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Abstract Phototransduction involves changes in concentration of ions and other solutes within photoreceptors and in subretinal space, which affect osmotic pressure and the associated water flow. Corresponding expansion and contraction of cellular layers can be imaged using optoretinography (ORG), based on phase-resolved optical coherence tomography (OCT). Until now, ORG could reliably detect only photoisomerization and phototransduction in photoreceptors, primarily in cones under bright stimuli. Here, by employing a phase-restoring subpixel motion correction algorithm, which enables imaging of the nanometer-scale tissue dynamics during minute-long recordings, and unsupervised learning of spatiotemporal patterns, we discover optical signatures of the other retinal structures’ response to visual stimuli. These include inner and outer segments of rod photoreceptors, retinal pigment epithelium, and subretinal space in general. The high sensitivity of our technique enables detection of the retinal responses to dim stimuli: down to 0.01% bleach level, corresponding to natural levels of scotopic illumination. We also demonstrate that with a single flash, the optoretinogram can map retinal responses across a 12° field of view, potentially replacing multifocal electroretinography. This technique expands the diagnostic capabilities and practical applicability of optoretinography, providing an alternative to electroretinography, while combining structural and functional retinal imaging in the same OCT machine.

Background: Narratives convey information and emotion, evoke understanding, empathy, and connection. Healthcare professionals can use narratives to reduce burnout, benefiting them, patients, and colleagues. Story slams are narrative sharing events used for group reflection, providing an opportunity for participants and listeners to improve their well-being by processing complex emotions and identities. Story slams have traditionally been popular with creative writers and nonprofit organizations. Methods: Following a local event hosted by The Moth, the Temple University Lewis Katz School of Medicine (LKSOM) Narrative Medicine program hosted nine story slams over five years with 93 presenters including students and health systems staff. Through a mixed-method analysis, the authors examined the stories for thematic patterns and surveyed presenters to investigate how the experience had impacted markers such as job satisfaction, stress levels, and connection to patients. Eleven presenters were interviewed to provide additional information about the impact they experienced. Results: Patient-centered care, resilience, and the value of learning comprised over half of all themes presented. Following the event, many presenters experienced improved connections with patients, and everyone reported feeling neutral or increased satisfaction with their profession. The interviews conveyed participation, created a lasting impact, fostered a sense of community, and increased appreciation for diversity. Conclusions: Overall, story slams nourish humanity and promote diversity, enthusiasm, and encouragement. This study and others suggest that story slams are inexpensive and effective events that can help reduce burnout and provide academic medical centers with a way to restore and cultivate community among students, physicians, and staff.

There is a wide spectrum of craniofacial bone disorders and dysplasias because embryological development of the craniofacial region is complex. Classification of craniofacial bone disorders and dysplasias is also complex because they exhibit complex clinical, pathological, and molecular heterogeneity. Most craniofacial disorders and dysplasias are rare but they present an array of phenotypes that functionally impact the orofacial complex. Management of craniofacial disorders is a multidisciplinary approach that involves the collaborative efforts of multiple professionals. This review provides an overview of the complexity of craniofacial disorders and dysplasias from molecular, clinical, and management perspectives.

Numerous efforts have been undertaken to develop rectifying antennas operating at high frequencies, especially dedicated to light harvesting and photodetection applications. However, the development of efficient high frequency rectifying antennas has been a major technological challenge both due to a lack of comprehension of the underlying physics and limitations in the fabrication techniques. Various rectification strategies have been implemented, including metal-insulator-metal traveling-wave diodes, plasmonic nanogap optical antennas, and whisker diodes, although all show limited high-frequency operation and modest conversion efficiencies. Here a new type of rectifying antenna based on plasmonic carrier generation is demonstrated. The proposed structure consists of a resonant metallic conical nano-antenna tip in contact with the oxide surface of an oxide/metal bilayer. The conical shape allows for an improved current generation based on plasmon-mediated electromagnetic-to-electron conversion, an effect exploiting the nanoscale-tip contact of the rectifying antenna, and proportional to the antenna resonance and to the surface-electron scattering. Importantly, this solution provides rectification operation at 280 THz (1064 nm) with a 100-fold increase in efficiency compared to previously reported results. Finally, the conical rectifying antenna is also demonstrated to operate at 384 THz (780 nm), hence paving a way toward efficient rectennas toward the visible range.

Abstract Background Long-term antiretroviral therapy (ART) perpetually suppresses HIV load and has dramatically altered the prognosis of HIV infection, such that HIV is now regarded as a chronic disease. Side effects of ART in Patients With HIV (PWH), has introduced new challenges including “metabolic” (systemic) and oral complications. Furthermore, inflammation persists despite great viral load suppression and normal levels of CD4+ cell count. The impact of ART on the spectrum of oral diseases among PWH is often overlooked relative to other systemic complications. There is paucity of data on oral complications associated with ART use in PWH. This is in part due to limited prospective longitudinal studies designed to better understand the range of oral abnormalities observed in PWH on ART. Methods We describe here the study design, including processes associated with subject recruitment and retention, study visit planning, oral health assessments, bio-specimen collection and preprocessing procedures, and data management and statistical plan. Discussion We present a procedural roadmap that could be modelled to assess the extent and progression of oral diseases associated with ART in PWH. We also highlight the rigors and challenges associated with our ongoing participant recruitment and retention. A rigorous prospective longitudinal study requires proper planning and execution. A great benefit is that large data sets are collected and biospecimen repository can be used to answer more questions in future studies including genetic, microbiome and metabolome-based studies. Trial registration National Institute of Health Clinical Trials Registration (NCT) #: NCT04645693.

Chronic obstructive pulmonary disease (COPD) is the world's third leading cause of death, posing a significant public health challenge. Heart failure is an important milestone in the natural history of this disease's ever-decreasing course. Cor pulmonale alone is sometimes insufficient to explain the scenario, as many heart failures are refractory even after standard treatment. A possible explanation is involvement of the left ventricle (LV). However, there is currently no consensus on a therapeutic approach to LV dysfunction in COPD. Some previous studies were conducted on COPD patients regardless of the presence or absence of other factors influencing LV function. This study attempted to rule out all known confounding factors/co-morbidities that influence LV function. We discovered that LV diastolic dysfunction was common in subjects at all stages of COPD. We believe that all COPD patients, regardless of stage, should have screening echocardiography.

Aim or Purpose: Our study seeks to classify the fusion of spheno-occipital synchondrosis (SOS) into 5 distinct novel stages based on CBCT visualization of SOS ossification. Materials and Methods: IRB-exempted protocol (#830154) was used to analyze CBCTs of 69 male and 67 female patients between the ages 5 and 25 using Osirix® and ITK SNAP® software. Midsagittal sections were sliced at 1mm to visualize the SOS. The mid-sagittal images were then organized based on gender and labeled according to the patient chronological age in years and months. These images were then classified using our novel 5-stage method. The 5 respective stages we developed are- SOS open (stage 1), the commencement of ossification (stage 2), less than 50% ossification at SOS (stage 3), greater than 50% ossification at SOS (stage 4), complete ossification of SOS (stage 5). Results: In our investigation thus far, it was noted that SOS ossification begins around 9.3 years in males and 8.7 years in females and is usually completely fused by the age of 17.8 for males and 14.9 for females. Conclusions: SOS is a cartilaginous cranial growth center that fuses the occipital and sphenoid bones during adolescence and can be used to assess the skeletal age of an orthodontic patient more accurately than existing methods without subjecting the patient to any additional radiation. Using the staging system proposed here, one can reliably and accurately determine the skeletal age of a patient. Our skeletal age estimation method may be used independently or as a supplement to hand-wrist radiographs and Cervical Vertebral Maturation.

Aim or Purpose: Short-term mini-implants or temporary anchorage devices (TAD) were used in Orthodontic practice in patients who require skeletal anchorage for tooth movement. The success of TAD anchorage depends on the location and initial stability of placement among other factors. This outcomes assessment seeks to analyze existing evidence to evaluate the efficacy of CBCT as compared to panoramic radiography in the placement of temporary anchorage devices (TADs) in terms of reducing TAD failure rates and improving patient outcomes. Materials and Methods: Existing literature between 2007-2023 was searched via PubMed, Embase, and Google Scholar using MeSH terms and non-MeSH terms. Articles were limited to human studies in english language, and PRISMA statement guidelines were used to eliminate non-relevant studies. The PICOT question asked was, “Is cone beam computed tomography superior to panoramic radiography as a reliable and safe technique for placement of TADs in the maxilla and mandible?” The results of five articles were considered in the analysis. Results: Across the studies included in the analysis, 236 TADs were placed with the use of CBCT, and 256 TADs were placed with 2D radiography. Placement of TADs using panoramic radiography or other forms of 2D imaging had a failure rate of 29.68%; whereas placement of TADs using CBCT resulted in a 14.40% failure rate. Conclusions: Failures were defined as contact with neighboring roots and the effects, TAD displacement upon force application, and deviation from ideal placement. Based on the results, CBCT-guided TADs had less failure rates as compared with those placed using panoramic radiography alone.

Aim or Purpose: To stage spheno-occipital synchondrosis (SOS) ossification using Cone Beam CT(CBCT) first, followed by the application of AI-based modified Convolutional Neural Networks for the automation of tasks. Materials and Methods: We used IRB exempted protocol (#830154) to analyze CBCTs obtained for 69 male and 67 female patients between the ages 5 and 25 using Osirix® and ITK Snap® software. Mid-sagittal sections of maxillofacial CBCT were obtained in order to visualize the SOS. Images were labeled according to chronological age in years and months and sorted based on gender. Spatial Configuration Net (SCN) was used to make landmark predictions. Using multiple hand-staged images of the SOS, the Euclidean pixel-wise distance between landmarks for a given stage was calculated and normalized. A support Vector Machine (SVM) algorithm was used to predict the stage of SOS ossification. Results: The SVM-classified SOS stages were compared with human classifications to see the level of accuracy using the Sorensen-DICE index. SOS ossification started around 9.3 years in males and 8.7 years in females, and completely fused by the age of 17.8 for males and 14.9 for females. Conclusions: SOS is a stable skeletal landmark and using our novel staging system proposed here, accurate determination of the skeletal age of a patient is possible. Manual identification of the ossification at SOS may lead to errors in age estimation, but artificial intelligence-based automation might be a useful clinical tool for orthodontists in the estimation of skeletal age.

This study aims to determine if a large anterior and reduced posterior/superior joint space is highly predictable for disc displacement. From patients with temporomandibular disorders symptoms, fifty-two experimental joints and fourteen control joints were included. The cone beam computed tomography (CBCT) images were used to calculate posterior-to-anterior (P-A) and superior-to-anterior (S-A) joint space ratios, while disc position was determined using magnetic resonance imaging (MRI). One-way analysis of covariance test and receiver operating characteristics analysis were carried out. The results showed that among the 52 experimental joints, 45 were diagnosed as disc displacement and 7 as normal disc positions (N). All 14 control joints showed normal disc positions. The P-A ratio was 1.46 ± 0.21, 0.99 ± 0.23, and 0.86 ± 0.30 in the control, N, and DD groups, respectively (p < 0.001). The S-A ratio was 1.80 ± 0.27, 1.44 ± 0.33, and 1.08 ± 0.35 in the control, N, and DD groups, respectively (p < 0.001). When an altered P-A ratio and/or S-A ratio are observed on the CBCT, the diagnosis of disc displacement is quite predictable with high sensitivity and specificity.