Responsible artificial intelligence for addressing equity in oral healthcare.

Oral diseases pose a significant burden on global healthcare. While many oral conditions are preventable and manageable through regular dental office visits, a substantial portion of the population faces obstacles in accessing essential and affordable quality oral healthcare. In this mini review, we describe the issue of inequity and bias in oral healthcare and discuss various strategies to address these challenges, with an emphasis on the application of artificial intelligence (AI). Recent advances in AI technologies have led to significant performance improvements in oral healthcare. AI also holds tremendous potential for advancing equity in oral healthcare, yet its application must be approached with caution to prevent the exacerbation of inequities. The "black box" approaches of some advanced AI models raise uncertainty about their operations and decision-making processes. To this end, we discuss the use of interpretable and explainable AI techniques in enhancing transparency and trustworthiness. Those techniques, aimed at augmenting rather than replacing oral health practitioners' judgment and skills, have the potential to achieve personalized dental and oral care that is unbiased, equitable, and transparent. Overall, achieving equity in oral healthcare through the responsible use of AI requires collective efforts from all stakeholders involved in the design, implementation, regulation, and utilization of AI systems. We use the United States as an example due to its uniquely diverse population, making it an excellent model for our discussion. However, the general and responsible AI strategies suggested in this article can be applied to address equity in oral healthcare on a global level.

Effects of Topoisomerase II alpha Inhibition on Oral Cancer Cell Metabolism and Cancer Stem Cell Function.

Background: Topoisomerase IIα (TOP2A), is an enzyme involved in DNA replication, transcription, recombination, and chromatin remodeling and is found in a variety of cancers. However, the role of TOP2A regulation in oral cancer progression is not fully explained. We investigated the effect of TOP2A inhibition on cell survival, metabolism, and cancer stem cell self-renewal function in oral cancer cells. Methods: Oral carcinoma cell line SCC25 was cultured in complete DMEM/F12 media and treated with 5µM of Etoposide (Topoisomerase II inhibitor) for 48h. The critical parameters of cellular metabolism, including extracellular acidification rate (ECAR) and mitochondrial oxidative phosphorylation based on the oxygen consumption rate of cancer cells were assessed using Seahorse assay. Western blotting was performed to assess the proteins that are associated with proliferation (Survivin, IL-6) and cancer stem cell function (Oct4, Sox2) in cell lysates prepared from control and etoposide treated groups. Statistical analysis was performed using One-way ANOVA with Dunnett's multiple comparisons test. Results: The protein expression of TOP2A was significantly (P<0.05) inhibited by etoposide. Additionally, TOP2A inhibition decreased the mitochondrial respiratory parameters including basal respiration, maximal respiration and ATP production. However, TOP2A inhibition has no impact on glycolytic function. Moreover, the proliferative marker survivin and IL-6 showed a significant (P<0.05) decrease after TOP2A inhibition. Conversely, the protein expression of cancer stem cell markers Oct-4 and Sox 2 were not altered. Conclusion: These results indicate that inhibition of TOP2A is more efficacious by decreasing the mitochondrial metabolic reprogramming and thereby downregulating the key anti-apoptotic and pro-survival mediators. Thus, TOP2A represents an ideal therapeutic target and offers a potential treatment strategy for OSCC.

Inhibition of cytochrome P450 epoxygenase promotes endothelium-to-mesenchymal transition and exacerbates doxorubicin-induced cardiovascular toxicity.

BACKGROUND: Doxorubicin (DOX) is a potent chemotherapy widely used in treating various neoplastic diseases. However, the clinical use of DOX is limited due to its potential toxic effect on the cardiovascular system. Thus, identifying the pathway involved in this toxicity may help minimize chemotherapy risk and improve cancer patients' quality of life. Recent studies suggest that Endothelial-to-Mesenchymal transition (EndMT) and endothelial toxicity contribute to the pathogenesis of DOX-induced cardiovascular toxicity. However, the molecular mechanism is yet unknown. Given that arachidonic acid and associated cytochrome P450 (CYP) epoxygenase have been involved in endothelial and cardiovascular function, we aimed to examine the effect of suppressing CYP epoxygenases on DOX-induced EndMT and cardiovascular toxicity in vitro and in vivo. METHODS AND RESULTS: To test this, human endothelial cells were treated with DOX, with or without CYP epoxygenase inhibitor, MSPPOH. We also investigated the effect of MSPPOH on the cardiovascular system in our zebrafish model of DOX-induced cardiotoxicity. Our results showed that MSPPOH exacerbated DOX-induced EndMT, inflammation, oxidative stress, and apoptosis in our endothelial cells. Furthermore, we also show that MSPPOH increased cardiac edema, lowered vascular blood flow velocity, and worsened the expression of EndMT and cardiac injury markers in our zebrafish model of DOX-induced cardiotoxicity. CONCLUSION: Our data indicate that a selective CYP epoxygenase inhibitor, MSPPOH, induces EndMT and endothelial toxicity to contribute to DOX-induced cardiovascular toxicity.

Synthesis of 3D Sb2O3-based heterojunction reinforced by SPR effect and photo-Fenton mechanism for upgraded oxidation of metronidazole in water environments.

The traditional homogenous and heterogenous Fenton reactions have frequently been restrained by the lower production of Fe2+ ions, which significantly obstructs the generation of hydroxyl radicals from the decomposition of H2O2. Thus, we introduce novel photo-Fenton-assisted plasmonic heterojunctions by immobilizing Fe3O4 and Bi nanoparticles onto 3D Sb2O3 via co-precipitation and solvothermal approaches. The ternary Sb2O3/Fe3O4/Bi composites offered boosted photo-Fenton behavior with a metronidazole (MNZ) oxidation efficiency of 92% within 60 min. Among all composites, the Sb2O3/Fe3O4/Bi-5% hybrid exhibited an optimum photo-Fenton MNZ reaction constant of 0.03682 min- 1, which is 5.03 and 2.39 times higher than pure Sb2O3 and Sb2O3/Fe3O4, respectively. The upgraded oxidation activity was connected to the complementary outcomes between the photo-Fenton behavior of Sb2O3/Fe3O4 and the plasmonic effect of Bi NPs. The regular assembly of Fe3O4 and Bi NPs enhances the surface area and stability of Sb2O3/Fe3O4/Bi. Moreover, the limited absorption spectra of Sb2O3 were extended into solar radiation by the Fe3+ defect of Fe3O4 NPs and the surface plasmon resonance (SPR) effect of Bi NPs. The photo-Fenton mechanism suggests that the co-existence of Fe3O4/Bi NPs acts as electron acceptor/donor, respectively, which reduces recombination losses, prolongs the lifetime of photocarriers, and produces more reactive species, stimulating the overall photo-Fenton reactions. On the other hand, the photo-Fenton activity of MNZ antibiotics was optimized under different experimental conditions, including catalyst loading, solution pH, initial MNZ concentrations, anions, and real water environments. Besides, the trapping outcomes verified the vital participation of •OH, h+, and •O2- in the MNZ destruction over Sb2O3/Fe3O4/Bi-5%. In summary, this work excites novel perspectives in developing boosted photosystems through integrating the photocatalysis power with both Fenton reactions and the SPR effects of plasmonic materials.

Sustainable kitchen wastewater treatment with electricity generation using upflow biofilter-microbial fuel cell system.

The microbial fuel cell (MFC) is considered a modern technology used for treating wastewater and recovering electrical energy. In this study, a new dual technology combining MFC and a specialized biofilter was used. The anodic materials in the system were crushed graphite, either without coating (UFB-MFC) or coated with nanomaterials (nano-UFB-MFC). This biofilter served as a barrier to retain and remove turbidity and suspended solids, while also facilitating the role of bacteria in the removal of organic pollutants, phosphates, nitrates, sulfates, oil and greases. The results demonstrated that both systems exhibited high efficiency in treating kitchen wastewater, specifically greywater and dishwashing wastewater with high detergent concentrations. The removal efficiencies of COD, oil and grease, suspended solids, turbidity, nitrates, sulfates, and phosphates in first UFB-MFC were found to be 88, 95, 89, 86, 87, 75, and 94%, respectively, and in Nano-UFB-MFC were 86, 99, 95, 91, 81, 88, and 95%, respectively, with a high efficiency in recovering bioenergy reaching a value of 1.8 and 1.5 A m-3, respectively. The results of this study demonstrate the potential for developing MFC and utilizing it as a domestic system to mitigate pollution risks before discharging wastewater into the sewer network.

Assessment of Native Myocardial T1 Mapping for Early Detection of Anthracycline-Induced Cardiotoxicity in Patients with Cancer: a Systematic Review and Meta-analysis.

Anthracycline antibiotic is one of the most effective anti-tumor drugs used to manage certain types of breast cancers, lymphomas, and leukemias. However, anthracyclines induce a dose-dependent cardiotoxicity that may progress to heart failure. Thus, using a sensitive predictor of early cardiac dysfunction in patients treated with anthracyclines can help detect subclinical cardiac dysfunction early and help initiate interventions to protect these patients. Among parameters of myocardial measure, cardiac magnetic resonance (CMR)-measured native myocardial T1 mapping is considered a sensitive and accurate quantitative measure of early subclinical cardiac changes, particularly cardiac inflammation and fibrosis. However, to understand the quality and the validity of the current evidence supporting the use of these measures in patients treated with anthracyclines, we aimed to conduct a systematic review of clinical studies of this measure to detect early myocardial changes in cancer patients treated with anthracyclines. The primary outcome was the level of native T1 mapping. We performed fixed-effects meta-analyses and assessed certainty in effect estimates. Of the 1780 publications reviewed (till 2022), 23 were retrieved, and 9 articles met the inclusion criteria. Our study showed that exposure to anthracycline was associated with a significant elevation of native myocardial T1 mapping from baseline (95% CI 0.1121 to 0.5802; p = 0.0037) as well as compared to healthy control patients (95% CI 0.2925 to 0.7448; p < 0.0001). No significant publication bias was noted on the assessment of the funnel plot and Egger's test. According to the Q test, there was no significant heterogeneity in the included studies (I2 = 0.0000% versus healthy controls and I2 = 14.0666% versus baseline). Overall, our study suggests that native myocardial T1 mapping is useful for detecting anthracycline-induced cardiotoxicity in patients with cancer.

Synthesis of novel bioadhesive hydrogels via facile Thiol-Ene click chemistry for wound healing applications.

Development of outstanding, cost-effective and elastic hydrogels as bioadhesive using Thiol-Ene click chemistry was verified. The visible light photocrosslinkable hydrogels composed of methacrylated chitosan/2,2'-(Ethylenedioxy) diethanethiol formed in presence of eosin-Y photoinitiator. Such hydrogels hold great promise for wound healing applications due to their tunable properties. Main components of hydrogels were extensively characterized using spectroscopic techniques for chemical analysis, thermal analysis, and topologic nanostructure. Various optimization conditions for best gelation time were investigated. Mechanical properties of tensile strength and elongation at break (%) were verified for best wound healing applications. Optimum hydrogel was subjected to for cytotoxicity and microbial suppression evaluation and in-vivo wound healing test for efficient wound healing evaluations. Our results demonstrate the potential use of injectable hydrogels as valuable bioadhesives in bioengineering and biomedical applications, particularly in wound closure and patches.

An Update on the Use of Artificial Intelligence in Digital Pathology for Oral Epithelial Dysplasia Research.

INTRODUCTION: Oral epithelial dysplasia (OED) is a precancerous histopathological finding which is considered the most important prognostic indicator for determining the risk of malignant transformation into oral squamous cell carcinoma (OSCC). The gold standard for diagnosis and grading of OED is through histopathological examination, which is subject to inter- and intra-observer variability, impacting accurate diagnosis and prognosis. The aim of this review article is to examine the current advances in digital pathology for artificial intelligence (AI) applications used for OED diagnosis. MATERIALS AND METHODS: We included studies that used AI for diagnosis, grading, or prognosis of OED on histopathology images or intraoral clinical images. Studies utilizing imaging modalities other than routine light microscopy (e.g., scanning electron microscopy), or immunohistochemistry-stained histology slides, or immunofluorescence were excluded from the study. Studies not focusing on oral dysplasia grading and diagnosis, e.g., to discriminate OSCC from normal epithelial tissue were also excluded. RESULTS: A total of 24 studies were included in this review. Nineteen studies utilized deep learning (DL) convolutional neural networks for histopathological OED analysis, and 4 used machine learning (ML) models. Studies were summarized by AI method, main study outcomes, predictive value for malignant transformation, strengths, and limitations. CONCLUSION: ML/DL studies for OED grading and prediction of malignant transformation are emerging as promising adjunctive tools in the field of digital pathology. These adjunctive objective tools can ultimately aid the pathologist in more accurate diagnosis and prognosis prediction. However, further supportive studies that focus on generalization, explainable decisions, and prognosis prediction are needed.

Monolithic Zirconia Single Crowns Supported by Narrow or Standard Diameter Titanium-zirconium Implants in Posterior Sites: One-year Results of a Randomized Controlled Trial.

The replacement of missing teeth with implant-supported prostheses has become a standard treatment option with reliable long-term outcomes in various clinical indications.1-6 The implant-supported single crowns, in particular, presented the most favorable outcome with a survival rate of 89.5% to 96% over a 10-year period.5,6 A notable prosthetic maintenance requirement, however, was reported irrespective of the prosthetic material used for the crown construction.1,7 Metal-ceramic restorations have been considered the gold standard when replacing single or multiple missing teeth with implant-supported fixed dental prostheses.8 A systematic review of 4363 metal-ceramic implant-supported single crowns in the anterior and posterior region reported an impressive survival rate of 98.3% over five years.9 Yet, the biologic and prosthetic complications associated with these restorations were substantial with a rate of 13.5%. In the posterior region, a recent systematic review of short-term randomized controlled trials10 reported a survival rate of 99.1% for metal-ceramic implant-supported single crowns. The reported prosthetic complications, mainly ceramic chipping, were also notable with an incidence rate of 7.6%.mIn recent years, the introduction of high-strength all-ceramic materials as well as digitaldesign and manufacturing processes, has allowed faster fabrication of more esthetic and cost effective restorations.11 Zirconia-based fixed dental prostheses on teeth and implants are now increasingly used and show 5-year cumulative survival rates of 89.4 to 100%.12 These restorations are typically made up of a zirconia framework that is veneered with a layer of glass ceramic to impart translucency for enhanced esthetics.13 However, chipping of the ceramic layer has been a lingering issue, shifting the attention toward the use of full anatomic monolithic zirconia restorations.14,15 Replacement of missing teeth with dental implants in posterior ridges with limited bone width can be surgically challenging and the notion of narrow diameter implants has been suggested.16,17 These implants were thought to offer potential advantages in terms of costeffectiveness and surgical morbidity.18,19 The literature, however, remains controversial on treatment outcomes with narrow diameter implants, particularly in posterior sites.19-21 When single tooth replacement with monolithic zirconia implant-supported single crowns in posterior sites are considered, only short to medium-term outcomes are available.22-26 The survival rates and clinical performances reported in these studies were variable. Crown survival rates between 84% and 100% were demonstrated over an observation time of one to three years, while the prosthetic complications were between 0% to 14%. In three studies,22,23,25 standard diameter titanium implants were used in premolar and molar sites to support the single crowns. The remaining two studies by Mühlemann et al. (2020) and Zumstein et al. (2023) reported the one-year and three-year outcomes, respectively, of the same cohort. In these studies, narrow titanium-zirconium (TiZr) implants of 3.3 mm diameter were exclusively utilized in molar sites. The implant and crown survival rates reported at one and three years were 97.4% and 84%, respectively. The lower survival rate observed in the report of Zumstein et al. (2023) resulted from fracture of five implants and the subsequent loss of their respective crowns. Aside from these two reports, no other information on the outcomes of monolithic zirconia single crowns supported by narrow diameter TiZr implants in posterior sites are available. The validity of this treatment, therefore, needs further investigation with well-designed clinical trials. Hence, a randomized controlled trial was undertaken to assess various implant, prosthetic, and patient-reported outcomes of monolithic zirconia single crowns supported by either narrow or standard diameter titanium-zirconium (TiZr) implants in posterior sites. The present report focuses on the one-year prosthetic results.

Factors contributing to patency after aneurysmorrhaphy and outflow repair in arteriovenous fistula aneurysm treatment.

INTRODUCTION: Vascular access-related aneurysms (VARA) are a complication of arteriovenous fistulas. Repair techniques have been described in the literature with varied outcomes. MATERIALS AND METHODS: We conducted a prospective cohort study on patients who had VARA repair over 41 months. The indication for repair was an aneurysmal arteriovenous fistula (AVF) at risk of haemorrhage or difficulty in cannulation. Pseudoaneurysms, infected AVF and bleeding VARA were excluded. All patients underwent outflow stenosis treatment when present, followed by aneurysmorrhaphy. They were monitored periodically over 12 months, measuring functional primary and cumulative patency and access flow. We studied the patient demography, access flow and presence of outflow stenosis. Access flow was measured from the brachial artery (Qa) as a surrogate using ultrasonography. A Kaplan-Meier survival analysis was used to predict the primary and cumulative patency at 12 months and factors contributing to 12-month patency were analysed. RESULTS: A total of 64 patients were recruited for this study, of whom 58 completed the study. Most of the participants were male (67%) with a median age of 45 years. Forty-six patients (79.3%) had brachiocephalic fistula (BCF) aneurysms. Thirty-nine (67.2%) had preexisting outflow stenoses that required intervention. All patients underwent an aneurysmorrhaphy, of whom 12% had a cephalic arch vein transposition due to severe stenosis. Primary patency at 12 months was 86%, whereas the cumulative patency rate was 95%. Patency was significantly associated with younger age and showed a positive trend with higher preintervention Qa. Symptomatic recurrent stenosis developed in 17.2% of the cohort. CONCLUSION: Improving the patency of VARA entails the treatment of outflow stenosis and aneurysmorrhaphy. Surveillance is important to detect and treat recurrent outflow stenoses. The outcome is better among younger patients with pre-interventional access flow as measured in the brachial artery as a surrogate.

CdIn2Se4@chitosan heterojunction nanocomposite with ultrahigh photocatalytic activity under sunlight driven photodegradation of organic pollutants.

This research focused on synthesizing a CdIn2Se4@Ch nanocomposite by doping CdIn2Se4 into chitosan using a photolysis assisted ultrasonic process. The aim was to enhance the photodegradation efficiency of ofloxacin and 2,4-dichlorophenoxyacetic acid under sunlight. The synthesized CdIn2Se4@Ch nanocomposite was investigated via different techniques, including XRD, XPS, FTIR, TEM, DSC, TGA, UV-Vis and PL. The study also investigated the influence of various reaction parameters, including the effects of inorganic and organic ions. The synthesized nanocomposite demonstrated exceptional efficiency, achieving 86 % and 95 % removal rates, with corresponding rate constants of 0.025 and 0.047 min-1. This performance surpasses that of CdIn2Se4 by approximately 1.35 and 2.25 times, respectively. The values of COD were decreased to 78 and 86 % for ofloxacin and 2,4-dichlorophenoxyacetic, while the TOC values decreased to 71 and 84 %, respectively, from their premier values. The improvement in performance is associated with the introduction of CdIn2Se4 into chitosan, resulting in the self-integration of Cd into the catalyst. This creates a localized accumulation point for electrons, enhancing the efficiency of charge separation and further reducing the surface charge of chitosan. Experimental evidence suggests that superoxide and hydroxyl radicals play a significant role in the photodegradation of pollutants. Additionally, the nanocomposite exhibits excellent stability and can be reused up to five times, indicating remarkable stability and reusability of the developed photocatalyst.

IPN based hydrogels for in-vivo wound dressings; catalytic wound healing dynamics and isothermal adsorption models.

Interpenetrating network (IPN) methacrylated chitosan or methacrylated flaxseed gum based hydrogels have been utilized to make outstanding in-vivo wound dressings. The photopolymerization process was accomplished in presence of Eosin-Y photoinitiator with average exposure time of 13-14 s for gelation. Spectroscopic structural investigations of 1H NMR. ATR-FTIR, TGA, and AFM techniques were used. In-vitro hemolysis test provided evidence of no cytotoxicity in both hydrogels observed. The in-vivo wound dressings were monitored for five mice coated with each hydrogel and another uncoated five mice for control (self-healing). All measurements were performed in quintuplicate (n = 5) and expressed as mean ± SD values. In wound healing dynamics, our data confirmed that wound healing pass through two stages; hemostasis and inflammation for stage 1, and proliferation and remodeling for stage 2. It also provided evidence of 1st order kinetics with descending rate of healing. Consequently, catalytic role of hydrogels in wound healing was checked via half-life (δ) and negative change of activation energy values (ΔEa). Various isothermal adsorption models demonstrated spontaneous and high binding affinities of hydrogels. It also confirmed the two-stage healing process in presence of hydrogels. Conclusively, the outstanding properties of the two hydrogels suggest their potential applications in treating venous ulcers and diabetic wound healing dressings.

Performance of AI chatbots on controversial topics in oral medicine, pathology, and radiology.

OBJECTIVES: In this study, we assessed 6 different artificial intelligence (AI) chatbots (Bing, GPT-3.5, GPT-4, Google Bard, Claude, Sage) responses to controversial and difficult questions in oral pathology, oral medicine, and oral radiology. STUDY DESIGN: The chatbots' answers were evaluated by board-certified specialists using a modified version of the global quality score on a 5-point Likert scale. The quality and validity of chatbot citations were evaluated. RESULTS: Claude had the highest mean score of 4.341 ± 0.582 for oral pathology and medicine. Bing had the lowest scores of 3.447 ± 0.566. In oral radiology, GPT-4 had the highest mean score of 3.621 ± 1.009 and Bing the lowest score of 2.379 ± 0.978. GPT-4 achieved the highest mean score of 4.066 ± 0.825 for performance across all disciplines. 82 out of 349 (23.50%) of generated citations from chatbots were fake. CONCLUSIONS: The most superior chatbot in providing high-quality information for controversial topics in various dental disciplines was GPT-4. Although the majority of chatbots performed well, it is suggested that developers of AI medical chatbots incorporate scientific citation authenticators to validate the outputted citations given the relatively high number of fabricated citations.

Apabetalone (RVX-208): A Potential Epigenetic Therapy for the Treatment of Cardiovascular, Renal, Neurological, Viral, and Cancer Disorders.

Bromodomain and extra-terminal domain proteins (BET proteins) are epigenetic reader proteins that have been implicated in regulating gene expression through binding to chromatin and interaction with transcription factors. These proteins are located in the nucleus and are responsible for recognizing acetylated lysine residues on histones, reading epigenetic messages, recruiting key transcription factors, and thereby regulating gene expression. BET proteins control the transcription of genes responsible for maladaptive effects in inflammation, cancer, and renal and cardiovascular diseases. Given the multifaceted role of BET proteins in the pathogenesis of various diseases, several small molecule inhibitors of BET proteins have been developed as potential therapeutic targets for treating different diseases in recent years. However, while many nonselective BET inhibitors are indicated for the treatment of cancer, a selective BET inhibitor, apabetalone, is the only oral BET inhibitor in phase III clinical trials for the treatment of cardiovascular diseases and others. Thus, this review aims to present and discuss the preclinical and clinical evidence for the beneficial effects and mechanism of action of apabetalone for treating various diseases.

Optimizing Recovery After Carpal Tunnel Syndrome Release Surgery: The Role of Counseling in Pain Management and Perioperative Functional Enhancement.

Background: Preoperative patient education is pivotal in improving patient outcomes during the perioperative phase, involving a thorough explanation of what patients can expect. This enhances adherence and reduces perioperative anxiety. In orthopedics, carpal tunnel syndrome, a common and painful hand condition, is effectively managed through surgical release under local anesthesia. Inadequate counseling before such procedures may intensify intraoperative anxiety and increase pain responses. Thus, this research aims to investigate the effects of comprehensive preoperative counseling on various parameters in carpal tunnel release surgery. Methods: A case-control study design was adopted for this study. A retrospective analysis of patients who underwent carpal tunnel release surgery was performed. These patients were categorized into two distinct groups: one group received comprehensive counseling during their clinic visits, while the other group reported receiving less effective counseling. Evaluation encompassed patient-related factors, disease-related aspects, and perioperative variables for both groups. Results: The study comprised 681 participants, with 526 (77.2%) being females, 421 (61.8%) undergoing surgery on the right side, and 519 (76.2%) employed in non-manual occupations. Moreover, 559 (82.1%) were non-smokers, while approximately two-thirds of the cohort had both diabetes and hypertension. The average age of participants was 52 years, and they reported a mean functional disability score of 7.2 out of 10. The comprehensive preoperative counseling group consisted of 333 patients, while the other group included 348 patients. The analysis revealed statistically significant differences between the two groups, including reduced intra-procedural anxiety (p = 0.043), decreased intraoperative pain (p = 0.005), lower rates of wound complications (p = 0.022), and improved self-reported pain relief (p = 0.3). Conclusion: Our study emphasizes the crucial role of preoperative counseling in improving patient experiences during perioperative care, leading to reduced anxiety, milder pain responses, fewer complications, decreased reliance on postoperative pain medication, and increased self-reported pain relief. Level of Evidence: Level III, Case-control retrospective study.

Unlocking the secrets: exploring the influence of the aryl hydrocarbon receptor and microbiome on cancer development.

Gut microbiota regulates various aspects of human physiology by producing metabolites, metabolizing enzymes, and toxins. Many studies have linked microbiota with human health and altered microbiome configurations with the occurrence of several diseases, including cancer. Accumulating evidence suggests that the microbiome can influence the initiation and progression of several cancers. Moreover, some microbiotas of the gut and oral cavity have been reported to infect tumors, initiate metastasis, and promote the spread of cancer to distant organs, thereby influencing the clinical outcome of cancer patients. The gut microbiome has recently been reported to interact with environmental factors such as diet and exposure to environmental toxicants. Exposure to environmental pollutants such as polycyclic aromatic hydrocarbons (PAHs) induces a shift in the gut microbiome metabolic pathways, favoring a proinflammatory microenvironment. In addition, other studies have also correlated cancer incidence with exposure to PAHs. PAHs are known to induce organ carcinogenesis through activating a ligand-activated transcriptional factor termed the aryl hydrocarbon receptor (AhR), which metabolizes PAHs to highly reactive carcinogenic intermediates. However, the crosstalk between AhR and the microbiome in mediating carcinogenesis is poorly reviewed. This review aims to discuss the role of exposure to environmental pollutants and activation of AhR on microbiome-associated cancer progression and explore the underlying molecular mechanisms involved in cancer development.

Experimental and theoretical study of improved mesoporous titanium dioxide perovskite solar cell: The impact of modification with graphene oxide.

The present study serves experimental and theoretical analyses in developing a hybrid advanced structure as a photolysis, which is based on electrospun Graphene Oxide-titanium dioxide (GO-TiO2) nanofibers as an electron transfer material (ETMs) functionalized for perovskite solar cell (PVSCs) with GO. The prepared ETMs were utilized for the synthesis of mixed-cation (FAPbI3)0.8(MAPbBr3)0.2. The effect of GO on TiO2 and their chemical structure, electronic and morphological characteristic were investigated and discussed. The elaborated device, namely ITO/Bl-TiO2/3 wt% GO-TiO2/(FAPbI3)0.8(MAPbBr3)0.2/spiro-MeTAD/Pt, displayed 20.14% disposition and conversion solar energy with fill factor (FF) of 1.176%, short circuit current density (Jsc) of 20.56 mA/cm2 and open circuit voltage (VOC) 0.912 V. The obtained efficiency is higher than titanium oxide (18.42%) and other prepared GO-TiO2 composite nanofibers based ETMs. The developed materials and device would facilitate elaboration of advanced functional materials and devices for energy storage applications.

Improvement of the photoelectric dye sensitized solar cell performance using Fe/S-TiO2 nanoparticles as photoanode electrode.

A sulfur nanoparticles-incorporated iron-doped titanium oxide (Fe/TiO2) with different ratio was successfully synthesized by photolysis method and utilized as effective photoanode in dye sensitized solar cell (DSSC) application with N719 dye. The photolysis method was contained the irradiation of the Fe, S and Ti mixture solution with 15 W source irradiation, and then calcined the formed precipitate. The DSSCs fabricated with Fe/S-TiO2 photoanode appeared an improved solar-to-electrical energy conversion efficiency of 6.46, which more than pure TiO2 (3.43) below full sunlight illumination (1.5 G). The impact of Fe content on the total efficiency was also inspected and the Fe content with 6% S-TiO2 was found 5 wt%. Due to the improved the efficiency of solar cell conversion of Fe/S-TiO2 nanocomposite, it should be deemed as a potential photoanode for DSSCs with high performance.

Development of 2nd generation aminomethyl spectinomycins that overcome native efflux in Mycobacterium abscessus.

Mycobacterium abscessus (Mab), a nontuberculous mycobacterial (NTM) species, is an emerging pathogen with high intrinsic drug resistance. Current standard-of-care therapy results in poor outcomes, demonstrating the urgent need to develop effective antimycobacterial regimens. Through synthetic modification of spectinomycin (SPC), we have identified a distinct structural subclass of N-ethylene linked aminomethyl SPCs (eAmSPCs) that are up to 64-fold more potent against Mab over the parent SPC. Mechanism of action and crystallography studies demonstrate that the eAmSPCs display a mode of ribosomal inhibition consistent with SPC. However, they exert their increased antimicrobial activity through enhanced accumulation, largely by circumventing efflux mechanisms. The N-ethylene linkage within this series plays a critical role in avoiding TetV-mediated efflux, as lead eAmSPC 2593 displays a mere fourfold susceptibility improvement against Mab ΔtetV, in contrast to the 64-fold increase for SPC. Even a minor shortening of the linkage by a single carbon, akin to 1st generation AmSPC 1950, results in a substantial increase in MICs and a 16-fold rise in susceptibility against Mab ΔtetV. These shifts suggest that longer linkages might modify the kinetics of drug expulsion by TetV, ultimately shifting the equilibrium towards heightened intracellular concentrations and enhanced antimicrobial efficacy. Furthermore, lead eAmSPCs were also shown to synergize with various classes of anti-Mab antibiotics and retain activity against clinical isolates and other mycobacterial strains. Encouraging pharmacokinetic profiles coupled with robust efficacy in Mab murine infection models suggest that eAmSPCs hold the potential to be developed into treatments for Mab and other NTM infections.

Generative Adversarial Networks in Digital Histopathology: Current Applications, Limitations, Ethical Considerations, and Future Directions.

Generative adversarial networks (GANs) have gained significant attention in the field of image synthesis, particularly in computer vision. GANs consist of a generative model and a discriminative model trained in an adversarial setting to generate realistic and novel data. In the context of image synthesis, the generator produces synthetic images, whereas the discriminator determines their authenticity by comparing them with real examples. Through iterative training, the generator allows the creation of images that are indistinguishable from real ones, leading to high-quality image generation. Considering their success in computer vision, GANs hold great potential for medical diagnostic applications. In the medical field, GANs can generate images of rare diseases, aid in learning, and be used as visualization tools. GANs can leverage unlabeled medical images, which are large in size, numerous in quantity, and challenging to annotate manually. GANs have demonstrated remarkable capabilities in image synthesis and have the potential to significantly impact digital histopathology. This review article focuses on the emerging use of GANs in digital histopathology, examining their applications and potential challenges. Histopathology plays a crucial role in disease diagnosis, and GANs can contribute by generating realistic microscopic images. However, ethical considerations arise because of the reliance on synthetic or pseudogenerated images. Therefore, the manuscript also explores the current limitations and highlights the ethical considerations associated with the use of this technology. In conclusion, digital histopathology has seen an emerging use of GANs for image enhancement, such as color (stain) normalization, virtual staining, and ink/marker removal. GANs offer significant potential in transforming digital pathology when applied to specific and narrow tasks (preprocessing enhancements). Evaluating data quality, addressing biases, protecting privacy, ensuring accountability and transparency, and developing regulation are imperative to ensure the ethical application of GANs.