Machine Learning-Assisted High-Throughput Identification and Quantification of Protein Biomarkers with Printed Heterochains.

Advanced in vitro diagnosis technologies are highly desirable in early detection, prognosis, and progression monitoring of diseases. Here, we engineer a multiplex protein biosensing strategy based on the tunable liquid confinement self-assembly of multi-material heterochains, which show improved sensitivity, throughput, and accuracy compared to standard ELISA kits. By controlling the material combination and the number of ligand nanoparticles (NPs), we observe robust near-field enhancement as well as both strong electromagnetic resonance in polymer-semiconductor heterochains. In particular, their optical signals show a linear response to the coordination number of the semiconductor NPs in a wide range. Accordingly, a visible nanophotonic biosensor is developed by functionalizing antibodies on central polymer chains that can identify target proteins attached to semiconductor NPs. This allows for the specific detection of multiple protein biomarkers from healthy people and pancreatic cancer patients in one step with an ultralow detection limit (1 pg/mL). Furthermore, rapid and high-throughput quantification of protein expression levels in diverse clinical samples such as buffer, urine, and serum is achieved by combining a neural network algorithm, with an average accuracy of 97.3%. This work demonstrates that the heterochain-based biosensor is an exemplary candidate for constructing next-generation diagnostic tools and suitable for many clinical settings.

Early-stage postoperative depression and anxiety following orthognathic surgery: a cross-sectional study.

BACKGROUND: The objective of this study was to observe the incidence and potential risk factors of postoperative depression and anxiety in patients during the early period after undergoing orthognathic surgery. METHODS: From March 7 to September 7, 2023, patients ≥ 18 years of age who were scheduled for elective orthognathic surgery under general anesthesia in Peking University School and Hospital of Stomatology were included in this study. We prospectively evaluated their degrees of pre- and postoperative depression and anxiety using the Patient Health Questionnaire-9 and the State Trait Anxiety Inventory. Associations between the perioperative factors and occurrences of postoperative anxiety and depression were evaluated using a multivariate logistic regression model. RESULTS: A total of 371 patients were included in the analysis. Within five days after surgery, we observed the occurrence of depression in 32% (116) of the patients and anxiety in 72.8% (270) of them. Their preoperative depression score on the Pain Catastrophizing Scale and intraoperative urine output were significantly associated with a higher risk of postoperative depression. The presence of preoperative anxiety, postoperative moderate-to-severe pain, postoperative nausea and vomiting and postoperative insomnia were significantly associated with a higher risk of postoperative anxiety. Furthermore, a monthly income ≥ ¥10000 was found to be significantly associated with a lower risk of postoperative anxiety. CONCLUSIONS: Postoperative depression and anxiety are common among patients who undergo orthognathic surgery. Moreover, preoperative psychological status and incidence of postoperative adverse events were associated with an increased risk of depression and anxiety after surgery. The results of the present study suggest that careful psychological assessment and appropriate management are necessary to improve patients' recovery following orthognathic surgery.

Safety of propofol-assisted deep extubation in the dental treatment of children-a retrospective, observational study.

PURPOSE: Awake extubation and deep extubation are commonly used anesthesia techniques. In this study, the safety of propofol-assisted deep extubation in the dental treatment of children was assessed. MATERIALS AND METHODS: Children with severe caries who received dental treatment under general anesthesia and deep extubation between January 2017 and June 2023 were included in this study. Data were collected on the following variables: details and time of anesthesia, perioperative vital signs, and incidence of postoperative complications. The incidence of laryngeal spasm (LS) was considered to be the primary observation indicator. RESULTS: The perioperative data obtained from 195 children undergoing dental treatment was reviewed. The median age was 4.2 years (range: 2.3 to 9.6 years), and the average duration of anesthesia was 2.56 h (range 1 to 4.5 h). During intubation with a videoscope, purulent mucus was found in the pharyngeal cavity of seven children (3.6%); LS occurred in five of them (2.6%), and one child developed a fever (T = 37.8 °C) after discharge. Five children (2.6%) experienced emergence agitation (EA) in the recovery room. Also, 13 children (6.7%) experienced epistaxis; 10 had a mild experience and three had a moderate experience. No cases of airway obstruction (AO) and hypoxemia were recorded. The time to open eyes (TOE) was 16.3 ± 7.2 min. The incidence rate of complications was 23/195 (11.8%). Emergency tracheal reintubation was not required. Patients with mild upper respiratory tract infections showed a significantly higher incidence of complications (P < 0.001). CONCLUSIONS: Propofol-assisted deep extubation is a suitable technique that can be used for pediatric patients who exhibited non-cooperation in the outpatient setting. Epistaxis represents the most frequently encountered complication. Preoperative upper respiratory tract infection significantly increases the risk of complications. The occurrence of EA was notably lower than reported in other studies.

A case of neonatal tsutsugamushi disease diagnosed with the aid of rickettsial macrogenomic detection.

BACKGROUND: Tsutsugamushi, also known as bush typhus, is a naturally occurring disease caused by Orientia tsutsugamushi. We reported a case of vertical mother-to-newborn transmission of Orientia tsutsugamushi infection in a newborn from Yunnan (China). CASE PRESENTATION: Decreased fetal movements were observed at 39 weeks of gestation. After birth, the newborn (female) had recurrent fever, shortness of breath, and bruising around the mouth and extremities. At 5 h 58 min of age, the newborn was admitted for fever, shortness of breath and generalized rash. The liver was palpable 3 cm below the costal margin, and the limbs showed pitting edema. There was subcutaneous bleeding. Investigations suggested heavy infection, myocardial damage, decreased platelets. Treatment with cefotaxime and ampicillin failed. The mother was hospitalized at 29 weeks of gestation with a fever for 4 consecutive days, and an ulcerated crust was found in the popliteal fossa. Due to this pregnancy history, A diagnosis of Orientia tsutsugamushi infection was suspected in our index case and confirmed by macrogenomic testing and she was treated with vancomycin and meropenem, and later azithromycin for 1 week. The newborn was discharged in good general condition, gradually normalizing body temperature, and decreasing rash and jaundice. There were no abnormalities on subsequent blood macrogenomic tests for the baby. And one month later she showed good mental health, sleep, and food intake and no fever, rash, or jaundice. CONCLUSION: Determining the cause of symptoms is the key to treating diseases, especially the rare diseases that can be misdiagnosed. SUITABLE FOR PEOPLE WITH: Infectious Diseases; Neonatology; Obstetrics.

Combining Network Pharmacology and Experimental Verification to Ascertain the Mechanism of Action of Asparagus officinalis Against the Brain Damage Caused by Fluorosis.

Asparagus officinalis (ASP) has antioxidation, anti-inflammatory, antiaging, and immune system-enhancing effects. We explored the preventive and therapeutic consequences of ASP on the brain damage elicited by fluorosis through network pharmacology and in vivo experimental validation. We ascertained the pharmaceutically active ingredients and drug targets of ASP from the Traditional Chinese Medicine Systems Pharmacology database, predicted the disease targets of fluorosis-induced brain injury using GeneCards and Online Mendelian Inheritance in Man databases, obtained target protein-protein interaction networks in the Search Tool for the Retrieval of Interacting Genes/Proteins database, used Cytoscape to obtain key targets and active ingredients, and conducted enrichment analyses of key targets in the Database for Annotation, Visualization and Integrated Discovery. Enrichment analyses showed that "mitogen-activated protein kinase" (MAPK), "phosphoinositide 3-kinase/protein kinase B" (PI3K-Akt), "nuclear factor-kappa B" (NF-κB), and the "neurotrophin signaling pathway" were the most enriched biological processes and signaling pathways. ASP could alleviate fluorosis-based injury, improve brain-tissue damage, increase urinary fluoride content, and improve oxidation levels and inflammatory-factor levels in the body. ASP could also reduce dental fluorosis, bone damage, fluoride concentrations in blood and bone, and accumulation of lipid peroxide. Upon ASP treatment, expression of silent information regulator (SIRT)1, brain-derived neurotrophic factor (BDNF), tropomyosin receptor kinase B (TrkB), MAPK, NF-κB, PI3K, Akt, and B-cell lymphoma-2 in rat brain tissue increased gradually, whereas that of Bax, caspase-3, and p53 decreased gradually. We demonstrated that ASP could regulate the brain damage caused by fluorosis through the SIRT1/BDNF/TrkB signaling pathway, and reported the possible part played by ASP in preventing and treating fluorosis.

Optical properties of monolithic zirconia fabricated with nanoparticle jetting.

STATEMENT OF PROBLEM: Excellent optical properties are essential for esthetic dental materials. However, the translucency and color masking ability of zirconia fabricated with nanoparticle jetting (NPJ), a type of printed zirconia, are unknown. PURPOSE: The purpose of this in vitro study was to evaluate the translucency and color masking ability of zirconia fabricated using NPJ. MATERIAL AND METHODS: A total of 90 specimens with thicknesses of 1.5, 1.0, and 0.5 mm were fabricated using high translucent milled zirconia (HT), low translucent milled zirconia (LT), and NPJ. CIELab values (L*, a*, and b*) of the specimens over 7 backgrounds, black, white, VitaB1, VitaA2, VitaA4, gold alloy (Au), and titanium (Ti), were obtained using a spectral radiometer. The relative translucency parameter (RTP) and color difference (∆E) of specimens over VitaB1, VitaA4, Au, and Ti were determined using VitaA2 as the control with the CIEDE2000 color difference equation. The normality of the data distribution was determined using the Shapiro-Wilk test. Differences among groups were analyzed using 2-way analysis of variance and the Student-Newman-Keuls (SNK) post hoc test (α=.05). The ∆E of specimens was analyzed according to perceptibility (∆E=0.8) and acceptability (∆E=1.8) thresholds using the 1 sample t test. The correlation between RTP and ∆E and RTP/∆E and thickness was examined using the Pearson correlation analysis. RESULTS: Statistically significant differences were observed in translucency and color masking ability among HT, LT, and NPJ (P<.05). The RTP value was the lowest for zirconia fabricated with NPJ (P<.001) and highest for HT (P<.001). Monolithic zirconia fabricated with NPJ had lower ∆E values than those of HT and LT for the same thickness and background (P<.05). A positive correlation was found in RTP and ∆E (P<.001). A negative correlation was observed in RTP and thickness (P<.001) and ∆E and thickness across a constant background (P<.001). CONCLUSIONS: Zirconia fabricated with NPJ was less translucent and had a greater color masking ability for discolored backgrounds than HT and LT.

Host Restriction Factor A3G Inhibits the Replication of Enterovirus D68 by Competitively Binding the 5' Untranslated Region with PCBP1.

The host restriction factor APOBEC3G (A3G) inhibits an extensive variety of viruses, including retroviruses, DNA viruses, and RNA viruses. Our study shows that A3G inhibits enterovirus 71 (EV71) and coxsackievirus A16 (CA16) via competitively binding the 5' untranslated region (UTR) with the host protein poly(C)-binding protein 1 (PCBP1), which is required for the replication of multiple EVs. However, whether A3G inhibits other EVs in addition to EV71 and CA16 has not been investigated. Here, we demonstrate that A3G could inhibit the replication of EVD68, which requires PCBP1 for its replication, but not CA6, which does not require PCBP1 for replication. Further investigation revealed that the nucleic-acid-binding activity of A3G is required for EVD68 restriction, similar to the mechanism presented for EV71 restriction. Mechanistically, A3G competitively binds to the cloverleaf (1 to 123 nucleotides [nt]) and the stem-loop IV (234 to 446 nt) domains of the EVD68 5' UTR with PCBP1, thereby inhibiting the 5' UTR activity of EVD68; by contrast, A3G does not interact with CA6 5' UTR, resulting in no effect on CA6 replication. Moreover, the nonstructural protein 2C, encoded by EVD68, overcomes A3G suppression by inducing A3G degradation via the autophagy-lysosome pathway. Our findings revealed that A3G might have broad-spectrum antiviral activity against multiple EVs through this general mechanism, and they might provide important information for the development of an anti-EV strategy. IMPORTANCE As the two major pathogens causing hand, foot, and mouth disease (HFMD), enterovirus 71 (EV71) and coxsackievirus A16 (CA16) attract a lot of attention for the study of their pathogenesis, their involvement with cellular proteins, and so on. However, other EVs such as CA6 and EVD68 constantly occur sporadically or have spread worldwide in recent years. Therefore, more information related to these EVs is needed in order to develop a broad-spectrum anti-EV inhibitor. In this study, we first reveal that the protein poly(C)-binding protein 1 (PCBP1), involved in PV- and EV71 virus replication, is also required for the replication of EVD68, but not for the replication of CA6. Next, we found that the host-restriction factor A3G specifically inhibits the replication of EVD68, but not the replication of CA6, by competitively binding to the 5' UTR of EVD68 along with PCBP1. Our findings broaden knowledge related to EV replication and the interplay between EVs and host factors.

Determination of the ED90 of Dexmedetomidine Infusion to Prevent Emergence Agitation in Children Undergoing Dental Rehabilitation With Sevoflurane Anesthesia: A Biased-Coin Up-and-Down Sequential Allocation Trial.

BACKGROUND: Emergence agitation (EA) is an adverse complication during early recovery from sevoflurane anesthesia. Continuous intravenous infusion of dexmedetomidine (DEX) is commonly used for EA prevention. However, a wide dose range is used for preventing EA, and the optimal dose remains unknown. This study was aimed at determining the optimal dose (the 90% effective dose [ED90]) of DEX for continuous intraoperative infusion for EA prevention in children. METHODS: We enrolled children aged 3 to 7 years who underwent dental treatment under sevoflurane anesthesia. DEX was continuously infused from the time of the establishment of the intravenous access until 5 minutes before the end of surgery. The initial DEX dose was 0.5 µg/kg/h, and subsequent dose adjustments were determined based on the response of the previous patient by using an up-down sequential allocation with a biased-coin design. The primary outcome was the ED90 for continuous DEX infusion based on the success or failure of the EA-preventing dose. RESULTS: Forty-five patients were enrolled in the study. The DEX dose ranged from 0.50 to 0.90 µg/kg/h. The estimated ED90 (95% confidence interval [CI]) for preventing EA was 0.74 µg/kg/h (0.67-1.05 µg/kg/h). The duration of surgery (mean ± standard deviation [SD]) was 113 ± 30 minutes. The times (mean ± SD) for extubation, time to emergence, and recovery time were 5 ± 2 minutes, 27 ± 9 minutes, and 39 ± 7 minutes, respectively. CONCLUSIONS: The ED90 for continuous intraoperative DEX infusion for EA prevention in pediatric patients receiving dental treatment under sevoflurane anesthesia was 0.74 µg/kg/h (95% CI, 0.67-1.05 µg/kg/h).

Effect of build angle on the dimensional accuracy of monolithic zirconia crowns fabricated with the nanoparticle jetting technique.

STATEMENT OF PROBLEM: The build angle is an essential parameter in additive manufacturing. Its effect on the dimensional accuracy of zirconia restorations fabricated using the nanoparticle jetting (NPJ) technique is unknown. PURPOSE: The purpose of this in vitro study was to evaluate the effect of the build angle on the dimensional accuracy of monolithic zirconia complete crowns fabricated by using NPJ. MATERIAL AND METHODS: Standardized artificial right maxillary incisors and mandibular first molars were prepared for ceramic complete crowns. In total, 100 monolithic zirconia crowns were fabricated using NPJ at build angles of 0, 45, 90, 135, and 180 degrees (n=10/angle for incisors and molars). The dimensional accuracies in the external, marginal, and intaglio regions were determined by superimposing the scanned data and computer-aided design data on the crowns. Root mean square (RMS) values were used to analyze the accuracy of the zirconia crowns overall and at the external, marginal, and intaglio surfaces. The Shapiro-Wilk test was used to examine the normality of data distribution. Differences among test groups were assessed using a 1-way analysis of variance and the post hoc least significant difference test (α=.05). RESULTS: Significant differences were found in the accuracy of monolithic zirconia incisor and molar complete crowns in the external, marginal, and intaglio regions among the 5 build angles (P<.05). For incisors, the external RMS value was lowest for a build angle of 45 degrees (18.2 ±3.0 µm), the marginal and intaglio RMS values were lowest for a build angle of 135 degrees (47.4 ±10.7 and 26.5 ±6.1 µm, respectively), and the overall RMS values did not differ significantly among the 5 build angles (P>.05). For molars, build angles of 0 degrees and 180 degrees yielded the lowest RMS values overall (22.3 ±1.5 and 21.8 ±3.2 µm, respectively) and in the external (23.2 ±2.9 and 22.3 ±2.5 µm, respectively) and intaglio (22.2 ±3.7 and 21.2 ±4.6 µm, respectively) regions. No significant difference was observed in the marginal area among the 5 build angles (P>.05). The overall RMS values reflecting dimensional accuracy for the 5 build angles were between 23.5 and 26.7 µm for incisors and 21.8 and 26.2 µm for molars. CONCLUSIONS: The dimensional accuracy of monolithic zirconia crowns fabricated by using NPJ was affected by the build angle and was within clinically acceptable limits.

Dimensional accuracy and clinical adaptation of monolithic zirconia crowns fabricated with the nanoparticle jetting technique.

STATEMENT OF PROBLEM: The nanoparticle jetting (NPJ) technique is a recently developed additive manufacturing method that may have useful dental applications. The manufacturing accuracy and clinical adaptation of zirconia monolithic crowns fabricated with NPJ are unknown. PURPOSE: The purpose of this in vitro study was to compare the dimensional accuracy and clinical adaptation of zirconia crowns fabricated with NPJ and those fabricated with subtractive manufacturing (SM) and digital light processing (DLP). MATERIAL AND METHODS: Five standardized typodont right mandibular first molars were prepared for ceramic complete crowns, and 30 zirconia monolithic crowns were fabricated using SM, DLP, and NPJ (n=10) with a completely digital workflow. The dimensional accuracy at the external, intaglio, and marginal areas was determined by superimposing the scanned data and computer-aided design data of the crowns (n=10). Occlusal, axial, and marginal adaptations were evaluated by using a nondestructive silicone replica and dual scanning method. The 3-dimensional discrepancy was evaluated to determine clinical adaptation. Differences among test groups were analyzed by using a MANOVA and the post hoc least significant difference test for normally distributed data or the Kruskal-Wallis test with Bonferroni correction for nonnormally distributed data (α=.05). RESULTS: Significant differences were found in the dimensional accuracy and clinical adaptation among the groups (P<.001). The NPJ group had a lower overall root mean square (RMS) value for dimensional accuracy (22.9 ±1.4 µm) than the SM (27.3 ±5.0 µm) and DLP (36.4 ±5.9 µm) groups (P<.001). The NPJ group had a lower external RMS value (23.0 ±3.0 µm) than the SM group (28.9 ±5.4 µm) (P<.001) and equivalent marginal and intaglio RMS values than the SM group. The DLP group had larger external (33.3 ±4.3 µm), intaglio (36.1 ±10.7 µm), and marginal (79.4 ±12.9 µm) deviations than the NPJ and SM groups (P<.001). With regard to clinical adaptation, the marginal discrepancy was smaller in the NPJ group (63.9 ±27.3 µm) than in the SM group (70.8 ±27.5 µm) (P<.001). No significant differences were found between the SM and NPJ groups in terms of the occlusal (87.2 ±25.5 and 80.5 ±24.2 µm, respectively) and axial (39.1 ±19.7 and 38.4 ±13.7 µm, respectively) discrepancies. The DLP group had larger occlusal (239.0 ±60.1 µm), axial (84.9 ±29.1 µm), and marginal (140.4 ±84.3 µm) discrepancies than the NPJ and SM groups (P<.001). CONCLUSIONS: Monolithic zirconia crowns fabricated using NPJ have higher dimensional accuracy and clinical adaptation than those fabricated using SM or DLP.

Morphological design of occlusal wear facets for the mandibular first molar crown using different bite registration methods.

PURPOSE: To compare the accuracy of occlusal wear facet morphology designed using different bite registration methods for mandibular first molar crowns. MATERIALS AND METHODS: The posterior teeth and intraoral intercuspal occlusions of 12 participants were scanned. The abutment shape of the mandibular first molars for complete crowns was virtually designed, and the anatomic coping design method was used to design crowns. In the anatomic coping design, digital wax patterns were constructed by elevating the wear facets on the original surface of the first molars and then adjusting the facets with 2 types of virtual occlusions determined by buccal bite registration (BBR) or segmented tooth registration (STR) methods, where the displacement of teeth under bite force was considered (STR) or not (BBR). The occlusal distance between the original wear facets and the antagonists as well as 3D deviations between the facets on the designed crowns and on the surfaces of the original teeth were measured. Paired-samples t-test was used to analyze the results (α = 0.05). RESULTS: Regarding occlusal distance, the mean 3D deviation and the root mean square (RMS) values of BBR were greater than those of the STR groups (p < 0.001 and p = 0.008). The mean 3D deviations of the crowns of the BBR and STR groups were 0.19 ±0.04 mm and 0.14 ±0.06 mm, respectively and the RMS values were 0.22 ±0.03 mm and 0.18 ±0.04 mm (p < 0.001), respectively. CONCLUSIONS: The morphology of occlusal wear facets of mandibular first molar crowns designed with the occlusion constructed using the segmented tooth registration method are more coincident with the original morphology.

Potential Food and Nutraceutical Applications of Alginate: A Review.

Alginate is an acidic polysaccharide mainly extracted from kelp or sargassum, which comprises 40% of the dry weight of algae. It is a linear polymer consisting of ß-D-mannuronic acid (M) and α-L-guluronic acid (G) with 1,4-glycosidic linkages, possessing various applications in the food and nutraceutical industries due to its unique physicochemical properties and health benefits. Additionally, alginate is able to form a gel matrix in the presence of Ca2+ ions. Alginate properties also affect its gelation, including its structure and experimental conditions such as pH, temperature, crosslinker concentration, residence time and ionic strength. These features of this polysaccharide have been widely used in the food industry, including in food gels, controlled-release systems and film packaging. This review comprehensively covers the analysis of alginate and discussed the potential applications of alginate in the food industry and nutraceuticals.

Evaluation methods of a rat sciatic nerve crush injury model.

BACKGROUND: The rat sciatic nerve crush injury model is one of the most commonly used models to research peripheral nerve injury (PNI), however, the evaluation of the model preparation lacks exact standards. This study aimed to investigate accurately assessment methods for research concerning the rat sciatic nerve crush injury. METHODS: The sciatic nerve crush injury model of was performed using the FST toothless forceps. The corresponding locations and pressures of different ratchet strengths were assessed by using CMAP, behavioral, and morphological methods. RESULTS: In each group of PNI, motor and sensory functions were gradually restricted on the injured side of rats as the applied pressure increased. CMAP was more sensitive to nerve injury arising out of the force values obtained from the forceps. CONCLUSIONS: As a sensitive indicator for PNI, the neuroelectrophysiological examination was more likely to reflect the morphological changes of injured nerves. These findings may provide a standardized approach to sciatic crush injury modelling.

Accuracy of three digital scanning methods for complete-arch tooth preparation: An in vitro comparison.

STATEMENT OF PROBLEM: The accuracy of digital scanning for complete dental arch and implant-supported complete-arch restorations has been reported. However, research addressing the accuracy of digital scanning methods for complete-arch tooth preparation is lacking. PURPOSE: The purpose of this in vitro study was to compare the accuracy of intraoral scanning, impression scanning, and cast scanning for complete-arch preparation. MATERIAL AND METHODS: Maxillary and mandibular jaw typodonts with 28 teeth prepared for complete crowns were used as reference casts and digitized as reference data sets with a desktop scanner. Three digital scanning methods were applied. First, the reference casts were each scanned 10 times with an intraoral scanner to generate the intraoral scanning group data sets. Second, the reference casts were each captured 10 times by using polyvinyl siloxane impression material, and the impressions were scanned with a desktop scanner to generate the impression scanning group data sets. Third, the impressions obtained in the impression scanning group were used to make gypsum casts which were then digitized with a desktop scanner to generate the cast scanning group data sets. Accuracy was determined by trueness and precision. Three-dimensional deviations of the prepared arches and anterior and posterior segments were measured from root mean square values and depicted on color-difference maps. Differences among test groups were analyzed by using a 1-way ANOVA and the post hoc Bonferroni test for normally distributed data or the Kruskal-Wallis test with Bonferroni correction for non-normally distributed data (α=.05). RESULTS: The trueness of the maxillary arch was significantly higher in the impression scanning group than in the cast scanning and intraoral scanning groups (P<.05), but no significant differences were found among the 3 groups of the mandibular arch (P>.05). The precision of both arches was significantly higher in the impression scanning and intraoral scanning groups than in the cast scanning group (P<.05). Color maps showed horizontal symmetrical displacement in the intraoral scanning group relative to the reference data sets and within-group unilateral distal-end distortion. Irregular arch deformations were noted in the impression scanning group, and buccal and occlusal expansion occurred in the anterior-posterior direction in the cast scanning group. Pooled data for anterior teeth indicated that the trueness was lowest in the intraoral scanning group; however, that for the maxillary anterior teeth did not differ, while that for the mandibular anterior teeth differed significantly among groups (P<.05). For the posterior teeth, deviation was the lowest in the impression scanning group, and significant differences were noted in both arches among the 3 groups (P<.05). CONCLUSIONS: Of the methods tested, impression scanning was the most accurate for the creation of a digital cast of a complete prepared arch.

Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial.

PURPOSE: To investigate the efficacy and safety of low-dose bolus plus continuous infusion of penehyclidine in preventing postoperative nausea and vomiting (PONV) following bimaxillary surgery. METHODS: Three hundred fifty-four patients were randomly allocated into three groups. In the Control group, placebo (normal saline) was injected before anesthesia and infused over 48 h after surgery; in the Bolus group, 0.5 mg penehyclidine was injected before anesthesia, whereas placebo was infused after surgery; in the Infusion group, 0.25 mg penehyclidine were injected before anesthesia, another 0.25 mg penehyclidine was infused after surgery. The primary endpoint was the incidence of PONV within 72 h. RESULTS: A total of 353 patients were included in intention-to-treat analysis. The PONV incidence was 61.0% (72/118) in the Control group, 40.2% (47/117) in the Bolus group, and 28.0% (33/118) in the Infusion group. The incidence was significantly lower in the Bolus group than in the Control group (RR 0.66; 95% CI 0.51-0.86; adjusted P = 0.003) and in the Infusion group than in the Control group (RR 0.46; 95% CI 0.33-0.63; adjusted P < 0.001); the difference between the Infusion and Bolus groups was not statistically significant (RR 0.70; 95% CI 0.48-1.00; adjusted P = 0.144). Emergence agitation occurred more frequently in the Bolus group than in the Control group (36.8% [43/117] vs. 21.2% [25/118], adjusted P = 0.027), but did not differ significantly between the Infusion and Control groups. CONCLUSIONS: A low-dose bolus plus continuous infusion of penehyclidine was effective in preventing PONV without increasing emergence agitation. TRIAL REGISTRATION: Clinicaltrials.gov. Identifier: NCT04454866.

[Research progress on liposome and nanomicelle targeted drug delivery system across blood-brain barrier].

The blood-brain barrier(BBB), a protective barrier between brain tissues and brain capillaries, can prevent drugs from entering the brain tissues to exert the effect, which greatly increases the difficulty in treating brain diseases. The drug delivery system across the BBB can allow efficient drug delivery across the BBB by virtue of carriers and formulations, thereby enhancing the therapeutic effect of drugs on brain tissue diseases. Liposomes and micelles have been extensively studied with advances in the targeted therapy across the BBB for the brain due to their unique structures and drug delivery advantages. This study summarized the research status of liposome and micelle drug delivery systems across the BBB based on the literature in recent years and analyzed their application advantages and mechanism in terms of trans-BBB capability, targeting, and safety. Moreover, the problems and possible countermeasures in the research on trans-BBB liposomes and micelles were discussed according to the current clinical translation, which may provide refe-rences and ideas for the development of trans-BBB targeted nano-drugs.

Amelogenin phosphorylation regulates tooth enamel formation by stabilizing a transient amorphous mineral precursor.

Dental enamel comprises interwoven arrays of extremely long and narrow crystals of carbonated hydroxyapatite called enamel rods. Amelogenin (AMELX) is the predominant extracellular enamel matrix protein and plays an essential role in enamel formation (amelogenesis). Previously, we have demonstrated that full-length AMELX forms higher-order supramolecular assemblies that regulate ordered mineralization in vitro, as observed in enamel rods. Phosphorylation of the sole AMELX phosphorylation site (Ser-16) in vitro greatly enhances its capacity to stabilize amorphous calcium phosphate (ACP), the first mineral phase formed in developing enamel, and prevents apatitic crystal formation. To test our hypothesis that AMELX phosphorylation is critical for amelogenesis, we generated and characterized a hemizygous knockin (KI) mouse model with a phosphorylation-defective Ser-16 to Ala-16 substitution in AMELX. Using EM analysis, we demonstrate that in the absence of phosphorylated AMELX, KI enamel lacks enamel rods, the hallmark component of mammalian enamel, and, unlike WT enamel, appears to be composed of less organized arrays of shorter crystals oriented normal to the dentinoenamel junction. KI enamel also exhibited hypoplasia and numerous surface defects, whereas heterozygous enamel displayed highly variable mosaic structures with both KI and WT features. Importantly, ACP-to-apatitic crystal transformation occurred significantly faster in KI enamel. Secretory KI ameloblasts also lacked Tomes' processes, consistent with the absence of enamel rods, and underwent progressive cell pathology throughout enamel development. In conclusion, AMELX phosphorylation plays critical mechanistic roles in regulating ACP-phase transformation and enamel crystal growth, and in maintaining ameloblast integrity and function during amelogenesis.

HA-coated collagen nanofibers for urethral regeneration via in situ polarization of M2 macrophages.

In situ tissue engineering utilizes the regenerative potential of the human body to control cell function for tissue regeneration and has shown considerable prospect in urology. However, many problems are still to be understood, especially the interactions between scaffolds and host macrophages at the wound site and how these interactions direct tissue integration and regeneration. This study was designed to evaluate the efficacy of hyaluronic acid (HA) functionalized collagen nanofibers in modulating the pro-healing phenotype expression of macrophages for urethral regeneration. Tubular HA-collagen nanofibers with HA-coating were prepared by coaxial electrospinning. The formation of a thin HA-coating atop each collagen nanofiber endowed its nanofibrous mats with higher anisotropic wettability and mechanical softness. The macrophages growing on the surface of HA-collagen nanofibers showed an elongated shape, while collagen nanofibers' surface exhibited a pancake shape. Immunofluorescence and ELISA analysis showed that elongation could promote the expression of M2 phenotype marker and reduce the secretion of inflammatory cytokines. In vivo experiments showed that tubular HA-collagen nanofibers significantly facilitate male puppy urethral regeneration after injury. In the regenerated urethra bridged by tubular HA-collagen nanofibers, anti-inflammatory M2 macrophages are recruited to the surface of the scaffold, which can promote angiogenesis and endogenous urothelial progenitor cell proliferation.

Learner behaviors in synchronous online prosthodontic education during the 2020 COVID-19 pandemic.

STATEMENT OF PROBLEM: Synchronous online prosthodontic courses became a popular learning mode during the 2020 COVID-19 pandemic crisis. Nonetheless, the extent of learner participation and completion of these courses remains unknown. PURPOSE: The purpose of this study was to assess learner behaviors in synchronous online prosthodontic continuing education lectures in China during the 2020 COVID-19 pandemic. MATERIAL AND METHODS: All live online prosthodontic courses held by an online dental school in China from February to May 2020 were retrieved. The no-cost lectures could be accessed anonymously and viewed repeatedly on the day of broadcast. Learning behavior data (teacher speaking time, audience total, timing of first visit to the online classroom, viewing time, and completion rate) were obtained. Learning progress was calculated by dividing viewing time by teacher speaking time. When a learner progressed through 95% of a lecture, the lecture was considered completed. RESULTS: A total of 41 781 learners participated in 18 online prosthodontic courses, which had a mean duration of 77.2 ±15.8 minutes. For each lecture, 2321 ±1454 participants attended, with 510 ±404 participants completing each session. There were 13 098 participants (31.35%) who viewed the lectures for less than 1 minute. Approximately half of the participants viewed the lectures for less than 10 minutes, with their learning progress failing to pass 10%. The average completion rate was 21.97%, with variation in completion rate dependent on when a learner first visited the online classroom. Significant differences were found among the lecture completion rates and the timing of the first visit to the online classroom (P<.001). CONCLUSIONS: Synchronous online prosthodontic education courses in China had a high number of participants but low learning progress and completion rates during the 2020 COVID-19 pandemic.

Trafficking and secretion of keratin 75 by ameloblasts in vivo.

A highly specialized cytoskeletal protein, keratin 75 (K75), expressed primarily in hair follicles, nail beds, and lingual papillae, was recently discovered in dental enamel, the most highly mineralized hard tissue in the human body. Among many questions this discovery poses, the fundamental question regarding the trafficking and secretion of this protein, which lacks a signal peptide, is of an utmost importance. Here, we present evidence that K75 is expressed during the secretory stage of enamel formation and is present in the forming enamel matrix. We further show that K75 is secreted together with major enamel matrix proteins amelogenin and ameloblastin, and it was detected in Golgi and the endoplasmic reticulum (ER)-Golgi intermediate compartment (ERGIC) but not in rough ER (rER). Inhibition of ER-Golgi transport by brefeldin A did not affect the association of K75 with Golgi, whereas ameloblastin accumulated in rER, and its transport from rER into Golgi was disrupted. Together, these results indicate that K75, a cytosolic protein lacking a signal sequence, is secreted into the forming enamel matrix utilizing portions of the conventional ER-Golgi secretory pathway. To the best of our knowledge, this is the first study providing insights into mechanisms of keratin secretion.