Integrative study of Permian coal-bearing horizons: biostratigraphy, palaeovegetation, and palaeoclimate in the South Karanpura Basin.

The article deals with the integrated and comprehensive study of the coal-bearing horizons from the South Karanpura Basin to delineate the biostratigraphy, palaeovegetation, palaeodepositional settings, and palaeoclimate in and around the investigated area during the deposition of Permian sediments. Highly diversified megafloral assemblages consist 13 genera and 72 species of order Glossopteridales, Cordaitales and Equisetales are documented among which 37 taxa are newly reported from Barakar and Raniganj formations of the area. Palynoassemblages-I and -II are recovered, which demonstrate the biostratigraphic age as Kungurian and Wordian-Capitanian, respectively. Overall the vegetation represents a luxuriant forest subjugated by arborescent deciduous trees bearing Glossopteris foliage with some conifers, cordaites, filicales, and peltaspermales. The biomarker study of the basin illustrates the unimodal distribution of n-alkanes in the sample set ranges from C14 to C29 which suggests major input from a single source of organic matter. The involvement of microbial activity and algal input is suggested for the basin. A relatively moderate-to-high water level condition can be inferred from elevated n-C25. The high CIA, PIA values and A-CN-K plot suggest intense weathering conditions in the source area. The source rocks are characterized by mature clayey type with abundant clay mineral, i.e., kaolinite. The current study portrays that the Permian climate was cooler in initial phase, which later on became warm temperate with high humidity. The palaeofloral entities and geochemical parameters suggest absolute diversification of Permian flora, the existence of continental freshwater setting in the vicinity and oxic to anoxic environment with fluctuating ground water conditions during the deposition of sediments.

Large Sternoabdominal Wound Dehiscence after Cardiac Surgery: Challenging Multimodal Treatment.

ABSTRACT: The authors report the case of a patient who presented with a nonhealing sternal wound 3 months after cardiac bypass surgery. The patient was treated with vacuum-assisted closure, surgical debridement, and IV antibiotics. Despite repeated flap closure procedures, a top closure device, and wound dressings, the patient developed an infection, and the wound size increased from 8 × 10 cm to 20 × 20 cm, advancing from the sternal to upper abdominal region. This wound was then treated with hyperbaric oxygen therapy and nonmedicated dressings until the patient was eligible to receive a split-thickness skin graft 1.5 years after initial presentation. The main takeaway from this case was that local and systemic factors affected the outcome of each surgical closure. The failure of each preceding treatment choice that led to further increases in size and area of the wound was the main challenge. Eliminating infection, preventing development of new infection, and managing the local and systemic factors before any definite surgery are key to the eventual wound closure.

Impact of COVID-19 on Structure and Function of Program of All-Inclusive Care for the Elderly (PACE) Sites in North Carolina.

OBJECTIVES: The novel coronavirus disease 2019 (COVID-19) deeply affected all forms of long-term care for older adults, highlighting infection control issues, provider and staff shortages, and other challenges. As a comparatively new, community-based long-term care option, the Program of All-Inclusive Care for the Elderly (PACE) faced unique challenges. This project investigated the impact of COVID-19 on operations in all PACE programs in one US state. DESIGN: Qualitative study. SETTING AND PARTICIPANTS: Structured interviews with administrators of all 12 PACE programs in North Carolina. METHODS: Interviews were conducted December 2020 to January 2021 by trained interviewers over Zoom; they were transcribed, coded, and qualitatively analyzed using thematic analysis. RESULTS: Reported COVID-19 infection rates among PACE participants for 2020 averaged 12.3 cases, 4.6 hospitalizations, and 1.9 deaths per 100 enrollees. Six themes emerged from analyses: new, unprecedented administrative challenges; insufficient access to and integration with other health care providers; reevaluation of the core PACE model, resulting in a transition to home-based care; reorientation to be more family-focused in care provision; implementation of new, creative strategies to address participant and family psychological and social well-being in the home; and major reconfiguration of staffing, including transitions to new and different roles and a concomitant effort to provide support and relief to staff. CONCLUSIONS AND IMPLICATIONS: While facing many challenges that required major changes in care provision, PACE was successful in mounting a COVID-19 response that upheld safety, promoted the physical and mental well-being of participants, and responded to the needs of family caregivers. Administrators felt that, after the pandemic, the PACE service model is likely to remain more home-based and less reliant on the day center than in the past. As a result, PACE may have changed for the better and be well-positioned to play an expanded role in our evolving long-term care system.

Fabrication of GaN nano-towers based self-powered UV photodetector.

The fabrication of unique taper-ended GaN-Nanotowers structure based highly efficient ultraviolet photodetector is demonstrated. Hexagonally stacked, single crystalline GaN nanocolumnar structure (nanotowers) grown on AlN buffer layer exhibits higher photocurrent generation due to high quality nanotowers morphology and increased surface/volume ratio which significantly enhances its responsivity upon ultraviolet exposure leading to outstanding performance from the developed detection device. The fabricated detector display low dark current (~ 12 nA), high ILight/IDark ratio (> 104), fast time-correlated transient response (~ 433 µs) upon ultraviolet (325 nm) illumination. A high photoresponsivity of 2.47 A/W is achieved in self-powered mode of operation. The reason behind such high performance could be attributed to built-in electric field developed from a difference in Schottky barrier heights will be discussed in detail. While in photoconductive mode, the responsivity is observed to be 35.4 A/W @ - 3 V along with very high external quantum efficiency (~ 104%), lower noise equivalent power (~ 10-13 WHz-1/2) and excellent UV-Vis selectivity. Nanotower structure with lower strain and dislocations as well as reduced trap states cumulatively contributed to augmented performance from the device. The utilization of these GaN-Nanotower structures can potentially be useful towards the fabrication of energy-efficient ultraviolet photodetectors.

Graphene Quantum Dot-Sensitized ZnO-Nanorod/GaN-Nanotower Heterostructure-Based High-Performance UV Photodetectors.

The fabrication of a superior-performance ultraviolet (UV) photodetector utilizing graphene quantum dots (GQDs) as a sensitization agent on a ZnO-nanorod/GaN-nanotower heterostructure has been realized. GQD sensitization displays substantial impact on the electrical as well as the optical performance of a heterojunction UV photodetector. The GQD sensitization stimulates charge carriers in both ZnO and GaN and allows energy band alignment, which is realized by a spontaneous time-correlated transient response. The fabricated device demonstrates an excellent responsivity of 3.2 × 103 A/W at -6 V and displays an enhancement of ∼265% compared to its bare counterpart. In addition, the fabricated heterostructure UV photodetector exhibits a very high external quantum efficiency of 1.2 × 106%, better switching speed, and signal detection capability as low as ∼50 fW.

The Canadian Core Cariology Curriculum: Outcomes of a national symposium.

Despite the efforts that have been made in dental education and clinical practice to adopt the evidence-informed, risk-based, nonsurgical caries management approach, the surgical treatment approach continues to prevail. There is an urgent need to understand resistance to such a paradigm shift and establish a coordinated evidence-based Cariology teaching approach in Canadian dental schools so trainees are equipped to implement caries management in their practice. To work towards this goal, a two-day interinstitutional symposium was organized in Montreal, QC, bringing together clinical and research experts in cariology and dental education from all 10 Canadian dental schools to develop a consensus on an evidence-informed Core Cariology Curriculum, and strategies for its implementation. Through consensus, participants produced the Core Cariology Curriculum for Canadian dental schools and articulated the challenges and solutions for its implementation. Future work will include working collaboratively on the curriculum integration and evaluation.

The effects of systemic proteolytic enzyme therapy on pain and swelling in third molar surgery equal to diclofenac therapy: a prospective randomized double blinded clinical trial.

OBJECTIVE: The aim of this study was to determine if the timing of administration of systemic enzyme therapy [SET] has any effect on its efficacy in controlling postoperative sequelae of third molar surgery. STUDY DESIGN: A double blinded prospective randomized control trial was planned. The sample included patients requiring impacted mandibular third molar surgical extraction. Patients were randomly allocated to four groups (50 patients per group). Group A included administration of SET 48 h prior to surgery; Group B, started on the day of surgery; Group C started immediately after surgery and control group D included NSAIDS started 3 h after surgery. The predictor variable was timing of administration of SET. The primary outcome variables were pain and swelling measured on 1st day, 5th day, and 7th day after surgery. FINDINGS: Groups A and D reported lower mean and median VAS scores and lesser swelling than groups C and D on postop day 1. On days 5 and 7, all four groups were comparable. On overall analysis, no statistically significant difference (p > 0.05) was evident. INTERPRETATION: The results of the study showed that the differences in swelling and pain with starting the SET 2 days before, on the day of surgery, or immediately after when compared with diclofenac was not statistically significant. TRIAL REGISTRATION: CTRI Registration Number CTRI/2018/03/012502.

Au-Nanoplasmonics-Mediated Surface Plasmon-Enhanced GaN Nanostructured UV Photodetectors.

The nanoplasmonic impact of chemically synthesized Au nanoparticles (Au NPs) on the performance of GaN nanostructure-based ultraviolet (UV) photodetectors is analyzed. The devices with uniformly distributed Au NPs on GaN nanostructures (nanoislands and nanoflowers) prominently respond toward UV illumination (325 nm) in both self-powered as well as photoconductive modes of operation and have shown fast and stable time-correlated response with significant enhancement in the performance parameters. A comprehensive analysis of the device design, laser power, and bias-dependent responsivity and response time is presented. The fabricated Au NP/GaN nanoflower-based device yields the highest photoresponsivity of ∼ 380 mA/W, detectivity of ∼ 1010 jones, reduced noise equivalent power of ∼ 5.5 × 10-13 W Hz-1/2, quantum efficiency of ∼ 145%, and fast response/recovery time of ∼40 ms. The report illustrates the mechanism where light interacts with the chemically synthesized nanoparticles guided by the surface plasmon to effectively enhance the device performance. It is observed that the Au NP-stimulated local surface plasmon resonance effect and reduced channel resistance contribute to the augmented performance of the devices. Further, the decoration of low-dimensional Au NPs on GaN nanostructures acts as a detection enhancer with a fast recovery time and paves the way toward the realization of energy-efficient optoelectronic device applications.

Role of nanowire length on the performance of a self-driven NIR photodetector based on mono/bi-layer graphene (camphor)/Si-nanowire Schottky junction.

In this article, we have demonstrated a solid carbon source such as camphor as a natural precursor to synthesize a large area mono/bi-layer graphene (MLG) sheet to fabricate a nanowire junction-based near infrared photodetectors (NIRPDs). In order to increase the surface-to-volume ratio, we have developed Si-nanowire arrays (SiNWAs) of varying lengths by etching planar Si. Then, the camphor-based MLG/Si and MLG/SiNWAs Schottky junction photodetectors have been fabricated to achieve an efficient response with self-driven properties in the near infrared (NIR) regime. Due to a balance between light absorption capability and surface recombination centers, devices having SiNWAs obtained by etching for 30 min shows a better photoresponse, sensitivity and detectivity. Fabricated NIRPDs can also be functioned as self-driven devices which are highly responsive and very stable at low optical power signals up to 2 V with a fast rise and decay time of 34/13 ms. A tremendous enhancement has been witnessed from 36 µA W-1 to 22 mA W-1 in the responsivity at 0 V for MLG/30 min SiNWAs than planar MLG/Si PDs indicating an important development of self-driven NIRPDs based on camphor-based MLG for future optoelectronic devices.

Unusually rare occurrence and recurrence of temporomandibular joint ankylosis and oral submucous fibrosis simultaneously in a patient: A surgeon's dilemma.

We here present a rare case of simultaneous occurrence and recurrence of TMJ ankylosis and submucous fibrosis in the same patient. Patient presented with limited mouth opening at both occasions. However, the diagnosis of submucous fibrosis was overlooked at the first presentation. The patient reported with recurrence of both the conditions after a period of 15 years. We presume that noncompliance of jaw exercises aggravated both the conditions as one led to the other. Since fibrosis sets in earlier than bony fusion, we theorized that the patient had acquired OSMF before TMJ ankyloses recurrence. The case was managed with release of fibrous bands intraorally followed by release of TMJ ankylosis and interposition with dermis fat graft. Physiotherapy is extremely essential when either pathology is treated in patients, especially when both are present in a single patient.

Effect of Different Finishing and Polishing Systems on the Surface Roughness of Resin Composite and Enamel: An In vitro Profilometric and Scanning Electron Microscopy Study.

AIM: The aim is to compare and evaluate the different finishing and polishing systems for the change in surface roughness of resin composites and enamel. MATERIALS AND METHODS: To conduct the study, 30 extracted human maxillary central incisors were selected, decoronated, and molded in self-cure acrylic molds. A box-shaped cavity of dimensions 3 mm × 3 mm × 2 mm was prepared in all the teeth. A nanohybrid composite resin (Filtek Z250) was then used to restore the prepared cavities. Thirty samples were divided into two groups, control group (Group A, n = 10) and experimental group (Group B, n = 20). The samples in Group A were cured through the Mylar matrix. The experimental group, i.e., Group B was divided into two subgroups, i.e., Subgroup BX, n = 10 in which Sof-Lex polishing system was used for polishing the tooth surface and Subgroup BF, n = 10 in which Shofu composite polishing system was used. The mean surface roughness (Ra in µm) of the composite restoration as well as for the enamel surface of all the samples before and after polishing was measured with a contact profilometer, and the values were correlated with scanning electron microscopy. RESULTS: The statistical analysis was carried out using paired t-test. The results exhibited a significant decrease in the surface roughness of the resin composite and enamel surface irrespective of the finishing and polishing system used. The mean surface roughness values demonstrated by Mylar matrix was the lowest followed by Sof-Lex polishing system. Shofu polishing system demonstrated the highest surface roughness values. CONCLUSION: Finishing and polishing of composite restoration can achieve a surface roughness similar to that of enamel. Involvement of marginal enamel in finishing and polishing procedures carried out for composite restoration results in smoother enamel surface.

Combined endoscopic and intra-oral approach for chronic maxillary sinusitis of dental origin-a prospective clinical study.

AIMS AND OBJECTIVES: The traditional Caldwell-Luc approach for maxillary diseases has been criticized for its shortcomings such as removal of a large amount of bone, numbness of the teeth, flap dehiscence, and recurrent sinusitis. On account of its minimal invasiveness and physiological approach, functional endoscopic sinus surgery (FESS) has come to replace the Caldwell-Luc approach for the treatment of chronic rhinosinusitis. Chronic maxillary sinusitis of dental origin (CMSDO) is a less common variant on the chronic rhinosinusitis spectrum whose treatment involves simultaneous management of both the diseased maxillary sinus and the dental source of infection. Thus, this study was undertaken to assess the efficacy of FESS when combined with an intra-oral approach for the treatment of CMSDO. MATERIAL AND METHODS: Eighteen patients with CMSDO in the age group of 18-50 years were treated with a combined endoscopic and intra-oral approach (buccal advancement flap with/without buccal fat pad) in this study. The patients were followed up for a total duration of 18 months. The primary outcome measurements were the SNOT-22 Quality of Life questionnaire and the Lund and Mackay CT Scan Scoring Criteria. The Friedman test was used to assess improvement in the above variables and the level of significance was set at 0.05. OBSERVATIONS AND RESULTS: There was a statistically significant reduction (p < 0.05) in both the above parameters at all post-operative intervals. Two patients presented with epistaxis (immediate post-operative phase) and synechiae (second week follow-up interval). Both complications were successfully resolved. Two patients showed recurrence at the 6th-month interval for which they underwent revision surgery successfully. Overall, results were maintained even at the 18th month follow-up interval. CONCLUSION: The endoscopic approach appears to be a reliable, minimally invasive technique associated with less morbidity and stable long-term results. Thus, a multi-disciplinary approach between maxillofacial surgeons and otolaryngologists is essential in the treatment of CMSDO.

Modified Cut for Gap Arthroplasty in Temporomandibular Joint Ankylosis.

Temporomandibular joint ankylosis is a debilitating disease affecting the function, esthetics and psychology of the patient. Treatment of this condition aims at establishing not only the function and esthetics but also aims to prevent reankylosis. Among the different treatment modalities, interpositional gap arthroplasty followed by aggressive jaw physiotherapy is considered most effective. This is achieved by making two horizontal osteotomy cuts at a distance of 10-15 mm in the TMJ region. The gap is then interposed with an autogenous or alloplastic graft material. However, during the application of a jaw stretcher intraoperatively with the surgical site open and with the jaw wide open, a bony contact was seen to occur between the posterior aspect of the upper and lower osteotomy cuts. Taking this into consideration, the lower osteotomy cut is modified by making the posterior one-third cut divergent. This eliminates the bony contact during maximum mouth opening and thus prevents the chances of reankylosis as well.

A Randomized Control Trial Comparing Buccal Infiltration of 4% Articaine with Buccal and Palatal Infiltration of 2% Lignocaine for the Extraction of Maxillary Premolar Teeth.

INTRODUCTION: The use of articaine has been claimed to obviate the need for routine palatal local anesthetic injections on account of its better diffusion through soft and hard tissues as compared to other local anesthetic agents. OBJECTIVE: The objective of the study is to evaluate the efficacy of 4% articaine (with 1:100,000 adrenaline) infiltrated only buccally in the extraction of maxillary premolars for orthodontic reasons. MATERIALS AND METHODS: A double-blind randomized clinical trial with a split-mouth design, where each patient (n = 100) was part of two groups, was conducted. Experimental Group 1: single buccal infiltration of 4% articaine with 1:100,000 adrenaline (Septanest™ with adrenaline 1:100,000 by Septodont). Control Group 2: routine buccal and palatal infiltrations of 2% lignocaine with 1:200,000 adrenaline (Lox™ 2% with adrenaline 1:200,000 by Neon). The parameters studied were time to onset of anesthesia, pain during the extraction procedure (not during the injecting of the local anesthetic), and frequency of extra amount of local anesthetic injected. RESULTS: The difference was not statistically significant (P > 0.05) between the two groups with respect to all three parameters. This proves that a single buccal infiltration of articaine can be used as an alternative to lignocaine for the extraction of the maxillary premolar teeth in most of the cases. CONCLUSION: This proves that a single buccal infiltration of articaine can be used as an alternative to lignocaine for the extraction of the maxillary premolar teeth in most of the cases.

The Pterygoid Hamulus Syndrome - An Important Differential in Orofacial Pain.

The purpose of this review was to document cases of pterygoid hamulus (PH) syndrome and to describe the various etiology, differential diagnosis, and management strategies so far reported in literature. Here, we also present two case reports of PH syndrome. A comprehensive search in PubMed/Medline database was done using MeSH terms such as "Pterygoid Hamulus," "Pterygoid Hamulus Syndrome," and "Hamular Bursitis" using various Boolean operators such as "AND" and "OR". Till date, 31 cases of this entity including the present cases have been found. Conservative management was followed in the earlier reported cases; however, most cases were treated by surgical resection.

Plaque Removal Efficacy of Different Toothbrushes: A Comparative Study.

AIM AND OBJECTIVE: This study aimed to compare the plaque removal efficacy of different toothbrushes and to ascertain the most efficient mechanical mean for daily plaque removal so as to maintain oral health in a preeminent way. STUDY DESIGN: It was a randomized controlled clinical trial consisting of 60 subjects divided into three groups (group I ultrasonic and sonic toothbrush, group II multidirectional toothbrush, and group III manual toothbrush) with 20 in each group. Prebrushing and postbrushing plaque scores were recorded at weekly intervals for four weeks using Turesky modification of Quigley and Hein plaque index. RESULTS: Statistically significant differences (p < 0.001) existed in mean percent reduction of pre-day 1 to pre-day 28 mean percent reduction in plaque values of the ultrasonic toothbrush group (111.92 ± 25.20), the multidirectional toothbrush group (189.06 ± 52.70), and the manual toothbrush group (42.34 ± 14.77). Similar results were found in post-day 1 to post-day 28 mean percent reduction in plaque values. CONCLUSION: Group II (i.e., multidirectional toothbrush) showed maximum mean percent reduction in prebrushing and postbrushing plaque scores at the end of four weeks when compared with the baseline values followed by ultrasonic toothbrush and manual toothbrush. HOW TO CITE THIS ARTICLE: Aggarwal N, Gupta S, Grover R, et al. Plaque Removal Efficacy of Different Toothbrushes: A Comparative Study. Int J Clin Pediatr Dent 2019;12(5):385-390.

Intraoperative Manipulation of Bony Segments: An Innovative Method.

INTRODUCTION: Various methods are deployed by an oral and maxillofacial surgeon to control the osteotomised/ fractured bony segments intraoperatively till the time a stable fixation in the desired position is achieved. Few of these include the use of bone holding crocodile forceps, towel clips, reduction forceps, wires, digital control (Thota and Mitchell in Br J Orthod 26(4):325, 1999). In our technique, we present the use of an IMF screw to manipulate bony segments intraoperatively. MATERIALS AND METHODS: We used this novel technique in a series of 12 patients. An IMF screw was fixed in the greatest bulk of the bony fragment so as to control it and hold it in the desired position in various surgical procedures. CONCLUSION: This technique was found to be minimally invasive and easy to perform to achieve a good hold and control of the bony segments.