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Abstract Computer-assisted diagnosis (CAD) plays a key role in cancer diagnosis or screening. Whereas, current CAD performs poorly on whole slide image (WSI) analysis, and thus fails to generalize well. This research aims to develop an automatic classification system to distinguish between different types of carcinomas. Obtaining rich deep features in multi-class classification while achieving high accuracy is still a challenging problem. The detection and classification of cancerous cells in WSI are quite challenging due to the misclassification of normal lumps and cancerous cells. This is due to cluttering, occlusion, and irregular cell distribution. Researchers in the past mostly obtained the hand-crafted features while neglecting the above-mentioned challenges which led to a reduction of the classification accuracy. To mitigate this problem we proposed an efficient dual attention-based network (CytoNet). The proposed network is composed of two main modules (i) Efficient-Net and (ii) Dual Attention Module (DAM). Efficient-Net is capable of obtaining higher accuracy and enhancing efficiency as compared to existing Convolutional Neural Networks (CNNs). It is also useful to obtain the most generic features as it has been trained on ImageNet. Whereas DAM is very robust in obtaining attention and targeted features while negating the background. In this way, the combination of an efficient and attention module is useful to obtain the robust, and intrinsic features to obtain comparable performance. Further, we evaluated the proposed network on two well-known datasets (i) Our generated thyroid dataset (ii) Mendeley Cervical dataset (Hussain in Data Brief, 2019) with enhanced performance compared to their counterparts. CytoNet demonstrated a 99% accuracy rate on the thyroid dataset in comparison to its counterpart. The precision, recall, and F1-score values achieved on the Mendeley Cervical dataset are 0.992, 0.985, and 0.977, respectively. The code implementation is available on GitHub. https://github.com/naveedilyas/CytoNet-An-Efficient-Dual-Attention-based-Automatic-Prediction-of-Cancer-Sub-types-in-Cytol.

This study aimed to evaluate the differential positional changes of the proximal and distal segments during mandibular setback surgery relapse. Thirty patients with mandibular prognathism who underwent bilateral sagittal split ramus osteotomy were included. Skull models from pretreatment, postsurgery, and post-treatment cone-beam computed tomography were superimposed to evaluate condylar displacement and rotational changes, and to determine the center of rotation (CRot) in the proximal and distal segments. During postsurgical relapse, the proximal segment rotated 2.4 ± 2.1° counterclockwise, with the CRot located near the mandibular condyle. The distal segment rotated 2.0 ± 2.3° counterclockwise, resulting in forward and upward movement of the chin. The displaced condyle partially returned to its original position during postsurgical orthodontic treatment. A vertical bony step (VBS) between the proximal and distal segments commonly occurs during mandibular setback surgery. As the VBS increases, the CRot of the distal segment shifts posterosuperiorly, following a predictable pattern outlined by regression equations. These findings suggest that relapse after mandibular setback surgery consistently occurs in an anterosuperior direction, with translatory movement becoming more prominent as the VBS increases. Including these regression equations in presurgical planning can enhance the precision of relapse simulations and help clinicians more accurately anticipate postsurgical relapse.

Silica nanoparticles are innovative solutions of surgical glue that can readily adhere to various tissue-like substrates without the need for time-consuming chemical reactions or ultraviolet irradiation. Herein, 10 nm-sized silica nanoparticle (SiNP10) treatment exhibited maximum adhesion strength in the porcine heart tissue model, which was approximately 7.15 times higher than that of the control group of non-treatment. We assessed the effects of silica nanoparticle treatment on in vivo skin wounds by scoring tissue adhesion and inflammation using histological images. Compared to the commercial cyanoacrylate skin adhesive (Dermabond), suppression of inflammatory cytokine levels in the incision wound skin was observed. We further quantified the expression of angiogenic growth factors and connective tissue formation-related proteins. On day 5 after wound closing treatment, the expression levels of PDGF-BB growth factor were significantly higher in SiNP10 treatment (0.64 ± 0.03) compared to Dermabond (0.07 ± 0.05). This stimulated angiogenesis and connective tissue formation in the skin of the incision wound may be associated with the promoting effects of SiNP10 treatment on wound closure and tissue adhesion.

Aortic pseudoaneurysms (PA) vary in size and may remain asymptomatic. PAs may be caused by vascular injury, such as trauma or surgery, or other non-traumatic causes, such as Bechet disease, infection, or penetrating atherosclerotic ulcers. The diagnosis of PAs may have been delayed for decades. We present a case of a PA detected incidentally in a male patient who experienced traumatic bowel perforation due to blunt abdominal trauma 30 years before presentation. Computed tomography (CT) displayed a 9.2 cm mass in the pelvis, initially considered a neoplasm of small bowel origin. Further analysis of the CT images suggested a thrombosed PA at the aortic bifurcation, which was confirmed via surgical exploration. Graft interposition was performed using a Dacron 16-8 mm graft and the patient recovered without any complications. This case highlights the importance of a high index of suspicion for the diagnosis of a thrombosed aortic PA.

ABSTRACTMany patients and guardians prefer not to have teeth extracted as part of orthodontic treatment. Modified C-Palatal Plates (MCPPs) have been developed as an effective oral appliance. The design and procedure for placing these appliances involve a sequence of steps and specialized instruments such as a miniscrew driver. By understanding the biomechanics associated with MCPP placement, molar positioning can be optimized with less distal tipping and greater distalization. In addition to recognizing the various advantages of MCPPs, the implications of MCPPs should be considered, including the following: how far back the molars need to be moved, the effects of second and third molars in adolescents, the effects in maxillary pneumatization cases, potential impact on the airway, long-term stability, and a comparison of MCPPs to headgear. The purpose of this report is to introduce MCPP as an oral appliance that uses both miniscrews and miniplates to efficiently distalize molars minimizing the need for extraction.

Background Hair diameter is a crucial element in deciding the treatment and predicting the prognosis of hair transplantation in patients with hair loss. Methods Ten female volunteers participated in this study. Three sites at different horizontal positions of the scalp were chosen for measurement: midoccipital, mastoid, and temporal. Three boxes of 1 cm2 were marked from superior to inferior along the midline of each site, and five anagen hairs ≥10 cm long were randomly sampled from each box. The thickness of each collected hair was measured at three positions along the hair length: 1 cm, 5 cm, and 10 cm from the surface of the skin. The diameters of the hairs were measured using a micrometer caliper and a Folliscope phototrichogram, and the measurements were compared. Results The average thickness of all hairs was 76.90±12.29 μm when measured with the caliper and 108.78±19.97 μm when measured with the phototrichogram. There was a statistically significant difference between the two measurement methods (P

Abstract Objective To compare the short‐term treatment effects between two types of facemasks in skeletal Class III patients. Materials and Methods This retrospective study included 40 skeletal Class III subjects (mean age: 7.7 years) who had been treated with protraction facemasks with forehead straps (PFFS) or Petit type facemasks (PTF). Lateral cephalograms were analyzed at pretreatment (T1) and posttreatment (T2) with an average interval of 9 months. Results At T1, PFFS and PTF groups showed similar sagittal, vertical dentoskeletal patterns. From T1 to T2, both groups presented significant forward movement of the maxilla, posterior movement and clockwise rotation of the mandible (all p

Meningiomas are common primary brain tumors, and their accurate preoperative grading is crucial for treatment planning. This study aimed to evaluate the value of radiomics and clinical imaging features in predicting the histologic grade of meningiomas from preoperative MRI. We retrospectively reviewed patients with intracranial meningiomas from two hospitals. Preoperative MRIs were analyzed for tumor and edema volumes, enhancement patterns, margins, and tumor–brain interfaces. Radiomics features were extracted, and machine learning models were employed to predict meningioma grades. A total of 212 patients were included. In the training group (Hospital 1), significant differences were observed between low-grade and high-grade meningiomas in terms of tumor volume (p = 0.012), edema volume (p = 0.004), enhancement (p = 0.001), margin (p < 0.001), and tumor–brain interface (p < 0.001). Five radiomics features were selected for model development. The prediction model for radiomics features demonstrated an average validation accuracy of 0.74, while the model for clinical imaging features showed an average validation accuracy of 0.69. When applied to external test data (Hospital 2), the radiomics model achieved an area under the receiver operating characteristics curve (AUC) of 0.72 and accuracy of 0.69, while the clinical imaging model achieved an AUC of 0.82 and accuracy of 0.81. An improved performance was obtained from the model constructed by combining radiomics and clinical imaging features. In the combined model, the AUC and accuracy for meningioma grading were 0.86 and 0.73, respectively. In conclusion, this study demonstrates the potential value of radiomics and clinical imaging features in predicting the histologic grade of meningiomas. The combination of both radiomics and clinical imaging features achieved the highest AUC among the models. Therefore, the combined model of radiomics and clinical imaging features may offer a more effective tool for predicting clinical outcomes in meningioma patients.

Purpose Recent reports indicate that small for gestational age (SGA) could be a risk factor for delayed thyroid stimulating hormone (dTSH) elevation in preterm infants. The development of dTSH elevation in SGA late-preterm infants with a gestational age of 34–36 weeks has been investigated in only a few studies. Methods In the present retrospective study, 70 SGA infants and 86 sex- and gestational age-matched controls who presented with normal results on initial thyroid function testing were included. Results SGA infants had a significantly higher prevalence of dTSH elevation (15.7% vs. 3.5%, P=0.009) compared with appropriate-for-gestational age infants. In SGA infants, the mean age at the time of dTSH was 24 days. Development of dTSH was associated with SGA and medical treatment with dopamine or furosemide. After adjusting for confounding factors, multiple logistic regression analysis showed SGA was a significant risk factor for the development of dTSH elevation (odds ratio, 23.2; 95% confidence interval, 2.27–236.91; P=0.008). Conclusions SGA infants may be at risk for dTSH and clinicians could consider a second thyroid screening test around the age of 1 month.

Abstract In the search for a more efficient solar cell, various types of tandem solar cells (TSCs) have been actively developed worldwide as the performances of the single junction solar cells approach their theoretical limits. Meanwhile, various materials and structures are adopted in TSCs, which makes their characterizations and comparison difficult. Along with the classical monolithic TSC, which exhibits two electrical contacts, devices with three or four electrical contacts have been widely studied as a more performing alternative of commercialized solar cells. For a fair and accurate evaluation of the device performance of TSCs, understanding the effectiveness and limitations of the characterization of the different types of TSCs is crucial. In this paper, we summarize various types of TSCs and discuss their characterization methods.

Objective: This case report describes the interdisciplinary treatment of a 10-year-old girl with asymmetric Class III malocclusion, severe maxillary crowding, and bilaterally impacted maxillary canines. Clinical considerations: The clinical decision-making factors regarding treatment alternatives and the final treatment plan are discussed. A two-phase nonextraction therapy was implemented to relieve severe crowding, eliminate the maxillary canine impactions, and compensate for skeletal Class III malocclusion. The first treatment phase involved aligning the left canine through conventional orthodontic traction, while the more deeply horizontally impacted right canine was corrected through transalveolar transplantation. In the second phase, the Class III dental relationship was corrected through mandibular molar retraction. The effective use of various temporary skeletal anchorage devices such as modified c-palatal plates and mini-implants was illustrated. Conclusions: At the end of the treatment, esthetic dental alignment was achieved, along with improved facial balance. The transplanted maxillary right canine showed good health and a favorable long-term prognosis over six years after the procedure.

Cervical cancer is a common and preventable disease that poses a significant threat to women’s health and well-being. It is the fourth most prevalent cancer among women worldwide, with approximately 604,000 new cases and 342,000 deaths in 2020, according to the World Health Organization. Early detection and diagnosis of cervical cancer are crucial for reducing mortality and morbidity rates. The Papanicolaou smear test is a widely used screening method that involves the examination of cervical cells under a microscope to identify any abnormalities. However, this method is time-consuming, labor-intensive, subjective, and prone to human errors. Artificial intelligence techniques have emerged as a promising alternative to improve the accuracy and efficiency of Papanicolaou smear diagnosis. Artificial intelligence techniques can automatically analyze Papanicolaou smear images and classify them into normal or abnormal categories, as well as detect the severity and type of lesions. This paper provides a comprehensive review of the recent advances in artificial intelligence diagnostics of the Papanicolaou smear, focusing on the methods, datasets, performance metrics, and challenges. The paper also discusses the potential applications and future directions of artificial intelligence diagnostics of the Papanicolaou smear.

Health screening is an important component of health promotion programs, and countries have promoted general health screening targeting the prevention and early management of common chronic diseases. In Korea, a General Health Screening Program (GHSP) began with workers in the 1950s and continuously expanded its target population, and currently includes the adult population. The main target diseases are cerebroand cardiovascular diseases, including hypertension, diabetes mellitus, dyslipidemia, obesity, and related health behaviors. Other target conditions include other diseases (e.g., anemia, liver disease, visual/auditory impairment), mental health (e.g., depression), and geriatric disease and function (osteoporosis, dementia, risk of fall, etc.). The National Health Information Database, including GHSP information, is now extensively used in clinical and public health research. The participation rate is currently 70% to 80%, but varies according to age, disability, and the socioeconomic status. There is a need for a more systematic evaluation of the screening items, reducing disparity gaps in participation, and linking GHSP to actual health promotion.

The purpose of this retrospective study was to evaluate changes in the temporomandibular joint spaces (TMJSs) in skeletal Class III adult patients with orthognathic surgery using cone-beam computed tomography (CBCT). CBCT images taken from 26 orthognathic surgery adult patients (15 females, 11 males, average 19.6 ± 2.8 years at pretreatment, range 15.8–26.8 years) with skeletal Class III malocclusion (ANB < 1°) were used for this study. TMJSs (AS, anterior space; SS, superior space; PS, posterior space; MS, medial space; CS, central space; LS, lateral space) were measured at each stage of treatment (T0, pretreatment; T1, presurgery; T2, postsurgery; T3, posttreatment, and T4, retention) and were compared according to gender, side, vertical skeletal pattern, number of surgery sites, and amount of mandibular setback. At T0, TMJSs were significantly greater in SS than in AS and PS. The ratio of AS to SS to PS was 1.0 to 1.5 to 1.1. TMJSs were significantly greater in MS and CS than in LS. The ratio of MS to CS to LS was 1.0 to 1.0 to 0.8. All TMJSs in males were significantly greater than in females except in PS. TMJSs on the left side were significantly greater than on the right side only in PS. TMJSs were not significantly different depending on the SN-MP, number of surgery sites, and amount of setback. From T0 to T4, there were no significant changes in TMJSs or their ratios according to gender, side, sella to nasion (SN), mandibular plane (MP), number of surgery sites, and amount of setback. Exceptionally, at T4, SS and CS were significantly greater in the small amount of setback group than in the large amount of setback group. There were no statistical changes in TMJSs throughout all stages when skeletal Class III patients were treated with surgery.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of anti-cancer drugs. The main symptoms often include sensory disturbances and neuropathic pain, and currently there is no effective treatment for this condition. This study aimed to investigate the suppressive effects of magnolin, an extracellular signal-regulated kinase (ERK) inhibitor substance derived from a 95% EtOH extract of the seeds of Magnolia denudata, on the symptoms of CIPN. A taxol-based anti-cancer drug paclitaxel (PTX) was repeatedly injected (2 mg/kg/day, total 8 mg/kg) into mice to induce CIPN. A neuropathic pain symptom was assessed using a cold allodynia test that scores behaviors of licking and shaking paw after plantar administration of acetone drop. Magnolin was administered intraperitoneally (0.1, 1, or 10 mg/kg) and behavioral changes to acetone drop were measured. The effect of magnolin administration on ERK expression in the dorsal root ganglion (DRG) was investigated using western blot analysis. The results showed that the repeated injections of PTX induced cold allodynia in mice. Magnolin administration exerted an analgesic effect on the PTX-induced cold allodynia and inhibited the ERK phosphorylation in the DRG. These results suggest that magnolin could be developed as an alternative treatment to suppress paclitaxel-induced neuropathic pain symptoms.

Our previous paper showed that microRNAs (miRNAs) present within human placental or mesenchymal stem cell-derived extracellular vesicles (EVs) directly interacted with the RNA genome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), inhibiting viral replication. In this paper, we analyzed whether these miRNAs could exert antiviral activity against other variants of SARS-CoV-2. We downloaded compete SARS-CoV-2 genome data submitted to the National Center for Biotechnology Information for each SARS-CoV-2 variant, aligned the data to the reference SARS-CoV-2 genome sequence, and then confirmed the presence of 3′ untranslated region (UTR) mutations. We identified one type of 3′ UTR mutation in the Alpha variant, four in the Beta variant, four in the Gamma variant, three in the Delta variant, and none in the Omicron variant. Our findings indicate that 3′ UTR mutations rarely occur as persistent mutations. Interestingly, we further confirmed that this phenomenon could suppress virus replication in the same manner as the previously discovered interaction of placental-EV-derived miRNA with 3′ UTRs of SARS-CoV-2. Because the 3′ UTR of the SARS-CoV-2 RNA genome has almost no mutations, it is expected to be an effective therapeutic target regardless of future variants. Thus, a therapeutic strategy targeting the 3′ UTR of SARS-CoV-2 is likely to be extremely valuable, and such an approach is also expected to be applied to all RNA-based virus therapeutics.

Purpose We investigated whether consecutive levels of new emerging renal biomarkers, including serum cystatin C (CysC) and urinary neutrophil gelatinase-associated lipocalin (NGAL)/creatinine (Cr) ratio, were affected by postconceptional age in very-low-birth-weight (VLBW) infants. Methods Repeatedly measured samples for each infant were divided into four groups according to postnatal age: at birth (stage I), 3 to 7 days postnatally (stage II), 8 to 28 days postnatally (stage III), and >28 days postnatally (stage IV). The association between renal biomarkers and postconceptional age was assessed using Pearson’s correlation coefficient, and the mean values of renal biomarkers in the four stages were compared using repeated-measures analysis of variance. Results For samples measured at birth, serum CysC (r=–0.358, P=0.032) and urinary NGAL/Cr ratio (r=–0.522, P=0.001) were negatively correlated with gestational age, whereas serum Cr (r=0.148, P=0.390) was not. In addition, for all samples measured, serum CysC (r=–0.209, P=0.012), urinary NGAL/Cr ratio (r=–0.536, P28 days postnatally seems to be more affected by postconceptional age than serum CysC in VLBW infants.

Background Spinal epidural hematoma is rare condition that can rapidly develop into severe neurologic deficits. The pathophysiology of this development remains unclear. There are several case reports of emergency hematoma evacuations after epidural steroid injection. Case We report on two patients who developed acute, large amounts of epidural hematoma without neurological deficits after transforaminal epidural steroid injection. After fluoroscopy guided aspiration for epidural hematoma was performed, neurological defects did not progress and the hematoma was shown to be absorbed on magnetic resonance imaging. Conclusions These reports are believed to be the first of treating epidural hematoma occurring after transforaminal epidural steroid injection through non-surgical hematoma aspiration. If large amounts of epidural hematoma are not causing neurological issues, it can be aspirated until it is absorbed.

In the original publication [...]

This case report presents the non-surgical orthodontic camouflage treatment of an 18-year-old male patient with skeletal Class III asymmetry and severe anterior open bite. The anterior open bite was corrected by extrusion of the maxillary and mandibular anterior teeth and clockwise and counterclockwise rotation of the maxillary and mandibular occlusal plane, respectively, using intermaxillary Class III elastics between the maxillary posterior buccal miniscrews and mandibular canines and anterior vertical elastics between the maxillary and mandibular canines. Class III dental relationships and dental asymmetry were corrected via unilateral distalization of the mandibular dentition on the left side using a closed coil spring between the buccal shelf screw and hook. The patient’s smile esthetics and dental relationship were improved with a more favorable facial profile, and facial asymmetry was slightly alleviated after orthodontic camouflage treatment. The total treatment time was 15 months. A modified wraparound retainer with a scalloped labial bow, tongue crib, and tooth positioner was used simultaneously to prevent the potential relapse.

The objective of this study was to assess the proximity of the mandibular molar roots and the lingual cortical bone in patients with various vertical facial patterns and determine factors related to root-cortical bone contact. A total of 145 patients (84 males, 61 females, mean age: 22.0 ± 1.76 years) were assigned to hypodivergent (36 patients), normovergent (80 patients) and hyperdivergent (29 patients) groups based on their facial height ratio. Cone-beam computed tomography (CBCT) images were used to measure the distance between the mandibular molar roots and the lingual cortical bone, and any instances of root-cortical bone contact were identified. The study investigated the correlation between the contact of the mandibular molar roots with the lingual cortical bone and several variables, including sex and cephalometric measurements. The distance between the mandibular molar roots and the lingual cortical bone was significantly shorter in the hyperdivergent group than in the hypodivergent group (p < 0.05). Of the total root-cortical bone contact, 87.6% was observed in the mandibular second molars, and the distal roots of the mandibular second molars had the highest contact rate at 43.1% in the hyperdivergent group (p < 0.05). Among the evaluated variables, only the distance between the distal root apex of the mandibular second molar and the mandibular plane was found to be associated with contact of the mandibular molar roots with the lingual cortical bone. An increase of 1 mm in this distance was associated with a 22% decrease in the likelihood of contact between the mandibular second molar roots and lingual cortical bone (p < 0.001). Given the proximity and high contact ratio between the mandibular molar roots and lingual cortical bone, it is recommended that these structures be evaluated using CBCT before planning molar distalization or intrusion in hyperdivergent patients.

Abstract We aimed to evaluate the efficacy of using airway ultrasonography to select the correct tracheal tube size and insertion depth in pediatric patients who underwent cleft repair surgery as a way to decrease airway complications and adverse events during perioperative periods. Fifty-one patients (age

Conventional human-centric image compression techniques are optimized for human visual perception, and are generally evaluated by metrics such as MSSSIM and PSNR. On the other hand, task-centric image compression techniques that target deep neural networks (DNN) inference focus on understanding images, and are measured by inference accuracy. As images should be encoded and decoded differently depending on the target metric, existing deep learning based compression techniques have focused on designing an independent neural network that is optimized for either one of the two targets. However, as these techniques require the target metric to be determined during a training phase, separate DNN models should be trained for different target applications, allowing no scalability between human- and task-centric compression. In this paper, we propose a target-dependent scalable image compression pipeline, where compressed images can be differently decoded in real time depending on the interpolated target between perceptual quality and DNN inference accuracy. This dynamic scalability is supported by a reconfigurable recurrent neural network (RNN) that can dynamically change its flow according to the interpolation parameter. The experimental results show that the proposed method achieves comparable MSSSIM and classification accuracy to the compression networks individually trained for human-centric and task-centric targets, respectively, while providing scalability between the two targets depending on the interpolation parameter.

Abstract Background The purpose of this study is to investigate the heritability of total rotation, matrix rotation, and intramatrix rotation of the mandible in Korean monozygotic (MZ) twins, dizygotic (DZ) twins, and their siblings. Materials and methods The samples consisted of 75 pairs of Korean twins (39.7 + 9.26 years; MZ group, 36 pairs; DZ group, 13 pairs; sibling group, 26 pairs). Lateral cephalograms were taken, and 13 variables related to internal and external mandible rotation were measured. Three types of occlusal planes (bisected occlusal plane, functional occlusal plane, and the MM bisector occlusal plane) were used to evaluate genetic influence on the occlusal plane. Heritability (h 2) was calculated by using the intraclass correlation coefficient (ICC) and Falconer’s method. Results With regard to mandibular rotation, the MZ twin group showed significantly higher ICC values compared to the DZ twin and sibling groups. The ICC mean values for 13 cephalometric measurements were 0.85 (MZ), 0.62 (DZ), and 0.52 (siblings) respectively. The heritability of the total rotation (0.48) and matrix rotation (0.5) between the MZ and DZ groups was higher than that of the intramatrix rotation (− 0.14). All of the three types of occlusal plane showed high heritability, and among the three types, the functional occlusal plane showed the highest heritability (h 2 = 0.76). Conclusion Based on these findings that showed a strong genetic effect on total rotation and matrix rotation, maintaining these rotations should be carefully considered in the orthodontic treatment plan, while the lower border of the mandible may be responsive to various treatments. Occlusal plane change, especially with regard to the functional occlusal plane, may not be stable due to strong genetic influences.

Brain-derived extracellular vesicles (BDEVs) are released from the central nervous system. Brain-related research and diagnostic techniques involving BDEVs have rapidly emerged as a means of diagnosing brain disorders because they are minimally invasive and enable repeatable measurements based on body fluids. However, EVs from various cells and organs are mixed in the blood, acting as potential obstacles for brain diagnostic systems using BDEVs. Therefore, it is important to screen appropriate brain EV markers to isolate BDEVs in blood. Here, we established a strategy for screening potential BDEV biomarkers. To collect various molecular data from the BDEVs, we propose that the sensitivity and specificity of the diagnostic system could be enhanced using machine learning and AI analysis. This BDEV-based diagnostic strategy could be used to diagnose various brain diseases and will help prevent disease through early diagnosis and early treatment.

The orthodontic treatment of patients having temporomandibular disorders are some of the most complicated cases to treat. The positions of the mandibular condyles are often unstable, which means clinicians find it difficult to have definite criteria for making an accurate and reliable orthodontic diagnosis. This article reports the orthodontic treatment of a patient showing skeletal Class II and temporomandibular disorders with condylar resorption. To stabilize her condylar position and to relieve her symptoms in the temporomandibular joint, a stabilization splint was used before orthodontic tooth movement. After the splint therapy, the patient exhibited significantly increased open bite and a more severe Class II occlusal relationship as her mandibular condyles were seated anteriorly and superiorly in the articular fossae. The occlusion and facial esthetics of the patient were improved by orthodontic camouflage treatment with the proper use of temporary skeletal anchorage devices and treatment mechanics.

Protrusion can occur after correction of the anterior crossbite in Class III malocclusions. Four-premolar extractions might be indicated if the patients asked for a profile reduction. Two similar Class III anterior crossbite cases illustrate how the skeletal anchorage can prevent protrusion after anterior crossbite correction and the need for four- premolar extractions, as in the first case. The use of extra-radicular miniscrews at the infrazygomatic crest and buccal shelf are recommended for whole arch distalization of the maxillary and mandibular arches to reduce protrusion after anterior crossbite correction. It is an effective and efficient treatment alternative to extraction therapy for the protrusion after anterior crossbite correction. Long-term follow-up records show encouraging results supporting this paradigm shift in anterior crossbite correction with extra-radicular miniscrews.

The objective of this study was to identify the change in incisive canal (IC) morphology and tooth–canal relationship after mini-implant-assisted rapid palatal expansion (MARPE). Pretreatment and posttreatment cone-beam computed tomography images of 30 subjects were retrospectively evaluated. The dimensional and volume changes of the IC after MARPE treatment were evaluated, and the tooth–canal relationship and positional relationship between the maxillary central incisors were additionally compared in the group where the root apex of the maxillary central incisors was higher than the IC oral opening. The mediolateral and labiopalatal widths of the IC were significantly increased in all three levels after MARPE treatment (p < 0.01). The amount of increase was greater in the mediolateral direction than in the labiopalatal direction. The anteroposterior distance from the mesial point of the maxillary central incisors to the anterior margin of the IC was significantly decreased only in the oral opening level in the samples where the apices of the maxillary central incisors were located more superior to the oral opening of the IC (p < 0.05). The mediolateral distance between the mesial points of the maxillary central incisors and the distance between the root apex of the maxillary central incisors significantly increased after MARPE (p < 0.001). However, the distance between the crown tips of the maxillary central incisors did not significantly increase, even after MARPE treatment (p > 0.05). The volume of the IC significantly increased after MARPE treatment (p < 0.001), and the average increase in the total volume of the IC was about 65%. MARPE increased the width and volume of the IC and did not result in a clinically significant change in the root–canal relationship.

Background: The aim of this study was to evaluate three-dimensional (3D) changes in nasal septal deviation (NSD) and related nasofacial structures after maxillary skeletal expansion (MSE). Methods: This retrospective study evaluated 28 patients aged 12.0–48.4 years (mean age, 20.4 ± 7.3 years; 12 males, 16 females) diagnosed with transverse maxillary deficiency and treated with MSE. Cone-beam computed tomography (CBCT) images were taken at pre-expansion (T1), post-expansion (T2), and 6-months after MSE (T3) and were reoriented. Three-dimensional coordinates (x,y,z) were constructed using nasion (N) as the reference point (0,0,0). A paired-sample t-test and an independent sample t-test were performed to investigate and compare the 3D changes of the NSD and nasofacial structures after MSE, depending on the direction and amount of NSD and the amount of midpalatal expansion (MPE). Results: NSD was alleviated at T3–T1 in the coronal plane; nasal septal length increased significantly. The absolute nasal floor (NF) angle (2.06° at T1) decreased at T2–T1 (p > 0.05) and increased at T3–T2 (p < 0.05). The midface moved forward and downward, and pogonion (Pog) and menton (Me) moved downward and backward. There were no significant differences between the higher and lower NSD groups and greater and lesser MPE groups. Conclusions: Consequently, NSD was alleviated with variable positive nasofacial changes after MSE in both the short and long term. Therefore, MSE can be used to improve or camouflage facial deformities.

The aim of this study was to determine the factors that affect esthetic preference regarding the perceived facial attractiveness of young Korean female adults with a normal skeletal pattern using cone-beam computed tomography (CBCT). After reorienting the CBCT images of 40 young Korean female adults, three-dimensional (3D) measurements were analyzed, and five 3D facial images were digitally constructed. A computer-based questionnaire was used to determine perceived facial attractiveness by scoring from 1 (very unattractive) to 10 (very attractive). Esthetic perception and the most influential facial view and component were examined and compared by orthodontists, general dentists, and laypeople to evaluate facial attractiveness. Compared to the unattractive group, the attractive group had significantly greater values for Pog-NB, L1SI-FH, U lip thickness, L lip-U lip, and Nasolabial angle, along with significantly lower values for U1SI-FH and Cant of U lip; the attractive group also had a more retruded U1MP (p < 0.01), L1MP (p < 0.01), U lip (p < 0.05), and L lip (p < 0.01) relative to N, as well as a more retruded U lip (p < 0.05) and L lip (p

Purpose Comparison between lung ultrasound (LUS) score and indices of respiratory severity in very preterm infants born at 28 to 31 weeks’ gestation. Methods We retrospectively reviewed medical records of 32 very preterm infants born at 28 to 31 weeks’ gestation at Keimyung University Dongsan Medical Center. Before surfactant administration, bedside LUS in the neonatal intensive care unit was recorded within the first hour of life. Partial pressure of capillary oxygen to fraction of inspired oxygen ratio (PcO2)/FiO2, alveolar-arterial gradient (A-aO2), modified oxygenation index (OI), and arterial to alveolar ratio were calculated. Correlation between LUS score and indices of respiratory severity were analyzed between the intubation and nasal continuous positive airway pressure (NCPAP) groups depending on the presence or absence of endotracheal intubation. Results Mean LUS scores, A-aO2, and modified OI in the intubation group were significantly higher than those in the NCPAP group. Conversely, PcO2/FiO2 and arterial to alveolar ratios in the intubation group were significantly lower than those in the NCPAP group. LUS score was found to be significantly correlated with A-aO2 (r=0.448, P 0.05) and arterial to alveolar ratio (r=–0.190, P>0.05). Conclusion The LUS score is well correlated with indices of respiratory severity in very preterm infants born at 28 to 31 weeks’ gestation. Further investigation is needed to use LUS as an alternative tool in infants with respiratory distress.

The size of an ion affects everything from the structure of water to life itself. Here, a sub-nanometer diameter pore sputtered through a thin silicon nitride membrane is used to systematically test ion permeability by measuring the electrolytic current and current noise and show that the ions move with a grossly distorted hydration shell in a correlated way.

Background Postoperative pain is one of the most common concerns of patients undergoing hair transplantation surgery. Because most patients are satisfied with the cosmetic improvement after transplantation, amelioration of postoperative pain would help to increase patient accessibility to hair restorative surgery and greatly impact patient satisfaction with the final cosmetic results. This study was performed to investigate postoperative pain after hair transplantation. Methods In total, 241 patients (202 who underwent follicular unit transplantation [FUT] and 39 who underwent follicular unit extraction [FUE]) were eligible for the study. Postoperative pain was evaluated on postoperative days 1, 2, 3, 4, 5, and 7 using the Wong-Baker Faces Pain Scale. The patients’ medical records were retrospectively reviewed for information on the harvesting method, number of transplanted grafts, size of donor design, and laxity, elasticity, and glidability of the scalp in relation to postoperative pain. Results Postoperative pain after hair transplantation, assessed with the Wong-Baker Faces Pain Scale, seemed to provide very subjective results. None of the variables were correlated with postoperative pain in the FUT group. Such pain, however, tended to disappear by postoperative day 3. Patients in the FUE group experienced significantly less severe pain than those in the FUT group. Conclusions Postoperative pain was significantly less severe in patients whose donor hair was harvested by the FUE than FUT method. Postoperative pain had almost disappeared by postoperative day 3 in the FUT group, whereas only minimal pain was present even on postoperative day 1 in the FUE group.

Background Successful aesthetic plastic surgery is devoid of both unsightly scarring and postoperative disfigurement. Patients undergoing midface-lifting surgery are very often disconcerted by an altered side hairline, including sideburns, despite considerable amelioration of facial wrinkles. This study was conducted to identify an effective means of approaching an altered hairline and the unavoidable scarring arising from midface-lifting surgery.

Purpose In this study, we investigated the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients. Methods A retrospective analysis was conducted on medical records from January 2010 to June 2017 (7.5 years) of a university hospital NICU. Results There were 45 cases of EOS (1.2%) in 3,862 infants. The most common pathogen responsible for EOS was group B Streptococcus (GBS), implicated in 10 cases (22.2%), followed by Escherichia coli, implicated in 9 cases (20%). The frequency of gram-positive sepsis was higher in term than in preterm infants, whereas the rate of gram-negative infection was higher in preterm than in term infants (P

Background:. Long hair follicular unit excision (LHF) allows surgeons to fully visualize hair curliness, which is crucial in eyebrow transplantation where matching curliness is a matter of utmost importance. In this study, we aimed to evaluate the clinical importance of LHF in eyebrow transplantation. Methods:. A total of 36 patients who had undergone eyebrow transplantation surgery with LHF were enrolled. Twelve of the 36 patients had previously undergone unsatisfactory surgery at another clinic. Of these, 2 patients underwent complete laser eyebrow removal, and 3 patients underwent selective electro-cautery with unmatched hair curliness before surgery. The remaining 7 patients underwent surgery to increase eyebrow hair density or to reshape their eyebrows. A satisfaction survey was administered to patients > 6 months after the procedure. Results:. All patients showed natural eyebrow transplant results at their follow-up visits and were satisfied with the results. Patient and surgeon satisfaction scores were 4.7 and 4.3, respectively. Four patients underwent a touch-up procedure to increase hair density with 21, 43, 12, and 45 follicular units, respectively, and were satisfied with the results. There were no cases of asymmetry or adverse events, such as folliculitis. Conclusions:. The authors derived satisfactory results from the patients who underwent eyebrow transplantation by the LHF method. Therefore, we conclude that LHF is a suitable surgical method for eyebrow hair transplantation.

PurposeTo evaluate changes in choroidal vascular structure and aqueous cytokine levels in eyes with vitreoretinal lymphoma (VRL) after intravitreal methotrexate (MTX) treatment.MethodsIn this retrospective study, VRL patients who visited our hospital between October 2018 and July 2020 were reviewed. Aqueous samples were obtained before treatment and at clinical resolution after intravitreal MTX therapy. Interleukin (IL)-6 and IL-10 levels and the IL-10-to-IL-6 ratio were evaluated. Swept-source optical coherence tomographic images were obtained along with the aqueous samples. Subfoveal choroidal thickness (SFCT), total vascular area of the choroid (TCA), stromal area (SA), luminal area (LA), and choroidal vascularity index (CVI) were assessed.ResultsTwelve patients were enrolled (female:male-5:7). The mean age (± standard deviation) at diagnosis was 60.9±8.5 years. In the 16 eyes diagnosed with VRL, values of SFCT, TCA, LA, and SA significantly decreased after treatment (all p-values ConclusionEyes with active VRL exhibited choroidal thickening with increased vascular and stromal areas that decreased after remission following MTX treatment. Higher aqueous IL-10 and IL-6 levels and lower visual acuity in the active phase may indicate the number of injections required for remission; this should be considered in the treatment of patients with VRL.

Introduction: This study aimed to evaluate mandibular molar changes after distalization using Class III elastics and modified C-palatal plates (MCPPs) in the maxilla and to use CBCT to specifically analyze the third-molar position after long-term retention in adolescents. Methods: The sample consisted of 65 mandibular third molars from 35 subjects, divided into two groups. Twenty-six of the third molars were from fourteen adolescent patients with Class I bimaxillary protrusion (mean age, 12.8 years) who had undergone bilateral maxillary distalization using an MCPP and mandibular distalization with Class III elastics with non-extraction treatment. For the control group, 39 third molars from 21 Class I normal-occlusion subjects were used. In the treated group, CBCT images were taken before distalization (T1), after molar distalization (T2), and at a long-term observation point (6.1 ± 2.7 years) (T3). Repeated measures ANOVA and a post hoc test with Bonferroni correction were used to analyze significant differences in the positions at the three points in time. Results: There were 2.3 and 1.7 mm of distal movement at the crown of the mandibular first and second molars, with distal tipping of 5.2° and 5.3°, respectively, and 3.0° of distal tipping of the third molars. Comparing the treated group with the control group at T3, there was a significant change in the angulation of the third molars (p < 0.001). In the long-term, the third molars from the treated group showed a downward and buccal position after distalization. Conclusions: In the long term, the developing mandibular third molar buds had downward and buccal positional changes after total arch distalization. These findings suggest the need for clinicians to consider the possibility of the impaction of developing third molars after mandibular total arch distalization in adolescents.

The purpose of this study is to evaluate the effect of the bioconversion products of Oenanthe javanica extract fermented by Lactiplantibacillus plantarum (OEFL) on relieving hangovers and improving liver function. In addition, the bioactive substance of the OEFL, which alleviates hangover and ethanol-induced liver damage, was identified and its bioactive property was verified through in vivo experiments. In major substances analysis using high-performance liquid chromatography, OEFL produced 9.5-fold higher p-coumaric acid than the O. Javanica extract (OE). In addition, considering that quinic acid, which is not present in the OE, was produced in the OEFL it was confirmed that chlorogenic acid was decomposed into quinic acid by bioconversion. In the in vivo experiment using Sprague-Dawley rats, the OEFL and p-coumaric acid diets reduced blood ethanol, acetaldehyde, GPT, and ALP concentrations, increasing blood albumin concentrations compared to ethanol-administered groups, demonstrating that OEFL and p-coumaric acid, the main substance in the OEFL, improved ethanol-induced liver damage. Furthermore, the OEFL and its main bioactive substance, p-coumaric acid, alleviated liver fibrosis by downregulating TGF-β, SMAD-2, SMAD-4, α-SMA, and upregulating MMP-1. Therefore, OEFL is expected to be used as a functional food or pharmaceutical material as it has been confirmed to effectively relieve hangovers, prevent liver damage, and delay liver fibrosis in ethanol-induced liver damages.

PurposeThe aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and β-2 microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged

The seated and prone positions are the most common surgical positions used during follicular unit extraction (FUE). Compared to the latter, the former eases centering and enables more optimal surgical field exposure due to gravitational effects on intraoperative bleeding. Furthermore, the surgeon can simultaneously work with multiple assistants, increasing efficiency and reducing operative time. During the harvesting stage of FUE, the patient is often seated in an electric height-adjustable salon chair. Such equipment, however, does not provide support for the head; maintaining a fixed upright position for an extremely long-lasting and delicate surgery that requires loupes with ×5 or higher magnification is challenging for both the surgeon and the patient. On the other hand, a support system that firmly fixes the patient’s forehead would have ergonomic benefits during the process of FUE donor harvesting in a seated position. Firm support of the forehead would also enable upward traction to provide tension on the scalp, lessen the gap between the hair exit angle and internal hair angle, and reduce graft torsion, ultimately minimizing follicular injury and optimizing graft quality.

The purpose of this study was to evaluate midpalatal bone density (BD) by using cone-beam computed tomography (CBCT) according to gender, age, and vertical and horizontal skeletal patterns. CBCT images from 126 subjects (64 females and 62 males) were reoriented and analyzed in order to attain BD values at the midpalatal suture. Four age groups were used for classification (adolescence, 10 ≤ early < 14 years, 14 ≤ middle ≤ 17 years, and 17 < late ≤ 21 years; adult > 21 years). Vertical skeletal pattern categories were differentiated by the Frankfort horizontal line to mandibular plane angle (hypodivergent < 22°, 22° ≤ normovergent ≤ 28°, and 28° < hyperdivergent). Horizontal skeletal pattern differentiation was defined by ANB angle (Class III < 0°, 0° ≤ Class I ≤ 4°, and 4° < Class II). Females showed significantly higher BD than males (p < 0.001). As age increased, BD increased significantly (p < 0.001). There were no significant differences between vertical skeletal patterns. Class II showed significantly less BD than Class III (p < 0.05). With this information, clinicians can better understand BD trends of the midpalatal suture and, thus, better understand our patient’s anatomy and potential hurdles in successful treatment.

Extracellular vesicles (EVs) are cell-released, nanometer-scaled, membrane-bound materials and contain diverse contents including proteins, small peptides, and nucleic acids. Once released, EVs can alter the microenvironment and regulate a myriad of cellular physiology components, including cell–cell communication, proliferation, differentiation, and immune responses against viral infection. Among the cargoes in the vesicles, small non-coding micro-RNAs (miRNAs) have received attention in that they can regulate the expression of a variety of human genes as well as external viral genes via binding to the complementary mRNAs. In this study, we tested the potential of EVs as therapeutic agents for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. First, we found that the mesenchymal stem-cell-derived EVs (MSC-EVs) enabled the rescue of the cytopathic effect of SARS-CoV-2 virus and the suppression of proinflammatory responses in the infected cells by inhibiting the viral replication. We found that these anti-viral responses were mediated by 17 miRNAs matching the rarely mutated, conserved 3′-untranslated regions (UTR) of the viral genome. The top five miRNAs highly expressed in the MSC-EVs, miR-92a-3p, miR-26a-5p, miR-23a-3p, miR-103a-3p, and miR-181a-5p, were tested. They were bound to the complemented sequence which led to the recovery of the cytopathic effects. These findings suggest that the MSC-EVs are a potential candidate for multiple variants of anti-SARS-CoV-2.

Objective This experiment was to determine proper physical traits in the diet for goats by investigating the effects of physically effective neutral detergent fiber (peNDF) content on dry matter intake (DMI), digestibility, and chewing activity in black goats fed with total mixed ration (TMR). Methods Six growing wethers of Korean native black goats (Capra hircus coreanae) aged 8 months and weighing between 26.9 kg and 27.1 kg (27.03±5.05 kg) were used in this experiment. Three diets of varying peNDF content were obtained by original TMR (T1), 12,000 rpm grinding (T2), and 15,500 rpm grinding (T3) of the same TMR diet. The peNDF1.18 content of the experimental diets was 23.85%, 21.71%, and 16.22% for T1, T2, and T3, respectively. Results Average daily gain (ADG) was higher in T2 group compared to those of the control and T3 groups, but ADG and DMI were not affected by the dietary particle size and peNDF content. Also, there was no difference between apparent nutrient digestibility of dry matter, crude fiber, ether extract, neutral detergent fiber, and acid detergent fiber. Although there was no significant difference, rumination and total chewing time were associated with decreased peNDF content. Conclusion The feeding of peNDF-based TMR showed no impact on apparent nutrient digestibility and nitrogen balance. Further studies are required with a wider range of dietary peNDF level and particle size to better identify the effect of dietary peNDF and particle size on chewing activity and performance in goats.

Background Little is known concerning hair diameter variation within the safe donor area for hair transplantation surgery. Thicker or thinner hair may be needed, depending on the recipient area, hairline design, and the purpose of surgery. Methods Twenty-seven patients (7 men and 20 women; mean age, 28 years; range, 20–47 years) were included in this study. The midoccipital point was used as the reference point on the horizontal plane at the upper border of the helical rim. The target area width was 15 cm (7.5 cm to the right and left of the reference point) and the height was 8 cm (2 cm above and 6 cm below the reference point). The study area was divided horizontally into 3 5-cm sections (A, B, C) and vertically into 4 2-cm sections (1–4), creating a total of 12 zones. Ten anagen hairs were randomly obtained from each zone and their diameters were measured. Results Hair diameter in the 4 vertical sections varied significantly, gradually decreasing from sections 1 (superior) to 4 (inferior) in all 3 horizontal sections (A, B, and C). Conclusions Our results suggest that sections 1 and 2 of the occipital safe donor area would be useful for obtaining thicker hair, such as in procedures to treat male- and female-pattern hair loss, whereas hair from zones 3 and 4 could be useful for transplantation surgery requiring thinner hair, such as eyebrows, eyelashes, and female hairline correction. Our results may be clinically valuable for planning hair transplant surgery and choosing the optimal donor region.

PurposeHypoxic-ischemic encephalopathy is a significant cause of neonatal morbidity and mortality. Erythropoietin (EPO) is emerging as a therapeutic candidate for neuroprotection. Therefore, this study was designed to determine the neuroprotective role of recombinant human EPO (rHuEPO) and the possible mechanisms by which mitogen-activated protein kinase (MAPK) signaling pathway including extracellular signal-regulated kinase (ERK1/2), JNK, and p38 MAPK is modulated in cultured cortical neuronal cells and astrocytes.MethodsPrimary neuronal cells and astrocytes were prepared from cortices of ICR mouse embryos and divided into the normoxic, hypoxia (H), and hypoxia-pretreated with EPO (H+EPO) groups. The phosphorylation of MAPK pathway was quantified using western blot, and the apoptosis was assessed by caspase-3 measurement and terminal deoxynucleotidyl transferase dUTP nick end labeling assay.ResultsAll MAPK pathway signals were activated by hypoxia in the neuronal cells and astrocytes (P

Abstract We report a three dimensional (3D) quantitative visualization of a mammalian mitochondrion by coherent x-ray diffractive imaging (CXDI) using synchrotron radiation. The internal structures of a mitochondrion from a mouse embryonic fibroblast cell line (NIH3T3) were visualized by tomographic imaging at approximately 60 nm resolution without the need for sectioning or staining. The overall structure consisted of a high electron density region, composed of the outer and inner membranes and the cristae cluster, which enclosed the lower density mitochondrial matrix. The average mass density of the mitochondrion was about 1.36 g/cm3. Sectioned images of the cristae reveal that they have neither a baffle nor septa shape but were instead irregular. In addition, a high resolution, about 14 nm, 2D projection image was captured of a similar mitochondrion with the aid of strongly scattering Au reference objects. Obtaining 3D images at this improved resolution will allow CXDI to be an effective and nondestructive method for investigating the innate structure of mitochondria and other important life supporting organelles.

Background Thin hairs are critical to achieve natural result in female hairline correction surgery. However, there are few studies on the usefulness of hair thinning by intense pulsed light (IPL) after hairline correction surgery in East Asian females. Methods Hair thinning using IPL was performed in 54 women who had complained about thick hairs along the frontal hairline after hairline correction surgery. Patient mean age was 31.2 years old and patients were an average of 2.1 years post-hairline correction surgery. Initial treatment used 10 J, while second and third sessions were conducted with 10 to 15 J according to responsiveness to treatment. Results Mean thickness of individual hairs assessed before the procedure was 78.86 µm. The mean number of procedures was 1.6 per patient. Forty of 54 subjects (74%) achieved satisfactory hair thinning with only one procedure from 78.01 to 66.14 µm after treatment. The measured thickness was 66.43 µm at the end of the first year in patients who were satisfied after one procedure. Thirteen cases achieved satisfactory hair thinning after two sessions. Mean thickness was 74.44 µm and 67.51 µm, before and after the second session. One case required a third session with 15J, thinning from 89.00 to 66.50 µm. Conclusions Hair thinning by IPL is a very useful method to provide a natural look after hairline correction surgery in East Asians, who have naturally thick hair.