Background/Objectives: Molar-incisor hypomineralization (MIH) causes post-eruptive enamel breakdown, hypersensitivity, and altered chewing, which may unbalance occlusal force distribution and masticatory muscle activity. The functional consequences of restoring MIH-affected teeth remain poorly understood. This exploratory pilot study assessed the feasibility of measuring short-term changes in occlusal force distribution and masticatory muscle activity after restorative treatment of MIH-affected molars. Methods: In this prospective single-arm pilot study, five children (aged 8-10 years) with symptomatic MIH affecting 10 first permanent molars were treated with a bulk-fill glass-hybrid material. Lateral occlusal force distribution (LOFD) was pre-specified as the primary exploratory outcome, bilateral masseter and anterior temporalis surface electromyography during maximum voluntary clenching as a secondary exploratory outcome, and the Schiff Cold Air Sensitivity Scale (SCASS) as an additional exploratory measure. Assessments were performed at baseline and three months. Results: All five participants completed follow-up. Mean deviation from bilateral occlusal balance fell from 11.14 ± 6.12 to 4.63 ± 2.89 percentage points (pp); the mean change was 6.51 pp (95% CI 0.44-12.57; p = 0.041 nominal; Cohen's dz = 1.33), and all five children changed in the same direction. Hypersensitivity resolved in all five participants (SCASS = 0 at T1 in every treated tooth); because the 10 teeth were nested within 5 children, this outcome is reported descriptively, with a participant-level sensitivity analysis (p = 0.063). No statistically detectable changes in the assessed sEMG parameters were observed over the three-month follow-up. Conclusions: In this small exploratory cohort, restoration of MIH-affected molars was followed by resolution of hypersensitivity and a reduction in lateral occlusal force asymmetry, while masticatory muscle activity showed no detectable change. These hypothesis-generating findings should not be read as evidence of efficacy; LOFD was feasible to measure and merits evaluation as an exploratory functional outcome in adequately powered controlled studies. Trial registration: ClinicalTrials.gov NCT07336212.

The management of naturally occurring canine wounds, such as bite and degloving injuries, remains a major veterinary challenge because standard treatments often struggle to balance infection control and tissue regeneration. Although povidone-iodine (PI) remains a widely used first-line antiseptic in both human and veterinary medicine, there are concerns regarding its potential for cytotoxicity and the inhibition of fibroblast growth, which can delay healing. To address these limitations, a prospective comparative study was conducted on 32 client-owned dogs at GADVASU in Ludhiana, where wounds were randomized into four treatment arms. The animals received either the novel natural product formulation VG111 or standard 5% PI, both with and without systemic cefotaxime. Clinical outcomes were assessed through wound contraction percentages and modified Bates-Jensen Wound Assessment Tool (BWAT) scores at 5-day intervals. The results revealed that the VG111-only group achieved complete healing by day 25 nearly twice as fast as the PI group, which took up to 50 days. Interestingly, the addition of systemic cefotaxime to VG111 modestly delayed healing kinetics rather than accelerating them. In addition to clinical evaluation, gas chromatography-mass spectrometry (GC-MS) analysis was utilized to identify 41 chemical constituents within VG111. These chemical findings were further complemented by in silico molecular docking simulations, indicating potential mechanisms underlying the formulation's robust antimicrobial activity.

Snakebites frequently cause venom-induced consumption coagulopathy (VICC). While bleeding is common, ischaemic stroke from large-vessel occlusion (LVO) is rare. The coexistence of LVO and active VICC creates a therapeutic paradox, as reperfusion therapies risk catastrophic haemorrhage. We report a woman in her mid-60s who developed left-sided hemiplegia 6 hours after a suspected viper bite. Investigations revealed profound VICC and an acute right middle cerebral artery (M1) occlusion. Due to extreme bleeding risks, standard reperfusion therapies-intravenous thrombolysis and mechanical thrombectomy-were contraindicated. Management prioritised rapid venom neutralisation using polyvalent anti-snake venom and supportive care. Once coagulation parameters normalised, cautious antiplatelet therapy was initiated, resulting in partial neurological recovery. This case highlights a rare clinical dilemma where modern stroke treatments are unsafe due to venom-induced coagulopathy, emphasising the necessity of individualised, risk-balanced management when ischaemic and haemorrhagic risks collide.

Skeletal Class III malocclusion, or mesiocclusion, is characterised by maxillary deficiency, mandibular excess or both, resulting in a reversed or edge-to-edge incisor relationship. It often reflects underlying skeletal discrepancies in the maxillary or dentoalveolar components and may be worsened by functional mandibular shifts. Treatment options depend on severity and growth status, ranging from orthopaedic correction in growing patients to orthodontic camouflage or orthognathic surgery in adults. Accurate diagnosis and case selection are critical to ensure favourable outcomes.The introduction of temporary anchorage devices has expanded the scope of non-surgical management for Class III cases by allowing controlled distalisation of the mandibular dentition with minimal reciprocal effects and reduced reliance on patient compliance. Micro-implants placed in the infrazygomatic crest or buccal shelf regions provide stable anchorage for en masse distal movement without proclination of the anterior teeth.This case report presents the successful orthodontic management of a patient with bilateral Angle Class III molar relationship, an edge-to-edge bite, 0 mm overjet and reduced overbite, accompanied by mild skeletal discrepancy and a slightly concave facial profile. The patient declined orthognathic surgery and a non-extraction, camouflage approach was pursued. Using miniscrew anchorage, controlled en masse distalisation of the mandibular dentition was achieved, resulting in improved occlusion, facial balance and patient satisfaction.This case demonstrates that skeletal anchorage-assisted distalisation can serve as an effective, minimally invasive alternative for adult Class III patients unwilling to undergo surgical correction, achieving functional and aesthetic harmony through precise biomechanical control.

The Devonian fish-to-tetrapod transition and the subsequent conquest of land involved multiple amphibious stem and early tetrapod lineages, yet how these animals reduced their dependence on aquatic environments remains uncertain. Feeding is central to this transition, as early tetrapods likely moved from predominantly aquatic suction feeding to jaw-based prey prehension and processing. Although recent functional approaches-including morphometrics, functional morphology and computational modelling-offer new perspectives, their interpretive strength depends on realistic soft-tissue inputs, particularly cranial musculature. Here, we reconstruct the principal cranio-mandibular (skull) musculature of the Middle Triassic capitosaur temnospondyl Mastodonsaurus giganteus to provide an explicit anatomical foundation for future functional and modelling studies of stem and early tetrapods and to refine ecological interpretations for this species. We formulate alternative muscle hypotheses within an extant phylogenetic bracket (EPB) framework that explicitly reflects uncertainty in temnospondyl placement (temnospondyl versus lepospondyl origin of lissamphibians). We developed hypotheses from a literature review and digital dissections of contrast-enhanced soft-tissue μCT datasets from selected extant bracket taxa and outgroups and assessed them against osteological correlates in M. giganteus. Our reconstruction indicates a more differentiated adductor system than commonly assumed, with subdivision of the adductor mandibulae externus and internus complexes and an inferred intramandibular component consistent with a cartilaginous sesamoid ('cartilago transiliens') functioning as a force-transmitting pulley. We further provide osteological evidence for previously unrecognised pterygoideus components, suggesting additional jaw-closing capacity and a potential contribution to rapid gape formation. The 'tongue' in M. giganteus was likely comparatively weak and less flexibly movable, while as a stereospondyl, it possessed a comparatively strong neck and specialised anterior ribs. Collectively, these traits are consistent with a mainly crocodile-like bite-and-hold prehension ecology and likely indicate kinetic-inertial feeding. Our muscle reconstruction further suggests a more balanced jaw-opening/closing system that may have enabled compensatory suction during gape formation.

IntroductionAchieving an optimal therapeutic ratio in head and neck cancer (HNC) radiotherapy requires balancing dose conformity with organ-at-risk (OAR) sparing. Traditional auxiliary devices often lack the customized geometry needed for modern techniques. This study developed and evaluated a 3D-printed integrated tissue compensator that serves as both a positioning stent for OAR displacement and a conformal bolus for dose build-up.MethodsIn this case series, five HNC patients (including floor of mouth, tongue, and nasal cavity and sinus cancers) were prospectively and consecutively enrolled, and their computed tomography (CT) data were used to fabricate the compensators. Dosimetric comparisons were conducted between the 3D-printed compensator, a simulated air cavity, and a conventional bite block.ResultsThe integrated device demonstrated adequate geometric fidelity, maintaining random translational setup errors (σ) at ≤ 1.34 mm, comparable to traditional immobilization. Compared to the conventional group, the device demonstrated a numerical reduction in the maximum dose to the hard palate and the mean dose to the external surface, while ensuring effective dose build-up in the target region. Compared with the air cavity group, the observed numerical reductions in dose for key OARs (oral cavity, mandible, and parotid gland) approached but did not reach conventional statistical significance (p = 0.063). Furthermore, the device maintained comparable conformity (CI) and homogeneity (HI) indices, showing an observed numerical improvement in homogeneity for high-dose targets.ConclusionThis feasibility study demonstrates that a 3D-printed integrated tissue compensator offers potential dosimetric advantages over conventional approaches. By maintaining setup reproducibility and OAR sparing, this device represents a practical exploratory tool for HNC radiotherapy.

Within the Diagnostic Criteria for Temporomandibular Disorders, masticatory myalgia is framed around muscle hyperactivity, yet a recognizable subgroup shows the opposite profile-low muscle tone, fatigue, masticatory pain, and a persistent sense that the bite no longer fits, without structural dental change-and responds poorly to conventional conservative care. We introduce G-SCORE (Gum-chewing-mediated Sensorimotor Calibration of Occlusion through Rhythmic Exercise), a proprioceptive recalibration strategy delivered as a bilateral gum-chewing (BGC) protocol: two equal halves of one sugar-free gum chewed simultaneously and symmetrically on both posterior segments in short, patient-titrated sessions, delivering balanced, rhythmic, low-load input to the trigeminal sensorimotor system. In a retrospective series of 41 patients, we characterized within-subject changes in pain, mandibular mobility, and occlusal parameters. Masticatory pain fell from 5.0 ± 2.9 to 0.7 ± 0.9 (0-10; n = 27; p < 0.001; r = 0.87), with 85% achieving a ≥2-point reduction. Occluding tooth positions and mouth opening also recovered; in an anterior open-bite subgroup, overbite improved (n = 6; p = 0.031). The observed changes were dominated by pain relief and restored bilateral occlusal contact rather than by raw force-a pattern more compatible with sensorimotor recalibration than with muscle hypertrophy. This low-cost, non-invasive technique may help selected patients avoid irreversible occlusal treatment.

Snakebite envenoming disproportionately affects Indigenous populations in the Brazilian Amazon, where centralized healthcare systems limit timely access to antivenom. The recently implemented SAVING Program has decentralized antivenom delivery to Indigenous primary healthcare facilities, improving access and clinical outcomes. This article examines the ethical considerations encountered and the approaches adopted to address these challenges. Using the WHO/TDR framework for ethics in implementation research as a starting point, we continuously adapted to ethical issues arising during the planning, implementation, and dissemination of the program. The analysis was informed by focus groups and stakeholder discussions involving Indigenous leaders, patients, healthcare professionals, health managers, policymakers, and representatives of Indigenous governance structures. Key themes included community and stakeholder responsiveness, informed consent, balancing risks and benefits, culturally appropriate standards of care, data governance, sustainability, and benefit sharing. Decentralizing antivenom delivery can improve equitable access to lifesaving treatment while strengthening Indigenous health systems. To date, the program has demonstrated the feasibility of building sustainable partnerships with Indigenous communities, enhancing acceptance and equity. The ethical lessons from the SAVING Program may provide practical guidance for implementing health innovations in Indigenous and other historically underserved communities.

Rabies is a universally fatal acute zoonotic disease caused by rhabdovirus, and postexposure prophylaxis (PEP) remains the mainstay of prevention. Patients who sustain animal bites may require urgent or elective surgical interventions for unrelated conditions while simultaneously undergoing rabies prophylaxis. The perioperative team often faces uncertainty regarding the safety of anesthesia and surgery in patients receiving rabies vaccines or rabies immunoglobulin (RIG). This report discusses such a scenario in a patient posted for elective lumbar spine surgery. We report the case of a male in his mid-60s with chronic low back pain and bilateral lower limb radiculopathy, with the left side more involved, diagnosed with a prolapsed intervertebral disc at the L5-S1 level with lumbar canal stenosis. Following failed conservative management for six weeks, he was planned for decompression and transforaminal lumbar interbody fusion (TLIF) at the L5-S1 level. On the day before surgery, he received a scratch from a monkey, classified as a Grade III wound, which was managed, and PEP was initiated, including human RIG and a four-dose intradermal vaccine regimen. Surgery was deferred till completion of PEP, following which he underwent TLIF at the L5-S1 level. There were no intraoperative adverse events. The immediate postoperative course was uneventful, with significant symptomatic improvement. The surgical site was found to be healthy on postoperative day 2, and the patient was discharged on the next postoperative day. Our case shows that timely administration of rabies PEP in the form of RIG and vaccine, along with postponement of elective surgery, does not preclude the patient from safely undergoing elective spine surgery in the future, provided vaccination schedules are not interrupted and adequate time is allowed after immunoglobulin administration. In our patient, lumbar TLIF was performed after completion of the PEP schedule, and he had an uneventful intraoperative and postoperative course, with a good clinical recovery. This highlights the importance of appropriate coordination between infectious disease management and individualized surgical planning, along with careful perioperative and postoperative monitoring, to balance the urgency of spinal disease and the need for effective rabies prevention for optimal surgical outcomes.

Dengue fever remains a persistent viral threat, affecting millions of families every year, turning a simple mosquito bite into a potentially life-threatening emergency. This disease remains a constant burden on our global healthcare system, demanding innovative solutions to protect worldwide communities. While many researchers discuss general treatments, preventions and modern medical interventions, there is often a lack of focus on how current, cutting-edge molecular and genetic tools are employed to engineer dengue strains as vaccine candidates. Therefore, in this paper, we explore the recent genetic strategies, such as targeted virulent gene deletions, CRISPR-Cas inactivation, and viral codon deoptimization approaches used to attenuate or inactivate Dengue viruses specifically. Assays and techniques used in validating Dengue viral attenuation or inactivation are also discussed in detail, highlighting the importance of the balance between safety and immunogenicity for Dengue vaccine uses. The article also briefly elaborates the complex biological challenges and safety concerns that centre on Dengue vaccine developments. By bridging the gap between advanced genetics and public health, this review provides readers with a comprehensive understanding of how modern genetics is paving the way for the next generation of safe and effective Dengue vaccines.

Density functional theory (DFT) calculations were performed to elucidate the reaction mechanism of a ruthenium-catalyzed aromatization-driven C-C bond cleavage and to rationalize the experimentally observed trends in product selectivity, substituent-controlled reactivity, ligand dependence, and counterion effects. β-Carbon elimination is identified as the turnover-limiting step, governing both reactivity and product selectivity. Substituent-dependent selectivities are qualitatively reproduced: ESP and ETS-EDA analyses highlight electrostatic and transition-state interactions for alkyl substrates, while LOL-π reveals π-stabilization responsible for selectivity reversal in aryl systems. To clarify the origin of substituent-controlled reactivity, CDA analysis shows that increasing substitution progressively perturbs the balance between metal-substrate donation and back-donation, which elevates the β-carbon elimination barrier and thereby reduces catalytic efficiency. Ligand effects are found to arise from a multidimensional interplay among P-Ru-P bite angles, effective steric confinement, transition-state distortion, and ligand-to-Ru donation, rather than from any single geometric or electronic descriptor. Finally, distortion-interaction and LOL analyses demonstrate that the pronounced counterion effect originates primarily from excessive geometric distortion and reduced transition-state stabilization in the PF6[-]-assisted pathway, explaining the dramatic suppression of catalytic activity relative to OTf[-].