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Purpose Surgical gesture recognition has been an essential task for providing intraoperative context-aware assistance and scheduling clinical resources. However, previous methods present limitations in catching long-range temporal information, and many of them require additional sensors. To address these challenges, we propose a symmetric dilated network, namely SD-Net, to jointly recognize surgical gestures and assess surgical skill levels only using RGB surgical video sequences. Methods We utilize symmetric 1D temporal dilated convolution layers to hierarchically capture gesture clues under different receptive fields such that features in different time span can be aggregated. In addition, a self-attention network is bridged in the middle to calculate the global frame-to-frame relativity. Results We evaluate our method on a robotic suturing task from the JIGSAWS dataset. The gesture recognition task largely outperforms the state of the arts on the frame-wise accuracy up to $$\sim $$ ∼ 6 points and the F1@50 score $$\sim $$ ∼ 8 points. We also keep the 100% predicted accuracy for the skill assessment task using LOSO validation scheme. Conclusion The results indicate that our architecture is able to obtain representative surgical video features by extensively considering the spatial, temporal and relational context from raw video input. Furthermore, the better performance in multi-task learning implies that surgical skill assessment has a complementary effects to gesture recognition task.

Argumentation plays a significant role in science as a scientific practice in which knowledge is constructed, evaluated, and modified. Scientific argumentation (SA) is thus a promising activity for students to pursue in order to think and act like scientists and to enhance their understanding of science. Considering the impact that assessments usually have on teaching and their role in understanding students' ability, this study aims to explore the assessment of scientific argumentation competence (SAC) and Chinese high school students' performance and perceptions of SA. This study, therefore, proposes a three-component framework for understanding SAC, including the competencies to identify, evaluate, and generate the SA elements outlined in Toulmin's argument model. Based on this framework, we hypothesize three levels of SAC and develop a test including 22 items to see whether these proposed SAC elements are valid and to what extent they represent students' levels of SAC. An iterative procedure is adopted to develop and validate the assessment instrument, validity evidence is collected from the analysis of teachers' interviews, students' think-aloud and follow-up interviews, and from confirmatory factor analysis and Rasch analysis of students' scores on the test. The results suggest that the measure, which includes three SAC components has acceptable reliability and validity, and the three-level progression of SAC is aligned with and further expands previous learning progressions of SA. We also find that most students in our sample are at level 1 of SAC and they in general hold positive attitudes toward learning through argumentation, but their willingness in engaging with SA tends to be affected by their perception of the intrinsic and practical value of SA and their personality. Providing them with explanations of SA elements does not improve their test performance.

Code-mixing is an natural phenomenon in multilingual and bilingual communities. As a result of language contact in China, code mixing is on the rise. This paper is devoted to exploring the attitude of contemporary college students towards the linguistic phenomenon of code mixing of Chinese and English. Through online survey and data analysis, this paper finds that the need to speak expressively, bring forth humorous effect and use euphemism to avoid awkward situation are the first three factors accounting for code-mixing. As talkers , they tend to use code mixing of Chinese-English in informal situations with more intimate people; as listeners, they hope that such expressions can make humor and make the topic easy. In terms of usage, they are more willing to accept English expressions to avoid some disadvantages. Most of them are remaining neutral on supporting or opposing the code mixing of Chinese and English.

OBJECTIVES: This study aimed to monitor the recovery of somatosensory function and oral health-related quality of life after tongue reconstruction using a non-innervated radial forearm free flap (RFFF).METHODS: Twenty patients (9 men, age: 42-67 years) underwent tongue reconstruction with non-innervated RFFFs, and twenty age- and sex-matched controls were included in this study. Quantitative sensory testing (QST), including cold, warm, and mechanical detection thresholds (CDT, WDT, MDT); cold, heat, and mechanical pain thresholds (CPT, HPT, MPT); and static two-point, sharp/blunt, and direction discrimination (S2-PD, S/BD, DD) were determined 9 months and 18 months after surgery on the surgical (9 M, 18 M) and contralateral sides (9Mc, 18Mc). Oral Health Impact Profile-49 (OHIP-49) was used to determine the oral-related quality of life of participants.RESULTS: All parameters showed significantly lower sensitivity at 9 M and 18 M (p < 0.001) compared to those for the controls and the contralateral side, except for DD (p = 0.101). In addition, the parameters showed a significant decrease in sensitivity for 9Mc and 18Mc (p ≤ 0.043) compared to those for the controls, except for MPT, HPT, S/SD, and DD (p ≥ 0.453). Findings on WDT, MPT, S2-PD, and DD (p ≤ 0.046) indicated significantly higher somatosensory function at 18 M than that at 9 M. MDT and MPT (p ≤ 0.038) showed significantly higher sensitivity at 18Mc than at 9Mc. Scores for all dimensions of OHIP-49 were significantly higher in patients (decrease in quality of life, p ≤ 0.002) than in controls, except for physical discomfort (p = 0.51). However, the scores were significantly higher at 18 M than at 9 M (p ≤ 0.011), except for handicap (p = 0.36). Postoperative chemotherapy was significantly correlated with impaired thermal sensitivity of the flaps (WDT, p = 0.049).CONCLUSION: The present findings showed significant impairment in somatosensory function on both the surgical and contralateral sides of patients with RFFFs. However, a significant increase in somatosensory function was observed on both sides over time. Somatosensory disturbances observed after surgery were associated with poor oral health-related quality of life.

To evaluate the effect of photobiomodulation therapy (PBMT) on painful temporomandibular disorders (TMD) patients in a randomized, double-blinded, placebo-controlled manner. Participants were divided into a masseter myalgia group (n = 88) and a temporomandibular joint (TMJ) arthralgia group (n = 87) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Both groups randomly received PBMT or placebo treatment once a day for 7 consecutive days, one session. The PBMT was applied with a gallium-aluminum-arsenide (GaAlAs) laser (wavelength = 810 nm) at pre-determined points in the masseter muscle (6 J/cm2, 3 regions, 60 s) or TMJ region (6 J/cm2, 5 points, 30 s) according to their most painful site. Pain intensity was rated on a 0–10 numerical rating scale (NRS) and pressure pain thresholds (PPT) and mechanical sensitivity mapping were recorded before and after the treatment on day 1 and day 7. Jaw function was assessed by pain free jaw opening, maximum unassisted jaw opening, maximum assisted jaw opening, maximum protrusion and right and left excursion. Data were analyzed with a mixed model analysis of variance (ANOVA). Pain intensity in arthralgia patients decreased over time (P

BACKGROUND High levels of lipoprotein(a) (Lp(a)) is an independent risk factor for premature coronary heart disease (PCHD). It is also considered a residual risk for controlled low density lipoprotein cholesterol (LDL-C). Dietary control, exercise, and drugs have limited effects on the levels of Lp(a). Recently, mental health was found to be associated with lipid levels and increased risk of PCHD. However, the relationship between mental health and Lp(a) is still unknown. This study explored the association between mental health and Lp(a) levels in men with PCHD. METHODS A retrospective, observational study was conducted. A total of 226 male patients with PCHD, aged 49.65±3.68 years, was included in this study. The control group consisted of 230 age-matched healthy male volunteers. Serum Lp(a) levels ≥30 mg/dL, as measured by the immunoturbidimetry method, were considered high. All participants received health related quality of life (HRQoL) scores using the self-assessed 36-Item Short Form Health Survey (SF-36). The HRQoL includes both a physical component summary (PCS) and a mental component summary (MCS). RESULTS Patients with PCHD were found to have higher levels of Lp(a) (51.61±33.39 vs. 26.42±21.93, P

Automatic surgical instruction generation is a prerequisite towards intra-operative context-aware surgical assistance. However, generating instructions from surgical scenes is challenging, as it requires jointly understanding the surgical activity of current view and modelling relationships between visual information and textual description. Inspired by the neural machine translation and imaging captioning tasks in open domain, we introduce a transformer-backboned encoder-decoder network with self-critical reinforcement learning to generate instructions from surgical images. We evaluate the effectiveness of our method on DAISI dataset, which includes 290 procedures from various medical disciplines. Our approach outperforms the existing baseline over all caption evaluation metrics. The results demonstrate the benefits of the encoder-decoder structure backboned by transformer in handling multimodal context., Comment: Accepted to MICCAI 2021

Customer retail environments represent an exciting and challenging context to develop and put in place cutting-edge computer vision techniques for more engaging customer experiences. Visual attention is one of the aspects that play such a critical role in the analysis of customers behaviour on advertising campaigns continuously displayed in shops and retail environments. In this paper, we approach the optimisation of advertisement layout content, aiming to grab the audience’s visual attention more effectively. We propose a fully automatic method for the delivery of the most effective layout content configuration using saliency maps out of each possible set of images with a given grid layout. Visual Saliency deals with the identification of the most critical regions out of pictures from a perceptual viewpoint. We want to assess the feasibility of saliency maps as a tool for the optimisation of advertisements considering all possible permutations of images which compose the advertising campaign itself. We start by analysing advertising campaigns consisting of a given spatial layout and a certain number of images. We run a deep learning-based saliency model over all permutations. Noticeable differences among global and local saliency maps occur over different layout content out of the same images. The latter aspect suggests that each image gives its contribution to the global visual saliency because of its content and location within the given layout. On top of this consideration, we employ some advertising images to set up a graphical campaign with a given design. We extract relative variance values out the local saliency maps of all permutations. We hypothesise that the inverse of relative variance can be used as an Effectiveness Score (ES) to catch those layout content permutations showing the more balanced spatial distribution of salient pixel. A group of 20 participants have run some eye-tracking sessions over the same advertising layouts to validate the proposed method.

OBJECTIVES: Musculoskeletal disorders (MSDs) in the neck and shoulder region may be associated with significant impairment of quality of life and well-being. The study was to determine the prevalence of painful MSDs in Chinese dentists and evaluate somatosensory function and neck mobility compared with non-dental professional controls.METHODS: One hundred dentists (age: 36.5 ± 9.8 years) and 102 controls (age: 36.2 ± 10.0 years) were recruited between September 2019 and December 2020. The Medical Outcome Study 36-item short-form health survey questionnaire and information of MSDs history were recorded. The cervical range of motion (CROM) with and without pain, and the pressure pain thresholds (PPTs) of the facial and neck muscles were tested. Chi-square test, Mann-Whitney U test and multiple linear regression analysis were used to analyze the data. The factors in the multiple linear regression analysis were occupation, working age, and gender.RESULTS: The prevalence rate of neck pain was significantly higher in dentists (73.0%) compared with the controls (52.0%) (P = .002). The regression models of cervical range of posterior extension, lateral flexion and rotation were statistically significant (P ≤ .001). The regression models of PPTs of the tested facial and neck muscles were statistically significant (P < .001).CONCLUSION: Dentists are at higher risk of neck pain. The bigger cervical range of left rotation of dentists could be related to the working posture. The lower PPTs in dentists may reflect a hypersensitivity in the facial and neck muscles. Preventive measures are needed to reduce occupational hazards in dentists.

[This corrects the article DOI: 10.1155/2019/9593464.].

To compare two pain models of myalgic TMD, delayed-onset muscle soreness (DOMS) and injections of nerve growth factor (NGF), in terms of pain-related and motor function outcomes, as well as activity-related temporal summation. Methods: Fifty age- and gender-matched healthy participants were recruited and randomized into one of three groups: to a repeated eccentric contraction task to cause DOMS (n = 20), to receive NGF injections into the masseter muscle (n = 20), or to a control group (n = 10). Mechanical sensitivity of masticatory muscles, chewing parameters, jaw function limitation, maximum bite force, and activity-related temporal summation were assessed at baseline and at days 1, 2, and 7 following the intervention. Results: Compared to baseline, both model groups showed increased mechanical sensitivity, jaw function limitation, pain on chewing, and decreased chewing efficiency, lasting longer in the NGF group than in the DOMS group (P .05). Conclusion: Both models produced similar pain- related outcomes, with the NGF model having a longer effect. Furthermore, the NGF model showed a more substantial effect on motor function, which was not seen for the DOMS model. Finally, neither of the models were able to provoke activity-related temporal summation of pain. J Oral Facial Pain Headache 2020;34:311–322. doi: 10.11607/ofph.2623

In this article, we propose a novel technique based on Head Movement tracking to explore multilayer digital content. We extend an existing method by Kazemi et al. dealing with the extraction of facial landmarks to define the “head-gaze” of the user. We use the “head-gaze” to calculate the users' on-screen coordinates. Hovering the cursor over an interactive area for a given time threshold allows users to explore the next layer contents. Our experimental sessions allowed us to measure the technique's level of control and usability. Our results were promising, and users were able to interact with considerably small regions. Furthermore, our lightweight method can be used with a low-cost camera or webcam and a wide range of screen sizes and distances.

Aim: This study was conducted to test segmental and extra-segmental temporal summation (TS) effects of repetitive mechanical stimulation in patients with painful temporomandibular joints (TMJ) and healthy individuals. Methods: Twenty patients with unilateral pain in the TMJ and 20 gender- and age-matched healthy controls were included. A modified Quantitative Sensory Testing (QST) protocol was performed including pressure pain thresholds (PPT), mechanical pain thresholds (MPT), and numerical rating scale (NRS) scores of TS effects of 10 repeated 0.5 kg, 1.0 kg pressure stimuli and pinprick stimuli were determined as wind-up ratios (WUR) on the glabrous skin of the dominant hand (extra-segmental) and bilaterally in the TMJ region. Kruskal-Wallis test was used for data analysis. Results: The PPT and MPT were significantly lower on painful TMJs compared to non-painful TMJs (P=0.001) and control TMJs (P=0.001). WUR of repetitive mechanical stimulation on painful TMJs was higher compared to control TMJs (P ≤ 0.012). Non-painful TMJs also had significantly higher WUR of pinprick stimuli compared to control TMJs (P=0.008). Except the WUR of repetitive mechanical stimulation (P=0.030) no significant differences were detected at the hand for any of the test parameters between the two groups (P ≥ 0.05). Conclusion: Patients with unilateral TMJ pain have segmentally, but not extra-segmentally, increased sensitivity to mechanical stimuli including facilitated temporal summation mechanisms at segmental as well at extra-segmental sites.

OBJECTIVES: This study aimed to assess the mechanical and thermal sensory thresholds of the gingiva in patients with plaque-induced gingivitis compared with a control group to help characterize effects of an inflammatory condition in the oral mucosa on somatosensory function.MATERIALS AND METHODS: Quantitative sensory testing (QST) was used in 22 patients (men 10, women 12, age 20-30 years) with plaque-induced gingivitis at the lower lateral incisors and in 22 age- and gender-matched healthy volunteers as a control group. One lower lateral incisor (32 or 42) was randomly identified for each included subject. Cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), and heat pain threshold (HPT) of the attached gingiva at the identified lower lateral incisors were assessed in both groups. Pressure pain threshold (PPT) at the teeth was also tested from vertical and lateral directions and analyzed. One-way ANOVA was used to compare the mean values of the identified lower lateral incisors between the two groups.RESULTS: The results showed that the CDT (P = 0.027), WDT (P = 0.021), and HPT (P = 0.005) at the gingiva and PPT (P CONCLUSIONS: Inflammatory reactions in the gingiva seem to be associated with demonstrable changes in somatosensory function including both hypo- and hyperesthesia.CLINICAL RELEVANCE: These findings may have significance for general oral health and well-being in patients with even plaque-induced gingivitis.

This article applies the semantic clustering to Construction the evaluation indicator of chain logistics service providers. First, Collect and analyze original texts. Second, Key words clustering analysis. Based on the grounded theory extract keywords, then cluster through the meaning of keywords. Finally, constructing the selecting index system of cold chain logistics service providers that contains 5 primary indicators and 24 secondary indicators.

Automatic surgical gesture recognition is a prerequisite of intra-operative computer assistance and objective surgical skill assessment. Prior works either require additional sensors to collect kinematics data or have limitations on capturing temporal information from long and untrimmed surgical videos. To tackle these challenges, we propose a novel temporal convolutional architecture to automatically detect and segment surgical gestures with corresponding boundaries only using RGB videos. We devise our method with a symmetric dilation structure bridged by a self-attention module to encode and decode the long-term temporal patterns and establish the frame-to-frame relationship accordingly. We validate the effectiveness of our approach on a fundamental robotic suturing task from the JIGSAWS dataset. The experiment results demonstrate the ability of our method on capturing long-term frame dependencies, which largely outperform the state-of-the-art methods on the frame-wise accuracy up to ~6 points and the F1@50 score ~6 points., Comment: Accepted to MICCAI 2020

The privacy of indoor temperature acquisition system is protected, and the information encryption and secure storage ability of indoor temperature acquisition are improved to prevent data leakage. A privacy protection and anti-attack encryption algorithm of indoor temperature acquisition based on MapReduce model is proposed. The data structure model of privacy protection data in indoor temperature acquisition system is analyzed, the information coding model of indoor temperature data is constructed, and the random sequence analysis of privacy protection data is carried out by combining data vector quantification coding method. MapReduce model and fuzzy block encryption control method are used to improve the anti-attack encryption algorithm of privacy protection data in indoor temperature acquisition system. The simulation results show that the algorithm can resist leakage encryption of privacy protection data in indoor temperature acquisition system, enhance the randomness of key coding distribution of data, reduce the deciphering probability, improve the privacy protection ability of indoor temperature acquisition, reduce the risk of data leakage and attack, improve the privacy protection performance of data encryption, and have good application value in indoor temperature acquisition and information encryption.

Objective: Transcutaneous electrical nerve stimulation (TENS) may serve as non-invasive intervention for painful temporomandibular disorders (TMD) to improve jaw motor function, but its efficacy is still debated. This parallel study evaluated the effect of TENS on pain and movement patterns after repeated jaw movements in patients with painful temporomandibular joints (TMJ) and disc displacement without reduction (DDwoR), and compared with healthy controls.Material and Methods: 20 patients with TMJ pain and DDwoR and 20 age- and gender-matched healthy volunteers were randomly assigned to TENS/sham TENS (sTENS) intervention groups in a block design (10 in each group). Participants performed 20 repeated jaw movements (4 x 5 sessions), and reported pain intensity on a 0-10 Numerical Rating Scale (NRS) subsequently both before and after the intervention. Data were tested by repeated measures analysis of variance (ANOVA).Results: Significant increase of pain intensity and reduction of opening range were shown within repeated jaw movements in TMJ pain patients in contrast to healthy participants (p ≤ .001). Pain was significantly reduced during repeated open-close (p = .007), fast open-close (p = .016) and horizontal movements (p = .023), accompanied with increased opening range (p = .033) and open-close velocity (p = .019) with TENS intervention when compared with sTENS group (p > .05) in TMJ pain patients.Conclusions: This study indicated that movement-evoked pain was reduced either spontaneously or by sTENS in TMJ pain patients with DDwoR, and interestingly, that TENS could attenuate movement-evoked pain and improve jaw motor function during repeated jaw movements. The findings may have implications for TENS treatment in TMJ pain patients with DDwoR.

Objective. To compare the effects of training of jaw and finger movements with and without visual feedback on precision and accuracy. Method. Twenty healthy participants (10 men and 10 women; mean age 24.6±0.8 years) performed two tasks: a jaw open-close movement and a finger lifting task with and without visual feedback before and after 3-day training. Individually determined target positions for the jaw corresponded to 50% of the maximal jaw opening position, and a fixed target position of 20 mm was set for the finger. Movements were repeated 10 times each. The variability in the amplitude of the movements was expressed as percentage in relation to the target position (Daccu—accuracy) and as coefficient of variation (CVprec—precision). Result. Daccu and CVprec were significantly influenced by visual feedback (P=0.001 and P<0.001, respectively) and reduced after training jaw and finger movements (P<0.001). Daccu (P=0.004) and CVprec (P=0.019) were significantly different between jaw and finger movements. The relative changes in Daccu (P=0.017) and CVprec (P=0.027) were different from pretraining to posttraining between jaw and finger movements. Conclusion. The accuracy and precision of standardized jaw and finger movements are dependent on visual feedback and appears to improve more by training in the trigeminal system possibly reflecting significant neuroplasticity in motor control mechanisms.

Impaired wound healing accompanies severe cell apoptosis in diabetic patients. Tissue inhibitor of metalloproteinases-1 (TIMP-1) was known to have effects on promoting growth and anti-apoptosis for cells. We aimed to determine the actual levels of TIMP-1 and cell apoptosis in: (i) the biopsies of diabetic and non-diabetic foot tissue and (ii) the human fibroblasts with or without treatments of advanced glycation end-products (AGEs). Next, we aimed to determine the improved levels of cell apoptosis and wound healing after the treatments of either active protein of TIMP-1 or in vivo expression of gene therapy vector-mediated TIMP-1 in both the human fibroblasts and the animal model of diabetic rats. The levels of TIMP-1 were significantly reduced in diabetic skin tissues and in AGEs-treated fibroblasts. Both AGEs-treated cells were effectively protected from apoptosis by active protein of TIMP-1 at appropriate dose level. So did the induced in vivo TIMP-1 expression after gene delivery. Similar effects were also found on the significant improvement of impaired wound healing in diabetic rats. We concluded that TIMP-1 improved wound healing through its anti-apoptotic effect. Treatments with either active protein TIMP-1 or TIMP-1 gene therapy delivered in local wound sites may be used as a strategy for accelerating diabetic wound healing.

Objective: This narrative review provides an overview of the quantitative sensory testing (QST) to assess somatosensory function in human oral mucosa. Material and methods: A literature search was conducted in the PubMed database to identify studies in vivo on human oral mucosa using QST methods. A list of 149 articles was obtained and screened. A total of 36 relevant articles remained and were read in full text. Manual search of the reference lists identified eight additional relevant studies. A total of 44 articles were included for final assessment. Results: The included studies were divided into six categories according to the study content and objective. In each category, there was a great variety of aims, methods, participants and outcome measures. The application of QST has nevertheless helped to monitor somatosensory function in experimental models of intraoral pain, effects of local anesthesia, after oral and maxillofacial surgery and after prosthodontic and orthodontic treatment. Conclusions: QST has been proved to be sufficiently stable and reliable, and valuable information has been obtained regarding somatosensory function in healthy volunteers, special populations and orofacial pain patients. However, as most of the studies were highly heterogeneous, the results are difficult to compare quantitatively. A standardized intraoral QST protocol is recommended and expected to help advance a mechanism-based assessment of neuropathies and other intraoral pain conditions.

Temporal summation of nociceptive inputs may be an important pathophysiological mechanism in temporomandibular disorders (TMD) pain; however, it remains unknown how natural jaw function relates to underlying pain mechanisms. This study evaluated changes in pain and movement patterns during repeated jaw movements in patients with painful temporomandibular joints (TMJ) compared with healthy controls. Twenty patients with TMD with TMJ pain, and an anterior disk displacement without reduction and 20 age- and gender-matched healthy volunteers were included. Participants performed 20 trials (4 × 5 sessions) of standardized and repeated mandibular movements, and scored the movement-associated pain intensity on 0 to 10 numeric rating scale in addition to measurements of jaw movements. Patients with TMJ pain reported higher baseline pain compared to the control group for all types of jaw movements (P = 0.001) and significant increases in numeric rating scale pain scores by repetition of jaw movements (P < 0.001), which was not observed in the control group (P > 0.05). Jaw total opening distance (P = 0.030), maximum opening velocity (P = 0.043) and average closing velocity (P = 0.044) in the TMJ pain group were significantly reduced during the repeated movements. In the control group, however, total opening distance (P = 0.499), maximum opening velocity (P = 0.064), and average closing velocity (P = 0.261) remained unchanged, whereas average opening velocity (P = 0.040) and maximum closing velocity (P = 0.039) increased. The study demonstrates that repeated jaw movements constitute a sufficient and adequate stimulation for triggering temporal summation effects associated with significant inhibition of motor function in painful TMJs. These findings have practical implications for diagnosis of TMD pain and for more mechanism-driven management protocols in the future.

OBJECTIVE: Few clinical techniques are available for the description of mechano-nociceptive function in human periodontal tissues. The objective of this study was to test a new technique for assessment of periodontal mechano-nociceptive function by direct application of controlled forces to the teeth and quantify site, side and gender differences in healthy individuals.DESIGN: Twenty healthy young adults (ten males and ten females) participated. A handheld pressure algometer was used to assess pressure pain threshold (PPT) on the maxillary and mandibular central incisors, canines and first premolars on the left and the right side from two directions: lateral and vertical. Statistical analysis was performed using analyses of variance (ANOVA) with repeated measures to compare data.RESULTS: There were significant gender differences of PPT for both lateral (Plateral=0.007) and vertical (Pvertical=0.001) directions with lower thresholds in females (higher sensitivity) than in males. A significant site effect (Plateral=0.002, PverticalCONCLUSION: The novel application of PPTs directly to the teeth indicated an adequate and practical method with potential value for clinical assessment of painful conditions affecting the periodontal ligament.

© Springer Nature Switzerland AG 2019. We present a novel integral-based Material Point Method (MPM) using state based peridynamics structure for modeling elastoplastic material and fracture animation. Previous partial derivative based MPM studies face challenges of underlying instability issues of particle distribution and the complexity of modeling discontinuities. To alleviate these problems, we integrate the strain metric in the basic elastic constitutive model by using material point truss structure, which outweighs differential-based methods in both accuracy and stability. To model plasticity, we incorporate our constitutive model with deviatoric flow theory and a simple yield function. It is straightforward to handle the problem of cracking in our hybrid framework. Our method adopts two time integration ways to update crack interface and fracture inner parts, which overcome the unnecessary grid duplication. Our work can create a wide range of material phenomenon including elasticity, plasticity, and fracture. Our framework provides an attractive method for producing elastoplastic materials and fracture with visual realism and high stability.

Aims: To determine whether patients with painful myofascial temporomandibular disorders (TMD) demonstrate facilitated temporal summation (TS) responses to painful heat stimuli applied to the painful trigeminal and extratrigeminal regions and whether there is a side difference in the trigeminal region for myofascial TMD pain patients compared to healthy controls. Methods: Twenty female Chinese myofascial TMD pain patients and 20 age-matched female volunteers participated in this case-control study. Thermal detection thresholds, thermal pain thresholds, and TS of 20 repetitive noxious thermal stimuli were measured on the skin above the masseter muscle on both sides and the thenar eminence of the less painful side/dominant hand. Numeric rating scale (NRS) scores of pain were provided after the 1st, 5th, 10th, 15th, and 20th stimuli, and TS was calculated as the highest NRS score minus the first NRS score in each test. Results: Evidence of TS was found in the trigeminal and extratrigeminal regions for both groups, but with facilitated TS responses in myofascial TMD pain patients (P < .001). Within the myofascial TMD group and control group, there were no side-to-side differences (P > .289). Interestingly, the repetition of the TS test was associated with facilitated responses in myofascial TMD pain patients (P < .001). Conclusion: The current findings suggest TS of painful heat stimulation is facilitated in myofascial TMD pain patients with no side difference in the trigeminal region.