Towards clinically applicable automated mandibular canal segmentation on CBCT.

OBJECTIVES: To develop a deep learning-based system for precise, robust, and fully automated segmentation of the mandibular canal on cone beam computed tomography (CBCT) images. METHODS: The system was developed on 536 CBCT scans (training set: 376, validation set: 80, testing set: 80) from one center and validated on an external dataset of 89 CBCT scans from 3 centers. Each scan was annotated using a multi-stage annotation method and refined by oral and maxillofacial radiologists. We proposed a three-step strategy for the mandibular canal segmentation: extraction of the region of interest based on 2D U-Net, global segmentation of the mandibular canal, and segmentation refinement based on 3D U-Net. RESULTS: The system consistently achieved accurate mandibular canal segmentation in the internal set (Dice similarity coefficient [DSC], 0.952; intersection over union [IoU], 0.912; average symmetric surface distance [ASSD], 0.046 mm; 95% Hausdorff distance [HD95], 0.325 mm) and the external set (DSC, 0.960; IoU, 0.924; ASSD, 0.040 mm; HD95, 0.288 mm). CONCLUSIONS: These results demonstrated the potential clinical application of this AI system in facilitating clinical workflows related to mandibular canal localization. CLINICAL SIGNIFICANCE: Accurate delineation of the mandibular canal on CBCT images is critical for implant placement, mandibular third molar extraction, and orthognathic surgery. This AI system enables accurate segmentation across different models, which could contribute to more efficient and precise dental automation systems.

Psychological impact and perceptions of orthodontic treatment of adult patients with different motivations.

INTRODUCTION: Motivations, perceptions, and psychosocial states of adult patients with orthodontic disorders in China have not been widely studied. The study assessed the psychosocial states and perceptions of adult patients undergoing orthodontic treatments with different motivations. METHODS: Two hundred forty-three adult patients (mean age, 30.2 ± 7.4 years; women, 79.0%) undergoing orthodontic treatment were recruited from a tertiary stomatology hospital. The patients answered a patient-centered questionnaire regarding motivations and perceptions of orthodontic treatment and the Psychosocial Impact of Dental Aesthetics Questionnaire. Data were analyzed using the chi-square test on the basis of multiple responses. Multiple linear regression analyses were performed to determine the association between motivation factors and the Psychosocial Impact of Dental Aesthetics Questionnaire subscale scores (P <0.05). RESULTS: Patients with various motivations were as follows: occlusal function reason (70.4%), dental esthetic reason (54.7%), facial esthetic reason (24.3%), and following others' suggestions (18.5%). Patients with esthetic or occlusal motivations exhibited significantly greater need and interest for orthodontic treatment (P <0.001). Multiple linear regression analyses revealed that the scores of social impact, psychological impact, and esthetic concern subscales were significantly associated with both dental and facial esthetic motivations (P <0.001). CONCLUSIONS: The primary motivations of Chinese patients were observed to be improved esthetics and occlusal function. Patients with esthetic or occlusal motivations exhibited significantly greater need and interest in treatment. Patients with facial or dental esthetic motivations experienced greater impacts of psychosocial states. Therefore, the patient motivations and impacts of esthetic-related psychosocial states on them should be considered during treatment.

Viability of the quintessential 5 temporomandibular disorder symptoms as a TMD screener.

OBJECTIVE: This study explored the viability of using the 5 temporomandibular disorder (TMD) symptoms (5Ts) of the Diagnostic Criteria for TMDs (DC/TMD) as a TMD screener. STUDY DESIGN: A total of 1039 adults (≥18 years old) with a mean age of 32.65 ± 12.95 years (77.4% women) from a tertiary dental hospital were enrolled. The 5Ts questionnaire (involving items on TMD/facial pain, headaches, temporomandibular joint noises, and closed- and open-locking) was administered, and TMD diagnoses were derived through clinical interviews and examinations, radiographic investigations, and the DC/TMD diagnostic algorithms and diagnostic tree. Diagnostic accuracy of the 5Ts was assessed using the area under the receiver operating characteristics curve and various measures, including sensitivity, specificity, predictive values, and likelihood ratios. RESULTS: Among the participants, 80.2% (n = 833) were 5Ts-positive, and 19.8% (n = 206) were 5Ts-negative, whereas 51.3% and 85.7% received at least 1 pain-related and intra-articular DC/TMD diagnosis, respectively. The 5Ts showed high accuracy for detecting all TMDs, pain-related and intra-articular, with area under the receiver operating characteristics curves of 0.98, 1.00, and 0.98, respectively. Sensitivity ranged from 96.1% to 99.2%, whereas specificity was 100.0%. CONCLUSIONS: The 5Ts demonstrated high diagnostic accuracy for identifying pain-related and/or intra-articular disorders.

Comparison of psychological states and oral health-related quality of life of patients with differing severity of temporomandibular disorders.

BACKGROUND: Studies on temporomandibular disorder (TMD) severity in patient populations are scarce. OBJECTIVES: This study sought to compare the psychological states and oral health-related quality of life (OHRQoL) among patients with differing TMD severity. METHODS: Adult patients (≥18 years old) with and without (controls) TMDs were recruited from the TMD/oro-facial pain centre and prosthodontics department, respectively. The presence and severity of TMDs were established with the Fonseca Anamnestic Index (FAI), and TMD diagnoses were confirmed with the Diagnostic Criteria for TMDs (DC/TMD). Psychological states and OHRQoL were examined with the Depression, Anxiety, Stress Scales-21 (DASS-21) and Oral Health Impact Profile for TMDs (OHIP-TMD). Data were subjected to chi-square, Kruskal-Wallis/Mann-Whitney U tests and Spearman's correlation (α = .05). RESULTS: A total of 961 participants with a mean age of 32.99 ± 13.14 years (71.19% women) were assessed. Frequencies of the various TMD categories were as follows: no TMD/controls (12.07%), mild TMD (24.56%), moderate TMD (40.37%) and severe TMD (23.00%). The three most common TMD-related symptoms were TMJ noises, mouth opening difficulty and muscle pain. Participants with moderate/severe TMD presented a higher proportion of intra-articular and/or combined disorders. They reported significantly higher levels of depression, anxiety, stress and poorer OHRQoL than their counterparts with no/mild TMD (p < .001). Moderate-to-strong correlations were observed between FAI and DASS-21/OHIP-TMD scores (rs = 0.42-0.72). CONCLUSIONS: Patients with moderate/severe TMD had significantly higher levels of psychological disturbance and poorer OHRQoL. As OHRQoL and psychological states are correlated, psychological well-being must be considered when managing patients with moderate/severe TMDs.

Diagnostic accuracy of the short-form Fonseca Anamnestic Index in relation to the Diagnostic Criteria for Temporomandibular Disorders.

STATEMENT OF PROBLEM: Screening for temporomandibular disorders (TMDs) is important in research and clinical practice. The short-form Fonseca Anamnestic Index (SFAI) was recently introduced but had only been validated for muscle disorders. PURPOSE: The purpose of this clinical study was to determine the diagnostic accuracy of the SFAI and its discrete and pooled items in relation to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) benchmark. MATERIAL AND METHODS: A total of 866 consecutive participants with TMDs and 57 TMD-free controls (aged ≥18 years) were recruited. The participants (n=923; mean age 32.8 ±13.3 years; women 79.2%) answered the FAI, and TMD diagnoses were derived based on the DC/TMD protocol and algorithms. The 5-item SFAI, which comprised 2 pain-related and 3 function-related TMD questions, was subsequently acquired and assessed with reference to the DC/TMD diagnoses. The receiver operating characteristics (ROC) was used to verify accuracy (area under the curve [AUC]) and the best cutoff points. Sensitivity, specificity, predictive values, and likelihood ratios were also examined. RESULTS: Pain-related (PT) and intra-articular (IT) TMDs were present in 48.3% (446/923) and 82.7% (763/923) of the participants, respectively. The SFAI demonstrated high accuracy for identifying all TMDs, PT, and IT (AUC of 0.97, 0.99, and 0.97, respectively). The best cutoff points were 12.5 for all TMDs/IT and 17.5 for PT. Sensitivity of the SFAI ranged from 90.7% to 97.5% while specificity varied from 93.0% to 96.5%, with the highest values for PT. As positive predictive values (99.4% to 99.5%) were greater than negative ones (41.7% to 83.3%), the SFAI was better at detecting the presence than the absence of TMDs. With reference to PT, the sensitivity, and specificity of the 2 discrete and pooled pain-related questions (questions 3 and 4), extended from 82.3% to 99.3% and 77.2% to 96.5% respectively. With regard to IT diagnoses, sensitivity and specificity ranged from 56.0% to 98.3% and 86.0% to 98.3% for the 3 discrete and pooled function-related items (questions 1, 2, and 5). CONCLUSIONS: The SFAI presented high degrees of diagnostic accuracy in relation to the DC/TMD and can be used for screening TMDs. SFAI scores between 15 and 50 points should be used to identify the presence of TMDs, with scores ≥20 points specifying possible pain-related TMDs.

Oral health-related quality of life of patients with acute and chronic temporomandibular disorder diagnostic subtypes.

BACKGROUND: Studies have indicated the negative effects of temporomandibular disorders (TMDs) on oral health-related quality of life (OHRQoL). The authors investigated the OHRQoL of patients with acute and chronic TMD subtypes. METHODS: The authors recruited a total of 830 patients. They derived TMD diagnoses using the Diagnostic Criteria for TMDs protocol involving symptom history, physical examination, and diagnostic imaging as indicated. The authors categorized patients into acute (≤ 3 months) or chronic (> 3 months) pain-related TMD (PT), nonpainful intra-articular TMD (IT), and combined TMD (CT) groups. They also gathered sociodemographic information and assessed OHRQoL with the Oral Health Impact Profile (OHIP)-TMDs. The authors evaluated data using 2-way analysis of variance and Bonferroni test and multiple regression analysis. RESULTS: Patients in the chronic PT and CT subgroups had significantly higher mean global OHIP scores than their acute counterparts. The authors observed significant acute-chronic differences in OHIP-TMDs domain scores in 5 and 2 domains for the PT and CT groups, respectively. Patients in the acute IT group had significantly higher functional limitation scores than those in the chronic IT group. The ranking of mean global scores, in descending order was CT, PT, and IT for acute TMDs and PT, CT, and IT for chronic TMDs, with significant differences observed among the 3 TMD subtypes (P < .001). CONCLUSIONS: Both TMD chronicity and subtypes influenced OHRQoL. Painful TMDs (PT and CT) were associated with significantly poorer OHRQoL than nonpainful TMDs. TMD chronicity appeared to affect OHRQoL only for the painful TMD conditions. Future work on the impact of TMDs on OHRQoL should strive to stratify patients by TMD chronicity and subtypes. PRACTICAL IMPLICATIONS: TMD chronicity and subtypes influence the impact of TMDs on OHRQoL. Given that chronic painful TMDs impair quality of life, early biopsychosocial intervention of acute TMD pain is important for minimizing chronification and OHRQoL deterioration.

Accuracy of the Fonseca Anamnestic Index for identifying pain-related and/or intra-articular Temporomandibular Disorders.

Objectives: This study established the diagnostic accuracy of the Fonseca Anamnestic Index (FAI) in relation to the Diagnostic Criteria for TMD (DC/TMD) standard.Methods: A total of 866 TMD patients and 57 TMD-free controls were instructed to answer the FAI and DC/TMD Symptom Questionnaire (SQ). Participants were subsequently categorized into no (NT), pain-related (PT), and/or intra-articular (IT) TMDs using the DC/TMD protocolized examination/algorithms. Receiver operating characteristics (ROC) curves, best cut-off points, and accuracy measures were determined.Results:The FAI demonstrated high accuracy for detecting all TMDs, PT, and IT (AUC = 0.96-0.98). The best cut-off points were 22.50 for all TMDs/IT and 27.50 for PT. Sensitivity of the FAI was high (94.23-98.21%), but specificity was moderate (87.72%) for all diagnostic categories.Discussion:The diagnostic accuracy of the FAI for identifying pain-related and intra-articular TMDs was high. FAI scores ≥25 points should be used to screen for TMDs.

Number and type of temporomandibular disorder symptoms: their associations with psychological distress and oral health-related quality of life.

OBJECTIVE: In this case-control study, we investigated the presence of differing numbers and types of temporomandibular disorder (TMD) symptoms, their association with psychological distress, and their impact on oral health-related quality of life (OHRQoL). STUDY DESIGN: We recruited a total of 814 participants with TMD and 147 control subjects. The participants were instructed to complete the Diagnostic Criteria for Temporomandibular Disorders Symptom Questionnaire; the Depression, Anxiety and Stress Scale-21; and the Oral Health Impact Profile-Temporomandibular Disorders. The participants were subsequently categorized by their number and type of TMD symptoms. Data were analyzed with the Kruskal-Wallis/Mann-Whitney U test (α = .05). RESULTS: The mean age of the participants (N = 961) was 32.99 ± 13.14 years, and 79.2% were women. Participants with more and all types of TMD symptoms generally exhibited significantly higher levels of psychological distress and worse OHRQoL (P < .001). Those with TMD pain plus temporomandibular joint (TMJ) sounds/dysfunction had significantly greater psychological distress, whereas those with painful symptoms and TMJ dysfunction experienced significantly more impairment in OHRQoL than individuals with only TMJ sounds. CONCLUSIONS: Psychological states and OHRQoL are influenced by the number and type of TMD symptoms. Individuals with more and all types of pain-related TMD symptoms with/without intra-articular features had greater psychological distress and OHRQoL impairment.

Temporomandibular disorder severity and diagnostic groups: Their associations with sleep quality and impairments.

OBJECTIVES: This study evaluated the impact of TMD severity on sleep quality and established the associations between TMD diagnostic groups/pain subtypes and sleep impairments. METHODS: A total of 1151 patients from a tertiary Dental Hospital were screened for eligibility. Consenting subjects who met the inclusion criteria were directed to complete a general/health questionnaire, the Fonseca Anamnestic Index (FAI), Diagnostic Criteria for Temporomandibular disorders (DC/TMD) Symptom Questionnaire, and Pittsburgh Sleep Quality Index (PSQI) at their intake visit. Patients who screened positive for TMDs with the FAI were subjected to a protocolized physical examination and TMD diagnostic groups/subtypes were subsequently derived based on the DC/TMD "diagnostic tree" and algorithms. Statistical analyses were conducted using non-parametric methods and logistic regression (α = 0.05). RESULTS: The final sample consisted of 845 subjects with TMDs and 116 TMD-free controls. The mean age of the TMD and TMD-free subjects were 33.17 ± 13.55 and 31.66 ± 9.50 years. Subjects with severe and moderate TMDs had significantly greater global PSQI scores than those with mild and no TMDs (p < 0.001). Those with pain-related, intra-articular, and combined TMDs reported significantly poorer sleep quality than those with no TMDs (p < 0.001). Moreover, subjects with myalgia and myalgia plus arthralgia presented significantly greater sleep impairments than their counterparts with intra-articular disorders (p < 0.001). Multivariate logistic regression indicated that pain-related (OR = 3.23; CI = 1.69-6.14) and intra-articular TMDs (OR = 1.91; CI = 1.15-3.16) were most related to poor sleep. CONCLUSIONS: Sleep quality worsened with increasing TMD severity and the presence of painful and intra-articular TMDs increased the likelihood of poor sleep.

Comparison of emotional disturbance, sleep, and life quality in adult patients with painful temporomandibular disorders of different origins.

OBJECTIVES: This study compared the differences in emotional disturbance, sleep, and life quality among adult patients with temporomandibular (TMD) muscle and/or joint pain. MATERIALS AND METHODS: The study involved an analytical cross-sectional design. A total of 420 consecutive patients diagnosed with pain-related TMDs based on the Diagnostic Criteria for TMDs (DC/TMD) were recruited from a TMD referral centre and stratified into three groups, namely muscle pain (MP; n = 50), joint pain (JP; n = 329), and combined muscle-joint pain (CP; n = 41). Emotional disturbance, sleep quality, and oral health-related quality of life (OHRQoL) were assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21), Pittsburgh Sleep Quality Index (PSQI), and Oral Health Impact Profile-TMDs (OHIP-TMDs) respectively. Statistical analyses were performed using the chi-square test, one-way ANOVA, and Pearson's correlation (p < 0.05). RESULTS: Mean age for the three pain groups (females = 349; males = 71) ranged from 37.15 ± 14.91 to 38.60 ± 14.37 years (p = 0.973). Ranking of depression, anxiety, and stress scores was as follows: CP > MP > JP. Significant differences in emotional disturbances were observed (p < 0.001). CP patients had significantly poorer sleep quality than those with JP (p = 0.004). Moreover, OHRQoL was also significantly more impaired as compared to both MP (p = 0.006) and JP (p < 0.001) patients. Correlations between global PSQI and OHIP-TMDs scores were weak to moderate (rs = 0.30-0.47). CONCLUSIONS: Patients with combined muscle-joint pain presented higher levels of emotional disturbance than those with only MP or JP. They also had significantly poorer sleep quality and lower OHRQoL. CLINICAL RELEVANCE: Emotional and sleep health must be considered in the management of painful TMDs.

The dorsal and the ventral side of hypoglossal motor nucleus showed different response to chronic intermittent hypoxia in rats.

PURPOSE: To study neurochemical reactions to chronic intermittent hypoxia (CIH) in the hypoglossal nucleus (HN) of rats. METHODS: Adult male Sprague-Dawley rats (n = 12) were randomly divided into two groups (the CIH and the control group). The CIH rats were housed in a hypoxic chamber with the fraction of oxygen volume alternating between 21% and 5% by providing air for 60 s and then providing nitrogen for 60 s from 8:30 am to 16:30 pm each day for 35 days. The control group was housed in a cabin with normal oxygen levels. We studied the expression of c-fos protein, 5-hydroxytryptamine (5-HT) positive terminals, and its 2A receptors in hypoglossal nuclei by immunohistochemistry. RESULTS: The expression of c-fos, 5-HT positive terminals, and accordingly 5-HT 2A receptors in the CIH group were significantly higher than that in the controls (p < 0.05). The ventral side of the HN showed a clearly higher expression of 5-HT and its 2A receptors than the dorsal side (p < 0.05). CONCLUSION: There were 2 responses of the HN to CIH. First, CIH induced a higher expression of 5-HT positive terminals and its 2A receptors, and second, this reaction was much more evident in ventral side than in the dorsal side. We postulate that these responses may serve to be a protective and compensatory mechanism for CIH.

Subtypes of acute and chronic temporomandibular disorders: Their relation to psychological and sleep impairments.

OBJECTIVES: To determine the differences in psychological states and sleep quality in patients with various temporomandibular disorder (TMD) subtypes, and to ascertain the relationships between TMD duration with psychological and sleep impairments. METHODS: A total of 830 TMD patients were recruited categorized into pain-related (PT), intra-articular (IT), and combined (CT) TMD groups. Each group was further divided into acute and chronic subtypes. The Depression, Anxiety, and Stress Scales-21 (DASS-21), and Pittsburgh Sleep Quality Index (PSQI) were used to assess emotional states and sleep problems. RESULTS: Although chronic TMDs generally had higher levels of anxiety, depression, stress, and sleep impairments than acute TMDs, significant differences were only observed for the PT group. Ranking of the mean depression, anxiety, and stress scores was as follows: acute TMDs: CT > PT > IT; chronic TMDs: PT > CT > IT. For both acute and chronic TMDs, the ranking of mean PSQI global and component scores was PT ≥ CT ≥ IT. Logistic regression analyses indicated that stress (ORs = 4.40) and depression (ORs = 2.82) increased the risks of chronic pain-related TMDs (p < .05). CONCLUSIONS: Chronic pain-related TMDs are associated with high levels of psychological distress and poorer sleep, while chronic intra-articular TMDs are not. Stress and depression increased the probability of chronic pain-related TMDs.

Age-related differences in diagnostic categories, psychological states and oral health-related quality of life of adult temporomandibular disorder patients.

OBJECTIVES: The peak prevalence of temporomandibular disorders (TMDs) may occur in middle age. This study determined the proportion of matured adults seeking TMD treatment and compared their diagnostic, psychological and oral health-related quality-of-life (OHRQoL) profiles to younger patients. METHODS: Adult subjects were recruited from a tertiary TMD centre and assigned to three age groups, namely 18-44 years (young adults [YA]), 45-64 (middle-aged adults [MA]) and ≥65 (old adults [OA]). TMD diagnoses were established with the Diagnostic Criteria for TMDs and categorised as pain-related (PT), intra-articular (IT) and combined (CT) TMDs. Psychological states and OHRQoL were assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Oral Health Impact Profile-TMDs (OHIP-TMDs). Demographic, DASS-21, and OHIP-TMDs data were analysed using chi-square test, one-way ANOVA and Pearson's correlation (P < .05). RESULTS: Middle-aged (19.7%; 136/692) and old (4.0%; 28/692) adults comprised about a quarter of the TMD patients. Although gender distribution was comparable, significant differences in TMD categories were observed (P < .001). Pain-related TMDs were more prevalent in the MA/OA groups while intra-articular TMDs were more frequent in the YA group. No significant difference in DASS-21 and total OHIP scores was noted among three groups. However, the MA and OA groups had significantly lower OHRQoL in the physical pain domain. Correlations between DASS-21 and OHIP-TMDs scores varied with age and ranged from rs  = 0.47-0.92. CONCLUSIONS: Matured patients constituted a quarter of TMD cohort and presented higher frequencies of painful TMDs. They have similar psychological profiles to younger patients but experienced lower OHRQoL in physical pain domain.

CD38 triggers inflammasome-mediated pyroptotic cell death in head and neck squamous cell carcinoma.

BACKGROUND: Pyroptosis is a form of inflammatory cell death. Although it is recognized that NLRP3 (nucleotide-binding domain, leucine-rich repeat-containing family, pyrin domain-containing 3) inflammasome is involved in pyroptosis activation, the mechanism by which head and neck squamous cell carcinoma (HNSCC) inhibits pyroptotic cell death remains undefined. This study aims to delineate the role of calcium regulator CD38 in NLRP3 inflammasome-dependent pyroptosis in HNSCC. METHODS: CD38 overexpressing HNSCC cell lines (SAS, CAL27, SNU899) were generated using lentiviral vectors. NLRP3 and gasdermin D (GSDMD) quantity were detected using Western blot. Caspase-1 activity changes were measured using the Caspase-Glo® 1 inflammasome assay. Cell death proportion was determined by flow cytometry analysis. Proliferation assay was performed using xCELLigence RTCA system. Mouse xenotransplantation was performed to evaluate the potential oncogenic or tumor-suppressive function of CD38. ChIP assay was conducted to verify whether transcription factor NFAT1-mediated NLRP3 expression. RESULTS: Exogenous calcium treatment can lead to a significant increase in caspase-1 activity in HNSCC. This feature was also observed in HNSCC cells with stable CD38 overexpression. CD38-overexpressing cell lines showed a significant reduction in proliferation. Further, expression of NLRP3 protein level was significantly increased in CD38-overexpressing cell lines. The N-terminal effector domain of GSDMD was remarkably increased in the CD38-overexpressing HNSCC. ChIP assay indicated that calcium-sensitive transcription factor NFAT1 was possibly involved in the transcriptional upregulation of NLRP3 observed in CD38-overexpressing HNSCC. The pre-clinical xenograft model revealed that CD38 expression had an inhibiting function on HNSCC progression. CONCLUSION: In conclusion, our results suggested that activation of pyroptosis in HNSCC is a calcium-dependent process. Reduced expression of calcium ion regulator CD38 functions could prevent inflammasome-induced pyroptosis in HNSCC. CD38 may function as a tumor suppressor in HNSCC progression.

Psychometric evaluation of the Chinese version of the Fonseca anamnestic index for temporomandibular disorders.

BACKGROUND: The Fonseca anamnestic index (FAI) offers a simple, low-cost, patient-reported method for screening temporomandibular disorders (TMDs). OBJECTIVES: This study described the development of the Chinese version of the FAI (FAI-C) and examined its reliability and validity when compared to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). METHODS: The FAI-C was created by translation and cross-cultural adaptation of the English instrument following international guidelines. Psychometric evaluation of the FAI-C was carried out on a sample of 613 patients with TMDs and 57 controls. Reliability of the FAI-C was determined by means of internal consistency and test-retest methods while validity was ascertained by criterion-related validity. Criterion validity was examined via Cohen's kappa, sensitivity and specificity when compared with DC/TMD Axis I diagnoses. RESULTS: Cronbach's alpha value (internal consistency) for total FAI-C score was 0.669, and intra-class correlation coefficient (ICC) value (test-retest reliability) was 0.823. For criterion validity, kappa coefficient value was 0.633 while sensitivity and specificity was 95.9% and 71.9%, respectively. CONCLUSION: The Chinese version of the FAI demonstrated acceptable reliability and good validity. The FAI-C could thus be used as an instrument for screening TMDs in Chinese literate populations.

A Novel Gene Bombyx mori Carotenoid Oxygenases and Retinal Isomerase (BmCORI) Related to ß-Carotene Depletion.

Carotenoids are the precursors of Vitamin A. They are cleaved by carotenoid oxygenase and then isomerized by retinoid isomerase. In this study, we identified a gene, Bombyx mori Carotenoid Oxygenases and Retinal Isomerase (BmCORI), which was the homolog of ß-carotene 15,15'-monooxygenase and the retinal pigment epithelium protein of 65 kD. Further analysis indicated that the expression of BmCORI in silkworms was significantly higher in females than in males. We also found that the ß-carotene content in BmCORI-expressed human embryonic kidney 293 cells was significantly lower than in the controls, while the lutein content showed a slight difference. These results suggested that BmCORI is related to carotenoid depletion, especially ß-carotene depletion. Our research provides new insight into the study of BmCORI function.

Curcumin enhances cisplatin sensitivity by suppressing NADPH oxidase 5 expression in human epithelial cancer.

Cisplatin-based chemotherapy regimens serve a pivotal role in human cancer treatment. Nevertheless, treatment failure may occur if the cancer is inherently resistant to cisplatin or acquires a resistant phenotype during the course of treatment. Although cisplatin resistance can hinder the efficacy of cisplatin treatment for human cancer, the underlying mechanism remains poorly understood. The current study established a cisplatin-resistant human epithelial cancer cell line. Notably, differential upregulation of NADPH oxidase 5 (NOX5) was identified in this resistant cell line. Furthermore, cisplatin treatment induced cancer cells to express NOX5 and cells that overexpressed NOX5 exhibited greater resistance to cisplatin via the activation of Akt. Treatment with curcumin may suppress NOX5 expression in cancer cells and enhance sensitivity to cisplatin treatment. In a xenograft model, a combined regimen of cisplatin with low-dose curcumin significantly reduced malignant tumor growth. These data demonstrate that curcumin has a chemosensitizing effect on cisplatin-resistant epithelial cancer types. Therefore, the use of curcumin in addition to a cisplatin-based treatment regimen may improve treatment outcomes in human patients with epithelial cancer.

Detection of Epstein-Barr virus (EBV)-encoded microRNAs in plasma of patients with nasopharyngeal carcinoma.

BACKGROUND: Nasopharyngeal carcinoma (NPC) latently infected by Epstein-Barr virus (EBV) expresses 40 EBV BART microRNAs (miRNAs). Difference in diagnostic efficacy of these miRNAs on NPC detection was observed. Here, we performed a comprehensive evaluation on the efficacy of these miRNAs. METHODS: Quantitative polymerase chain reaction was performed on plasma nucleic acid isolated from patients with NPC and noncancer donors. RESULTS: For primary NPC, BART2-5P, BART6-3P, BART7-3P, BART7-5P, BART9-5P, BART11-3P, BART17-5P, and BART19-5P were significantly elevated. For recurrent NPC, plasma levels of BART2-3P, BART2-5P, BART5-3P, BART5-5P, BART6-3P, BART8-3P, BART9-5P, BART17-5P, BART19-3P, and BART20-3P were significantly increased. Area under curve (AUC) analysis showed that BART19-5P had the best performance to identify NPC which was serologically EBV DNA undetectable. For recurrent NPC, BART8-3P and BART10-3P had highest AUC value for identifying cancer in EBV DNA undetectable plasma. CONCLUSION: Our data supported the use of circulating EBV miRNAs in NPC and recurrent NPC detection.

Epstein-Barr virus-encoded microRNA BART7 downregulates major histocompatibility complex class I chain-related peptide A and reduces the cytotoxicity of natural killer cells to nasopharyngeal carcinoma.

Evasion from natural killer (NK) cell surveillance enables cancer to proliferate and spread at the early stages. NK cells mediate specific cytolysis by activation of the triggering receptors on their cell surface, of which the communication between natural killer group 2, member D (NKG2D) and major histocompatibility complex class I chain-related peptide A (MICA) is a key regulatory axis. It has been indicated that cancer cells can reduce the surface expression of MICA, which thereby reduces the cytotoxicity of NK cells. In nasopharyngeal carcinoma (NPC), however, the underlying mechanism remains unclear. The present study indicated that MICA expression in NPC was regulated by TGFß1. Furthermore, the human MICA gene was demonstrated to contain the c-Myc binding site in the promoter region. Notably, the results suggested that TGFß1 upregulated MICA expression by promoting c-Myc expression. Additionally, the findings demosntrated that TGFß1 expression in NPC was negatively controlled by Epstein-Barr virus-encoded microRNA BART7 (ebv-miR-BART7). In ebv-miR-BART7-expressing NPC, the TGFß1/c-Myc/MICA regulatory axis was significantly inhibited. Notably, functional analysis indicated that NPC cells expressing ebv-miR-BART7 were less sensitive to the cytolysis mediated by NK cells. In conclusion, the present results revealed that ebv-miR-BART7-expressing NPC may impair NK cells recognition and activity, which suggests that targeting ebv-miR-BART7 may be a useful therapeutic strategy in NPC immunotherapy.

CLD1/SRL1 modulates leaf rolling by affecting cell wall formation, epidermis integrity and water homeostasis in rice.

Leaf rolling is considered as one of the most important agronomic traits in rice breeding. It has been previously reported that SEMI-ROLLED LEAF 1 (SRL1) modulates leaf rolling by regulating the formation of bulliform cells in rice (Oryza sativa); however, the regulatory mechanism underlying SRL1 has yet to be further elucidated. Here, we report the functional characterization of a novel leaf-rolling mutant, curled leaf and dwarf 1 (cld1), with multiple morphological defects. Map-based cloning revealed that CLD1 is allelic with SRL1, and loses function in cld1 through DNA methylation. CLD1/SRL1 encodes a glycophosphatidylinositol (GPI)-anchored membrane protein that modulates leaf rolling and other aspects of rice growth and development. The cld1 mutant exhibits significant decreases in cellulose and lignin contents in secondary cell walls of leaves, indicating that the loss of function of CLD1/SRL1 affects cell wall formation. Furthermore, the loss of CLD1/SRL1 function leads to defective leaf epidermis such as bulliform-like epidermal cells. The defects in leaf epidermis decrease the water-retaining capacity and lead to water deficits in cld1 leaves, which contribute to the main cause of leaf rolling. As a result of the more rapid water loss and lower water content in leaves, cld1 exhibits reduced drought tolerance. Accordingly, the loss of CLD1/SRL1 function causes abnormal expression of genes and proteins associated with cell wall formation, cuticle development and water stress. Taken together, these findings suggest that the functional roles of CLD1/SRL1 in leaf-rolling regulation are closely related to the maintenance of cell wall formation, epidermal integrity and water homeostasis.