Carotenoid intake and SCD genotype exert complementary effects over fat content and fatty acid composition in Duroc pigs.

Nutritional and genetic strategies are needed to enhance intramuscular fat (IMF) and MUFA content without altering carcass leanness. Dietary vitamin A restriction has been suggested to specifically promote IMF, whereas a polymorphism of the () gene has shown to specifically increase MUFA. The purpose of this study was to investigate the combined effects of provitamin A (PVA) carotenoid intake and genotype (>) on hepatic retinoid content and on the liver, muscle (LM and gluteus medius [GM]), and subcutaneous fat (SF) content and fatty acid composition. Following a split-plot design, 32 castrated Duroc pigs, half of each of the 2 homozygous genotypes (CC and TT), were subjected from 165 to 195 d of age to 2 finishing diets differing in the PVA carotenoid content (an enriched-carotene diet [C+] and a control diet [C-]). Both diets were identical except for the corn line used in the feed. The C+ was formulated with 20% of a carotenoid-fortified corn (M37W-Ph3) whereas the C- instead used 20% of its near isogenic M37W line, which did not contain PVA carotenoids. No vitamin A was added to the diets. The C- was estimated to provide, at most, 1,300 IU of vitamin A/kg and the C+ to supply an extra amount of at least 800 IU vitamin A/kg. Compared with the pigs fed the C-, pigs fed with C+ had 3-fold more retinoic acid ( < 0.01) and 4-fold more gene expression in the liver ( = 0.06). The diet did not affect performance traits and backfat thickness, but pigs fed the C+ had less fat (4.0 vs. 5.0%; = 0.07) and MUFA (18.3 vs. 22.5%; = 0.01) in the liver, less IMF (5.4 vs. 8.3%; = 0.04) in the GM, and more fat content (90.4 vs. 87.9%; = 0.09) and MUFA (48.0 vs. 46.6%; = 0.04) in SF. The TT genotype at the gene increased MUFA ( < 0.05) in all tissues (21.4 vs. 19.5% in the liver, 55.0 vs. 53.1% in the LM, 53.9 vs. 51.7% in the GM, and 48.0 vs. 46.7% in SF for TT and CC genotypes, respectively). Liver fat and MUFA content nonlinearly declined with liver all- retinoic acid, indicating a saturation point at relatively low all- retinoic acid content. The results obtained provide evidence for a complementary role between dietary PVA and genotype, in the sense that the TT pigs fed with a low-PVA diet are expected to show higher and more monounsaturated IMF without increasing total fat content.

Cost-utility analysis of certolizumab pegol in combination with methotrexate in patients with moderate-to-severe active rheumatoid arthritis in Greece.

We aimed to evaluate the cost-effectiveness of certolizumab pegol (CZP), a pegylated fc-free anti-TNF, as add-on therapy to methotrexate (MTX) versus etanercept, adalimumab, or golimumab in patients with moderate-to-severe active rheumatoid arthritis (RA) not responding to the conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). A Markov model (6-month cycle length) assessed health and cost outcomes of CZP versus other anti-TNFs recommended for RA in Greece over a patient's lifetime. Following discontinuation of first-line anti-TNF, patients switched to second anti-TNF and then to a biologic with another mode of action. Sequential use of csDMARDs followed third biologic. Clinical data and utilities were extracted from published literature. Analysis was conducted from third-party payer perspective in Greece. Costs (drug acquisition, administration, monitoring, and patient management) were considered for 2014. Results presented are incremental cost-effectiveness ratios (ICERs) per quality-adjusted life year (QALY). Probabilistic sensitivity analysis (PSA) ascertained robustness of base-case findings. Base-case analysis indicated that CZP+MTX was more costly and more effective compared with Etanercept+MTX (base-case ICER: €3,177 per QALY), whilst versus adalimumab/golimumab, CZP was dominant (less costly, more effective). For all comparisons, CZP treatment resulted in greater improvements in life expectancy and QALYs. PSA indicated that at the willingness-to-pay threshold of €34,000/QALY, CZP+MTX was associated with a 71.6, 97.9, or 99.2% probability of being cost-effective versus etanercept, golimumab, or adalimumab, respectively, in combination with MTX. This analysis demonstrates CZP+MTX to be a cost-effective alternative over Etanercept+MTX and a dominant option over Adalimumab+MTX and Golimumab+MTX for management of RA in Greece.

Palatal morphology changes in post-stroke patients measured by geometric morphometrics.

This study aimed to describe longitudinal palatal shape changes in post-stroke patients when compared to a sample of healthy subjects through linear measurements and geometric morphometrics. The 3D palatal scanned models of seven stroke patients having a 1-year post-stroke follow-up were matched with seven control subjects of the same age group (range 50-87 years). Intercanine, intermolar distances and palatal height were measured. 3D images were also analysed through geometric morphometrics to assess changes in the shape of the palate from T0 to T1 (1 year after the stroke). Principal component analysis was used to describe shape morphology changes, and visual colour maps were used to qualitatively assess differences between T0 and T1. No changes were detected nor in linear measures neither in palatal shape in healthy subjects from T0 to T1. The palates of stroke patients showed no linear differences either. However, when visualising shape changes through colour maps, the lateral aspects of the palatal vault were slightly narrower in T1, with respect to T0 in stroke patients. This may be attributed to altered tongue function following the stroke.

Cyanovirin-N produced in rice endosperm offers effective pre-exposure prophylaxis against HIV-1BaL infection in vitro.

KEY MESSAGE: Cyanovirin-N produced in rice endosperm provides efficient pre-exposure prophylaxis against HIV-1 BaL infection in vitro. Cyanovirin-N (CV-N) is a lectin with potent antiviral activity that has been proposed as a component of microbicides for the prevention of infection with Human immunodeficiency virus (HIV). The production of protein-based microbicide components requires a platform that is sufficiently economical and scalable to meet the demands of the large at-risk population, particularly in resource poor developing countries. We, therefore, expressed CV-N in rice endosperm, because the dried seed is ideal for storage and transport and crude extracts could be prepared locally and used as a microbicide component without further purification. We found that crude extracts from rice seeds expressing up to 10 µg CV-N per gram dry seed weight showed dose-dependent gp120 binding activity, confirming that the protein was soluble, correctly folded and active. The recombinant lectin ((OS)CV-N) reduced the infectivity of HIV-1BaL (an R5 virus strain representing the majority of transmitted infections) by ~90 % but showed only weak neutralization activity against HIV-1RF (representative of X4 virus, rarely associated with transmission), suggesting it would be highly effective for pre-exposure prophylaxis against the vast majority of transmitted strains. Crude extracts expressing (OS)CV-N showed no toxicity towards human cells at working dilutions indicating that microbicide components produced in rice endosperm are safe for direct application as topical microbicides in humans.

Prediction model of regional orthodontic workforce needs, using Greece as an example.

AIM: To develop a theoretical aepidemiological model for the prediction of orthodontic workforce needs, based on regional orthodontic treatment need. MATERIALS AND METHODS: Data were collected for the number of children between the ages of 8-11 years attending primary schools in Greece, within each regional division. Treatment need of the children was estimated using the Index of Orthodontic Treatment Need (IOTN). Demographics of practicing orthodontists in Greece were also collected. Based on the distribution of orthodontists and the number of children per region who would potentially receive orthodontic treatment (IOTN 3-5), the presence and distribution of orthodontic manpower was evaluated. RESULTS: Overall orthodontic manpower is sufficient for Greece's needs with an excess of 55 orthodontists. Distribution however is not uniform, and this ranges from a large underrepresentation of orthodontists in the Ionian Islands (47% of those required) to an overrepresentation in the Attica region (183% of those required). CONCLUSION: Based on the present theoretical model, Greece has an adequate overall orthodontic workforce for coverage of the population needs, but with large regional variations indicating that some regions have a surplus while others a shortage of orthodontists. The present model seems suitable for the calculation of regional orthodontic workforce coverage of a population.

Can plant biotechnology help break the HIV-malaria link?

The population of sub-Saharan Africa is at risk from multiple, poverty-related endemic diseases. HIV and malaria are the most prevalent, but they disproportionately affect different groups of people, i.e. HIV predominantly affects sexually-active adults whereas malaria has a greater impact on children and pregnant women. Nevertheless, there is a significant geographical and epidemiological overlap which results in bidirectional and synergistic interactions with important consequences for public health. The immunosuppressive effects of HIV increase the risk of infection when individuals are exposed to malaria parasites and also the severity of malaria symptoms. Similarly, acute malaria can induce a temporary increase in the HIV viral load. HIV is associated with a wide range of opportunistic infections that can be misdiagnosed as malaria, resulting in the wasteful misuse of antimalarial drugs and a failure to address the genuine cause of the disease. There is also a cumulative risk of toxicity when antiretroviral and antimalarial drugs are given to the same patients. Synergistic approaches involving the control of malaria as a strategy to fight HIV/AIDS and vice versa are therefore needed in co-endemic areas. Plant biotechnology has emerged as a promising approach to tackle poverty-related diseases because plant-derived drugs and vaccines can be produced inexpensively in developing countries and may be distributed using agricultural infrastructure without the need for a cold chain. Here we explore some of the potential contributions of plant biotechnology and its integration into broader multidisciplinary public health programs to combat the two diseases in developing countries.

Novel software for quantitative evaluation and graphical representation of masticatory efficiency.

Blending of chewing gums of different colours is used in the clinical setting, as a simple and reliable means for the assessment of chewing efficiency. However, the available software is difficult to use in an everyday clinical setting, and there is no possibility of automated classification of the patient's chewing ability in a graph, to facilitate visualisation of the results and to evaluate potential chewing difficulties. The aims of this study were to test the validity of ViewGum - a novel image analysis software for the evaluation of boli derived from a two-colour mixing ability test - and to establish a baseline graph for the representation of the masticatory efficiency in a healthy population. Image analysis demonstrated significant hue variation decrease as the number of chewing cycles increased, indicating a higher degree of colour mixture. Standard deviation of hue (SDHue) was significantly different between all chewing cycles. Regression of the log-transformed values of the medians of SDHue on the number of chewing cycles showed a high statistically significant correlation (r² = 0.94, P < 0.01). ViewGum eliminates drawbacks of previous two-colour chewing gum test methods by the simplicity of its application. The newly developed ViewGum software provides speed, ease of use and immediate extraction of clinically useful conclusions to the already established method of chewing efficiency evaluation and is a valid adjunct for the evaluation of masticatory efficiency with two-colour chewing gum.

The application of GMOs in agriculture and in food production for a better nutrition: two different scientific points of view.

This commentary is a face-to-face debate between two almost opposite positions regarding the application of genetic engineering in agriculture and food production. Seven questions on the potential benefits of the application of genetic engineering in agriculture and on the potentially adverse impacts on the environment and human health were posed to two scientists: one who is sceptical about the use of GMOs in Agriculture, and one who views GMOs as an important tool for quantitatively and qualitatively improving food production.

Functional characterization of the recombinant HIV-neutralizing monoclonal antibody 2F5 produced in maize seeds.

Monoclonal antibodies (mAbs) that neutralize human immunodeficiency virus (HIV) can be used as microbicides to help prevent the spread of HIV in human populations. As an industry standard, HIV-neutralizing mAbs are produced as recombinant proteins in mammalian cells, but the high manufacturing costs and limited capacity reduce the ability of target populations in developing countries to gain access to these potentially life-saving medicines. Plants offer a more cost-effective and deployable production platform because they can be grown inexpensively and on a large scale in the region where the products are required. Here we show that the maize-derived HIV-neutralizing mAb 2F5 is assembled correctly in planta and binds to its antigen with the same affinity as 2F5 produced in mammalian cells. Although 2F5 has been produced at high levels in non-plant platforms, the yield in maize seeds is lower than previously achieved with another HIV-neutralizing mAb, 2G12. This suggests that the intrinsic properties of the antibody (e.g. sensitivity to specific proteases) and the environment provided by the production host (e.g. the relative abundance of different proteases, potential transgene silencing) may combine to limit the accumulation of some antibodies on a case-by-case basis.

Quantitative assessment of facial muscle impairment in patients with hemispheric stroke.

Facial weakness is frequently observed in patients with hemispheric stroke. Most reports refer to qualitative assessment. The aim was to quantify the upper and lower facial muscle function in patients with hemispheric stroke. Three different facial expressions (forced smile, posed smile and maximum eyebrow lift) and facial rest position were mapped using a 3D video system. Twenty-seven patients with hemispheric stroke (PG) and 22 controls (CG) were recruited. Facial asymmetry was expressed as absolute side differences between four corresponding distances. In PG, a longer distance was found from inner canthus to oral commissure (dist1) on the impaired side in all investigated poses (PG non-affected-affected side: range of all poses 1·18 ± 4·45 to 1·80 ± 2·37 mm; CG right-left side: range -0·69 ± 1·55 to -0·43 ± 1·39 mm, Mann-Whitney tests: 0·0002 < P < 0·0423). In addition, the ratio of the impaired to the non-affected side was different in PG for dist1 in rest and eyebrow lift (Wilcoxon tests: 0·0011 < P < 0·0288). CG showed asymmetries in rest and forced smile (Wilcoxon tests: P = 0·0392 and P = 0·0424). Furthermore, dist1 in PG showed higher variances than in CG (F-tests: 0·0001 < P < 0·0445) except for the relative dist1 at rest (F-test: P = 0·0533). The distance between inner eyebrow corner and inner canthus showed no side difference in both groups during eyebrow lift (n.s.); nevertheless, two patients showed distinct asymmetries. The employed 3D video system proved sensitive in assessing facial muscle function. The results confirm and quantify that the lower facial muscles are more affected by hemispheric stroke than the upper ones and show that the measured distances were more variable in post-stroke patients than in control subjects.

Carotid artery calcification in ischemic stroke patients detected in standard dental panoramic radiographs - a preliminary study.

PURPOSE: Examine the prevalence of carotid artery calcifications in standard dental panoramic radiographs (OPT), their association to gender, medical history and oral status. Assess the predictive value of a dental OPT in early diagnosis of carotid artery calcifications. MATERIAL AND METHODS: Fourteen patients admitted to Geneva University Hospital for recent ischemic stroke and stenosis of the carotid artery confirmed by Duplex sonography. All OPTs were digitised and subsequently assessed independently by two operators. RESULTS: From 21 carotid artery calcifications detected with Doppler sonography 15 were visible on the corresponding OPT, most of them on the right side (n=11). No correlation was found between the side of calcification and cerebral lesion. Hypertension and periodontal disease were the most prevalent cardiovascular risk factors. CONCLUSIONS: Dentists who either detect carotid artery calcifications in OPTs or see patients with severe periodontitis should consider a prophylactic specialist examination.

Masseter muscle thickness in hospitalised stroke patients.

The aim of the study was to investigate the thickness of the masseter muscles in stroke patients when compared to a control group (CG). Hospitalised stroke patients (18 men, 13 women; age 69.0 +/- 12.7 years) were compared to a CG (13 men, 11 women; age 68.8 +/- 10.8 years) composed to correspond to in age, gender and dental state. The thickness of the masseter muscle was recorded by means of a real-time ultrasound scanner on both sides, twice under contraction and twice in relaxed condition. In the stroke patients, the thickness of the masseter muscle of the affected side (aff) was smaller than the one of the non-affected side (non-aff) both, under contraction (aff 13.1 +/- 2.4 mm; non-aff 13.8 +/- 2.3 mm, P

The orthodontic-periodontic interrelationship in integrated treatment challenges: a systematic review.

Orthodontic treatment aims at providing an acceptable functional and aesthetic occlusion with appropriate tooth movements. These movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent years, because of the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face patients with periodontal problems. Aesthetic considerations, like uneven gingival margins or functional problems resulting from inflammatory periodontal diseases should be considered in orthodontic treatment planning. Furthermore, in cases with severe periodontitis, orthodontics may improve the possibilities of saving and restoring a deteriorated dentition. In modern clinical practice, the contribution of the orthodontist, the periodontist and the general dentist is essential for optimized treatment outcomes. The purpose of this systematic review is to highlight the relationship between orthodontics and periodontics in clinical practice and to improve the level of cooperation between dental practitioners. Potentials and limitations that derive from the interdisciplinary approach of complex orthodontic-periodontal clinical problems are discussed.

Professionals' and laypersons' appreciation of various options for Class III surgical correction.

SUMMARY: The objectives of this study were to evaluate the assessments of maxillofacial surgeons, orthodontists, and laypersons on the predicted aesthetic outcome of various surgical options in Class III correction and the associations between certain initial cephalometric values and the judges' preferred option. Pre-surgical lateral headfilms and coloured profile photographs of 18 skeletal Class III Caucasian adult patients (10 males and 8 females) with a mean age of 24.5 years were used. The headfilms were hand traced and digitized. Conventional cephalometric analysis was performed. Computerized predictions of three surgical options, mandibular setback, Le Fort I advancement, and bimaxillary surgery, were made. For each case, the pre-surgical profile photograph with the three predictions was presented on a printed page. The questionnaire was sent to 51 maxillofacial surgeons (response rate 45.1 per cent), 78 orthodontists (response rate 71.8 per cent), and 61 laypersons (response rate 100 per cent) to aesthetically evaluate the pre-surgical photographs and the surgical predictions by placing a mark along a 10-graded visual analogue scale (VAS) using a standard profile for calibration. Confidence interval was calculated for each patient. An independent samples t-test was used to detect initial cephalometric values associated with the judges' preferred option and analysis of variance/Tukey's honestly significant differences to evaluate differences between judges. Intra-observer reliability was assessed with a paired t-test. All treatment predictions led to improved scoring of facial aesthetics with the exception of the setback option for three patients. For 14 patients, general agreement for the preferred option existed between the three groups of judges. Laypersons tended to give lower improvement scores than professionals. Overjet, nasofacial, and nasomental angles were important in decision making between the mandibular setback and Le Fort I options (the more negative the overjet, the larger the nasofacial angle, the smaller the nasomental angle, the greater the preference for the Le Fort I option). Wits appraisal seemed to be important in decision making between the mandibular setback and bimaxillary options (the more negative the Wits appraisal, the greater the preference for the latter option).

Orthodontists' and laypersons' aesthetic assessment of Class III subjects referred for orthognathic surgery.

This study was undertaken to compare laypersons' and professionals' perception of soft tissue profiles of Class III adults, and to evaluate which cephalometric variables are likely to influence the profile assessment score (PAS). Lateral headfilms and coloured profile photographs of 18 skeletal Class III Caucasian adult patients (10 males, 8 females with a mean age of 24.5 years) prior to surgery, and nine adult Caucasian patients (four males, five females with a mean age of 27.4 years) with a dental Class I occlusion and no major skeletal discrepancy were included in the study. The headfilms were hand traced and digitized. Various cephalometric variables were calculated by computer software. Each printed profile photograph was evaluated aesthetically by 18 laypersons and 18 orthodontists using a 10-graded visual analogue scale (VAS) and a standard profile for calibration. Intra-observer reliability was tested and no significant error was found. Paired and unpaired t-tests were used to compare the scores. The association between various cephalometric variables and the PAS was tested. In general, compared with orthodontists, laypersons were less critical in their evaluation of the Class III profiles (+0.3 grade on the VAS) as well as the reference profiles (+0.7). The reference profiles were found to be more attractive than the Class III profiles by both laypersons and orthodontists (+2.3 grades). The degree of facial concavity had a negatively predictive value for the orthodontists' and laypersons' evaluations. The degree of facial concavity together with the steepness of the mandibular plane were negatively predictive factors for the PAS given by the orthodontists.

Three-dimensional changes in the position of unopposed molars in adults.

The aim of this study was to longitudinally examine, in adults, changes of position in the three dimensions of maxillary molars unopposed for more than 10 years. Twelve healthy mature adults (six males, six females; mean age 45 years 11 months) with unopposed molars were followed-up for a mean period of 10 years 7 months. Plaster casts were made at the first and last examination. The patients presented 22 unopposed maxillary molars at both recordings and 14 posterior teeth with antagonists, at least one in each subject, without significant modifications during the study period. On three-dimensional scanned plaster casts, changes in the centroid of the occlusal surface were measured in the three dimensions. The changes observed on both occasions were compared with a t-test. Vertical displacement of unopposed molars [0.8 mm, standard deviation (SD) 0.65 mm] and controls (0.4 mm, SD 0.2 mm) was noted. The unopposed teeth overerupted more than the controls (P

A two-colour chewing gum test for masticatory efficiency: development of different assessment methods.

OBJECTIVE: The aim of this study was to investigate different assessment methods of a two-colour chewing gum test for masticatory efficiency to determine its validity for research and clinical purposes. MATERIALS AND METHODS: Twenty adult volunteers, eleven women and nine men (mean age of 27.5 years), participated in this study. All participants perceived their masticatory efficiency as normal. The task was to chew five samples of a two-colour chewing gum for 5, 10, 20, 30 and 50 cycles respectively. Maximum bite force was measured. All samples were assessed twice by two independent operators both, as 'bolus' and after flattening to 1 mm thick 'wafers'. The latter were scanned and the unmixed pixels counted using Adobe Photoshop Elements to calculate the ratio of unmixed colour to the total surface. RESULTS: Digital image processing confirmed a significant correlation between colour mixing and chewing duration (P < 0.001). Subjective assessment proved less accurate with fair to substantial intra-examiner agreement for 'bolus' (0.20 < kappa < 0.63) and substantial to almost perfect agreement for 'wafer' (0.60 < kappa < 0.88). Inter-examiner agreement was consistently moderate or substantial only for specimen chewed 20 cycles or longer. No significant correlation was found between the colour mixture and the maximum bite force. CONCLUSION: Digital image processing of the two-colour chewing gum test specimen provides reliable quantitative data for chewing efficiency. Visual assessments were less reliable but might still be useful in screening for chewing deficiencies in a clinical setting. In this context, the test should be performed with a flattened specimen chewed, probably for 20 cycles.