Diagnostic utility of CT enterography in the evaluation of ileocecal mucosal lesions of uncertain diagnosis on ileocolonoscopy.

Purpose: Ileocolonoscopy aids in the diagnosis of ileocecal region pathologies when typical mucosal lesions are seen. However, in many cases the mucosal lesions of the ileocaecal region are atypical, rendering themselves to diagnostic dilemma. The present study aimed to study the role of computed tomography (CT) enterography in the evaluation of symptomatic patients who demonstrated ileocecal mucosal lesions of uncertain diagnosis on ileocolonoscopy. Material and methods: Symptomatic patients who had ileocolonoscopy documented ileocecal mucosal lesions of uncertain diagnosis were enrolled. Patients were subjected to CT enterography within 10 days of ileocolonoscopy. On CT enterography a diagnosis of Crohn's disease (CD) or ileocaecal tuberculosis (ITB) was made. The diagnosis obtained by CT enterography was correlated with the final diagnosis obtained from histopathology. Using descriptive statistics, the diagnostic performance of CT enterography was evaluated. Results: A total of 153 cases were enrolled in the study. CT enterography findings were present in 147 cases, resulting in a diagnostic yield of 96%. Out of these, 58.16% (89/153) had CD, 26.14% (40/153) had ITB, 6.5% (10/153) had infectious ileitis, and 9.15% (14/153) were indeterminate on histopathology. CT enterography correctly identified 78.65% (70/89) of CD and 75% (30/40) of ITB. CT enterography had a sensitivity of 78.65% and 75%, specificity of 67.19% and 87.61%, positive predictive value of 76.92% and 68.18%, and diagnostic accuracy of 73.86% and 84.31% for diagnosing CD and ITB, respectively. Conclusions: CT enterography provided a high diagnostic yield in ileocaecal mucosal lesions of uncertain significance on endoscopy. CD and ITB were the predominant diseases detected in these individuals. CT enterography had a good diagnostic performance in the detection of these 2 disorders.

Oral candidal carriage and its association with dental carious lesions in asymptomatic adults: a cross-sectional study from the UAE.

BACKGROUND: Candida's potential association with dental caries has previously been reported in children. This research aimed at investigating the associations between Candida species in whole saliva and dental and periodontal health indices in a sample of adult patients. METHODS: A cross-sectional study involving 160 patients investigated the associations between Candida species collected by oral rinse technique, and Decayed, Missing, and Filled Surfaces (DMFS), and periodontal health indices. Chi-square and Independent Samples t-test were used to assess the associations between Candida carriage and confounding variables. Binary logistic regression was used to assess association strengths between Candida carriage and DMFS, adjusted for socio-demographic variables, diabetes mellitus and plaque index. RESULTS: Candida colonies were identified in 49 (30.6%) patients with CFUs ranging from 103 to 105 colonies per mL. The quantity of Candida CFUs increased with age (r = 0.200; p < 0.05). Among all dental and periodontal health indices, only DMFS was significantly associated with higher values of Candida carriage (p = 0.034), and this association was independent from sex, age, smoking, diabetes mellitus and plaque index (OR: 1.014; 95% CI 1.0-1.03; p = 0.048). CONCLUSION: The association between Candida species in whole saliva and DMFS reported here supports an etiological role of Candida in dental cariogenesis among adults.

Rise and regional disparities in buprenorphine utilization in the United States.

PURPOSE: Buprenorphine is an opioid partial agonist used to treat opioid use disorder. While several policy changes have attempted to increase buprenorphine availability, access remains well below optimal levels. This study characterized how buprenorphine utilization in the United States has changed over time and whether there are regional disparities in distribution of the medication. METHODS: The amount of buprenorphine distributed from 2007 to 2017 was obtained from the Drug Enforcement Administration's Automated Reports and Consolidated Ordering System. Data were expressed as the percent change and milligrams per person in each state. The formulations and cost for prescriptions covered by Medicaid (2008 to 2018) were also examined. RESULTS: Buprenorphine distributed to pharmacies increased about 7-fold (476.8 to 3179.9 kg) while the quantities distributed to hospitals grew 5-fold (18.6 to 97.6 kg) nationally from 2007 to 2017. Buprenorphine distribution per person was almost 20-fold higher in Vermont (40.4 mg/person) relative to South Dakota (2.1 mg/person). There was a strong association between the number of physicians authorized to prescribe buprenorphine and distribution per state (r[49] = +0.94, P < .0005). The buprenorphine/naloxone sublingual film (Suboxone) was the predominant formulation (92.6% of 0.31 million Medicaid prescriptions) in 2008 but accounted for less than three-fifth (57.3% of 6.56 million prescriptions) in 2018. CONCLUSIONS: Although buprenorphine availability has substantially increased over the last decade, distribution was very nonhomogeneous across the United States.

Pharmacists' clinical competency towards oral mucosal diseases: Results from a mystery shopper study.

OBJECTIVES: To investigate the clinical advices pharmacists would give to patients who present with various oral mucosal lesions. SUBJECTS AND METHODS: One hundred and twenty pharmacists in three major cities in the United Arab Emirates (UAE) were approached by senior dental students acting as mystery shoppers. Pharmacists were shown an image of one of four oral mucosal lesions representing candidosis, aphthous ulcer, erosive lichen planus and squamous cell carcinoma (SCC). Pharmacists' referral pattern and choices of medications were recorded and assessed against demographic variables. RESULTS: Eighty-eight per cent (88%) of pharmacists dispensed a non-prescription medication to treat the oral lesions, including SCC, while only 12% recommended that the lesion shown to them be assessed by a clinician. Among all referral recommendations, 32% were for SCC (p = .006). Geographical proximity of a clinic to the pharmacy was a significant factor in determining pharmacists' referral recommendation (p = .036). CONCLUSION: Most pharmacists dispensed a medication for oral mucosal lesions, including potentially malignant and malignant ones, without referring patients to a medical or dental practitioner. Pharmacists should be aware of the serious nature of some oral mucosal lesions and the necessity to refer those cases to a qualified practitioner for proper clinical assessment.

Vitamin D and hematinic deficiencies in patients with recurrent aphthous stomatitis.

OBJECTIVES: Recurrent aphthous stomatitis (RAS) represents a dysfunction in focal inflammatory processes. With the emerging anti-inflammatory roles of vitamin D (VD), we wanted to investigate the association between the onset and severity of RAS and serum VD level. METHODS: Fifty-two RAS cases and sex and age-matched controls were screened for serum iron, B12, folic acid, VD and red cell indices. Variables were compared using independent samples t test and chi square. Binary logistic regression was used to assess the association between the severity of RAS and various hematinic deficiencies. RESULTS: VD was deficient in 53% of the study population with no statistically significant difference between the RAS patients and healthy controls (53.6 versus 51.5 nmol/l, respectively). In comparison with controls, RAS patients had lower means of iron (81.0 versus 89.3 µg/dl), vitamin B12 (368.5 versus 412.7 pg ml) and most of the red cell indices; however, these differences were not statistically significant. No correlations were seen between RAS severity assessed by ulcer diameter, number of ulcers and their frequency and hematinic deficiencies. However, logistic regression showed a significant association between the number of ulcers (single or multiple) and VD deficiency (OR 4.978; 95% CI 1.204-20.576; p value = 0.027), adjusted for age, sex and other hematinics. CONCLUSIONS: VD deficiency appears to have a role in aggravating RAS ulcerative episodes, but not their onset. CLINICAL RELEVANCE: Multiple aphthous ulcers might represent a subcategory of RAS lesions in which VD deficiency plays a role in aggravating the oral ulcerative condition.

Stylohyoid Ligament Calcification and Its Association With Dental Diseases.

OBJECTIVES: This research aimed at investigating the relationship between calcification of the stylohyoid ligaments (SHLs) and odontogenic inflammatory events. METHODS: Cone-beam computed tomography scans of 175 patients were retrospectively assessed for presence of SHL calcifications. Frequencies of 4 types of odontogenic inflammatory events were assessed using the same scans, namely dental extractions, root canal treatments, furcation lesions, and periapical lesions. Patients were telephone-interviewed and asked about histories of tonsillectomy and head and neck trauma. Mann-Whitney U and binary logistic regression tests were used to assess associations between SHL calcification and mean ranks of odontogenic inflammatory events. RESULTS: Calcification of SHLs was detected in 71 (41%) and 58 (33%) patients on the right and left sides, respectively. Tonsillectomy and trauma were reported in 14% and 10% of the sample, respectively. Amongst all inflammatory events, root canal treatments were significantly associated with SHL calcification (U = 2755; Z = -2.1; P = .035). This association was independent from patient age, tonsillectomy, trauma, and other inflammatory events (odds ratio, 1.2; 95% confidence interval, 1.0-1.4; P = .036). CONCLUSIONS: This study presents new evidence that intra-oral inflammatory events, particularly related to root canal treatments, have a stronger association with SHL dystrophic calcification than that associated with traditional predisposing factors (ie, old age, tonsillectomy, and trauma).

World Workshop on Oral Medicine VIII: Barriers to research in oral medicine: results from a global survey.

OBJECTIVES: To explore factors influencing research interest and productivity and perceived barriers to conducting research in Oral Medicine (OM). METHODS: Invitations to participate in an online survey were e-mailed to a network of international OM practitioners and related professional organizations. Questions captured respondents' demographic/professional variables and gauged research interest, productivity, and perceived barriers to conducting research specifically in OM. Statistical analysis was conducted via descriptive, logistic regression, and multivariate modeling. RESULTS: Five hundred and ninety-three OM practitioners from 55 countries completed the survey, with 54%, 25%, and 21% practicing in high, upper-middle, and lower-middle-income countries, respectively. Eighty-six percent of respondents were interested in conducting research. Age (less interest with an increase in age), working in academia, and practicing in a lower-middle vs high-income country were significant predictors of research interest. Self-reported research productivity was significantly greater among males, those working in academia, and those who graduated from programs that mandated research presentation/publication. Obtaining research funding was a significant barrier among respondents from lower and upper-middle-income countries, whereas finding time for research was a reported barrier by respondents from high-income countries. CONCLUSION: The results of this survey identified perceived barriers to conducting research in OM and highlighted solutions to address such barriers.

A Machine Learning Approach for the Detection of QRS Complexes in Electrocardiogram (ECG) Using Discrete Wavelet Transform (DWT) Algorithm.

This study describes a modified approach for the detection of cardiac abnormalities and QRS complexes using machine learning and support vector machine (SVM) classifiers. The suggested technique overtakes prevailing approaches in terms of both sensitivity and specificity, with 0.45 percent detection error rate for cardiac irregularities. Moreover, the vector machine classifiers validated the proposed method's superiority by accurately categorising four ECG beat types: normal, LBBBs, RBBBs, and Paced beat. The technique had 96.67 percent accuracy in MLP-BP and 98.39 percent accuracy in support of vector machine classifiers. The results imply that the SVM classifier can play an important role in the analysis of cardiac abnormalities. Furthermore, the SVM classifier also categorises ECG beats using DWT characteristics collected from ECG signals.

A Multi-Attribute Decision-Making Model for the Selection of Polymer-Based Biomaterial for Orthopedic Industrial Applications.

The potential of quantifying the variations in IR active bands was explored while using the chemometric analysis of FTIR spectra for selecting orthopedic biomaterial of industrial scale i.e., ultra-high molecular weight PE (UHMWPE). The nano composites UHMWPE with multi-walled carbon nano-tubes (MWCNTs) and Mg-silicate were prepared and irradiated with 25 kGy and 50 kGy of gamma dose. Principal component analysis (PCA) revealed that first three principal components (PCs) are responsible for explaining the >99% of variance in FTIR data of UHMWPE on addition of fillers and/or irradiation. The factor loadings plots revealed that PC-1 was responsible for explaining the variance in polyethylene characteristics bands and the IR active region induced by fillers i.e., 440 cm−1, 456 cm−1, from 900−1200 cm−1, 1210 cm−1, 1596 cm−1, PC-2 was responsible for explaining the variance in spectra due to radiation-induced oxidation and cross linking, while the PC-3 is responsible for explaining the variance induced because of IR active bands of MWCNTs. Hierarchy cluster analysis (HCA) was employed to classify the samples into four clusters with respect to similarity in their IR active bands which is further confirmed by PCA. According to multi attribute analysis with PCA and HCA, 65 kGy irradiated sample is optimum choice from the existing alternatives in the group of irradiated pristine UHMWPE, UHMWPE/Mg-silicate irradiated with 25 kGy of gamma dose was the optimum choice for UHWMPE/Mg-silicate nano composites, and UHMWPE/γMWCNTs composites containing 1.0% dof γ MWCNTs for UHMWPE/MWCNTs nanocomposites, respectively. The results show the effectiveness of quantifying the variance for decision as far as optimization of biomaterials in orthopedic industrial applications is concerned.

Changing Professional Behaviors in the Digital World Using the Medical Education e-Professionalism (MEeP) Framework-A Mixed Methods Multicentre Study.

Background: There is increasing evidence on the exponential use of technology-based social media in medical field that has led to a proliferation of unprofessional behaviors in digital realm. Educating, training, and changing the behaviors of healthcare professionals are essential elements to restrain the rising unprofessional incidents. Therefore, this research was designed to determine the impact of an interventional workshop on the medical and dental students in improving their professional behaviors in the digital world using the newly developed medical Education e-Professionalism (MEeP) framework. Methods: We adopted the Theory of Planned Behavior (TPB) as a benchmark reference which explores constructs intertwined with the mission-based MEeP framework; values (whistleblowing-raising concerns), behaviors (being responsible in the digital world) and identity (reflective practice in the digital world). A multicentre 3-phased mixed-method study was conducted using a pre-workshop survey, an online interventional workshop, and a post-workshop survey. SPSS and NVivo were the tools used for the data analysis. Results: A total of 130 students registered for workshop out of which 120 completed the pre-workshop survey, 62 joined the workshop and 59 completed the workshop and post-workshop survey. From the whistleblowing - raising concern perspective, we found that attitudes and perceived behavioral control had a significant relationship. While for responsible in digital world category, attitude and perceived behavioral control had a significant bearing on the intentions. Third, for reflective practice, attitude and subjective norms significantly enhanced the intention of participants. A multi layered thematic analysis yielded four overarching themes of attitudes, subjective norms, perceived behavioral control and intentions. Most students showed positive attitudes of being reflective, self-directed, and humane. Students realized the subjective norms had made them conscientious, self-aware and conformative. While perceived behavioural control manifested as identity and Intentions were heavily reliant on self-actualization. Conclusion: Our mixed method study found that the interventional workshop using MEeP framework significantly improved attitudes, subjective norms, perceived behavioral control, and intentions. This study provides valuable evidence of MEeP framework evaluation using the theoretical underpinning of TPB by reporting positive changes in professional values, behaviors, and identities of undergraduate medical and dental students.

Willingness of dentists in the United Arab Emirates to perform restorative and surgical treatments for patients infected with hepatitis C.

BACKGROUND: Dentists' refusal to treat patients infected with hepatitis C (HCV) continues to raise ethical concerns, particularly in countries where HCV is prevalent. The aim of this cross-sectional study was to assess dentists' willingness to treat patients infected with HCV and the socio-demographic variables that influence their decision. METHODS: An online questionnaire was disseminated to dentists practicing in the United Arab Emirates (UAE) and enquired about their willingness to perform two dental treatments: restorative and surgical, to patients infected with HCV, while hypothetically being equipped with optimal personal protective equipment. Binary logistic regression test was used to assess socio-demographic factors that predict dentists' unwillingness decision. RESULTS: Two-hundred and forty-five dentists participated in this survey. Among those, 25.6 and 19.3% were unwilling to perform dental extractions and aerosol-generating restorative dental treatments for patients infected with HCV, respectively. Dentists' clinical experience was a significant predictor of their unwillingness decision, with those of shorter clinical experience expressing greater reluctance than their counterparts (OR:1.61; 95% CI: 1.02-2.54; p = 0.042). CONCLUSION: Patients infected with HCV who need dental care could face rejection by early career dentists, particularly if that treatment is a surgical one. Fresh dental graduates should be made aware of their ethical and legal responsibilities towards patients with infectious diseases, particularly HCV.

Anxiety among dental professionals and its association with their dependency on social media for health information: insights from the COVID-19 pandemic.

BACKGROUND: Social media can play a detrimental role during a global health emergency. In this study, we aimed at assessing the impact social media has on the anxiety level of dental healthcare workers (DHCWs) whilst living through the COVID-19 pandemic. METHODS: An online questionnaire was disseminated to a cross-sectional sample of DHCWs from 19 countries using social media platforms. The questionnaire enquired about DHCWs' frequency of using social media and their dependency on health-related information posted on those platforms. Anxiety was measured using General Anxiety Disorder scale (GAD-7). RESULTS: Four-hundred and three (403) DHCWs completed the online questionnaire. Sixty-eight percent (68%) frequently use social media for information on COVID-19. The frequency of social media use was higher among younger DHCWs, with shorter clinical experience, and holders of undergraduate qualifications (p = 0.009, p = 0.002, and p = 0.023, respectively). Almost one third of DHCWs had moderate to severe anxiety (31.7%), which was significantly associated with the frequency of social media use (p = 0.016). This association was adjusted for age, years of experience and qualification level (OR 1.75; 95% CI 1.05-2.93; p = 0.032). CONCLUSION: COVID-19 social media infodemic has been adversely impacting the psychological wellbeing of DHCWs. More effective measures are needed to control the quality and spreadability of health information on social media platforms.

The effect of styloid process medial angulation on Eagle's syndrome's self-reported symptoms: A preliminary cross-sectional study.

OBJECTIVE: The aim of this study was to investigate whether the medial angulation of the styloid process (SP), regardless of its length, has an association with self-reported symptoms of Eagle's syndrome. STUDY DESIGN: In this cross-sectional study, we measured the length and medial angulation of the SP, including ossification of the stylohyoid ligaments, in archived cone beam computed tomography scans. Patients with valid contact details were interviewed by telephone and asked about the clinical symptoms related to Eagle's syndrome. RESULTS: Eighty-eight patients participated in this study. Their median age was 39.0 years and ranged from 18 to 75 years. Thirty-one (35.2%) of the participants reported cervicalgia with at least one other symptom related to Eagle's syndrome. The mean length and angulation of the right SP were 37.2 mm and 36.3°, respectively, with both readings showing positive correlation with the left SP (r = 0.746 and r = 0.670, respectively; P < .001). Medial angulation of the SP was a predictor of Eagle's syndrome self-reported symptoms (odds ratio, 1.082; 95% confidence interval, 1.003-1.167; P = .042), adjusted for SP length and the patient's age. CONCLUSIONS: Self-reported clinical symptoms of Eagle's syndrome appear to be more associated with the medial angulation of the SP than with its length. Further research on larger samples is needed to establish the medial angulation cutoff angle and the specific symptoms that are attributed to that angulation.

Simulation of Light Distribution in Gamma Irradiated UHMWPE Using Monte Carlo Model for Light (MCML) Transport in Turbid Media: Analysis for Industrial Scale Biomaterial Modifications.

(1) Background: This study investigated the miscibility of carbon-based fillers within industrial scale polymers for the preparation of superior quality polymer composites. It focuses on finding the light distribution in gamma irradiated ultra-high molecular weight polyethylene (UHMWPE). (2) Methods: The Kubleka-Munk model (KMM) was used to extract the optical properties, i.e., absorption coefficients (µa) and scattering coefficients (µs). Samples amounting to 30 kGy and 100 kGy of irradiated (in the open air) UHMWPE from 630 nm to 800 nm were used for this purpose. Moreover, theoretical validation of experimental results was performed while using extracted optical properties as inputs for the Monte Carlo model of light transport (MCML) code. (3) Conclusions: The investigations revealed that there was a significant decrease in absorption and scattering coefficient (µa & µs) values with irradiation, and 30 kGy irradiated samples suffered more compared to 100 kGy irradiated samples. Furthermore, the simulation of light transport for 800 nm showed an increase in penetration depth for UHMWPE after gamma irradiation. The decrease in dimensionless transport albedo  µs(µa+µs) from 0.95 to 0.93 was considered responsible for this increase in photon absorption per unit area with irradiation. The report results are of particular importance when considering the light radiation (from 600 nm to 899 nm) for polyethylene modification and/or stabilization via enhancing the polyethylene chain mobility.

Structure and Performance Attributes Optimization and Ranking of Gamma Irradiated Polymer Hybrids for Industrial Application.

The selection of suitable composite material for high-strength industrial applications, from the list of available alternatives, is a tedious task as it requires an optimized structural performance-based solution. This study aimed to optimize the concentration of fillers, i.e., vinyl tri-ethoxy silane and absorbed gamma-dose, to enhance the properties of an industrial scale polymer, i.e., ultra-high molecular weight polyethylene (UHMWPE). The UHMWPE hybrids, in addition to silane, were treated with (30, 65, and 100 kGy) gamma dose and then tested for ten application-specific structural and performance attributes. The relative importance of attributes based on an 11-point fuzzy conversation was used for establishing the material assessment graph and corresponding adjacency matrix. Afterwards, the normalized values of attributes were used to establish the decision matrix for each alternative. The normalization was performed after the identification of high obligatory valued (HOV) and low obligatory valued (LOV) attributes. After this, suitability index values (SIVs) were calculated for ranking the hybrids that revealed hybrids 65 kGy irradiated the hybrid as the best choice and ranked as first among the existing alternatives. The major responsible factors were higher oxidation strength, a dense cross-linking network, and elongation at break. The values of the aforementioned factors for 65 kGy irradiated hybrids were 0.24, 91, and 360 MPa, respectively, as opposed to 0.54, 75, and 324 MPa for 100 kGy irradiated hybrids, thus placing the latter in second place regarding higher values of Yield Strength and Young Modulus. Finally, it is believed that the reported results and proposed model in this study will improve preoperative planning as far as considering these hybrids for high-strength industrial applications including total joint arthroplasty, textile-machinery pickers, dump trucks lining ships, and harbors bumpers and sliding, etc.

Development of a real-time quantitative PCR assay for detection of a stable genomic region of BK virus.

BACKGROUND: BK virus infections can have clinically significant consequences in immunocompromised individuals. Detection and monitoring of active BK virus infections in certain situations is recommended and therefore PCR assays for detection of BK virus have been developed. The performance of current BK PCR detection assays is limited by the existence of viral polymorphisms, unknown at the time of assay development, resulting in inconsistent detection of BK virus. The objective of this study was to identify a stable region of the BK viral genome for detection by PCR that would be minimally affected by polymorphisms as more sequence data for BK virus becomes available. RESULTS: Employing a combination of techniques, including amino acid and DNA sequence alignment and interspecies analysis, a conserved, stable PCR target region of the BK viral genomic region was identified within the VP2 gene. A real-time quantitative PCR assay was then developed that is specific for BK virus, has an analytical sensitivity of 15 copies/reaction (450 copies/ml) and is highly reproducible (CV ≤ 5.0%). CONCLUSION: Identifying stable PCR target regions when limited DNA sequence data is available may be possible by combining multiple analysis techniques to elucidate potential functional constraints on genomic regions. Applying this approach to the development of a real-time quantitative PCR assay for BK virus resulted in an accurate method with potential clinical applications and advantages over existing BK assays.

Ulcerative Stomatitis as the Sole Manifestation of Progesterone Hypersensitivity.

Oral mucosal involvement of autoimmune progesterone dermatitis is exceedingly rare. This report presents a woman with very painful ulcerative stomatitis that recurred with every menstrual period, in the absence of other clinical manifestations. Ulcers were eventually controlled with oral tamoxifen treatment for three months. Subsequent follow-up visits showed complete resolution of her oral ulcerative lesions. The non-specific nature of her oral ulcers resulted in multiple medical and dental consultations and a delay in reaching the final diagnosis. Clinicians should be aware of the possibility of progesterone hypersensitivity when painful oral ulcerative lesions appear concurrently with each progesterone surge.

Urinary and Plasma Metabolomics Identify the Distinct Metabolic Profile of Disease State in Chronic Mouse Model of Multiple Sclerosis.

Identification of non-invasive biomarkers of disease progression in multiple sclerosis (MS) is critically needed for monitoring the disease progression and for effective therapeutic interventions. Urine is an attractive source for non-invasive biomarkers because it is easily obtained in the clinic. In search of a urine metabolite signature of progression in chronic experimental autoimmune encephalomyelitis (EAE), we profiled urine at the chronic stage of the disease (day 45 post immunization) by global untargeted metabolomics. Using a combination of high-throughput liquid-and-gas chromatography with mass spectrometry, we found 105 metabolites (P < 0.05) significantly altered at the chronic stage, indicating a robust alteration in the urine metabolite profile during disease. Assessment of altered metabolites against the Kyoto Encyclopedia of Genes and Genomes revealed distinct non-overlapping metabolic pathways and revealed phenylalanine-tyrosine and associated metabolism being the most impacted. Combined with previously performed plasma profiling, eight common metabolites were significantly altered in both of the biofluids. Metaboanalyst analysis of these common metabolites revealed that phenylalanine metabolism and Valine, leucine, and isoleucine biosynthetic pathways are central metabolic pathways in both bio-fluids and could be analyzed further, either for the discovery of therapeutics or biomarker development. Overall, our study suggests that urine and plasma metabolomics may contribute to the identification of a distinct metabolic fingerprint of EAE disease discriminating from the healthy control which may aid in the development of an objective non-invasive monitoring method for progressive autoimmune diseases like MS. Graphical Abstract Untargeted urinary metabolomics of a chronic mouse model of multiple sclerosis identified Phenylalanine, tyrosine & tryptophan metabolism as the significantly altered metabolic pathway. Eight common metabolites were identified when we combined urinary and plasma metabolic signature, which revealed a perturbation of Phenylalanine metabolism and valine, leucine & isoleucine metabolic pathways, involved in CNS dysfunction during diseases. The identified eight metabolic signature of urine and plasma may be of clinical relevance as potential biomarkers and guide towards the identification of specific metabolic pathways as novel drug targets.

Prevalence of hepatitis B, C, and HIV among patients attending a teaching dental hospital. A 7-year retrospective study from the United Arab Emirates.

OBJECTIVES: To determine the seroprevalence and case characteristics of hepatitis B, C and human immunodeficiency virus (HIV), and their transmissibility from patients to dental personnel following percutaneous and mucocutaneous injuries. METHODS: All incidents of sharp and splash injuries reported between January 2010 and January 2017 were retrospectively reviewed and analyzed. Descriptive statistics were calculated using the Statistical Package for the Social Science (SPSS). Prevalence was calculated as percentages, and chi-square test was used to assess categorical variables where a p-value of ≤0.05 was considered significant. RESULTS: Among the 436 reported incidents, 372 patients underwent serological screening. Fourteen patients (3.8%) had antibodies against hepatitis C virus, and 8 patients (2.2%) were positive for hepatitis B surface antigens. All positive cases were clinically asymptomatic. There were no positive cases for HIV. Three of the 14 hepatitis C positive patients were actively infectious upon polymerase chain reaction (PCR) analysis, but none of the injured dental personnel seroconverted upon a 6-month follow up. Approximately 88% of dental personnel were vaccinated against hepatitis B. Female personnel showed better vaccination rate by comparison to male personnel (p=0.005). Among the 5 different categories of professional status, cleaners showed a significantly low hepatitis B vaccination rate (p less than 0.000). CONCLUSION: The prevalence of hepatitis B and C is higher than that previously reported from the United Arab Emirates, but transmissibility of viral hepatitis seems to be negligible.

The effect of rubber dam on atmospheric bacterial aerosols during restorative dentistry.

Rotatory dental instruments generate atmospheric aerosols that settle on various surfaces, including the dentist's head. The aim of this study was to quantitatively assess bacterial contamination of the dentist's head and to evaluate whether it is affected by using a rubber dam. Senior dental students (n=52) were asked to wear autoclaved headscarves as collection media while performing restorative dental treatment with and without a rubber dam. Four points from each headscarf were swabbed for bacterial culture after 30min of operative work. Bacterial contamination was quantified by counting the colony-forming units. Regardless of the collection point, using a rubber dam was associated with more bacterial colony-forming units than not using a rubber dam (P=0.009). Despite its clinical value, the rubber dam seems to result in significantly higher aerosol levels on various areas of the dentist's head, requiring that dentists cover their heads with suitable protective wear.