Objectives: . This experimental study compared the precision and surgical outcomes of manual versus robotic electrode insertions in cochlear implantation. Methods: . The study was conducted on formalin-fixed cadaveric heads, with nine senior neurotologists performing both manual and robotic insertions. Results: . The results showed no statistically significant differences between the two methods in terms of insertion angle, cochlear coverage, or electrode coverage. However, the robotic method demonstrated a significantly slower and more controlled insertion speed (0.1 mm/sec) compared to manual insertion (0.66±0.31 mm/sec), which is crucial for minimizing intra-cochlear force and pressures. Although robotic insertions resulted in fewer complications such as tip fold-over or scala deviation, there were instances of incomplete insertion. Conclusion . The robotic system provided a consistent and controlled insertion process, potentially standardizing cochlear implant operations and reducing outcome variability. The study concludes that robotic-assisted insertion offers significant advantages in controlling insertion speed and consistency, supporting the continued development and clinical evaluation of robotic systems for cochlear implant surgery.

Objectives: . This experimental study compared the precision and surgical outcomes of manual versus robotic electrode insertions in cochlear implantation. Methods: . The study was conducted on formalin-fixed cadaveric heads, with nine senior neurotologists performing both manual and robotic insertions. Results: . The results showed no statistically significant differences between the two methods in terms of insertion angle, cochlear coverage, or electrode coverage. However, the robotic method demonstrated a significantly slower and more controlled insertion speed (0.1 mm/sec) compared to manual insertion (0.66±0.31 mm/sec), which is crucial for minimizing intra-cochlear force and pressures. Although robotic insertions resulted in fewer complications such as tip fold-over or scala deviation, there were instances of incomplete insertion. Conclusion . The robotic system provided a consistent and controlled insertion process, potentially standardizing cochlear implant operations and reducing outcome variability. The study concludes that robotic-assisted insertion offers significant advantages in controlling insertion speed and consistency, supporting the continued development and clinical evaluation of robotic systems for cochlear implant surgery.

Objectives: . This experimental study compared the precision and surgical outcomes of manual versus robotic electrode insertions in cochlear implantation. Methods: . The study was conducted on formalin-fixed cadaveric heads, with nine senior neurotologists performing both manual and robotic insertions. Results: . The results showed no statistically significant differences between the two methods in terms of insertion angle, cochlear coverage, or electrode coverage. However, the robotic method demonstrated a significantly slower and more controlled insertion speed (0.1 mm/sec) compared to manual insertion (0.66±0.31 mm/sec), which is crucial for minimizing intra-cochlear force and pressures. Although robotic insertions resulted in fewer complications such as tip fold-over or scala deviation, there were instances of incomplete insertion. Conclusion . The robotic system provided a consistent and controlled insertion process, potentially standardizing cochlear implant operations and reducing outcome variability. The study concludes that robotic-assisted insertion offers significant advantages in controlling insertion speed and consistency, supporting the continued development and clinical evaluation of robotic systems for cochlear implant surgery.

This review paper aims to present the evolution in methods of delivering oral hygiene information to orthodontic patients. Orthodontic fixed appliance treatment confers numerous benefits to patients in terms of occlusion, function and aesthetics, but it is associated with unwanted consequences due to challenges in maintaining oral hygiene. The ways of delivering oral hygiene information to patients have progressed over the years. Recent years have seen an increase in the popularity of incorporating technology in delivering oral hygiene information and monitoring of oral hygiene practices. The use of video-based instructions to web-based platforms such as Massive Open Online Course (MOOC) and social media platforms such as YouTube, Instagram and TikTok have all become a mode of oral hygiene information conveyance. Mobile apps are now a popular means to keep track of oral care practices such as toothbrushing frequency. The active ingredients of oral care products have improved providing a greater anticariogenic and antiplaque effect to the user as have the design of toothbrushes and even dental floss. In the future, more advanced technology may be used, such as artificial intelligence (AI) and machine learning, to create intelligent machines that can help educate patients on oral health maintenance and improvement.

Introduction: Studies show that adolescents are more reward sensitive compared to other age groups. The nucleus accumbens (NAcc) has been identified as a key brain area involved in reward through its connectivity to other reward-related brain areas. Our study aimed to characterise the white matter structural connectivity of nucleus accumbens with brain areas that are most often associated with reward in female adolescents. Methods: Fifteen healthy female Malay adolescents were recruited and underwent diffusion-weighted brain scanning. Two behaviour scales were also given to verify typical reward responsiveness. Then, probabilistic tractography and NAcc segmentation were performed on the data using FMRIB Software Library (FSL). Probabilistic tractography was performed to determine the relative connection probability of nucleus accumbens (NAcc) to areas shown to be associated with reward, namely amygdala, anterior cingulate cortex (ACC), medial orbitofrontal cortex (mOFC), hippocampus, ventrolateral prefrontal cortex (vlPFC) and dorsolateral prefrontal cortex (dlPFC). Connectivity-based segmentation of NAcc was performed to determine the spatial distribution of its connectivity with the target brain areas according to the highest connection probability. Results: The highest relative connection probability was found between NAcc to mOFC, while the NAcc parcellation showed the widest distribution of connection to mOFC compared to the other five targets on both sides of the brain. Conclusion: Our findings demonstrated the strongest structural connectivity and widest distribution between NAcc and mOFC compared with other brain areas related to reward. This study’s findings could be used as baseline to compare with people with atypical reward circuit problems.

Bone metabolism requires a balance mechanism between intricate processes of bone formation and resorption, which is affected by the essential interaction between osteoblasts and osteoclasts. Interleukin-17 (IL-17) is a family of cytokines consisting of six isoforms: IL-17A, IL-17B, IL-17C, IL-17D, IL-17E, and IL-17F. Among these isoforms, IL-17A has shown promising and novel roles in the regulation of bone metabolism. IL-17A has also captivated the interest of many researchers since its discovery because of its role as a pro-inflammatory cytokine which mediates a few inflammatory processes. This review describes the biology of IL-17A and its receptor as well as summarises the regulatory role of IL-17A in bone metabolism and diseases through some known pathways. Understanding the function of IL-17A in bone metabolism may lead to the development of therapeutics or diagnostic strategies for some bone diseases; as well as future therapy using tissue engineering and regenerative medicine approaches.

Introduction: The use of assessment tools to measure postnatal mental illness is essential in healthcare settings. However, variations in the types of tools and their reliability in a particular population lead to under-recognition of mental health status in postnatal mothers. The aim of this review is to evaluate the most recent 10 year of research on the validity and reliability of postnatal mental illness assessment tools. Methods: A literature search of studies from online databases PubMed, Scopus, and Science Direct was conducted. Results: A total of 59 studies were selected for this review. Several studies utilised multiple assessment tools, and a total of 96 assessment tools were identified and classified into six domains: postnatal blues, postnatal stress, postnatal anxiety, postnatal depression, postnatal psychosis, and postnatal psychological disorder. In this review, EPDS was the most common tool used to identify postnatal depression and anxiety while DASS 21 was the most common tool used to identify postnatal psychological disorder. There is a wide range in preponderance of evidence for the reliability of each assessment tool and there were inconsistencies in assessing the validity of the assessment tools. Conclusion This review provides information regarding some of the main assessment tools currently available to measure postnatal mental illnesses. There were no standardised tools that were used in a particular setting. The results may differ in different population because there are differences in not only languages and dialects, but also cultural and racial backgrounds, which greatly influences their perception and interpretation of postnatal mental illness.
Mental Disorders

Aims: The effect of Quercus infectoria (QI) gall extract on the fungal expression of antioxidant defense enzymes of Candida albicans was studied in an effort to unravel its anti-fungal mechanism. Methodology and results: Minimum inhibitory concentration (MIC), minimum fungicidal concentration (MFC), and time kill assays were conducted to analyse the antifungal activity of the extract against C. albicans. Total protein profiles of C. albicans were determined by SDS-PAGE and real-time PCR was used to quantify the genes expression level of superoxide dismutase (SOD1), catalase (CAT1) and glutathione peroxidase (GPX3) following treatment with aqueous QI gall extract. The MIC and MFC values of the extract against C. albicans were 8 mg/mL and 16 mg/mL respectively. Fungistatic and fungicidal activities of the extract were observed after 24 h at 1× MIC and 2× MIC from the time-kill assay. A lower total protein bands density of extract-treated C. albicans was visualized when compared to the untreated cells at concentrations of 1× MIC and 2× MIC. A significant reduction in the expression of GPX3 (p 0.05). Conclusion, significance and impact of study In conclusion, QI gall extract exerted an anti-Candida activity and it is apparently effective in downregulating the gene expression of GPX3 in C. albicans. Of note, the present findings elucidated a preliminary mechanism associated with the organism’s survival resilience which represents a key target for the development of anti-Candida agents in future.
Quercus ; Candida albicans

Intermaxillary tooth size discrepancy (TSD) is the disproportion in patients’ tooth size that is usually referred to the Bolton analysis. This size imbalance may also affect the outcome of orthodontic treatment. Therefore, this retrospective study was conducted to determine the prevalence of intermaxillary tooth size discrepancy (TSD) beyond 2 standard deviation (2 SD) from Bolton’s mean in orthodontic patients and to evaluate the effect of TSD beyond 2 SD of Bolton’s mean on orthodontic treatment outcomes. A total of 226 sets of orthodontic study models that met the selection criteria were selected from 3077 orthodontic cases. Bolton's analysis of the anterior and overall ratios was performed on each of the pre-treatment models. The orthodontic treatment outcomes for the cases which were identified of having TSD beyond 2 SD were evaluated and any interventional techniques to improve the outcome of the treatment were recorded. The results showed that 29.20% of cases had TSD beyond 2 SD of Bolton’s mean. 26.54% of cases had anterior ratio of more than 2 SD. Meanwhile, 7.08% of cases had an overall ratio greater than 2 SD. Of all cases with TSD beyond 2 SP, most of these cases (62.12%) had affected the outcome of orthodontic treatment. In conclusion, there is more than one quarter of orthodontic patients present with TSD beyond 2 SD of Bolton’s mean which may influence the outcome of orthodontic treatment. Intervention techniques should be carefully planned to achieve satisfactory treatment outcomes.

Introduction: Delivering oral hygiene instruction is one of the integral parts of orthodontic treatment. However, there is scarce information regarding the impact of audiovisual method on knowledge retention among orthodontic patients. This study aimed to assess knowledge retention of the patient after instruction delivered in audiovisual (AV) method and compare it to the standard written and verbal (WV) method. Methods: This prospective clinical trial was conducted on 60 patients aged 13 to 40 years. They were randomized into the audiovisual group (n=30) and written & verbal group (n=30). Patients’ knowledge retention was measured using a self-administered questionnaire in Google form, immediately after instruction given as short-term retention and long-term retention for three timepoint, i.e., 1-month, 3-month, and 6-month. Results: There was a significant improvement in knowledge for both AV and WV methods at immediate and 1-month assessment and the knowledge retained until 6-month follow up. The AV method demonstrated a significantly higher increase in knowledge retention at immediate and 1-month than the WV method. Conclusion: The AV method was significantly more effective in improving patient's knowledge retention compared to the written & verbal methods. Repetition of instruction also influence the retention of knowledge.