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Abstract Objective The objective of this study was to measure the forces and moments exerted by direct printed aligners (DPAs) with varying facial and lingual aligner surface thicknesses, in all three planes of space, during lingual movement of a maxillary central incisor. Materials and methods An in vitro experimental setup was used to quantify forces and moments experienced by a programmed tooth to be moved and by adjacent anchor teeth, during lingual movement of a maxillary central incisor. DPAs were directly 3D-printed with Tera Harz TC-85 (Graphy Inc., Seoul, South Korea) clear photocurable resin in 100-µm layers. Three multi-axis sensors were used to measure the moments and forces generated by 0.50 mm thick DPAs modified with labial and lingual surface thicknesses of 1.00 mm in selective locations. The sensors were connected to three maxillary incisors (the upper left central, the upper right central, and the upper left lateral incisors) during 0.50 mm of programmed lingual bodily movement of the upper left central incisor. Moment-to-force ratios were calculated for all three incisors. Aligners were benchtop tested in a temperature-controlled chamber at intra-oral temperature to simulate intra-oral conditions. Results The results showed that increased facial thickness of DPAs slightly reduced force levels on the upper left central incisor compared to DPAs of uniform thickness of 0.50 mm. Additionally, increasing the lingual thickness of adjacent teeth reduced force and moment side effects on the adjacent teeth. DPAs can produce moment-to-force ratios indicative of controlled tipping. Conclusions Targeted increases in thickness of direct 3D-printed aligners change the magnitude of forces and moments generated, albeit in complex patterns that are difficult to predict. The ability to vary labiolingual thicknesses of DPAs is promising to optimize the prescribed orthodontic movements while minimizing unwanted tooth movements, thereby increasing the predictability of tooth movements.

Abstract Trichotillomania refers to repetitive pulling of hair from the body and may be accompanied by trichophagia, the ingesting of extracted hair. It is frequently comorbid with other psychiatric disorders and resulting hair loss can seriously affect quality of life. Trichophagia can lead to trichobezoars, indigestible aggregations of hair in the gastrointestinal tract that can cause pain and bowel obstruction. Descriptions of trichotillomania and trichophagia have generally assumed European hair texture and styling conventions with little attention to Black hair. Here we report the case of a 23-year-old African-American female patient that presented with a small bowel obstruction from ingestion of hair extracted from a hair weave, a popular styling practice and form of hair extension frequently used with women of African descent and various ethnic groups.

The rapid rise of artificial intelligence (AI) in medicine in the last few years highlights the importance of developing bigger and better systems for data and model sharing. However, the presence of Protected Health Information (PHI) in medical data poses a challenge when it comes to sharing. One potential solution to mitigate the risk of PHI breaches is to exclusively share pre-trained models developed using private datasets. Despite the availability of these pre-trained networks, there remains a need for an adaptable environment to test and fine-tune specific models tailored for clinical tasks. This environment should be open for peer testing, feedback, and continuous model refinement, allowing dynamic model updates that are especially important in the medical field, where diseases and scanning techniques evolve rapidly. In this context, the Discovery Viewer (DV) platform was developed in-house at the Biomedical Engineering and Imaging Institute at Mount Sinai (BMEII) to facilitate the creation and distribution of cutting-edge medical AI models that remain accessible after their development. The all-in-one platform offers a unique environment for non-AI experts to learn, develop, and share their own deep learning (DL) concepts. This paper presents various use cases of the platform, with its primary goal being to demonstrate how DV holds the potential to empower individuals without expertise in AI to create high-performing DL models. We tasked three non-AI experts to develop different musculoskeletal AI projects that encompassed segmentation, regression, and classification tasks. In each project, 80% of the samples were provided with a subset of these samples annotated to aid the volunteers in understanding the expected annotation task. Subsequently, they were responsible for annotating the remaining samples and training their models through the platform’s “Training Module”. The resulting models were then tested on the separate 20% hold-off dataset to assess their performance. The classification model achieved an accuracy of 0.94, a sensitivity of 0.92, and a specificity of 1. The regression model yielded a mean absolute error of 14.27 pixels. And the segmentation model attained a Dice Score of 0.93, with a sensitivity of 0.9 and a specificity of 0.99. This initiative seeks to broaden the community of medical AI model developers and democratize the access of this technology to all stakeholders. The ultimate goal is to facilitate the transition of medical AI models from research to clinical settings.

Abstract Background The objective of this work to calculate prescribed quantity of an active pharmaceutical ingredient (API) in prescription medications for human use, to facilitate research on the prediction of amount of API released to the environment and create an open-data tool to facilitate spatiotemporal and long-term prescription trends for wider usage. Design We have developed an R package, PrAna to calculate the prescribed quantity (in kg) of an APIs by postcode using England’s national level prescription data provided by National Health Service, for the years 2015–2018. Datasets generated using PrAna can be visualized in a real-time interactive web-based tool, PrAnaViz to explore spatiotemporal and long-term trends. The visualisations can be customised by selecting month, year, API, and region. Results PrAnaViz’s targeted API approach is demonstrated with the visualisation of prescribed quantities of 14 APIs in the Bath and North East Somerset (BANES) region during 2018. Once the APIs list is loaded, the back end retrieves relevant data and populates the graphs based on user-defined data features in real-time. These plots include the prescribed quantity of APIs over a year, by month, and individual API by month, general practice, postcode, and medicinal form. The non-targeted API approach is demonstrated with the visualisation of clarithromycin prescribed quantities at different postcodes in the BANES region. Conclusion PrAna and PrAnaViz enables the analysis of spatio-temporal and long-term trends with prescribed quantities of different APIs by postcode. This can be used as a support tool for policymakers, academics and researchers in public healthcare, and environmental scientist to monitor different group of pharmaceuticals emitted to the environment and for prospective risk assessment of pharmaceuticals in the environment.

Background and Aim. RNA extraction is a commonly used technique in molecular biology. In recent years, commercially available RNA extraction kits have largely replaced conventional approaches. However, these commercial kits are expensive and are not readily available in many resource-constrained institutions and laboratories. This study therefore compared the performance of the conventional acid guanidinium thiocyanate-phenol-chloroform (AGPC) extraction method to QIAamp® Viral RNA Mini Kit (QIAGEN, Cat. No. 52906) and OxGEn RNA Kit (OxGEn Molecular Solutions, GE-009) to build an in-house RNA extraction technique from blood and oral swab samples. Method. In a comparative experimental cross-sectional study, RNA was extracted from oral swabs and blood samples from 25 healthy individuals at the Department of Molecular Medicine, KNUST. RNA was extracted by the manual AGPC extraction method and commercial RNA extraction kits. The quantity (ng/μl) and purities (260/280 nm) of the extracted RNA were measured spectrophotometrically using the IMPLEN NanoPhotometer® N60. The presence of RNA in the extracts was confirmed using 2% agarose gel electrophoresis. Statistical analyses were conducted using R language. Results. The yield of RNA extracted from blood and oral swab samples using modified AGPC was significantly higher compared to the commercial methods (p

Background: Patient-centered outcomes research seeks to answer patient-centered questions. The process includes varied locations and individuals throughout the care continuum to address individual differences and constraints in implementation and dissemination. Problem: This paper intends to answer this question: do academic nurses practice what they preach by assisting patient-centered outcomes research and researchers through their engagement with patients, caregivers, and other community stakeholder partners in nursing research? Approach: This paper provides an overview of how academic nurses in a single institution (the University of Texas Medical Branch at Galveston School of Nursing) began to embrace patient-centered outcomes research. Conclusion: Whether academic nurses are practicing what they preach in terms of patient-centered outcomes research remains uncertain. More examples from academia are required to make that determination. Academic nurses worldwide have embarked on a steep learning curve to embrace patient-centered outcomes research. This journey will require patience and a systematic strategy.

Abstract There is a global unmet need for rapid and cost-effective prognostic and diagnostic tools that can be used at the bedside or in the doctor’s office to reduce the impact of serious disease. Many cancers are diagnosed late, leading to costly treatment and reduced life expectancy. With prostate cancer, the absence of a reliable test has inhibited the adoption of screening programs. We report a microelectronic point-of-care metabolite biomarker measurement platform and use it for prostate cancer detection. The platform, using an array of photodetectors configured to operate with targeted, multiplexed, colorimetric assays confined in monolithically integrated passive microfluidic channels, completes a combined assay of 4 metabolites in a drop of human plasma in under 2 min. A preliminary clinical study using l-amino acids, glutamate, choline, and sarcosine was used to train a cross-validated random forest algorithm. The system demonstrated sensitivity to prostate cancer of 94% with a specificity of 70% and an area under the curve of 0.78. The technology can implement many similar assay panels and hence has the potential to revolutionize low-cost, rapid, point-of-care testing.

Teacher burnout affects job performance and mental and physical health. This study evaluated the effects of a meditation-based wellness program on burnout, resilience, psychological distress, and fatigue. Seventy-eight participants, randomly assigned to the Transcendental Meditation program (n = 39) or to a wait-list control group (n = 39), were administered the Maslach Burnout Inventory, Resilience Scale, Perceived Stress Scale, and the National Institutes of Health Patient-Reported Outcomes Measurement Information System fatigue and depression scales at baseline and at four-month posttest. Intention-to-treat with all 78 participants was used for all analyses. Significant reduction on emotional exhaustion, the main scale of the Maslach Burnout Inventory, was found for the meditation group compared to controls (p = 0.019). Significant improvements were also found on resilience (p = 0.014), perceived stress (p < 0.001), fatigue (p = 0.001), and depression (p = 0.091). Eighty-seven percent were compliant with their meditation home practice. Findings indicate that meditation is effective in improving burnout and associated resilience, psychological distress, and fatigue factors. Teachers may benefit from in-school wellness programs.

Great strides have been made to encourage researchers to archive data created by research and provide the necessary systems to support their storage. Additionally it is recognised that data are meaningless unless their provenance is preserved, through appropriate meta-data. Alongside this is a pressing need to ensure the quality and archiving of the software that generates data, through simulation, control of experiment or data-collection and that which analyses, modifies and draws value from raw data. In order to meet the aims of reproducibility we argue that data management alone is insufficient: it must be accompanied by good software practices, the training to facilitate it and the support of stakeholders, including appropriate recognition for software as a research output.

Epibiotic bacteria associated with the filamentous marine cyanobacterium Moorea producens were explored as a novel source of antibiotics and to establish whether they can produce cyclodepsipeptides on their own. Here, we report the isolation of micrococcin P1 (1) (C48H49N13O9S6; obs. m/z 1144.21930/572.60381) and micrococcin P2 (2) (C48H47N13O9S6; obs. m/z 1142.20446/571.60370) from a strain of Bacillus marisflavi isolated from M. producens’ filaments. Interestingly, most bacteria isolated from M. producens’ filaments were found to be human pathogens. Stalked diatoms on the filaments suggested a possible terrestrial origin of some epibionts. CuSO4·5H2O assisted differential genomic DNA isolation and phylogenetic analysis showed that a Kenyan strain of M. producens differed from L. majuscula strain CCAP 1446/4 and L. majuscula clones. Organic extracts of the epibiotic bacteria Pseudoalteromonas carrageenovora and Ochrobactrum anthropi did not produce cyclodepsipeptides. Further characterization of 24 Firmicutes strains from M. producens identified extracts of B. marisflavi as most active. Our results showed that the genetic basis for synthesizing micrococcin P1 (1), discovered in Bacillus cereus ATCC 14579, is species/strain-dependent and this reinforces the need for molecular identification of M. producens species worldwide and their epibionts. These findings indicate that M. producens-associated bacteria are an overlooked source of antimicrobial compounds.

The transformation of nanophotonic sensors from laboratory-based demonstrations to a portable system to ensure widespread applicability in everyday life requires their integration with detectors for direct electrical read out. As complementary metal oxide semiconductor (CMOS) technology has revolutionized the electronics industry, the integration of nanophotonic structures with CMOS technology will also transform the sensing market. However, nanophotonic sensors have to fulfill certain requirements for their integration with CMOS detectors, such as operation in the visible wavelength range, operation in normal incidence configuration, use of CMOS compatible materials, and capability to give large optical intensity change due to resonance wavelength shift. In this paper, we have designed and developed one-dimensional silicon nitride grating structures that satisfy all these conditions simultaneously. The gratings can achieve 1 and 6 nm linewidths for the transverse-electric (TE) and transverse-magnetic (TM) polarizations, respectively, with 90% resonance depth. The experimental linewidth is 8 nm with 55% resonance depth, which is limited by the detector resolution. The experimental sensitivity of the device is 160 nm/refractive index unit (RIU), which translates to a very high intensity sensitivity of 1700%/RIU, which would enable sensing of very small changes in refractive index when integrated with a detector.

In this piece, I argue that the marginalized status of ugliness in the field of aesthetics, particularly in aesthetic conversations in the broader field of curriculum, is indicative of an as-of-yet unexplored source for understanding our societal values. The fact that we do not talk about the ugly is reason to believe that there is something that we do not want to talk about, and whenever such is the case, there is often a deep-seated reason as to why. I begin by establishing the case that ugliness is, in fact, a marginal idea in aesthetic conversations. From there, I explore notions of ugliness as interruptive; the treatment of the physically ugly and its implications; and ugliness of thought, both emotionally and through purposeful philosophizing. While I relate each of these back to the study of curriculum within their own sections, I also move forward to explore what an ugly curriculum may look like, utilizing the concept of asymmetry as a grounding ideal.

Considering works of Horror artistic manifestations of cultural nightmares, the author takes up the charge that dreams deserve a place in the study of curriculum. Utilizing an object-oriented approach to aesthetic and educational inquiry, the author first develops a theory of Horror that divides the genre into the distinct categories of Supernatural, Unnatural, Psychotic, and Psychological. Once this theory is established, the author unpacks the notion of duomining—a process in which objects are simultaneously reduced to mere collections of their components as well as reduced to their relations to other objects and as appearances-to-consciousness—and argues that this process provides the groundwork for horror in works of Psychological Horror, then further translating this sense of horror to the standardized classroom as well as the notion of a “student-centered” classroom.

In this text, I outline the relationship between beauty, knowledge, and terror through a syllogism and an exploration of each term individually. Before undertaking a full analysis of the interrelationships between beauty, knowledge, and terror, I would provide two illustrations: a visual representation of the proposed syllogism, and a description of a moment that seems to recur in more or less the same form year after year in my classroom; it is not illustrative in itself, but through careful analysis of the different phenomena which add up to create the moment, and which further extend from the moment, I explore the interaction of the three major elements at work here. The movement from beauty to knowledge to terror is explored in the context of the educative moment, which is important as this is largely a meditation on teaching. I conclude with the idea that the postmodern instructor needs to be consistently aware of the relationship between these to educate effectively, because the terror that arises with the possibility of new knowledge can prevent students from opening themselves to that knowledge, maintaining a ground for developing terror.

A range of nanophotonic sensors composed of different materials and device configurations have been developed over the past two decades. These sensors have achieved high performance in terms of sensitivity and detection limit. The size of onchip nanophotonic sensors is also small and they are regarded as a strong candidate to provide the next generation sensors for a range of applications including chemical and biosensing for point-of-care diagnostics. However, the apparatus used to perform measurements of nanophotonic sensor chips is bulky, expensive and requires experts to operate them. Thus, although integrated nanophotonic sensors have shown high performance and are compact themselves their practical applications are limited by the lack of a compact readout system required for their measurements. To achieve the aim of using nanophotonic sensors in daily life it is important to develop nanophotonic sensors which are not only themselves small, but their readout system is also portable, compact and easy to operate. Recognizing the need to develop compact readout systems for onchip nanophotonic sensors, different groups around the globe have started to put efforts in this direction. This review article discusses different works carried out to develop integrated nanophotonic sensors with compact readout systems, which are divided into two categories; onchip nanophotonic sensors with monolithically integrated readout and onchip nanophotonic sensors with separate but compact readout systems.

Background Prostate cancer is the most common cancer in men worldwide. As many as one-third of patients diagnosed with prostate cancer will experience a recurrence of their disease after treatment. This case study details the treatment of a patient with recurrent adenocarcinoma of the prostate, presenting 18 years after initial treatment. The patient was treated using magnetic resonance (MR)--guided radiation therapy, which allows for tighter treatment margins and improved imaging of soft tissue compared with traditional external beam radiation therapy. Discussion The treatment resulted in adequate coverage of the prostate tumor while limiting the dose to sensitive surrounding tissues, including the urethra. The patient tolerated the treatment well and experienced a decrease in prostatespecific antigen in the months after treatment. Conclusion Although more research is needed on a standard protocol for partial prostate reirradiation, MR--guided radiation therapy might offer certain advantages when treating patients with recurrent adenocarcinoma of the prostate. [ABSTRACT FROM AUTHOR]