Comparative Evaluation of Microbial Flora of Endodontic Origin in Teeth with Endo-Perio Lesions.

Background: Endodontic microbial flora plays a pivotal role in the development and persistence of periodontal endodontic lesions (PELs). Understanding the composition and prevalence of microbial species in PELs is essential for effective treatment strategies. Materials and Methods: Microbial samples were collected from 50 teeth diagnosed with PELs. Sterile paper points were used to obtain samples from the root canals. Deoxyribonucleic acid (DNA) was extracted and subjected to polymerase chain reaction (PCR) amplification of the 16S ribosomal RNA (rRNA) gene to identify bacterial species. The obtained data were analyzed using statistical methods. Results: The microbial analysis revealed a diverse range of bacterial species in PELs. The most prevalent species were Porphyromonas gingivalis (32.5%), Treponema denticola (28.0%), and Fusobacterium nucleatum (22.5%). Streptococcus mutans (9.0%) and Actinomyces naeslundii (8.0%) were also frequently detected. Additionally, Prevotella intermedia (7.0%), Aggregatibacter actinomycetemcomitans (3.5%), and Enterococcus faecalis (2.5%) were present in lower frequencies. Conclusion: The presence of a diverse microbial flora in teeth with PELs underscores the polymicrobial nature of these lesions. The predominance of periodontal pathogens such as Porphyromonas gingivalis, Treponema denticola, and Fusobacterium nucleatum suggests a strong association between periodontal and endodontic infections. A comprehensive understanding of the microbial profile in PELs is crucial for tailored therapeutic approaches targeting the specific pathogens involved.

Folded interferometer to measure coherence-polarization matrix.

We present and experimentally demonstrate a new, to the best of our knowledge, technique to quantitatively measure coherence-polarization (BCP) matrix with correlations of only two Stokes fluctuations. The BCP matrix is a square matrix with four elements that involves two-point correlations among orthogonal polarization components. A theoretical framework of the technique is developed, and its viability is demonstrated by a proof of principle experiment. Experimental tests and measurement of the elements of the BCP matrix of statistically stationary beams are demonstrated.

Hanbury Brown-Twiss approach for imaging through a dynamic scattering medium.

The Hanbury Brown-Twiss approach, associated with the correlation of intensity fluctuations at two different points in a wave field, unveils fundamental aspects of light. Here, we propose and experimentally demonstrate an imaging and phase recovery technique through a dynamic scattering medium using the Hanbury Brown-Twiss approach. A detailed theoretical basis is presented and verified by experimental demonstrations. To validate the application of the proposed technique, the randomness of the dynamically scattered light is exploited using temporal ergodicity for evaluating the correlation of intensity fluctuations and consequently applying it in the reconstruction of the object hidden behind the dynamic diffuser.

On-axis phase-shifting correlation holography with un-polarized light.

We propose and experimentally demonstrate an on-axis phase-shifting correlation holography technique with un-polarized light. The randomness of the un-polarized light is exploited to evaluate the higher-order polarization correlation and to consequently apply it in the reconstruction of the hologram from the randomness. A detailed theoretical analysis is developed and verified by numerical simulations and followed by experimental demonstrations. To validate the application of the proposed technique, imaging of different helical phase objects with randomness is presented. A good affinity is found between simulation and experimental results, which validates the accuracy of the proposed technique.

Anomalies of motor unit amplitude and territory after botulinum toxin injection.

Objective. Botulinum toxin (BT) induced cholinergic denervation of hyperactive motor units (MUs) is a clinically accepted and extensively practiced way of managing focal spasticity after stroke. The denervation potentially initiates a temporary reorganization of the MU activation patterns and structures by inducing the emergence of a large number of newly innervated muscle fibers. In this study, we quantify the effect of the BT on MU action potential (MUAP) amplitudes and on the MU territory areas (MUTAs) as seen on the surface of the skin over the biceps brachii (BB) muscle.Approach. We have used a 128-channel high-density surface electromyography (HDsEMG) grid on the spastic and contralateral BB muscle and recorded the myoelectric activity along with the contraction force during isometric contraction of the elbow muscles. We have decomposed the recorded EMG signal into individual MU potentials and estimated the MUAP amplitudes and territory areas before and two weeks after a BT injection.Main result. There were significantly larger median (47 ± 9%) MUAP amplitudes as well as reduction of MUTA (20 ± 2%) two weeks after the injection compared to the respective pre-injection recording.Significance. The observed covariation of the amplitude and the territory area indicates that the large amplitude MUs that appeared after the BT injection have a relatively smaller territory area. These results provide a rare insight into the BT-induced changes of MU characteristics and have the potential to improve spasticity treatment. We discuss the potential contributing factors to these changes subsequent to the injection in the context of the investigated subject cohort.

Characteristic Variation of Electromechanical Delay After the Botulinum Toxin Injection in Spastic Biceps Brachii Muscles.

The objective of this study was to characterize the effects of intramuscular botulinum toxin (BT) injections on the electromechanical delay (EMD) in spastic human biceps muscles. The EMD is calculated as the time lag between the muscle activation onset, as recorded from the surface electromyogram (sEMG), and the onset of recorded force. In a cohort of chronic stroke survivors, we compared the computed EMD derived from the spastic (injected) biceps brachii with that from the contralateral muscle. Eight participants were tested before and up to 3 months after a BT injection. At each session, participants followed an isometric trapezoidal force trajectory at 50 and 30%, respectively, of the tested maximum voluntary contraction (MVC). Joint force and sEMG signals were recorded as well. The number of zero crossings (ZC) of the sEMG during the steady-state portion of the task was also computed. The EMD post-BT was found to increase by 64 ± 10% (at 50% MVC) and 93 ± 18% (at 30% MVC) when compared to pre-BT values, while the number of sEMG-ZC, the mean MVC values, and the force-EMD slope exhibited striking reductions. These parameters, calculated on the contralateral side, remained relatively constant across sessions, with the EMD significantly lower and the MVC values much higher. We discuss potential contributing factors to an increase in EMD values on the affected side, both pre- and post-BT. The observed co-variation across sessions of the increased EMD values with the decreased ZC estimates, a surrogate of motor outflow, and, potentially, more compliant muscle fascicles suggests that the altered motor unit (MU) behavior contributes, at least in part, to the delayed force production.

Performance Evaluation of a Wearable Tattoo Electrode Suitable for High-Resolution Surface Electromyogram Recording.

OBJECTIVE: High-density surface electromyography (HD-sEMG) has been utilized extensively in neuromuscular research. Despite its potential advantages, limitations in electrode design have largely prevented widespread acceptance of the technology. Commercial electrodes have limited spatial fidelity, because of a lack of sharpness of the signal, and variable signal stability. We demonstrate here a novel tattoo electrode that addresses these issues. Our dry HD electrode grid exhibits remarkable deformability which ensures superior conformity with the skin surface, while faithfully recording signals during different levels of muscle contraction. METHOD: We fabricated a 4 cm×3 cm tattoo HD electrode grid on a stretchable electronics membrane for sEMG applications. The grid was placed on the skin overlying the biceps brachii of healthy subjects, and was used to record signals for several hours while tracking different isometric contractions. RESULTS: The sEMG signals were recorded successfully from all 64 electrodes across the grid. These electrodes were able to faithfully record sEMG signals during repeated contractions while maintaining a stable baseline at rest. During voluntary contractions, broad EMG frequency content was preserved, with accurate reproduction of the EMG spectrum across the full signal bandwidth. CONCLUSION: The tattoo grid electrode can potentially be used for recording high-density sEMG from skin overlying major limb muscles. Layout programmability, good signal quality, excellent baseline stability, and easy wearability make this electrode a potentially valuable component of future HD electrode grid applications. SIGNIFICANCE: The tattoo electrode can facilitate high fidelity recording in clinical applications such as tracking the evolution and time-course of challenging neuromuscular degenerative disorders.

Characterization of Differences in the Time Course of Reflex and Voluntary Responses Following Botulinum Toxin Injections in Chronic Stroke Survivors.

Spasticity is a major impairment that can occur following a hemispheric stroke and is often treated with injections of botulinum toxin, a neurotoxin that impairs transmission at the neuromuscular junction. Hyperreflexia is a defining feature of spasticity. Our main objective here was to quantify the time course of changes in the deep tendon reflex (DTR) responses and voluntary activation capacity following BT injection as well as to track changes in a clinical assessment of spasticity. Four chronic stroke survivors, scheduled to receive BT in their Biceps Brachii(BB) as part of their clinical care plan, were recruited for repeated testing sessions over the course of 4 months post injection. Both surface BB EMG reflex response to bicipital tendon taps as well as signals of applied tendon tap forces were recorded before and up to 18 weeks post-BT. Voluntary force and biceps EMG signals were also recorded during maximum voluntary (isometric) contractions (MVC) at each testing session. Our results show major reductions (up to 75%) in voluntary sEMG and force arising between 11 to 35 days post-BT-injection. The stretch reflex gain declined two weeks after the maximal reductions in voluntary EMG and force. Paradoxically, there was a short-term increase in stretch reflex gain, in three out of four participants, approximately 11-35 days post BT. The time course of recovery of voluntary MVC and reflex responses varied considerably with a longer recovery time for the reflex responses.

Diode Laser - A Novel Therapeutic Approach in the Treatment of Chronic Periodontitis in Type 2 Diabetes Mellitus Patients: A Prospective Randomized Controlled Clinical Trial.

Introduction: Maturity-onset diabetes mellitus affecting the elderly population is marked by insulin resistance and decreased insulin production. The relationship between periodontitis and diabetes is bidirectional. Type 2 diabetic patients are more prone to chronic periodontitis (CP) and severe periodontitis affects the glycemic control in such patients. Recently, dental diode laser has become an effective tool in controlling CP. To date, very few studies have been conducted to check the efficacy of diode laser in control of periodontal destruction in type 2 diabetes mellitus (DM2) patients. Hence, the need of the study was to evaluate whether diode laser helps improvement of periodontal outcome and reduction in anaerobic bacteria in elderly diabetic patients with CP. Methods: Forty DM2 patients with CP were randomized into group A (control): scaling and root planing (SRP) only and group B (test): SRP followed by soft tissue dental diode laser (808 nm) application. Four patients (2 in each group) were lost during follow up. Clinical parameters, plaque samples and glycated hemoglobin levels were evaluated at both baseline and 90 days post-treatment. Results: Improvement in clinical, microbiological and glycemic parameters were noted in the group that received SRP as well as SRP + LANAP (laser-assisted new attachment procedure). The reductions in clinical parameters were statistically significant after 3 months (P<0.001). The microbial analysis of plaque samples for Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) decreased significantly after 3 months in group B than in group A. Glycated hemoglobin level (HbA1c) decreased significantly after 90 days in both the groups (P<0.001) with more reduction in the SRP+LANAP group (6.49%) in comparison to SRP alone (16.25% vs. 9.76%). However, on the intergroup comparison, the difference in HbA1c reduction was nonsignificant. Conclusion: Laser as an adjunct to SRP is an effective procedure for improving clinical and microbiological parameters in maturity onset diabetes mellitus patients with CP. Also, there was a better improvement in glycemic control in the test group compared to control group after 3 months. Hence, medically compromised patients like DM2 with CP with delayed wound healing can effectively be treated by laser as an adjunct to nonsurgical periodontal therapy for better results.

Effect of Botulinum Toxin on the Spatial Distribution of Biceps Brachii EMG Activity Using a Grid of Surface Electrodes: A Case Study.

Botulinum toxin (BT) is widely prescribed by physicians for managing spasticity post stroke. In an ongoing study, we examine the spatial pattern of muscle activity in biceps brachii of stroke survivors before and after receiving BT, examined over the course of 11 weeks (2 weeks before - 9 weeks after). We hypothesize that BT alters muscle electrophysiology by disrupting fiber neuromuscular transmission in an inhomogeneous manner and we seek to detect these changes using grid surface electromyography (sEMG). Also, we obtained B-mode ultrasound images to have an accurate interpretation of sEMG data by looking at the fiber angle and subcutaneous fat thickness distribution across muscle. Here, we are reporting a single case where a chronic stroke survivor received BT injection in the biceps brachii (BB). A 16x8 sEMG electrode grid was used to capture the muscle activity distribution of BB during sustained non-fatiguing isometric contraction at 40% of maximal voluntary (MVC) elbow flexion. We obtained the root mean squared (RMS) maps of the signal recorded at each of the $16 \times 8$ electrodes. We observed substantial changes in the RMS pattern of BB muscle after receiving BT. More than 80% decrease in sEMG amplitude (RMS) was observed for the channels around the BT injection site as well as about 74% elbow flexion force reduction at the time point of 3-4 weeks post-injection. We also found significant differences between the spatial voluntary activation pattern of pre and post BT RMS maps. We further observed a non-uniform effect and recovery caused by the BT on the distribution of muscle activity. In conclusion, we observed evidence of alteration of the amplitude and pattern of muscle activity after botulinum toxin injection and can document the capability of grid recordings to detect these pattern changes. Our major goals target further investigation to provide an indepth understanding of the effect of botulinum toxin injection at motor unit level.

Differential analysis of muscle fatigue induced elbow and wrist tremor in controlled laparoscopic manoeuvring.

BACKGROUND: Fatigue induced hand tremor (FIT) is a primary limiting concern for the prolonged surgical intervention in minimally invasive surgery (MIS) and robot-assisted-minimally invasive surgery (RAMIS). A thorough analysis is necessary to understand the FIT characteristics in laparoscopic tool movement. The primary aim of this study is to perform a differential analysis of the elbow and wrist tremor due to muscle fatigue in laparoscopic manoeuvring. METHODS: We have introduced a joint angle based tremor analysis method, which enables us to perform a differential study of FIT characteristics at the individual joint. Experimental data was acquired from a group of subjects during static and dynamic laparoscopic movement in an imitative RAMIS master manipulation scenario. A repetitive task was performed with a total span of 1 h for observing the effect of muscle fatigue. Along with the joint angle variation, surface electromyography (sEMG) signal was also studied in the analysis. RESULTS: The wrist tremor is more predominant than tremor generated at the elbow, especially in highly fatigued condition. The high-frequency tremor (>4 Hz) is contributed by the wrist joint. Moreover, the variation of the wrist and elbow tremor ratio was found to be dependent upon the experience of the surgeons. CONCLUSIONS: In this work, we have investigated the attribution of elbow and wrist joints in FIT during laparoscopic tool manipulation. The outcomes may be useful for the design of robot-assisted surgical manipulator, and can be used for quality assessment of surgical training as well.

Dominant component in muscle fatigue induced hand tremor during laparoscopic surgical manipulation.

Accuracy of laparoscopic surgery gets affected by the hand tremor of the surgeons. Though cognitive load is inevitable in such activity which promotes tremor, muscle fatigue induced tremor is significant among the most important sources of tremor. Characteristic of fatigue induced hand tremor and its dominant directional properties are reported in this work. For a fixed laparoscopic tool grip with temporally synchronized predefined task protocols, characteristics of fatigue induced tremors have been studied. Dominant component of tremor was found to be in the sagittal plane in case of both static and dynamic tasks. In order to relate it with the muscle fatigue level, spectral properties of surface electromyography (SEMG) were also investigated simultaneously. A study of transient effect on tool positioning was also included, which conjointly advocates the other experimental results on fatigue induced hand tremor as well.

Anticancer and immunostimulatory activity by conjugate of paclitaxel and non-toxic derivative of LPS for combined chemo-immunotherapy.

PURPOSE: Cancer is a multifactorial syndrome; hence, multidimensional therapy with a chemo-immunotherapeutic conjugate could be more effective in curing the disease. METHODS: We used SP-LPS, a bio-polymer having potent immunostimulatory activity, for conjugation with paclitaxel to make a chemo-immunotherapeutic conjugate. Its physicochemical characterization was done by HPLC, NMR and IR spectra. Stability was measured at different pH, temperature and in tissue homogenates. Chemotherapeutic and immunostimulatory activity was evaluated in vitro and also in tumor microenvironment. RESULTS: The conjugate self assembled into nanoparticulate structure, probably due to micelle formation. Stability was pH and temperature dependent. The conjugate exhibited chemotherapeutic and immunotherapeutic activity in vitro. In vivo antitumor activity was significantly higher and a higher percentage of activated immune cells were found in the tumor microenvironment of the conjugate-treated mice as compared to Taxol®-treated group. CONCLUSIONS: This conjugate is a potential chemo-immunotherapeutic compound for the treatment of cancer with advantages over present day chemotherapy with Taxol in terms of higher anticancer activity, less toxicity and ease of delivery.