Nutritional supplementation, tooth crown size, and trait expression in individuals from Tezonteopan, Mexico.

Understanding how epigenetic factors impact dental phenotypes can help refine the use of teeth for elucidating biological relationships among human populations. We explored relationships among crown size, principal cusp spacing, and accessory cusp expression in maxillary dental casts of nutritionally supplemented (n = 34) and non-supplemented (n = 39) individuals from Tezonteopan, Mexico. We hypothesized that the non-supplemented group would exhibit smaller molar crowns and reduced intercusp spacing. Since intercusp spacing is thought to be more sensitive to epigenetic influences than crown size, we predicted that the supplemented and non-supplemented groups would differ more in the former than the latter. Previous work suggests that molar accessory cusp expression may be elevated under conditions of stress. We therefore expected evidence of greater Carabelli and Cusp 5 trait expression in the non-supplemented group. We further hypothesized that anterior teeth would be affected by nutritional stress during development, with the non-supplemented group having smaller anterior tooth crowns and therefore limited space to form the tuberculum dentale. Finally, we tested whether the presence of molar accessory traits followed predictions of the Patterning Cascade Model of tooth morphogenesis in the entire sample. Our results supported the expectation that cusp spacing would differ more than molar crown size between the two groups. Carabelli trait showed little evidence of frequency differences between groups, but some evidence of greater trait scores in the non-supplemented group. The non-supplemented group also showed evidence of greater Cusp 5 frequency and expression. In the central incisors and canines, there was strong evidence for smaller crown sizes and reduced tuberculum dentale frequency in the non-supplemented group. With both groups pooled together, there was strong evidence of closer mesiodistal distances among principal cusps in molars with accessory cusps, a finding that is consistent with the PCM. Overall, our findings suggest that nutritional stress may affect accessory cusp expression.

Dental complexity and diet in amniotes: A meta-analysis.

Tooth morphology is among the most well-studied indicators of ecology. For decades, researchers have examined the gross morphology and wear patterns of teeth as indicators of diet, and recent advances in scanning and computer analysis have allowed the development of new and more quantitative measures of tooth morphology. One of the most popular of these new methods is orientation patch count (OPC). OPC, a measure of surface complexity, was originally developed to distinguish the more complex tooth crowns of herbivores from the less complex tooth crowns of faunivores. OPC and a similar method derived from it, orientation patch count rotated (OPCR), have become commonplace in analyses of both modern and fossil amniote dietary ecology. The widespread use of these techniques makes it possible to now re-assess the utility of OPC and OPCR. Here, we undertake a comprehensive review of OPC(R) and diet and perform a meta-analysis to determine the overall difference in complexity between herbivores and faunivores. We find that the relationship between faunivore and herbivore OPC or OPCR values differs substantially across studies, and although some support the initial assessment of greater complexity in herbivores, others do not. Our meta-analysis does not support an overall pattern of greater complexity in herbivores than faunivores across terrestrial amniotes. It appears that the relationship of OPC or OPCR to diet is taxon-specific and dependent on the type of faunivory of the group in question, with insectivores often having values similar to herbivores. We suggest extreme caution in comparing OPC and OPCR values across studies and offer suggestions for how OPCR can constructively be used in future research.

Spinal Cord Stimulator Related Infections: Findings From a Multicenter Retrospective Analysis of 2737 Implants.

INTRODUCTION: Surgical site infection is a potential complication of spinal cord stimulator (SCS) implantation. Current understanding of the epidemiology, diagnosis, and treatment of these infections is based largely on small clinical studies, many of which are outdated. Evidence-based guidelines for management of SCS-related infections thus rely instead on expert opinion, case reports, and case series. In this study, we aim to provide a large scale retrospective study of infection management techniques specifically for SCS implantation. METHODS: A multicenter retrospective study of SCS implants performed over a seven-year period at 11 unique academic and non-academic institutions in the United States. All infections and related complications in this cohort were analyzed. RESULTS: Within our study of 2737 SCS implant procedures, we identified all procedures complicated by infection (2.45%). Localized incisional pain and wound erythema were the most common presenting signs. Laboratory studies were performed in the majority of patients, but an imaging study was performed in less than half of these patients. The most common causative organism was Staphylococcus aureus and the IPG pocket was the most common site of an SCS-related infection. Explantation was ultimately performed in 52 of the 67 patients (77.6%). Non-explantation salvage therapy was attempted in 24 patients and was successful in resolving the infection in 15 patients without removal of SCS hardware components. DISCUSSION: This study provides current data regarding SCS related infections, including incidence, diagnosis, and treatment.

Spinal Cord Stimulator Implant Infection Rates and Risk Factors: A Multicenter Retrospective Study.

OBJECTIVES: Spinal cord stimulation is an evidence-based treatment for a number of chronic pain conditions. While this therapy offers improvement in pain and function it is not without potential complications. These complications include device failure, migration, loss of therapeutic paresthesia, and infection. This article looked to establish a modern infection rate for spinal cord stimulators, assess the impact of known risk factors for surgical site infections and to determine the impact of certain preventative measures on the rate of infection. METHODS: After institutional review board approval, a multisite, retrospective review was conducted on 2737 unique implants or revisions of SCS systems. Patient demographics, risk factors including diabetes, tobacco use, obesity, revision surgery, trial length, implant location, implant type, surgeon background, prophylactic antibiotic use, utilization of a occlusive dressing, and post-operative antibiotic use were recorded and analyzed. RESULTS: The overall infection rate was 2.45% (n = 67). Diabetes, tobacco use, and obesity did not independently increase the rate of infection. Revision surgeries had a trend toward higher infection rate; however, this did not meet statistical significance. There was no difference in the rate of infection between implants performed by physicians of different base specialties, cylinder leads vs. paddle leads, or between different prophylactic antibiotics. Implants performed at academic centers had a higher rate of infection when compared to implants performed in nonacademic settings. When patients received an occlusive dressing or post-operative antibiotics they had a lower rate of infection. CONCLUSIONS: The infection rate (2.45%) reported in this study is lower than the previously reported rates (3-6%) and are on par with other surgical specialties. This study did not show an increased rate of infection for patients that used tobacco, had diabetes or were obese. It's possible that given the low overall infection rate a larger study is needed to establish the true impact of these factors on infection. In addition, this study did not address the impact of poorly controlled diabetes mellitus (elevated hemoglobin A1c) vs. well-controlled diabetes. It can be concluded from this study that utilizing an occlusive dressing over the incision in the post-operative period decreases the rate of infection and should become the standard of care. This study also demonstrated the positive impact of post-operative antibiotics in decreasing the rate of infection. Studies in other surgical specialties have not shown this impact which would suggest that further research is needed.

Evolution and function of the upper molar talon and its dietary implications in microbats.

The evolution of mammalian molars has been marked by transitions representing significant changes in shape and function. One such transition is the addition and elaboration of the talon, the distolingual region of the ancestral tribosphenic upper molar of therian mammals and some extinct relatives. This study uses suborder Microchiroptera as a case study to explore the adaptive implications of the expansion of the talon on the tribosphenic molar, specifically focusing on the talon's role in the compression and shear of food during breakdown. Three-dimensional computer renderings of casts of the upper left first molars were created for microbat species of a variety of dietary categories (frugivore, etc.) and physical properties of food (hard and soft). Relief Index (RFI) was measured to estimate the topography and function of the whole tooth and of the talon and trigon (the remaining primitive tribosphenic region) individually, in order to examine 1) how the shape of the whole tooth, trigon, and talon reflects the compromise between their crushing and shearing functions, 2) how whole tooth, trigon, and talon function differs according to diet, and 3) how the presence of the talon affects overall molar function. Results suggest that RFI of both the whole tooth and the trigon varies according to dietary groups, with frugivores having greater crushing function when compared with the other groups. The talon, however, consistently has low RFI (a flatter topography), and its presence lowers the RFI of the whole tooth across all dietary categories, suggesting that the talon is primarily functioning in crushing during food breakdown. The potential benefits of a crushing talon for microbats of various dietary groups are discussed.

Model of tooth morphogenesis predicts carabelli cusp expression, size, and symmetry in humans.

BACKGROUND: The patterning cascade model of tooth morphogenesis accounts for shape development through the interaction of a small number of genes. In the model, gene expression both directs development and is controlled by the shape of developing teeth. Enamel knots (zones of nonproliferating epithelium) mark the future sites of cusps. In order to form, a new enamel knot must escape the inhibitory fields surrounding other enamel knots before crown components become spatially fixed as morphogenesis ceases. Because cusp location on a fully formed tooth reflects enamel knot placement and tooth size is limited by the cessation of morphogenesis, the model predicts that cusp expression varies with intercusp spacing relative to tooth size. Although previous studies in humans have supported the model's implications, here we directly test the model's predictions for the expression, size, and symmetry of Carabelli cusp, a variation present in many human populations. METHODOLOGY/PRINCIPAL FINDINGS: In a dental cast sample of upper first molars (M1s) (187 rights, 189 lefts, and 185 antimeric pairs), we measured tooth area and intercusp distances with a Hirox digital microscope. We assessed Carabelli expression quantitatively as an area in a subsample and qualitatively using two typological schemes in the full sample. As predicted, low relative intercusp distance is associated with Carabelli expression in both right and left samples using either qualitative or quantitative measures. Furthermore, asymmetry in Carabelli area is associated with asymmetry in relative intercusp spacing. CONCLUSIONS/SIGNIFICANCE: These findings support the model's predictions for Carabelli cusp expression both across and within individuals. By comparing right-left pairs of the same individual, our data show that small variations in developmental timing or spacing of enamel knots can influence cusp pattern independently of genotype. Our findings suggest that during evolution new cusps may first appear as a result of small changes in the spacing of enamel knots relative to crown size.

Identification of two mosquitocidal Bacillus cereus strains showing different host ranges.

Mosquitocidal bacteria, M413 and C32 have been isolated from sediment samples collected from woodland and ditch, respectively. Gas chromatographic analysis of fatty acids methyl esters (GC-FAME) and 16S rRNA gene sequence alignment results showed these isolates belong to Bacillus cereus. The SDS-PAGE analysis of sporulated cultures of both isolates showed two major bands very similar in size. Interestingly, however, M413 is mainly toxic to 4th instars of Ochlerotatus taeniorhynchus whereas C32 is to those of Culex quinquefasciatus.