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Objective: The purpose of our study is to develop a spoken dialogue system (SDS) for pain questionnaire in patients with spinal disease. We evaluate user satisfaction and validated the performance accuracy of the SDS in medical staff and patients.Methods: The SDS was developed to investigate pain and related psychological issues in patients with spinal diseases based on the pain questionnaire protocol. We recognized patients’ various answers, summarized important information, and documented them. User satisfaction and performance accuracy were evaluated in 30 potential users of SDS, including doctors, nurses, and patients and statistically analyzed.Results: The overall satisfaction score of 30 patients was 5.5 ± 1.4 out of 7 points. Satisfaction scores were 5.3 ± 0.8 for doctors, 6.0 ± 0.6 for nurses, and 5.3 ± 0.5 for patients. In terms of performance accuracy, the number of repetitions of the same question was 13, 16, and 33 (13.5%, 16.8%, and 34.7%) for doctors, nurses, and patients, respectively. The number of errors in the summarized comment by the SDS was 5, 0, and 11 (5.2%, 0.0%, and 11.6 %), respectively. The number of summarization omissions was 7, 5, and 7 (7.3%, 5.3%, and 7.4%), respectively.Conclusion: This is the first study in which voice-based conversational artificial intelligence (AI) was developed for a spinal pain questionnaire and validated by medical staff and patients. The conversational AI showed favorable results in terms of user satisfaction and performance accuracy. Conversational AI can be useful for the diagnosis and remote monitoring of various patients as well as for pain questionnaires in the future.

From the socio-critical perspective of mathematical modeling, reflexive discussions about the nature, criteria, and consequences of mathematical models are not a natural consequence of modeling in school. This report is part of a larger study focused on stimulating reflexive discussions in practice employing constructivist grounded theory as a research method. Twenty-seven college algebra students engaged in a 3-week modeling project at a community college in the USA. Audio-recorded group discussions and written reflections were collected to determine how reflexive discussions were taking place. Analysis of students’ actions and reflexive discussions during the modeling project produced four concepts: voicing mathematics, personalizing mathematics, challenging mathematics, and negotiating mathematics. These concepts are integrated into an overall process for stimulating reflexive discussions and are conceptualized as unboxing mathematics. The overarching concept of unboxing mathematics represents one interpretation of how reflexive discussions may be constituted during modeling activities and identifies classroom mathematical practices specific to the socio-critical modeling context of this study.

Periodontitis is an oral disease caused by a bacterial infection that has stages according to the severity of tissue destruction. The advanced stage of periodontitis presents irreversible destruction of soft and hard tissues, which finally results in the loss of teeth. When conventional treatment modalities show limited results, tissue regeneration therapy is required in patients with advanced periodontitis. In the present study, we aimed to evaluate the effect of bone marrow-derived mesenchymal stem cells (BM-MSCs) delivering bone morphogenetic protein 7 (BMP-7) on tissue regeneration in a periodontitis model. BMP-7 is a member of the BMP family that shows bone-forming ability; however, BMP's rapid clearing and degradation and unproven efficacy make it difficult to apply it in clinical dentistry. To overcome this, we established BMP-7-expressing engineered BM-MSCs (BMP7-eBMSCs) that showed superior osteogenic differentiation potential when subcutaneously transplanted with a biphasic calcium phosphate scaffold into immunocompromised mice. Furthermore, the efficacy of BMP7-eBMSC transplantation for periodontal tissue regeneration was evaluated in a rat ligature-induced periodontitis model. Upon measuring 2D and 3D amounts of regenerated alveolar bone using micro-computed tomography, the amounts were found to be significantly higher in the BMP7-eBMSC transplantation group than in the eBMSC transplantation group. Most importantly, fibrous periodontal ligament tissue regeneration was also achieved upon BMP7-eBMSC transplantation, which was evaluated by calculating the modified relative connective tissue attachment. The amount of connective tissue attachment in the BMP7-eBMSC transplantation group was significantly higher than that in the ligature-induced periodontitis group, although the increase was comparable between the BMP7-eBMSC and human periodontal ligament stem cell transplantation groups. Taken together, our results suggested that the sustainable release of BMP-7 induces periodontal tissue regeneration and that transplantation of BMP7-eBMSCs is a feasible treatment option for periodontal regeneration.

Recent case reports have suggested that anti-tumor necrosis factor (TNF) agents are associated with an increased risk of developing psoriasis in patients with inflammatory bowel disease (IBD).This meta-analysis of published studies aimed to evaluate the association between anti-TNF treatment and psoriasis in patients with IBD.An electronic search for original articles published before April 7, 2022, was performed using PubMed, EMBASE, and the Cochrane Library. Independent reviewers conducted the article screening and data extraction. Psoriasis development between anti-TNF-treated and anti-TNF-naïve patients was compared. Patients with ulcerative colitis and Crohn disease were compared with determine the differences in anti-TNF-induced psoriasis. Also, psoriasis development was compared according to the types of anti-TNF agents. Random-effects model meta-analyses, network meta-analysis, funnel plot asymmetry, Begg rank correlation test, and Egger regression test were performed to generate summary estimates and explore the possibility of publication bias.We analyzed a total of 10,778 articles searched and 14 articles were selected to analyze. There was no significant difference in psoriasis development between anti-TNF-treated and anti-TNF-naïve patients (relative risk = 1.14; 95% confidence interval = 0.77-1.68). No differences were found for psoriasis development between anti-TNF-treated ulcerative colitis and Crohn disease patients (relative risk = 1.30; 95% confidence interval = 0.87-1.95). No significant difference was reported with respect to psoriasis development according to the types of anti-TNF agents. We found no definitive publication bias in our analyses.Anti-TNF treatment did not contribute to the psoriasis development in patients with IBD. Based on our study, anti-TNF agents may be used for IBD treatment without concern for psoriasis development.

Impinging gas jets can induce depressions in liquid surfaces, a phenomenon familiar to anyone who has observed the cavity produced by blowing air through a straw directly above a cup of juice. A dimple-like stable cavity on a liquid surface forms owing to the balance of forces among the gas jet impingement, gravity and surface tension1,2. With increasing gas jet speed, the cavity becomes unstable and shows oscillatory motion, bubbling (Rayleigh instability) and splashing (Kelvin-Helmholtz instability)3,4. However, despite its scientific and practical importance-particularly in regard to reducing cavity instability growth in certain gas-blown systems-little attention has been given to the hydrodynamic stability of a cavity in such gas-liquid systems so far. Here we demonstrate the stabilization of such instabilities by weakly ionized gas for the case of a gas jet impinging on water, based on shadowgraph experiments and computational two-phase fluid and plasma modelling. We focus on the interfacial dynamics relevant to electrohydrodynamic (EHD) gas flow, so-called electric wind, which is induced by the momentum transfer from accelerated charged particles to neutral gas under an electric field. A weakly ionized gas jet consisting of periodic pulsed ionization waves5, called plasma bullets, exerts more force via electrohydrodynamic flow on the water surface than a neutral gas jet alone, resulting in cavity expansion without destabilization. Furthermore, both the bidirectional electrohydrodynamic gas flow and electric field parallel to the gas-water interface produced by plasma interacting 'in the cavity' render the surface more stable. This case study demonstrates the dynamics of liquids subjected to a plasma-induced force, offering insights into physical processes and revealing an interdependence between weakly ionized gases and deformable dielectric matter, including plasma-liquid systems.

This research shows that employing critical thinking (problem-solving and scientific reasoning) skills when learning about climate change helped undergraduate biology students to understand the sub...

Previous bibliometric analyses of industrial symbiosis (IS) research have focused on a limited body of literature owing to the scope of keyword searches or limitations of library databases. This study seeks to apply bibliometrics to explore broader, epistemological questions, particularly about the structure and geospatial development of IS as a sub‐field of industrial ecology. We also evaluate the benefits of using Google Scholar, in addition to the conventional databases Web of Science (WoS) and Scopus, for better understanding academic domains. By using WoS and Scopus, 805 articles on IS that met our criteria were identified, published in 212 journals from 1995 through 2018. On average, the cumulative number of relevant articles grew at an exponential rate of 18% per year—more than double the estimated growth of global scientific output. We observed the largest increases in articles that: (1) model the material and energy flows in IS clusters; (2) propose strategies and ideas for implementing symbiosis; and (3) evaluate the performance of IS networks. By the end of 2018, 54 countries were featured in IS articles retrieved from WoS and Scopus, with China as the single most studied country. The analysis of Google Scholar suggested that it can capture more IS articles than the conventional databases owing to its unique characteristic of searching the entire text of documents rather than solely their metadata as with WoS and Scopus. Google Scholar revealed IS discourse from additional countries and disciplines previously omitted, enabling a more acute view of its patterns of diffusion.

Objectives Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 posttrauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P

Focusing on the significant changes in interpretation of public garden, the aim of this study was to investigate the cognitive image, effect and communality by analyzing the perceptional difference in urban garden between garden education participants, potential participants, and general citizen group. Principal images were “familiar, affective” (relationship with nature), “progressive, sociable” (attitude toward garden activities), “expansive, autonomous” (spatial evaluation), using 24 adjectives representing urban garden image. Through factor analysis by principal components based on the factor loadings of education participants group, factor 1 could be named “Public Role and Communality of urban garden” (Potential Dimension), factor 2 explains “Differentiation as a Public Landscape” (Evaluative Dimension), and factor 3 as “Aesthetic Experience” (Active Dimension). In particular, participants were more aware of the social and environmental effects of urban garden, and the average value of communality index was higher than that of potential participants (3.4 & 3.31) and general citizens (2.69). The urban garden can play a social, environmental, economical role being recognized as lifelong education or community activities beyond just acquiring knowledge. The significance of citizen gardener education could be reaffirmed and needed to systemize for continuity.

Submental or submandibular intubation has been reported to cause fewer complications than tracheostomy. However, the risk of infection is always inherent because oral wounds are exposed to microbial flora and bacteria in the oral cavity. A novel technique of submandibular intubation was devised to reduce infection and injury to the soft tissues. We would like to report a novel safe technique that can be performed in patients requiring submental or submandibular intubation. This is the first report of submandibular intubation using a sterile disposable camera cable drape. This novel technique of submandibular intubation is safer, more sterile, easier, and less invasive than conventional submandibular intubation.

Innate-like T (iT) cells comprise a population of immunoregulatory T cells whose effector function is imposed during their development in the thymus to provide protective immunity prior to antigen encounter. The molecular mechanism that drives the generation of iT cells remains unclear. Here, we report that the cytokine receptor γc plays a previously unappreciated role for thymic iT cells by controlling their cellular abundance, lineage commitment, and subset differentiation. As such, γc overexpression on thymocytes dramatically altered iT cell generation in the thymus, as it skewed the subset composition of invariant NKT (iNKT) cells and promoted the generation of IFNγ-producing innate CD8 T cells. Mechanistically, we found that the γc-STAT6 axis drives the differentiation of IL-4-producing iNKT cells, which in turn induced the generation of innate CD8 T cells. Collectively, these results reveal a cytokine-driven circuity of thymic iT cell differentiation that is controlled by the abundance of γc proteins.

This study evaluated the long-term survival and success rates of dental implants placed with autogenous onlay block bone grafts harvested from the mandibular ramus. Materials and methods: Patients treated with onlay bone graft from the mandibular ramus due to a severe vertical alveolar defect from 2001 to 2017 were included in this study. The marginal bone loss, success, and survival time of the implants were recorded and analyzed with clinical factors, such as time from bone graft to implant placement, type of implant prosthesis connection, history of periodontitis, and insertion depth. Results: Seventy-five implants in 40 onlay bone-grafted areas of 38 patients were included, with a mean follow-up period of 102 months (range: 14 to 192 months). Two grafts were removed before implant placement. Of the 75 implants, 11 implants were lost. History of periodontitis and marginal bone loss at 6 months after implant placement were significantly associated with implant success. The receiver operating characteristic curve showed that a marginal bone loss of 0.75 mm after 6 months of implant placement was related to implant success, with a sensitivity of 72.2% and specificity of 89.6%. Conclusion: Implants placed with onlay bone graft from ramal bone had more frequent biologic complications, and failures may be predicted by measuring the amount of implant bone loss after 6 months of placement.

Background: Recently, there have been various developments in medical service robots (MSRs). However, few studies have examined the perceptions of those who use it. The purpose of this study is to identify user perceptions of MSRs.Methods: We conducted a survey of 320 patients, doctors, and nurses. The contents of the survey were organized as follows: external appearances, perceptions, expected utilization, possible safety accidents, and awareness of their responsibilities. Statistical analyses were performed using t-test, chi-square test, and analysis of variance.Results: The most preferred appearance was the animal type, with a screen. The overall average score of positive questions was 3.64±0.98 of 5 points and that of negative questions was 3.24±0.99. Thus, the results revealed that the participants had positive perceptions of MSR. The overall average of all expected utilization was 4.05±0.84. The most expected utilization was to guide hospital facilities. The most worrisome accident was exposure to personal information. Moreover, participants thought that the overall responsibility of the robot user (hospital) was greater than that of the robot manufacturer in the case of safety accidents.Conclusion: The perceptions of MSRs used in hospital wards were positive, and the overall expected utilization was high. It is necessary to recognize safety accidents for such robots, and sufficient attention is required when developing and manufacturing robots.