Comparison of micromorphological changes in enamel using SEM analysis after conventional and erbium, chromium:yttrium, scandium, gallium, and garnet hard-tissue laser fissurotomy: An in vitro study.

Background: Well articulated by John Knowles - "Everything has to evolve or else it perishes." With the paradigm shift of emphasis toward the prevention of dental caries, it has been proven that laser irradiation protects against both caries initiation and caries progression. Aim: The aim of the study was to evaluate and compare the micromorphology of caries-free extracted premolars using a Scanning electron microscope (SEM) after fissurotomy by conventional fissurotomy bur and erbium, chromium: yttrium, scandium, gallium, and garnet (ER, CR: YSGG) hard-tissue laser. Methodology: Sixty caries-free premolars extracted atraumatically for orthodontic treatment were included in the study. The samples were divided into two groups randomly (Group 1: fissurotomy by bur, n = 30, and Group 2: fissurotomy by hard-tissue laser, n = 30). Each sample was further divided into halves from the occlusal surface wherein one-half of the occlusal surface received fissurotomy procedure and the other half was control. Samples were analyzed by scanning electron microscopy (SEM) for micromorphological changes. Results: Profile image of control samples revealed the disorganization of enamel surface at the junction of fissures forming a heterogeneous tissue and agglomeration of enamel with deep pit and fissure. On the contrary, the image of experimented samples (with laser fissurotomy) showed smooth enamel surface and homogeneous enamel subsurface with wider pit and fissure owing to self-cleansing ability. Conclusion: On the grounds of the present study results, it could be concluded that the intervention of ER, CR: YSGG hard-tissue laser possesses self-cleansable pit and fissures for caries prevention and has the potential to irradicate the smear layer entirely for superior attachment of remineralizing agents.

Association of Superoxide Dismutase Level in Women with Polycystic Ovary Syndrome.

Several biomarkers involved in oxidative stress may influence polycystic ovary syndrome (PCOS). Superoxide dismutase (SOD) has been commonly identified as dismutase enzyme catalyzes the conversion of superoxide to hydrogen peroxide and elemental oxygen, and could serve as an important biomarker in this direction. The objective of the present study to determine the precise role of SOD levels in women with PCOS using a meta-analysis approach. The electronic databases like PubMed, Google Scholar, Web of Sciences, Clinical trial.gov, Cochrane Database of Systematic Review were searched for obtaining relevant studies on the association of SOD level in women with PCOS. Pooled standardized mean difference with 95% CI was computed using the DerSimonian and Liard method. A total of 267 articles were screened, out of which 12 articles fulfilled the inclusion criteria of the present meta-analysis involving 558 cases and 529 controls. Analysis including overall studies observed a higher SOD level (statistically non-significant) in women with PCOS compared to controls (SMD 0.35, 95% Cl -0.91 to 1.62, P = 0.58), however, statistically significant higher SOD levels were noted in studies using serum as a source of sample (SMD 1.53, 95% CI 0.25 to 2.81, P = 0.019). In conclusion, women with PCOS exhibited increased SOD levels compared to controls suggesting that the byproduct of oxidative damage is expected to be increased in women with PCOS.

Remote and local drivers of Pleistocene South Asian summer monsoon precipitation: A test for future predictions.

South Asian precipitation amount and extreme variability are predicted to increase due to thermodynamic effects of increased 21st-century greenhouse gases, accompanied by an increased supply of moisture from the southern hemisphere Indian Ocean. We reconstructed South Asian summer monsoon precipitation and runoff into the Bay of Bengal to assess the extent to which these factors also operated in the Pleistocene, a time of large-scale natural changes in carbon dioxide and ice volume. South Asian precipitation and runoff are strongly coherent with, and lag, atmospheric carbon dioxide changes at Earth's orbital eccentricity, obliquity, and precession bands and are closely tied to cross-equatorial wind strength at the precession band. We find that the projected monsoon response to ongoing, rapid high-latitude ice melt and rising carbon dioxide levels is fully consistent with dynamics of the past 0.9 million years.

Tectonic and climatic drivers of Asian monsoon evolution.

Asian Monsoon rainfall supports the livelihood of billions of people, yet the relative importance of different drivers remains an issue of great debate. Here, we present 30 million-year model-based reconstructions of Indian summer monsoon and South East Asian monsoon rainfall at millennial resolution. We show that precession is the dominant direct driver of orbital variability, although variability on obliquity timescales is driven through the ice sheets. Orographic development dominated the evolution of the South East Asian monsoon, but Indian summer monsoon evolution involved a complex mix of contributions from orography (39%), precession (25%), atmospheric CO2 (21%), ice-sheet state (5%) and ocean gateways (5%). Prior to 15 Ma, the Indian summer monsoon was broadly stable, albeit with substantial orbital variability. From 15 Ma to 5 Ma, strengthening was driven by a combination of orography and glaciation, while closure of the Panama gateway provided the prerequisite for the modern Indian summer monsoon state through a strengthened Atlantic meridional overturning circulation.

Synergistic impacts of anthropogenic fires and aridity on plant diversity in the Western Ghats: Implications for management of ancient social-ecological systems.

Identifying the impacts of anthropogenic fires on biodiversity is imperative for human-influenced tropical rainforests because: i) these ecosystems have been transformed by human-induced fires for millennia; and ii) their effective management is essential for protecting the world's terrestrial biodiversity in the face of global environmental change. While several short-term studies elucidate the impacts of fires on local plant diversity, how plant diversity responds to fire regimes over long timescales (>100 years) is a significant knowledge gap, posing substantial impediment to evidence-based management of tropical social-ecological systems. Using wet evergreen forests of the Western Ghats of India as a model system, we discuss the synergistic effects of anthropogenic fires and enhanced aridity on tropical plant diversity over the past 4000 years by examining fossil pollen-based diversity indices (e.g., pollen richness and evenness, and temporal ß-diversity), past fire management, the intervals of enhanced aridity due to reduced monsoon rainfall and land use history. By developing a historical perspective, our aim is to provide region-specific management information for biodiversity conservation in the Western Ghats. We observe that the agroforestry landscape switches between periods of no fires (4000-1800 yr BP, and 1400-400 yr BP) and fires (1800-1400 yr BP, and 400-0 yr BP), with both fire periods concomitant with intervals of enhanced aridity. We find synergistic impacts of anthropogenic fires and aridity on plant diversity uneven across time, pointing towards varied land management strategies implemented by the contemporary societies. For example, during 1800-1400 yr BP, diversity reduced in conjunction with a significant decrease in the canopy cover related to sustained use of fires, possibly linked to large-scale intensification of agriculture. On the contrary, the substantially reduced fires during 400-0 yr BP may be associated with the emergence of sacred forest groves, a cultural practice supporting the maintenance of plant diversity. Overall, notwithstanding apparent changes in fires, aridity, and land use over the past 4000 years, present-day plant diversity in the Western Ghats agroforestry landscape falls within the range of historical variability. Importantly, we find a strong correlation between plant diversity and canopy cover, emphasising the crucial role of maintenance of trees in the landscape for biodiversity conservation. Systematic tree management in tropical social-ecological systems is vital for livelihoods of billions of people, who depend on forested landscapes. In this context, we argue that agroforestry landscapes can deliver win-win solutions for biodiversity as well as people in the Western Ghats and wet tropics at large.

Inter-comparison of antimicrobial photodynamic therapy, LASER, and an antifungal agent as adjunct intracanal irrigation techniques to standard disinfection protocols in reducing Candida albicans counts in the root canals of primary teeth: A pilot study.

BACKGROUND: Despite endodontic infections being a common problem in the primary dentition, some of the infected primary teeth can remain functional until the exfoliation through endodontic treatment. The primary endodontic treatment goal must be to optimize root canal disinfection and to prevent reinfection. AIM: The aim of this study is to compare the antifungal efficacy of antimicrobial photodynamic therapy, LASER, and 1% clotrimazole as irrigants by reducing the colony-forming units (CFU) of Candida albicans in the infected root canals of primary teeth. MATERIALS AND METHODS: Pulp therapy was performed on deciduous mandibular second molars of 20 healthy children aged 5-8 years, which were divided into four groups of intracanal disinfection protocols: Group 1 (n = 5) - Sodium Hypochlorite, Group 2 (n = 5) - Photodynamic, Group 3 (n = 5) - Normal saline with LASER, and Group 4 - (n = 5) Antifungal. Disinfection potential was compared by collecting samples one just after access opening and the other after the experimental groups using paper points. The samples were cultured and incubated for 48 h to check change in CFU of the fungi. RESULTS: Data were analyzed statistically using the Shapiro-Wilk's test, Mann-Whitney U-test; Kruskal-Wallis test, and Wilcoxon signed-ranks test. No significant difference (P > 0.05) was found between the different groups. However, complete inhibition of C. albicans CFU was seen with Group 4. CONCLUSION: One percent Clotrimazole (antifungal) can be utilized as an adjunct in the endodontic irrigation protocol for better success of pulpectomy in children.

Twice-weekly glucocorticosteroids in infants and young boys with Duchenne muscular dystrophy.

INTRODUCTION: Glucocorticosteroids (GC) are effective in slowing weakness in boys with Duchenne muscular dystrophy (DMD). METHODS: This is a multisite, 1-year, open-label trial of twice-weekly prednisolone (5 mg/kg/dose) in infants/young boys (0.4-2.4 years) with DMD. We compared changes in Bayley III Scales of Infant Development (Bayley-III) with untreated boys followed for 1 year (historical control cohort [HCC]). Twenty-three of 25 participants completed the study. RESULTS: Treated boys gained an average of 0.5 points on the Bayley-III gross motor scaled score (GMSS) compared with the HCC who, on average, declined 1.3 points (P = 0.03). All boys maintained linear growth, and none developed Cushingoid features. Excessive weight gain occurred in 13 of 23 (56%) boys. DISCUSSION: This study provides evidence that twice-weekly GC is well tolerated in infants and young boys with DMD and improves GMSS. Excessive weight gain is a potential risk. Longer follow-up is required to determine whether early GC initiation is feasible in most infants/boys with DMD. Muscle Nerve 59:650-657, 2019.

Clinical trial readiness in non-ambulatory boys and men with duchenne muscular dystrophy: MDA-DMD network follow-up.

INTRODUCTION: Outcomes sensitive to change over time in non-ambulatory boys/men with Duchenne muscular dystrophy (DMD) are not well-established. METHODS: Subjects (n = 91; 16.8 ± 4.5 years old) were assessed at baseline and 6-month intervals for 2 years. We analyzed all subjects using an intent-to-treat model and a subset of stronger subjects with Brooke Scale score ≤4, using repeated measures. RESULTS: Eight patients (12-33 years old) died during the study. Sixty-six completed 12-month follow-up, and 51 completed 24-month follow-up. Those taking corticosteroids performed better at baseline, but rates of decline were similar. Forced vital capacity percent predicted (FVC% predicted) declined significantly only after 2 years. However, Brooke and Egen Klassifikation (EK) Scale scores, elbow flexion, and grip strength declined significantly over both 1 and 2 years. CONCLUSION: Brooke and EK Scale scores, elbow flexion, and grip strength were outcomes most responsive to change. FVC% predicted was responsive to change over 2 years. Corticosteroids benefited non-ambulatory DMD subjects but did not affect decline rates of measures tested here. Muscle Nerve 54: 681-689, 2016.

Motor and cognitive assessment of infants and young boys with Duchenne Muscular Dystrophy: results from the Muscular Dystrophy Association DMD Clinical Research Network.

Therapeutic trials in Duchenne Muscular Dystrophy (DMD) exclude young boys because traditional outcome measures rely on cooperation. The Bayley III Scales of Infant and Toddler Development (Bayley III) have been validated in developing children and those with developmental disorders but have not been studied in DMD. Expanded Hammersmith Functional Motor Scale (HFMSE) and North Star Ambulatory Assessment (NSAA) may also be useful in this young DMD population. Clinical evaluators from the MDA-DMD Clinical Research Network were trained in these assessment tools. Infants and boys with DMD (n = 24; 1.9 ± 0.7 years) were assessed. The mean Bayley III motor composite score was low (82.8 ± 8; p ≤ .0001) (normal = 100 ± 15). Mean gross motor and fine motor function scaled scores were low (both p ≤ .0001). The mean cognitive comprehensive (p=.0002), receptive language (p ≤ .0001), and expressive language (p = .0001) were also low compared to normal children. Age was negatively associated with Bayley III gross motor (r = -0.44; p = .02) but not with fine motor, cognitive, or language scores. HFMSE (n=23) showed a mean score of 31 ± 13. NSAA (n = 18 boys; 2.2 ± 0.4 years) showed a mean score of 12 ± 5. Outcome assessments of young boys with DMD are feasible and in this multicenter study were best demonstrated using the Bayley III.