Mean DT Research Articles

Lymphatic Mapping with Multi-Lymphosome Indocyanine Green Lymphography in Legs with Lymphedema.

It is observed that the locations of the most functional lymphatic vessels in the lymphedematous limbs can differ significantly from those in healthy limbs. The aim of this study was to elucidate the lymphatic map of lymphedematous limbs. We retrospectively analyzed 59 patients (118 limbs) with lower limb lymphedema. Fifty-five were women and four were men. The mean age and duration of lymphedema was 62.4 and 7.7 years, respectively. For the lateral thigh lymphosome, we injected indocyanine green (ICG) at the lateral knee and measured the distance (Dt) between the anterior superior iliac spine (ASIS) and the point where the lymphatic vessels crossed the reference line (the line connecting the ASIS and the patellar center). For the lateral calf lymphosome, we injected ICG at the lateral ankle and measured the distance (Dc) between the inferior patellar border and the point where the lymphatic vessels crossed the reference line (the anterior border of the tibia). In the lateral thigh, the mean Dt was 30.4 ± 0.6 cm (range, 0-41 cm) and the distribution peaked at approximately 30 cm from the ASIS. In the calf, the mean Dc was 13.1 ± 0.9 cm (range, -11 to 32 cm). The distribution of lymphatic vessel locations was highly variable. We could establish the lymphatic map in the lymphedematous legs. The distribution of lymphatic vessels in the thigh and lower legs had one and two peaks, respectively.

Social Inequities in Access to Dental Care in Australian Adults over Time.

Social inequities in dental caries are reflected by both inequities in the social structures that contribute to disease severity and inequities in the provision of dental care. This study aimed to describe social differentials in the dental caries experience among Australian adults across a 13-y period and to examine if the highest magnitude of oral health inequities persisted across dental caries prevalence (decayed teeth [DT]) or its management (missing teeth [MT], filled teeth [FT]). Data were from 2 population-based cross-sectional surveys of Australian adult oral health conducted in 2004-2006 (National Survey of Adult Oral Health-1 [NSAOH-1], n = 5,505) and 2017-2018 (NSAOH-2, n = 5,022). In each survey, representative samples of adults were obtained through a 3-stage, stratified sample design within metropolitan and regional areas in each state/territory. Clinical outcomes included the prevalence and mean of DT, MT, FT, and DMFT. Equivalized household income was grouped into approximately quartiles from low to high. Across all income quartiles, the mean DT and % DT >0 was higher in NSAOH-2 than in NSAOH-1. The increase in prevalence was highest in the third highest income group (prevalence difference [PD] = 8.4, from 24.1 to 32.5). Similarly, % MT >0 was lower in NSAOH-2 than in NSAOH-1 across all income groups, with the decrease most marked for the lowest income group (PD = -6.5, from 74.1 to 67.8). Across all income quartiles, % FT >0 was lower in NSAOH-2 than in NSAOH-1. The decrease was the most marked for the lowest income group (PD = -8.9, from 81.1 to 72.2). The findings confirm that although oral health inequities decreased for the most extreme management outcome of dental caries (MT), inequities increased for experience of that disease (DT) and the more conservative management of dental caries (FT). For all D, M, and F components (DMFT), inequities between the lowest and highest household income groups increased from 2004-2006 to 2017-2018. This study found that social inequities in oral health (experience of untreated dental caries and missing teeth) increased between the most socially advantaged and disadvantaged groups between 2004-2006 and 2017-2018. This suggests that models of dental service provision in Australia are increasingly benefitting those who can afford and access the care and who arguably need the services less than their less socially advantaged counterparts do.

Comparison of conventional diffusion-weighted imaging, diffusion kurtosis imaging and intravoxel incoherent motion in characterization of sonographically indeterminate adnexal masses.

To evaluate the role of conventional diffusion weighted imaging, diffusion kurtosis imaging (DKI), and intravoxel incoherent motion (IVIM) in distinguishing benign from malignant adnexal masses. 38 patients with 45 adnexal masses were enrolled in this prospective study and assessed with multiparametric MRI, including the IVIM-DKI sequence, on a 3T MRI system. The mean apparent diffusion coefficient (ADC) from conventional DWI, the apparent diffusion coefficient derived from DKI (Dapp), the apparent kurtosis coefficient (Kapp), true diffusion coefficient (Dt), perfusion fraction (f) and pseudo-diffusion coefficient (Dp) were measured. The mean ADC, Dapp, and Dt were significantly higher in benign adnexal masses than in malignant adnexal masses (p < 0.001). f and Dp were also significantly higher in benign adnexal masses, with p values of 0.026 and 0.002, respectively. Kapp was higher in malignant masses (p < 0.001). Among mean ADC, Dapp, and Dt, mean ADC had the highest area under the curve (AUC) of 0.885. However, no statistically significant differences were observed between the ROCs of various diffusion parameters. The mean ADC, Dapp, and Kapp are useful parameters in discriminating between benign and malignant adnexal masses. Dt derived from IVIM also helps in distinguishing benign and malignant adnexal masses; however, no incremental role of IVIM and DKI over ADC could be identified in our study.

Dose–effect relationships in neuroendocrine tumour liver metastases treated with [166Ho]-radioembolization

PurposeAim of this study was to investigate a dose-response relationship, dose-toxicity relationship, progression free survival (PFS) and overall survival (OS) in neuroendocrine tumour liver metastases (NELM) treated with holmium-166-microspheres radioembolization ([166Ho]-radioembolization).Materials and methodsSingle center, retrospective study included patients with NELM that received [166Ho]-radioembolization with post-treatment SPECT/CT and CECT or MRI imaging for 3 months follow-up. Post-treatment SPECT/CT was used to calculate tumour (Dt) and whole liver healthy tissue (Dh) absorbed dose. Clinical and laboratory toxicity was graded by Common Terminology Criteria for Adverse Events (CTCAE), version 5 at baseline and three-months follow-up. Response was determined according to RECIST 1.1. The tumour and healthy doses was correlated to lesion-based objective response and patient-based toxicity. Kaplan Meier analyses were performed for progression free survival (PFS) and overall survival (OS).ResultsTwenty-seven treatments in 25 patients were included, with a total of 114 tumours. Median follow-up was 14 months (3 – 82 months). Mean Dt in non-responders was 68 Gy versus 118 Gy in responders, p = 0.01. ROC analysis determined 86 Gy to have the highest sensitivity and specificity, resp. 83% and 81%. Achieving a Dt of ≥ 120 Gy provided the highest likelihood of response (90%) for obtaining response. Sixteen patients had grade 1–2 clinical toxicity and only one patient grade 3. No clear healthy liver dose-toxicity relationship was found. The median PFS was 15 months (95% CI [10.2;19.8]) and median OS was not reached.ConclusionThis study confirms the safety and efficacy of [166Ho]-radioembolization in NELM in a real-world setting. A clear dose–response relationship was demonstrated and future studies should aim at a Dt of ≥ 120 Gy, being predictive of response. No dose-toxicity relationship could be established.

Periodic repolarization dynamics: Different methods for quantifying low-frequency oscillations of repolarization

BackgroundPeriodic repolarization dynamics (PRD) is an electrocardiographic biomarker that quantifies low-frequency (LF) instabilities of repolarization. PRD is a strong predictor of mortality in patients with ischaemic and non-ischaemic cardiomyopathy. Until recently, two methods for calculating PRD have been proposed. The wavelet analysis has been widely tested and quantifies PRD in deg2 units by application of continuous wavelet transformation (PRDwavelet). The phase rectified signal averaging method (PRDPRSA) is an algebraic method, which quantifies PRD in deg. units. The correlation, as well as a conversion formula between the two methods remain unknown. MethodThe first step for quantifying PRD is to calculate the beat-to-beat change in the direction of repolarization, called dT°. PRD is subsequently quantified by means of either wavelet or PRSA-analysis. We simulated 1.000.000 dT°-signals. For each simulated signal we calculated PRD using the wavelet and PRSA-method. We calculated the ratio between PRDwavelet and PRDPRSA for different values of dT° and RR-intervals and applied this ratio in a real-ECG validation cohort of 455 patients after myocardial infarction (MI). We finally calculated the correlation coefficient between real and calculated PRDwavelet. PRDwavelet was dichotomized at the established cut-off value of ≥5.75 deg2. ResultsThe ratio between PRDwavelet and PRDPRSA increased with increasing heart-rate and mean dT°-values (p < 0.001 for both). The correlation coefficient between PRDwavelet and PRDPRSA in the validation cohort was 0.908 (95% CI 0.891–0.923), which significantly (p < 0.001) improved to 0.945 (95% CI 0.935–0.955) after applying the formula considering the ratio between PRDwavelet and PRDPRSA obtained from the simulation cohort. The calculated PRDwavelet correctly classified 98% of the patients as low-risk and 87% of the patients as high-risk and correctly identified 97% of high-risk patients, who died within the follow-up period. ConclusionThis is the first analytical investigation of the different methods used to calculate PRD using simulated and clinical data. In this article we propose a novel algorithm for converting PRDPRSA to the widely validated PRDwavelet, which could unify the calculation methods and cut-offs for PRD.

Bipolar Radiofrequency Ablation of the Adrenal Gland: In Vivo and Ex Vivo Experiments.

Laparoscopic adrenalectomy is currently the standard treatment modality for unilateral aldosterone-producing adenoma (APA); however, a less-invasive treatment is needed for its treatment. A new bipolar ablation system that poses a lower risk of complications has been recently developed. This study aimed to evaluate the safety and performance of a novel bipolar radiofrequency ablation (RFA) system for the treatment of APAs. Ablations were performed in an ex vivo study using bovine adrenal glands [group A: n = 6, single-probe; group B: n = 6, two probes, interprobe distance (ID) = 12 mm; group C: n = 6, two probes, ID = 20 mm]. The in vivo study was conducted in groups A and B (n = 2 each) using porcine adrenal glands. For the ex vivo study, the mean vertical diameter (Dv) of the coagulative necrosis area and the mean transverse diameter (Dt) values were 11.99 mm and 10.96 mm for group A, 12.66 mm and 10.0 mm for group B, and 23.37 mm and 22.10 mm for group C, respectively. For the in vivo study, the mean Dv and Dt values were 12.23 mm and 9.03 mm for group A, and 16.38 mm and 9.52 mm for group B, respectively. No heat-induced damage to the adjacent organs was observed. To our best knowledge, this is the first study to evaluate the performance of the bipolar system in RFA of the adrenal gland. RFA using the new bipolar ablation system is safe and produces a sufficient coagulation area to treat APAs.

Physical parameters in thermal imaging of basal cell cancer patients treated with high-dose-rate brachytherapy - first study.

The basal cell carcinoma (BCC) is often treated by surgery or radiotherapy using ionizing radiation. While there is an established diagnostic path before treatment and also for the follow-up there are no good noninvasive methods objectifying irradiated area evolution during treatment. The main goal of preliminary studies was to try to answer if there are any useful information that can be derived from temperature effects of high-dose-rate (HDR) brachytherapy in treatment of BCC. Moreover, the temperature gradient was introduced as a physical parameter characterizing the thermal map of the lesion, its surroundings and reference area, which provided information about cancer tissue thermal reaction to brachytherapy. Thirty-three patients suffering from BCC were monitored with thermovision during the brachytherapy treatment. All lesions were diagnosed as superficial and were confirmed with histopathology examination. Results of the study showed two groups of patients characterized with two thermal maps and temperature gradient describing the lesion and surrounding area of BCC. The first group was characterized by higher temperature of the lesion than the surrounding tissue temperature (mean dT = 0,41°) whereas the other one, with lower lesion temperature (mean dT = -0.42°). It seems that the temperature changes observed in designated areas before and after therapy may provide physicians with additional information which could be useful in planning the treatment process, especially when considering temperature gradient changes during therapy. Although the data obtained indicate the possibilities of temperature distribution in pre-irradiation cases, further research is required for estimation of clinical effects of treatment.

Ruxolitinib Adherence in Myelofibrosis and Polycythemia Vera: The "RAMP” Multicenter Prospective Study

Ruxolitinib (RUX) is beneficial in myelofibrosis (MF) and polycythemia vera (PV) patients (pts). However, little is known about patient adherence (ADH) to this chronic therapy. Poor ADH may increase treatment failure, with serious welfare and economic consequences (Osterberg L, N Engl J Med 2005). The Adherence to Refills and Medications Scale (ARMS) (Kripalani S, Value Health 2009) and the Distress Thermometer and Problem List (DTPL) (Donovan KA, Psycho-oncology 2014) measure drug ADH and psychological distress, respectively. After IRB approval, the RAMP (Rux Adherence in MF and PV) multicenter prospective observational study included 189 consecutive pts with MF (n. 141, 75%) or PV (n.48, 25%), that received RUX according to routine practice in 9 Hematology Centers. The ARMS included 12 questions, 6 evaluating intentional and 6 unintentional ADH. The DT describes pts’ level of distress using a scale of 0 (no distress) to 10 (extreme distress). Also, pts can select problems from a list (39 areas divided in 5 subgroups). First tests administration occurred at the earliest convenient time (week, wk0), irrespective of the time of RUX start, and again after 4 (wk4), 8 (wk8), 12 (wk12), 24 (wk24) and 48 weeks (wk48). The aims of the RAMP study are to evaluate: 1) baseline level of RUX ADH and distress, and characteristics associated to low ADH; 2) modifications of ARMS/DTPL scores over time; 3) impact of ARMS/DTPL scores on IWG-MRT defined spleen response in MF. Between June 2020 and March 2022, 189 pts completed ≥1 ARMS and DTPL test; median age, 70 yrs (33-89); 59.2% males. The first questionnaire was completed within 1 yr from RUX start in 127 pts (67.2%) (EARLY-ADH), and after >1 yr of RUX therapy in 62 pts (32.8%). At wk0, the mean ARMS and DT scores were 13.2 (SD, 1.95) and 2.9 (SD, 2.79), respectively. Based on the DT ≥4 cutoff, 76 pts (38.1%) had high distress (Table 1). Overall, 11.1%, 4.5%, 28.5% and 55.9% of pts had no emotional/physical problems, only emotional, only physical and both problems, respectively. 77.8% of pts with both emotional/physical problems also had high distress (compared to 41.5% in pts with low distress, p=0.002). Overall, 95 pts (50.3%) had HIGH-ADH (ARMS score of ≥14) and 94 (49.7%) had LOW-ADH (score <14). LOW-ADH was intentional in 49 (52.1%), unintentional in 20 (21.3%) and both in 25 pts (26.6%). LOW-ADH was comparable in PV (45.8%) and MF (51.8%) pts (p=0.48); however, unintentional LOW-ADH was more frequent in PV than in MF pts (43.8% vs 25.5%, p=0.02). In multivariate regression analysis, LOW-ADH was associated to male sex (odd ratio, OR: 3.2, p=0.007), high distress (OR: 3.7, p=0.003), and RUX duration >1yr (OR: 2.23, p=0.003). Male sex and high distress remained associated with LOW-ADH in MF pts (OR:3.7p=0.002; OR: 3.6, p=0.002 respectively) and only in those who completed the ARMS/DTPL > 1 yr after RUX start (OR: 3.7, p=0.002; OR: 3.7, p=0.003, respectively). Overall, 146 (77.2%) pts completed both tests at w24. Full completers with HIGH-ADH tended to increase over time (from 47.3% at wk0 to 52.4% at wk24), while pts with high distress decreased (from 44.3% to 36.2%). Pts with high distress more frequently also showed LOW-ADH (p=0.05). Over time, 25% of pts with baseline LOW-ADH acquired a HIGH-ADH, while distress improved in 27% of pts. MF pts who maintained high ADH and low distress over time were more likely to obtain or maintain spleen response at 24 weeks (Mc Nemar test, p=0.02 and p=0.04) (Table 2). At wk24, pts reporting sexual dysfunctions (13.7% vs 7.5%, p=0.04) and insomnia (24.6% vs 15.1%, p=0.01) significantly decreased compared to wk0, along with emotional distress (60.9% vs 29.5%, p<0.001). ARMS/DTPL results at wk48 will also be provided to explore long-term ADH/distress. The RAMP study highlights that LOW-ADH to RUX remains an unmet clinical need in MF and PV. The association between LOW-ADH and spleen response supports that ADH evaluation in real-life practice may improve MF therapy and prognosis. LOW-ADH is more frequently intentional in MF, and unintentional in PV; thus, differentiated corrective interventions are needed in the two diseases. Male pts and those on RUX for >1 yr are at higher risk for LOW-ADH and should be monitored more closely. As ADH increased over time, it is possible that periodic ARMS administration may be beneficial in itself. Since high distress correlates with LOW-ADH, DTPL evaluation and targeted support may also improve treatment success. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Role for a Web-Based Intervention to Alleviate Distress in People With Newly Diagnosed Testicular Cancer: Mixed Methods Study.

Distress is common immediately after diagnosis of testicular cancer. It has historically been difficult to engage people in care models to alleviate distress because of complex factors, including differential coping strategies and influences of social gender norms. Existing support specifically focuses on long-term survivors of testicular cancer, leaving an unmet need for age-appropriate and sex-sensitized support for individuals with distress shortly after diagnosis. We evaluated a web-based intervention, Nuts & Bolts, designed to provide support and alleviate distress after diagnosis of testicular cancer. Using a mixed methods design to evaluate the acceptability, feasibility, and impact of Nuts & Bolts on distress, we randomly assigned participants with recently diagnosed testicular cancer (1:1) access to Nuts & Bolts at the time of consent (early) or alternatively, 1 week later (day 8; delayed). Participants completed serial questionnaires across a 4- to 5-week period to evaluate levels of distress (measured by the National Comprehensive Cancer Network Distress Thermometer [DT]; scored 0-10), anxiety, and depression (Hospital Anxiety and Depression Score [HADS]-Anxiety and HADS-Depression; each scored 0-21). The primary end point was change in distress between consent and day 8. Secondary end points of distress, anxiety, and depression were assessed at defined intervals during follow-up. Optional, semistructured interviews occurring after completion of quantitative assessments were thematically analyzed. Overall, 39 participants were enrolled in this study. The median time from orchidectomy to study consent was 14.8 (range 3-62) days. Moderate or high levels of distress evaluated using DT were reported in 58% (23/39) of participants at consent and reduced to 13% (5/38) after 1 week of observation. Early intervention with Nuts & Bolts did not significantly decrease the mean DT score by day 8 compared with delayed intervention (early: 4.56-2.74 vs delayed: 4.47-2.74; P=.85), who did not yet have access to the website. A higher baseline DT score was significantly predictive of reduction in DT score during this period (P<.001). Median DT, HADS-Anxiety, and HADS-Depression scores reduced between orchidectomy and 3 weeks postoperatively and then remained stable throughout the observation period. Thematic analysis of 16 semistructured interviews revealed 4 key themes, "Nuts & Bolts is a helpful tool," "Maximizing benefits of the website," "Whirlwind of diagnosis and readiness for treatment," and "Primary stressors and worries," as well as multiple subthemes. Distress is common following the diagnosis of testicular cancer; however, it decreases over time. Nuts & Bolts was considered useful, acceptable, and relevant by individuals diagnosed with testicular cancer, with strong support for the intervention rendered by thematic analyses of semistructured interviews. The best time to introduce support, such as Nuts & Bolts, is yet to be determined; however, it may be most beneficial as soon as testicular cancer is strongly suspected or diagnosed.

Caries Experience and Erosive Tooth Wear in Finnish Men Conscripts 2021: A Cross-Sectional Study.

Background: In Finland, the development of oral health in young, 19- to 21-year-old males regarding restorative treatment need seems to have slowed down according to cross-sectional conscript studies between 1976 and 2011. At the individual level, the mean number of decayed teeth (DT > 0) has also steadily continued to decline. In Finland, military service is mandatory, and around 85% of males complete it. The aim of this cross-sectional study was to investigate the oral health status of young men at the beginning of the 2020s. Methods: The data were collected in July 2021 in the eight biggest Finnish Defence force garrisons by ten calibrated dentists serving in the ranks. The inclusion criteria for this study were a year of birth between 2000 and 2002 and male gender (n = 508). Third molars were included. Restorative treatment need was evaluated using ICDAS scoring. The study was designed according to the STROBE guidelines. Results: Mean DT value was 1.13 when third molars were included and 1.03 when they were excluded. Mean DMFT value was 3.23 and 2.98, respectively. The proportion of conscripts with DT > 0 was 36.4% and 34.8%, respectively. The prevalence of caries was concentrated among a small number of conscripts. Most (76.5%) had BEWE (basic erosive wear examination) of 0–2. Conscripts in the moderate and severe ETW (erosive tooth wear) groups (BEWE 3–13) comprised 23.5% of the cohort. None of the conscripts fell into the most severe group (BEWE 14–18). Conclusions: The oral health of conscripts has improved over the last ten years, and restorative treatment need has decreased significantly. Compared to previous studies, restorative treatment need was concentrated on an even smaller proportion of conscripts.

Investigation of heart rate variability of patients undergoing coronary artery bypass grafting using the statistical signal characterization method.

Autonomic function can be estimated non-invasively using heart rate variability (HRV). HRV of patients undergoing coronary artery bypass grafting (CABG) is investigated in time-domain and frequency-domain before and after CABG to study the effect of operation on the status of patients. The main purpose of this work is to evaluate the effect of CABG surgery on patients with ischemic heart disease (IHD) before operation, and to monitor the status of patients on day 6 and day 30 after the CABG operation. The statistical signal characterization (SSC) technique is used in this work in order to derive different morphology-based parameters to indirectly describe time-domain and frequency-domain HRV parameters in 24 patients undergoing CABG operation, before the operation (Group 1: G1), 6days after operation (Group 2: G2) and 30days after operation (Group 3: G3). The data is obtained from the Sultan Qaboos University Hospital in Oman. The SSC parameters Mean(mt) and Mean(dt) are reduced in all 24 patients and in 23 out of 24 patients in G2 compared to G1 (6-days after operation compared with before operation), respectively. Comparing G3 to G1 the reduction in Mean(mt) and Mean(dt) is noted in 18 of the 24 patients. The parameters Mean(mt) and Mean(dt) are successful parameters to follow the HRV for patients undergoing CABG surgery. A relation between those SSC parameters and the HRV time-domain and frequency-domain parameters is investigated in this paper to understand the physiological behavior of the patients.

Multicenter RCT on intensive caries prevention for children undergoing dental general anaesthesia: Intensive caries prevention for children undergoing dental general anesthesia

ObjectivesEarly childhood caries is a persistent problem often leading to dental treatment under general anesthesia (GA). Thus, this study investigated the effect of two additional individual caries prevention appointments before and after GA. Materials and MethodsIn this multi-center, 2-arm randomized, controlled clinical trial, 408 children (age 2–5 years, mean 4.2 ± 1.04) intended for GA were recruited and randomly assigned to the intervention and control groups with or without two additional intensive oral hygiene appointments before and after the GA. At baseline and at 6-/12-months follow-ups, approximal plaque index (API), gingival sulcus bleeding index (SBI), caries experience (dmft/s) and initial caries were recorded. ResultsParticipants in test group and control group (ITT; n = 161 vs. n = 147) as well as drop-outs in test and control groups (n = 40 vs. n = 58) showed no statistical significant difference in baseline characteristics. Test and control groups showed equivalent baseline oral health parameters (API: 78 and 77%, SBI: 22.6 and 23.5%, dmft: 8.5 and 8.2, respectively), which continuously improved during the study. The test group exhibited statistically significant greater improvement (API: 42%, SBI: 7%) than the control (API: 54%, OR: 0.48; P = 0.003; SBI: 12%, OR=0.44; P = 0.005). Due to the robust rehabilitation with predominantly stainless steel crowns and extractions, caries incidence was minimal and, therefore, without statistical significance (mean increase dt, test: 0.5, control: 0.6; P = 0.68), which was also true for new initial carious lesions (mean increase test: 0.8 vs. control: 0.9; P = 0.55). ConclusionsAdditional preventive sessions for children undergoing treatment under GA improved their oral hygiene parameters signifiqantly. Clinical significanceIntensive caries prevention appointments for children receiving dental treatment under GA improved their oral hygiene and might reduce their caries risk.

Scientometrics Analysis on Water Treatment During 2011 to 2020

The present study examines the Scientometrics Analysis on Water Treatment during 2011 To 2020. The data were collected from the Scopus database and 7582 records are retrieved within the scientometric study. Mostly published articles in 2020 within 1079 (14.23%) records are highest during the ten years periods. The RGR was 0.73 in 2012 which declined up to 0.15 within 2020. A mean RGR of 1.79 might be deduced for the study period. The general mean DT was 1.79. Top ten ranking of Prolific Authors of Water Treatment Research within 10 author’s highest number of articles from the Wang, C and most citation who contributed 50 articles. The Ranking wise Subject Areas ecology with 7013 records (28.28%) is top most level followed by second ranked as on Engineer, 5200 (20.97%), Chemical Engineering, 3006 (12.12%) scored as a 3rd rank.

Time Series Analysis Research on Electric Vehicles in India, USA and Global

The study attempts to analyze research in the field of electric vehicles contributions data from Web of Science (WoS) publications period from 2011 to 2020. This study also explores the Time Series Analysis, (RGR, and (TD) in electric vehicles publications of total 66,758 with 9,21,127 citation and India country 3,131 papers with 21,057 citations, USA 12,524 papers with 3,07,781 citations research articles published. RGR India decreases from 1.01 to 0.18, doubling time increases from 2012 to 2020, the average of mean RGR 0.44 and the mean DT 2.06. USA country RGR was 0.82 in the year 2012 and slowly 0.13 decreases in the year 2020, DT slowly increases, the average of mean RGR 0.31 and the mean DT 3.01. Global wise RGR decreases from 0.85 to 0.13, DT increases, and the average of mean RGR 0.34 and the mean DT 2.71. It is observed that in Time series analysis that India has 9.13% increased publications papers in the year 2021 and 12.08% increase papers in the year 2025, USA 7.84% increased publications papers in the year 2021 and 9.25% increase papers in the year 2025, Global wise 8.26% increased publications papers in the year 2021 and 10.18% increase papers in the year 2025. In conclusion India, USA and Global research and development in the field of electric vehicles papers is growing.

Oral health status of 12-year-old children in Lisu minority ethnic group in China: a cross-sectional study

BackgroundLisu is an ethnic minority group and most of them are living in Yunnan, China. This study investigated the oral health status among 12-year-old Lisu children in Yunnan.MethodThis survey employed a multistage sampling method to recruit 12-year-old Lisu children. Two calibrated dentists performed the oral examinations in the primary schools. They examined dental caries, gingival bleeding and dental fluorosis using the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed to the children to collect their sociodemographic background information and oral health-related behaviours. A chi-square test, the Mann–Whitney U test, zero-inflated negative binomial (ZINB) regression and multivariate logistic regression were used for statistical analysis.ResultsThis survey invited 512 children, and 482 children (48% boys) participated in the study (response rate: 94%). Their caries prevalence was 35% and their caries experience in mean (SD) DMFT scores was 0.63 (0.10). The mean (SD) DT score was 0.60 (1.10), consisting 95% of the mean DMFT scores. No dental fluorosis was observed; whereas 426 children (88%) had gingival bleeding. Results of ZINB model indicated sex and sugary-snacking habits were related to the dental caries experience (p < 0.05). The gingival-bleeding prevalence was associated with the mother’s education level, the child’s monthly-pocket money and daily toothbrushing frequency (p < 0.05).ConclusionDental caries and gingival bleeding were prevalent among 12-year-old Lisu children in the Yunnan province in China, and most of the decayed teeth were unrestored. Dental fluorosis was not observed in the children.

Caries experience among adults in core Sámi areas of Northern Norway.

Dental caries is a major oral health problem among indigenous people worldwide, but knowledge on this issue among the indigenous Sámi people in Norway is scarce. The aim of the study was to describe dental caries experience in an adult population in core Sámi areas of Northern Norway and to assess the corresponding associations with socio-demographic, socioeconomic and oral health-related behavioural factors. This cross-sectional study is based on data from the Dental Health in the North study (2033 participants aged 18-75years). A questionnaire was used to collect data on socio-demographic, socioeconomic and oral health-related behavioural factors. Clinical examinations were performed by dentists and dental hygienists at Public Dental Service (PDS) clinics in core Sámi areas of Northern Norway. About 68% (n=1380) of participants reported Sámi ethnicity, and the mean number of decayed (D), missed (M) and filled (F) teeth (T) was 16.2 (standard deviation [SD]=6.7). The mean DMFT was 15.7 (SD=6.7) among Sámi and 17.0 (SD=6.7) among non-Sámi. The mean DT among Sámi was 1.0 (SD=1.6), with a significant, higher prevalence among coastal Sámi (DT=1.3, SD=1.8) than inland Sámi (DT=0.8, SD=1.5). Living in the coastal region, consumption of sugary soft drinks several times a week or daily, toothbrushing less than daily and irregular dental visits were associated with DT. Caries experience among adults in core Sámi areas of Northern Norway was common. Dental caries were more common in the coastal than the inland region, with minor differences in caries experience between Sámi and non-Sámi people within these regions.

Thermal imaging for microvascular free tissue transfer monitoring: Feasibility study using a low cost, commercially available mobile phone imaging system.

The use of infrared thermography to evaluate the perfusion of tissue flaps have been studied. This study aims to evaluate the utility of thermal imaging for flap monitoring with a low-cost, readily available smartphone imaging device. Adult subjects who underwent head and neck reconstruction using a microvascular free flap with a cutaneous paddle were recruited. Thermal images were taken of the free flap before, during and after anastomosis. Thermal images were analyzed by measuring the average flap temperature minus the average surrounding tissue temperature (dT). Twenty-one patients were enrolled. The mean dT for flaps intraoperatively prior to anastomosis was -11.47 °F. For 20 patients, dT averaged between -0.30 to 0.12 °F. One flap was inadequately perfused and dT was found to be -4.35 °F. Low cost, mobile smartphone devices such as the thermal camera may provide an objective method of monitoring microvascular free flaps. 2 Prospective Cohort Study.

Assessment of distance from skin surface to muscle for evaluation of the risk of inadvertent intramuscular insulin injection at potential injection sites among patients attending a tertiary care children's hospital in Sri Lanka–an observational study

BackgroundInsulin therapy is essential for type 1 diabetes. While a reasonable glycemic control prevents complications, inadvertent intramuscular (IM) insulin injection results in hypoglycemia and fluctuations of blood glucose levels. ObjectiveTo assess the subcutaneous thickness (SCt) at the potential insulin injection sites, in order to determine the suitable needle length. MethodsDiabetic and non-diabetic children (n=125; aged 2–14 years) attending a tertiary care hospital were examined, after excluding those who had skin abnormality at the injection site, were hospitalized for>3 days, or had any other chronic illnesses. Dermal thickness (Dt) and SCt at the potential insulin injection sites were measured with ultrasonography. ResultsThe mean age of the patients was 8 years and 57% were boys; mean Dt was 2.1±0.4 mm, SCt was 7.45.6±3.7 mm, and maximum SCt was 29.8 mm in the anterior abdominal wall. SCt increased with age and by raising a skin fold (sf). There was no difference (P>0.05) in Dt between genders, and limbs showed thinner Dt values than the abdomen. SCt changed with the injection site: it was the lowest in the thigh and the highest in the abdomen. SCt was thicker in females, with or without sf (P<0.001). For all sites, IM risk was high for 15-mm needles: it was highest in the thighs (98%) and reduced to 86% with sf. IM risk was low for 5-mm needles: it was highest in the thigh (38%), and reduced to 12% with sf. Compared with girls (up to 42%), IM risk was higher for boys (up to 54%), even for 5-mm needles with a sf. ConclusionUsing a short needle is recommended for children, particularly for boys. Regardless of the needle length, the raised sf technique is associated with reduced IM risk.

Correlation of oral health related quality of life with dentition status and treatment need among 12 year old school children of Dilsukhnagar, Hyderabad.

To determine the relationship between Oral Health-related Quality of Life (OHRQoL) with Dentition Status and Treatment need among 12 year old school children of Dilsukhnagar, Hyderabad. A cross sectional study was carried out among 990 private school children aged 12 years old in Dilsukhnagar, Hyderabad city. OHRQoL was assessed by 16-item Child Perceptions Questionnaire (CPQ11-14), and Oral hygiene was evaluated using Simplified Oral Hygiene Index (OHI-S), and Dentition status and Treatment need. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 21.0. Study population proportions and mean scores were compared using Chi-square test, Student t- test, and Analysis of Variance (ANOVA). Spearman's analysis was done to determine correlation between CPQ11-14and its domain scores with OHI-S and Dentition status and Treatment Need based on gender. P < 0.05 was considered statistically significant. In the present study, all domains of CPQ11-14i.e., Oral Symptoms (OS) (3.27 ± 2.5; P = 0.0001), Functional Limitation (FL) (1.48 ± 2.1; P = 0.02), Emotional Wellbeing (EW) (1.83 ± 2.5; P = 0.02) and Social Wellbeing (SW) (1.25 ± 2.02; P = 0.0002) showed significant gender difference, with males having higher mean score compared to females. The majority of the study population was caries free 789 (79.7%). In addition, the dental caries experience among males and females was around 20% (p = 0.92). When total mean DMFT and DT scores were compared based on gender, no statistically significant difference was noted though females showed higher mean score. The study results indicate that, there is a correlation between oral hygiene status and dentition status with quality of life.

Dental Disease Outcomes Following a 2-Year Oral Health Promotion Program for Australian Aboriginal Children and Their Families: A 2-Arm Parallel, Single-blind, Randomised Controlled Trial

BackgroundDental disease has far-reaching impacts on child health and wellbeing. We worked with Aboriginal Australian communities to develop a multifaceted oral health promotion initiative to reduce children's experience of dental disease at age 2 years. MethodsThis was a single-blind, parallel-arm, randomised controlled trial. Participants were recruited from health service providers across South Australia. Women pregnant with an Aboriginal child were eligible. The intervention comprised: (1) provision of dental care to mothers during pregnancy; (2) application of fluoride varnish to teeth of children at ages 6, 12 and 18 months; (3) motivational interviewing delivered in conjunction with; (4) anticipatory guidance. The primary outcome was untreated dental decay as assessed by the number of teeth with cavitated and non-cavitated carious lesions (mean dt) at child age 24 months. Analyses followed intention-to-treat principles. The RCT was registered with the Australian and New Zealand Clinical Trial Registry, ACTRN12611000111976. FindingsWomen (n = 448) were recruited from February 2011 to May 2012, resulting in 223 children in the treatment group and 225 in the control. Mean dt at age two years was 0.62 (95% CI 0.59 to 0.65) for the intervention group and 0.89 (95% CI 0.85 to 0.92) for the control group (mean difference −0.27 (95% CI −0.31, −0.22)). InterpretationA culturally-appropriate intervention at four time-points from pregnancy through to 18-months resulted in improvements in the oral health of Aboriginal children. Further consultation with Aboriginal communities is essential for understanding how to best sustain these oral health improvements for young Aboriginal children.