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Introduction: During orthodontic treatment, temporary anchoring devices (TADs) are used to restrain tooth movement. They are a relatively recent addition to the dental toolkit. Aim: As TADs have limitations, Dr. Eric Lieu of Taiwan developed Infra Zygomatic Crest (IZC) screws which are placed between the maxillary second premolar at the bony crest. Treatment Planning: The goal of this case study is to emphasize the value of anatomy, site selection, and IZC retrieval in the event of an accident. Cone beam computed tomography was used as a diagnostic tool for the precise location of the displaced IZC and immediate surgical retrieval was done under local anesthesia from the infratemporal space to prevent further complications. Take-away Lessons: Orthodontists knowledge of soft tissue and hard tissue anatomy and precise positioning is crucial for successful TAD implantation.

Context: The city of Chennai is one of the largest metropolitan cities in India where apart from a large traditional population, there has been a continuous migration from rural areas and growing sophistication in lifestyle. Twinning rates trend in the present world would be interesting to study. Aims: The aim of the present study was to analyse the twinning rate in the city of Chennai, the distribution amongst various city zones and the present trends in the co-relation between the maternal age of the twins with the zygosity. Settings and Design: A population-based study was conducted on twin births in various corporation Zones in the Chennai Metropolitan, between 2010 and 2012. As per the Chennai corporation and Health Department register, there were a total of 2,32,884 births registered in the city of which 4,500 were twin births over the 3 years. Only 1371 pairs were found residing in Chennai at the time of study, and hence, a study was conducted on this population only. Statistical Analysis Used: The data were analysed with Epiinfo software. Results: A twining rate of 19.3 per 1000 births was observed as per Corporation records. In the present study, the sample of 150 pairs, 34 pairs (22.6%) comprised of monozygotic (MZ) twins and 116 pairs (77.3%) comprised of dizygotic twins giving a ratio of 1:3. The maternal age groups 25–30 and 30–35 years comprised of the maximum twinning rates. Most twin births were of the first order. An analysis of Weinberg's Differential Rule method to determine zygosity showed a significant difference compared to the Questionnaire method. Conclusions: The twinning rate observed in Chennai in the present study is interestingly very high, compared to the overall twinning rate reported in the past in the state of Tamilnadu. The Wienberg's Differential method for zygosity determination is again found to be questionable. The zygosity proportion, maternal age and parity relations are not very different from previously available data.

Purpose: The negligence of oral health combined with barriers in accessing adequate oral care is more commonly encountered in children with sensory deficits. In a developing country like India, there is a severe lacuna in data regarding the oral health status and treatment needs in this group of population. The purpose of this study is to assess the oral health status and treatment needs of children with sensory deficits, using WHO criteria of Basic Oral Health Survey Methods, 1997. Materials and Methods: A descriptive cross-sectional study was conducted using the WHO criteria (Basic Oral Health Survey, 1997); questionnaire data regarding the demographic profile, oral hygiene status, degree of sensory impairment were recorded and tabulated. The Chi-square test was used to determine whether there existed a significant difference in the oral health status. The confidence interval was set at 95% and alpha error was assumed at 0.05. Results: Among the 742 sensory deficit children examined, 371 children are visually impaired and 371 are hearing impaired. Gingival bleeding and poor oral hygiene is diagnosed in more than 70% of the visually impaired children. The prevalence of trauma is estimated to be 8% in children, who are visually impaired. In the hearing impairment group, gingival bleeding because of inadequate oral hygiene is seen in 58% of the population examined. There is no statistically significant difference in the dental caries status between visually impaired and hearing impaired children (P > 0.05). There is also no statistically significant difference in the restorative treatment need and trauma status between visually impaired and hearing impaired children (P > 0.05). Conclusion: The present study shows a high prevalence of gingival diseases and dental caries in the special health care group children. The study signifies a wide spread presence of unmet treatment needs among children in this study population.

Background: Conflict is an inevitable and integral part of any work environment including nursing. Unresolved conflicts among nurses may lead to increased errors in patient care, affect their morale, and even increase turnover. Objective: The objective of the study is to determine the conflict-handling styles practiced by newly joined nursing staff working in a tertiary care hospital. Materials and Methods: This descriptive cross-sectional study was conducted on newly joined 297 nurses. Standardized Thomas-Kilmann Conflict Mode Instrument was used to collect the data. Nurses were asked to give answers that characterized their dominant response in a conflict situation. Results: A total of 34.7% nurses used accommodating style for conflict management whereas 30.3% used collaborating style. It was followed by compromising, competing, and avoiding styles of conflict management. Conclusion: There is a need to enhance nurses' conflict management skills which in long run may lead to improvement in the quality of work as well as job satisfaction among nurses.

The importance of predicting crop yields has increased due to growing concerns of surrounding food security. Early forecasting of crop yields holds a pivotal role in avoiding starvations by estimating the food supply available for the expanding global population. Several Deep Learning (DL) and Machine Learning (ML) techniques are involved to develop effective and accurate crop yield prediction model. Nevertheless, existing models faces some limitations such as less accuracy, high error rate because of noisy data, high training time and extracted less effective features for prediction. To overcome these issues, the novel DL methodology is introduced for attaining high accurate crop yield prediction. Initially, the soil, weather and other resources big data are collected from the various agriculture field. In data collection phase, the input data of larger size are stored in the Hadoop platform for the purpose of storing as well as processing the entire data in a distributed manner. The data are pre-processed through the utilization of Missing value imputation and z-score based data normalization. From the pre-processed data, the optimal features are considered using Integrated Correlation Random recursive elimination (InCorRe) approach. Based on the previous soil and weather information, the suitable yield of crops can be predicted using Multi head Residual dilated convolution assisted gated unit (MResGat) model. Finally, the losses of the network model can be optimized using African vulture optimization algorithm (AVO). The proposed method is evaluated using the several performance metrics, which achieved 0.023% of MSE value and 0.036% of MAE values. [ABSTRACT FROM AUTHOR]

Background of the Study: Low back pain is one of the most common health problem and 80% of people experiences low back pain in their lifetime. Majority of low back pain is due to the muscle imbalance. Muscle imbalance occurs due to shortened or lengthened in structure and it leads to injury which causes changes in motor programming. Objectives: To compare the effects of Muscle Energy Technique, Positional Release Technique and Conventional Therapy on improving pain, range of motion and functional ability in patients with mechanical low back pain. Subjects and Methods: Twenty four patients of complaining of mechanical low back pain participated in the study. Patients were randomly allocated using computer generator software into three groups: group A which received Muscle Energy Technique, group B which received Positional Release Technique and group C which received Conventional Therapy. Treatment sessions were given three times per week for three weeks. Patients were assessed before and after treatment using Numerical Pain Rating Scale(NPRS),Modified Oswestry Disability Index (MODI), and Modified Schobers Test to assess pain severity, functional ability, and range of motion of lumbar spine respectively. Results: Based on this statistical analysis, Group A showed better statistically significance in NPRS,MODI and ROM mean values as compared to Group B and C. Hence alternate hypothesis is accepted and null hypothesis is rejected. This we conclude that Muscle Energy Technique is more beneficial compared to Positional Release Technique and Conventional Therapy group. Conclusion: Muscle Energy Technique and Conventional therapy group shows significant improvement on Pain and Lumbar Extension Range of Motion compared to Positional Release Technique, whereas there was no significant difference in MODI on Muscle Energy Technique, Positional Release Technique and Conventional therapy. [ABSTRACT FROM AUTHOR]

Introduction: Although diarrheal diseases are highly preventable, they remain one of the leading causes of mortality and morbidity in the pediatric population in developing countries. Knowledge of etiological agents is essential to implement public health programs. Viral infections are the most common cause of acute infectious diarrhea among children. There is a paucity of information regarding viral enteropathogens responsible for diarrhea in India, as many hospitals do not routinely carry out diagnostic tests for viral detection. Aim and Objectives: To estimate the prevalence of viral enteropathogens in children under five years of age presenting with acute diarrhea using real-time multiplex polymerase chain reaction (PCR) and its correlation with clinico-demographic features. Methodology: A cross-sectional study was carried out in a tertiary care center in Maharashtra from January 2016 to June 2019. Our study included 300 children who were under five years old with acute diarrhea. Standard protocols were advocated for the collection and transportation of stool samples. All samples were subjected to real-time multiplex PCR (Light cycler 480 Roche) using Fast Track Diagnostic kits for viral gastroenteritis. Data analysis was done using descriptive and analytical methods. Results: In our study, 57% of samples were positive for viral enteropathogens. Rotavirus (32%) was the most common isolate, followed by Norovirus Genogroup II (GII) (17%). The majority of pathogens were isolated from children less than 2 years of age. Conclusion: There is a need to test stool specimens of clinically confirmed diarrheal patients for enteric virus. This will avoid blind antibiotic treatment. [ABSTRACT FROM AUTHOR]

Rationale: Sinonasal tumours are rare occurrences accounting for 3–4% of tumours (benign/malignant/co-existing) in the head-and-neck region, making it difficult to render an absolute diagnosis and treatment, thereof keeping in mind the tumour presentation and quality of life of the patient. Patient Concerns: The patient reported with complaints of swelling over the right side of the face associated with recent onset of pain in the same region. Diagnosis: Upon clinical, radiographic and histopathological examination, it was diagnosed as right Sinonasal inverted papilloma (SNIP). Treatment: The clinicians in the study approached the SNIP by opting for tumour resection with subtotal maxillectomy and reconstruction using a prosthetic obturator. Outcomes: Patient was operated and relived of the pathology and followed up for 18 months. She is now taken up for prosthetic rehabilitation. Take-away Lessons: The authors advocate the choice for open surgeries in cases where minimally invasive techniques do not meet the needs of desired results. [ABSTRACT FROM AUTHOR]

Rationale: Osteochondroma, a benign bony neoplasm that can develop in any part of the body, commonly appears in the ends of the long bones. It can also occur in the craniofacial region such as mandibular condyle and coronoid region. We describe the clinical presentation, diagnostic process, surgical management and post-operative outcomes in a 34-year-old male patient. Only few cases are reported in literature till now and often are mistaken as bony exostosis. Patient Concerns: The patient sought medical attention due to the cosmetic concerns. Diagnosis: Through clinical palpation and radiological interpretation. Provisional diagnosis of bony exostosis was made, which was later confirmed as osteochondroma on histopathological examination. Treatment: Surgical removal of the bony growth was performed. Outcomes: Follow-up was uneventful with no evidence of recurrence. Take-away Lessons: The report aims to raise awareness about this manifestation and to encourage further research to better understand aetiology, management and outcomes of osteochondroma in unusual locations. [ABSTRACT FROM AUTHOR]

This research paper explores the implications of technology in promoting wellness tourism in Thrissur, Kerala. Thrissur, renowned for its cultural heritage and natural beauty, has emerged as a significant destination for wellness tourism, offering Ayurvedic retreats, yoga centers, and holistic healing practices. In recent years, technological advancements have reshaped the tourism industry, presenting opportunities for enhanced marketing strategies, personalized experiences, and improved accessibility. Through a mixed-methods approach combining quantitative analysis of online marketing data and qualitative insights from tourists, wellness practitioners, and local stakeholders, this study aims to assess the effectiveness of technology-driven promotional strategies in attracting wellness tourists to Thrissur. It also analyzes the impact of digital platforms on visitor experiences, identifies challenges and opportunities for leveraging technology in wellness tourism promotion, and provides recommendations for stakeholders. The findings contribute to the understanding of the role of technology in shaping wellness tourism destinations and offer practical insights for destination marketers, policymakers, and businesses in Thrissur. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disorder involving the joints along with various other extra-articular manifestations. Mortality due to coronary artery disease is higher in patients with RA when compared to the general population. Hence, this study is undertaken to assess the predictors of sub-clinical atherosclerosis in patients with RA, so that early prompt management can prevent cardiovascular complications. Methods: A case-control study with 42 patients of RA and 42 healthy age- and sex-matched controls was undertaken. Relevant investigations were done. Disease Activity Score (DAS)-28 was calculated. Carotid artery doppler was performed on both sides to examine the common carotid artery. Results: The mean carotid intima-media thickness (CIMT) (mm) was significantly higher in RA patients compared to controls on the right side (0.57 ± 0.11 Vs 0.40 ± 0.03; P < 0.001) as well as left side (0.56 ± 0.11 Vs 0.39 ± 0.06; P < 0.001). Only age (P = 0.006) and DAS-28 (P = 0.002) showed a positive correlation with CIMT. Conclusions: CIMT can be used as a marker for the detection of subclinical atherosclerosis and the risk of atherosclerosis increases with the increasing age and increasing disease severity. [ABSTRACT FROM AUTHOR]

Recommender Systems have been widely employed in information systems over the past few decades, making it easier for each user to choose their own products based on their past behaviour. Data mining tasks and visualization tools regularly use clustering techniques in the scientific and commercial arenas. It has been shown that clustering-based methods are effective and scalable to big data sets. The accuracy and coverage of clustering-based recommender systems are, however, somewhat low. In this paper, we suggest an improved multi-view clustering method for the recommendation of items in social networks to overcome these problems. To create better partitions, the artificial Bees colony optimization algorithm (ABC) is first used to improve the initial medoids' selection. After that, users are clustered iteratively using views of both rating patterns as well as social information using multiview clustering (MVC) (i.e. trust and friendships). Ultimately, a framework is suggested for evaluating the various options. This research study suggests a novel MVC clustering approach using the ABC optimization technique. The proposed ABC-MVC algorithm's usefulness in terms of enhancing accuracy is demonstrated by experimental findings performed on a real-world dataset and it is observed that it performs better than the pre-existing techniques and baselines. [ABSTRACT FROM AUTHOR]

Rationale: Mesiodens are supernumerary teeth located in the pre-maxilla between the two central incisors with a prevalence rate of 0.15–1.9%. An impacted mesiodens may cause delayed eruption of permanent incisors, ectopic eruption, pathological disturbances and malalignment of teeth. Patient Concerns: The patient complained of missing upper front teeth associated with pain in the same region for two weeks. Diagnosis: Upon clinical and radiographic examination, it was diagnosed as triple impacted mesiodens with impacted permanent maxillary central incisors. Treatment: The clinicians in the study approached the issue by surgical removal of the impacted mesiodens and orthodontic treatment for extrusion of the impacted permanent maxillary central incisors. Outcomes: The patient was relieved of the pre-operative concerns and followed up regularly for the eruption of permanent maxillary central incisors. Take-away Lessons: The authors advocate the importance of timely diagnosis and proper management of such rare pathologies. [ABSTRACT FROM AUTHOR]