Comparison of Automatically Controlled Injection System with a Traditional. Syringe for Multiple Infiltrations in Children Aged 6-12 Years: A Randomized Controlled Trial.

Children's conduct is significantly impacted by pain during dental procedures. Children's pain and discomfort can be reduced using computer-controlled local anesthetic delivery, which applies a steady, gradual flow of the anesthetic solution into the tissues. Using a self-report anxiety scale, the study aimed to assess and compare children's perceptions of discomfort following a new auto-controlled injection method to a traditional local anesthetic procedure. A total of 25 children, ages 6-12 requiring the use of local anesthesia for treatment on both sides of the arch were selected. It was a split-mouth design, in which each participating child received both types of infiltrations in two separate, consecutive visits, using a metallic syringe in one session, and using the I-Ject device in the other. Before administering anesthesia, all the children's anxiety scales were recorded using the Modified Child Dental Anxiety Faces Scale simplified to assess the anxiety level of a child. In the first appointment, Conventional anesthetic technique was and in the second appointment anesthesia was delivered using a computer-controlled device. Faces pain scaleRevised, a selfreport measure of pain was recorded immediately after completion of both types of local anesthesia (LA) administration. Patients reported greater comfort with the I-Ject computer-controlled device than with conventional anesthesia. Together with the practitioner, the computer system produced a pleasant and cozy environment for the youngster.

The Variants of Frontal Recess and Its Effect in the Development and Prevalence of Frontal Sinusitis in Patients in a Tertiary Care Hospital: A Retrospective Observational Study.

According to medical literature, the frontal recess' intricate physical structure resembles an inverted funnel. The anatomical structure is not distant from the frontal ostium. Surgery requires a good understanding of the frontal recess architecture because of the intricate anatomy of this relatively small area. The pathophysiological characteristics of frontal sinusitis and the process of sinus ventilation through the sinus ostium have been linked, according to medical literature. Medical studies show that one of the most important factors affecting the amount of drainage in the frontal sinuses is the size of the frontal sinus ostium. Inflammation brought on by frontal recess cells can frequently affect the airflow in the frontal sinuses. The drainage channel of the frontal sinus is stated as narrowing in the current investigation as an observed phenomenon. The aim of this study was to examine the frontal recess changes and how they might affect the emergence of frontal sinusitis. The classification of frontal recesses according to their various categories was the study's principal finding. The investigation of the causal elements that resulted in the development of frontal sinusitis was the study's secondary goal. In a hospital setting, a cohort of 200 patients with sinonasal disorders underwent a retrospective observational research. Over the course of a year, from July 2021 to June 2022, the study participants had evaluations at a tertiary care center. 200 CT PNS images of individuals who fit certain inclusion and exclusion criteria were examined in this study. Using the chi-square test, the study looked into the relationships between several risk factors, including age, gender, and the type of frontal recess. The presence of frontal sinusitis served as the main outcome indicator. This study included a total of 200 participants with a mean age was 43.38 years (± 10.69). There was 146 (73%) male and 54 (27%) female were in the study. Type I frontal recess in 50 (25%), type II in 82 (41%), type III in 24 (12%) and type IV in 18 (9%) patients. The association of age (P = 0.141) and gender (P = 0.345) with frontal sinusitis was not significant. The statistical association between type of frontal recess and frontal sinusitis was statistically not significant. The association between age and the type of frontal recess was found to be statistically significant by Fischer's exact test with P value of 0.012 (< 0.05), whereas gender was not associated with the type of frontal recess by the same test. It is difficult to overstate the significance of the terms frontal recess, frontal sinusitis, and sinus ostium in this particular medical context. This article was a retrospective observational study that investigates the connection between frontal sinusitis and changes in the frontal recess in patients receiving care at tertiary medical facilities.

Ent Manifestations in Sculptors of South Chennai, India: A Cross Sectional Observational Study.

Despite the National Occupational Safety and Legislation Act 2020's implementation, reports of workplace accidents are rising in India. Various ear, nose, and throat conditions have been linked to a wide range of physico-chemical variables. Due to a lack of training, inadequate knowledge, a lack of awareness of occupational health and safety risks, or a lack of accessibility to or use of personal protective equipment (PPE), sculptors are frequently exposed to a variety of physical, compound and unplanned risks, chemical, and accidental hazards. The study aimed to assess the various ear, nose and throat manifestations like noise induced hearing loss, occupational rhinitis and non-infectious pharyngitis among the sculptors working in the southern part of Chennai. This observational study was performed in a total of 110 sculptors. Demographic data like age, education, duration of occupation, use of PPE like face mask, ear plug during work hours, whether sculpting is a family occupation or first generation sculptor. A detailed history and thorough ENT examination was performed with pure tone audiometry (PTA), diagnostic nasal endoscopy (DNE) and videolaryngoscopy (VLS). If any problem is detected they will be treated accordingly. Most of them (70%) were in the age group of 21-40 years but 71% of them are sculptors for more than 15 years which infers introduction to the occupation at an early age. The reason for this could be more than 80% of them possessed the heritage of sculpting as their family occupation. Duration of occupation was significantly associated with chronic rhinitis (P value was 0.002) and NIHL (P value was 0.002) whereas education and use of PPE like face mask or ear plugs were not associated with ENT manifestations. This study focuses on the sculptors' working habits, their ignorance of safety precautions, and an assessment of the numerous ENT ailments. These manifestations showed a strong correlation to exposure time. To prevent the issues from becoming more severe, regular medical monitoring is required for early detection and intervention.

Audiological Profile in Allergic Rhinitis, a Hospital Based Study.

A type-I hypersensitivity reaction of the nasal mucosa, allergic rhinitis (AR) is distinguished by nasal obstruction, watery rhinorrhea, sneezing, and throat, mouth, and nose irritation. It is assumed that allergies can affect the inner, middle, or outer ear. Many writers have studied the relationship between allergic rhinitis and otitis media. Most of them concur that bacterial infection and Eustachian tube obstruction are significant risk factors for the development of otitis media with effusion in addition to allergies. One hundred study participants had a full clinical evaluation that included an ENT history and examination. In the ENT OPD, the audiological examination was conducted using Pure Tone Audiometry (PTA) and Impedance Audiometry (IA). At frequencies of 250 and 8000 Hz, respectively, the bone and air conduction thresholds were studied. The commercially available "AT235 INTERACOUSTICS" tympanometer was used for the tympanometry procedure. With pressure variations between + 200 and - 300daPa, tympanometry was carried out employing a 226 Hz probe tone. Mean age of study population was 52.16 and 24% each in age group 51 to 60 and 61 to 70 years respectively. 73 (73%) were male and 27 (27%) were female. 46% of allergic rhinitis study population was found to have normal hearing and 43% had mild conductive hearing loss. Most common type of impedance curve was A type (47%). Patients having acute phase of allergy with symptoms less than 3 months had more ear block and secretory otitis media. Patients with duration more than 3 months had resolved secretory otitis media hence the hearing was normal in 33 cases and 11 had mild conductive hearing loss. This study was concluded that there is correlation between the severity of the hearing loss and duration of allergic rhinitis.

Internal Rotation Measurement of the Knee with Polymer-Based Capacitive Strain Gauges versus Mechanical Rotation Measurement Taking Gender Differences into Account: A Comparative Analysis.

With the conventional mechanical rotation measurement of joints, only static measurements are possible with the patient at rest. In the future, it would be interesting to carry out dynamic rotation measurements, for example, when walking or participating in sports. Therefore, a measurement method with an elastic polymer-based capacitive measuring system was developed and validated. In our system, the measurement setup was comprised of a capacitive strain gauge made from a polymer, which was connected to a flexible printed circuit board. The electronics integrated into the printed circuit board allowed data acquisition and transmission. As the sensor strip was elongated, it caused a change in the spacing between the strain gauge's electrodes, leading to a modification in capacitance. Consequently, this alteration in capacitance enabled the measurement of strain. The measurement system was affixed to the knee by adhering the sensor to the skin in alignment with the anterolateral ligament (ALL), allowing the lower part of the sensor (made of silicone) and the circuit board to be in direct contact with the knee's surface. It is important to note that the sensor should be attached without any prior stretching. To validate the system, an in vivo test was conducted on 10 healthy volunteers. The dorsiflexion of the ankle was set at 2 Nm using a torque meter to eliminate any rotational laxity in the ankle. A strain gauge sensor was affixed to the Gerdii's tubercle along the course of the anterolateral ligament, just beneath the lateral epicondyle of the thigh. In three successive measurements, the internal rotation of the foot and, consequently, the lower leg was quantified with a 2 Nm torque. The alteration in the stretch mark's length was then compared to the measured internal rotation angle using the static measuring device. A statistically significant difference between genders emerged in the internal rotation range of the knee (p = 0.003), with female participants displaying a greater range of rotation compared to their male counterparts. The polymer-based capacitive strain gauge exhibited consistent linearity across all measurements, remaining within the sensor's initial 20% strain range. The comparison between length change and the knee's internal rotation angle revealed a positive correlation (r = 1, p < 0.01). The current study shows that elastic polymer-based capacitive strain gauges are a reliable instrument for the internal rotation measurement of the knee. This will allow dynamic measurements in the future under many different settings. In addition, significant gender differences in the internal rotation angle were seen.

Strategies to Improve Medical Communication.

This JAMA Insights summarizes strategies for effective medical communication, with considerations for the message delivered, the messenger source, and the social context.

Cri-Du-Chat Syndrome - A Rare Case Report.

The Cri-du-chat Syndrome (CdCs) is a rare genetic syndrome first described by Jerome Lejeune in 1963, characterized mainly by the high pitched cat like cry. The prevalence of CdCs was varied in between 1:15,000 to 1:50,000 in live birth and more common in female gender with a ratio of 4:3 [1, 2] .The condition may be accompanied by developmental and cognitive delays, poor spatial awareness, impaired ambulation, and poor sensori-motor skills. Other associated problems described include cardiovascular, renal, gastrointestinal, neurological abnormalities, preauricular tags, syndactyly, hypospadias, and cryptorchidism.1 Recent literatures show that autistic behaviours are common in various genetic disorders [3].Fatigue level of children with cri du chat syndrome was associated with the expression of autistic features [4]. Cri-du-chat syndrome is a rare genetic disorder resulting in various physical and psychological abnormalities due the deletion of chromosome 5P-. We encountered a case of cri-du-chat syndrome having external auditory canal atresia, hearing loss with speech delay. A multidisciplinary approach is required for diagnosis and management of such patients. Otological management is early identification of hearing loss and speech rehabilitation. Awareness about antenatal screening for congenital anomalies and genetic counselling is necessary among the general population.

Engineering semi-permeable giant liposomes.

Giant unilamellar vesicles (GUVs) with a semi-permeable nature are prerequisites for constructing synthetic cells. Here we engineer semi-permeable GUVs by the inclusion of DOTAP lipid in vesicles. Diffusion of molecules of different charge and size across GUVs are reported. Control over size-selective permeability is demonstrated by modulating the DOTAP lipid composition in different lipid systems without reconstituting membrane proteins. Such semi-permeable GUVs have immense applications for constructing synthetic cells.

GA-coupled ANN model for predicting porosity in alginate gel scaffolds.

Alginate gel scaffolds are biocompatible and biodegradable materials that have been used in a variety of tissue engineering applications. The porosity of alginate gel scaffolds is an important property that affects their performance. However, it is difficult to predict the porosity of alginate gel scaffolds accurately. In this study, a GA-coupled ANN model was developed to predict the porosity of alginate gel scaffolds. The model was trained on a dataset of 107 scaffolds with known porosities. The model was able to achieve a mean absolute error of 0.13, which suggests that it is able to accurately predict the porosity of alginate gel scaffolds. The alginate scaffold was fabricated by a microfluidic technique using a syringe pump and a flow device. The crosslinker solution was poured into the Petri dish to crosslink the polymer to the gel structure. The Archimedes method was used to determine the scaffold's apparent porosity. The artificial neural network has been used to model the porosity of the gel scaffold using the input parameters such as alginate-pluronic viscosity, surface tension, and contact angle etc. The maximum porosity was modelled to be 96.4 % using GA whereas the experimental value for the same was measured to be 92.8 ± 2 %. A 3.7% variation in the porosity was found from modelled value. To the best of our knowledge, this study is the first to develop an integrated ANN-coupled GA model to predict the maximum porosity of the gel scaffold. The result indicates that artificial intelligence has great potential for optimizing the parameters to fabricate the gel scaffold that can be used for tissue engineering applications.

Comparison of Single Versus Two Non-Compression Miniplates in the Management of Unfavourable Angle Fracture of the Mandible Orginal Research.

Aim: To compare the postoperative complications of fixing Mandibular angle fractures with two non-compression mini plates, on the superior and lateral the aspects of the mandible, to the standard technique of using a single non-compression miniplate on the superior border. Methodology: Fifty patients with MAF were divided equally into two groups. Patients in Group 1 were secured with two mini plates at the lateral and superior border of the MA using an extraoral approach; for patients in Group 2 a single non-compression miniplate was used via an intraoral extended third molar approach as described by Champy et al. The post-operative complications in both groups were compared statistically. Results: The findings of this study revealed that there was no significant difference in postoperative complications between the two groups when fixing MAF with two non-compression mini plates versus the standard technique of using a single non compression miniplate on the superior border of the mandible. However, the surgery time with one miniplate was significantly more than the dual plate approach. Conclusion: We advocate using two mini plates to treat an unfavorable angle fracture.

Digital measurement of anterolateral knee laxity using strain sensors.

PURPOSE: The ambition of the research group was to develop a sensor-based system that allowed the transfer of results with strain sensors applied to the knee joint. This system was to be validated in comparison to the current static mechanical measurement system. For this purpose, the internal rotation laxity of the knee joint was measured, as it is relevant for anterolateral knee laxity and anterior cruciate ligament (ACL) injury. METHODS: This is a noninvasive measurement method using strain sensors which are applied to the skin in the course of the anterolateral ligament. The subjects were placed in supine position. First the left and then the right leg were clinically examined sequentially and documented by means of an examination form. 11 subjects aged 21 to 45 years, 5 women and 6 men were examined. Internal rotation of the lower leg was performed with a torque of 2 Nm at a knee flexion angle of 30°. RESULTS: Comparison of correlation between length change and internal knee rotation angle showed a strong positive correlation (r = 1, p < 0.01). Whereas females showed a significant higher laxity vs. males (p = 0.003). CONCLUSIONS: The present study showed that the capacitive strain sensors can be used for reproducible measurement of anterolateral knee laxity. In contrast to the previous static systems, a dynamic measurement will be possible by this method in the future.

Advances in giant unilamellar vesicle preparation techniques and applications.

Giant unilamellar vesicles (GUVs) are versatile and promising cell-sized bio-membrane mimetic platforms. Their applications range from understanding and quantifying membrane biophysical processes to acting as elementary blocks in the bottom-up assembly of synthetic cells. Definite properties and requisite goals in GUVs are dictated by the preparation techniques critical to the success of their applications. Here, we review key advances in giant unilamellar vesicle preparation techniques and discuss their formation mechanisms. Developments in lipid hydration and emulsion techniques for GUV preparation are described. Novel microfluidic-based techniques involving lipid or surfactant-stabilized emulsions are outlined. GUV immobilization strategies are summarized, including gravity-based settling, covalent linking, and immobilization by microfluidic, electric, and magnetic barriers. Moreover, some of the key applications of GUVs as biomimetic and synthetic cell platforms during the last decade have been identified. Membrane interface processes like phase separation, membrane protein reconstitution, and membrane bending have been deciphered using GUVs. In addition, vesicles are also employed as building blocks to construct synthetic cells with defined cell-like functions comprising compartments, metabolic reactors, and abilities to grow and divide. We critically discuss the pros and cons of preparation technologies and the properties they confer to the GUVs and identify potential techniques for dedicated applications.

Dynamic Control of Functional Coacervates in Synthetic Cells.

Membrane-less compartments formed via liquid-liquid phase separation (LLPS) are regulated dynamically via enzyme reactions in cells. Giant unilamellar vesicles (GUVs) provide a promising chassis to control, mimic, and understand the LLPS process; however, they are challenging to construct. Here, we engineer the dynamic assembly and disassembly of LLPS compartments using complex coacervates as models inside synthetic cells. Semipermeable GUVs constructed with defined lipid composition encapsulate the biomolecules, including enzymes required to regulate coacervates. Assembly and disassembly of coacervates are triggered in independent systems by the diffusion of substrates through the membrane into the vesicle lumen. The coupling of enzyme networks in a single synthetic cell system allows for reversible and out-of-equilibrium regulation of coacervates. The functional properties of the coacervates are revealed by sequestering biomolecules, including drugs and enzymes. GUVs, with functional LLPS compartment assembly, open avenues in constructing programmable autonomous synthetic cells with membrane-less organelles. The coacervate-in-vesicle platform has significant implications for understanding LLPS regulation mechanisms in cells.

To Determine the PH of External Auditory Canal in Otitis Externa: A Prospective Observational Study in a Tertiary Health Care Centre.

Otitis externa is an inflammatory condition of the external auditory canal which occurs due to any trauma, changes in the PH of the skin of external auditory canal. The normal PH of the external auditory canal skin should be in the acidic medium. This inhibits the growth of certain infectious microorganisms. Once the external canal skin PH becomes alkaline, the chances of inflammation of the skin increases. To assess the pH of the external auditory canal in cases of otitis externa with secretion and compare the treatment efficacy of treating it with topical anti-inflammatory like ichthammol glycerine, topical steroid cream and oral antibiotics. A prospective observational study involved a total of 120 patients who came with symptoms and signs of external otitis. pH of external canal was measured during first visit and at 42 days. The patients were divided into three groups. First group was treated with Ichthammol glycerine, second group was treated with Ichthammol glycerine with topical steroid cream and third group was treated with oral antibiotics with topical steroid cream. Patients were analyzed based on severity score during first visit, at 7 days, at 21 days and 42 days. This study involved 64(53.3%) patients were male and 56(46.7%) were females. The mean age group involved in the study was 42.50 years. The mean PH value in the external auditory canal during the first visit was alkaline (6.09) and the mean PH value at 42 days was changed to acidic (4.95) which was statistically significant (p = 0.00). There was significant reduction in the severity score in the oral antibiotic with topical steroid cream, followed by IG with topical steroid cream followed by Ichthammol glycerine (p = 0.001). In this study we have analyzed the pH level favorable in causing otitis externa and the best available treatment for the same. It has been observed that the alkaline Ph is more favorable in causing otitis externa. Efficacy of Topical corticosteroid with antibiotics is maximum in the management of otitis externa.

Bacterial Outer-Membrane-Mimicking Giant Unilamellar Vesicle Model for Detecting Antimicrobial Permeability.

The construction of bacterial outer membrane models with native lipids like lipopolysaccharide (LPS) is a barrier to understanding antimicrobial permeability at the membrane interface. Here, we engineer bacterial outer membrane (OM)-mimicking giant unilamellar vesicles (GUVs) by constituting LPS under different pH conditions and assembled GUVs with controlled dimensions. We quantify the LPS reconstituted in GUV membranes and reveal their arrangement in the leaflets of the vesicles. Importantly, we demonstrate the applications of OM vesicles by exploring antimicrobial permeability activity across membranes. Model peptides, melittin and magainin-2, are examined where both peptides exhibit lower membrane activity in OM vesicles than vesicles devoid of LPS. Our findings reveal the mode of action of antimicrobial peptides in bacterial-membrane-mimicking models. Notably, the critical peptide concentration required to elicit activity on model membranes correlates with the cell inhibitory concentrations that revalidate our models closely mimic bacterial membranes. In conclusion, we provide an OM-mimicking model capable of quantifying antimicrobial permeability across membranes.

Electrochemical-based approaches for the treatment of forever chemicals: Removal of perfluoroalkyl and polyfluoroalkyl substances (PFAS) from wastewater.

Electrochemical based approaches for the treatment of recalcitrant water borne pollutants are known to exhibit superior function in terms of efficiency and rate of treatment. Considering the stability of Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are designated as forever chemicals, which generating from various industrial activities. PFAS are contaminating the environment in small concentrations, yet exhibit severe environmental and health impacts. Electro-oxidation (EO) is a recent development that treats PFAS, in which different reactive species generates at anode due to oxidative reaction and reductive reactions at the cathode. Compared to water and wastewater treatment methods those being implemented, electrochemical approaches demonstrate superior function against PFAS. EO completely mineralizes (almost 100 %) non-biodegradable organic matter and eliminate some of the inorganic species, which proven as a robust and versatile technology. Electrode materials, electrolyte concentration pH and the current density applying for electrochemical processes determine the treatment efficiency. EO along with electrocoagulation (EC) treats PFAS along with other pollutants from variety of industries showed highest degradation of 7.69 mmol/g of PFAS. Integrated approach with other processes was found to exhibit improved efficiency in treating PFAS using several electrodes boron-doped diamond (BDD), zinc, titanium and lead based with efficiency the range of 64 to 97 %.

Strategies for enhancing the efficacy of anaerobic digestion of food industry wastewater: An insight into bioreactor types, challenges, and future scope.

Food waste have become a growing concern worldwide with raising population and economic growth. Wastewater discharged from food industries contains many valuable and toxic components that have a negative impact on the ecological system. Large amounts of wastewater are discharged from the food industry, which necessitates the creation of effective technologies. Wastewater from the food industry can be seen as a rich source of energy and a primary source for generating valuable products. Waste disposal and resource recovery are sustainably valued by anaerobic digestion of wastewater from the food sector. The characteristics, composition, and nature of wastewater produced from various food sectors are elaborated upon in this review. An overview of the anaerobic digestion process for wastewater treatment in the food industry is included. Enhancement strategies for the anaerobic digestion process have been discussed in detail. In addition, various types of reactors utilized for performing anaerobic digestion is illustrated. Though anaerobic digestion process possesses advantages, the challenges and future scope are examined for improving the outcome.

Individualization of the Dosage Regimen of Erythropoietin is Crucial in End-stage Renal Disease Patients.

The objective of this study was to understand the utilization pattern of erythropoietin in end-stage renal disease patients, along with the effect of body weight and sex on the patients' responses. In this retrospective single-center study, 120 patients were included who were on a once weekly (n = 79), twice weekly (n = 37), or thrice weekly (n = 4) regimen. The doses of erythropoiesis-stimulating agents (ESA) were collected, and the erythropoietin resistance index (ERI) was determined. The Kruskal-Wallis test was used to evaluate the dose schedules, and the once-weekly regimen produced a greater response (P = 0.001). The asymptotic significance of Pearson's Chi-square-test equating the mean ERI and body mass index (BMI) was 0.034. No statistically significant correlation was estimated between sex and mean ERI (P = 0.201). Our study demonstrated that the once-weekly regimen dominated over the others in terms of efficacy, and individuals with a higher BMI were found to respond better to the ESA therapy.

Assembly of transmembrane pores from mirror-image peptides.

Tailored transmembrane alpha-helical pores with desired structural and functional versatility have promising applications in nanobiotechnology. Herein, we present a transmembrane pore DpPorA, based on the natural pore PorACj, built from D-amino acid α-helical peptides. Using single-channel current recordings, we show that DpPorA peptides self-assemble into uniform cation-selective pores in lipid membranes and exhibit properties distinct from their L-amino acid counterparts. DpPorA shows resistance to protease and acts as a functional nanopore sensor to detect cyclic sugars, polypeptides, and polymers. Fluorescence imaging reveals that DpPorA forms well-defined pores in giant unilamellar vesicles facilitating the transport of hydrophilic molecules. A second D-amino acid peptide based on the polysaccharide transporter Wza forms transient pores confirming sequence specificity in stable, functional pore formation. Finally, molecular dynamics simulations reveal the specific alpha-helical packing and surface charge conformation of the D-pores consistent with experimental observations. Our findings will aid the design of sophisticated pores for single-molecule sensing related technologies.