Suitability of treated wastewater for irrigation and its impact on groundwater resources in arid coastal regions: Insights for water resources sustainability.

Water scarcity threatens agriculture and food security in arid regions like Saudi Arabia. The nation produces significant quantities of municipal wastewater, which, with adequate treatment, could serve as an alternative water source for irrigation, thereby reducing reliance on fossil and non-renewable groundwater. This study assessed the appropriateness of using treated wastewater (TWW) for irrigation in a dry coastal agricultural region in Eastern Saudi Arabia and its impact on groundwater resources. Field investigations were conducted in Qatif to collect water samples and field measurements. A multi-criteria approach was applied to evaluate the TWW's suitability for irrigation, including complying with Saudi Standards, the Irrigation Water Quality Index (IWQI), the National Sanitation Foundation water quality index (NSFWQI), and the individual irrigation indices. In addition, the impact of TWW on groundwater was assessed through hydrogeological and isotope approaches. The results indicate that the use of TWW in the study area complied with the Saudi reuse guidelines except for nitrate, aluminum, and molybdenum. However, irrigation water quality indices classify TWW as having limitations that necessitate the use for salt-tolerant crops on permeable and well-drained soils. Stable isotopic analysis (δ2H, δ18O) revealed that long-term irrigation with TWW affected the shallow aquifer, while deep aquifers were minimally impacted due to the presence of aquitard layer. The application of TWW irrigation has successfully maintained groundwater sustainability in the study area, as evidenced by increased groundwater levels up to 2.3 m. Although TWW contributes to crop productivity, long term agricultural sustainability could be enhanced by improving effluent quality, regulating irrigation practices, implementing buffer zones, and monitoring shallow groundwater. An integrated approach that combines advanced wastewater treatment methods, community involvement, regulatory oversight, and targeted monitoring is recommended to be implemented.

The use of guided tissue regeneration in endodontic Microsurgery: Setting a threshold.

Aim: We aimed to compare the radiographic outcomes of conventional and regenerative approaches in endodontic microsurgery (EMS) and set a critical defect size for healing in conventional and regenerative therapies. Methodology: The study evaluated 53 root canal-treated teeth (33 patients) with periapical lesions. Among them, 19 teeth (35.8 %) were treated with regenerative treatment, whereas 34 teeth (64.1 %) were managed with the conventional approach. Conventional and regenerative approaches were performed by endodontic and periodontic residents under consultants' supervision. Healing was evaluated after a minimum period of 6 months by comparing pre- and post-operative cone-beam computed tomography (CBCT) findings. The radiographic interpretation was conducted by a single examiner who was not participating in the surgeries and was blind on the type of treatment prior to CBCT evaluation. New healing criteria were proposed owing to the limitations on the present criteria in evaluating endodontic surgery after regenerative treatment. Critical measurements were calculated for each approach based on periapical lesion dimensions. Results: The regenerative approach presented significantly better healing than conventional treatment (mean, 1.21 and 1.59, respectively; p = 0.047). Based on the critical-point calculations, the conventional approach was effective in lesions of up to 3 mm depth and height, whereas the regenerative approach resulted in better healing rates in lesions with 3-9 mm depth and 3-6 mm height. Conclusions: Performing the regenerative approach in EMS resulted in better healing rates than those of the conventional approach. The conventional approach is recommended for small periapical lesions, whereas the first had better results in larger lesions.

Emerging iron-based mesoporous materials for adsorptive removal of pollutants: Mechanism, optimization, challenges, and future perspective.

Iron-based materials (IBMs) have shown promise as adsorbents due to their unique physicochemical properties. This review provides an overview of the different types of IBMs, their synthesis methods, and their properties. Results found in the adsorption of emerging contaminants to a wide range of IBMs are discussed. The IBMs used were evaluated in terms of their maximum uptake capacity, with special consideration given to environmental conditions such as contact time, solution pH, initial pollutant concentration, etc. The adsorption mechanisms of pollutants are discussed taking into account the results of kinetic, isotherm, thermodynamic studies, surface complexation modelling (SCM), and available spectroscopic data. A current overview of molecular modeling and simulation studies related to density functional theory (DFT), surface response methodology (RSM), and artificial neural network (ANN) is presented. In addition, the reusability and suitability of IBMs in real wastewater treatment is shown. The review concludes with the strengths and weaknesses of current research and suggests ideas for future research that will improve our ability to remove contaminants from real wastewater streams.

Ventral hippocampal interneurons govern extinction and relapse of contextual associations.

Contextual associations are critical for survival but must be extinguished when new conditions render them nonproductive. By most accounts, extinction forms a new memory that competes with the original association for control over behavior, but the mechanisms underlying this competition remain largely enigmatic. Here we find the retrieval of contextual fear conditioning and extinction yield contrasting patterns of activity in prefrontal cortex and ventral hippocampus. Within ventral CA1, activation of somatostatin-expressing interneurons (SST-INs) occurs preferentially during extinction retrieval and correlates with differences in input synaptic transmission. Optogenetic manipulation of these cells but not parvalbumin interneurons (PV-INs) elicits bidirectional changes in fear expression following extinction, and the ability of SST-INs to gate fear is specific to the context in which extinction was acquired. A similar pattern of results was obtained following reward-based extinction. These data show that ventral hippocampal SST-INs are critical for extinguishing prior associations and thereby gate relapse of both aversive and appetitive responses.

How Does an Eating Disorder Affect Your Physical and Mental Health and How It Is Related to Sleeve Gastrectomy?

Background Obesity is the pandemic of this era. At the same time, the commercialisation of thinness has also increased its adversity. Dissatisfaction with body shape is leading to many eating disorders. These disorders further cause several health problems. It has been found that individuals with eating disorders experience insomnia, depression, and anxiety. It also affects the endocrine system and digestive systems of the body. The surgical approach provides a more efficient treatment of obesity with sustainable results. Sleeve gastrectomy is the most popular surgical treatment. Sleeve gastrectomy is one of the prominent bariatric surgeries. Patients going through sleeve gastrectomy not only lose weight but also improve their mental health. Objective This study assesses the relationship between obesity, eating disorders, and physical health. It also focuses on the prevalence of sleeve gastrectomy procedures in such individuals and their outcomes. Methods This study used a cross-sectional design and a convenient sampling technique. The obese individuals who had eating disorders residing in Medina Al-Munawara and Riyadh city were taken as the samples. Online questionnaires were shared with participants to collect their perspectives on their weight, eating disorders, and their impact on physical health. The study collected both retrospective and present data. Results A total sample of 335 participants was taken, of which 181 (54%) were females and 154 (46%) were males, with a mean BMI of 28.85±2.57. The fear of weight gain was found among 265 (79%) of participants, 151 (45%) were feeling guilt while eating, 275 (82%) were weighing themselves daily, 325 (97%) were unable to stop eating even when complete, and 117 (35%) were unable to control themselves when they have food. As per the methods of avoiding weight gain, 166 (49.6%) were skipping a meal, 157 (47%) were following a diet, 17 (5%) were inducing vomiting, and 16 (4.8%) reused laxatives and diuretics. A total of 158 (47.2%) were involved in sports, but it was reduced to 61 (18.25%) upon sickness. Only 24 (7%) participants had undergone sleeve gastrostomy, and 181 (54%) believed that their cravings had increased, 238 (71%) complained of dizziness, and 151 (45%) believed that fast food caused gut unrest. Conclusion Obese individuals who are going through eating disorders are psychologically and physically compromised. They consider skipping meals to be the most efficient means of weight loss, and only a small percentage prefer to go for sleeve gastrectomy.

Desalination and environment: A critical analysis of impacts, mitigation strategies, and greener desalination technologies.

The desalination of seawater is perceived as one of the most viable processes to fulfill the mounting demand for freshwater. Despite enormous economic, social, and health benefits offered by desalination, there are several concerns regarding its prospective environmental impacts (EIs). The objective of this work is to critically evaluate the potential EIs of seawater desalination, and assess the prospects of greener desalination. The EIs of desalination on marine environment, land, groundwater, and air quality was systematically reviewed. An attempt has been made to analyze the actuality of these so-called impacts with reference to evidence from real desalination plants. The mitigative measures to counterbalance these unfavorable impacts are critically appraised. Furthermore, the brine management technologies for the disposal of reject stream, the recovery of precious materials and water, and the production of useful chemicals are also reviewed. Current challenges to minimize the adverse impacts of desalination and prospects of sustainable greener desalination to overwhelm global water scarcities are also discussed. The current desalination approaches have moderate and minor negative EIs. However, with proper mitigation and utilization of modern technologies, these impacts can be lessened. Furthermore, by employing various modern techniques, reject brine can be utilized for several useful applications while reducing its adverse impacts simultaneously. Recent advancements in desalination technologies have also offered many alternative approaches that provide a roadmap towards greener desalination. This review article will be beneficial for all the stakeholders in the desalination industry.

Risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infection.

OBJECTIVES: This retrospective cohort study examines incidence, risk factors, and clinical outcomes of acute myocardial infarction (AMI) and acute ischemic stroke (AIS) within one year of gram-negative bloodstream infection (GN-BSI) based on predefined clinical criteria. METHODS: Hospitalized adults with GN-BSI at Prisma Health-Midlands hospitals in South Carolina, USA from 2010 through 2015 were identified. Kaplan-Meier analysis was used to determine incidence of AMI and AIS within one year after GN-BSI. Multivariate Cox proportional hazards regression models were used to examine risk factors for AMI or AIS and impact on 1-year mortality. RESULTS: Among 1292 patients with GN-BSI, 263 and 17 developed AMI and AIS within 1-year with incidences of 23.4% and 1.9%, respectively. Majority of AMI were type 2 (164; 62%); 99 patients had type 1 AMI with incidence of 8.9%. Age >65 years (hazard ratio [HR] 1.52, 95% CI: 1.17-1.99), prior coronary artery disease or stroke (HR 1.74, 95% CI: 1.34-2.25), hypertension (HR 1.55, 95% CI: 1.13-2.15), end-stage renal disease (HR 1.52, 95% CI: 1.09-2.08), and quick Pitt bacteremia score (HR 1.55 per point, 95% CI: 1.40-1.72) were predictors of AMI/AIS. Development of type 1 AMI or AIS after GN-BSI was independently associated with increased 1-year mortality (HR 1.47, 95% CI: 1.03-2.07). CONCLUSIONS: AMI and AIS occur frequently within one year of GN-BSI and have negative impact on 1-year survival. Future randomized clinical trials are needed to determine the most effective clinical interventions for prevention of AMI/AIS following BSI in high risk patients and improve survival after these events.

Nonvariceal upper GI hemorrhage after percutaneous coronary intervention for acute myocardial infarction: a national analysis over 11 months.

BACKGROUND AND AIMS: Nonvariceal upper GI hemorrhage (NVUGIH) is a feared adverse event after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). We aimed to determine the incidence of NVUGIH after PCI for AMI and its impact on mortality, morbidity, and health care resource utilization over 11 months. METHODS: We used the Nationwide Readmission Database 2014. Inclusion criteria were (1) a principal diagnosis of ST or non-ST-elevation myocardial infarction, (2) in-hospital PCI, and (3) admission in January. Exclusion criteria were age less than 18 years and elective admission. The primary outcome was the 11-month incidence of NVUGIH. Secondary outcomes were 11-month mortality rate, prolonged mechanical ventilation, shock, upper endoscopy, length of stay, and total hospitalization costs and charges. Independent risk factors for NVUGIH were identified using multivariate logistic regression analysis. RESULTS: A total of 22,669 patients were included in the study. The mean age was 63.8 years (range, 63.4-64.1 years), and 31.7% of patients were female. The 11-month incidence of NVUGIH was 1.6%. The onset of NVUGIH was associated with an increase in the 11-month mortality rate (adjusted odds ratio, 1.94; 95% confidence interval, 1.01-3.72; P =.04). The upper endoscopy, shock, and prolonged mechanical ventilation rates were 72%, 6.2%, and 1.9%, respectively. In total, 26,532 days were associated with NVUGIH, with a total health care in-hospital economic burden of U.S.$17.6 million. Independent predictors of NVUGIH were female gender, Charlson comorbidity score, and length of stay. CONCLUSIONS: The 11-month incidence of NVUGIH among patients who undergo PCI for AMI is 1.6%. NVUGIH has a substantial impact on mortality, morbidity, and in-hospital health care resource utilization.

Ambulatory Pharmacotherapy of Five Psychiatric Disorders in Bahrain: a Descriptive Study.

We examined the outpatient prescription pattern of psychotropic drugs used for the treatment of five major psychiatric diseases in Bahrain. Setting outpatient department of the main psychiatric hospital in Bahrain. Methods This was a retrospective, cross-sectional study in which we targeted randomly selected prescriptions (n = 992, 56.1% males, 43.9% females) from 1st of January until 31st of December, 2017. Main outcome measure the types of outpatient psychotropic drugs prescribed by the physicians. Results The pharmacotherapy of schizophrenia consisted of atypical anti-psychotics (92.8%), or typical anti-psychotics (17.8%). The anti-depressants used were: Selective-serotonin reuptake inhibiters (SSRIs) (41.6%), Serotonin-norepinephrine reuptake inhibiters (SNRIs) (34.5%), tricyclic anti-depressants (TCAs) (12.8%), and atypical anti-depressants (10.6%). Combination anti-depressants was employed in (12.4%) of cases. The pharmacotherapy for anxiety disorders was composed of benzodiazepines (59.5%), atypical anti-psychotics (45.2%), SSRIs (40.5%), SNRIs (28.6%), TCAs (14.3%), and anti-convulsants (16.7%) and atypical anti-psychotics (7.1). The medications prescribed for bipolar disorder were atypical anti-psychotics (78.6%), anti-convulsants (66.5%), benzodiazepines (27.7%), typical anti-psychotics (8.9%) and lithium (6.7%). Schizoaffective disorder patients received atypical anti-psychotics (97.3%), anti-convulsants (47.8%), benzodiazepines (27.4%), SNRIs (25.7%), SSRIs (15%), typical anti-psychotics (10.6%), atypical anti-depressants (10.6%) and TCAs (6.2%). A combination of antipsychotics and anti-depressants was employed in 33.6% and 4.7% of all subjects regardless of the diagnosis, respectively. Conclusions With a few exceptions, the pharmacotherapy of psychiatric diseases in Bahrain was in line with the latest recommendations. However, psychotropic polypharmacy was observed and calls for immediate attention.

The prevalence and predictors of refractive error among school children in Riyadh, Saudi Arabia.

PURPOSE: Refractive error (RE) is one of the most common ocular disorders among children worldwide. This study aimed to investigate the prevalence of RE and possible risk factors among school children in Riyadh. METHODS: This is a cross-sectional study using data collected at various schools. To achieve the aim of the study, we selected a random sample of 850 school children aged 6-15 years. The examination was based on the RESC protocol and included full visual assessment. Furthermore, a questionnaire was sent to the parents of the participants to ascertain information about lifestyle factors. We constructed a logistic regression model to evaluate the predictors of RE. RESULTS: Close to a third of the children had a RE. Of those identified as having the condition, 60% did not wear glasses (newly diagnosed). Nearly all the children (95.4%) in our sample reported using electronic devices, according to parents. No association was found between using electronic devices and having a RE (P = 0.26). Doing outdoor activities was associated with 52% lower odds of a RE (odds ratio = 1.52). CONCLUSION: We found a higher prevalence of uncorrected RE than previously reported in other Saudi studies. About 60% of children who had RE were not wearing glasses, highlighting the need for a standardized school screening program for early detection and management. Outdoor activities were associated with a lower likelihood of having a RE. These findings might support initiatives to encourage outdoor activities among school children.

Characterisation and microbial community analysis of lipid utilising microorganisms for biogas formation.

In the anaerobic process, fat-oil-grease (FOG) is hydrolysed to long-chain fatty acids (LCFAs) and glycerol (GLYC), which are then used as substrates to produce biogas. The increase in FOG and LCFAs inhibits methanogenesis, and so far, most work investigating this inhibition has been carried out when FOG or LCFAs were used as co-substrates. In the current work, the inhibition of methanogenesis by FOG, LCFAs and GLYC was investigated when used as sole substrates. To gain more insight on the dynamics of this process, the change of microbial community was analysed using 16S rRNA gene amplicon sequencing. The results indicate that, as the concentrations of cooking olive oil (CO, which represents FOG) and LCFAs increase, methanogenesis is inhibited. For instance, at 0.01 g. L-1 of FOG, the rate of biogas formation was around 8 ml.L-1.day-1, and this decreased to <4 ml.L-1.day-1 at 40 g.L-1. Similar results were observed with the use of LCFAs. However, GLYC concentrations up to 100g.L-1 did not affect the rate of biogas formation. Acidic pH, temperature > = 45°C and NaCl > 3% led to a significant decrease in the rate of biogas formation. Microbial community analyses were carried out from samples from 3 different bioreactors (CO, OLEI and GLYC), on day 1, 5 and 15. In each bioreactor, microbial communities were dominated by Proteobacteria, Firmicutes and Bacteroidetes phyla. The most important families were Enterobacteriaceae, Pseudomonadaceae and Shewanellaceae (Proteobacteria phylum), Clostridiacea and Ruminococcaceae (Firmicutes) and Porphyromonadaceae and Bacteroidaceae (Bacteroidetes). In CO bioreactor, Proteobacteria bacteria decreased over time, while those of OLEI and GLYC bioreactors increased. A more pronounced increase in Bacteroidetes and Firmicutes were observed in CO bioreactor. The methanogenic archaea Methanobacteriaceae and Methanocorpusculaceae were identified. This analysis has shown that a set of microbial population is selected as a function of the substrate.

The Effect of Oral Health Knowledge, Attitude, and Practice on Periodontal Status among Dental Students.

OBJECTIVES: The primary aim of the current study is to relate oral health knowledge, attitude, and oral hygiene practice with the periodontal condition of both undergraduate and postgraduate dental students. MATERIALS AND METHODS: Data were collected through a combination of self-reported questionnaire and clinical examination. The estimated sample size was 246. Probing depths and clinical attachment loss were measured in interproximal sites, whereas the gingival index was calculated based on Ramfjord teeth. The Centers for Disease Control and the American Academy of Periodontology classification was used for periodontal diagnosis. The subjects were divided into three groups. Group 1 was composed of undergraduate, preclinical dental students, group 2 consisted of undergraduate clinical-year dental students, whereas group 3 included postgraduate residents. RESULTS: A total of 296 dental students participated in this study. Significant differences were found among the groups in their oral health knowledge, attitude, and practice scores. Gingival disease was detected among most of the participants (99.2-100%) with significant differences between different educational levels (group 1 = 1.13, group 2 = 1.16, group 3 = 0.96, p-value = 0.001). Sixty percent of dental students were diagnosed with periodontal disease regardless of its severity. A positive correlation was established between oral health knowledge and attitude and oral hygiene practice. In addition, gingival inflammation severity and the severity of periodontal disease showed a positive correlation. CONCLUSIONS: This study highlighted the need to improve the oral health knowledge, attitude, and practice of dental students. Gingival and periodontal inflammation was highly prevalent among participants.

Maternal and Neonatal Outcomes among Obese Pregnant Women in King Abdulaziz University Hospital: A Retrospective Single-Center Medical Record Review.

INTORUCTION: Pregnancy results in different physiological changes to the pregnant body resulting in weight gain. This added weight can result in poor pregnancy outcomes in obese women. AIM: To assess the adverse maternal and neonatal outcomes among obese pregnant women. METHODS: This is a retrospective record review conducted on obese pregnant women who delivered in the last five years attending King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Therefore, for analysis we used the following; 1- descriptive analysis, 2- Chi-square test, Pearson correlation, independent t-test, and one-way ANOVA to test the difference in obese and adverse pregnancy outcomes. Advance statistics such as binary, and multinomial logistic regression were used to examine the relationship between obesity and all adverse pregnancy outcomes. RESULTS: A total of 1037 obese pregnant women were enrolled in our study including 620 (59.8%) obese in class I (30-34.9), 262 (25.3%) obese in class II (35-39.9), and 155 (14.9%) obese in class III (40). About 74.73% of the population were Saudis. The average age was 31.96 (5.79) years. Out of 1037 obese pregnant women, 449 did develop undesired antepartum outcomes, while 729 and 163 had adverse neonatal, and postpartum outcomes. Antepartum variables such as preeclampsia, gestational diabetes mellitus, impaired glucose tolerance test, antiphospholipid syndrome, premature rupture of membranes, placenta previa, anemia, urinary tract infection, and oligohydramnios, and rate of Cesarean section were significantly associated with obesity (P<0.05). Postpartum variables such as vaginal laceration, perianal laceration, postpartum hemorrhage, and endometritis were also significantly associated with obesity (P<0.05). Moreover, adverse neonatal outcomes such as low APGAR scores at 1 and 5 minutes, birthweight, gestational age, admission to neonatal intensive care unit, intrauterine fetal death, and neonatal death, were significant significantly associated with obesity (P<0.05). CONCLUSION: As our study demonstrated, maternal obesity resulted in adverse outcomes for the mother and fetus. Hence, to yield a better outcome for these women and their offspring, periconceptional counseling, conducting health education, and comprehensive plan prior to their pregnancy should be enforced.

Synthesis of silver sulfide modified carbon materials for adsorptive removal of dibenzothiophene in n-hexane.

Carbon nanotube (CNT) and graphene oxide (GO) as common nanostructures were modified with silver sulfide (Ag2S) using chemical vapor deposition. The raw and modified materials were tested for the removal of Dibenzothiophene (DBT) from a model fuel in batch mode adsorption experiments. The maximum adsorption capacities of DBT were 52.18 and 49.65 mg g-1, using CNT-Ag2S and GO-Ag2S, respectively. The adsorption isotherm was modeled using Freundlich, Langmuir and Temkin models using linear and non-linear regression. The squared correlation coefficient (R2) and HYBRID error function were used to determine the best adsorption model. IR spectroscopy was used to study the DBT adsorption mechanism, and it was found that the DBT molecules lie flat on the surface of the developed adsorbents. Significant improvement was achieved in the adsorption of DBT using CNT-Ag2S and GO-Ag2S, where the maximum adsorption capacity increased by 127% and 117% respectively, which indicates a stronger interaction between DBT and the modified adsorbents.

Smad2 overexpression induces alveolar bone loss and up regulates TNF-α, and RANKL.

OBJECTIVE: The aim of the current study was to investigate whether Smad2 overexpression in JE cells induced alveolar bone loss, and to understand the mechanisms regulating the bone loss. METHODS: A mouse line was created that used a cytokeratin 14 (K14) promoter to overexpress Smad2 in the epithelium of the transgenic mice (K14-Smad2). Micro CT radiographs (µCT) were used to assess bone loss, bone volume, and bone density. The expression of Tnfα, Il1-ß, Ifγ, Rankl, and Opg were assessed by RT-PCR. Western blots were used to detect the protein levels of TNF-α and IL1-ß. Tartrate-resistant acid phosphatase (TRAP) was used as a marker for osteoclasts. Wild type (WT) mice were used as controls in all steps of the current study. RESULTS: K14-Smad2 mice had 52.5% (±4.2) root exposed compared to 32.4%(±3.2) in the WT mice. There was a significant difference in alveolar bone volume in the K14-Smad2 mice when compared to WT mice 2.65mm3 (±0.3) and 4.3mm3 (±0.35) respectively. K14-Smad2 mice also had reduced bone density 696.8mg/cc (±70) at 12 months when compared to WT mice 845.9mg/cc(±10). The mRNA levels of Tnfα and Rankl increased by 3.26- and 2.5-fold respectively in the K14-Smad2 mice when compared to controls. The protein level of TNF-α was also significantly increased to 2.8-fold in K14-Smad2 mice when compared to WT mice. Smad2 overexpression increased the total numbers of osteoclasts in K14-Smad2 mice (3.4±0.2)-fold when compared to WT mice. CONCLUSION: Smad2 overexpression induces alveolar bone loss and increases the numbers of osteoclasts. Also, Smad2 overexpression up-regulates TNF-α and RANKL.

Olmsted syndrome with oral involvement, including premature teeth loss.

INTRODUCTION: Olmsted syndrome is a rare palmoplantar keratodermal disease that has not previously been reported to have an association with periodontal disease. The aim of this study is to report and document a case of Olmsted syndrome with evidence of severe periodontal disease. CASE REPORT: A 38-year old Saudi male patient presented to the dental clinic diagnosed previously with Olmsted syndrome. Clinical and radiographic examinations were done and provided evidence of the typical clinical findings in Olmsted syndrome and evidence of severe periodontal disease. The patient had severe generalized hyperkeratotic lesions on the palms, soles, and perioral skin as well as hyperkeratosis of oral mucosa at multiple sites. CONCLUSION: This case report documents the first reported case of Olmsted syndrome to be associated with severe periodontal disease. The altered differentiation of oral mucosa linked to Olmsted syndrome may contribute to the periodontal disease. Patients diagnosed with this syndrome should receive a comprehensive oral examination to determine whether periodontal destruction is a significant component of their disease or not.

Poldip2 controls vascular smooth muscle cell migration by regulating focal adhesion turnover and force polarization.

Polymerase-δ-interacting protein 2 (Poldip2) interacts with NADPH oxidase 4 (Nox4) and regulates migration; however, the precise underlying mechanisms are unclear. Here, we investigated the role of Poldip2 in focal adhesion turnover, as well as traction force generation and polarization. Poldip2 overexpression (AdPoldip2) in vascular smooth muscle cells (VSMCs) impairs PDGF-induced migration and induces a characteristic phenotype of long cytoplasmic extensions. AdPoldip2 also prevents the decrease in spreading and increased aspect ratio observed in response to PDGF and slightly impairs cell contraction. Moreover, AdPoldip2 blocks focal adhesion dissolution and sustains H2O2 levels in focal adhesions, whereas Poldip2 knockdown (siPoldip2) significantly decreases the number of focal adhesions. RhoA activity is unchanged when focal adhesion dissolution is stimulated in control cells but increases in AdPoldip2-treated cells. Inhibition of RhoA blocks Poldip2-mediated attenuation of focal adhesion dissolution, and overexpression of RhoA or focal adhesion kinase (FAK) reverses the loss of focal adhesions induced by siPoldip2, indicating that RhoA and FAK mediate the effect of Poldip2 on focal adhesions. Nox4 silencing prevents focal adhesion stabilization by AdPoldip2 and induces a phenotype similar to siPoldip2, suggesting a role for Nox4 in Poldip2-induced focal adhesion stability. As a consequence of impaired focal adhesion turnover, PDGF-treated AdPoldip2 cells are unable to reduce and polarize traction forces, a necessary first step in migration. These results implicate Poldip2 in VSMC migration via regulation of focal adhesion turnover and traction force generation in a Nox4/RhoA/FAK-dependent manner.