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Context: Nanoparticles, owing to their smaller size, penetrate regions inaccessible to other delivery systems, such as periodontal pockets. Thus, the present study aimed to comparatively evaluate efficacy of 2% curcumin with nanocarrier and 1% chlorhexidine gel as a local drug delivery (LDD) in the treatment of periodontal pockets. Materials and Methods: Forty-five chronic periodontitis patients with pocket depth 5-7 mm in two or more teeth were selected. Full-mouth scaling and root planing (SRP) was done for all patients followed by random allocation to the three treatment groups, namely SRP group (Group 1), 2% curcumin with nanogel (Group 2), and 1% chlorhexidine gel (Group 3). Clinical parameter assessment and microbiological analysis of subgingival plaque samples for Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf) was done at baseline, 21st day, and 45th day. Results: The results showed that when the two LDD agents were used as an adjunct to SRP in chronic periodontitis, there was an improvement in all clinical parameters. Evaluation of microbiological parameters also showed a significant reduction in Aa, Pg, and Tf levels. Comparison of 2% turmeric extract with a nanocarrier system with 1% chlorhexidine gel showed that both the agents had a comparable antibacterial effect on the three selected periodontopathic bacteria. Conclusion: The present study showed that both the LDD agents showed an effective improvement of clinical and microbiologic parameters. 2% curcumin delivered with a nanocarrier system showed results comparable to chlorhexidine gel and hence shows promising future as an LDD agent in the treatment of periodontal pockets.

Epidermal inclusion cysts are lesions that are benign and commonly occur on the regions of the scalp, face, neck, and scrotum. It is usually a painless condition but may become painful if it gets infected. A rupture of the cyst wall can lead to an intensely painful inflammatory reaction, and it is a common presentation to a surgeon. In this case, the patient reported multiple painless swellings on the scrotum, which were excised under spinal anesthesia. It was initially thought to be trichilemmal cysts, but on histopathological examination (HPE), it was diagnosed as epidermal inclusion cysts.

ObjectivesTo integrate morphological, haemodynamic and mechanical analysis of carotid atheroma driving plaque disruption.Materials and methodsFirst, we analysed the phenotypes of carotid endarterectomy specimens in a photographic dataset A, and matched them with the likelihood of preoperative stroke. Second, laser angioscopy was used to further define the phenotypes in intact specimens (dataset B) and benchmark with histology. Third, representative vascular geometries for each structural phenotype were analysed with Computational Fluid Dynamics (CFD), and the mechanical strength of the complicated atheroma to resist penetrating forces was quantified (n=14).ResultsIn dataset A (n=345), ulceration (fibrous cap disruption) was observed in 82% of all plaques, intraplaque haemorrhage in 68% (93% subjacent to an ulcer) and false luminal formation in 48%. At least one of these ‘rupture’ phenotypes was found in 97% of symptomatic patients (n=69) compared with 61% in asymptomatic patients. In dataset B (n=30), laser angioscopy redemonstrated the structural phenotypes with near-perfect agreement with histology. In CFD, haemodynamic stress showed a large pulse magnitude, highest upstream to the point of maximal stenosis and on ulceration the inflow stream excavates the necrotic core cranially and then recirculates into the true lumen. Based on mechanical testing (n=14), the necrotic core is mechanically weak and penetrated by the blood on fibrous cap disruption.ConclusionsFibrous cap ulceration, plaque haemorrhage and excavation are sequential phenotypes of plaque disruption resulting from the chiselling effect of haemodynamic forces over unmatched mechanical tissue strength. This chain of events may result in thromboembolic events independently of the degree of stenosis.

INTRODUCTION Despite high recanalization rates in large vessel occlusion (LVO) strokes, about 40% of patients still experience poor neurological outcomes and many can’t be recanalized at the first attempt. Failure mechanisms are poorly understood, as phantoms cannot appropriately reproduce the complexity of the cerebrovascular system and physicians have no direct visualization of the interaction between the arteries, emboli, and endovascular devices. Here, we reveal failure mechanism discovered in the first human brain test bed of LVO. METHODS Three types of representative embolus analogs (EAs) were fabricated (elastic, fragment-prone and stiff) using a multilinear regression model derived from histological and mechanical analysis of 16 emboli retrieved during LVO thrombectomy. Twenty-four human brains were harvested and the arterial systems physiologically pressurized by a pulsatile pump. Then, 105 LVO were generated and recanalization attempted in 61 cases using ADAPT technique (ACE™ 68; Penumbra) and in 44 cases using CAPTIVE technique (Solitaire™ Platinum, Medtronic and ACE™ 68, Penumbra). A total of 184 passes were recorded by trans-mural visualization and recanalization scored per an adjusted Thrombolysis in Cerebral Infarction (aTICI) scale. Success rates, failure modes and arterial responses to mechanical load were described and quantified. RESULTS First pass successful (45%), successful (71%) and complete (60%) recanalization rates in this model were consistent with the literature. Current technologies load emboli with tensile forces, and the emboli elongate and undergo intravascular fragmentation leading to downstream embolization to the microcirculation and/or recurrent (15%) and residual (73%) LVO, or both (12%), requiring more passes. We also demonstrate that: a) residual emboli remain in branching and perforating arteries in 28% of cases of complete recanalization; b) vacuum can cause arterial collapse at physiological pressures (43% in our model); c) arterial traction during withdrawal of devices occurs 41%; and d) in severe cases of arterial traction or distal thrombectomy, arterial deformation and displacement provoke avulsion of perforating arteries and cortical arteries. CONCLUSION Current thrombectomy devices load emboli with tensile forces leading to fragmentation, embolization and residual occlusion and casue significant arterial deformation.

INTRODUCTION Mechanical thrombectomy has become the standard of care for ischemic stroke with large vessel occlusion (LVO) since 2015. However, 20–30% of cases do not lead to full recanalization thus preventing opportunity for clinical improvement as well as necessitating technological improvements. To facilitate the development and testing of thrombectomy devices, realistic embolus analogs (EAs) are critical as access to patient emboli is limited. To date, techniques for fabricating standardized human blood-derived EAs are limited in the variety of compositions, and the mechanical properties relevant to thrombectomy are not quantified. METHODS EAs were made by mixing human banked red blood cells (RBCs), plasma, and platelet-rich plasma in 10 different volumetric percentage combinations to mimic a cohort of emboli retrieved from patients with LVO stroke. The composition and mechanical properties were evaluated by histology and tensile test, respectively. The tensile test pulled the EAs to fracture to mimic the catheter/stent pull during thrombectomy procedures. At fracture, EAs has maximum elongation ϵut and maximum stress σut (load per unit cross-sectional area). For each of the EA type, 5 samples were fabricated and analyzed. RESULTS From the histology, EAs in this study have 0–96% RBCs, 0.78%-92% fibrin, and 2.1%-22% platelets, and the ranges are similar to those found in the literature. From the tensile test, EAs have maximum elongation of 81% to 136%, and maximum stress of 16 to 949 kPa. In comparison, patient emboli have maximum elongation of 105% to 489%, and maximum stress of 63 to 2396 kPa. EAs with lower RBC and higher fibrin content can withstand higher elongation and stress. CONCLUSION This study is the first to make human EAs with a range of histologic compositions and tensile strength thus providing a platform for the evaluation of newer thromebctomy devices.

Multi Degree-of-Freedom (DOF) robots have taken significant roles in the robotization of various industries. They provide significantly more accuracy in performing regular tasks compared to manual work. The robot arms comprise a microcontroller, shoulder, elbow, wrist, and a gripper. Smooth movement in the joints is required for the robot to work with precise and safe operation. An articulated robot was considered for pick and place operations performed in the CoppeliaSim simulator to study the movements. This study provided forward and inverse kinematics calculations, and then simulations were performed to analyze the movements in joints according to time.The transformation matrices were calculated using the Denavit-Hartenberg convention, and the parameters of Denavit-Hartenberg were assigned according to the robot's kinematic model. Forward kinematics was derived, which was the final transformation matrix, and Inverse kinematics was derived for a given position and orientation of the robot. The third-order cubic polynomial with intermediate points method was used for trajectory. The simulations were performed in CoppeliaSim software with Lua Programming Language, and simulation data was saved as a .csv file for the position, velocity, and accelerations plot analysis.

Acute laryngeal injury (ALgI) is created as a result of endotracheal tube pressure ulcer formation leading to fibrosis and inflammation. This condition often leads to airway obstruction and voice and swallowing dysfunction. This study demonstrates a reliable animal model of ALgI to reproduce the acute wound process seen clinically, to explore the pathophysiology of this disease process, and to serve as a reproducible injury suitable for the evaluation of therapeutic interventions. An ALgI model was developed in New Zealand White rabbits using precise mucosal stripping of the posterior larynx, followed by intubation with an oversized 4.0 endotracheal tube for 1 h to mimic intubation-associated trauma and pressure ischemia. Laryngoscopy and laryngeal harvest were performed 2 weeks post-injury for histologic and immunofluorescent evaluation. Injured rabbits demonstrated an eightfold increase in posterior glottic thickness (1.57 vs. 0.19 mm in controls;  = 0.0004) and an 11-fold increase in collagen content (1.93 vs. 0.17 mm ;  = 0.005). Collagen subtype analysis revealed a shift toward active collagen within the injured larynx compared to the uninjured, with increased Type III Collagen (69.0% vs. 26.1%;  < 0.0001) and reduced Type I Collagen (27.2% vs. 73.9%;  < 0.0001) in the posterior glottis, consistent with the proliferative phase of wound healing. Collagen fiber alignment analysis demonstrated increased coherency in injured tissues (0.36 vs. 0.21;  = 0.023), indicating early organized collagen formation consistent with scar formation within the posterior glottis. The model offers a robust platform for studying the acute pathogenesis of laryngeal injury and for testing the treatment options in the management of ALgI. 3.

Alkali-Silica Reaction is an unwanted reaction which occurs over time between cement paste and silica. This in turn alters the expansion of the aggregate and often in an unpredictable way, which will result in loss of strength of concrete and complete failure. This research studies the effects of using locally available coarse and fine aggregates available in Arkansas. This research will provide the necessary information in selecting the type of aggregate that is to be used in constructions and a viable comparison between different aggregates available in Arkansas have been made. Different materials used for preparation of concrete samples have been mentioned. A major criterion in this research is the increase in the length of the concrete samples being tested with time. The time span selected for this research is about two years for the results to be used in real conditions. After testing different samples, crushed limestone with Arkansas River Sand has shown minimum expansion over chosen period, the expansion percentage from this material was 0.01% after a period of two years. Key Words: Alkali-Silica-Reaction(ASR), Expansion due to Alkali-Silica-Reaction, Aggregates, Supplementary Cement Materials.