Visual interpretation of clinical images among dental students using eye-tracking technology.

BACKGROUND: Tele-consultations are increasingly used for screening and diagnosis. Only a few studies have assessed dental students' visual attention to clinical images. AIM: To (i) determine dental students' gaze behavior, visual fixations, and diagnostic competence while viewing clinical images, and (ii) explore potential opportunities to strengthen the teaching-learning approaches. DESIGN: Tobii Pro Nano-device captured the eye-tracking data for 65 dental undergraduate students in this cross-sectional study. The predetermined areas of interest (AOI) for all five clinical photographs were uploaded onto Tobii software. All participants used a think-aloud protocol with no restrictions to view time. RESULTS: A total of 325 clinical pictures were analyzed, and the average view time was 189.25 ± 76.90 s. Most participants started at the center of the image (three frontal photos), spent a significant share of their view time on prominent findings, did not follow a systematic pattern, and exhibited diagnostic incompetence. Also, most participants followed a "Z" viewing pattern (oscillating movement from left to right) for the remaining two pictures. CONCLUSIONS: Subjects frequently fixated on the prominent AOI, however, failed to make the correct diagnosis. Their view patterns revealed no sequential viewing. Therefore, emphasizing knowledge about common dental abnormalities and focusing on full coverage of clinical pictures can improve dental students' diagnostic competence and view patterns.

Network-based identification and prioritization of key transcriptional factors of diabetic kidney disease.

Diabetic nephropathy (DN) is one of the most established microvascular complications of diabetes and a key cause of end-stage renal disease. It is well established that gene susceptibility to DN plays a critical role in disease pathophysiology. Therefore, many genetic studies have been performed to categorize candidate genes in prominent diabetic cohorts, aiming to investigate DN pathogenesis and etiology. In this study, we performed a meta-analysis on the expression profiles of GSE1009, GSE30122, GSE96804, GSE99340, GSE104948, GSE104954, and GSE111154 to identify critical transcriptional factors associated with DN progression. The analysis was conducted for all individual datasets for each kidney tissue (glomerulus, tubules, and kidney cortex). We identified distinct clusters of susceptibility genes that were dysregulated in a renal compartment-specific pattern. Further, we recognized a small but a closely connected set of these susceptibility genes enriched for podocyte differentiation, several of which were characterized as genes encoding critical transcriptional factors (TFs) involved in DN development and podocyte function. To validate the role of identified TFs in DN progression, we functionally validated the three main TFs (DACH1, LMX1B, and WT1) identified through differential gene expression and network analysis using the hyperglycemic zebrafish model. We report that hyperglycemia-induced altered gene expression of the key TF genes leads to morphological abnormalities in zebrafish glomeruli, pronephric tubules, proximal and distal ducts. This study demonstrated that altered expression of these TF genes could be associated with hyperglycemia-induced nephropathy and, thus, aids in understanding the molecular drivers, essential genes, and pathways that trigger DN initiation and development.

Comparative evaluation of subgingival microbiome in healthy periodontium and gingivitis using next-generation sequencing technology: A case-control study.

Background: Human dental plaque is a complex microbial community containing millions of species. Gingivitis is a dysregulated immune-inflammatory response induced by dysbiotic plaque biofilm that interrupts symbiosis. The emergence of next-generation sequencing with 16S rRNA gene has greatly contributed in understanding the complexity of microbiota. However, studies focusing on microbiome in gingivitis are limited. The whole bacterial community is important in causing periodontal disease than a small number of periodontal pathogens. In this study, we attempted to profile the subgingival microbiome from individuals with healthy gingiva and in patients with gingivitis using next-generation sequencing technology. Materials and Methods: Subgingival plaque samples from 15 healthy periodontium (Group I) and 15 gingivitis (Group II) were collected and 16s rRNA sequencing was done in Illumina Solexa Sequencer. Data analysis using 16s metagenomics tool from BaseSpace onsite operational taxonomic units was assigned to each sequence using HOMD database. Individual variation in the microbiome of the subgingival samples between the two groups was also evaluated. Results: The comparison of top 20 species between Group I and Group II revealed no significant species group between them. Synergistetes was absent in Group I samples but found in Group II. At the genus level, HACEK group species were found in both the groups, while Dialister and Aneroglobus were found abundantly in the Group II. Conclusion: The presence of unique genera and species seen in Group II samples could point toward a dysbiotic shift that could be taking place in the subgingival environment leading to gingivitis.

Biocompatible Films of Collagen-Procyanidin for Wound Healing Applications.

The study investigated the effect of polyphenols present in Cassia auriculata (CA) leaves in enhancing the stability of the collagen protein and the wound healing potential of collagen films. The crude ethanol extract of CA was analyzed for the presence of phytochemicals and purified by column chromatography using solvents with increasing polarity. The ethanol eluted active fractions (EEAF) that precipitated gelatin was characterized using HP-TLC, FTIR spectroscopy, ESI-FT-MS/MS, and 1H NMR spectroscopy. The active compound was identified to be procyanidin B belonging to the proanthocyanidins group. The wound healing property of EEAF and collagen type I extracted from Clarias batrachus fish skin and the bovine tendon was assessed by in vitro scratch assay on L929 mice fibroblast cell lines. The EEAF-treated collagen coating enhanced in vitro wound closure in comparison with the uncoated dish. It was observed that EEAF treatment improved the physical strength of collagen films. The in vivo wound healing of the EEAF-treated collagen film was examined in male Wister rats and the wound site tissues were assessed. In vivo wound examination showed enhanced healing with EEAF incorporated collagen films. Comparatively, the EEAF-treated bovine tendon collagen films showed improved physical properties and better wound healing property than fish collagen films.

Knowledge, attitude, and health seeking behavior on leprosy among urban adults in Kancheepuram district of Tamil Nadu: A Community-based cross-sectional study.

INTRODUCTION: Although various measures are taken to create awareness about the epidemiological features of leprosy and encourage health-seeking behavior, they have seldom been able to tackle the high incidence of new leprosy cases in India. OBJECTIVE: To determine Leprosy-related knowledge, attitude, and health seeking behavior among the urban population in Kancheepuram district of Tamil Nadu. MATERIALS AND METHODS: This community-based cross-sectional study was conducted among a sample size of 640 people above 18 years of age residing in the study area, selected by multistage random sampling. A structured pretested questionnaire was used for data collection, and the data analysis was done using SPSS version 22. RESULTS: Among the study participants, 54.7% of the participants had adequate knowledge and 23.3% had favorable attitude towards leprosy. With regard to knowledge, 66% of the participants believe that leprosy is a serious disease, and 71.2% of them were aware of transmission of leprosy from person to person. With regard to attitude, 57.7% were afraid of being diagnosed with leprosy, and 57% felt compassion and desire to help those diagnosed with leprosy. With regard to health-seeking behavior, around 83% preferred treatment from government hospitals and allopathic treatment. Male sex, occupation, education, and marital status were found to be having statistically significant association with knowledge, while the latter two were found to be associated with favorable attitude towards leprosy. CONCLUSION: Unfavorable attitude and inadequate knowledge regarding leprosy was found among the study participants. Behavior change communication programs have to be enhanced at community level to improve the knowledge and attitude regarding leprosy among the population.

Morphological variations and prevalence of aberrant traits of primary molars.

BACKGROUND: Morphological variations in tooth structure exhibit as metric and non-metric traits which play an important role in dental anthropology. AIM: The purpose of this study was to determine the prevalence of morphometric traits and mean crown dimensions of primary molars in children. SUBJECTS AND METHODS: This cross-sectional study was carried out in 4256 sectional dye casts of caries-free children aged 2.5-4 years from Puducherry. Two calibrated examiners graded the non-metric traits utilising the Arizona State University Dental Anthropological System classification and measured the crown dimensions in primary molars. The results are expressed in the form of numbers and percentages. RESULTS: Of the eight non-metric traits studied, metaconule (30.17%), Cusp of Carabelli (90.6%), and deflecting wrinkle (87.41%) in second primary molars, and distal trigonid crest (93.06%) and parastyle (3.48%) in first primary molars, seemed to have higher prevalence, and the overall crown dimensions were found to be smaller in comparison with those in other populations. CONCLUSION: This study highlights the prevalence of aberrant dental traits in primary molars in a population. The study describes, for the first time, the existence of these traits in first primary molars, adding anthropological significance of primary dentition in various other populations.

Insights into substrate specificity of proteases for screening efficient dehairing enzymes.

Though numerous proteases have been isolated and screened for the dehairing purpose, their use in the leather industry is limited mainly due to high cost, the need for expertise, and control during unit operation and alterations in the quality of leather due to lack of the right kind of substrate specificity of the enzymes used. This paper deals with the comparative specificity and dehairing efficiency of proteases isolated from Bacillus cereus VITSP01 (PE2) and Brevibacterium luteolum VITSP02 (PE). PE2 and PE were found to be trypsin-like and elastase-like serine proteases respectively. The protease of VITSP02 degraded the proteoglycans efficiently in comparison to that of VITSP01. The results suggest that the possible targets of the studied proteases might be skin proteoglycans, including those cementing the hair root bulb. Hence, an in-depth study on the substrate specificity of the dehairing proteases would help in designing an improved screening method for isolating potent dehairing enzymes.

Prevalence of the Cusp of Carabelli: a systematic review and meta-analysis.

CONTEXT: The Cusp of Carabelli (CoC) is the most commonly occurring dental morphological trait. OBJECTIVE: To provide a pancontinental overview on the prevalence of the CoC in primary maxillary second molars and permanent maxillary molars. METHODS: An electronic search was conducted on ten databases without year restrictions up to July 2020. All cross-sectional studies published in the English language reporting prevalence estimate of CoC were included. A modified version of the Newcastle-Ottawa scale was used to assess study quality. Meta-analyses were conducted for studies that reported data using Dahlberg and ASUDAS classification across continents. RESULTS: For qualitative synthesis, 142 studies (45,327 participants) were included, of which 130 studies had moderate risk of bias. Random effects meta-analysis was performed for 41 studies. For prevalence of CoC in primary maxillary second molars, the estimate was 72% (2,829 participants). The overall percentage attained for permanent maxillary molars was 59% (16,607 participants) for first molars; 8% (2,277 participants) for second molars; and 10% (89 participants) for third molars. Subgroup analysis revealed the European continent reported the highest prevalence in permanent maxillary first and second molars. CONCLUSION: Primary maxillary second molars recorded highest prevalence of CoC followed by permanent maxillary first, third and second molars. Pancontinental studies with regard to primary maxillary second molars are warranted.

Prevalence of Cusp of Carabelli and its caries susceptibility - an ambidirectional cohort study.

BACKGROUND/AIM: To investigate the susceptibility of Cusp of Carabelli (CoC) to caries in 3- to 4-year-old children. METHODS: The prevalence of CoC was obtained, by two calibrated examiners using 2128 maxillary posterior sectional die models of 1064 caries-free children (that were prepared 8 months back). Four months after recording the CoC, prospective clinical examination of above-mentioned children was carried out by a calibrated third examiner. International Caries Detection and Assessment System was used to record caries of the mesiopalatal surfaces (site of CoC) of the primary maxillary second molars. Data were expressed in numbers and percentages and subjected to chi-square and logistic regression analyses. RESULTS: The prevalence of CoC was 90.6%. The incidence of caries in association with CoC was 10.5%, and this association was statistically significant (0.004), with an odds ratio of 4.7. A statistically significant association was found between positive and negative expression of CoC and caries (0.001), with an odds ratio of 7.7 in positive expression and 4.1 in negative expression. CONCLUSION: The prevalence of CoC was high, with an increased risk for caries with a positive cusp expression. This highlights the need for closer assessment of the mesiopalatal surfaces of primary maxillary second molars during examination.

Total synthesis and biological evaluation of clavaminol-G and its analogs.

The first total synthesis of clavaminol-G (1) and 1-aminoundecan-2-ol (2) has been achieved from 10-undecenoic acid using epoxidation, regioselective azidolysis and in situ detosylation and reduction reactions as key steps. The methodology is extended for the synthesis of 1-aminoundecan-2-ol derivatives; namely, methyl 11-amino-10-hydroxyundecanoate (3), 11-amino-10-hydroxyundecanoic acid (4) and 11-aminoundecan-1,10-diol (5). Among these, 1-aminoundecan-2-ol (2) exhibited good antimicrobial activity and promising cytotoxicity towards HeLa, MDA-MB-231, MCF-7 and A549 cell lines with IC50 values of 4.36, 4.02, 3.88 and 6.78 µM, respectively. Compound 3 exhibited good activity against HeLa cells (IC50 = 3.59 µM), while compound 5 showed moderate activity towards HeLa and A549 cell lines. Clavaminol G (1) and compound 4 showed no activity towards all the cell lines.

Synthesis, biological evaluation of 5-carbomethoxymethyl-7-hydroxy-2-pentylchromone, 5-carboethoxymethyl-4',7-dihydroxyflavone and their analogues.

In this letter, we describe the first synthesis of two recently isolated flavones 5-carbomethoxymethyl-7-hydroxy-2-pentylchromone (3a), 5-carboethoxymethyl-4',7-dihydroxyflavone (3b) and their derivatives (3c-t), evaluated for their antimicrobial, antioxidant and anticancer activities. Most of the synthesized compounds exhibited antimicrobial activity against the tested microbial strains and some of these compounds were found to be more potent as compared to the standard drugs like neomycin and luteolin. Interestingly, some of these synthesized compounds also showed moderate antioxidant property.