Duration Of Wear Research Articles

Correlation of twin-block appliance efficacy and wear duration as assessed with a compliance indicator

The aim of this study was to investigate the association between objective wear time and treatment efficacy of a twin block (TB) appliance. A TB appliance incorporating a compliance indicator was delivered to 44 children in the age group of 11-14 years (25 boys and 19 girls). Participants were instructed to wear the appliance full time and were recalled at 3-4- week intervals. Cephalograms and study models were taken at baseline and after 6 months of appliance therapy. Data from 41 of the 44 participants were analyzed. A wide variation in daily wear time among participants was observed. Based on wear time, they were divided into full time (FT >17 h/d) and part time (PT < 12 h/d) wear groups. Mean wear durations were 20.86 hours in the FT-wear group and 9.55 hours in the PT-wear group. In skeletal changes, the ANB (A point, nasion, B point) angle was reduced by 2.69° in the FT-wear group, and 1.33° in the PT-wear group, and statistically significant increases were seen for the mandibular base measurement (Pg/OLp) in the FT-wear group (2.22mm), compared with those in the PT-wear group (0.44mm). . In dental changes, overjet were reduced by 3.91 mm and 2.0 mm in the FT-wear and PT-wear group, respectively. This difference was statistically significant. Skeletal effects were pronounced in the FT-wear group, and dentoalveolar changes were comparable in the 2 wear groups. The maximum skeletal treatment effect of a TB appliance was found to occur with FT wear over a 6-month treatment period.

Detection of Food Intake Sensor's Wear Compliance in Free-Living.

Objective detection of periods of wear and non-wear is critical for human studies that rely on information from wearable sensors, such as food intake sensors. In this paper, we present a novel method of compliance detection on the example of the Automatic Ingestion Monitor v2 (AIM-2) sensor, containing a tri-axial accelerometer, a still camera, and a chewing sensor. The method was developed and validated using data from a study of 30 participants aged 18-39, each wearing the AIM-2 for two days (a day in pseudo-free-living and a day in free-living). Four types of wear compliance were analyzed: 'normal-wear', 'non-compliant-wear', 'non-wear-carried', and 'non-wear-stationary'. The ground truth of those four types of compliance was obtained by reviewing the images of the egocentric camera. The features for compliance detection were the standard deviation of acceleration, average pitch, and roll angles, and mean square error of two consecutive images. These were used to train three random forest classifiers 1) accelerometer-based, 2) image-based, and 3) combined accelerometer and image-based. Satisfactory wear compliance measurement accuracy was obtained using the combined classifier (89.24%) on leave one subject out cross-validation. The average duration of compliant wear in the study was 9h with a standard deviation of 2h or 70.96% of total on-time. This method can be used to calculate the wear and non-wear time of AIM-2, and potentially be extended to other devices. The study also included assessments of sensor burden and privacy concerns. The survey results suggest recommendations that may be used to increase wear compliance.

Strategies for extended lifetime of implantable intraperitoneal insulin catheters

Implantable insulin infusion systems using the intra-peritoneal route have dramatically changed the management of diabetes paving the way toward the realization of the potential “holy grail” of a fully implantable artificial pancreas. However, the wear duration of delivery catheters is compromised by the foreign body-mediated immune response. Both occlusion material present at the distal catheter tip end and fibrotic encapsulation surrounding the catheters influence the controlled and precise delivery of insulin, which eventually leads to the need for surgical intervention. The novel part of the current work is the investigation of the roles of implant physical properties (catheter size and tip configuration), as well as local inflammation control (through utilization of an anti-inflammatory agent) on the host fibrotic response using a previously developed animal model. The cellular and molecular response, the medication delivery efficacy as well as the ability to flush the catheters were examined and further compared among the different mitigation strategies. Reduction in catheter size as well as tuning the tip configuration from a cone shape to a round shape showed delayed host recognition and delayed propagation of the fibrotic response. However, the round shaped tips had an increased occurrence of lumen occlusion as a result of flow change. It became apparent that changing the physical properties of the catheters was not a long-term solution to catheter obstructions caused by the foreign body reaction. In comparison, control of the local inflammatory response through the use of an anti-inflammatory agent demonstrated a promising strategy for maintenance of catheter functionality without any type of obstructions. These finding will have a large impact toward the development of long-term use catheters for continuous intraperitoneal insulin infusion.

Effects of long‑term soft contact lens wear on corneal epithelial thickness after small incision lenticule extraction

The present study investigated changes in corneal epithelial thickness after small incision lenticule extraction (SMILE) in patients with long-term preoperative soft contact lens (SCL) wear, the impact of SCL wear on the efficacy of surgical outcomes and the effects of long-term SCL wear on postoperative corneal aberrations. Patients were assigned to three groups according to the duration of SCL wear: Group A, the non-SCL-wearing group; group B, those with SCL wear ≤1 year; and group C, those with SCL wear >1 year. Epithelial thickness was recorded in nine zones by anterior segment optical coherence tomography across a 5-mm diameter before surgery and at 1 week, and 1, 3 and 6 months post-surgery. Corneal epithelial thickness and corneal aberrations among the three groups were compared, as well as the effects of changes in corneal epithelial thickness on postoperative visual acuity and manifest refraction. No significant differences were noted with regard to age or preoperative spherical equivalent among groups A (22 eyes), B (17 eyes) and C (18 eyes). Preoperative corneal epithelial thickness in the inferonasal, inferior and inferotemporal zones was thinner in group B compared with that in group A, and corneal epithelial thickness was thinner in all nine zones in group C compared with that in group A (P<0.05). At all follow-up time points, in the central, nasal, inferonasal, inferior, inferotemporal and temporal areas, the epithelial thickness was thinner in group C compared with that in group A (P<0.05). At 3 months postoperatively, the epithelial thickness was thinner in the inferonasal and inferior sectors in group C compared with that in group B (P<0.05), and at 6 months postoperatively, the epithelial thickness in the inferior region was thinner in group C compared with that in group B (P<0.05). There were no significant differences in visual acuity or manifest refraction among the three groups at all postoperative time points. The total higher-order aberrations were greater in group C compared with those in group A for all time points (P<0.05) and were greater in group C at 1 and 3 months postoperatively compared with those in group B (P<0.05). The spherical aberrations at 3 and 6 months postoperatively were greater in group C compared with those in group A (P<0.05). The coma aberrations were greater in group C compared with those in groups A and B for all time points (P<0.05). In conclusion, long-term SCL wear will result in corneal epithelial thinning, which does not impact visual acuity or manifest refraction after SMILE.

Correlation between long-term use of rigid gas permeable contact lenses and endothelial morphometric changes in keratoconus patients

PurposeThis study was conducted to evaluate the effects of long-term use of rigid gas-permeable (RGP) contact lenses on corneal endothelium in keratoconus (KC) patients using non-contact specular microscopy. In addition, the correlation between wearing duration of RGP lenses (years & hours /d) and endothelial morphometric changes in KC patients was performed. This may provide more useful data for clinical application of RGP contact lens. Study designThis study was a prospective, observational, comparative, hospital based, nonrandomized, cross-sectional, and quantitative study. Subjects and methodsThe study included 40 eyes of non-wearer contact lens KC patients (group 1) and 38 KC eyes with a long history of Rose K2 RGP contact lens wearing (group 2). The corneal endothelial morphology such as endothelial cell density (ECD); coefficient of variation of cell area (CV); percentage of hexagonal cells (HEX); and central corneal thickness (CCT) were evaluated in all patients using SP3000P Specular Microscope. ResultsThe study included 40 eyes of non-wearer contact lens KC patients (20 mild KC eyes and 20 moderate KC eyes) and 38 KC eyes with a long history of RGP contact lens wearing (18 mild KC eyes and 20 moderate KC eyes). The mean duration of RGP lenses wearing was 5.67 ± 3.481 years & 12.11 ± 2.698 h/d in mild KC eyes and 7.15 ± 5.294 years &13.65 ± 2.889 h/d in moderate KC eyes. Wearing duration in hours in mild KC eyes showed a significant moderate negative correlation with ECD (r = −0.529, p = 0.024) and a moderate positive correlation with CV (r = 0.565, p = 0.015). In addition, wearing duration in years in moderate KC eyes showed a significant moderate negative correlation with ECD (r = −0.465, p = 0.039) and moderate positive correlation with CV (r = 0.627, p = 0.003). However, wearing duration in hours in moderate KC eyes showed a significant moderate negative correlation with HEX only (r = −0.490, p = 0.028). This study reported significant corneal thinning in contact lens wearer KC eyes in contrast to non-wearer KC eyes. ConclusionThis study documented a significant correlation between a long-term use of Rose K2 RGP using the three-point touch and corneal endothelial morphometric changes in KC patients. In addition, the current study confirmed a significant corneal thinning in RGP contact lens wearer compared to non-contact lens wearer KC patients. Further studies are recommended to evaluate the association between different RGP lens materials with different oxygen permeability transmissibility; different lens design types; different fitting methods; the duration of contact lens wear and the endothelial morphometric changes in KC patients.

One Week Sustained In Vivo Therapeutic Release and Safety of Novel Extended-Wear Silicone Hydrogel Contact Lenses.

Since the seminal work of Wichterle in 1965 describing the first soft contact lenses and their potential for ocular drug delivery, the field has yet to realize his vision. Maintaining all lens commercial properties combined with a mechanism for controlled drug release of therapeutically relevant concentrations for duration of wear is a major challenge. Here, successful in vivo week-long sustained release of a small molecular weight therapeutic in rabbits from extended-wear silicone hydrogel contact lenses meeting all commercial specifications by utilizing a novel macromolecular memory strategy is reported for the first time. Lens-treated eyes show a continuous, therapeutically relevant bromfenac tear concentration of 256.4± 23.1µg mL-1 for 8 days. Bromday (bromfenac ophthalmic solution, 0.09%, Bausch+Lomb) topical drops exhibit a quick peak concentration of 269.3 ± 85.7µg mL-1 and 100 min duration. Bioavailability (AUC0-8days ) and mean residence time of lenses are 26 and 155 times higher than drops, respectively. Lenses are safe, well tolerated, and no corneal histological differences are observed. This work highlights the enormous potential of drug releasing lenses as a platform strategy, and offers a new dropless clinical strategy for post-cataract, uveitis, post-LASIK, and corneal abrasion treatment.

Relationship between degree of disability, usefulness of assistive devices, and daily use duration: an investigation in children with congenital upper limb deficiencies who use upper limb prostheses

ABSTRACT Upper limb prostheses can help children with congenital upper limb deficiencies (ULDs) perform activities of daily living. Although the degree of disability and prosthesis usefulness may be related to becoming accustomed to wearing a prosthesis, these relationships have not been confirmed. This study was aimed at investigating the relationship between motor function, the usefulness of prostheses in everyday activities, and daily duration of prosthesis use in children with congenital ULDs. Eleven children with congenital transcarpal or transradial ULDs and their caregivers participated in this study. The caregivers were asked to complete a questionnaire concerning their children’s everyday activities and the daily duration of prosthesis wearing. The adaptive behavior scale was used to measure motor function prior to intervention. Correlations analyses revealed no significant correlation between the children’s adaptive behavior, including motor skills before intervention, and daily duration of prosthesis wearing, but revealed a positive correlation between the number of activities that the children performed more effectively with their prostheses and the daily use duration. To ensure that children with congenital ULDs become accustomed to wearing their prostheses, the prostheses should meet the requirements of everyday activities.

A study on orthodontic retention practices in Nepal

Introduction: Retainers are used after all orthodontic treatment, to prevent or minimize relapse and recurrence. Among various retainers used, Hawley retainer and ‘invisible’ retainers are the most common. Most of the orthodontists favored permanent retention. It is obvious that the retention procedures are variable and depended largely on personal preferences, and there does not seem to be any consistent pattern in the application of retention methodologies. The purpose of this study was to survey the retention protocols among orthodontists in Nepal. Materials and Method: The complete lists of the names and addresses of orthodontists in Nepal was obtained from the ODOAN. The questionnaire was sent to them which consisted of multiple-choice questions and short answer, related to background information of the individual orthodontist, retention use in general, the frequency of different types of bonded or removable retainers that are used, the retention protocol, the type of retainer used in specific situation. All statistical analyses were performed using the Statistical Package for Social Sciences (SPSS), version 12.0.1 (SPSS Inc, Chicago, Illinois, USA) Result: The survey questionnaires were completed by 90.42% of the 94 orthodontists of Nepal, 58.8% males and 41.2% females with a mean age of 36.7 years. Most of the orthodontists used a clear (vacuum) retainer (80%) in the maxilla and fixed bonded retainer in the mandible. Most of them prefer the use of retainer for a continuous 24 hours except during eating and brushing for 6 months to 1 year (56.5%) and if possible, for 1 to 2 years (28.2%). Conclusion: Majority of Nepalese orthodontists provide vacuum formed retainer on maxillary arch and bonded retainer in mandibular arch. There is no specific consensus on other type of retainers, duration of wear and follow up visits which is affected by various other factors.

Mask-induced dermatoses during the COVID-19 pandemic: a questionnaire-based study in 12 Korean hospitals.

SummaryBackgroundDuring the coronavirus disease 2019 (COVID‐19) pandemic, various adverse skin reactions to long‐term mask wearing have been reported.AimTo assess the clinical features of mask‐induced dermatoses and to recommend prevention and treatment options.MethodsFrom April to August 2020, questionnaires including topics such as demographic information, pre‐existing skin disorders, reported mask‐related symptoms, daily mask‐wearing duration and frequency, types of masks used and whether the participant was a healthcare worker, were distributed to patients in 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis and recorded treatments.ResultsItchiness was the most frequent symptom, mostly affecting the cheeks. The most common skin disease was new‐onset contact dermatitis (33.94%), followed by new‐onset acne (16.97%) and worsening of pre‐existing acne (16.97%). Daily wearing of masks was significantly (P = 0.02) associated with new‐onset contact dermatitis. More than half of patients with pre‐existing skin problems experienced disease worsening while wearing masks. Longer duration of wearing (> 6 h/day, P = 0.04) and use of cotton masks (P < 0.001) significantly increased acne flare‐up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical treatment. The study had some limitations: the effect of seasonal characteristics and other risk factors were not assessed, and the patients were visiting dermatological clinics and had interest in their skin status, thus, there may have been selection bias.ConclusionMask‐induced/‐triggered dermatoses contribute to increase the dermatological burden during the pandemic.

Improved contact lens fitting after corneal cross-linking in eyes with progressive keratoconus

ObjectivesThe study aimed to assess the possible effects of corneal cross-linking (CXL) on contact lens (CL) fitting in patients with progressive keratoconus who initially had CL intolerance. MethodsA retrospective review was performed of the medical records of patients who had stopped CL wear due to discomfort prior to CXL and who were fitted with CLs after CXL. All eyes were evaluated pre- and 1, 6, 12, 24 months postoperatively. Data collected included pre- and post-CXL refraction, corneal topographic data, uncorrected visual acuity, and best-corrected visual acuity (BCVA). CL comfort was evaluatedusing theLikert scale post-CXL. ResultsA total of 20 eyes from 14 patients were included in the study. Preoperative Kmax values significantly decreased by 2.8 D at 6 months and by 4.1 D at 12 months after CXL (p < 0.001 for both). CLs were prescribed on average 12 ± 2.5 months after CXL. The mean duration of successful CL wear was 10.4 ± 2.8 months during the follow-up period. Subjective CL comfort scores were satisfactory post-CXL. ConclusionCXL not only halts the progression of keratoconus but may also improve CL tolerance by providing a more regular shaped cornea in these patients. Ongoing corneal topographic changes in the late postoperative period after CXL may have a positive effect on CL fitting.

Investigation of Dry Eye Symptoms in Health Workers of National Medical College and Teaching Hospital following Corona Virus Pandemic

Background: With the outspread of global pandemic Corona virus disease 19. (COVID-19), use of face masks was taken as a vital deed against severe acute respiratory syndrome coronavirus-2. (SARS-CoV-2) The aim of this study was to assess symptoms of mask associated dry eye (MADE) among health workers.&#x0D; Materials and Methods: A total of 169 heath workers meeting the inclusion criteria were selected by simple random sampling from respective department. Data were obtained by providing with questionnaire established by the researcher and Ocular Surface Disease Index (OSDI) to the participants from November 1, 2020 to March 31, 2021 at National Medical College and Teaching Hospital. The data were evaluated using correlation test.&#x0D; Results: A total of 169 heath workers were enrolled in the study. The mean age of the patient was 31.74±7.34 years (range 19-56).According to OSDI, 27(15.9%) of the participants had mild dry eye symptoms followed by 15 (8.87%) cases of moderate and 44(26.03%) of severe respectively. Duration of mask wearer and electronic devices usage were two variables that were statistically correlated with OSDI (p&lt;0.01). The OSDI was not statistically correlated with age, glass wear and sleep duration.&#x0D; Conclusion: With the emergence of COVID -19, measures to cope against this pandemic are must. With the increasing use of controlling measures, it is prime responsibility of ophthalmic faculty to start awareness regarding proper use of these anti-COVID measures and make sustainable environment in future.

Assessing the impact of FFP3 masks to oxygen saturation and pulse rate in the Oral Surgery department at the Glasgow Dental Hospital during the COVID-19 pandemic: an observational study.

AimThe impact on physiological parameters and well‐being from potential respiratory distress caused by FFP3 masks, particularly during extensive clinical sessions, has been widely speculated during the COVID‐19 pandemic. This study aims to investigate the effect of FFP3 mask wear on clinicians’ pulse rate and oxygen saturation.Material & MethodsClinical staff within the Oral Surgery department recorded their oxygen saturation (SpO2) and pulse rate prior to donning an FFP3 mask, prior to doffing FFP3 mask and after doffing FFP3 mask using a finger pulse oximeter for a two‐week period in May–June 2020. The duration of wear, the session (AM/PM), the brand of mask and the presence of previous COVID‐19 symptoms were also recorded.ResultsTwenty‐eight data sets were collected from twelve participants (1M:11F). Of the FFP3 masks worn, nineteen (67.86%) were ARCOTM, eight (28.57%) were 3MTM masks and one (3.57%) was 3M+TM. At baseline, the mean SpO2 was 98.39% and the mean pulse rate was 72.11. Prior to mask removal, the mean SpO2 was 97.82% and the mean pulse rate was 70.04. At the end of the session, the mean SpO2 was 98.14% and the mean pulse rate was 69.54. The mean duration of wear was 150.34 min. Data sets were collected evenly across AM (14) and PM (14) sessions. Five participants (17.86%) reported previous COVID‐19 symptoms.ConclusionThe data demonstrated a mean reduction of 0.25% in oxygen saturation and 3.56% in pulse rate, following the use of an FFP3 mask. These changes in physiological parameters are not clinically significant and sessional use appears to be safe.

A national survey of orthodontists in Malaysia and their use of functional appliances for Class II malocclusions

Abstract Objectives The aim of this study was to evaluate the use of functional appliances by the currently practising orthodontists in Malaysia. The objectives were to identify the different types of functional appliances used by Malaysian orthodontists and to investigate the variation in treatment protocols when attempting growth modification. Methods An online questionnaire consisting of 24 open-ended and multiple-choice questions was emailed to members of the Malaysian Association of Orthodontists (MAO) (n = 183). The survey was based on a previous study conducted by members of the British Orthodontic Society and was modified to suit the Malaysian population. The data were analysed using SPSS to generate frequency tables and descriptive statistics. Results Seventy-two responses were received from current Malaysian orthodontists. Of the respondents, 71% practised in a government setting and 29% were in private practice. The Clark Twin Block was the most frequently used functional appliance by 90% of Malaysian orthodontists. Many of the respondents (57%) prescribed full-time wear of removable functional appliances for 6–9 months (except during mealtimes) (51%). Following active removable functional appliance therapy, 91% prescribed a period of retention which involved a reduction in the duration of wear. The retention phase extended for 2 to 3 months (41%) or for 4 to 6 months (39%) for the majority of the respondents. Conclusions The Clark Twin Block is the most frequently-used functional appliance for the management of a Class II malocclusion by orthodontists currently practising in Malaysia.

Skin adverse events related to personal protective equipment: a systematic review and meta-analysis.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global pandemic that has spread all over the word. To avoid the virus transmission, healthcare workers must wear adequate personal protective equipment (PPE). PPE is associated with several side events, including skin reactions. The objective of this study was to summarize the prevalence, type and risk factors for cutaneous adverse events related to PPE and prevention measures to avoid them. A systematic review and meta-analysis was conducted using MEDLINE, Scopus and EMBASE databases from conception to 21 January 2021. All types of epidemiological studies regarding skin adverse events related to PPE were included. The literature search identified 1007 references, 35 of them met the eligible criteria and were included for analysis, representing 31453 participants. The media of skin side events related to PPE was 75.13%. The rate of cutaneous adverse events related to mask was 57.71%, and those associated with gloves and hand hygiene products was 49.16%. Most common skin adverse events were contact dermatitis, acne and itching. The most damaged anatomical regions were the nasal bridge, the cheeks and the hands. The duration of PPE wearing was the most common risk factor. Frequent handwashing, gloves and masks were the agents most frequently related to skin reactions. N95 respirators were the most harmful mask type for the skin. Hydrocolloid use prevented from developing skin adverse events related to masks. In conclusion, the rate of cutaneous adverse events related to PPE use is high. A longer duration of PPE wearing was the most common risk factor. Using hydrocolloid could prevent from skin injuries related to mask use.

A Survey of Retention Practices and Protocols Followed Among Orthodontists in India.

Background:There are different types of retention protocols and retainers prescribed by the orthodontists across the globe.Aim:The study was conducted with the aim of evaluating the retention practices followed by the orthodontists in India.Materials and Methods:A questionnaire link with a set of 29 questions was generated using the Google Forms App. The questions related to the basic demographic details followed by retention procedures in maxilla and mandible as related to the type of retainer, duration of wear, retention check-ups, and adjunctive procedures being followed. The Google forms were mailed to 1147 registered life members of the Indian Orthodontic Society.Results:The overall response rate was 20.1%. On receiving of the completed questionnaires, the data were statistically analyzed. Dual mode of retention, fixed retainers with removable thermoplastic resin (TR)/vacuum formed retainers (VFR) (24%) were the common type of retention in maxilla whereas the fixed bonded retainer (44.5%) was more commonly used in mandible. Full time wear of maxillary retainer was recommended by 85.2% of the respondents. The recommended duration of the fixed retainer is for 2–5 years (41.9%).Conclusion:A trend towards more dual retention instead of solitary removable or solitary fixed retention, more VFR instead of Hawley-type retainers has been demonstrated in the survey.

101-LB: Reported Satisfaction during the Medtronic Extended-Wear Infusion Set (EWIS) Pivotal Trial

Objective: Most insulin infusion sets (ISs) are labeled for 2- or 3-days use. The Medtronic EWIS is designed to increase wear time up to 7 days, and demonstrated a 74.8% survival rate (77.8%, excluding inadvertent early removal) in the pivotal trial (ClinicalTrials.gov: NCT04113694). This study reports on study participant satisfaction during the EWIS pivotal trial.Method: This multi-center (15), single-arm, non-randomized, non-inferiority trial in 259 participants (18-80yrs) with T1D using the MiniMed™ 670G system (with Humalog™ or Novolog™ insulin) involved wearing a 2- or 3-day IS for 2 weeks (run-in) followed by 12 consecutive EWIS wears (study phase). The latter was worn for ≥174 hours or until set failure. Participants completed a Medtronic Likert-based questionnaire at baseline and study exit. The averaged paired change in score at study-baseline was determined (Wilcoxon signed-rank test).Result: Reported satisfaction data during 2- or 3-day IS versus EWIS wear (Figure) show that ease and convenience of use, comfort, wear duration and time required to change a set were significantly improved with EWIS (p<0.001).Conclusion: These findings point to significantly greater satisfaction with the EWIS when compared with a 2- or 3-day IS, which may result in reduced care burden and improved adherence.View largeDownload slideView largeDownload slide DisclosureR. L. Brazg: Research Support; Self; Abbott Diabetes, Ascensia Diabetes Care, Lexicon Pharmaceuticals, Inc., Lilly Diabetes, Medtronic, Pfizer Inc., Roche Diagnostic USA, Senseonics. B. Horowitz: Research Support; Self; Abbott Laboratories, BD, Celgene, Crinetics Pharmaceuticals, Gan & Lee Pharmaceuticals, Medtronic, Speaker’s Bureau; Self; AstraZeneca, Lilly Diabetes, Merck & Co., Inc., Novo Nordisk Inc. K. B. Kaiserman: Advisory Panel; Self; Medtronic, Consultant; Self; Medtronic, Employee; Self; MannKind Corporation, Research Support; Self; Medtronic, Speaker’s Bureau; Self; Medtronic, Stock/Shareholder; Self; MannKind Corporation. S. Huang: None. V. Chen: Employee; Self; Medtronic. G. Zhang: Employee; Self; Medtronic. S. Chattaraj: Employee; Self; Medtronic. J. Shin: Employee; Self; Medtronic. R. Vigersky: Employee; Self; Medtronic. T. S. Bailey: Consultant; Self; Abbott Diabetes, LifeScan, Novo Nordisk, Sanofi, Research Support; Self; Abbott, Abbott Diabetes, Biolinq, Capillary Biomedical, Inc., Dexcom, Inc., Eli Lilly and Company, Kowa Research Institute, Inc., Lexicon Pharmaceuticals, Inc., Livongo, Medtronic, Medtrum Technologies, Novo Nordisk, REMD Biotherapeutics, Sanofi, Sanvita, Viacyte, Inc., vTv Therapeutics, Zealand Pharma A/S, Speaker’s Bureau; Self; BD, Medtronic, Sanofi. Y. C. Kudva: Research Support; Self; Dexcom, Inc. S. K. Garg: Advisory Panel; Self; Eli Lilly and Company, Medtronic, Novo Nordisk Inc., Zealand Pharma A/S, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Medtronic. G. Grunberger: Research Support; Self; Medtronic, Speaker’s Bureau; Self; Abbott Diabetes, Eli Lilly and Company, Novo Nordisk. A. Cavale: Research Support; Self; Eli Lilly and Company, Medtronic. J. Thrasher: Advisory Panel; Self; Medtronic, Board Member; Self; Medtronic, Consultant; Self; Medtronic, Research Support; Self; Eli Lilly and Company, Lexicon Pharmaceuticals, Inc., Medtronic, Mylan N. V., Novo Nordisk, Sanofi, Speaker’s Bureau; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Medtronic, Sanofi. A. Bhargava: Research Support; Self; Abbott, AbbVie Inc., Amgen Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Boston Therapeutics, Inc., Covance Inc., Dexcom, Inc., Eli Lilly and Company, Gan & Lee Pharmaceuticals, Insulet Corporation, Janssen Research & Development, LLC, Kowa Pharmaceuticals America, Inc., Madrigal Pharmaceuticals, Inc., Medtronic, Merck & Co., Inc., Mylan N. V., Novo Nordisk, Poxel SA, Quintiles, Sanofi, Senseonics, Tolerion, Inc., Viking Therapeutics. B. A. Buckingham: Advisory Panel; Self; Medtronic, Tolerion, Inc., Research Support; Self; Beta Bionics, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care.

Evaluation of Corneal Densitometry and Endothelial Layer in Soft Contact Lens Users.

Soft contact lens wear may lead to physiological changes in the cornea. Corneal densitometry is a new software tool that may detect these physiological changes by monitoring their effects on corneal transparency. This study aimed to assess corneal densitometry values and corneal endothelium in patients using soft contact lenses. The study included 36 eyes of 36 subjects with soft contact lens use (group 1) and 36 eyes of 36 healthy control subjects (group 2). Anterior segment parameters and corneal densitometry of all subjects were evaluated using Scheimpflug corneal topography (Pentacam; Oculus Inc., Wetzlar, Germany). A total corneal area of 12 mm was divided into four annular zones (0 to 2, 2 to 6, 6 to 10, and 10 to 12 mm) and into three regions as anterior, central, and posterior for densitometry examination. Cell density, cell distribution, and cell morphology (quadrangular, pentagonal, hexagonal, and other cell percentages) of the endothelial layer were examined in both groups using specular microscopy (Nidek CEM 530; Nidek Co., Gamagori, Aichi, Japan). In group 1, the mean duration of contact lens wear was 4.45 ± 2.15 years. The anterior segment parameters were not significantly different between the two groups (P > .05). The anterior 0- to 2- and 2- to 6-mm corneal densitometry values were significantly higher in group 1 compared with group 2 (23.2 ± 4.7 for group 1 and 17.3 ± 5.6 for group 2 [P = .03]; 22.4 ± 6.4 for group 1 and 17.8 ± 1.4 for group 2 [P = .03], respectively). There were no significant differences between the groups for corneal densitometry values between 6 and 12 mm, or for cell density, cell distribution, and cell morphology (P > .05). Although the cornea remains transparent in soft contact lens wearers, corneal densitometry may increase in the 0- to 6-mm annular zone of the anterior region.

Face Mask Controls and Duration of Wearing: What Medical Research Can Teach the Cleanroom Manager

No mask is 100% effective. Masks are a tradeoff between bacterial and particle efficiency and user comfort, with a 97.5% bacterial filter efficiency the typical rating. Achieving this is dependent upon the mask integrity and worn correctly. This paper covers cleanroom contamination control, more recent research within the medical field has been driven by responses to the coronavirus, and some recommendations for the control of surgical face masks worn in cleanrooms.

Long-term periodontal changes associated with oral appliance treatment of obstructive sleep apnea.

To characterize the mandibular anterior teeth crown height as a marker of periodontal changes and bone loss as a side effect of an oral appliance worn for a minimum of 4.5 years. This retrospective study conducted in patients with healthy baseline periodontium recruited participants among consecutive sleep apnea patients treated with an oral appliance between 2004 to 2014. Eligible participants were recalled for a follow-up visit at which a periodontal examination was performed and a lateral cephalogram and dental impressions were obtained. Clinical crown height for mandibular anterior teeth and cephalometric variables were measured and compared before and after treatment. A full periodontal evaluation was performed at the follow-up visit. Twenty-one patients enrolled with a mean treatment length of 7.9 ± 3.3 years. For the mandibular anterior teeth, clinical crown height did not change over the evaluated period. At follow-up, all the periodontal assessed variables were within normal limits, with the mean probing depth of 1.4 ± 0.5 mm, recession 0.6 ± 1.1 mm, and clinical attachment loss 0.8 ± 1.0 mm. Compared with baseline, there was a significant proclination of mandibular incisors (mean increase of 5.1 degrees) with the continued use of an oral appliance. Gingival levels were maintained with clinically insignificant changes during the observation period. Inclination of the mandibular incisors increases significantly with the use of an oral appliance in patients with obstructive sleep apnea. Positional changes in these teeth were not associated with any measured evidence of increase in clinical crown height or gingival recession. Heda P, Alalola B, Almeida FR, Kim H, Peres BU, Pliska BT. Long-term periodontal changes associated with oral appliance treatment of obstructive sleep apnea. J Clin Sleep Med. 2021;17(10):2067-2074.

MoS2 Nanocomposite Films with High Irradiation Tolerance and Self-Adaptive Lubrication.

Although nanostructures and oxide dispersion can reduce radiation-induced damage in materials and enhance radiation tolerance, previous studies prove that MoS2 nanocomposite films subjected to several dpa heavy ion irradiation show significant degradation of tribological properties. Even in YSZ-doped MoS2 nanocomposite films, irradiation leads to obvious disordering and damage such as vacancy accumulation to form lamellar voids in the amorphous matrix, which accelerates the failure of lubrication. However, after thermal annealing in vacuum, YSZ-doped MoS2 nanocomposite films exhibit high irradiation tolerance, and their wear duration remains unchanged and the wear rate was nearly three orders of magnitude lower than that of the as-deposited films after 7 dpa irradiation. This successful combination of anti-irradiation and self-adaptive lubrication mainly results from the manipulation of the nanosize and the change of composition by annealing. Compared with the smaller nanograins in as-deposited MoS2/YSZ nanocomposite films, the thermally annealed MoS2 nanocrystals (7-15 nm) with fewer intrinsic defects exhibited remarkable stabilization upon irradiation. Abundant amorphous nanocrystal phases in ion-irradiated thermally annealed films, where each has advantages of their own, greatly inhibit accumulation of voids and crack growth in irradiation; meanwhile, they can be easily self-assembled under induction of friction and achieve self-adaptive lubrication.