared to controls. Increased cortisol levels were observed among 17 (56.6%) OLP patients in the study group. A positive correlation was found between psychological factors and salivary cortisol levels in the OLP patients. The values of Pearson′s correlation coefficient "r", between depression, anxiety, and stress with salivary cortisol was: +0.42,S; +0.27,NS; and +0.65,HS, respectively among the study group.

Objective : The aim of the study was to assess the severity of the disease in oral submucous fibrosis (OSF), correlate the clinical, functional staging with histopathological staging, and analyze collagen distribution in different stages of OSF using the picrosirius red stain under polarizing microscopy. Materials and Methods : The study included randomly incorporated 50 subjects, of whom 40 were patients with OSF, and 10 were in the control group. Clinical, functional staging in OSF cases was done depending upon definite criteria. A histopathological study was conducted using the hematoxylin and eosin stain and picrosirius red stain. Collagen fibers were analyzed for thickness and polarizing colors. Furthermore, clinical, functional, and histopathological stages were compared. Statistical Analysis : Descriptive data which included mean, SD, and percentages were calculated for each group. Categorical data were analyzed by the chi-square test. Multiple group comparisons were made by one-way ANOVA followed by Student′s t-test for pairwise comparisons. For all tests, a P-value of 0.05 or less was considered for statistical significance. Results : As the severity of the disease increased, clinically, there was definite progression in subjective and objective symptoms. Polarized microscopic, examination revealed, there was a gradual decrease in the green-greenish yellow color of the fibers and a shift to orange red-red color with increase in severity of the disease. Thereby, it appeared that the tight packing of collagen fibers in OSF progressively increased as the disease progressed from early to advanced stages. We observed that the comparison of functional staging with histopathological staging was a more reliable indicator of the severity of the disease. Conclusion : In the present study, we observed that mouth opening was restricted with advancing stages of OSF. The investigation also points to the importance of assessing the cases of OSF, especially with regard to functional and histological staging in planning the treatment.

Ellis-van Creveld syndrome (EvC) is a disease complex, where all the three embryonic layers appear to be involved. This disorder is also called as Chondroectodermal dysplasia. EvC is an autosomal recessive disorder resulting from mutations in these patients. Mutations in the two genes EVC and EVC2, have been identified to cause the condition. It has been considered as a skeletal dysplasia with an incidence of approximately 1 out of 1,50,000 live births. A high prevalence has been reported among certain populations like Amish and Arabs of Gaza strip. There are more than 300 cases of EvC reported into the literature. About 50-60% of cases have been reported with congenital cardiac malformations.

Glanzmann′s thrombasthenia is a rare hemorrhagic disorder characterized by prolonged bleeding time and diminished clot retraction. The disease is marked by frequent mucocutaneous hemorrhage which is mainly due to qualitative defects of platelets. A case of a 14-year-old HBsAg-positive adolescent male with Glanzmann′s thrombasthenia has been presented.

Most arthroscopic rotator cuff repairs utilize suture passing devices placed through arthro- scopic cannulas. These devices are limited by the size of the passing device where the suture is passed through the tendon. An alternative technique has been used in the senior author’s practice for the past ten years, where sutures are placed through the rotator cuff tendon using percutaneous passing devices. This technique, dubbed the global percutaneous shuttling technique of rotator cuff repair, affords the placement of sutures from nearly any angle and location in the shoulder, and has the potential advantage of larger suture bites through the tendon edge. These advantages may increase the area of tendon available to compress to the rotator cuff footprint and improve tendon healing and outcomes. The aim of this study is to describe the global percutaneous shuttling (GPS) technique and report our results using this method. The GPS technique can be used for any full thickness rotator cuff tear and is particularly useful for massive cuff tears with poor tissue quality. We recently followed up 22 patients with an average follow up of 32 months to validate its usefulness. American Shoulder and Elbow Surgeons scores improved significantly from 37 preoperatively to 90 postoperatively (P

Myofunctional appliances encompass a diverse range of intraoral devices that rely on the intrinsic forces of the orofacial musculature for their functionality. These appliances are typically designed to be removable and exhibit a passive mechanism of action. Caries and demineralisation are well known adverse side effects of myofunctional orthodontic appliances, with the most frequent reports relating to fixed appliance treatment. Hereby, the authors present a case report of a 12-year-old male patient with a slight neuromotor defect who developed significant caries and demineralisation of the permanent mandibular anteriors due to the consumption of large quantities of carbonated drinks and acidic fruits while wearing a twin block appliance for eight months and failing to return for regular orthodontic follow-ups. The patient was provided with strategies for oral health training and diet modification. Fluoride varnish was applied to treat the caries and pain caused by hypersensitivity. Additionally, at-home application of GC Tooth Mousse Plus, which is rich in Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride (CCP-ACPF), was utilised for remineralisation and dentinal tubule occlusion. The mandibular anteriors were restored with composite resin using an ultra-conservative 3D guided technique, alongside preventive care during the fluoride varnish application. The present case report emphasises the risk of decalcification of teeth during orthodontic treatment and the importance of regular dental check-ups.

Abstract The arthropod mushroom body is well-studied as an expansion layer representing olfactory stimuli and linking them to contingent events. However, 8% of mushroom body Kenyon cells in Drosophila melanogaster receive predominantly visual input, and their function remains unclear. Here, we identify inputs to visual Kenyon cells using the FlyWire adult whole-brain connectome. Input repertoires are similar across hemispheres and connectomes with certain inputs highly overrepresented. Many visual neurons presynaptic to Kenyon cells have large receptive fields, while interneuron inputs receive spatially restricted signals that may be tuned to specific visual features. Individual visual Kenyon cells randomly sample sparse inputs from combinations of visual channels, including multiple optic lobe neuropils. These connectivity patterns suggest that visual coding in the mushroom body, like olfactory coding, is sparse, distributed, and combinatorial. However, the specific input repertoire to the smaller population of visual Kenyon cells suggests a constrained encoding of visual stimuli.

Abstract Brain evolution has primarily been studied at the macroscopic level by comparing the relative size of homologous brain centers between species. How neuronal circuits change at the cellular level over evolutionary time remains largely unanswered. Here, using a phylogenetically informed framework, we compare the olfactory circuits of three closely related Drosophila species that differ in their chemical ecology: the generalists Drosophila melanogaster and Drosophila simulans and Drosophila sechellia that specializes on ripe noni fruit. We examine a central part of the olfactory circuit that, to our knowledge, has not been investigated in these species—the connections between projection neurons and the Kenyon cells of the mushroom body—and identify species-specific connectivity patterns. We found that neurons encoding food odors connect more frequently with Kenyon cells, giving rise to species-specific biases in connectivity. These species-specific connectivity differences reflect two distinct neuronal phenotypes: in the number of projection neurons or in the number of presynaptic boutons formed by individual projection neurons. Finally, behavioral analyses suggest that such increased connectivity enhances learning performance in an associative task. Our study shows how fine-grained aspects of connectivity architecture in an associative brain center can change during evolution to reflect the chemical ecology of a species.

In a variety of species and behavioral contexts, learning and memory formation recruits two neural systems, with initial plasticity in one system being consolidated into the other over time. Moreover, consolidation is known to be selective; that is, some experiences are more likely to be consolidated into long-term memory than others. Here, we propose and analyze a model that captures common computational principles underlying such phenomena. The key component of this model is a mechanism by which a long-term learning and memory system prioritizes the storage of synaptic changes that are consistent with prior updates to the short-term system. This mechanism, which we refer to as recall-gated consolidation, has the effect of shielding long-term memory from spurious synaptic changes, enabling it to focus on reliable signals in the environment. We describe neural circuit implementations of this model for different types of learning problems, including supervised learning, reinforcement learning, and autoassociative memory storage. These implementations involve synaptic plasticity rules modulated by factors such as prediction accuracy, decision confidence, or familiarity. We then develop an analytical theory of the learning and memory performance of the model, in comparison to alternatives relying only on synapse-local consolidation mechanisms. We find that recall-gated consolidation provides significant advantages, substantially amplifying the signal-to-noise ratio with which memories can be stored in noisy environments. We show that recall-gated consolidation gives rise to a number of phenomena that are present in behavioral learning paradigms, including spaced learning effects, task-dependent rates of consolidation, and differing neural representations in short- and long-term pathways.

A study was conducted on desflurane in chloroform solution in the 2000-900 cm-1 region to determine its vibrational adsorption and circular dichroism spectra. The spectra were compared with ab initio predictions of absorption and vibrational circular dichroism spectra derived from density functional theory using B3LYP/6-31G* and B3PW91/6-311G(2d) basis sets. Results suggested that the observed spectral features of desflurane in chloroform solution is due to three different conformers of the volatile anesthetic.

Summary: Thalamocortical loops have a central role in cognition and motor control, but precisely how they contribute to these processes is unclear. Recent studies showing evidence of plasticity in thalamocortical synapses indicate a role for the thalamus in shaping cortical dynamics through learning. Since signals undergo a compression from the cortex to the thalamus, we hypothesized that the computational role of the thalamus depends critically on the structure of corticothalamic connectivity. To test this, we identified the optimal corticothalamic structure that promotes biologically plausible learning in thalamocortical synapses. We found that corticothalamic projections specialized to communicate an efference copy of the cortical output benefit motor control, while communicating the modes of highest variance is optimal for working memory tasks. We analyzed neural recordings from mice performing grasping and delayed discrimination tasks and found corticothalamic communication consistent with these predictions. These results suggest that the thalamus orchestrates cortical dynamics in a functionally precise manner through structured connectivity.

Introduction The medical subinternship (also known as an acting internship) offers postclerkship medical students an opportunity for significant professional development. However, the skills required of a successful subintern—efficiency, patient triage, and advanced organization—are distinct from skills generally refined during the medicine clerkship. Few published curricula exist to prepare postclerkship students for success in this new role. To address this training gap, we introduced a novel tabletop role-playing game to equip medical subinterns with the necessary skills to deliver safe and efficient patient care. Methods We created an hour-long game-based learning session for rising internal medicine and family medicine subinterns. Led by a single facilitator, students worked together to triage and complete tasks in a gamified simulated environment of a morning on the wards. To assess the session, we surveyed participants (N = 130) immediately after activity completion. Results Eighty-three participants completed the postactivity survey, for a response rate of 64%. A majority of students agreed that TaskMaster: The Subintern Adventure Game met its educational goals of increasing comfort with task prioritization, organization, and patient triage. Ninety-three percent of respondents (77 of 83) either agreed or strongly agreed that they felt more prepared to be a covering provider for patients after the activity. Participants also reported high engagement with the activity. Discussion Leveraging the interactivity, teamwork, and contextualized practice of game-based learning can offer low-cost and adaptable opportunities to teach higher-order clinical skills and increase preparedness for the subinternship.

Objectives: Pericoronitis of mandibular third molars is commonly encountered in our day to day practice. Most of the case extraction becomes mandatory. This study was carried out to find the incidence of periodontitis on the distal aspect of the second molar adjacent to impacted third molar. Materials and Methods: A total of 400 patients were included in the study. Patient selection was randomly done. Whoever came with a chief complaint of pain in the third molar area were included in the study. They were evaluated both clinically and radiographically with an orthopantomogram. Patients' age, gender, type of impaction, presence or absence of bone loss, type of bone loss, and presence or absence of caries was evaluated radiographically and noted. Results: Periodontitis was observed in 39% of the cases and caries in 26% of the cases. Conclusions: These percentages are alarming and could be used to prophylactically extract the impacted third molars and thereby promoting the oral health of the individual. [ABSTRACT FROM AUTHOR]

Background: Betel quid (BQ) consumption is prevalent globally, majorly consumed in South-Asia and South-East Asian countries. Among the other country studies done on BQ, the focus has been on its consumption prevalence, its physiological and psychological effects, and aids to discontinue this habit. Systematic literature research on suitability of different instruments (metric or scale) to measure BQ dependency is scarce, hence pointing to the need of more evidence-based studies in this domain. Aim: The aim of the article was to identify the instruments used in the published literature to measure BQ dependency among young and adult chewers and draw a comparison. Methodology: The electronic retrieval systems and databases PubMed (Medline), Cochrane Library, Scopus, Web of Science, and Google Scholar were searched independently by two authors from January 2011 to September 2022 for the collection of desired data. Results: Among 1271 articles, 337 were duplicates and removed, 866 did not meet selection criteria. Out of 68 articles, 57 were excluded due to the lack of relevant data. Finally, only 11 articles were included for the analysis in this systematic review. Conclusion: Due to a scarcity of researches in this direction, no scale can be assigned as the best Dependence Scale, thus necessitating more such systematic reviews and meta-analysis for better comprehension and usage of present dependence scales.

The cerebellar granule cell layer has inspired numerous theoretical models of neural representations that support learned behaviors, beginning with the work of Marr and Albus. In these models, granule cells form a sparse, combinatorial encoding of diverse sensorimotor inputs. Such sparse representations are optimal for learning to discriminate random stimuli. However, recent observations of dense, low-dimensional activity across granule cells have called into question the role of sparse coding in these neurons. Here, we generalize theories of cerebellar learning to determine the optimal granule cell representation for tasks beyond random stimulus discrimination, including continuous input-output transformations as required for smooth motor control. We show that for such tasks, the optimal granule cell representation is substantially denser than predicted by classical theories. Our results provide a general theory of learning in cerebellum-like systems and suggest that optimal cerebellar representations are task-dependent.