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Preliminary Neurocognitive Finding From A Multi-Site Study Investing Long-Term Neurological Impact Of Covid-19 Using Ultra-High Field 7 Tesla Mri-Based Neuroimaging, Jonika D. Tannous, Farhaan S. Vahidy, Riddhi Patira, Alison M. Luckey, Mitzi M. Gonzales, Akram A. Hosseini, Timothy D. Girard, Tamer Ibrahim, Heidi I.L. Jacobs, Valentina R. Garbarino

School of Medicine Publications

Background: Globally, over six hundred million cases of SARS-CoV-2 have been confirmed. As the number of individuals in recovery rises, examining long-term neurological effects, including cognitive impairment and cerebral microstructural and microvascular changes, has become paramount., We present preliminary cognitive findings from an ongoing multi-site study investigating the long-term neurological impacts of COVID-19 using 7 Tesla MRI-based neuroimaging.

Methods: Across 3 US and 1 UK sites, we identified adult (>=18) COVID-19 survivors (CS) and healthy controls (HC) without significant pre-existing medical, neurological, or psychiatric illness. Using the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS-3) battery …

Poor Cognition Is Associated With Increased Abundance Of Alistipes And Decreased Abundance Of Clostridium Genera In The Gut, Jazmyn A. Muhammad, Yannick Joel Wadop Ngouongo, Sophia Ramirez, Tiffany F. Kautz, Claudia L. L. Satizabal, Jayandra Jung Himali, Sudha Seshadri, Bernard Fongang

School of Medicine Publications

Background: Brain and gut health are intricately connected via the gut-microbiota-brain axis. Studies have shown that gut dysbiosis is associated with neurodegenerative diseases, including Alzheimer’s disease. However, how cognitive changes affects the gut microbiome structure is currently understudied. We aimed to assess the association between the gut microbiome and global cognitive scores in the Framingham Heart Study (FHS).

Method: Our sample included 1,014 participants (mean age 52, 55% female) of the third generation FHS cohort with available stool samples, cognitive assessments, and no history of dementia or stroke (Table 1).We quantified the gut microbiome composition using 16S rRNA …

Exploration Of The Tumorigenic, Metabolic, And Cognitive Consequences Of Tau Protein Removal, Jennifer M. Erichsen, Valentina R. Garbarino, Anna Rodriguez, Jillian K. Lee, Justin C. Shayne, Timothy C. Orr, Miranda E. Orr

School of Medicine Publications

Background: Tau accumulation causes tauopathies and drives cellular senescence, which can lead to inflammation, neurodegeneration, and cognitive impairment. The association between intracellular tau deposition and pathogenesis has prompted therapeutic strategies that reduce tau expression. However, tau is also critical in microtubule stabilization, synaptic plasticity, and maintaining DNA integrity. We investigated the impact of tau removal on brain cell senescence and associated neurocognitive behaviors in aged tau knockout (Mapt^0/0) and wild type control (Mapt^+/+) mice. We also assessed physical, metabolic, histological, and biochemical outcomes in Mapt^0/0 and Mapt^+/+ mice and in response to …

Zirconia Implants: A Mapping Review, Steven J. Sadowsky

Pacific Faculty Work

The advent of zirconia ceramics with excellent mechanical, biomechanical, and optical properties has made them attractive metal-free substitutes for titanium implants. Both animal and human studies have documented shortcomings with titanium implants. A mapping review of the current literature on three iterations of zirconia implant designs has been challenging due to heterogeneous success data and limited follow-up. Zirconia implants hold promise for a new generation of dental implants, but technical developments are needed for design and material enhancements that will need to be validated by long-term rigorous studies.

Late-Onset Stiff-Person Syndrome: Challenges In Diagnosis And Management, Marinos Dalakas, Jessica Yi

Department of Neurology Faculty Papers

BACKGROUND: Stiff person syndrome (SPS) is a rare slowly progressive autoimmune neuronal hyperexcitability disease with very-high GAD-65 antibody titers that most commonly presents above the age of 20, with muscle stiffness, painful muscle spasms, slow gait, and falls leading to disability. In other autoimmune disorders, late-onset disease has different symptom-spectrum and outcomes, but there is no information regarding late-onset SPS (LOSPS).

OBJECTIVE: Highlight delayed diagnosis and poor tolerance or incomplete response to therapies of patients with LOSPS and outline how best to increase disease awareness early at onset.

DESIGN A RETROSPECTIVE CHART REVIEWMETHODS: We reviewed GAD-positive SPS patients with symptom …

Advances In Research On Active Faults And Exploration Of Relevant Frontier Scientific Problems, Xu Xiwei, Li Feng, Cheng Jia, Liu Baojin, Chen Guihua, Li Kang, Ren Junjie, Jia Qichao

Coal Geology & Exploration

This study reviewed the approval and initiation processes and major research contents of China's active fault-related projects, such as the urban active fault survey projects, large-scale mapping programs of active faults, and the earthquake hazard assessment of active faults in key earthquake monitoring and prevention areas. By combining the scientific investigation results of the surface rupture zones induced by strong earthquakes over the past 20 years, this study elaborated on significant advances achieved in the following aspects: the survey and positioning techniques for concealed active faults under strong-noise and weak-signal conditions, the quantitative identification techniques for fault activity, theories and …

Application Of High-Precision Lidar Technology In Research On Active Fault-Induced Offset Geomorphic Features - A Case Study Of The Juxian-Tancheng Segment Of The Yishu Fault Zone, Yang Bin, Wang Hualin, Wu Hongbin, Ge Fugang, Zou Hao, Su Sili

Coal Geology & Exploration

The Tancheng-Lujiang fault zone (also referred to as the TanLu fault zone), one of the most significant large-scale active faults in eastern China, has great seismogenic potential while passing through several cities with the activities and accumulation of human beings. To investigate the geometric distribution and activity characteristics of the TanLu fault zone, this study focused on the Juxian-Tancheng segment of the Yishu fault zone—a part of the TanLu fault zone. Given the vegetation coverage in eastern China, airborne light detection and ranging (LiDAR) and terrestrial laser scanning were employed to collect high-precision topographic data of the Zuoshan (Yibujian), Zhonghuashan, …

Table Of Contents, The Editors

Coal Geology & Exploration

No abstract provided.

Optimization Of Data Acquisition Parameters For Deep Seismic Reflection Surveys In Complex Terrain, Yan Yunxiang, Li Pei, Zhi Min, Liu Jianda, Wang Zichen, Zhang Ying, Pei Gendi, Li Linyuan, Mou Qi, Jia Jin

Coal Geology & Exploration

Fujian, located in the orogen region of the coastal areas of southeast China, exhibits well-developed structures and complex surface conditions, which make deep seismic reflection surveys challenging. In response to the diversity and complexity of seismogeological conditions in Fujian, this study optimized the seismic excitation means based on previous deep seismic surveys. Specifically, the combination of large, medium, and small guns was transitioned into the layout of normal guns (spacing of shot points: 600 m) and large shots (spacing of shot points: 15 km), leading to enhanced folds of large shots. Through simulation analysis, this study calculated the spacing of …

Mechanical Behavior And Failure Response Characteristics Of Hard Sandstones Considering Bedding Dip Angles, Song Zhanping, Liu Hongke, Zheng Fang, Cheng Yun, Sun Yinhao, Song Wanxue

Coal Geology & Exploration

This study focuses on the mechanical behavior and failure responses of hard sandstones considering bedding dip angles. Through uniaxial compression tests of hard sandstones with different bedding dip angles, this study delved into the influence of bedding dip angles on the mechanical behavior of hard sandstones and the relationship between the bedding dip angles and fractal characteristics of hard sandstone fragments. The test results show that bedding dip angles produced negligible effects on the type of the stress-strain curves of hard sandstones. However, low dip angles (0°, 22.5°, and 45°) corresponded to unimodal curves, while high dip angles (67.5° and …

Coal-Based Solid Waste From The Panyi Mine In The Huainan Mining Area: Fine-Scale Chemical Structure And Ecological Risk Assessment Of Heavy Metals, Yin Wenwen, Zhang Liqun, Ding Dan, Shan Shifeng, Chen Yongchun, An Shikai, Zheng Liugen

Coal Geology & Exploration

The utilization of clean coal-based solid waste is a pressing issue in the ecological construction of mining areas. To address this issue, the key is to ascertain the structures and morphology of heavy metals in coal-based solid waste. This study investigated the coal gangue and fly ash samples from the Panyi Mine in the Huainan mining area, Anhui Province. First, this study characterized the coal-based solid waste using microanalysis methods, such as X-ray fluorescence spectrometry (XRF), X-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier transform infrared spectroscopy (FTIR). Then, it examined the fine-scale chemical structure and heavy metal dissemination …

Current States , Prediction And Prevention Suggestions For Water Hazard Accidents In China’S Coal Mines, Sun Wenjie, Li Wenjie, Ning Dianyan, Ren Lingfeng

Coal Geology & Exploration

At present, the pattern of coal resource development in China has changed, but the water hazard accidents that restrict the safety production of coal mine still occur from time to time. In order to explore the characteristics and laws of water hazard accidents in coal mines in China and scientifically study and judge the evolution trend of water hazard accidents, study was performed in terms of the year, region, accident level and influencing factors of water hazard accidents, with the nationwide water hazard accidents from 2001 to 2022 as the statistical objects. Meanwhile, the Long Short-Term Memory (LSTM) model was …

Critical Links And Development Trends Of Research On Active Tectonics, Yuan Daoyang, Wang Youlin, Li Shuwu, Wang Wanhe, Li Linyuan, Zou Xiaobo, Wen Yameng

Coal Geology & Exploration

Following a brief introduction of the general characteristics of active tectonics in China, this study analyzed two new features of large earthquakes with M_s ≥ 7 that have struck continental China since the beginning of the 21st century: (1) Large earthquakes occur primarily in clusters along the boundary fault zone of the Bayanhar active tectonic block—part of the Qinghai-Tibet ateau active tectonic block. (2) Reverse fault-fold earthquakes have occurred multiple times within active basins or at basin-mountain boundaries. In response to the new seismic activity features and the new demand for disaster prevention and mitigation of engineering construction and …

New Evidence For Holocene Activity Of The Northern Segment Of The Puqian-Qinglan Fault In Northern Hainan Province, Liu Huaguo, Li Feng, Jia Qichao, Wang Zhicheng, Zhang Pan, Lin Zhen, Zhang Jiehan, Shi Chunhua, Zhang Yanbo, Jia Wei, Li Changlong

Coal Geology & Exploration

The Puqian-Qinglan fault, located in northern Hainan Province, is closely related to the judgment of the seismogenic structure of the Qiongshan M7½ earthquake in 1605. To accurately determine the latest activity characteristics of this fault, this study, adopting artificial shallow seismic exploration with large-tonnage seismic sources combined with small-spacing cross-well stratigraphic correlation, investigated the sedimentary geological conditions of the Quaternary basalt cover and significantly thick marine sand layers in northern Hainan Province through exploration at Qishantou and Dongzhai villages in the Sanjiang Town, Jiangdong New Area, Haikou. Key results are as follows: (1) the Puqian-Qinglan fault dislocates multiple marker …

Activity Variations Of The Shanzuokou-Sihong Fault Within The Jiangsu Segment Of The Tancheng-Lujiang Fault Zone And Their Origins, Zhang Hao, Li Wei, Li Limei, Yan Yunxiang, Jiang Xin, Wang Jinyan, Zhao Qiguang, Gu Qinping, Xu Hangang

Coal Geology & Exploration

The Shanzuokou-Sihong fault, having undergone the entire evolutionary process of the Tancheng-Lujiang fault zone, exhibits segmentation during the latest activity epoch. Determining the location and origin of its activity segmentation will provide a significant reference for exploring the activity variations of its branch faults and their origins. This study investigated the activity of the Shanzuokou-Sihong fault using a three-dimensional approach combining field geological surveys, shallow seismic exploration, and cross-well stratigraphic correlation. The results show that the Shanzuokou-Sihong fault is a Late Pleistocene active fault on the east side of the North Maling Mountain and a Middle Pleistocene fault in Xinyi …

Activity Of The Liyang-Nandu Fault In Southern Jiangsu, Zhang Shuo, Zhang Ping, Chen Huogen, Xu Shugang, Gong Xulong, Xu Hangang, Li Limei, Feng Wenli, He Zongnan

Coal Geology & Exploration

Located in the central part of the Sunan Modernization Construction Demonstration Area—one of the areas with the densest population and urban areas and the most developed economy in China, the Liyang-Nandu fault is an important concealed fault with a nearly E-W strike in the Yangtze River Delta in eastern China. This fault serves as an important regional geomorphic and neotectonic boundary. However, there is a lack of systematic research on this fault, and its latest activity era is yet to be ascertained. Using seismic exploration P-waves and S-waves and cross-well stratigraphic correlation, this study investigated the spatial distribution and Quaternary …

Theory And Application Of Setback Distance From Active Faults, Wei Leiming, Xu Xiwei, Li Feng, Cao Jun, Ren Junjie, Cheng Jia, Zhang Xianbing, Jia Qichao, Chen Guihua, Wu Xiyan

Coal Geology & Exploration

Determining setbacks from active faults is the “last 1 km” from active fault surveys to their application to seismic disaster mitigation. It is also a technique for blocking the risk sources of earthquake-induced chains of geologic hazards. Field investigations and experimental studies have demonstrated that buildings and structures can be free from catastrophic destruction caused by coseismic ruptures and offset of active faults provided they are kept at a certain finite distance from the active fault traces. Therefore, determining setbacks from active faults serves as an ultimate goal of the surveys and precise localization of active faults. Based on the …

Revealing Fine-Scale Crustal Structure And Tectonic Features In The Xiong’An New Area And Its Periphery Using Deep Seismic Reflection Profiling, Yue Hangyu, Wang Kai, Wang Xiaojiang, Zhang Baowei, Zhang Kai

Coal Geology & Exploration

As an effective method to accurately reveal the deep geological structures and tectonic features of the Earth, deep seismic reflection profiling has been increasingly applied to the exploration of the continental and oceanic crusts, as well as the upper mantle of the lithosphere, making it internationally recognized pioneer technique for deep Earth exploration. This study examined the deep seismic reflection profile spanning across the Xiong’an New Area in Hebei Province, aiming to reveal the crustal structure and tectonic features of the study area. Key findings are as follows: (1) The crust in the study area can be divided into the …

Revealing The Upper Crustal Structure In The Fujian Region Using Deep Seismic Profiling, Li Pei, Ren Congrong, Li Haiyan, Wang Shanxiong

Coal Geology & Exploration

The Fujian region, located along the southeastern margin of the Chinese continent, constitutes an active tectonic belt along the coastal area in southeast China, with complex formation and evolution histories. To understand the characteristics of upper crustal structures and basement structures in the Fujian, this study collected the Pg travel time data from four NE-trending deep seismic sounding (DSS) survey lines in the region. Employing finite-difference tomography, this study obtained the fine-scale velocity structure of the upper crust along the four profiles, revealing the lateral variations in the upper crustal velocity structure, basement structures, and shallow fault characteristics in the …

Analogue Modeling Of Love-Type Channel Waves And Their Response To Faults, Liu Qiang, Hu Jiwu, Wang Pan, Shi Xianxin, Jia Qian

Coal Geology & Exploration

Owing to its high resolution and low energy attenuation, channel wave-based seismic exploration has been widely applied in the geophysical prospecting of hidden disaster-causing factors in underground coal mines. However, its accuracy fails to meet the requirements of intelligent mine mining presently. At present, the analogue modeling of channel waves mostly focuses on Rayleigh-type channel waves using 2D models, leading to a lack of research on Love-type channel waves. To explore the propagation law of Love-type channel waves, this study investigated the waves in the 3D analogue modeling of channel waves. Firstly, the wave and particle vibration characteristics of Love-type …

Multipoint Sources-Based High-Resolution Electrical Detection Of The Water-Rich Areas Near Mining Faces Of Coal Mine Roadways, Wu Rongxin, Xu Hui

Coal Geology & Exploration

To accurately explore the spatial distribution of water-rich areas near mining faces of mine roadways, this study proposed a multipoint sources-based high-resolution electrical detection technology. A multi-channel electrode observation system was arranged behind a roadway mining face, with electrodes at a distance of 1/4 measuring lines behind the mining face as point source electrodes sequentially. Data were collected using a monopole-dipole device, with the obtained apparent resistivity considered the sounding data of multipoint sources-based electrical detection. The images of multipoint sources-based electrical sounding allow for quickly determining the presence of water-rich areas and their locations relative to the mining faces …

Enhanced Bmp Signaling In Cathepsin K-Positive Tendon Progenitors Induces Heterotopic Ossification, Hiroyuki Yamaguchi, Margaret Li, Megumi Kitami, Sowmya Swaminathan, Yuji Mishina, Yoshihiro Komatsu

Faculty, Staff and Student Publications

Heterotopic ossification (HO) is abnormal bone growth in soft tissues that results from injury, trauma, and rare genetic disorders. Bone morphogenetic proteins (BMPs) are critical osteogenic regulators which are involved in HO. However, it remains unclear how BMP signaling interacts with other extracellular stimuli to form HO. To address this question, using the Cre-loxP recombination system in mice, we conditionally expressed the constitutively activated BMP type I receptor ALK2 with a Q207D mutation (Ca-ALK2) in Cathepsin K-Cre labeled tendon progenitors (hereafter “Ca-Alk2:Ctsk-Cre”). Ca-Alk2:Ctsk-Cre mice were viable but they formed spontaneous HO in the Achilles tendon. Histological and molecular …

The 2023 Orthopedic Research Society's International Consensus Meeting On Musculoskeletal Infection: Summary From The In Vitro Section, Noreen J. Hickok, Bingyun Li, Ebru Oral, Sebastian A.J. Zaat, David A. Armbruster, Gerald J. Atkins, Antonia F. Chen, Débora C. Coraça-Huber, Tianhong Dai, Edward M. Greenfield, Rajendra Kasinath, Matthew Libera, Cláudia N.H. Marques, T. Fintan Moriarty, K. Scott Phillips, Kapil Raghuraman, Dacheng Ren, Lia Rimondini, Kordo Saeed, Thomas P. Schaer, Edward M. Schwarz, Christopher Spiegel, Paul Stoodley, Vi Khanh Truong, Shao-Ting Jerry Tsang, Britt Wildemann, Anja R. Zelmer, Annelies S. Zinkernagel

Department of Orthopaedic Surgery Faculty Papers

Antimicrobial strategies for musculoskeletal infections are typically first developed with in vitro models. The In Vitro Section of the 2023 Orthopedic Research Society Musculoskeletal Infection international consensus meeting (ICM) probed our state of knowledge of in vitro systems with respect to bacteria and biofilm phenotype, standards, in vitro activity, and the ability to predict in vivo efficacy. A subset of ICM delegates performed systematic reviews on 15 questions and made recommendations and assessment of the level of evidence that were then voted on by 72 ICM delegates. Here, we report recommendations and rationale from the reviews and the results of …

Comparison Of Edta And Boric Acid Irrigation In Terms Of Root Canal Dentin Microhardness And Sealer Penetration Depth, Selen İnce Yusufoğlu, Esma Saricam, Neslihan Bulak, Mustafa Güngörmüs, Fatih Tulumbacı, Suat Özcan

Journal of Dentistry Indonesia

Chemo mechanical preparation is one of the important stages for successful endodontic treatment, and Boric acid has been proposed as an alternative irrigation solution for root canal treatment. Objective: The purpose of this study was to evaluate the effect of irrigation with boric acid (BA) and EDTA on the mineral content and microhardness of dentin and penetration of the AH Plus root canal sealer. Methods: 63 single-rooted teeth were instrumented. Microhardness analysis, 45 teeth were cut longitudinally and then transversely to obtain dentin. Pre- and post-treatment microhardness values were measured. The samples were randomly assigned into 3 groups …

Effect Of Triple Antibiotic Paste, Double Antibiotic Paste, And Calcium Hydroxide On Antibiotic Resistance Of Tet Repressor Proteins, Tetracycline Resistance Gene W, And Tetracycline Resistance Gene Q: A Randomized Controlled Clinical Trial, Ertuğrul Karataş, Özgen Kırmızıbekmez, Mustafa Özkan Baltacı, Ahmet Adıgüzel

Journal of Dentistry Indonesia

Objective: To investigate the effect of the use of Calcium Hydroxide (Ca(OH)2), Triple Antibiotic Paste (TAP), and Double Antibiotic Paste (DAP) as intra-canal medicaments on the development of antibiotic resistance by evaluating tetracycline genes. Methods: Forty five patients were randomly assigned into 3 groups according to the intracanal medication using a web program (www.randomizer.org), (Ca(OH)2, TAP and DAP). Root canal bacteriological samples were collected before root canal treatment (S1) and after chemo-mechanical procedures (S2). Following root canal shaping procedures, intra-canal medication of the root canals was performed with selected intra-canal medicament. A second appointment was planned for the …

Evaluation Of Trabecular Bone Around The Impacted Maxillary Canine On Cbct Images By Fractal Analysis, Zeynep Betül Arslan, Berrin Çelik

Journal of Dentistry Indonesia

Objective: The aim of this study was to evaluate the position, angulation and surrounding trabecular bone structure of a unilateral impacted maxillary canine (IMC) tooth using fractal analysis. Methods: Cone beam computed tomography images of 50 patients (38 female, 12 male) with unilateral IMC were selected for this retrospective study. A 25x25 pixel region of interest (ROI) was selected in the trabecular bone between the premolars on the impacted and non-impacted side and fractal analysis was conducted. The angulation of unilateral impacted canines was measured and the position was categorized as vestibular, intra-alveolar and palatal. Results: Of …

The Effect Of Several Electric Cigarette Puffs On Nanohybrid Composite Resin Surface Roughness, Alvi Rizqi Amaliyah, Haris Budi Widodo, Irfan Dwiandhono

Journal of Dentistry Indonesia

Nanohybrid composite resin is a dental restorative material comprising micro and nano-sized fillers. When accompanied by smoking habits, it can alter the surface roughness of composite resin. Objective: This study aimed to determine the effect of several electric cigarette (e-cigarette) puffs on the surface roughness of nanohybrid composite resin. Methods: This study was conducted in the experimental laboratory with a pretest-posttest control group design using 48 nanohybrid composite resin specimens divided into six groups. Subsequently, the experimental groups were exposed to 75, 150, 225, 300, and 450 puffs of e-cigarette, and the control group was given artificial saliva …

Management Of Ankyloglossia In A Non-Syndromic Patient Using A Super Pulsed Laser: A Life-Changing Treatment- A Case Report, Urfi Jawed, Afaf Zia, Ramniwas Kumawat, Afshan Bey, Maahin Mahmood

Journal of Dentistry Indonesia

Objective: Ankyloglossia affects a person’s overall well-being and life, from malnutrition due to poor feeding and mechanical problems to psychological stress and low self-esteem, thus affecting social life. This case reports the use of non-scalpel techniques, such as a super pulsed laser, to manage ankyloglossia in a non-syndromic patient suffering from speech incompetence and restricted tongue mobility and highlights its advantages over other conventional techniques. Case Report: A 17-year-old male patient presented with a complaint of restricted tongue mobility, due to which he could not pronounce certain words clearly. As the patient was apprehensive about the use of …

Evaluation Of Morphologic And Morphometric Characteristics Of The Mental Foramen And Anterior Loop In A Turkish Subpopulation Using Cone Beam Computed Tomography, Fatma Büşra Doğan, Faruk Akgünlü

Journal of Dentistry Indonesia

Objective: Before a surgical intervention in the mandibular interforaminal area, it is important to have a full understanding of the anatomy of the mandibular anterior segment. The evaluation of anatomical structures, variations and pathologies is performed with radiological imaging methods. Today, cone beam computed tomography (CBCT) is an imaging method which offers all the features necessary for this. In addition to its importance in surgical applications, it is also valuable in terms of anatomical studies thanks to the reliability of its measurements and the fact that it allows for a three-dimensional evaluation. The mental foramen and anterior loop are …

Prevalence And Clinical Characteristics Of Temporomandibular Disorders In Adults: An Epidemiological Study In The Mediterranean Region Of Türkiye, Esra Yavuz, Selmi Yardimci, Humeyra Tercanli

Journal of Dentistry Indonesia

The prevalence and clinical characteristics of temporomandibular disorders (TMD) in the Mediterranean region of Türkiye have not yet been thoroughly investigated. Objective: This study aimed to determine the prevalence and severity of TMD in a sample of the population in this region and to characterize the clinical findings related to TMD. Methods: Four hundred and one participants were included in this study. “Presence of TMD” in the participants was evaluated using the Fonseca Anamnestic Index. Through clinical examination, the findings in the participants were classified as limited mouth opening, deviation, temporomandibular joint (TMJ) sounds, TMJ pain, and muscle …