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This study aims to review the long-term subjective and objective efficacy of mandibular advancement devices (MAD) in the treatment of adult obstructive sleep apnea (OSA). Electronic databases such as PubMed, Embase, and Cochrane Library were searched. Randomized controlled trials (RCTs) and non-randomized self-controlled trials with a treatment duration of at least 1 year with MAD were included. The quality assessment and data extraction of the included studies were conducted in the meta-analysis. A total of 22 studies were included in this study, of which 20 (546 patients) were included in the meta-analysis. All the studies had some shortcomings, such as small sample sizes, unbalanced sex, and high dropout rates. The results suggested that long-term treatment of MAD can significantly reduce the Epworth sleepiness scale (ESS) by -3.99 (95%CI -5.93 to -2.04, p <0.0001, I 2 = 84%), and the apnea-hypopnea index (AHI) -16.77 (95%CI -20.80 to -12.74) events/h ( p <0.00001, I 2 = 97%). The efficacy remained statistically different in the severity (AHI<30 or >30 events/h) and treatment duration (duration <5y or >5y) subgroups. Long-term use of MAD could also significantly decrease blood pressure and improve the score of functional outcomes of sleep questionnaire (FOSQ). Moderate evidence suggested that the subjective and objective effect of MAD on adult OSA has long-term stability. Limited evidence suggests long-term use of MAD might improve comorbidities and healthcare. In clinical practice, regular follow-up is recommended.

Background When analyzing the relationship between adenotonsillar hypertrophy and craniofacial morphology, researchers generally regarded hypertrophied adenoids and tonsils as a whole. It remains unclear whether different enlarged sites of pharyngeal lymphoid tissue would correlate with multiple craniofacial subtypes. We hypothesized there would be craniofacial subtypes correlated with different locations of hypertrophied adenoid and tonsil. Methods Lateral cephalometric radiographs were obtained from 466 children (171 boys and 295 girls, aged 12.27 ± 2.69 years). They were divided into four groups according to different sites of enlarged pharyngeal lymphoid tissue: adenoid hypertrophy group (AG, n = 126), tonsillar hypertrophy group (TG, n = 59), adenotonsillar hypertrophy group (ATG, n = 69) and control group (CG, n = 212). Five commonly used angles for cephalometric measurements were investigated: SNA (Sella-Nasion-Point A), SNB (Sella-Nasion-Point B), ANB (Point A-Nasion-Point B), mandibular plane angle (MP/SN) and Y-axis angle (SGn/FH). Results Children with isolated tonsillar hypertrophy correlated with increased SNA (unstandardized regression coefficient B = 1.38, p  = 0.009) and SNB (B = 1.99, p  = 0.001) compared with controls. However, children with isolated adenoid hypertrophy correlated with decreased SNB (B=-0.94, p  = 0.036), increased ANB (B = 0.74, p  = 0.014) and increased MP/SN (B = 2.22, p  < 0.001). Similarly, children with adenotonsillar hypertrophy correlated with decreased SNB (B=-1.36, p  = 0.015), increased ANB (B = 1.35, p  < 0.001) and increased MP/SN (B = 2.64, p  = 0.001). Conclusions Isolated adenoid hypertrophy correlated with a retrognathic mandible, an increased maxillo-mandibular sagittal discrepancy, and an increased mandibular plane angle. Isolated tonsillar hypertrophy correlated with maxillary and mandibular protrusion. Adenotonsillar hypertrophy did not show a superimposed craniofacial pattern of the above two but showed the same craniofacial pattern as isolated adenoid hypertrophy.

Objectives This study aimed to summarize the clinical features of non-syndromic late developing supernumerary teeth (LDST) and comparisons with common supernumerary teeth (ST) and explore the association between LDST and the third dentition. Materials and methods This study retrospected cone-beam computed tomography (CBCT) and medical history of 41,903 consecutive patients from January to December 2021. Comparisons between ST and LDST were evaluated by Chi-square test or Fisher exact test. Correlation between chronological age and dental stage age was evaluated by Spearman’s rank correlation coefficient. Binary logistic regression analysis was used to explore the features of LDST originating from the third dentition. Results Sixty patients with 126 non-syndromic LDST and 1602 patients with 1988 non-syndromic ST were identified. The prevalence of ST and LDST was 3.82% and 0.14%, respectively, with a male-female ratio of 1.78:1 and 1.31:1. LDST patients mainly had LDST in multiple (58.33%) and bilaterally (41.67%), with an average of 2.1/patient. Most LDST were normal-shaped (84.13%), vertically oriented (71.43%), located in the mandible (80.16%), and distributed in the premolar region (82.54%). The study also indicated that the development of LDST was correlated with permanent teeth, with LDST developing 6.48 to 10.45 years later. In this study, 72.22% of LDST met the clinical criteria for the third dentition. Conclusions LDST manifested different clinical features from common ST. LDST might be closely related to the third dentition. Clinical relevance This work would help to comprehend LDST from a clinical perspective, and may be complementary to the criteria of the third dentition.

Background The pleiotropic drug resistance ( PDR ) proteins, which are full-sized ABCG transporters belonging to the ATP-binding cassette (ABC) family, play an indispensable role in regulating various physiological and developmental processes of plants. However, the PDR transporters and their functional roles in Artemisia argyi , a significant traditional medicinal plant in Asia, remain poorly understood. Results In this study, a total of 68 PDR genes, distributed across 17 chromosomes, were identified in the genome of Artemisia argyi and classified into five distinct subgroups based on phylogenetic analysis and domain types. The evolutionary characteristics investigation of the AarPDR gene family demonstrated that the 9 AarPDR genes had a high conservation between the genomes of Artemisia argyi and Arabidopsis during the evolution of dicots. Cis-element analysis revealed that AarPDRs might respond to diverse environmental stresses and multiple plant hormones. Furthermore, the expression analysis in different tissues and developmental stages of leaves indicated that various AarPDRs displayed distinct expression profiles within or among subfamilies, and the AarPDRs expression could be easily induced by the light conditions. Besides, the AarPDR family proteins had a potential function in metabolite transportation. Conclusions The AarPDRs were characterized by integrating genome analysis, transcriptome, and metabolite profiling. The results can provide useful clues for future studies aimed at the functional characterization of AarPDR genes.

This study aimed to analyze the periodontal conditions of patients with obstructive sleep apnea (OSA) in relation to the salivary microbiome. In total, 54 male adults (27 with OSA, 27 controls) completed this cross-sectional study. All participants were monitored by overnight polysomnography (PSG) and underwent full-mouth periodontal examination. Saliva samples were then collected, and the microbial 16S ribosomal RNA gene was sequenced. The data were analyzed to determine the microbial distribution and the community structure of the two groups. Demonstrated by alpha and beta diversity, the OSA group had a lower microbial richness and a lower observed species than the controls. There was no significant difference in the microbial species diversity or evenness between the OSA and the non-OSA groups. The OSA group had fewer operational taxonomic units (OTUs), and the distribution of microbiome showed that several gram-positive bacteria had higher abundance in the OSA group. As for periodontal pathogens, the relative abundance of was significantly increased in the OSA group. No significant difference was observed in the relative abundance of other pathogens at either the genus or species level. The salivary microbial community structure was altered in patients with OSA in terms of species richness and trans-habitat diversity, along with an increase in , a specific periodontal pathogen. These findings might explain the high prevalence of periodontitis in OSA patients.

Microorganisms contribute to the pathogenesis of obesity, while more studies focus on gut microbiome. However, the relationship between oral microbiota and obesity has yet to be elucidated. This study was designed to investigate the similarities and differences in the effects of a high-fat diet on salivary and gut microbiota through mouse experiments, exploring the hypothesis that oral microbial mechanisms may contribute to obesity. An obese mouse model was established in male C57BL/6J mice by feeding a high-fat diet, confirmed by body weight records and blood glucose tests. This study evaluated the physiological effects of the high-fat diet on mice. 16S rRNA sequencing technology was used to analyze changes in salivary and gut microbiota, and gas chromatography-mass spectrometry was employed to evaluate 17 short-chain and medium-chain fatty acids quantitatively. The microbiota distribution in salivary was different between the high-fat diet (HFD) and normal chow diet (NCD) groups. At the genus level of salivary microbiota, and were highly abundant in the HFD group. and were more abundant in the NCD group. Regarding the gut microbiome, the diversity changes of gut microbiota are more significant than those of salivary microbiota. The HFD group had a significantly higher abundance of , , and a lower abundance of . Nine genera had consistent alterations in salivary and gut microbiota, among which , , and were significantly correlated with physiological indicators, and was significantly correlated with increased decanoic acid levels in the HFD group. The dysregulated nine genera were associated with significant upregulation of certain metabolic pathways of the HFD group, including the pentose phosphate, bacterial invasion of epithelial cells, and steroid biosynthesis pathways. There are differences and similarities in the effects of HFD on salivary and gut microbiota. Certain genera of the oral-gut axis altered consistently by HFD may affect obesity through mechanisms involving metabolic pathways and inflammation.

At present, ginkgo nut shellers have many problems, such as low shelling rate and high damage rate. To address these problems, a multifunctional ginkgo nut sheller was designed. The equipment had functions for shell breaking, shelling, and separation of shell from the kernel. The influencing factors of the shelling process were analyzed. A three-factor two-level response surface test was conducted, and mathematical models for the response surface were established. The influence of each factor on the operation quality was analyzed, and a combination of parameters was optimized. The experimental results showed that the factors in the order of importance of their influence on shelling rate was as follows: feeding rate, chainplate speed, and shelling gap. The factors in the order of importance of their influence on damage rate was as follows: shelling gap, chainplate speed, and feeding rate. The results of the interaction analysis conducted showed that the interaction between the chainplate speed and shelling gap had the highest significant effect on the shelling rate, followed by the interaction between the feeding rate and chainplate speed. The interaction between the chainplate speed and shelling gap had a significant effect on damage rate. The interaction between the other factors had no significant effect on shelling and damage rates. The optimal combination of parameters was as follows: the feeding rate was 30.2 g/s, the chainplate speed was 0.48 m/s, and the shelling gap was 12.3 mm. The optimal combination was employed, and the validation test resulted in a shelling rate of 98.02% and damage rate of 4.45%. The relative error between the measured and theoretical values was less than 5%, indicating that the models were reliable. This study can provide a reference for subsequent research on shelling equipment of ginkgo nut.

Whether the orthodontic treatment with premolar extraction and maximum anchorage in adults will lead to a narrowed upper airway remains under debated. The study aims to investigate the airway changes after orthodontic extraction treatment in adult patients with Class II and hyperdivergent skeletal malocclusion. This retrospective study enrolled 18 adults with Class II and hyperdivergent skeletal malocclusion (5 males and 13 females, 24.1 ± 3.8 years of age, BMI 20.33 ± 1.77 kg/m2). And 18 untreated controls were matched 1:1 with the treated patients for age, sex, BMI, and skeletal pattern. CBCT images before and after treatment were obtained. DOLPHIN 11.7 software was used to reconstruct and measure the airway size, hyoid position, and craniofacial structures. Changes in the airway and craniofacial parameters from pre to post treatment were assessed by Wilcoxon signed rank test. Mann-Whitney U test was used in comparisons of the airway parameters between the treated patients and the untreated controls. Significant level was set at 0.05. The upper and lower incisors retracted 7.87 mm and 6.10 mm based on the measurement of U1-VRL and L1-VRL (P < 0.01), while the positions of the upper and lower molars (U6-VRL, and L6-VRL) remained stable. Volume, height, and cross-sectional area of the airway were not significantly changed after treatment, while the sagittal dimensions of SPP-SPPW, U-MPW, PAS, and V-LPW were significantly decreased (P < 0.05), and the morphology of the cross sections passing through SPP-SPPW, U-MPW, PAS, and V-LPW became anteroposteriorly compressed (P <0.001). No significant differences in the airway volume, height, and cross-sectional area were found between the treated patients and untreated controls. The airway changes after orthodontic treatment with premolar extraction and maximum anchorage in adults are mainly morphological changes with anteroposterior dimension compressed in airway cross sections, rather than a decrease in size.

There is currently a lack of comprehensive literature analysis on the global burden and trends of pulmonary arterial hypertension (PAH) among women of childbearing age (WCBA). We fill this evidence gap by evaluating the burden and temporal trends of PAH in WCBA at global, regional, and national levels from 1990 to 2021. Data about PAH burden were extracted from the Global Burden of Disease Study (GBD) 2021. Moreover, PAH burden was explored across regions with different age, social development index (SDI) or health system. There was a significant global increase in incident and prevalent cases of PAH among WCBA. Disability-adjusted life years (DALYs) and deaths initially increased but began to decline after 2010. Age-standardized incident rate (ASIR) and age-standardized prevalent rate (ASPR) increased in all SDI regions except in low SDI. Low and low-middle SDI regions bore the heaviest burden. Basic and limited healthcare systems showing the most pronounced increases in cases, but with advanced healthcare systems demonstrating a sharp reduction in age-standardized rates (ASR) of DALYs and deaths. Geographically, the highest ASIR were observed in Sub-Saharan Africa regions. Meanwhile, Central Asia and Tropical Latin America had the highest ASR of DALYs and deaths. National-level analysis identified India and China with the highest case numbers, and Sweden with the highest ASPR. Mauritius, Mongolia and Tajikistan topped ASR of DALYs and deaths. This study provides a comprehensive, time-series portrait of PAH burden and inequalities among WCBA worldwide. Addressing socioeconomic factors and strengthening healthcare systems are essential measures, especially in high-burden regions.

To improve the performance of green manure sowing and processing equipment, it is necessary to investigate the physical properties of seeds, including their dimensions, bulk density, and frictional characteristics. Focusing on the main cultivated varieties of green manure in China—milk vetch, hairy vetch, and sesbania—this study proposes three low-cost, convenient, and high-precision experimental methods to measure the geometric size of small seeds. The measured results show that the milk vetch seeds were 2.60–3.40 mm in length, 1.90–2.40 mm in width, and 0.71–0.97 mm in height. The hairy vetch pods were 23.03–32.83 mm in length, 7.39–9.74 mm in width, and 4.06–6.15 mm in height, and the seeds were 3.04–4.10 mm in diameter. The sesbania seeds were 3.81–4.29 mm in length, 1.98–2.37 mm in width, and 1.85–2.08 mm in height. The thousand-seed weights of milk vetch, hairy vetch, and sesbania seeds were 3.40 g, 26.50 g, and 15.58 g, with moisture contents of 7.18%, 9.81%, and 8.73%, respectively. The bulk densities of milk vetch, hairy vetch, and sesbania seeds were 732 g/L, 761 g/L, and 845 g/L. The angles of repose of milk vetch, hairy vetch, and sesbania seeds were 31.66°, 28.15°, and 29.82°, measured using an angle-of-repose tester. Sliding friction angles of 25.85°, 23.55°, and 24.03° for milk vetch, hairy vetch, and sesbania seeds were obtained using a dividing head. These methods and results provide valuable references for the measurement of the physical properties of small-seeded crops (e.g., green manures) as well as other small or irregularly shaped particles.