RESUMEN
This study evaluated in vivo, an intraoral device against the gold standard esophageal device for gastroesophageal reflux disease (GERD) monitoring. Subjects scheduled for a catheter-based esophageal pH/impedance testing at a gastroenterology clinic were recruited. They were screened using the GerdQ questionnaire, demographics and dental conditions recorded. A prototype intraoral device, consisting of a Bravo™ capsule embedded in an Essix-style retainer fabricated for each subject, monitored intraoral pH. Concurrently, subjects underwent 24-h esophageal pH-impedance monitoring. A self-administered survey elicited the comfort and acceptance of both devices. The study recruited ten adult subjects (23 to 60-years-old) with a median GerdQ score of 9.5 corresponding to a 79% likelihood of GERD. Subjects with severe dental erosion had significantly (p < 0.05) higher acid exposure time and more non-meal reflux events. No adverse events were associated with the intraoral device while one was recorded for the esophageal device. The intraoral device was significantly more comfortable to place, more comfortable to wear, and interfered less with daily routine compared to the esophageal device. Accuracy of the intraoral device ranged between 86.15% and 37.82%. Being more tolerable than traditional esophageal pH monitoring, intraoral pH monitoring may be a useful adjunct for the diagnosis and management of GERD.
Asunto(s)
Monitorización del pH Esofágico , Reflujo Gastroesofágico , Humanos , Reflujo Gastroesofágico/diagnóstico , Adulto , Persona de Mediana Edad , Masculino , Femenino , Monitorización del pH Esofágico/instrumentación , Monitorización del pH Esofágico/métodos , Adulto Joven , Concentración de Iones de Hidrógeno , Proyectos Piloto , Encuestas y Cuestionarios , Impedancia EléctricaRESUMEN
In recent years, osteoarthritis of the knee, a common degenerative joint disease, often occurs in the elderly population. This disease has a significant impact on the quality of life of patients. For treating knee osteoarthritis, physical therapy is highly regarded as a very effective treatment method. This article delves deeply into commonly used physical therapy methods and analyzes their therapeutic effects, cost-effectiveness, and applicability, aiming to find treatments with broader applicability and better cost-effectiveness. The goal is to help a large number of patients effectively alleviate the discomfort caused by knee osteoarthritis, enhance the clinical therapeutic effects, and introduce home treatment methods to reduce financial burdens. The article also compares various physical therapy methods and finds that moxibustion and electrotherapy are more suitable for home use. Other treatment methods provide a reliable scientific basis for patient treatment.
Asunto(s)
Osteoartritis de la Rodilla , Modalidades de Fisioterapia , Humanos , Osteoartritis de la Rodilla/terapia , Análisis Costo-Beneficio , Calidad de Vida , Moxibustión/métodos , Terapia por Estimulación Eléctrica/métodosRESUMEN
BACKGROUND: There is currently insufficient evidence on potential predictors of a child's behaviour with nitrous oxide (N2O) sedation. AIM: To examine the association between a child's temperament and behavioural outcomes during dental treatment with N2O sedation, and the child's perception to N2O sedation. DESIGN: At the first visit (dental treatment visit), temperament was assessed using the Child Behaviour Questionnaire-Short Form and behaviour was assessed by an independent rater using the Venham Behaviour Rating Scale. At the second visit, the child's experience with N2O sedation was elicited. RESULTS: Seventy-two healthy children aged between 36 and 95 months were recruited. Planned dental treatment was completed in 84.7% of the subjects. Venham behaviour success <3 and Venham behaviour success <1 were achieved in 73.6% and 33.3%, respectively. The temperament domain of effortful control was associated with Venham behaviour score (ρ = -0.266, p = .024) and Venham behaviour success <1 (OR = 3.506, 95% CI = 1.328-9.259, p = .011). Baseline Frankl behaviour score was significantly associated with all behavioural outcomes. Venham behaviour success <3 was significantly associated with a child reporting to have enjoyed the dental treatment visit (p = .026). CONCLUSION: Effortful control and baseline behaviour were associated with behavioural outcomes of N2O sedation and can be used to predict a child's behaviour.
RESUMEN
Background: The chondrogenic differentiation of mesenchymal stem cells (MSCs) to enhance cartilage repair and regeneration is a promising strategy to alleviate osteoarthritis (OA) progression. Method: The potency of JD-312 in inducing chondrogenic differentiation of MSCs was assessed and verified. The efficacy of JD-312-treated MSCs was evaluated using a Sprague-Dawley rat DMM model. Additionally, the capacity of JD-312 to successfully recruit bone marrow-derived mesenchymal stem cells (BMSCs) for the treatment of OA in vitro was confirmed via intra-articular injection. The repair status of the articular cartilage was analyzed in vivo through histological examination. Result: In this study, we identify JD-312 as a novel non-toxic small molecule that can promote chondrogenic differentiation in human umbilical cord-derived MSCs (hUCMSCs) and human bone marrow MSCS (hBMSCs) in vitro. We also show that transient differentiation of MSCs with JD-312 prior to in vivo administration remarkably improves the regeneration of cartilage and promotes Col2a1 and Acan expression in rat models of DMM, in comparison to kartogenin (KGN) pre-treatment or MSCs alone. Furthermore, direct intra-articular injection of JD-312 in murine model of OA showed reduced loss of articular cartilage and improved pain parameters. Lastly, we identified that the effects of JD-312 are at least in part mediated via upregulation of genes associated with the focal adhesion, PI3K-Akt signaling and the ECM-receptor interaction pathways, and specifically cartilage oligomeric matrix protein (COMP) may play a vital role. Conclusion: Our study demonstrated that JD-312 showed encouraging repair effects for OA in vivo. The translational potential of this article: Together, our findings demonstrate that JD-312 is a promising new therapeutic molecule for cartilage regeneration with clinical potential.
RESUMEN
BACKGROUND: No studies have evaluated the unique potential of nurse-led silver diamine fluoride (SDF) application for children to bridge the gap in interprofessional collaboration. AIM: To investigate the attitudes, beliefs and perceptions of nurses regarding nurse-led SDF application at the well-child visit and identify possible barriers and make recommendations. DESIGN: Mixed methods design involving a questionnaire and semi-structured individual interviews were conducted. RESULTS: All eligible nurses (n = 110) completed the questionnaire, and 16 were interviewed. Questionnaire responses highlighted that nurses were not confident in providing oral health services (score: <3 of 5) beyond oral hygiene advice (score: ≥3.9 of 5) but believed that they should be providing these services for individuals with difficulty accessing care. Interviews reflected that most nurses viewed oral health care as an important part of paediatric health but were limited by knowledge, time and manpower. Most were willing to expand their job scope to include SDF application with formal education and training, competency assessments and approaches to counter time limitations. CONCLUSION: Where nurses are already providing basic oral healthcare, nurse-led SDF application could be the next step. Findings suggest that systemic changes should include strategies to empower and motivate nurses to apply SDF at the well-child visit.
Asunto(s)
Actitud del Personal de Salud , Fluoruros Tópicos , Compuestos de Amonio Cuaternario , Compuestos de Plata , Humanos , Fluoruros Tópicos/uso terapéutico , Compuestos de Amonio Cuaternario/uso terapéutico , Encuestas y Cuestionarios , Femenino , Niño , Masculino , Adulto , Cariostáticos/uso terapéutico , Atención Dental para Niños/métodosRESUMEN
OBJECTIVES: To compare the level of acceptance of silver diamine fluoride (SDF) treatment between different functional groups of older adults aged 65-years-old and above. METHODS: Three groups were recruited representing functionally-independent ("Community dwelling"), frail ("Nursing home"), and functionally-dependent older adults ("Caregiver": proxy respondent involved in caring for an older adult of all functional levels). Participants viewed a video on SDF and an interviewer-led questionnaire collected demographics, dental experience and perception on SDF use. RESULTS: The study recruited 201 participants (100 "Community dwelling", 51 "Nursing home", 50 "Caregiver"). Overall, 73 % of participants were accepting of SDF treatment. Those in the "Community dwelling" group were most accepting (85 %), followed by the "Nursing home" group (61 %) and "Caregiver" group (60 %) (p<0.001). Participants were more accepting of SDF use on posterior (73 %) compared to anterior teeth (46 %). They were more accepting when SDF was presented as a treatment to avoid infection and pain (87 %), and general anesthesia (78 %). In a regression analysis, "Nursing home" and "Caregiver" participants were three times less likely to accept SDF (OR 0.27 [95 % CI: 0.13 to 0.60], and OR 0.27 [95 % CI: 0.12 to 0.58] respectively) compared to "Community dwelling" participants. After adjusting for other factors, only the "Caregiver" group remained significant (Adjusted OR 0.32 [95 % CI: 0.13 to 0.78]). CONCLUSIONS: Older adults were accepting of SDF and this treatment modality has the potential to be a routine treatment option in dental caries management in this population. However, this was less certain among frail and functionally dependent older adults. CLINICAL SIGNIFICANCE: An SDF program to manage caries is likely to be well-received by functionally-independent older adults. However, the acceptance among frail and functionally-dependent older adults were lower even though SDF is mostly likely to benefit these populations. There is a need to investigate this relatively lower levels of acceptance.
Asunto(s)
Cariostáticos , Caries Dental , Humanos , Anciano , Cariostáticos/uso terapéutico , Caries Dental/tratamiento farmacológico , Caries Dental/prevención & control , Cuidadores , Vida Independiente , Fluoruros Tópicos/uso terapéutico , Compuestos de Amonio Cuaternario/uso terapéutico , Compuestos de Plata/uso terapéutico , Casas de SaludRESUMEN
PURPOSE: Oral mucositis is a common complication for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) and causes pain and difficulties in functions like eating and swallowing, resulting in lower quality of life and greater need of treatment with opioids and parenteral nutrition. This prospective multicenter study focused on pediatric recipients of HSCT in the neutropenic phase concerning oral complications, timing, severity, and patient experience. METHODS: The cohort comprised 68 patients, median age 11.1 years (IQR 6.3) receiving allogeneic HSCT at three clinical sites. Medical records were retrieved for therapy regimens, concomitant medications, oral and dental history, and subjective oral complaints. Calibrated dentists conducted an oral and dental investigation before HSCT. After HSCT graft infusion, study personnel made bedside assessments and patients filled out a questionnaire once or twice a week until neutrophil engraftment. RESULTS: We followed 63 patients through the neutropenic phase until engraftment. 50% developed oral mucositis of grades 2-4. Peak severity occurred at 8-11 days after stem cell infusion. Altogether, 87% had subjective oral complaints. The temporal distribution of adverse events is similar to the development of oral mucositis. The most bothersome symptoms were blisters and oral ulcerations, including mucositis; 40% reported severe pain and major impact on activities of daily living despite continuous use of opioids. CONCLUSION: This study highlights the burden of oral complications and their negative effect on the health and quality of life of HSCT recipients.
Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Estomatitis , Humanos , Niño , Estudios Prospectivos , Incidencia , Calidad de Vida , Actividades Cotidianas , Estomatitis/epidemiología , Estomatitis/etiología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Trasplante de Células Madre Hematopoyéticas/métodos , Dolor/etiología , Estudios Multicéntricos como AsuntoRESUMEN
OBJECTIVES: There is a lack of studies evaluating the accuracy of the 2009 American Association of Endodontists (AAE) diagnostic criteria for diagnosing pulpal health in primary teeth. This study aimed to estimate and correlate the diagnostic accuracy of clinical diagnosis of reversible and irreversible pulpitis using the 2009 AAE criteria with histological findings in primary teeth. METHODS: Eighty primary teeth that were clinically diagnosed with normal pulp (n = 10), reversible pulpitis (n = 30), irreversible pulpitis (n = 30) and pulp necrosis (n = 10) were collected. The teeth were histo-processed, and pulp tissues were diagnosed histologically as uninflamed pulp, reversible or irreversibly inflamed and necrosis based on previously proposed criteria. RESULTS: The clinical diagnosis of pulp necrosis (sensitivity 70%, specificity 96%) and normal pulp (sensitivity 91%, specificity 100%) matched the histological diagnosis of necrosis and uninflamed pulp in 70% and 100%, respectively. The clinical diagnosis of irreversible pulpitis (sensitivity 64%, specificity 72%) matched the histological diagnosis of irreversible pulp inflammation for 47% of teeth evaluated. For the clinical diagnosis of reversible pulpitis (sensitivity: 65%, specificity: 86%), 80% matched the histological diagnosis of reversible pulp inflammation. Teeth with histologically diagnosed irreversible pulp inflammation were more likely to have lingering (OR 5.08; 95% CI 1.48-17.46, P = 0.010) and nocturnal tooth pain (OR 15.86; 95% CI 1.57-160.47, P = 0.019) when compared to teeth with reversible pulp inflammation. Using the classification and regression tree model, the presence of widened periodontal ligament space and nocturnal tooth pain were useful predictors of irreversible pulp inflammation with an accuracy of 78%. CONCLUSION: The 2009 AAE criteria was acceptable for primary teeth with pulp necrosis and normal pulp but poor for reversible pulpitis and irreversible pulpitis.
Asunto(s)
Endodoncistas , Pulpitis , Humanos , Pulpitis/diagnóstico , Necrosis de la Pulpa Dental/diagnóstico , Pulpa Dental , Inflamación/patología , Necrosis/patología , Diente Primario , DolorRESUMEN
Background: There has been a debate about the use of Hall Technique (HT), whether it can be considered as a standard technique for the management of carious primary molars. Aim: To summarise the evidence on HT for managing dentine caries in primary teeth. Design: MEDLINE, Embase, CENTRAL and Epistemonikos databases were searched for clinical studies conducted from 2007 to 2021 evaluating HT in primary teeth. Two reviewers independently screened, data extracted and quality assessed the studies. Results: Eleven publications from eight unique studies were included. Four were of low risk of bias overall and five studies were included in a meta-analysis. Overall, HT was 49 % (RR 1.49 [95 % CI: 1.15-1.93], I2 =89.5 %, p < 0.001) more likely to succeed. When compared to direct restorations, HT was 80 % more likely to succeed; while similar success was found when compared to conventional preformed metal crowns. HT was also over 6 times (RR 0.16 [95 %CI: 0.10-0.27], I2 =0 %, p < 0.001) less likely to fail. Most of the studies included proximal or multi-surface lesions. Conclusions: HT is successful option for the management of caries in primary teeth, particularly for proximal or multi-surface dentine lesions. It is well-tolerated by children and acceptable to parent, with mild adverse effects reported.
RESUMEN
Depression is a common and severe mental disease that places a heavy burden on human society, which can lead to decreased cognitive function, energy loss, insomnia, and even suicide. Although medication plays an important role in improving the symptoms of depression, approximately one third of people with depression do not significantly benefit from medication and experience various adverse reactions. Recently, increasing evidence has shown that gut microbes play an important role in the occurrence and development of depression. There have been illuminating studies previously conducted on the relationship between antidepressant chemicals, traditional Chinese medicine, and the microbiota-gut-brain axis (MGBA). Therefore, in this review, we summarize the role of the MGBA in the occurrence and development of depression, especially the important role of the MGBA in the mechanism of action of antidepressants. Modulation of the MGBA is proposed to enhance the efficacy of antidepressant drugs and reduce their side effects and disease recurrence, so as to provide a new method for the treatment of depression.
Asunto(s)
Microbioma Gastrointestinal , Medicina Tradicional China , Antidepresivos/efectos adversos , Eje Cerebro-Intestino , Depresión/tratamiento farmacológico , HumanosRESUMEN
OBJECTIVE: This study aims to characterize the cytotoxicity potential of silver diamine fluoride (SDF) on dental pulp stem cells (DPSC) and gingival equivalents. METHODS: DPSC cultured on 96-well plates was exposed directly to SDF (0.0001-0.01%) and cell viability (IC50) quantified. Effect of SDF on DPSC viability under flow (with dentin barrier) conditions was evaluated using a custom-designed microfluidic "tooth-on-a-chip". Permeability of dentin discs (0.5-1.5 mm thickness) was evaluated using lucifer yellow permeation assay. Dentin discs were treated with 38% SDF (up to 3 h), and cell viability (live/dead assay) of the DPSC cultured in the inlet (unexposed) and outlet (exposed) regions of the pulp channel was evaluated. To assess the mucosal corrosion potential, gingival equivalents were treated with 38% SDF for 3 or 60 min (OECD test guideline 431) and characterized by MTT assay and histomorphometric analysis. RESULTS: DPSC exposed directly to SDF showed a dose-dependent reduction in cell viability (IC50: 0.001%). Inlet channels (internal control) of the tooth-on-a-chip exposed to PBS and SDF-exposed dentin discs showed> 85% DPSC viability. In contrast, the outlet channels of SDF-exposed dentin discs showed a decreased viability of< 31% and 0% (1.5 and ≤1.0 mm thick dentin disc, respectively) (p < 0.01). The gingiva equivalents treated with SDF for 3 and 60 min demonstrated decreased epithelial integrity, loss of intercellular cohesion and corneal layer detachment with significant reduction in intact epithelial thickness (p < 0.05). SIGNIFICANCE: SDF penetrated the dentin (≤1 mm thick) inducing significant death of the pulp cells. SDF also disrupted gingival epithelial integrity resulting in mucosal corrosion.
Asunto(s)
Caries Dental , Encía , Dentina , Fluoruros Tópicos , Humanos , Dispositivos Laboratorio en un Chip , Microfluídica , Compuestos de Amonio Cuaternario/toxicidad , Compuestos de PlataRESUMEN
Silver-modified atraumatic restorative technique (SMART) is an emerging restorative technique; however, the effect of silver diamine fluoride (SDF) application on the bond strength of glass ionomer cement (GIC) is unknown. This study aimed to determine if SDF application to sound and artificial caries-affected dentin (ACAD) immediately prior to GIC restoration affected microtensile bond strength (µTBS). Caries was induced on extracted molars using a pH-cycling protocol that was validated against natural caries (similar µTBS). Dentin surfaces were treated with 38% SDF, control groups with de-ionized water and immediately restored. Beam-shaped specimens were sectioned and subjected to tensile forces for µTBS determination. Two hundred and eighty-seven specimens from 40 teeth were tested. SDF application significantly (p<0.001) reduced µTBS in sound dentin (19.00±8.20 MPa vs. 14.60±6.68 MPa), while no difference was found in ACAD. No difference was found in failure mode among groups. For SMART, SDF application on sound dentin before immediate GIC restoration may decrease bond strength.
Asunto(s)
Recubrimiento Dental Adhesivo , Caries Dental , Caries Dental/terapia , Susceptibilidad a Caries Dentarias , Dentina , Fluoruros Tópicos , Cementos de Ionómero Vítreo/química , Humanos , Ensayo de Materiales , Compuestos de Amonio Cuaternario , Compuestos de Plata/química , Resistencia a la Tracción , AguaRESUMEN
BACKGROUND AND AIMS: Microbiome dysbiosis is associated with inflammatory destruction in Crohn's disease [CD]. Although gut microbiome dysbiosis is well established in CD, the oral microbiome is comparatively under-studied. This study aims to characterize the oral microbiome of CD patients with/without oral manifestations. METHODS: Patients with CD were recruited with age-, gender- and race-matched controls. Potential confounders such as dental caries and periodontal condition were recorded. The oral microbiome was collected using saliva samples. Microbial DNA was extracted and sequenced using shotgun sequencing. Metagenomic taxonomic and functional profiles were generated and analysed. RESULTS: The study recruited 41 patients with CD and 24 healthy controls. Within the CD subjects, 39.0% had oral manifestations with the majority presenting with cobblestoning and/or oral ulcers. Principal coordinate analysis demonstrated distinct oral microbiome profiles between subjects with and without CD, with four key variables responsible for overall oral microbiome variance: [1] diagnosis of CD, [2] concomitant use of steroids, [3] concomitant use of azathioprine and 4] presence of oral ulcers. Thirty-two significant differentially abundant microbial species were identified, with the majority associated with the diagnosis of CD. A predictive model based on differences in the oral microbiome found that the oral microbiome has strong discriminatory function to distinguish subjects with and without CD [AUROC 0.84]. Functional analysis found that an increased representation of microbial enzymes [n = 5] in the butyrate pathway was positively associated with the presence of oral ulcers. CONCLUSIONS: The oral microbiome can aid in the diagnosis of CD and its composition was associated with oral manifestations.
Asunto(s)
Enfermedad de Crohn , Caries Dental , Microbioma Gastrointestinal , Úlceras Bucales , Humanos , Enfermedad de Crohn/diagnóstico , Disbiosis , Heces , Microbioma Gastrointestinal/genética , ARN Ribosómico 16S/genéticaRESUMEN
Osteosarcoma is one of the most common malignant bone tumors. However, the treatment and clinical outcomes of osteosarcoma have hardly changed over the past three decades due to the comprehensive heterogeneity and higher rate of mutation of osteosarcoma. Recent studies have shown that STAT3 has the potential to suppress the proliferation and metastasis of osteosarcoma. In this study, a novel class of 2-amino-3-cyanothiophene derivatives were designed and synthesized to inhibit osteosarcoma by targeting STAT3. Representative compound 6f showed potent antiproliferative effects against osteosarcoma cells, directly bound to the STAT3 SH2 domain with a KD of 0.46 µM, and inhibited the phosphorylation of STAT3 Y705 in a dose-dependent manner. Furthermore, compound 6f promoted osteosarcoma cell apoptosis in vitro and significantly suppressed the growth and metastasis of osteosarcoma in vivo. These findings demonstrate that targeting STAT3 may be a feasible therapeutic strategy for the treatment of metastatic osteosarcoma.
Asunto(s)
Neoplasias Óseas , Osteosarcoma , Apoptosis , Neoplasias Óseas/patología , Línea Celular Tumoral , Proliferación Celular , Humanos , Osteosarcoma/patología , Factor de Transcripción STAT3/metabolismoRESUMEN
BACKGROUND: Virtual reality (VR) can be used to simulate the viewpoint of a child to allow dental students to experience what a child experiences during a dental visit. AIM: The aim of this study was to evaluate the effect of VR simulation on the empathy and comfort managing children among dental students. DESIGN: Sixty dental students experienced a VR scenario created for the study. Empathy levels were examined using the Jefferson Scale of Empathy (JSE). A self-administered questionnaire was used to collect information on self-perceived ability, comfort and impact of the intervention. RESULTS: There was a significant (p = .004) increase (indicating greater empathy) in JSE scores between pre-intervention (112.35 ± 9.34) and post-intervention (117.64 ± 10.03), which returned to baseline 3 months later (112.72 ± 10.36). Dental students perceived themselves to be more confident at communicating (6.45 ± 1.64 vs. 5.75 ± 1.71, p = .011) and interacting (6.63 ± 1.44 vs. 6.00 ± 1.78, p = .046) with children after the intervention. All (100%) felt that the VR scenarios helped them better empathize with children. Only 30% revisited the scenario after the intervention, and they were significantly more likely (p < .001) to find it helpful for actual clinical sessions. CONCLUSION: Virtual reality could be used to improve empathy, self-perceived comfort and ability at managing children in dental students. Yet, they should be encouraged to revise using it to maintain this effect.
Asunto(s)
Empatía , Realidad Virtual , Niño , Humanos , Estudiantes de Odontología , Encuestas y CuestionariosRESUMEN
BACKGROUND: There is no consensus regarding when children are ready to brush independently. AIM: To examine the effects of chronological age and motor development on toothbrushing effectiveness in 5- to 7-year-old children. DESIGN: In this cross-sectional study, the change in Oral Hygiene Index (OHI) score and the improvement in OHI category (eg, poor to fair) were used to measure toothbrushing effectiveness. Motor development was assessed using the Beery-Buktenica Developmental Test of Visual Motor Integration, and a parental questionnaire was used to determine the child's ability to perform certain daily tasks. RESULTS: Children aged ≥6 years were significantly more likely to show improvement in OHI category (OR = 2.4, p = .032) than 5-year-old children. Parental report of their child's ability to write/print addresses (OR = 3.7, p = .009), tie shoelaces (OR = 2.9, p = .008), and cut/file nails (OR = 3.2, p = .036) was significantly more likely to show improvement in OHI category. A model using chronological age, visual motor age, ability to write/print addresses, tie shoelaces, cut/file nails, and toothbrushing duration achieved 61.8% sensitivity and 80.4% specificity in predicting a child's ability to achieve improvement in OHI category. CONCLUSIONS: Children entering elementary school (≥6 years old) brushed their teeth more effectively than preschool children. A multifactorial model provided an acceptable predictor of the child's ability to brush effectively.
Asunto(s)
Padres , Cepillado Dental , Niño , Preescolar , Estudios Transversales , Humanos , Instituciones Académicas , Encuestas y CuestionariosRESUMEN
PURPOSE: The range of child behaviors encountered in real-life situations far exceeds that of any classroom-based simulated scenarios. For such reasons, clinical training with real-time clinical supervisor's feedback is optimal for learner-centricity. This study aimed to objectively evaluate the effect of video feedback on the student dentist's ability to manage behaviors in children. METHODS: Third-year dental student volunteers were randomly allocated to two groups: control and intervention. They were video recorded for three pediatric dental treatment sessions and received standard feedback for all sessions. Additionally, the intervention group received two constructive 1-on-1 feedback sessions after the first and second video sessions. Students' application of behavior management techniques for all recorded treatment sessions was scored with a study-specific objective scale (maximum score: 20; larger score indicating better performance) by two independent and blinded evaluators. A self-administered student questionnaire elicited subjective feedback on the intervention. RESULTS: There was a significant difference (p = 0.008) between behavior management scores when comparing all pre-intervention sessions (10.74 ± 3.55) and all post-intervention sessions (13.57 ± 2.96). The intervention significantly improved these techniques: 1. Providing specific feedback - positive reinforcement and descriptive praise (p = 0.006) and 2. Distraction - Using imagination with stories and singing (p = 0.035). The feedback sessions (4.29 ± 0.54) were perceived to be significantly (p = 0.032) more effective than having the students view the videos on their own (3.76 ± 0.87). CONCLUSION: Video feedback improved the behavior management scores of student dentists. The faculty feedback sessions were found by student dentists to improve confidence and the techniques for managing children.
RESUMEN
BACKGROUND: This study aims to characterize, the gut and oral microbiome in Asian subjects with Crohn's disease (CD) using whole genome shotgun sequencing, thereby allowing for strain-level comparison. METHODS: A case-control study with age, sex and ethnicity matched healthy controls was conducted. CD subjects were limited to well-controlled patients without oral manifestations. Fecal and saliva samples were collected for characterization of gut and oral microbiome respectively. Microbial DNA were extracted, libraries prepared and sequenced reads profiled. Taxonomic diversity, taxonomic association, strain typing and microbial gene pathway analyses were conducted. RESULTS: The study recruited 25 subjects with CD and 25 healthy controls. The oral microbe Streptococcus salivarius was found to be enriched and of concordant strains in the gut and oral microbiome of Crohn's disease subjects. This was more likely in CD subjects with higher Crohn's Disease Activity Index (184.3 ± 2.9 vs 67.1 ± 82.5, p = 0.012) and active disease status (Diarrhoea/abdominal pain/blood-in-stool/fever and fatigue) (p = 0.016). Gut species found to be significantly depleted in CD compared to control (Relative abundance: Median[Range]) include: Faecalibacterium prausnitzii (0.03[0.00-4.56] vs 13.69[5.32-18.71], p = 0.010), Roseburia inulinivorans (0.00[0.00-0.03] vs 0.21[0.01-0.53], p = 0.010) and Alistipes senegalensis (0.00[0.00-0.00] vs 0.00[0.00-0.02], p = 0.029). While Clostridium nexile (0.00[0.00-0.12] vs 0.00[0.00-0.00], p = 0.038) and Ruminococcus gnavus (0.43[0.02-0.33] vs 0.00[0.00-0.13], p = 0.043) were found to be enriched. C. nexile enrichment was not found in CD subjects of European descent. Microbial arginine (Linear-discriminant-analysis: 3.162, p = 0.001) and isoprene (Linear-discriminant-analysis: 3.058, p < 0.001) pathways were found at a higher relative abundance level in gut microbiome of Crohn's disease. CONCLUSIONS: There was evidence of ectopic gut colonization by oral bacteria, especially during the active phase of CD. Previously studied gut microbial differences were detected, in addition to novel associations which could have resulted from geographical/ethnic differences to subjects of European descent. Differences in microbial pathways provide possible targets for microbiome modification.
RESUMEN
The emergence of multidrug resistance (MDR) in Proteus mirabilis clinical isolates is a growing public health concern and has serious implications for wildlife. What is the role of wildlife has been become one of the hot issues in disseminating antimicrobial resistance. Here, 54 P. mirabilis isolates from 12 different species were identified. Among them, 25 isolates were determined to be MDR by profile of antimicrobial susceptibility; 10 MDR P. mirabilis isolates were subjected to comparative genomic analysis by whole genome sequencing. Comprehensive analysis showed that chromosome of P. mirabilis isolates mainly carries multidrug-resistance complex elements harboring resistance to carbapenem genes blaOXA-1 , blaNDM-1 , and blaTEM-1 . Class I integron is the insertion hotspot of IS26; it can be inserted into type I integron at different sites, thus forming a variety of multiple drug resistance decision sites. At the same time, Tn21, Tn7, and SXT/R391 mobile elements cause widespread spread of these drug resistance genes. In conclusion, P. mirabilis isolates from wildlife showed higher resistance to commonly used clinic drugs comparing to those from human. Therefore, wild animals carrying MDR clinical isolates should be paid attention to by the public health.
Asunto(s)
Animales Salvajes/microbiología , Antibacterianos/farmacología , Proteus mirabilis/efectos de los fármacos , Salud Pública , beta-Lactamasas/metabolismo , Animales , China , Farmacorresistencia Bacteriana Múltiple , Regulación Bacteriana de la Expresión Génica , Regulación Enzimológica de la Expresión Génica , Infecciones por Proteus/microbiología , Infecciones por Proteus/veterinaria , beta-Lactamasas/genéticaRESUMEN
Purpose: he purpose of this study was to evaluate in vitro the effect of 5.25 percent sodium hypochlorite (NaOCl) on the bond strength of resin sealant to hypomineralized enamel. Methods: Sound (S) and hypomineralized (H) enamel specimens were subjected to three different treatments: (1) etch only (E); (2) 5.25 percent NaOCl treatment (60 seconds) after (Post) etching; and (3) 5.25 percent NaOCl treatment (60 seconds) before (Pre) etching. A sealant rod was bonded for microshear bond strength (µSBS) testing. DIAGNOdent™ and spectrophotometry were used to detect changes in surface organic content and verify the amount of organic material removed. Results: Ninety S and 90 H specimens were randomly grouped into SE, SPost, SPre, HE, HPost, HPre groups. The average µSBS of hypomineralized enamel in etch only (HE) and NaOCl pre-etch (HPre) were significantly lower (9.2 MPa). NaOCl after etching significantly increased the µSBS of hypominineralized enamel (HPost) to 14.5 MPa, similar to sound enamel. DIAGNOdent™ readings were significantly lower in NaOCl Post versus E and NaOCl Pre, suggesting lower surface organic content. Spectrophotometry confirmed that NaOCI significantly removed more organic material in hypomineralized enamel. Conclusion: Applying 5.25 percent sodium hypochlorite for 60 seconds after etching (32 percent phosphoric acid) increased the bond strength of resin sealant to hypomineralized enamel comparable to that of sound enamel, as a result of surface organic content removal.