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Sara Moradi Tuchayi,1 Ying Wang,1 Isaac J Pence,1 Alex Fast,1 Anat Stemmer-Rachamimov,2 Conor L Evans,1 R Rox Anderson,1 Lilit Garibyan1 1Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, MA, USA; 2Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, MA, USACorrespondence: Lilit Garibyan, Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street-Thier 2, Boston, MA, 02114, USA, Tel +1 617-726-2005, Email lgaribyan@mgh.harvard.eduBackground: Cryoneurolysis uses tissue cooling as an opioid-sparing, long-lasting treatment for peripheral nerve pain. A nerve-selective method for cryoneurolysis by local injection of ice-slurry was developed to allow cryoneurolysis to be performed with a standard needle and syringe, similar to peripheral nerve blocks. Since the treatment of patients with chronic pain may require repeated injections, we investigated the safety and tolerance of repeated treatments in a rat model.Methods: Three repeated ice-slurry treatments, given 6 weeks apart were performed around the rat sciatic nerve. Nerve and surrounding tissues were collected up to 4 months after the third treatment for analysis. Coherent anti-Stokes Raman scattering (CARS) microscopy was used to study effects on myelin sheaths and axon structure. Immunofluorescence (IF) staining was used to study effects on axon density. Hematoxylin and Eosin (H&E) staining was used to examine histologic effects on sciatic nerve and surrounding tissue.Results: Histologic and CARS image analysis of nerve tissue collected months after three injections demonstrated recovery of nerve structure, myelin organization and axon density to baseline levels, without any residual inflammation, scarring or neuroma formation. No inflammation or scarring was detected in surrounding skin and muscle tissues.Conclusion: Repeated ice-slurry injections cause temporary, nerve-selective and reversible changes in the peripheral nerve. There was no histologic damage to surrounding skin and muscle tissues. Repeated treatments with injectable ice-slurry for cryoneurolysis appear to be safe and well tolerated. Clinical studies for patients with chronic pain are warranted.Keywords: pain treatment, slurry, cooling, multiple treatments

Purpose: The current Classification of Periodontal and Peri-Implant Diseases and Conditions, published and disseminated in 2018, involves some difficulties and causes diagnostic conflicts due to its criteria, especially for inexperienced clinicians. The aim of this study was to design a decision system based on machine learning algorithms by using clinical measurements and radiographic images in order to determine and facilitate the staging and grading of periodontitis., Methods: In the first part of this study, machine learning models were created using the Python programming language based on clinical data from 144 individuals who presented to the Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University. In the second part, panoramic radiographic images were processed and classification was carried out with deep learning algorithms., Results: Using clinical data, the accuracy of staging with the tree algorithm reached 97.2%, while the random forest and k-nearest neighbor algorithms reached 98.6% accuracy. The best staging accuracy for processing panoramic radiographic images was provided by a hybrid network model algorithm combining the proposed ResNet50 architecture and the support vector machine algorithm. For this, the images were preprocessed, and high success was obtained, with a classification accuracy of 88.2% for staging. However, in general, it was observed that the radiographic images provided a low level of success, in terms of accuracy, for modeling the grading of periodontitis., Conclusions: The machine learning-based decision system presented herein can facilitate periodontal diagnoses despite its current limitations. Further studies are planned to optimize the algorithm and improve the results., Competing Interests: No potential conflict of interest relevant to this article was reported., (Copyright © 2023. Korean Academy of Periodontology.)

We present a rapidly tunable dual-output all-fiber light source for coherent Raman imaging, based on a dispersively matched mode-locked laser pumping a parametric oscillator. Output pump and Stokes pulses with a maximal power of 170 and 400 mW, respectively, and equal durations of 7 ps could be generated. The tuning mechanism required no mechanical delay line, enabling all-electronic arbitrary wavelength switching across more than 2700  cm - 1 in less than 5 ms. The compact setup showed a reliable operation despite mechanical shocks of more than 25  m / s 2 and is, thus, well suited for operation in a mobile cart. Imaging mouse and human skin tissue with both the portable light source and a commercial laboratory-bound reference system yielded qualitatively equal results and verified the portable light source being well suited for coherent Raman microscopy., Competing Interests: M. Brinkmann and T. Hellwig are pursuing the commercialization of the presented light source by means of the company Refined Laser Systems UG (haftungsbeschränkt), Münster, Germany (I,P,S)., (Published by The Optical Society under the terms of the Creative Commons Attribution 4.0 License. Further distribution of this work must maintain attribution to the author(s) and the published article’s title, journal citation, and DOI.)