Search results for: dental emergencies

Authors: Michael Wagner, Philipp Steinbauer, Andrea Katharina Lietz, Alexander Hoffelner, Johannes Fessler

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Background: Cardiopulmonary resuscitations are stressful situations in which vital decisions must be made within seconds. Lack of routine due to the infrequency of pediatric emergencies can lead to serious medical and communication errors. Virtual reality can fundamentally change the way simulation training is conducted in the future. It appears to be a useful learning tool for technical and non-technical skills. It is important to investigate the use of VR in providing a strong sense of presence within simulations. Methods: In this randomized study, we will enroll doctors and medical students from the Medical University of Vienna, who will receive learning material regarding the resuscitation of a one-year-old child. The study will be conducted in three phases. In the first phase, 20 physicians and 20 medical students from the Medical University of Vienna will be included. They will perform simulation-based training with a standardized scenario of a critically ill child with a hypovolemic shock. The main goal of this phase is to establish a baseline for the following two phases to generate comparative values regarding cognitive load and stress. In phase 2 and 3, the same participants will perform the same scenario in a VR setting. In both settings, on three set points of progression, one of three predefined events is triggered. For each event, three different stress levels (easy, medium, difficult) will be defined. Stress and cognitive load will be analyzed using the NASA Task Load Index, eye-tracking parameters, and heart rate. Subsequently, these values will be compared between VR training and traditional simulation-based training. Hypothesis: We hypothesize that the VR training and the traditional training groups will not differ in physiological response (cognitive load, heart rate, and heart rate variability). We further assume that virtual reality training can be used as cost-efficient additional training. Objectives: The aim of this study is to measure cognitive load and stress level during a real-life simulation training and compare it with VR training in order to show that VR training evokes the same physiological response and cognitive load as real-life simulation training.

Keywords: virtual reality, cognitive load, simulation, adaptive virtual reality training

Procedia PDF Downloads 116

Authors: Awais Ali, Hesham Ali

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The absence of teeth through either premature loss or developmental absence is a common condition with potentially severe impact on affected individuals. Management of these cases presents a clinical challenge which may be difficult to resolve given the effects of tooth loss or hypodontia over the course of a patient’s lifetime. Treatment of such cases is often best provided by a multi-disciplinary team, where the patient’s expectations and care delivery can be optimally managed. Orthodontic treatment is often used to prepare the dentition in advance of restorative replacement of missing teeth. Conversely, the placement of implants may precede the delivery of orthodontic treatment and indeed may function as an adjunctive orthodontic procedure. We discuss the use of both approaches here and illustrate their clinical implementation with two case reports. The first case demonstrates the use of fixed appliances to prepare the mouth for an opposing implant-retained complete denture. A second case demonstrates the use of implant-retained crowns to provide orthodontic anchorage in a partially dentate patient. We propose that complex cases such as these should always be planned and treated by a multi-disciplinary team in order to optimise the delivery of care, patient experience, and treatment outcome. The presented cases add to the body of evidence in this area.

Keywords: orthodontics, dental implantology, hypodontia, multi-disciplinary

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Authors: Shengping Zhong, Qimin Shi, Yaling Deng, Shoufeng Yang

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Additive manufacturing has exerted a tremendous fascination on the development of the manufacturing and materials industry in the past three decades. Zirconia-based advanced ceramic has been poured substantial attention in the interest of structural and functional ceramics. As a novel material jetting process for selectively depositing nanoparticles, NanoParticle Jetting™ is capable of fabricating dense zirconia components with a high-detail surface, precisely controllable shrinkage, and remarkable mechanical properties. The presence of NPJ™ gave rise to a higher elevation regarding the printing process and printing accuracy. Emphasis is placed on the performance evaluation of NPJ™ printed ceramic components by which the physical, chemical, and mechanical properties are evaluated. The experimental results suggest the Y₂O₃-stabilized ZrO₂ boxes exhibit a high relative density of 99.5%, glossy surface of minimum 0.33 µm, general linear shrinkage factor of 17.47%, outstanding hardness and fracture toughness of 12.43±0.09 GPa and 7.52±0.34 MPa·m¹/², comparable flexural strength of 699±104 MPa, and dense and homogeneous grain distribution of microstructure. This innovative NanoParticle Jetting system manifests an overwhelming potential in dental, medical, and electronic applications.

Keywords: nanoparticle jetting, ZrO₂ ceramic, materials jetting, performance evaluation

Procedia PDF Downloads 178

Authors: Olphiara Rodolpheza Alexandre, Carla David, Rafael Guerra Lund, Nadia Ferreira

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Due to the increasing demand for biomaterials in the dental field, especially in endodontics, calcium silicate-based cements (CSCs) have gained prominence because of their biocompatibility and tissue regeneration capabilities. Originating from Mineral Trioxide Aggregate (MTA), the first bioceramic in endodontics derived from Portland cement, these materials are becoming increasingly prevalent in the market. For any drug released to the market, pharmacovigilance must ensure the absence of adverse health effects on consumers through rigorous toxicological testing. Although these materials have undergone in vitro and in vivo testing, such tests have typically been conducted over a limited period. Some effects may only become apparent after several years, and these studies are generally carried out on a non-specific population. However, the variety of calcium silicate-based products, including cement and sealers, raises questions about their toxicity, particularly considering potential long-term effects not addressed in existing studies. While the scientific literature includes comparative studies on the toxicity of these materials, the consistency of their conclusions is often controversial. Therefore, this project aims to map the scientific evidence from in vitro biocompatibility studies, including those investigating the toxicity of calcium silicate-based bioceramics.

Keywords: toxicity, toxicity test, bioceramics, calcium silicate, genotoxicity

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Authors: Onyekachi Onwudike, Russell Lock, Iain Phillips

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The variability that exists across governments, her departments and the provisioning of services has been areas of concern in the E-Government domain. There is a need for reuse and integration across government departments which are accompanied by varying degrees of risks and threats. There is also the need for assessment, prevention, preparation, response and recovery when dealing with these risks or threats. The ability of a government to cope with the emerging changes that occur within it is known as resilience. In order to forge ahead with concerted efforts to manage reuse and integration induced risks or threats to governments, the ambiguities contained within resilience must be addressed. Enhancing resilience in the E-Government domain is synonymous with reducing risks governments face with provisioning of services as well as reuse of components across departments. Therefore, it can be said that resilience is responsible for the reduction in government’s vulnerability to changes. In this paper, we present the use of the ontology to measure the resilience of governments. This ontology is made up of a well-defined construct for the taxonomy of resilience. A specific class known as ‘Resilience Requirements’ is added to the ontology. This class embraces the concept of resilience into the E-Government domain ontology. Considering that the E-Government domain is a highly complex one made up of different departments offering different services, the reliability and resilience of the E-Government domain have become more complex and critical to understand. We present questions that can help a government access how prepared they are in the face of risks and what steps can be taken to recover from them. These questions can be asked with the use of queries. The ontology focuses on developing a case study section that is used to explore ways in which government departments can become resilient to the different kinds of risks and threats they may face. A collection of resilience tools and resources have been developed in our ontology to encourage governments to take steps to prepare for emergencies and risks that a government may face with the integration of departments and reuse of components across government departments. To achieve this, the ontology has been extended by rules. We present two tools for understanding resilience in the E-Government domain as a risk analysis target and the output of these tools when applied to resilience in the E-Government domain. We introduce the classification of resilience using the defined taxonomy and modelling of existent relationships based on the defined taxonomy. The ontology is constructed on formal theory and it provides a semantic reference framework for the concept of resilience. Key terms which fall under the purview of resilience with respect to E-Governments are defined. Terms are made explicit and the relationships that exist between risks and resilience are made explicit. The overall aim of the ontology is to use it within standards that would be followed by all governments for government-based resilience measures.

Keywords: E-Government, Ontology, Relationships, Resilience, Risks, Threats

Procedia PDF Downloads 338

Authors: Kirstin Griffin

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During a period of increased anxiety and stress, communication became the essential tool to help the public stay informed and feel prepared during the Covid-19 pandemic. However, certain groups of patients were not feeling as reassured. The news and media blasted the message that patients with diabetes were “high-risk" in regards to contracting the Covid-19 infection. Routine clinics were being cancelled, GP practices were closing their doors, and patients with type 1 diabetes were understandably scared. The influx of calls to diabetes specialists nurses from concerned patients highlighted the need for better and more specialised information. An Application specifically for patients with type 1 diabetes was created to deliver this information, and it proved to be the essential communication tool that was desperately needed. The Application for patients with type 1 diabetes aimed to deliver specialist information to patients in regards to their diagnosis, management, and ongoing follow-up commitments. The Application gives practical advice on multiple areas of diabetes management, including sick-day rules and diabetic emergencies, as well as up-to-date information on technology, including setting up Libre devices and downloading glucose meters to facilitate attending virtual clinics. Delivery of this information in an easy-to-understand and comprehensive way is intended to improve patient engagement with diabetes services and ultimately empower patients in the control of their own disease. The application also offers a messaging service to allow the diabetes team to send out alerts to patient groups on specific issues, such as changes to clinics, or respond to recent news updates regarding Covid-19. The App was launched in NHS Fife in June 2020 and has amassed 800 active users so far. There is growing engagement with the App since its launch, with over 1000 user interactions in the last month alone. Feedback shows that 100% of users like the App and have found it useful in the management of their diabetes. The App has proven to be an essential tool in communication with one of the most vulnerable groups during the Covid-19 pandemic, and its ongoing development will continue to increase patient engagement and improve glycaemic control for patients with type 1 diabetes. The future of chronic disease management should involve digital solutions such as apps to further empower patients in their healthcare.

Keywords: diabetes, endocrinology, digital healthcare, medical apps

Procedia PDF Downloads 88

Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

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Authors: Ali Mohammed Saleh Al-Hamzi

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This study aims at finding out the most difficult position in pronouncing the bilabial plosive sounds at the fourth level of English foreign language students of the Faculty of Education, Mahweet, Sana’a University in Yemen. The subject of this study were 50 participants from English foreign language students aged 22-25. In describing sounds according to their place of articulation, sounds are classified as bilabial, labiodental, dental, alveolar, post-alveolar, palato-alveolar retroflex, palatal, velar, uvular, and glottal. In much the same way, sounds can be described in their manner of articulation as plosives, nasals, affricates, flaps, taps, rolls, fricatives, laterals, frictionless continuants, and semi-vowels. For English foreign language students in Yemen, there are some articulators that are difficult to pronounce. In this study, the researcher focuses on difficulties in pronouncing the English bilabial plosive sounds among English foreign language students. It can be in the initial, medial, and final positions. The problem discussed in this study was: which position is the most difficult in pronouncing the English bilabial plosive sounds? To solve the problem, a descriptive qualitative method was conducted in this study. The data were collected from each English bilabial plosive sounds produced by students. Finally, the researcher reached that the most difficult position in pronouncing the English bilabial plosive sounds is when English bilabial plosive /p/ and /b/ occur word-finally, where both are voiceless.

Keywords: difficulty, EFL students’ pronunciation, bilabial sounds, plosive sounds

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Authors: Rym Taktak, Achwek Elghazel, Jamel Bouaziz

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In the present work, we explored the potential of tribological behavior of tricalcium phosphate-Fluorapatite (β Tcp-Fap) bioceramic which has attracted considerable attention for orthopedics and dental applications. The approximate representatives Fap-βTcp were respectively [{13.26 wt%, 86.74 wt%} {19.9 wt%, 80.1 wt%},{ 26.52 wt%, 73.48 wt%}, {33.16 wt%, 66.84 wt%} and {40 wt%, 60 wt%}. The effects of Fluorapatite additives on friction and wear behavior were studied and discussed. The wear test was conducted using pion-disk tribometer at room temperature under dry condition using a constant sliding speed of 0,063 m/s, and three loads 3, 5 and 8 N. The wear rate and friction coefficient of β Tcp with different additive amounts were compared. An Alumina ball specimens were used as the pin and flat surface β Tcp-Fap specimens as the antagonist counterface. The results show a huge difference between the wear rate of β TCP samples and the other β TCP-Fap composites for all normal forces applied. This result shows the beneficial effect of fluorapatite on the tribological behavior of the β TCP. Moreover, we note that β Tcp-26% Fap specimens exhibit, under dry condition, the lower friction coefficient and the smaller wear rate than other biocomposites. Thereby, the friction and wear behavior is influenced by the addition of fluorapatite, the applied normal force, and the sliding velocity. To extend the understanding of the wear process, the surface topography of β Tcp-26% Fap specimens and the wear track obtained during the wear tests were studied using a surface profilometer, optical microscopy, and scanning electron microscopy.

Keywords: alumina, bioceramic, friction and wear test, tricalcium phosphate

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Authors: Gouda K. Helal, Marwa I. Shabayek, Heba A. El-Ramly, Heba A. Awida

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The adverse effects of Clindamycin (Clind.) / Ibuprofen (Ibu.) combination on liver, kidney, blood elements and the significances of antioxidants (N-acetylcysteine and Zinc) against these effects were evaluated. The study includes: Group I; control n=30, Group II; patients on Clind.300mg/Ibu.400mg twice daily for a week n=30, Group III; patients on Clind.300mg/Ibu.400mg+N-acetylcysteine 200mg twice daily for a week n=15 and Group IV; patients on Clind.300mg/Ibu.400mg+Zinc50mg twice daily for a week n=15. Serum malondialdehyde (MDA), alanine transferase (ALT), aspartate transferase (AST), γ glutamyl transferase (GGT), creatinine, blood urea nitrogen (BUN) were measured. Applying one way ANOVA followed by Tuckey Kramer post test, Group II showed significant increase in ALT, AST, GGT, BUN and decrease in Hb, RBCs, platelets than Group I. Group III showed significant decrease in ALT, AST, GGT, BUN than Group II. Moreover, Group IV showed significant decrease in ALT, AST, GGT and increase in Hb, RBCs, and platelets than Group II. Conclusively, Adding Zinc or N-acetylcysteine buffer the oxidative stress and improve the therapeutic outcome of Clindamycin/Ibuprofen combination.

Keywords: clindamycin, ibuprofen, adverse effects, antioxidant, zinc, N-acetylcysteine

Procedia PDF Downloads 384

Authors: Meltem Eryılmaz

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With the emergence of the COVID-19 infection outbreak, the socio-cultural, political, economic, educational systems dynamics of the world have gone through a major change, especially in the educational field, specifically dentistry preclinical education, where the students must have a certain amount of real-time experience in endodontics and other various procedures. The totality of the digital and physical elements that make our five sense organs feel as if we really exist in a virtual world is called virtual reality. Virtual reality, which is very popular today, has started to be used in education. With the inclusion of developing technology in education and training environments, virtual learning platforms have been designed to enrich students' learning experiences. The field of health is also affected by these current developments, and the number of virtual reality applications developed for students studying dentistry is increasing day by day. The most widely used tools of this technology are virtual reality glasses. With virtual reality glasses, you can look any way you want in a world designed in 3D and navigate as you wish. With this project, solutions that will respond to different types of dental practices of students who study dentistry with virtual reality applications are produced. With this application, students who cannot find the opportunity to work with patients in distance education or who want to improve themselves at home have unlimited trial opportunities. Unity 2021, Visual Studio 2019, Cardboard SDK are used in the study.

Keywords: dentistry, intelligent tutoring system, virtual reality, online learning, COVID-19

Procedia PDF Downloads 203

Authors: Sreejith Jayachandran, Mojtaba Ghods, Morteza Mohammadzaheri

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The modern busy world is running behind new embedded technologies based on computers and software; meanwhile, some people forget to do their health condition and regular medical check-ups. Some of them postpone medical check-ups due to a lack of time and convenience, while others skip these regular evaluations and medical examinations due to huge medical bills and hospital expenses. Engineers and medical experts have come together to give birth to a new device in the telemonitoring system capable of monitoring, checking, and evaluating the health status of the human body remotely through the internet for the needs of all kinds of people. The remote health monitoring device is a microcontroller-based embedded unit. Various types of sensors in this device are connected to the human body, and with the help of an Arduino UNO board, the required analogue data is collected from the sensors. The microcontroller on the Arduino board processes the analogue data collected in this way into digital data and transfers that information to the cloud, and stores it there, and the processed digital data is instantly displayed through the LCD attached to the machine. By accessing the cloud storage with a username and password, the concerned person’s health care teams/doctors and other health staff can collect this data for the assessment and follow-up of that patient. Besides that, the family members/guardians can use and evaluate this data for awareness of the patient's current health status. Moreover, the system is connected to a Global Positioning System (GPS) module. In emergencies, the concerned team can position the patient or the person with this device. The setup continuously evaluates and transfers the data to the cloud, and also the user can prefix a normal value range for the evaluation. For example, the blood pressure normal value is universally prefixed between 80/120 mmHg. Similarly, the RHMS is also allowed to fix the range of values referred to as normal coefficients. This IoT-based miniature system (11×10×10) cm³ with a low weight of 500 gr only consumes 10 mW. This smart monitoring system is manufactured with 100 GBP, which can be used not only for health systems, it can be used for numerous other uses including aerospace and transportation sections.

Keywords: embedded technology, telemonitoring system, microcontroller, Arduino UNO, cloud storage, global positioning system, remote health monitoring system, alert system

Procedia PDF Downloads 90

Authors: Aaron Huber, Manoj Karwa

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Floods, heat waves, drought, wildfires, tornadoes and other environmental disasters are a snapshot of looming national problems that can create increasing demands on the national grid. With nearly 500,000 school buses on the road and the environmental protection agency (EPA) providing nearly $1B for electric school buses, there is a solution for this national issue. Bidirectional batteries in electric school buses enable a future proof solution to sustain the power grid during adverse environmental conditions and other periods of high demand. School buses have larger batteries than standard electric vehicles. When they are not transporting students, these buses can spend peak solar hours parked and plugged into bi-directional direct current fast chargers (DCFC). A partnership with Highland Electric, Proterra and Rhombus enabled over 7 MWh of energy servicing Massachusetts and Vermont grids. The buses were part of a vehicle to grid (V2G) program with National Grid and Green Mountain Power that can charge an average American home for one month with a single bus. V2G infrastructure enables school systems to future proof their charging strategies, strengthen their local grids and can create additional revenue streams with their EV fleets. A bidirectional ecosystem with Highland, Proterra and Rhombus can enable grid resiliency or the ability to withstand power outages caused by excessive demands, natural disasters or rogue nation's attacks with no loss of service. A fleet of school buses is a standalone resilient asset that can be accessed across a city to keep its citizens safe without having any toxic fumes. Nearly 95% of all school buses across USA are powered by diesel internal combustion engines. Diesel exhaust has been classified as a human carcinogen, and it can lead to and exacerbate respiratory conditions. Bidirectional school buses and chargers enable energy justice by providing backup power in case of emergencies or high demand for marginalized communities and aim to make energy more accessible, affordable, clean, and democratically managed.

Keywords: V2G, vehicle to grid, electric buses, eBuses, DC fast chargers, DCFC

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Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

Procedia PDF Downloads 235

Authors: Ould Ali R.L, Bensadok S, Mrabet S, Ahmed Fouatih N

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According to the terminology of Angle, the functional mandibular prognathism belongs to the class III malocclusion. Considered as a functional anomaly with considerable aesthetic prejudice, it needs to be detected and treated early to prevent it from becoming skeletal anomaly. With this in mind, early treatment enables a correct anterior guide to be restored quickly, and above all to rehabilitate craniofacial growth. Material and methodology Patient G.H, aged 11 years, who was treated in the Department of Dentofacial Orthopaedics at Oran University Hospital. He presented with functional mandibular prognathism and a sever crowding, which put the upper canines at risk of impaction. Results The orthodontic treatment of this case was divided into two distinct phases, the first of which aimed to correct the functionnal mandibular prognathism and thus re-establish a correct anterior articulation, using a Biourge appliance. The second phase aimed to create the needed space for the eruption of the upper canines, thus eliminating the risk of impaction thanks to multi-attachment fixed therapy. Conclusion Through this clinical case, we have once again been able to demonstrate the value of early caring for young patients. Although these are simple methods, the key is to know how to introduce them in the right way and at the right time. It would therefore seem useful to democratise this type of practice as part of the day-to-day management carried out in the dental practice. We'll finish by quoting Jean Rotrou, the French poet, who said ‘When you can prevent, it's weakness to wait’.

Keywords: functional mandibular prognathism, early treatment, impaction, orthodontics

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Authors: Hanifa Maryani Ahmad, Muslim Yusuf

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Background: Unilateral crossbite can be defined as an abnormal transverse relationship between the upper and lower teeth where the mandibular buccal cusp occluding to the maxillary buccal cusp and which involves only one side of the arch. This report describes the treatment of an adolescent female with Class III malocclussion unilateral crossbite resulting from a mildly constricted maxillary arch. The patient had a Class III skeletal relationship, Class III molar relationships, unilateral crossbite on the left side, and deviated midlines. Objectives: The treatment objectives were to correct the abnormal transverse relationship, achieve proper dental inclination, and correct the unilateral crossbites to improve the facial profile. Case management: The treatment protocol was using transpalatal arch with extension arm modification to expand the maxillary arch. Following the levelling and aligning stage of treatment, using a vertical loop while mandibular arch was expanded after getting an end to end relationship on the anterior side. Results: Corrections of the unilateral crossbite were achieved in 4 months. The treatment is still on process because the canines relationship were not corrected. Conclusions: This report highlights a treatment using transpalatal arch with extension arm modification that can be used to expand the transverse width of an arch to correct the discrepancy. Even though the treatment processes were still ongoing, the correction of the unilateral crossbite have been achieved in 4 months by only using the transpalatal arch.

Keywords: crossbite unilateral, late growing, non-extraction, transpalatal arch

Procedia PDF Downloads 215

Authors: Kinneret Segal

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The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world, and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives, has not been sufficiently explored. The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life and organizational commitment among midwifery nurses in Israeli hospitals. 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms and organizational commitment, predicted satisfaction from compassion. Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: traumatic experirnces, midwives, quality of life, burnout, organizational commitment, personal resilience

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Authors: Xiao Luo, Jayashree Arcot, Timothy P. Gill, Jimmy C. Louie, Anna M. Rangan

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Excessive consumption of added sugar is negatively associated with many health outcomes such as lower diet quality, dental diseases and other non-communicable diseases. Sugar-sweetened baked goods are popular discretionary foods that contribute significant amounts of added sugar to people’s diets worldwide. Food reformulation is of the most effective methods to reduce consumption of added sugar without significantly altering individual's diet pattern. However, sucrose, as the major sugar in baked goods, plays several vital functional roles such as providing sweetness and bulking, and suitable substitutes must be able to address these. The review examines the literature on sugar-reduced baked goods to summarise the feasible reformulations of low/no added sugar baked goods, and indicates the future directions for healthier baked goods reformulation. Based on this review, polyols and non-nutritive sweeteners (NNS) are suitable for alternative sweeteners to partially or fully replace sucrose in baked goods. Low-calorie carbohydrates such as oligofructose, polydextrose, maltodextrins are the mostly used bulking agents to compensate the loss of bulk due to the removal of sucrose. This review found that maltitol seems the most suitable sole sucrose substitution at present, while diverse mixtures of NNS( stevia, sucralose, acesulfame-K), other polyols and inulins can also deliver the functionalities of sucrose in baked products.

Keywords: alternative sweeteners, baked goods, reformulation, sugar reduction

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Authors: Suteera Pradubwong, Darawan Augsornwan, Pornpen Pathumwiwathana, Benjamas Prathanee, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) congenital anomalies have a high prevalence in the Northeast of Thailand. A care team’s understand of treatment plan would help to guide the family of patients with CLP to achieve the treatment. Objectives: To examine the impact of the empowering volunteer project, established in the northeast Thailand. Materials and Methods: The Empowering Volunteer project was conducted in 2008 under the Tawanchai Royal Granted project. The patients and family’s general information, treatment, the group brainstorming, and satisfaction with the project were analyzed. Results: Participants were 12 children with CLP, their families and five volunteers with CLP; the participating patients were predominantly females and the mean, age was 12.2 years. The treatment comprised of speech training, dental hygiene care, bone graft and orthodontic treatment. Four issues were addressed including: problems in taking care of breast feeding; instructions’ needs for care at birth; difficulty in access information and society impact; and needs in having a network of volunteers. Conclusions: Empowering volunteer is important for holistic care of patients with CLP which provides easy access and multiple channels for patients and their families. It should be developed as part of the self-help and family support group, the development of community based team and comprehensive CLP care program.

Keywords: self-help and family support group, community based model, volunteer, cleft lip-cleft palate

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Authors: Barry Hojjatie

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Uniaxial (e.g., three-point bending) and biaxial flexure tests are used frequently for determining the strength of ceramics. It is generally believed that the biaxial test has an advantage as compared to uniaxial test because it produces a state of pure tension on the lower surface of the specimen and the maximum tensile stress, which is usually responsible for crack initiation and failure is unaffected by the edge condition. However, inconsistent strength values have been reported for the same material and testing conditions. The objective of this study was to analyze the strength of dental porcelain materials using the two different test methods and evaluate the main contributions to variability in biaxial testing and to analyze the relative influence of variables such as specimen geometric conditions and loading conditions on calculated strength of porcelain subjected to biaxial testing. Porcelain disks (16 mm dia x 2 mm thick) were subjected to biaxial flexure (pin-on-three-ball), and flexure strength values were calculated. A 3-D finite element model was developed to simulate various biaxial flexure test conditions. Stresses were analyzed for ceramic thickness in the range of 1.0-3.0 mm. For a 2-mm-thick disk subjected to a point load of 200 N, the maximum tensile stress at the lower surface was 180 MPa. This stress decreased to 95, 77, 68, and 59 MPa for the radius of the load values of 0.15, 0.3, 0.6, and 1.0 mm, respectively. Tensile stresses which developed at the top surface near the site of loading were small for the radius of the load ≥ 0.6 mm.

Keywords: ceramis, biaxial, flexure test, uniaxial

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Authors: Tosin Samson Olagunju

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This study is a contrastive study of affixation in Ipe and Yoruba Languages with the aim of looking at the implications for English pedagogy. This study, with the use of Hocket's Theory of Item and Arrangement and Word and Paradigm (as expatiated by Crystal), examines the aspect of affixation in Ipe and Yoruba Languages with the help of contrastive analysis which provides a basis for contrasting the morphological patterns of two different indigenous languages. It examines four affixes: prefix, infix, interfix, and suffix with numerous examples in the languages under investigation. The study is corpus based as it depends primarily on the words available in the lexicon of the languages under examination. Data were elicited from both monolingual and bilingual native-speakers of Ipe Language and Yoruba Language in Ipe-Akoko and Oyo respectively. Ibadan 400-wordlist was utilised as a tool for collecting data from informants who are between age fifty and seventy through audio recording as it is believed that they are the custodians of culture and tradition. Consequently, the study reveals that Ipe and Yoruba morphology have affixation such as prefix, interfix, and suffix. It also finds out that 'infix' is an unproductive aspect in English, Ipe, and Yoruba; although a few examples are in English. Interfix is very productive in Ipe and Yoruba but not in English at all. Phonologically, it is discovered that Ipe language has the two dental fricative consonants just like the English language, i.e., /Ɵ/ and /ð/. This is rare among the indigenous languages in Nigeria. This research believes that in the teaching of English consonants to the people of Ipe-Akoko, such areas will be taught with ease. The study concludes that morphological processes of Nigerian indigenous languages are studied the more so that they will not face endangerment which can lead to extinction.

Keywords: affixation, contrastive study, Ipe, morphology, pedagogy, Yoruba

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Authors: Javier Alfonso Bonilla-Chávez, Angélica Lozano

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In North America, more than 2,000 people annually die in accidents related to railroad tracks. In 2020, collisions at grade crossings were the main cause of deaths related to railway accidents in Mexico. Railway networks have constant interaction with motor transport users, cyclists, and pedestrians, mainly in grade crossings, where is the greatest vulnerability and risk of accidents. Usually, accidents at grade crossings are directly related to risky behavior and non-compliance with regulations by motorists, cyclists, and pedestrians, especially in developing countries. Around the world, countries classify these crossings in different ways. In Mexico, according to their dangerousness (high, medium, or low), types A, B and C have been established, recommending for each one different type of auditive and visual signaling and gates, as well as horizontal and vertical signaling. This classification is based in a weighting, but regrettably, it is not explained how the weight values were obtained. A review of the variables and the current approach for the grade crossing classification is required, since it is inadequate for some crossings. In contrast, North America (USA and Canada) and European countries consider a broader classification so that attention to each crossing is addressed more precisely and equipment costs are adjusted. Lack of a proper classification, could lead to cost overruns in the equipment and a deficient operation. To exemplify the lack of a good classification, six crossings are studied, three located in the rural area of Mexico and three in Mexico City. These cases show the need of: improving the current regulations, improving the existing infrastructure, and implementing technological systems, including informative signals with nomenclature of the involved crossing and direct telephone line for reporting emergencies. This implementation is unaffordable for most municipal governments. Also, an inventory of the most dangerous grade crossings in urban and rural areas must be obtained. Then, an approach for improving the classification of grade crossings is suggested. This approach must be based on criteria design, characteristics of adjacent roads or intersections which can influence traffic flow through the crossing, accidents related to motorized and non-motorized vehicles, land use and land management, type of area, and services and economic activities in the zone where the grade crossings is located. An expanded classification of grade crossing in Mexico could reduce accidents and improve the efficiency of the railroad.

Keywords: accidents, grade crossing, railroad, traffic safety

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Authors: Murniwati, Nurul Khairiyah, Putri Ovieza Maizar

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The association between general and oral health is clearly important, particularly in adults with medical conditions. Many of the medical systemic conditions are either caused or aggravated by poor oral hygiene and vice versa. Hypertension is one of common medical systemic problem which has been a public health concern worldwide due to its known consequences. Those consequences must be related to oral health status as well, whether it may cause or worsen the oral health conditions. The objective of this study was to find out the association between hypertension and oral health status in adults. This study was an analytical observational study by using cross-sectional method. A total of 42 adults both male and female in Padusunan Village, Pariaman, West Sumatra, Indonesia were selected as subjects by using purposive sampling. Manual sphygmomanometer was used to measure blood pressure and dental examination was performed to calculate the decayed, missing, and filled teeth (DMFT) scores in order to represent oral health status. The data obtained was analyzed statistically using One Way ANOVA to determine the association between hypertensive adults and their oral health status. The result showed that majority age of the subjects was ranging from 51-70 years (40.5%). Based on blood pressure examination, 57.1% of subjects were classified to prehypertension. Overall, the mean of DMFT score calculated in normal, prehypertension and hypertension group was not considered statistically significant. There was no significant association (p>0.05) between hypertension and oral health status in adults.

Keywords: blood pressure, hypertension, DMFT, oral health status

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Authors: Anurag Tripathi, Sanad Khandelwal

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Age and gender determination are required in forensic for victim identification. There is secondary dentine deposition throughout life, resulting in decreased pulp volume and size. Evaluation of pulp volume using Cone Beam Computed Tomography (CBCT)is a noninvasive method to evaluate the age and gender of an individual. The study was done to evaluate the efficacy of pulp volume method in the determination of age and gender.Aims/Objectives: The study was conducted to estimate age and determine sex by measuring tooth pulp volume with the help of CBCT. An observational study of one year duration on CBCT data of individuals was conducted in Lucknow. Maxillary central incisors (CI) and maxillary canine (C) of the randomly selected samples were assessed for measurement of pulp volume using a software. Statistical analysis: Chi Square Test, Arithmetic Mean, Standard deviation, Pearson’s Correlation, Linear & Logistic regression analysis. Results: The CBCT data of Ninety individuals with age range between 18-70 years was evaluated for pulp volume of central incisor and canine (CI & C). The Pearson correlation coefficient between the tooth pulp volume (CI & C) and chronological age suggested that pulp volume decreased with age. The validation of the equations for sex determination showed higher prediction accuracy for CI (56.70%) and lower for C (53.30%).Conclusion: Pulp volume obtained from CBCT is a reliable indicator for age estimation and gender prediction.

Keywords: forensic, dental age, pulp volume, cone beam computed tomography

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Authors: Kinneret Segal

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Background: The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives has not been sufficiently explored. Aim: The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life, and organizational commitment among midwifery nurses in Israeli hospitals. Methods: 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. Results: The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother, and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms, and organizational commitment predicted satisfaction from compassion. Conclusions: Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: organizational commitment, traumatic experiences, personal resilience, quality of life

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Authors: Chan Park, Sang-Won Park, Kwi-Dug Yun, Hyun-Pil Lim

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Purpose: Plasma treatment under various conditions has been studied to increase the bonding strength and surface sterilization of dental ceramic materials. We assessed the evolution of the shear bond strength (SBS) and antimicrobial effect of nonthermal atmospheric pressure plasma (NTAPP) treatment over time. Methods: Presintered zirconia specimens were manufactured as discs (diameter: 15 mm, height: 2 mm) after final sintering. The specimens then received a 30-min treatment with argon gas (Ar², 99.999%; 10 L/min) using an NTAPP device. Five post-treatment intervals were evaluated: control (no treatment), P0 (within 1 h), P1 (24 h), P2 (48 h), and P3 (72 h). This study investigated the surface characteristics, SBS of two different resin cement (RelyXTM U200 self-adhesive resin cement, Panavia F2.0 methacryloyloxydecyl dihydrogen phosphate (MDP)-based resin cement), and Streptococcus mutans biofilm formation. Results: The SBS of RelyXTM U200 increased significantly (p < 0.05) within 2 days following plasma treatment (P0, P1, P2). For Panavia F 2.0, a significant decrease (p < 0.05) was detected only in the group that had undergone cementation immediately after plasma treatment (P0). S. mutans adhesion decreased significantly (p < 0.05) within 2 days of plasma treatment (P0, P1, P2) compared to the control group. The P0 group displayed a lower biofilm thickness than the P1 and P2 groups (p < 0.05). Conclusions: After NTAPP treatment of zirconia, the effects on bonding strength and antimicrobial growth persist for a limited duration. The effect of NTAPP treatment on bonding strength depends on the resin cement.

Keywords: NTAPP, SBS, antimicrobial effect, zirconia

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Authors: Rana Praween Kumar

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Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in developing countries and has been linked to poor periodontal health during pregnancy. Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory oral diseases. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. This study is intended to investigate predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems during pregnancy with age and socio economic status of the individual. A community –based prospective cohort study will be conducted in Jamshedpur, Jharkhand, India among pregnant women using completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices with adequate sample size and informed consent to the patient following proper inclusion and exclusion criteria. Multiple logistic regression analyses will be used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) will be used to investigate the relationship between periodontal problems with the age and socioeconomic status. The result will help in proper monitoring of periodontal health during pregnancy encouraging the delivery of healthy child and the maintenance of proper health of the mother.

Keywords: infant, periodontal problems, pregnancy, pre-term-low birth weight delivery

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Authors: Fateme Aysin Anka, Farzad Kiani

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Forced migration is a situation in which people are forced to leave their homes against their will due to political conflicts, wars and conflicts, natural disasters, climate change, economic crises, or other emergencies. This type of migration takes place under conditions where people cannot lead a sustainable life due to reasons such as security, shelter and meeting their basic needs. This type of migration may occur in connection with different factors that affect people's living conditions. In addition to these general and widespread reasons, water security and resources will be one that is starting now and will be encountered more and more in the future. Forced migration may occur due to insufficient or depleted water resources in the areas where people live. In this case, people's living conditions become unsustainable, and they may have to go elsewhere, as they cannot obtain their basic needs, such as drinking water, water used for agriculture and industry. To cope with these situations, it is important to minimize the causes, as international organizations and societies must provide assistance (for example, humanitarian aid, shelter, medical support and education) and protection to address (or mitigate) this problem. From the international perspective, plans such as the Green New Deal (GND) and the European Green Deal (EGD) draw attention to the need for people to live equally in a cleaner and greener world. Especially recently, with the advancement of technology, science and methods have become more efficient. In this regard, in this article, a multidisciplinary case model is presented by reinforcing the water problem with an engineering approach within the framework of the social dimension. It is worth emphasizing that this problem is largely linked to climate change and the lack of a sustainable water management perspective. As a matter of fact, the United Nations Development Agency (UNDA) draws attention to this problem in its universally accepted sustainable development goals. Therefore, an artificial intelligence-based approach has been applied to solve this problem by focusing on the water management problem. The most general but also important aspect in the management of water resources is its correct consumption. In this context, the artificial intelligence-based system undertakes tasks such as water demand forecasting and distribution management, emergency and crisis management, water pollution detection and prevention, and maintenance and repair control and forecasting.

Keywords: water resource management, forced migration, multidisciplinary studies, artificial intelligence

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Authors: A. Chari, A. El Bouari, B. Orayech, A. Faik, J. M. Igartua

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The phosphate is a natural resource of great importance in Morocco. In order to exploit this wealth, synthesis and studies of new a material based phosphate, were carried out. The apatite structure present o lot of characteristics, One of the main characteristics is to allow large and various substitutions for both cations and anions. Beside their biological importance in hard tissue (bone and teeth), apatites have been extensively studied for their potential use as fluorescent lamp phosphors or laser host materials.The apatite have interesting possible application fields such as in medicine as materials of bone filling, coating of dental implants, agro chemicals as artificial fertilizers. The LiPb2Ca2(PO4)3 was synthesized by the solid-state method, its crystal structure was investigated by Rietveld analysis using XRPD data. This material crystallizes with a structure of lacunar apatite anion deficit. The LiPb2Ca2(PO4)3 is hexagonal apatite at room temperature, adopting the space group P63/m (ITA No. 176), Rietveld refinements showed that the site 4f is shared by three cations Ca, Pb and Li. While the 6h is occupied by the Pb and Li cations. The structure can be described as built up from the PO4 tetrahedra and the sixfold coordination cavities, which delimit hexagonal tunnels along the c-axis direction. These tunnels are linked by the cations occupying the 4 f sites. Raman and Infrared spectroscopy analyses were carried out. The observed frequencies were assigned and discussed on the basis of unit-cell group analysis and by comparison to other apatite-type materials.

Keywords: apatite, Lacunar, crystal structure, Rietveldmethod, LiPb2Ca2(PO4)3, Phase transition

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Authors: Alexandra Shipley

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Background: Undergraduate paediatric teaching must overcome two major challenges: 1) balancing patient safety with active student engagement and 2) exposing students to a comprehensive range of pathologies within a relatively short clinical placement. Whilst lectures and shadowing on paediatric wards constitute the mainstay of learning, Simulation and Virtual Reality (VR) are emerging as effective teaching tools, which - immune to the unpredictability and seasonal variation of hospital presentations - could expose students to the entire syllabus more reliably, efficiently, and independently. We aim to evaluate the potential utility of Simulation and VR in addressing gaps within the traditional paediatric curriculum from the perspective of medical students. Summary of Work: Exposure to and perceived utility of various learning opportunities within the Paediatric and Emergency Medicine courses were assessed through a questionnaire completed by 5th year medical students (n=23). Summary of Results: Students reported limited exposure to several common acute paediatric presentations, such as bronchiolitis (41%), croup (32%) or pneumonia (14%), and to clinical emergencies, including cardiac/respiratory arrests or trauma calls (27%). Across all conditions, average self-reported confidence in assessment and management to the level expected of an FY1 is greater amongst those who observed at least one case (e.g. 7.6/10 compared with 3.6/10 for croup). Students rated exposure through Simulation or VR to be of similar utility to witnessing a clinical scenario on the ward. In free text responses, students unanimously favoured being ‘challenged’ through ‘hands-on’ patient interaction over passive shadowing, where it is ‘easy to zone out.’ In recognition of the fact that such independence is only appropriate in certain clinical situations, many students reported wanting more Simulation and VR teaching. Importantly, students raised the necessity of ‘proper debriefs’ after these sessions to maximise educational value. Discussion and Conclusion: Our questionnaire elicited several student-perceived challenges in paediatric education, including incomplete exposure to common pathologies and limited opportunities for active involvement in patient care. Indeed, these experiences seem to be important predictors of confidence. Quantitative and qualitative feedback suggests that VR and Simulation satisfy students’ self-reported appetite for independent engagement with authentic clinical scenarios. Take-aways: Our findings endorse further development of VR and Simulation as high-yield adjuncts to paediatric education.

Keywords: paediatric emergency education, simulation, virtual reality, medical education

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