Search Results (29)

Introduction: This manuscript addresses the limitations of traditional orthognathic surgery in achieving both functional and aesthetic correction in patients with Class II malocclusion and severe mandibular retrusion. Current techniques often struggle to simultaneously address mandibular deficiency and inadequate transverse dimension, leading to unsatisfactory outcomes. Methods: Seven male patients underwent bimaxillary osteotomy with mandibular advancement. A novel surgical plate, Implate, was used, which was designed to facilitate precise osteotomy and stabilization. Pre-surgical planning included CBCT scanning, 3D modeling, and surgical simulation. Postoperative assessments included clinical examinations, CT and OPT scans. Results: Implate successfully addressed the challenges of conventional techniques, minimizing the formation of bony steps and achieving a more harmonious facial profile. The minimally invasive procedure, with careful periosteal and muscle management, contributed to stable outcomes, and no complications were reported. At the 6-month follow-up, OPT analysis showed a mean mandibular width increase of 18.1 ± 6.2 mm and vertical ramus height gains of 6.0 ± 3.1 mm (left) and 5.8 ± 1.7 mm (right). Conclusions: According to our preliminary experience, the integration of Implate into surgical practice offers a significant improvement in treating complex Class II malocclusions. By simultaneously correcting mandibular retrusion and width while minimizing complications, Implate provides a superior solution compared to traditional methods. This innovative approach highlights the potential of combining advanced surgical techniques with personalized 3D-printed implants to achieve optimal functional and aesthetic outcomes. Further prospective studies with controls and longer follow-up are needed to validate the efficacy and reproducibility of Implate in wider clinical use. Full article

Background and Clinical Significance: Acute pediatric rhinosinusitis is most commonly caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The involvement of Enterobacter species is rare and typically linked to chronic or nosocomial infections. Typical cases of acute rhinosinusitis in children present with abundant nasal discharge, headache, and fever and are generally managed with systemic antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), mucolytics, and topical intranasal treatment. Atypical presentations prompt heightened clinical attention, and depending on the symptoms and patient status, surgical interventions might be considered. Case Presentation: We report the case of a previously healthy 5-year-old boy presenting with painful unilateral palpebral edema, minimal ipsilateral nasal discharge, and persistent headache despite standard rhinosinusitis therapy. Imaging tests revealed complete right maxillary sinus opacification. As the clinical response to ceftriaxone and dexamethasone was minimal, we opted for endoscopic sinus surgery. A nasal swab culture identified Enterobacter spp. in the nasal discharge. Conclusions: Unusual pathogens like Enterobacter spp. can cause acute sinusitis in children without prior risk factors. Early surgical intervention and culture-adjusted antimicrobial therapy remain critical for favorable outcomes. Full article

Background and clinical significance: Phyllodes tumors (PTs) are rare stromal neoplasms originating in the connective tissue of the breast, distinct from carcinomas that arise from the ducts or lobules. These tumors exhibit a broad spectrum of morphologic features and are traditionally classified as benign, borderline, or malignant. Case presentation: We present the case of a 71-year-old female diagnosed with a malignant PT and treated at our hospital. The patient noticed a gradually enlarging lump in her right breast over several months. Mammography was inconclusive, but an ultrasound later revealed a lobulated, firm mass, classified as BIRADS 5. Physical examination identified a 20 cm mass, and core needle biopsy suggested a borderline PT. Following lumpectomy, pathology confirmed a malignant tumor with narrow surgical margins (0.1 cm). Although mastectomy was recommended to achieve wider margins, the patient opted for adjuvant radiotherapy. She received 50 Gy in 25 fractions to the whole breast, followed by a 16 Gy boost to the tumor bed in 8 fractions. The treatment was well tolerated and completed successfully. Initially, the patient’s therapeutic management was delayed due to a combination of personal and organizational factors. However, the process was later streamlined through the use of a novel digital tool developed to facilitate the entire patient journey within our hospital system. Conclusions: This case highlights the diagnostic complexities of PTs, the critical need for effective collaboration between specialties, and the importance of timely treatment planning for optimal patient outcomes. Full article

The current advancements in the field of machine learning can have an important application in agriculture and global food security. Machine learning has considerable potential in establishing knowledge-based farming systems. One of the main challenges of data-driven agriculture is to minimize food waste and establish more sustainable farming systems. The prediction of the right harvest time is one of the ways to obtain the mentioned goals. This paper describes multiple machine learning algorithms that are used to predict peach firmness. By accurately predicting peach firmness based on various peach measurement data, a more precise harvest time can be obtained. The evaluation of nature-inspired metaheuristic optimization algorithms in enhancing machine learning model accuracy is the primary objective of this paper. The possibility of improving the peach firmness prediction accuracy of regression tree models using various metaheuristic optimization techniques implemented in GA and metaheuristicOpt R packages is studied. The RMSE on test data of the default regression tree model is 1.722285, while the regression tree model optimized using the gray wolf optimization algorithm scored the lowest RMSE of 1.570924. The obtained results show that it is possible to improve the peach firmness prediction accuracy of the regression tree model by 8.8% using the described method. Full article

When performing surgical treatment for shoulder dislocation, the Remplissage procedure for large Hill-Sachs lesions, which correspond to off-track lesions, has been reported to yield satisfactory results using an arthroscopic approach. However, in cases of high-energy acute dislocation or acute-on-chronic dislocation, when the humeral head bony defect is too large, severe external rotation limitation may occur postoperatively, and if the bone quality is poor, there is a higher risk of anchor pull-out, leading to potential failure. To overcome these limitations, we opted to apply subscapularis augmentation instead, aiming to achieve satisfactory results. A 21-year-old male patient underwent subscapularis augmentation for a right shoulder dislocation accompanied by severe glenoid bone loss following seizures. Two years and three months later, he experienced another seizure episode without recurrence of right shoulder dislocation and showed satisfactory clinical outcomes. However, he developed a left shoulder dislocation. Therefore, we report a case of subscapularis augmentation as an alternative treatment for shoulder dislocation with significant glenoid bone loss. We aim to present a satisfactory outcome along with a literature review on this approach. Full article

In the contemporary era, smart buildings, characterized by their integration of advanced technologies to enhance energy efficiency and user experience, are becoming increasingly prevalent. While these advancements offer notable benefits in terms of operational efficiency and sustainability, they concurrently introduce a myriad of privacy concerns. This review article delves into the multifaceted realm of privacy issues associated with energy-efficient smart buildings. We commence by elucidating the potential risks emanating from data collection, storage, and analysis, highlighting the vulnerability of the personal and behavioral information of inhabitants. The article then transitions into discussing the rights of occupants, emphasizing the necessity for informed consent and the ability to opt-out of invasive data collection practices. Lastly, we provide an overview of existing regulations governing the intersection of smart buildings and privacy. We evaluate their effectiveness and present gaps that necessitate further legislative action. By offering a holistic perspective on the topic, this review underscores the pressing need to strike a balance between harnessing the benefits of technology in smart buildings and safeguarding the privacy of their occupants. Full article

The activational effects of sex hormones on spatial ability have been well documented. It has been suggested that these effects might be related to hormonally induced changes in interhemispheric communication. In this EEG study, we opted to explore menstrual cycle-related changes in the efficacy of solving mental rotation tasks and laterality indices while participants were engaged with the tasks. We compared 2D and 3D mental rotation tasks, as they differ both psychometrically and in terms of lateralization. A group (n = 39) of healthy young women was tested twice, once during the mid-luteal (high estrogen and progesterone) and once during the early follicular (low levels of sex hormones) phase of menstrual cycle. The differences in power within the same frequency band on homologous sites of the left and right hemispheres were then calculated. Participants were faster, more accurate, and showed higher laterality scores when solving 3D mental rotation tasks in the early follicular phase compared to the mid-luteal phase. This indicates a higher lateralization of this specific spatial function when the levels of sex hormones are low. However, for 2D mental rotation tasks, participants showed neither shifts in efficacy nor in hemispheric laterality as a function of the menstrual cycle. This pattern of results provides further support for the notion that fluctuations in sex hormones affect laterality, and consequently, the expression of lateralized cognitive abilities. Full article

The 22q11.2 deletion syndrome (22q11.2DS) is the most common chromosomal microdeletion disorder caused by hemizygous microdeletion of the long arm of chromosome 22. It is now known to have a heterogenous presentation that includes multiple additional congenital anomalies and later-onset conditions, such as gastrointestinal and renal abnormalities, autoimmune disease, variable cognitive delays, behavioral phenotypes and psychiatric illness. The purpose of our paper is to present the case of a fetus diagnosed with a complex association of cardiac anomalies: interrupted aortic arch type B, large malalignment-type ventricular septal defect, pulmonary valve dysplasia, and aberrant right subclavian artery for whom the result of genetic testing revealed 22q11.2 deletion. The pregnancy was regularly followed until delivery which took place in Germany so that neonatal cardiac surgery could be performed in an experienced center for cardiac malformations. The distinctivness of our report resides in the fact that it offers a complete image of a case of 22q11.2 deletion syndrome starting from the prenatal diagnosis (and emphasizing on the most relevant sonographic features) and, with parents not opting for termination of pregnancy, ending with the newborn surviving major cardiac surgery, offering thus the possibility to bring into focus postnatal outcome and future expectations in similar cases. Full article

The COVID-19 pandemic, and the social and economic instability that followed, has given new life to conspirituality and far-right ideology in so-called Australia. This article discusses how politico-spiritual communities invested in both conspiracy theories and New Age spirituality have pieced together settler narratives about a New World Order and external threats to Western society from far-right and white supremacist Christian ideology circulated via new media. Using anti-colonial discourse analysis, we elucidate the undercurrent of white supremacist ideology in the Australian anti-vax movement, and highlight the misuse of Indigeneity in far-right and anti-vax narratives. We discuss how these narratives are settler-colonial and how conspiritualists co-opt and perform Indigeneity as a form of settler nativism. As a case study, we analyse the use of the term sovereignty by settlers attached to Muckadda Camp—a camp of ‘Original Sovereigns’ occupying the lawn outside Old Parliament house from December 2021 to February 2022. Using Indigenous critique from both new media and academia, we argue that although settlers may perform Indigeneity, they are exercising white supremacist settler narratives, and not Indigenous sovereignty. Full article

In the United States, religious exemptions to health-driven mandates enjoy, and should enjoy, protected status in medical ethics and healthcare law. Religious exemptions are defined as seriously professed exceptions to state or federal laws, which appeal to Title VII of the Civil Rights Act of 1964, allowing workers to request an exception to a job requirement, including a health-protective mandate, if it “conflicts with their sincerely held religious beliefs, practices, or observances”. In medical ethics, such religious exceptions are usually justified on the basis of the principle of autonomy, where personally held convictions, reflected in scripture or established religious norms, are safeguarded on the basis of the first amendment, thereby constituting an important area in which societal good must yield to individual liberty. Acknowledging the longstanding category of “religious exemptions”, and referencing some examples that adhere to its parameters in good faith (e.g., objections made by some institutions to HPV vaccines), I argue that, to date, no coherent basis for religious exemptions to COVID-19 vaccines has been offered through appeal to the principle of autonomy, or, in a healthcare context, to “medical freedom”. Indeed, proponents of characterizing these exemptions as legitimate misconstrue autonomy and abuse the reputation of the religious traditions they invoke in defense of their endeavors to opt out. The upshot is not only an error in interpreting the principle of autonomy, whereby it is issued a “blank check”, but also a dishonesty in itself whereby a contested political position becomes deliberately disguised as a protected religious value. “Sincerely held beliefs”, I conclude, appear no longer to constitute the standard for religious accommodation in the era of COVID-19. Individual declaration, seemingly free of any reasonable constraint, does. This is a shift that has serious consequences for public health and, more broadly, the public good. Full article

Most women who have had a mastectomy and have not opted for breast reconstruction choose to use an external breast prosthesis. This study aimed to assess the impacts of external breast prostheses on the body postures of women after unilateral mastectomies. An additional aim was to identify whether postural asymmetry depended on the side of mastectomy. This study involved 52 women after unilateral mastectomy and consisted of two parts: (1) anthropometric measurement and (2) assessment of body posture using the moiré topography method. The posturometric indices showed that the body posture of the subjects in the sagittal plane is characterized by forward trunk inclination and a tendency to excessive kyphosis. There were no significant differences between parameters characterizing body posture with and without external breast prosthesis. The lack of external breast prosthesis had a significant effect only on excessive forward trunk inclination. Significant differences were found in the posturometric parameters in the transverse plane between the groups of patients after left- and right-sided mastectomy. The obtained results did not fully confirm the hypothesis that the external breast prosthesis affects the body posture of women after unilateral mastectomy. Full article

Australia has a high prevalence of diabetes, with approximately 1.2 million Australians diagnosed with the disease. In 2012, the Australasian Diabetes Data Network (ADDN) was established with funding from the Juvenile Diabetes Research Foundation (JDRF). ADDN is a national diabetes registry which captures longitudinal information about patients with type-1 diabetes (T1D). Currently, the ADDN data are directly contributed from 42 paediatric and 17 adult diabetes centres across Australia and New Zealand, i.e., where the data are pre-existing in hospital systems and not manually entered into ADDN. The historical data in ADDN have been de-identified, and patients are initially afforded the opportunity to opt-out of being involved in the registry; however, moving forward, there is an increased demand from the clinical research community to utilise fully identifying data. This raises additional demands on the registry in terms of security, privacy, and the nature of patient consent. General Data Protection Regulation (GDPR) is an increasingly important mechanism allowing individuals to have the right to know about their health data and what those data are being used for. This paper presents a mobile application being designed to support the ADDN data collection and usage processes and aligning them with GDPR. The app utilises Dynamic Consent—an informed specific consent model, which allows participants to view and modify their research-driven consent decisions through an interactive interface. It focuses specifically on supporting dynamic opt-in consent to both the registry and to associated sub-projects requesting access to and use of the patient data for research purposes. Full article

Danish elementary school Religious Education (RE) dates back to the beginning of the Danish public schools in 1814 and remained confessional until 1975. In 1937, an option for exemption for teachers and pupils was introduced. However, the non-confessionalisation of the school subject did not indicate that the exemption was removed. At present, pupils (excluding teachers) may still be exempted. In this study, the authors examine the current situation of the subject, the exemption rules, and related human rights aspects. We analyse the contents and aims of RE, the exemption regulations and the related political, public and educational debates on the option for exemption. The analyses and discussions cover a few key non-Danish and Danish articles and discussions from a human rights and an educational perspective of RE and human rights in Europe. The articles are particularly related to the freedom of religion or belief and include discussions on the requirements for RE to be compulsory and thus have no ‘opt-out’ option for pupils and parents. Full article

(1) Background: Water security is at the front and center of climate change, human security, and sustainable development in regions and communities with competing water usage contexts, climate change effects, and cross-border water-sharing agreements, resulting in conflicts arising. Shared water agreements are affected by geopolitics, segregation, water availability, and access rights. Climate change can worsen water problems by changing precipitation trends or causing droughts. (2) Methods: Document and content analysis and primary and secondary data assessment were used to develop spatio-temporal patterns. In establishing a water security narrative for the region, the selection of SDG 6 (water) and SDG 13 (climate action) targets and indicators was also evaluated. UN-Water’s 2013 water security conceptual framework was used to examine water and climate security concerns and give a set of principles to assess gaps and fulfill needs toward a ‘water security future’ for communities and states in the region. Also, hydro-political perspectives in the region or state were evaluated using discourse analysis and guiding notes from emerging scholarship to support suggestions and prospective solutions toward mitigating water insecurity and risks from climate change and disasters, including resource (water) related conflicts. (3) Results: Hydro-hegemony keeps the water sector in one state under massive stress, and the lack of consensus-building for the regional water agenda continues to breed conflicts between communities and states. (4) Conclusions: We reiterate that the escalating water and climate crises will deepen, and at the national and local scale for OPT, the restrictions and geopolitical tensions about shared waters can render coping and adaptation mechanisms for people and stakeholders challenging. Full article

Retrospective observational studies using medical records require researchers to guarantee the right to opt out of the study. However, is it also necessary to confirm whether the medical professionals who created those medical records permit their use as well? In this article, we consider possible options based on a fictitious scenario. Based on our deliberations, we recommend that the information be disclosed on the hospital’s homepage or in leaflets (principal investigator: hospital director), and, similar to patients, attending physicians should be given the opportunity to opt out. We also recommend that an application be submitted to the hospital’s research ethics committee. In this paper, we address the public interest aspect of the use of patient information as a primary item for ethical scrutiny. In addition to research ethics, this particular point underscores the importance of public health ethics, particularly as they pertain to the conflict between individual freedom and public interest. Full article