Optimizing SARS-CoV-2 vaccine responses in kidney transplant recipients: an urgent need.

Kidney transplant recipients (KTRs) have been identified as a population at increased risk for severe SARS-CoV-2 infection outcomes. This study focused on understanding the immune response of KTRs post-vaccination, specifically examining both serological and cellular responses to the SARS-CoV-2 vaccine. Thirteen individuals, including seven KTRs and six healthy donors, were evaluated for antibody levels and T cell responses post-vaccination. The study revealed that KTRs had significantly lower serological responses, including reduced anti-receptor binding domain (RBD) binding antibodies and neutralizing antibodies against the Wuhan, Delta, and Omicron BA.2 strains. Additionally, KTRs demonstrated weaker CD8 T cell cytotoxic responses and lower Th1 cytokine secretion, particularly IFN-γ, after stimulation with variant spike peptide pools. These findings highlight the compromised immunity in KTRs post-vaccination and underscore the need for tailored strategies to bolster immune responses in this vulnerable group. Further investigations are warranted into the mechanisms underlying reduced vaccine efficacy in KTRs and potential therapeutic interventions. IMPORTANCE: Some studies have revealed that KTRs had lower serological response against SARS-CoV-2 than healthy people. Nevertheless, limited studies investigate the cellular response against SARS-CoV-2 in KTRs receiving SARS-CoV-2 vaccines. Here, we found that KTRs have lower serological and cellular responses. Moreover, we found that KTRs had a significantly lower IFN-γ secretion than healthy individuals when their PBMCs were stimulated with SARS-CoV-2 spike peptide pools. Thus, our findings suggested that additional strategies are needed to enhance KTR immunity triggered by the vaccine.

Enhancement of NETosis by ACE2-cross-reactive anti-SARS-CoV-2 RBD antibodies in patients with COVID-19.

BACKGROUND: High levels of neutrophil extracellular trap (NET) formation or NETosis and autoantibodies are related to poor prognosis and disease severity of COVID-19 patients. Human angiotensin-converting enzyme 2 (ACE2) cross-reactive anti-severe acute respiratory syndrome coronavirus 2 spike protein receptor-binding domain (SARS-CoV-2 RBD) antibodies (CR Abs) have been reported as one of the sources of anti-ACE2 autoantibodies. However, the pathological implications of CR Abs in NET formation remain unknown. METHODS: In this study, we first assessed the presence of CR Abs in the sera of COVID-19 patients with different severity by serological analysis. Sera and purified IgG from CR Abs positive COVID-19 patients as well as a mouse monoclonal Ab (mAb 127) that can recognize both ACE2 and the RBD were tested for their influence on NETosis and the possible mechanisms involved were studied. RESULTS: An association between CR Abs levels and the severity of COVID-19 in 120 patients was found. The CR Abs-positive sera and IgG from severe COVID-19 patients and mAb 127 significantly activated human leukocytes and triggered NETosis, in the presence of RBD. This NETosis, triggered by the coexistence of CR Abs and RBD, activated thrombus-related cells but was abolished when the interaction between CR Abs and ACE2 or Fc receptors was disrupted. We also revealed that CR Abs-induced NETosis was suppressed in the presence of recombinant ACE2 or the Src family kinase inhibitor, dasatinib. Furthermore, we found that COVID-19 vaccination not only reduced COVID-19 severity but also prevented the production of CR Abs after SARS-CoV-2 infection. CONCLUSIONS: Our findings provide possible pathogenic effects of CR Abs in exacerbating COVID-19 by enhancing NETosis, highlighting ACE2 and dasatinib as potential treatments, and supporting the benefit of vaccination in reducing disease severity and CR Abs production in COVID-19 patients.

Correlation between patient satisfaction and color changes after tooth bleaching.

OBJECTIVE: This study aimed to investigate the relationship between patient satisfaction of outcomes and tooth color changes during and after tooth bleaching. METHODS: In this clinical trial, 63 volunteers participated in an in-office bleaching procedure using a 40% hydrogen peroxide gel. The treatment consisted of two sessions, each comprising two 30-min applications of the bleaching gel. The L*, a*, and b* values of six maxillary anterior teeth were measured at baseline (T1), after the first bleaching session (T2), after the second bleaching session (T3), 1 week after the second in-office bleaching session (T4), and 3 weeks after the second in-office bleaching session (T5). The color differences (ΔE00 ) were calculated using CIEDE2000. A satisfaction scale with a score ranging from 0 to 3 was used to record participants' level of satisfaction with their tooth color at each time point. The data were statistically analyzed using repeated measures analysis of variance and logistic regression (α = 0.05). RESULTS: Significant correlations were observed between ΔL*, Δb*, and ΔE00 values at T3 and patient satisfaction (all p < 0.05). The regression model indicated a more pronounced impact of Δb* on patient satisfaction compared to ΔL*. The established regression models were as follows: Logit (PL*b* ) = -4.354 + 0.271ΔL* - 0.585Δb* and Logit (PΔE00 ) = -2.552 + 0.521ΔE00 . The findings suggested a minimum ΔE00 value of 4.90 for satisfactory results. A minimum ΔE00 value of 3.9, 5.0, and 6.8 was necessary for central incisors, lateral incisors, and canines, respectively, to achieve a satisfactory result. CONCLUSIONS: The ΔL*, Δb*, and ΔE00 values were found to be significantly correlated with patient satisfaction after bleaching. Δb* was identified as having a greater influence on patient satisfaction than ΔL* values in the regression model. Furthermore, attaining a minimum ΔE00 value of 4.90 is necessary to achieve satisfactory outcomes. A greater ΔE00 value is needed for canines than for incisors to achieve equivalent patient satisfaction. CLINICAL SIGNIFICANCE: This study emphasizes the importance of considering the extent of color change needed to achieve patient satisfaction after tooth bleaching procedures.

Enhancing the inhibition of dental erosion and abrasion with quercetin-encapsulated hollow mesoporous silica nanocomposites.

Introduction: Dental erosion and abrasion pose significant clinical challenges, often leading to exposed dentinal tubules and dentine demineralization. The aim of this study was to analyse the efficacy of quercetin-encapsulated hollow mesoporous silica nanocomposites (Q@HMSNs) on the prevention of dentine erosion and abrasion. Method: Q@HMSNs were synthesized, characterized, and evaluated for their biocompatibility. A total of 130 dentine specimens (2 mm × 2 mm × 2 mm) were prepared and randomly distributed into 5 treatment groups (n = 26): DW (deionized water, negative control), NaF (12.3 mg/mL sodium fluoride, positive control), Q (300 µg/mL quercetin), HMSN (5.0 mg/mL HMSNs), and Q@HMSN (5.0 mg/mL Q@HMSNs). All groups were submitted to in vitro erosive (4 cycles/d) and abrasive (2 cycles/d) challenges for 7 days. The specimens in the DW, NaF, and Q groups were immersed in the respective solutions for 2 min, while treatment was performed for 30 s in the HMSN and Q@HMSN groups. Subsequently, the specimens were subjected to additional daily erosion/abrasion cycles for another 7 days. The effects of the materials on dentinal tubule occlusion and demineralized organic matrix (DOM) preservation were examined by scanning electron microscopy (SEM). The penetration depth of rhodamine B fluorescein into the etched dentine was assessed using confocal laser scanning microscopy (CLSM). The erosive dentine loss (EDL) and release of type I collagen telopeptide (ICTP) were measured. The data were analysed by one-way analysis of variance (ANOVA) with post hoc Tukey's test (α = 0.05). Results: Q@HMSNs were successfully synthesized and showed minimal toxicity to human dental pulp stem cells (HDPSCs) and gingival fibroblasts (HGFs). Q@HMSNs effectively occluded the dentinal tubules, resulting in a thicker DOM in the Q@HMSN group. The CLSM images showed more superficial penetration in the HMSN and Q@HMSN groups than in the quercetin, NaF, and DW groups. The Q@HMSN group exhibited a significantly lower EDL and reduced ICTP levels compared to the other groups (p < 0.05). Conclusion: Q@HMSNs hold promise for inhibiting dentine erosion and abrasion by promoting tubule occlusion and DOM preservation.

Effect of Acupoint Stimulation on Improving Gastrointestinal Motility in Patients After Gastrectomy: A Systematic Review and Meta-Analysis.

Introduction: Gastrointestinal immobility is experienced by many patients who undergo gastric surgery. This complication delays enteral nutrition, prolongs hospitalization, and causes discomfort. Acupoint stimulation is a popular alternative nonpharmacological treatment for gastrointestinal immobility. This study aimed to explore the effects of acupoint stimulation on gastrointestinal immobility after gastrectomy. Design: Systematic review and meta-analysis. Methods: Databases (PubMed, Cochrane, Joanna Briggs Institute EBP Database, Medline, CINAHL Complete, and Airiti library) were searched from their inception to April 2022 for relevant articles. Articles in Chinese and English were included, without limitations on year, region, or country. The inclusion criteria were studies with participants >18 years of age, postgastric surgery, and hospitalization. In addition, randomized controlled trials (RCTs) were included. Data were analyzed using random effects models, and data heterogeneity was investigated using subgroup analysis. Meta-analysis was performed using Review Manager 5.4 software. Results: We included 785 participants from six studies. Invasive and noninvasive acupoint stimulation reduced the time of gastrointestinal mobility better than usual care. In the control group, the time of first flatus was 43.56 ± 9.57 h to 108 ± 19.2 h, and the time of first defecation was 77.27 ± 22.67 h to 139.2 ± 24 h. In the experimental group, the time of first flatus and defecation was 36.58 ± 10.75 h to 79.97 ± 37.31 h and 70.56 ± 15.36 h to 108.55 ± 10.75 h, respectively. Subgroup analysis showed that invasive acupoint stimulation with acupuncture reduced the time of first flatus and defecation to 15.03 h (95% confidence interval [CI] = -31.06 to 1.01) and 14.12 h (95% CI = -32.78 to 4.54), respectively. Noninvasive acupoint stimulation, including acupressure and transcutaneous electrical acupoint stimulation (TEAS), reduced the time of first flatus and defecation to 12.33 h and (95% CI = -20.59 to -4.06) and 12.20 h (95% CI = -24.92 to 0.52), respectively. Conclusions: Acupoint stimulation improved the gastrointestinal immobility of postgastrectomy. In the included RCT articles, invasive and noninvasive stimulations were effective. However, noninvasive acupoint stimulation, such as with TEAS and acupressure, was more efficient and convenient than invasive stimulation. Overall, health care professionals with adequate training or under the supervision of an acupuncturist can effectively perform acupoint stimulation to improve the quality of postgastrectomy care. They can select commonly used and effective acupoints to enhance gastrointestinal motility. Clinical relevance: Acupoint stimulation, such as acupressure, electrical acupoint stimulation, or acupuncture, can be included in postgastrectomy routine care to improve gastrointestinal motility and reduce abdominal discomfort.

Using Machine Learning for the Risk Factors Classification of Glycemic Control in Type 2 Diabetes Mellitus.

Several risk factors are related to glycemic control in patients with type 2 diabetes mellitus (T2DM), including demographics, medical conditions, negative emotions, lipid profiles, and heart rate variability (HRV; to present cardiac autonomic activity). The interactions between these risk factors remain unclear. This study aimed to use machine learning methods of artificial intelligence to explore the relationships between various risk factors and glycemic control in T2DM patients. The study utilized a database from Lin et al. (2022) that included 647 T2DM patients. Regression tree analysis was conducted to identify the interactions among risk factors that contribute to glycated hemoglobin (HbA1c) values, and various machine learning methods were compared for their accuracy in classifying T2DM patients. The results of the regression tree analysis revealed that high depression scores may be a risk factor in one subgroup but not in others. When comparing different machine learning classification methods, the random forest algorithm emerged as the best-performing method with a small set of features. Specifically, the random forest algorithm achieved 84% accuracy, 95% area under the curve (AUC), 77% sensitivity, and 91% specificity. Using machine learning methods can provide significant value in accurately classifying patients with T2DM when considering depression as a risk factor.

Antibodies against the SARS-CoV-2 S1-RBD cross-react with dengue virus and hinder dengue pathogenesis.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally since December 2019. Several studies reported that SARS-CoV-2 infections may produce false-positive reactions in dengue virus (DENV) serology tests and vice versa. However, it remains unclear whether SARS-CoV-2 and DENV cross-reactive antibodies provide cross-protection against each disease or promote disease severity. In this study, we confirmed that antibodies against the SARS-CoV-2 spike protein and its receptor-binding domain (S1-RBD) were significantly increased in dengue patients compared to normal controls. In addition, anti-S1-RBD IgG purified from S1-RBD hyperimmune rabbit sera could cross-react with both DENV envelope protein (E) and nonstructural protein 1 (NS1). The potential epitopes of DENV E and NS1 recognized by these antibodies were identified by a phage-displayed random peptide library. In addition, DENV infection and DENV NS1-induced endothelial hyperpermeability in vitro were inhibited in the presence of anti-S1-RBD IgG. Passive transfer anti-S1-RBD IgG into mice also reduced prolonged bleeding time and decreased NS1 seral level in DENV-infected mice. Lastly, COVID-19 patients' sera showed neutralizing ability against dengue infection in vitro. Thus, our results suggest that the antigenic cross-reactivity between the SARS-CoV-2 S1-RBD and DENV can induce the production of anti-SARS-CoV-2 S1-RBD antibodies that cross-react with DENV which may hinder dengue pathogenesis.

How Do Children with Autism Spectrum Disorder and Children with Developmental Delays Differ on the Child Behavior Checklist 1.5-5 DSM-Oriented Scales?

The Child Behavior Checklist 1.5-5 (CBCL 1.5-5) is applied to identify emotional and behavioral problems on children with developmental disabilities (e.g., autism spectrum disorder [ASD] and developmental delays [DD]). To understand whether there are variations between these two groups on CBCL DSM-oriented scales, we took two invariance analyses on 443 children (228 children with ASD). The first analysis used measurement invariance and multiple-group factor analysis on the test structure. The second analysis used item-level analysis, i.e., differential item functioning (DIF), to discover whether group memberships responded differently on some items even though underlying trait levels were the same. It was discovered that, on the test structure, the Anxiety Problems scale did not achieve metric invariance. The other scales achieved metric invariance; DIF analyses further revealed that there were items that functioned differently across subscales. These DIF items were mostly about children's reactions to the surrounding environment. Our findings provide implications for clinicians to use CBCL DSM-oriented scales on differentiating children with ASD and children with DD. In addition, researchers need to be mindful about how items were responded differently, even though there were no mean differences on the surface.

Comparison of smile esthetics among celebrities, dentists, and dental students in a Han Chinese population.

STATEMENT OF PROBLEM: Various components of smile esthetics have been evaluated. However, whether these components affect smile esthetics in Han Chinese celebrities, dentists, and dental students is unknown. PURPOSE: The purpose of this study was to evaluate the smile esthetics of celebrities, dentists, and dental students in a Han Chinese population. MATERIAL AND METHODS: Frontal images of smiles were obtained from the Internet for the celebrity group, while images of dentists and dental students were collected for the dentist and dental student groups. The buccal and posterior corridor ratios, the alignment discrepancy between the commissural and interpupillary lines, the number of teeth revealed, the width ratio relative to the golden proportion, and the width-to-length ratios of maxillary anterior teeth were calculated by using a photo-editing software program. Statistical analysis was performed by using 2-way ANOVA and the Tukey HSD test (α=.05). RESULTS: Eligible images were obtained for 81 celebrities, 83 dentists, and 78 dental students. The celebrities were found to have the highest buccal and posterior corridor ratios and reveal the least teeth in the smile among the 3 groups (all P<.001). The alignment discrepancy for celebrities was significantly less than that for dental students (P=.025). Moreover, the absolute difference of width ratios from the golden proportion was significantly different from 0 for all groups (all P<.001). CONCLUSIONS: Significant differences were found in the smiles of Han Chinese celebrities, dentists, and dental students in regard to the buccal and posterior corridor ratios, the alignment discrepancy between the commissural and interpupillary lines, and the number of teeth revealed. Chinese celebrities tended to have a smile that displays to the second premolar, with a medium buccal corridor width.

In Vitro Cytotoxicity of Self-Adhesive Dual-Cured Resin Cement Polymerized Beneath Three Different Cusp Inclinations of Zirconia.

The aim of the present study was to evaluate the in vitro cytotoxicity of self-adhesive dual-cured resin cement (SADRC) polymerized beneath three different cusp inclinations of zirconia with different light curing time. A commercial SADRC (Multilink Speed) was polymerized beneath zirconia (ZrO2) with three different cusp inclinations (0°, 20°, and 30°) for 20 s or 40 s. After being stored in light-proof box for 24 h, the ZrO2-SADRC specimens were immersed in DMEM for 72 h and then we got the extract solution, cultured the human gingival fibroblasts (HGF, 8 × 103 per well) with 100% or 50% concentrations of the extract solution for 24 h, 72 h, and 120 h, respectively, and evaluated cytotoxicity of the polymerized SADRC with CCK-8 assay in optical density (OD) values, relative growth rates (RGR), and cytotoxicity grades. Statistical analysis was conducted using a two-way ANOVA followed by post hoc Student-Newman-Keuls test. The OD values varied from 0.8930 to 3.2920, the RGR varied from 33.93% to 98.68%, and the cytotoxicity grades varied from 0 to 2. There was significant difference in the OD values among the different cusp inclinations of zirconia (P < 0.001), and there was significant difference in the OD values between the different light curing times in some situations (P < 0.05). The cusp inclination of zirconia affects the in vitro cytotoxicity of SADRC. Prolonging the light curing time from 20 s to 40 s can reduce the in vitro cytotoxicity of SADRC when the cusp inclination of zirconia is smaller than 20°.

Effect of surface removal following bleaching on the bond strength of enamel.

BACKGROUND: A reduction in bond strength of bleached enamel has been confirmed in the literature. Although limited information is available, it is conceivable that the veneer preparation process may remove the impacted enamel and further eliminate the compromised bond strength between the composite resin and bleached enamel. This study aimed to evaluate the effect of surface removal following bleaching on the micro-shear bond strength (µSBS) of bleached enamel. METHODS: Forty-eight specimens were prepared from bovine incisors and were randomly divided into 2 groups (n = 24): group B (bleaching with 40% hydrogen peroxide for 2 × 45 min with a 1-week interval) and group C (control group without bleaching treatment). Immediately after receiving the treatments, 0.5 mm of the enamel was removed from the specimen surface, followed by bonding of composite resin to the enamel surface. Each group was further divided into 2 subgroups of 12 specimens each: subgroup T (with 5000 thermocycles in water baths at 5 °C and 55 °C), and subgroup N (without thermocycling). The µSBS values were measured using a universal testing machine and subjected to two-way analysis of variance (α = 0.05). The fracture modes of the specimens were observed using a stereomicroscope. RESULTS: The µSBS values of the different groups ranged from 21.42 to 25.21 MPa. Following a surface reduction of 0.5 mm, bleaching treatment and thermocycling did not significantly affect the µSBS values (P = 0.348 and P = 0.507, respectively). No significant interaction was found between the bleaching treatment and thermocycling (P = 0.514). All the groups exhibited a high percentage of mixed failures. Compared with group C, group B exhibited higher percentage of adhesive failure. CONCLUSION: The results suggested that the bonding procedure could be performed on the bleached enamel following a surface reduction of 0.5 mm immediately after the bleaching treatment.

Separate but correlated: The latent structure of space and mathematics across development.

The relations among various spatial and mathematics skills were assessed in a cross-sectional study of 854 children from kindergarten, third, and sixth grades (i.e., 5 to 13 years of age). Children completed a battery of spatial mathematics tests and their scores were submitted to exploratory factor analyses both within and across domains. In the within domain analyses, all of the measures formed single factors at each age, suggesting consistent, unitary structures across this age range. Yet, as in previous work, the 2 domains were highly correlated, both in terms of overall composite score and pairwise comparisons of individual tasks. When both spatial and mathematics scores were submitted to the same factor analysis, the 2 domain specific factors again emerged, but there also were significant cross-domain factor loadings that varied with age. Multivariate regressions replicated the factor analysis and further revealed that mental rotation was the best predictor of mathematical performance in kindergarten, and visual-spatial working memory was the best predictor of mathematical performance in sixth grade. The mathematical tasks that predicted the most variance in spatial skill were place value (K, 3rd, 6th), word problems (3rd, 6th), calculation (K), fraction concepts (3rd), and algebra (6th). Thus, although spatial skill and mathematics each have strong internal structures, they also share significant overlap, and have particularly strong cross-domain relations for certain tasks. (PsycINFO Database Record

Protective effects of pulmonary epithelial lining fluid on oxidative stress and DNA single-strand breaks caused by ultrafine carbon black, ferrous sulphate and organic extract of diesel exhaust particles.

Pulmonary epithelial lining fluid (ELF) is the first substance to make contact with inhaled particulate matter (PM) and interacts chemically with PM components. The objective of this study was to determine the role of ELF in oxidative stress, DNA damage and the production of proinflammatory cytokines following physicochemical exposure to PM. Ultrafine carbon black (ufCB, 15 nm; a model carbonaceous core), ferrous sulphate (FeSO(4); a model transition metal) and a diesel exhaust particle (DEP) extract (a model organic compound) were used to examine the acellular oxidative potential of synthetic ELF and non-ELF systems. We compared the effects of exposure to ufCB, FeSO(4) and DEP extract on human alveolar epithelial Type II (A549) cells to determine the levels of oxidative stress, DNA single-strand breaks and interleukin-8 (IL-8) production in ELF and non-ELF systems. The effects of ufCB and FeSO(4) on the acellular oxidative potential, cellular oxidative stress and DNA single-strand breakage were mitigated significantly by the addition of ELF, whereas there was no decrease following treatment with the DEP extract. There was no significant effect on IL-8 production following exposure to samples that were suspended in ELF/non-ELF systems. The results of the present study indicate that ELF plays an important role in the initial defence against PM in the pulmonary environment. Experimental components, such as ufCB and FeSO(4), induced the production of oxidative stress and led to DNA single-strand breaks, which were moderately prevented by the addition of ELF. These findings suggest that ELF plays a protective role against PM-driven oxidative stress and DNA damage.

The relation between space and math: developmental and educational implications.

There is a well-known relation between spatial ability and mathematics dating back to the work of early twentieth century factor analysts. This connection is a ripe opportunity for educators, who might use spatial training to improve math learning. However, a closer look at the literature reveals gaps that impede direct application. The primary problem is that although this relation is well established in older children and adults, its emergence in early development and subsequent developmental interactions are not well documented. Moreover, there is a need for more mechanistic explanations that might be leveraged to improve math education. In this chapter, we attempt to address these issues by reviewing the existing literature to identify instances where answers are available and others where further research is needed.