Effectiveness of various methods of educating children and adolescents for the maintenance of oral health: A systematic review of randomized controlled trials

BACKGROUND

School-based oral health education has emerged as one of the most effective methods to instill a positive attitude toward oral health in children.

AIM

This systematic review (SR) aimed to assess the effectiveness of different methods of oral health education in children and adolescents.

DESIGN

Systematic search was conducted in PubMed, Cochrane, Web of Science, LILACS, Scopus, and EMBASE on January 29, 2023. Review included only randomized controlled trials (RCTs), and their risk of bias (ROB) was assessed by Cochrane RoB-2. Data were extracted and analyzed by expert group. The GRADE approach was used to assess the quality of evidence for each outcome. Every step was conducted in duplicate, and disagreements were resolved by consulting the third reviewer.

RESULTS

The SR included 10 RCTs with majority showing a high ROB. They included 12 methods with the commonest being the use of leaflets/flash cards. Most interventions were effective in improving oral hygiene, gingival health, and knowledge except conventional teaching methods, lecture by using PowerPoint by dentists, and e-learning interventions. The grade of evidence in the majority of outcomes was found to be low or very low.

CONCLUSION

Interventions using the interactive methods such as games, motivational-experiential learning, and audiovisual methods were found to be more effective than controls and other interventions. Variabilities in study methods and outcome variables must be addressed in the future.

The risk of bonded fragment loss in crown-fractured anterior teeth managed by fragment reattachment: a systematic review and meta-analysis

PURPOSE

To identify the factors affecting the risk of bonded fragment loss in crown-fractured anterior teeth managed by fragment reattachment.

METHODS

The study protocol followed the best practices of evidence-based medicine and was registered in PROSPERO. A comprehensive literature search was performed electronically in six databases (PubMed, Embase, SCOPUS, Web-of-Science, Lilacs, and Cochrane) on 18-09-2023. It was saved in EndNote-online and duplicates were removed. Selection of articles was performed in two stages, followed by data-extraction, risk of bias assessment, data-analysis, and meta-analysis. The quality of evidence for the outcomes was assessed by the GRADE-approach.

RESULTS

The study included six articles that had similar selection protocols with variations in duration from trauma to treatment and the observation period. Only one study employed pre-attachment fragment preparation and three performed post-attachment reinforcements. Overall loss of fragment was 20% (95%CI-13,30%). When the risk ratio for loss of restoration or fragment was compared, it was found to be 2.21 (95%CI-1.52,3.21) in uncomplicated crown fractures, 2.54 (95%CI-1.35,4.79) in complicated crown fractures. The risk of bias was found to be low in two and moderate in four studies. Grade of evidence for all the outcomes was very low.

CONCLUSION

Fragment loss was lowest in uncomplicated crown fractures where reinforcement had been performed, and highest when bonding was done in complicated crown fractures without reinforcement. The risk of fragment loss was higher than the loss of composite restorations.

Risk of pulp necrosis and related complications in the permanent anterior teeth with lateral luxation: A systematic review and meta-analysis

This systematic review aimed to evaluate the evidence related to the occurrence of pulp necrosis and related complications in permanent anterior teeth with lateral luxation. It was envisaged to address the ambiguity related to the recommendation for pulp extirpation in teeth with mature root apex. An a priori protocol was formulated as per the best practices of evidence-based medicine and registered in PROSPERO. A comprehensive search was performed electronically in PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane on July 10,2023 without any restriction of language or year of publication. The screening of titles and abstracts and later the full-text articles were performed. Later, the data extraction was performed by using a self-designed sheet, risk of bias (ROB) assessment was done, meta-analysis was performed, and the GRADE approach was used to assess the quality of evidence. The qualitative synthesis was performed on 13 studies done from 1985 to 2020 in hospital settings. There was variability in the minimum and total observation periods, sample sizes, and characteristics of the sample population. The overall pooled prevalence of pulp necrosis was found to be 57% (95% CI: 42, 72%). It was 12% (95% CI: 8%, 18%, I2 = 0%) in immature teeth, and 58% (95% CI: 42, 73%, I2 = 86%) in mature teeth. The pooled prevalence of EIRR was found to be 11% (95% CI: 4, 27%, I2 = 95%) with greater risk in teeth with mature root apex (RR: 1.26, 95% CI: 1.12, 1.42, I2 = 0%). The ROB was moderate or high in nine studies and the GRADE of evidence was very low in 14 of 15 outcomes. There are greater chances of pulp necrosis in teeth with lateral luxation, especially with mature apex. However, it can still be less than 60% in most cases with the prevalence of EIRR less than 20%. Hence, an absolute recommendation for endodontic intervention in mature teeth with lateral luxation must be interpreted with slight caution.

Comparative assessment of scientific reach and utilization of the International Association of Dental Traumatology 2020 guidelines: An altmetric and citation analysis

BACKGROUND/AIM

The updated version of the International Association of Dental Traumatology (IADT) guidelines was published online in May 2020 in the form of four papers. They are extensively used in dental trauma education in textbooks, undergraduate and postgraduate programs, and clinical workshops. Hence, this study aimed to assess the impact, global scientific reach, and utilization of these guidelines through altmetric and citation analysis.

MATERIAL AND METHODS

The protocol was prepared after an expert group discussion. Dimensions database was used to derive the altmetric and citation data on April 10th, 2023. The data was extracted by using a self-designed pre-piloted form by two authors independently. The citing articles were further categorized into the type of study and the domains and subdomains of dental traumatology. The VOSviewer program was utilized to explore the correlation between the subdomains and the overlap of citations was assessed by creating a citation matrix.

RESULTS

A total of 552 citations had been collectively received by the four papers. The highest was seen for the guidelines for fracture and luxation in permanent teeth (FL), avulsion in permanent teeth (AV), general introduction (GI), and primary teeth (PT). Dental Traumatology had the maximum number of citing papers for each guideline. They were from 52 countries with English being the commonest language. Overall, the maximum number of citations had been received in narrative reviews (n = 104) and the majority of cited papers were categorized in the therapeutic domains. The most common subdomain for the papers that cited GI, FL, and AV was "treatment protocols in permanent teeth", while it was "awareness of prevention and emergency management of traumatic dental injuries" for the papers that had cited PT.

CONCLUSIONS

This analysis highlighted that the IADT 2020 guidelines are globally popular resources, which are widely used by the researchers across specialities and are intended towards clinical application.

Enhancement in the dielectric and magnetic properties of Ni2+-Cu2+ co-doped BaFe11Cu1-xNixO19 hexaferrites (0.0 ≤ x ≤ 1.0)

Herein, Ni2+-Cu2+ co-doped barium hexaferrites (BaFe11Cu1-xNixO19, 0.0 ≤ x≤ 1.0 with an interval of 0.25) were successfully synthesized using a co-precipitation method. The formation of a magnetoplumbite structure with the P63/mmc space group was confirmed by Rietveld refinement of the obtained X-ray diffraction patterns. Microstructural investigations revealed grains in the shape of hexagonal plates, while co-doping resulted in a variation in the grain sizes of the prepared samples. X-ray photoelectron spectroscopy was performed to determine the valence state of iron in the prepared hexaferrites. Impedance spectroscopy analysis revealed that dielectric permittivity initially decreased with an increase in the co-dopant content up to x = 0.5 and then increased by two orders of magnitude for x = 1.0. Alternatively, resistive properties showed microstructural resistance values in the range 105-108 Ω, with the highest value obtained for the sample with x = 0.5. Furthermore, magnetic measurements indicated that all the prepared samples exhibited ferrimagnetic behaviour. Saturation magnetization and magnetic anisotropy values were found to be the highest for the sample with x = 1.0, which also had the lowest coercivity among the prepared samples. Herein, the observed variations in the obtained results can be explained by the variations in grain sizes and the Fe2+/Fe3+ ratio associated with the preferential occupation of co-dopants at octahedral sites. Based on our findings, the BaFe11Ni1O19 (x = 1.0) composition appears to be the most promising choice as a microwave absorption material among the prepared samples owing to the coexistence of high dielectric permittivity (>103 at 107 Hz) and saturation magnetization (73 emu g-1).

Comparative evaluation of three materials used for fragment reattachment in uncomplicated crown fracture-An in vitro study using bovine teeth

BACKGROUND/AIMS

The recommended treatment for uncomplicated crown fractures is bonding the fractured fragment or the fragment reattachment. A paucity was identified regarding the studies comparing the efficacy of micro-hybrid and nanohybrid composites in fragment reattachment. Hence, the present study aimed to evaluate and compare three materials for bonding of fragments rehydrated by humidification in teeth with uncomplicated crown fractures.

MATERIAL AND METHODS

Eighty mandibular bovine incisors with similar dimensions and free of any structural deformities were fractured similar to the technique followed in previous studies. Fracture was simulated, fragments, and stumps were coded, stumps were stored in artificial saliva and the fragments were dehydrated at room temperature and pressure. They were randomly assigned to Group-1 (no rehydration), Group-2 (rehydrated and bonded by flowable nanohybrid composite-3M Filtek Supreme Syringe Flowable Composite Resin-A2, Sao Paulo, Brazil), Group-3 (rehydrated and bonded by flowable micro-hybrid composite- Ruby Flow, InciDental, England, United Kingdom), and Group-4 (rehydrated and bonded by light-cured Glass-Ionomer-Cement-Voco Ionoseal, Cuxhaven, Germany). The samples were subjected to a universal testing machine to evaluate the force required to fracture the bonded fragments.

RESULTS

The highest median value of the force required to fracture was recorded for Group 2 (208.4 N) followed by Group 3 (195.2). The force required to fracture the bonded fragments was lowest in Group 4 (67.2 N) which was lower than the negative control (131.4 N). The differences between the observations in Groups 2 and 3 were not found to be statistically significant.

CONCLUSION

The nano and micro-hybrid composites showed greater force required to fracture than fragments bonded by LC-GIC. Dehydrated fragments bonded using nanocomposites performed better than rehydrated fragments bonded by using LC-GIC.

Methods and applications of finite element analysis in dental trauma research: A scoping review

Finite Element Analysis (FEA) is vital for understanding dental traumatology (DT) biomechanics, aiding diagnosis, treatment planning, and outcome prediction. This review explores FEA applications in DT research, evaluates their quality and outcomes, and assesses methodological aspects. Accordingly, recommendations for future researchers are provided. The study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews and registered in Open Science framework. A comprehensive search using relevant text-words and MeSH terms was performed in established databases. The inclusion criteria encompassed all Finite element analysis (FEA)-based Dental traumatology (DT) studies without language or publication year restrictions. Risk of bias was assessed with the Risk of bias tool for the use of finite element analysis in dentistry (ROBFEAD) tool. Forty-six studies published from 2001 to 2023 were included in the qualitative synthesis. The studies were categorized into five domains and six subdomains based on objectives. Maxillary central incisors and surrounding structures were commonly modelled (n = 27). Most studies utilized Computed tomography (CT), Cone Beam CT, or micro CT. Traumatic injury forces ranged from 100 N to 2000 N, and occlusal forces ranged from 150 N to 350 N. All studies were rated as high risk of bias. Fory-six studies were categorized, with most focusing on stress distribution and fracture patterns in dento-alveolar structures under various conditions, while few assessed displacements. Methodological quality lacked robustness in model development and substructure properties. Future studies should address these limitations and enhance reporting practices.

Effect of wire diameter and extent of wire composite splint on the mobility of luxated and anchor primary teeth: A typodont study

BACKGROUND/AIMS

The recommendations for splinting are well established for the injuries of permanent dentition; however, ambiguity still exists for the injuries in primary dentition. Hence, this study aimed to determine the most appropriate dimensions of stainless steel wire and its extent, for achieving the physiologic mobility in primary dentition.

MATERIAL AND METHODS

This study was designed as an in vitro experiment by using a typodont model of primary dentition. The baseline mobility of primary maxillary incisors was calibrated to the physiologic mobility of natural primary incisors by using a Teflon tape wrapped around the roots of resin teeth. Splinting was done using a stainless steel wire of 0.2 mm (Group I), 0.3 mm (Group II), and 0.4 mm (Group III). These groups were subdivided (a, b, and c) on the basis of the extent of the splint, and pre splint mobility (Pre-PV) and post-splint mobility (Post-PV) were tested by Periotest M. The splint effect was calculated by subtracting Post-PVs and Pre-PVs.

RESULTS

The normal values of mobility in healthy human volunteers ranged from 10.5 to 13. The overall splint effect was higher in Group III irrespective of the extent of the splint, whereas it was found to be the lowest in Group I (b and c). The splint effect increased with the extent of the splint in all the groups. Among all the groups, the splint effect on the anchor teeth was observed to increase with the extent of the splint and the diameter of the wire.

CONCLUSION

The mobility of the injured and anchor teeth splinted with 0.2-mm stainless steel wire was similar to the pre-splint and physiologic mobility. The most favorable extension was one tooth adjacent to the injured tooth on each side for both 0.2- and 0.3-mm wires.

Quality analysis of the clinical practice guidelines for management of impacted maxillary central incisors: a systematic review

PURPOSE

To assess the quality of clinical practice guidelines (CPG) for management of impacted central incisors.

METHODS

Search was performed in PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane databases, and guideline-focused databases/repositories on 15-09-2022 without any limitations and was updated on 15-07-2023. Grey literature search was also performed. Two independent reviewers were involved in the study selection and data extraction. Quality assessment of the included CPG was performed by four independent appraisers using the AGREE-II instrument. The degree of agreement among the appraisers was calculated using the intraclass correlation coefficient (ICC).

RESULTS

Five CPG were included in the review. The Ministry of Health, Malaysia (MHM) guideline obtained the highest scores in all six domains of AGREE-II and an overall score of 73% demonstrating the "highest" quality. The remaining four guidelines obtained overall "low-quality" scores ranging from 34.57-37.52%. The ICC scores ranged from 0.530 to 0.990 for various domains of AGREE-II.

CONCLUSION

MHM guidelines demonstrated high-quality scores in domains of 'scope and purpose', 'clarity of presentation', 'applicability domain', and 'editorial independence', while others were found to have moderate or low quality. This review identified areas that can be addressed by future guideline developers to avoid these discrepancies.

Isolation and detection of bacterial species on mitis salivarius bacitracin agar from the plaque samples of caries active children

BACKGROUND

In cariology studies, mitis-salivarius-bacitracin (MSB) agar has been commonly considered as the selective medium for Streptococcusmutans growth. The present study was the part of a funded project (a noninferiority randomized controlled trial) which compared the efficacy of a plant extract-based mouth rinse with that of a fluoride mouth rinse on the S.mutans counts of the children.

AIM

This study aimed to identify the frequency of detection of S.mutans and nonstreptococcal bacterial species from the dental plaque of caries active children using a combined technique of anaerobic culture and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry.

SETTINGS AND METHODS

Caries-active children (8-12 years old) were enrolled from a pediatric dental outpatient department at a tertiary care hospital. From each participant, dental plaque samples were collected from carious surfaces under sterilized conditions and then subjected to anaerobic culture. After 48 h of incubation, the bacterial colonies were isolated by sub-culture and identified by the MALDI-TOF.

RESULTS

In all, 13 different bacterial species were isolated from the MSB agar medium. Other than S.mutans species, colonies of bacterial species such as Veillonelladispar,Streptococcusanginosus, Veillonellaparvula, and Streptococcusgordonii were also frequently observed from the medium.

CONCLUSIONS

The study concluded that several bacterial strains, both streptococcal and nonstreptococcal, could be isolated from the MSB agar medium; hence, this medium should no longer be considered selective medium for the culture of S.mutans in clinical and epidemiological studies.

Development and validation of risk of bias tool for the use of finite element analysis in dentistry (ROBFEAD)

There has been a systematic review of studies that used FEA in dental sciences, but no adequate risk of bias (RoB) analysis technique has been developed. Therefore, the development and validation process of RoB in studies using the finite element analysis in dentistry (ROBFEAD) tool is described. In the first phase of development, the scope of the tool and possible modifications were covered, and validation was done in the second phase. The developed tool comprised 6 domains and a total of 22 guiding questions in these domains. This article proposes the development and validation of ROBFEAD, a tool for measuring RoB in finite element research in dentistry.

Effect of 940 nm diode laser irradiation and dentin bonding agent on permeability of furcation area in primary molars

Purpose

Multiple accessory canals make furcation area of primary molars the most common port of entry of bacterial endotoxins to periradicular area. Reduction in permeability can improve prognosis of these teeth. Therefore, this study was designed to compare the effect of 940 nm diode laser and dentin bonding agent on the dye penetration of furcation area in primary molars.

Material and Methods

Thirty teeth were divided into three groups, that is, Group 1 (control group), Group 2 (dentin bonding agent applied over floor of pulp chamber), and Group 3 (diode laser irradiated over floor of pulp chamber). The samples were prepared and seven from each group were tested by dye penetration and three were sent for scanning electron microscopy. Rise in temperature in the perifurcal area was also recorded at the time of laser irradiation. Dunn's pair-wise comparison analysis was used for the analysis for the difference in dye penetration among the group.

Results

: The maximum rise in temperature recorded postirradiation was 6.90C. Dye penetration was significantly reduced in Group 2 Dentin bonding group (DBG) as compared to control group (P = 0.0025). Reduction in permeability was observed in Group 3 Laser group (LG) but this was not statistically significant (P = 0.197). Scanning electron microscope revealed open dentinal tubules in Group 1. There were no open dentinal tubules in Group 2, while Group 3 had sealed dentinal tubules with glass-like surface over the region.

Conclusion

Dentin bonding agent led to substantial decrease in dye penetration of furcation area of primary molars. This method should be evaluated clinically to improve successful pulpectomy procedures of primary molars.

Fabrication of La3+ doped Ba1-x La x TiO3 ceramics with improved dielectric and ferroelectric properties using a composite-hydroxide-mediated method

Lanthanum (La³⁺) doped Ba_1-x La _x TiO₃ (x = 0.0, 0.0025, 0.005, 0.0075) ceramics were synthesized by the composite-hydroxide-mediated method. Rietveld refinement of the XRD patterns confirmed the formation of a perovskite crystal structure that transforms from tetragonal to pseudo-cubic with La³⁺ doping content (x). Scanning electron microscopy displayed a dense and homogeneous microstructure with reduced grain size on La³⁺ doping. The frequency and temperature-dependent dielectric measurements showed an improvement in the dielectric permittivity, a decrease in the ferroelectric-paraelectric transition temperature, and an increase in the dielectric diffusivity with increasing La³⁺ doping content. Complex impedance analysis indicated the semiconducting behavior with a positive temperature coefficient of resistance effect, which could be explained in terms of a charge compensation mechanism in the donor doped BaTiO₃. The ferroelectric hysteresis loops revealed that these ceramics are ferroelectric in nature, while an improvement in the energy storage density and energy storage efficiency was observed for the doped samples due to reduced grain size on La³⁺ doping. Here, the sample with x = 0.005 has a high dielectric permittivity, a low dielectric tangent loss, and the highest energy storage efficiency. This makes this composition interesting for energy storage applications.

Long-term effects of chemotherapy and radiation received during early childhood on the developing dentition of pediatric cancer patients

INTRODUCTION

The short-term effects of chemotherapy and irradiation are well documented; however, there is paucity regarding their long-term effects, especially in children and adolescents.

CASE DESCRIPTION

This paper discusses the long-term effects of chemotherapy and/or radiation received by the patients during their early childhood on the developing dentition. It comprises the compilation of 11 cases with alteration in the dental development screened from 138 cases of the childhood cancer patients who received the chemotherapy and/or radiation as a part of anticancer therapy.

RESULTS AND CONCLUSION

The findings revealed that the age of initiation of anticancer therapy along with the synergistic effect of chemo-irradiation, and the dose of radiation used were the principal determinants for the dental abnormalities. The root-related abnormalities were found to be varied and more common as compared to the missing teeth and defects related to the tooth crown.

Essentially entropic lattice Boltzmann model: Theory and simulations

We present a detailed description of the essentially entropic lattice Boltzmann model. The entropic lattice Boltzmann model guarantees unconditional numerical stability by iteratively solving the nonlinear entropy evolution equation. In this paper we explain the construction of closed-form analytic solutions to this equation. We demonstrate that near equilibrium this analytic solution reduces to the standard lattice Boltzmann model. We consider a few test cases to show that the analytic solution does not exhibit any significant deviation from the iterative solution. We also extend the analytical solution for the Ellipsoidal Statistical (ES)-Bhatnagar-Gross-Krook model to remove the limitation on the Prandtl number for heat transfer problems. The simplicity of the analytic solution removes the computational overhead and algorithmic complexity associated with the entropic lattice Boltzmann models.

Unusual semiconductor-metal-semiconductor transitions in magnetite Fe3O4 nanoparticles

Magnetite (Fe₃O₄) nanoparticles were successfully prepared by a co-precipitation method. Rietveld refinement on the X-ray diffraction pattern confirmed the development of a single-phase cubic spinel structure with space group Fd3̄m. However, ⁵⁷Fe Mössbauer spectroscopy suggested the presence of Fe³⁺ and Fe^2.5+ (mixed Fe³⁺ and Fe²⁺) ions at the tetrahedral and octahedral sites of the inverse spinel structure, respectively. Impedance spectroscopy measurements showed a discontinues variation in the temperature dependence of the sample's resistive behavior, indicating the appearance of semiconductor–metal–semiconductor like transitions between the temperature range of 293 and 373 K. A similar dual transition was also observed from the dielectric and conductivity measurements around the same temperature regions. The observed unusual transition is explained in term of the competitive effects among the hopping of localized/delocalized and short-range/long-range charge carriers present in the sample. Moreover, the prepared sample exhibits colossal dielectric permittivity (∼10⁶), reduced tangent loss (∼0.2) and moderate conductivity (>10⁻⁶ S cm⁻¹) values, making Fe₃O₄ nanoparticles a potential candidate for electromagnetic absorbing materials.

Herein, we report the existence of a novel semiconductor–metal–semiconductor type transition in Fe₃O₄ nanoparticles by employing impedance spectroscopy techniques.

Reporting guidelines for in-silico studies using finite element analysis in medicine (RIFEM)

BACKGROUND

To the best of our knowledge, there are no reporting guidelines for design, conduct and reporting of Finite Element studies in health sciences. We intend to propose specific and detailed guidelines for reporting these studies.

METHOD

After recognizing the need to have uniform guidelines for reporting of finite element analysis in medicine and dentistry, a group of 5 researchers working on FEA as their research area met in the summer of 2020 and drafted the methodology for the development of such guidelines. Each researcher individually made a list of major headings required for reporting these studies and met again in September 2020 to finalize the domains. Subsequently, sub headings and details were charted. The draft list of items for reporting the guidelines were presented to a larger team of 15 experts and some changes were further made based on their inputs.

RESULTS

The guidelines entail seven major domains and their sub-domains, including parameters for model structure, segmentation, mesh structure, force application and model validation, etc. This checklist aims to improvise the reporting and consistency of FEA studies.

CONCLUSION

We hope that the usage and adoption of these guidelines by the scientific community would result in more thoughtful and uniform documentation. Also, the confidence in the results would be enhanced through model reproducibility, reusability and accountability. The proposed guidelines were named as 'Reporting of in-silico studies using finite element analysis in medicine' and the term 'RIFEM' was used as acronym.

Up-regulation of GINS1 highlighted a good diagnostic and prognostic potential of survival in three different subtypes of human cancer

Cancer is a fatal malignancy and its increasing worldwide prevalence demands the discovery of more sensitive and reliable molecular biomarkers. To investigate the GINS1 expression level and its prognostic value in distinct human cancers using a series of multi-layered in silico approach may help to establish it as a potential shared diagnostic and prognostic biomarker of different cancer subtypes. The GINS1 mRNA, protein expression, and promoter methylation were analyzed using UALCAN and Human Protein Atlas (HPA), while mRNA expression was further validated via GENT2. The potential prognostic values of GINS1 were evaluated through KM plotter. Then, cBioPortal was utilized to examine the GINS1-related genetic mutations and copy number variations (CNVs), while pathway enrichment analysis was performed using DAVID. Moreover, a correlational analysis between GINS1 expression and CD8+ T immune cells and a the construction of gene-drug interaction network was performed using TIMER, CDT, and Cytoscape. The GINS1 was found down-regulated in a single subtypes of human cancer while commonly up-regulated in 23 different other subtypes. The up-regulation of GINS1 was significantly correlated with the poor overall survival (OS) of Liver Hepatocellular Carcinoma (LIHC), Lung Adenocarcinoma (LUAD), and Kidney renal clear cell carcinoma (KIRC). The GINS1 was also found up-regulated in LIHC, LUAD, and KIRC patients of different clinicopathological features. Pathways enrichment analysis revealed the involvement of GINS1 in two diverse pathways, while few interesting correlations were also documented between GINS1 expression and its promoter methylation level, CD8+ T immune cells level, and CNVs. Moreover, we also predicted few drugs that could be used in the treatment of LIHC, LUAD, and KIRC by regulating the GINS1 expression. The expression profiling of GINS1 in the current study has suggested it a novel shared diagnostic and prognostic biomarker of LIHC, LUAD, and KIRC.

Automated image classification of chest X-rays of COVID-19 using deep transfer learning

INTRODUCTION

In December 2019, the city of Wuhan, located in the Hubei province of China became the epicentre of an outbreak of a pandemic called COVID-19 by the World Health Organisation. The detection of this virus by rRTPCR (Real-Time Reverse Transcription-Polymerase Chain Reaction) tests reported high false negative rate. The manifestations of CXR (Chest X-Ray) images contained salient features of the virus. The objective of this paper is to establish the application of an early automated screening model that uses low computational power coupled with raw radiology images to assist the physicians and radiologists in the early detection and isolation of potential positive COVID-19 patients, to stop the rapid spread of the virus in vulnerable countries with limited hospital capacities and low doctor to patient ratio in order to prevent the escalating death rates.

MATERIALS AND METHODS

Our database consists of 447 and 447 CXR images of COVID-19 and Nofindings respectively, a total of 894 CXR images. They were then divided into 4 parts namely training, validation, testing and local/Aligarh dataset. The 4th (local/Aligarh) folder of the dataset was created to retest the diagnostics efficacy of our model on a developing nation such as India (Images from J.N.M.C., Aligarh, Uttar Pradesh, India). We used an Artificial Intelligence technique called CNN (Convolutional Neural Network). The architecture based on CNN used was MobileNet. MobileNet makes it faster than the ordinary convolutional model, while substantially decreasing the computational cost.

RESULTS

The experimental results of our model show an accuracy of 96.33%. The F1-score is 93% and 96% for the 1st testing and 2nd testing (local/Aligarh) datasets (Tables 3.3 and 3.4). The false negative (FN) value, for the validation dataset is 6 (Fig. 3.6), for the testing dataset is 0 (Fig. 3.7) and that for the local/Aligarh dataset is 2 . The recall/sensitivity of the classifier is 93% and 96% for the 1st testing and 2nd testing (local/Aligarh) datasets (Tables 3.3 and 3.4). The recall/sensitivity for the detection of specifically COVID-19 (+) for the testing dataset is 88% and for the locally acquired dataset from India is 100%. The False Negative Rate (FNR) is 12% for the testing dataset and 0% for the locally acquired dataset (local/Aligarh). The execution time for the model to predict the input images and classify them is less than 0.1 s.

DISCUSSION AND CONCLUSION

The false negative rate is much lower than the standard rRT-PCR tests and even 0% on the locally acquired dataset. This suggests that the established model with end-to-end structure and deep learning technique can be employed to assist radiologists in validating their initial screenings of Chest X-Ray images of COVID-19 in developed and developing nations. Further research is needed to test the model to make it more robust, employ it on multiclass classification and also try sensitise it to identify new strains of COVID-19. This model might help cultivate tele-radiology.

A novel mathematical model for COVID-19 with remedial strategies

Coronavirus (COVID-19) outbreak from Wuhan, Hubei province in China and spread out all over the World. In this work, a new mathematical model is proposed. The model consists the system of ODEs. The developed model describes the transmission pathways by employing non constant transmission rates with respect to the conditions of environment and epidemiology. There are many mathematical models purposed by many scientists. In this model, "α E " and "α I ", transmission coefficients of the exposed cases to susceptible and infectious cases to susceptible respectively, are included. " δ " as a governmental action and restriction against the spread of coronavirus is also introduced. The RK method of order four (RK4) is employed to solve the model equations. The results are presented for four countries i.e., Pakistan, Italy, Japan, and Spain etc. The parametric study is also performed to validate the proposed model.

Mathematical modeling and experimental analysis of the efficacy of photodynamic therapy in conjunction with photo thermal therapy and PEG-coated Au-doped TiO2 nanostructures to target MCF-7 cancerous cells

Some nanoscale morphologies of titanium oxide nanostructures blend with gold nanoparticles and act as satellites and targeted weapon methodologies in biomedical applications. Simultaneously, titanium oxide can play an important role when combined with gold after blending with polyethylene glycol (PEG). Our experimental approach is novel with respect to the plasmonic role of metal nanoparticles as an efficient PDT drug. The current experimental strategy floats the comprehensive and facile way of experimental strategy on the critical influence that titanium with gold nanoparticles used as novel photosensitizing agents after significant biodistribution of proposed nanostructures toward targeted site. In addition, different morphologies of PEG-coated Au-doped titanium nanostructures were shown to provide various therapeutic effects due to a wide range of electromagnetic field development. This confirms a significantly amplified population of hot electron generation adjacent to the interface between Au and TiO₂ nanostructures, leading to maximum cancerous cell injury in the MCF-7 cell line. The experimental results were confirmed by applying a least squares fit math model which verified our results with 99% goodness of fit. These results can pave the way for comprehensive rational designs for satisfactory response of performance phototherapeutic model mechanisms along with new horizons of photothermal therapy (HET) and photodynamic therapy (HET) operating under visible and near-infrared (NIR) light.

Effect of inciso-cervical position of wire-composite splint on the mobility of an avulsed permanent tooth: A cadaveric model study

Introduction

The wire composite splint as a general rule is placed on the middle third of labial surface of the tooth. This is due to ease of application, better isolation, and fewer chances of contamination. However, these assumptions are opinion-based, with no scientific evidence to support them. In addition, to best of our knowledge no research has been carried out to evaluate the effect of position of wire splints on the mobility of the affected tooth and anchor teeth.

Aim

The aim of this study was to evaluate the effect of the cervico-incisal position of splinting wire on the mobility of a replanted tooth and anchor teeth in a cadaveric model.

Methodology

Three cadavers (one female, 45 years old and two males, each 40 years old) were included in the study. periotest S was used to assess physiologic-tooth-mobility in three cadavers at baseline and after "extraction-replantation-wire-composite" splinting-protocol.

Results

Greatest splint effect for horizontal-mobility was found to be 9.33 ± 0.57 for Cadaver-I (incisal-third), whereas it was highest (3.66 ± 2.51) for vertical-mobility in Cadaver-II (cervical third).

Conclusion

Middle third position of wire composite splint have lowest splint effect on both horizontal and vertical mobility of replanted teeth, thus rendering the most favorable position for the establishment of physiologic mobility.

Manganese-doped cerium oxide nanocomposite as a therapeutic agent for MCF-7 adenocarcinoma cell line

The preparation of a manganese-doped cerium oxide (Mn:CeO₂) nanocomposite via hydrothermal route is described. Cubic fluorite structure of single phase was exhibited by studying structural analysis through x-ray diffraction (XRD) technique and morphological analysis was conducted by scanning electron microscope. Surface analytic technique of energy dispersive x-ray spectroscopy (EDX) was conducted to analyze the relative amount of any impurity and doping. Structural changes due to manganese doping such as increment in production of vacancies of oxygen within crystal of cerium oxide, and reduction in size of crystallite and constant of lattice was observed in our research study. Moreover, the Mn:CeO₂ nanocomposite demonstrates differential cytotoxicity against MCF-7 adenocarcinoma cell line, which renders it a promising candidate for targeted cancer therapy. The anti-tumorous activity of the cerium oxide nanocomposite was significantly enhanced with doping of manganese, which is directly linked with the generation of highly reactive oxygen facets. The experimental results are supported by a mathematical model that confirms a confidence level of 95%. This research has paved the way for many utilities in therapeutics and magnetic resonance imaging diagnostics through new observations, and hence verified their math model.

Synergistic effect of TEMPO-coated TiO2 nanorods for PDT applications in MCF-7 cell line model

This study focuses on the synthesis, characterization, and assessment of the synergistic effect of 2,2,6,6, tetramethylpiperidine-N-oxyl (TEMPO)-coated titanium dioxide nanorods (TiO2 NRs) for photodynamic therapy (PDT). Firstly, TiO2 NRs were synthesized by the sol-gel technique. Then, TEMPO was grafted on TiO2 NRs with the aid of oxoammonium salts. Next, the final product was characterized by applying manifold characterization techniques. X-ray diffraction was used to perform crystallographic analysis; transmission electron microscopy (TEM) was used to conduct morphological analysis; Fourier transform infrared (FTIR) and Raman spectra were recorded to perform molecular fingerprint analysis. Furthermore, experimental and empirical modeling was performed to confirm the suitability of as-prepared samples for PDT applications using (MCF-7 cell line) Human Breast Cancer cell line. Our results revealed that bare TiO2 NRs did not exhibit a significant response for therapeutic applications compared to TEMPO-conjugated TiO2 NRs in the dark; however, they exhibited a prominent response for the PDT application under UV-A light. Therefore, it is concluded that TEMPO-coated TiO2 NRs shows the synergistic response for therapeutic approach under UV-A light irradiation. In addition, TEMPO capped TiO2 nanorods not only overcome the multidrug resistance (MDR) hindrance but also exhibit excellent response for cancer cell (MCF-7 cells) treatment only under UV light irradiation via PDT. It is expected that the proposed TiO2 NRs + TEMPO nanocomposite, which is suitable for PDT treatment, may be essential for photodynamic therapy.

Global status of knowledge for prevention and emergency management of traumatic dental injuries in sports persons and coaches: A systematic review

BACKGROUND/AIMS

Sports-related dental injuries can cause pain, disfigurement, and broken teeth which may affect the athlete's well-being and psychological status. Such injuries may also lead to the fear of re-injury and other problems. Since a delay in adequate emergency treatment can have adverse effects, it is imperative that athletes and coaches have sufficient awareness of emergency treatment options. Hence, the aim of this systematic review was to evaluate the global status of knowledge among athletes and coaches regarding the prevention and emergency management of traumatic dental injuries.

METHODS

The protocol was designed using the PRISMA guidelines and registered in PROSPERO (CRD42020184956). A broad-based search using text words and MeSH terms was performed in established databases according to a predefined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity, and reliability were excluded. Data extraction was performed and risk-of-bias assessment was done by means of the Joanna Briggs Institute's critical appraisal tool.

RESULTS

Nine studies published between 2005 and 2020 were included for qualitative synthesis. They were primarily from Asia with none from North America and Australia. Most of them were cross-sectional, used convenience sampling, and were interview-based. Less than 10% of the participants in two studies had adequate knowledge of the immediate emergency management of tooth avulsion, while only 2.4% of basketball players and coaches knew that it was necessary to collect the avulsed tooth or broken tooth fragments. The overall level of knowledge was reported as poor or insufficient in all studies, with moderate or high risk-of-bias in six studies.

CONCLUSION

The knowledge regarding emergency management of TDI was found to be low globally. Along with the choice of the sport, there was a high level of variability in the study design and sampling characteristics.

An experimental and algorithm-based study of the spectral features of breast cancer patients by a photodiagnosis approach

In the present study, the spectral diagnosis of blood plasma samples of breast cancer patients and an equal number of normal controls was investigated. A set of ratio parameters was acquired by employing SXS and FES. The samples were also analyzed statistically by employing Welch two-sample t-tests, and the effects of three ratio parameters, R₁, R₂, and R₃, were also studied by plotting them against the subject numbers. A linear discriminant was also applied to verify the exact classification of normal control and breast cancer patients. It was observed that the levels of biofluorophores such as porphyrin, NADH, tryptophan and flavins were elevated 2- to 3-fold for breast cancer patients compared to normal controls, with an accuracy of approximately 100 %. We have also confirmed the validity of the obtained experimental results by using an advanced robust diagnostic algorithm. The experimental results of the current study may have a vital and substantial impact on the detection and screening protocols used for future breast cancer patients. The spectral analysis of body fluid could be of great value to add to and enhance the current procedures with an accuracy of approximately 100 % with limited number of samples. The results and objectives of this preliminary study were encouraging and useful for the discrimination of the features of breast cancer patients compared to those of normal controls.

Correction: Iqbal, S. et al. Empirical Modeling of Zn/ZnO Nanoparticles Decorated/Conjugated with Fotolon (Chlorine e6) Based Photodynamic Therapy towards Liver Cancer Treatment. Micromachines, 2019, 10, 60

In the published paper [...].

Lattice Boltzmann model for weakly compressible flows

We present an energy conserving lattice Boltzmann model based on a crystallographic lattice for simulation of weakly compressible flows. The theoretical requirements and the methodology to construct such a model are discussed. We demonstrate that the model recovers the isentropic sound speed in addition to the effects of viscous heating and heat flux dynamics. Several test cases for acoustics and thermal and thermoacoustic flows are simulated to show the accuracy of the proposed model.

Effect of ZnO Nanoparticles Coating Layers on Top of ZnO Nanowires for Morphological, Optical, and Photovoltaic Properties of Dye-Sensitized Solar Cells

This paper reports on the synthesis of ZnO nanowires (NWs), as well asthe compound nanostructures of nanoparticles (NPs) and nanowires (NWs+NPs) with different coating layers of NPs on the top of NWs and their integration in dye-sensitized solar cells (DSSCs). In compound nanostructures, NWs offer direct electrical pathways for fast electron transfer, and the NPs of ZnOdispread and fill the interstices between the NWs of ZnO, offering a huge surface area for enough dye anchoring and promoting light harvesting. A significant photocurrent density of 2.64 mA/cm² and energy conversion efficiency of 1.43% was obtained with NWs-based DSSCs. The total solar-to-electric energy conversion efficiency of the NWs+a single layer of NPs was found to be 2.28%, with a short-circuit photocurrent density (J_SC) of 3.02 mA/cm², open-circuit voltage (V_OC) of 0.74 V, and a fill factor (FF) of 0.76, which is 60% higher than that of NWs cells and over 165% higher than NWs+a triple layer of NPs-based DSSCs. The improved performance was obtained due to the increased specific surface area for higher dye anchoring and light harvesting of compound nanostructures with NWs+a single layer of NPs.

Use of intraarticular injections of platelet-rich plasma in the treatment of knee osteoarthritis: A review article

Osteoarthritis is one of the most common degenerative conditions affecting knee joint. As our understanding in the disease pathogenesis is evolving, so do the treatment modalities. One of the postulated mechanisms suggests the production of inflammatory cytokines secondary to repeated micro trauma than in turn lead to cartilage damage overtime. Cartilage being avascular structure has limited potential for repair. Based on this, recent studies have been focusing on stimulating cartilage-healing process by growth factors. This is where platelet-rich plasma comes in to light. Literature is showing promising results of platelet-rich plasma in treating knee osteoarthritis. In this review we have discussed the preparation, composition, classification, uses of platelet-rich plasma as well as evidence for its efficacy and complications.

Does surgical approach affect outcome after fixation of intra-articular fractures of distal humerus? Retrospective cohort study from a level-1 trauma centre in a metropolitan city

Introduction

Fractures around the distal humerus fractures make up to 2% of all fractures. Complex intra-articular distal humerus fractures present as challenge to restore of painless, stable and mobile elbow joint. Surgical exposure to all critical structures is of paramount importance to achieve anatomic reduction. Conflict still persists regarding the choice of ideal approach. In this study we compare the effect of surgical approach triceps lifting vs olecranon osteotomy on the functional outcome after fixation of distal humerus fractures.

Methods

Non-funded, non-commercial, retrospective cohort study was conducted on patients with closed distal humerus intra-articular fractures between 2010 and 2015 at our tertiary care level-1 trauma and university hospital. Patients >18 years of age with closed complex intra-articular distal humerus fracture were operated using one of the two surgical approaches, either triceps lifting approach (Group1) or with olecranon osteotomy (Group 2). Functional evaluation using quick DASH scores at 1 year of follow-up. Study is registered with ID:NCT03833414 and work has been reported in line with the STROCSS criteria.

Results

Out of 43 patients 16 were treated with triceps lifting approach and 27 with olecranon osteotomy. The difference between the mean quick DASH score for both groups was not statistically significant (p = 0.52) although higher for group 1. Complications were comparable for both groups but 2 patients suffered delayed union of osteotomy site in group 2.

Conclusion

Triceps lifting approach can be used equally efficiently for exposure of these complex distal humerus injuries with no comprise in visibility of articular fragments.

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Complex intra-articular distal humerus fractures present as challenge to restore of painless, stable and mobile elbow joint.

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Surgical exposure to all critical structures is of paramount importance to achieve anatomic reduction.

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For long time, olecranon osteotomy approach was utilized to provide clear access to the joint.

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This is at the cost of creating osteotomy and the risk of its delayed/nonunion.

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Triceps lifting approach avoids this catastrophic complication.

The role of FOXP3+ regulatory T cells in human autoimmune and inflammatory diseases

CD4⁺ regulatory T cells (T_reg ) expressing the forkhead box protein 3 (FOXP3) transcription factor (T_regs ) are instrumental for the prevention of autoimmune diseases. There is increasing evidence that the human T regulatory population is highly heterogeneous in phenotype and function. Numerous studies conducted in human autoimmune diseases have shown that T_reg cells are impaired either in their suppressive function, in number, or both. However, the contribution of the FOXP3⁺ T_reg subpopulations to the development of autoimmunity has not been delineated in detail. Rare genetic disorders that involve deficits in T_reg function can be studied to develop a global idea of the impact of partial or complete deficiency in a specific molecular mechanism involved in T_reg function. In patients with reduced T_reg numbers (but no functional deficiency), the expansion of autologous T_reg cells could be a suitable therapeutic approach: either infusion of in-vitro autologous expanded cells, infusion of interleukin (IL)-2/anti-IL-2 complex, or both. T_reg biology-based therapies may not be suitable in patients with deficits of T_reg function, unless their deficit can be corrected in vivo/in vitro. Finally, it is critical to consider the appropriate stage of autoimmune diseases at which administration of T_reg cellular therapy can be most effective. We discuss conflicting data regarding whether T_reg cells are more effectual at preventing the initiation of autoimmunity, ameliorating disease progression or curing autoimmunity itself.

Empirical Modeling of Zn/ZnO Nanoparticles Decorated/Conjugated with Fotolon (Chlorine e6) Based Photodynamic Therapy towards Liver Cancer Treatment

The current study is based on Zn/ZnO nanoparticles photodynamic therapy (PDT) mediated effects on healthy liver cells and cancerous cells. The synthesis of Zn/ZnO nanoparticles was accomplished using chemical and hydrothermal methods. The characterization of the synthesized nanoparticles was carried out using manifold techniques (e.g., transmission electron microscopy (TEM), X-ray diffraction (XRD), and energy dispersive X-ray spectroscopy (EDS)). In order to study the biotoxicity of the grown nanoparticles, they were applied individually and in conjunction with the third generation photosensitiser Fotolon (Chlorine e6) in the in vivo model of the normal liver of the Wister rat, and in the in vitro cancerous liver (HepG2) model both in the dark and under a variety of laser exposures (630 nm, Ultraviolet (UV) light). The localization of ZnO nanoparticles was observed by applying fluorescence spectroscopy on a 1 cm² selected area of normal liver, whereas the in vitro cytotoxicity and reactive oxygen species (ROS) detection were carried out by calculating the loss in the cell viability of the hepatocellular model by applying a neutral red assay (NRA). Furthermore, a statistical analysis is carried out and it is ensured that the p value is less than 0.05. Thus, the current study has highlighted the potential for applying Zn/ZnO nanoparticles in photodynamic therapy that would lead to wider medical applications to improve the efficiency of cancer treatment and its biological aspect study.

In vitro evaluation of the toxic effects of MgO nanostructure in Hela cell line

MgO is an attractive choice for carcinogenic cell destruction in photodynamic therapy, as confirmed by manifold analysis. The prime focus of the presented research is to investigate the toxicity caused by morphologically different MgO nanostructures obtained by annealing at various annealing temperatures. Smart (stimuli-responsive) MgO nanomaterials are a very promising class of nanomaterials, and their properties can be controlled by altering their size, morphology, or other relevant characteristics. The samples investigated here were grown by the co-precipitation technique. Toxicity-dependent parameters were assessed in a HeLa cell model after annealing the grown samples at 350 °C, 450 °C, and 550 °C. After the overall characterization, an analysis of toxicity caused by changes in the MgO nanostructure morphology was tested in a HeLa cell model using a neutral red assay and microscopy. The feasibility of using MgO for PDT was assessed. Empirical modelling was applied to corroborate the experimental results obtained from assessing cell viability losses and reactive oxygen species. The results indicate that MgO is an excellent candidate material for medical applications and could be utilized for its potential ability to upgrade conventionally used techniques.

A modified artificial neural network based prediction technique for tropospheric radio refractivity

Radio refractivity plays a significant role in the development and design of radio systems for attaining the best level of performance. Refractivity in the troposphere is one of the features affecting electromagnetic waves, and hence the communication system interrupts. In this work, a modified artificial neural network (ANN) based model is applied to predict the refractivity. The suggested ANN model comprises three modules: the data preparation module, the feature selection module, and the forecast module. The first module applies pre-processing to make the data compatible for the feature selection module. The second module discards irrelevant and redundant data from the input set. The third module uses ANN for prediction. The ANN model applies a sigmoid activation function and a multi-variate auto regressive model to update the weights during the training process. In this work, the refractivity is predicted and estimated based on ten years (2002–2011) of meteorological data, such as the temperature, pressure, and humidity, obtained from the Pakistan Meteorological Department (PMD), Islamabad. The refractivity is estimated using the method suggested by the International Telecommunication Union (ITU). The refractivity is predicted for the year 2012 using the database of the previous ten years, with the help of ANN. The ANN model is implemented in MATLAB. Next, the estimated and predicted refractivity levels are validated against each other. The predicted and actual values (PMD data) of the atmospheric parameters agree with each other well, and demonstrate the accuracy of the proposed ANN method. It was further found that all parameters have a strong relationship with refractivity, in particular the temperature and humidity. The refractivity values are higher during the rainy season owing to a strong association with the relative humidity. Therefore, it is important to properly cater the signal communication system during hot and humid weather. Based on the results, the proposed ANN method can be used to develop a refractivity database, which is highly important in a radio communication system.

Essentially Entropic Lattice Boltzmann Model

The entropic lattice Boltzmann model (ELBM), a discrete space-time kinetic theory for hydrodynamics, ensures nonlinear stability via the discrete time version of the second law of thermodynamics (the H theorem). Compliance with the H theorem is numerically enforced in this methodology and involves a search for the maximal discrete path length corresponding to the zero dissipation state by iteratively solving a nonlinear equation. We demonstrate that an exact solution for the path length can be obtained by assuming a natural criterion of negative entropy change, thereby reducing the problem to solving an inequality. This inequality is solved by creating a new framework for construction of Padé approximants via quadrature on appropriate convex function. This exact solution also resolves the issue of indeterminacy in case of nonexistence of the entropic involution step. Since our formulation is devoid of complex mathematical library functions, the computational cost is drastically reduced. To illustrate this, we have simulated a model setup of flow over the NACA-0012 airfoil at a Reynolds number of 2.88×10^{6}.

Defining pharmacy and its practice: a conceptual model for an international audience

Background

There is much fragmentation and little consensus in the use of descriptors for the different disciplines that make up the pharmacy sector. Globalization, reprofessionalization and the influx of other disciplines means there is a requirement for a greater degree of standardization. This has not been well addressed in the pharmacy practice research and education literature.

Objectives

To identify and define the various subdisciplines of the pharmacy sector and integrate them into an internationally relevant conceptual model based on narrative synthesis of the literature.

Methods

A literature review was undertaken to understand the fragmentation in dialogue surrounding definitions relating to concepts and practices in the context of the pharmacy sector. From a synthesis of this literature, the need for this model was justified. Key assumptions of the model were identified, and an organic process of development took place with the three authors engaging in a process of sense-making to theorize the model.

Results

The model is “fit for purpose” across multiple countries and includes two components making up the umbrella term “pharmaceutical practice”. The first component is the four conceptual dimensions, which outline the disciplines including social and administrative sciences, community pharmacy, clinical pharmacy and pharmaceutical sciences. The second component of the model describes the “acts of practice”: teaching, research and professional advocacy; service and academic enterprise.

Conclusions

This model aims to expose issues relating to defining pharmacy and its practice and to create dialogue. No model is perfect, but there are implications for what is posited in the areas of policy, education and practice and future research. The main point is the need for increased clarity, or at least beginning the discussion to increase the clarity of definition and consistency of meaning in-and-across the pharmacy sector locally, nationally and internationally.

Empirical Modeling of Physiochemical Immune Response of Multilayer Zinc Oxide Nanomaterials under UV Exposure to Melanoma and Foreskin Fibroblasts

Carcinogenesis is a complex molecular process starting with genetic and epigenetic alterations, mutation stimulation, and DNA modification, which leads to proteomic adaptation ending with an uncontrolled proliferation mechanism. The current research focused on the empirical modelling of the physiological response of human melanoma cells (FM55P) and human foreskin fibroblasts cells (AG01518) to the multilayer zinc oxide (ZnO) nanomaterials under UV-A exposure. To validate this experimental scheme, multilayer ZnO nanomaterials were grown on a femtotip silver capillary and conjugated with protoporphyrin IX (PpIX). Furthermore, PpIX-conjugated ZnO nanomaterials grown on the probe were inserted into human melanoma (FM55P) and foreskin fibroblasts cells (AG01518) under UV-A light exposure. Interestingly, significant cell necrosis was observed because of a loss in mitochondrial membrane potential just after insertion of the femtotip tool. Intense reactive oxygen species (ROS) fluorescence was observed after exposure to the ZnO NWs conjugated with PpIX femtotip model under UV exposure. Results were verified by applying several experimental techniques, e.g., ROS detection, MTT assay, and fluorescence spectroscopy. The present work reports experimental modelling of cell necrosis in normal human skin as well as a cancerous tissue. These obtained results pave the way for a more rational strategy for biomedical and clinical applications.