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BACKGROUND AND OBJECTIVE: There is a risk of damage to the inferior alveolar nerve when extracting third molars. A variety of common imaging modalities, such as panoramic radiography (PR) and cone-beam computed tomography (CBCT), are recommended for examination prior to mandibular third molar surgery. The aim of this study was to compare the findings of panoramic radiography and CBCT in evaluating the relation between the root of the mandibular third molar and the inferior alveolar canal. METHODS: In this cross-sectional study, 75 panoramic and CBCT images were evaluated. Cases in panoramic radiography that were suspected of the relation between the root of the mandibular third molars and the inferior alveolar canal were collected. To determine the type of connection of apex and root canal, the samples were divided into 6 groups: normal, inferior alveolar canal path loss, canal path narrowing, sudden canal path change, radiolucent band over the roots, and root curvature. Cases in the panoramic radiograph that were suspected of root contact with the canal were examined by the CBCT in terms of the position of the canal relative to the tooth (buccal or lingual or middle of the root - upper or lower) and the type of connection (whether the tooth is connected to the canal). FINDINGS: In panoramic findings, 23 cases (30.7%) were normal, 19 cases (25.3%) showed canal path loss, 9 cases (12%) canal path narrowing, 5 cases (6.7%) sudden canal path change, 3 cases (4%) radiolucent band over the roots and 16 cases (21.3%) showed root curvature. According to CBCT findings, the position of the canal relative to the root apex was lingual in 39 cases (52%) and there was connection between the mandibular canal and the third molar in 39 cases (78.7%). There was no significant relationship between panoramic radiographic and CBCT findings and only in two cases of specific radiolucent band over the roots, there was a complete agreement between panoramic and CBCT findings. CONCLUSION: Based on the results of this study, if a radiolucent band is observed on the root of the mandibular molars or a sudden change is observed in the canal path, panoramic radiography can be used to detect the relation between the inferior alveolar canal and the root of the third molars. [ABSTRACT FROM AUTHOR]

The objective of this paper is to apply time series analysis and multiple regression method to ozone data in order to obtain the optimal statistical model for forecasting next day ozone level. The best estimated model is then used to produce one-step ahead point and interval estimates of future values of the ozone series. Ozone data is analyzed using time series analysis, which resulted in an Auto Regressive Moving Average, ARMA (20, 2) with Mean Absolute Percentage Error (MAPE)=42%. Applying multiple regression method and examination of several possible contributing factors, showed that Wind speed, Mixing height where the complex chemical reactions that produce ozone take place, current and predicted next day temperatures and current ozone concentration are influential on the next day ozone concentration levels. Diagnostics tests and statistics including R-square, residual analysis and Durbin-Watson Statistic (DW) were applied in order to select the best fitted model and finally the best prediction model was found using MAPE and Mean Absolute Deviation (MAD) as predictive criteria. Regression analysis of this data, using tomorrow's and today's maximum temperature, today's wind speed and tomorrow's maximum height at 10 am, as explanatory variables results in R-square of 50.7% with MAD=12.423, MAPE=30% and DW=1.66 [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to identify the impact of COVID-19-related "shelter in place" restrictions on stroke metrics in two metropolitan Texas cities, Austin and San Antonio., Materials and Methods: Data was derived from stroke quality metric registries and compared between two treatment periods: (1) during the state's COVID-19 "shelter in place" restriction period, and (2) the corresponding period during the previous year for Austin and San Antonio, Texas. Primary outcomes include the dichotomized process measures of time last known well (TLKW) to arrival, arrival to brain imaging initiation, and arrival to administration of thrombolytic therapy. Secondary outcomes are clinical endpoints: independent ambulation at discharge, discharge to home, and in-hospital mortality., Results: Austin patients were older and presented with less-severe strokes. San Antonio patients were more likely to be Hispanic, suffer from a large vessel occlusion, and have independent ambulation at discharge (adjusted odds ratio, 2.04; 95% confidence intervals, (1.25-3.37). Within-city analyses revealed a trend toward increased TLKW to arrival in Austin and San Antonio during COVID-19. During COVID, Austin patients had decreased length of stay (LOS) while a higher proportion of San Antonio patients had a favorable outcome (discharged home & independent ambulation)., Conclusions: Longer TLKW to hospital arrival during COVID did not impact arrival-to-imaging, arrival-to-treatment times nor patient outcomes, even in patients at higher risk for stroke. Future studies should continue to assess the impact of COVID-19 on stroke care and outcomes pre- and post-introduction of the COVID-19 vaccine, and as infectivity rates spike or recede., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: There is little information regarding the safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke and COVID-19., Methods: This multicenter study included consecutive stroke patients with and without COVID-19 treated with IV-tPA between February 18, 2019, to December 31, 2020, at 9 centers participating in the CASCADE initiative. Clinical outcomes included modified Rankin Scale (mRS) at hospital discharge, in-hospital mortality, the rate of hemorrhagic transformation. Using Bayesian multiple regression and after adjusting for variables with significant value in univariable analysis, we reported the posterior adjusted odds ratio (OR, with 95% Credible Intervals [CrI]) of the main outcomes., Results: A total of 545 stroke patients, including 101 patients with COVID-19 were evaluated. Patients with COVID-19 had a more severe stroke at admission. In the study cohort, 85 (15.9%) patients had a hemorrhagic transformation, and 72 (13.1%) died in the hospital. After adjustment for confounding variables, discharge mRS score ≥2 (OR: 0.73, 95% CrI: 0.16, 3.05), in-hospital mortality (OR: 2.06, 95% CrI: 0.76, 5.53), and hemorrhagic transformation (OR: 1.514, 95% CrI: 0.66, 3.31) were similar in COVID-19 and non COVID-19 patients. High-sensitivity C reactive protein level was a predictor of hemorrhagic transformation in all cases (OR:1.01, 95%CI: 1.0026, 1.018), including those with COVID-19 (OR:1.024, 95%CI:1.002, 1.054)., Conclusion: IV-tPA treatment in patients with acute ischemic stroke and COVID-19 was not associated with an increased risk of disability, mortality, and hemorrhagic transformation compared to those without COVID-19. IV-tPA should continue to be considered as the standard of care in patients with hyper acute stroke and COVID-19., Competing Interests: Declaration of Competing Interest Authors reports no disclosures., (Copyright © 2021. Published by Elsevier Inc.)

Background: Since the emergence of COVID-19 pandemic, several cases of cerebral venous sinus thrombosis (CVST) have been reported in SARS-CoV-2 infected individuals., Methods: Consecutive patients with documented SARS-CoV-2 infection, as well as clinical and radiological characteristics of CVST, were reported from three teaching hospitals in the South West, North West, and the center of Iran between June and July 2020. We also searched the abstract archives until the end of August 2020 and gathered 28 reported cases. The diagnostic criteria for SARS-CoV-2 infection were determined according to SARS-CoV-2 detection in oropharyngeal or nasopharyngeal samples in clinically suspected patients. Demographics, prominent COVID-19 symptoms, confirmatory tests for SARS-CoV-2 infection diagnosis, the interval between the diagnosis of SARS-CoV-2 infection and CVST, clinical and radiological features of CVST, therapeutic strategies, CVST outcomes, rate of hemorrhagic transformation, and mortality rate were investigated., Results: Six patients (31-62 years-old) with confirmed CVST and SARS-CoV-2 infection were admitted to our centers. Four patients had no respiratory symptoms of SARS-CoV-2 infection. Five patients developed the clinical manifestations of CVST and SARS-CoV-2 infection simultaneously. Three patients had known predisposing factors for CVST. Despite receiving CVST and SARS-CoV-2 infection treatments, four patients died. SARS-COV-2 associated CVST patients were older (49.26 vs. 37.77 years-old), had lower female/male ratio (1.42 vs. 2.19), and higher mortality rate (35.29% vs. 6.07%) than CVST not associated with COVID-19., Conclusions: The role of SARS-CoV-2 as a "cause" versus an "additive contributor" remains to be elucidated. Practitioners should be aware of the possibility of CVST in SARS-CoV-2 infection., (© 2021. Springer-Verlag GmbH, DE part of Springer Nature.)

Background: Hepatocellular malignant neoplasm, not otherwise specified (HEM, NOS), is a rare liver tumor that is most commonly seen in adolescents. To the best of our knowledge, there has been no published review on this rare tumor in the English literature so far., Summary: In this review, we will discuss all reported details, including demographic findings, clinical presentations, molecular histogenesis, imaging, gross pathology and histopathology, immunohistochemical findings, treatment modalities, and outcome, of the published cases of HEM, NOS, in the liver., Key Message: Twenty-two cases of HEM, NOS, have been reported in the last 10 years in the English literature. This tumor produces a large liver mass and is characteristically seen in adolescents presenting with right upper quadrant pain. Histologically, HEM, NOS, is a nonbiliary hepatocytic tumor with a biphasic pattern, that is, a mixture of 2 components of hepatocellular carcinoma and hepatoblastoma (HBL). There is no characteristic immunohistochemical feature for this tumor. Imaging findings are also not specific. Treatment of this tumor needs extensive surgery or even liver transplantation. Most of the cases in the literature were treated with the primary diagnosis of HBL, so pathologists, onco-surgeons, and oncologists should get familiar with this tumor to provide better treatment options. More case series with more follow-ups are necessary for the definite determination of the outcome of this tumor as a unique entity., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 by S. Karger AG, Basel.)

Background: The most common type of oral cancer is oral squamous cell carcinoma. If it is diagnosed in the early stages; the success of the treatment can be increased. It seems that ELISA-based techniques as a screening tool for society are the most cost-effective methods for early diagnosis. CD44 is a key marker for the detection of SCC stem cells. The aim of this study was to compare the level of soluble CD44 in saliva and serum between patients with oral SCC and healthy controls. Materials and Methods: Saliva and serum were collected from 20 patients with primary OSCC and 20 healthy persons as control group. The samples were evaluated by an ELISA test kit. Data were analyzed by SPSS software version 22, chi-square, ANOVA, T-test and Spearman correlation test. Results: The mean of soluble CD44 level in serum and saliva of the patient and control groups are 531.51±228.95 and 453.3±113.74 (for serum) and 48.53±59.02 and 17.76±39.14 (for saliva) respectively. There was no statistically significant difference in serum and saliva solCD44 level between the patient and control groups (P value = 0.182 and P value = 0.061 respectively). Also, there was no significant correlation between the solCD44 level in each patient and control group in serum (P value = 0.61) and in saliva (P value = 0.445). Conclusions: Determination of solCD44 level in saliva and serum can be a useful method for diagnosis the person’s involvement with cancer cells and the cancer in the early stages. But according to the controversial outcomes of past studies, larger and more accurate studies are needed in groups with more cases of oral cancer., (Creative Commons Attribution License)

Background and Objective: The degree of ossification of the midpalatal suture is an important factor in the selection of treatment procedure, especially in young individuals. Considering the discrepancies in the results of studies on the exact time of the closure of this suture, the present study was undertaken to evaluate ossification and morphology of the suture with the use of CBCT., Methods: In the present cross-sectional study, the CBCT images of the maxilla in 144 Iranian subjects (72 males, 72 females) with an age range of 10 to 70 years, referring to a private radiology center in Sari, Iran, were evaluated. The CBCT images were evaluated in the axial cross-sectional slice at 1 mm intervals to determine morphology and the maturation stage of the suture and its degree of ossification. The six developmental stages that were observed were as follows: stage A, a direct line without disturbances; stage B, a scalloped appearance in the suture; stage C, two parallel lines with a scalloped appearance that were connected at some points; stage CD, the anterior portion was similar to stage C, and the posterior region was similar to stage D; stage D, ossification only in the palatine bone; stage E, complete ossification of the suture. The degree of ossification of the suture was calculated with the use of the ratio of the length of the ossified segment to the entire length of the suture. Data were analyzed with Spearman's correlation test, Chi-squared test, t-test, ANOVA, Mann-Whitney U, and Kruskal-Wallis test. Intra-observer agreement was calculated with the use of weighted kappa coefficient. Data were analyzed with SPSS 17., Results: There was a strong correlation between the age groups and the developmental stages of the midpalatal suture in both genders (r=0.681, p<0.001). The ossification process occurred in the posterior to anterior direction in 98% of the cases. There was a significant relationship between aging and the degree of ossification (p<0.001); however, the difference was not significant between the two genders (p=0.193)., Conclusion: Although the rate of suture closure increased with aging, age was not a reliable factor alone to determine the developmental stage of the suture. Use of CBCT is necessary in all the patients to determine the degree of ossification and morphology of the midpalatal suture., Competing Interests: Conflict of Interest: There is no conflict of interest to be declared.

Zygomycosis is characterized by tissue invasion with broad, non-septate hyphae of species such as Rhizopus, Rhizomucor, Lichtheimia (Absidia) and Basidiobolus. Basidiobolus ranarum usually causes subcutaneous infection, and gastrointestinal manifestations in immunocompetent patients have rarely been reported. It is difficult to diagnose gastrointestinal basidiobolomycosis because of the non-specific clinical presentation and the absence of a definite risk factor. This study identified 14 cases of gastrointestinal basidiobolomycosis, all of which were diagnosed after surgery by characteristic histopathological findings. Diagnosis of this disease requires a high index of suspicion in patients presenting with abdominal symptoms, fever, gastrointestinal mass and eosinophilia accompanied by a high erythrocyte sedimentation rate.

Objective: The essential aim of this article is to develop effective methods for improving the flow properties of active pharmaceutical ingredients (APIs) without requiring particle size or shape modification., Methods: The 'formulation' approach used here focuses on enhancing flow properties of three chemically different drug powders (micronized acetaminophen, levalbuterol tartrate, and didesmethylsibutramine tartrate) by using small amounts of lubricants, glidants, and other additives, both individually and in combination. Additives are intimately mixed using a laboratory-scale V-blender with an intensifier bar. Flow index, dilation, and electrical impedance were measured for a total of 24 blends., Results: The flow behavior of all three APIs improved with the addition of these additives. Relative effectiveness of different additive combinations displayed remarkable consistency for all three APIs. Simultaneous presence of SiO2, MgSt, and talc led to substantial decreases in cohesiveness, causing major improvements in flowability of powder. All three properties showed a very tight correlation., Conclusions: Drug powders with improved flow were found to exhibit low dilation and low impedance values. A common linear correlation between flow index and impedance and also between dilation and impedance was observed for all three APIs, indicating that electric properties play a substantial role in the cohesivity of all three APIs, and suggesting the presence of a common mechanism for the emergence (and mitigation) of cohesive phenomena.

Desmoplastic ameloblastoma is an unusual type of ameloblastoma with special histologic and radiographic features and anatomic distribution which differs from those in the classic type of ameloblastoma. The purpose of this article is to assist the dental community in better understanding of this variation of odontogenic tumor. We present a patient with desmoplastic and conventional variant of ameloblastoma (hybrid lesion) localized in the anterior portion of the mandible. The tumor was expansile and painless. The radiographic finding showed an ill-defined mixed (radiopaque/radiolucent) lesion between roots of the lower left canine and the lateral incisor. Marginal resection was performed. Follow-up examination one year later revealed no recurrence of the tumor. Desmoplastic variant of ameloblastoma tends to infiltrate between bone trabeculae. Curettage leaves islands of the tumor within bone, which later manifest as recurrences. Therefore, for big lesions en bloc excision is the most widely used treatment to avoid recurrence.