Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study.

AIM: The aim of the present study was to assess the stain removal ability and color stability of three distinct dentifrices on artificially stained enamel surface. MATERIALS AND METHODS: This study included 75 intact, healthy premolars free of dental caries that were extracted during orthodontic therapy. The samples were allowed to dry for 6 hours after being submerged in the prepared tea solution for roughly 18 hours every day. Then this procedure was repeated for seven successive days. All samples were randomly divided into three experimental groups with 25 samples in each group. Group I: control dentifrice, group II: dentifrice containing hydrogen peroxide, group III: dentifrice containing papain and bromelain. A specially designed toothbrushing simulator was used to brush every sample in the relevant group. Using a spectrophotometer and a measurement program, color measurement was evaluated after staining process after 4 weeks and 8 weeks of teeth cleaning. Using a profilometer, the surface roughness values (Ra) were assessed. RESULTS: After 8 weeks of brushing of stained samples, the color stability was better in dentifrice containing hydrogen peroxide (1.14 ± 0.11) followed by dentifrice containing papain and bromelain (1.22 ± 0.08) and control group (1.30 ± 0.09). And after 8 weeks of brushing of stained samples, the surface roughness was more in dentifrice containing hydrogen peroxide (0.237 ± 0.02) followed by dentifrice containing papain and bromelain (0.229 ± 0.13) and control group (0.207 ± 0.05). CONCLUSION: The present study concluded that the dentifrice containing hydrogen peroxide showed a superior whitening effect on the stained enamel surface than dentifrice containing papain and bromelain and control dentifrice. CLINICAL SIGNIFICANCE: The development of various dentifrice products has been greatly aided by the increased demand for an improved esthetic appearance. Teeth's natural color and any external stains that could accumulate on the tooth surface combine to determine a tooth's color. Additionally, the use of whitening dental pastes to remove external stains has grown in favor. With the development of these whitening toothpastes, dentifrices' ability to lessen or eliminate extrinsic dental stains has increased. How to cite this article: Mishra D, Kamath DG, Alagla M, et al. Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study. J Contemp Dent Pract 2024;25(1):68-71.

Sensing potential of C6N8 for ammonia (NH3) and nitrogen triflouride (NF3): A DFT study.

The detection of toxic gases (NH3 and NF3) in regulating and monitoring air quality in the atmosphere has drawn a lot of attention. Herein, we explored a novel material (C6N8) for the detection of the important but toxic gases (NH3 and NF3). We investigated the interactions of the NH3 and NF3 with C6N8 through DFT at B3LYP, ωB97XD, and non-DFT M06-2X. Counterpoise interaction energy values (Eint. cp.) of NH3@C6N8 and NF3@C6N8 are -0.45 eV and -3.51 eV (for B3LYP), -0.42 eV and 2.11 eV (for ωB97XD) and -0.44 eV and -3.41eV (for M06-2X), respectively. Complexes having the most stable configurations were then subjected to further analyses including frontier molecular orbitals, H-L gap, and conductivity of complexes. An increase in the H-L gap in complexes (NH3@C6N8 and NF3@C6N8) is observed. The conductivity of NH3@C6N8 and NF3@C6N8 decreases as compared to C6N8. A considerable change in dipole moment was seen in C6N8 before and after complex formation. This is because of the shifting of charge between C6N8 and gases (NH3 and NF3). CHELPG and NBO charge analysis were used to evaluate the amount of charge transfer between C6N8 and gases. These analyses demonstrate that NH3 and NF3 withdraw electron density from C6N8. It was found that NH3 tends to be physically adsorbed on C6N8 while NF3 adsorbs chemically on C6N8. NCI and QTAIM analyses were performed to investigate the kind of interactions between the surface (C6N8) and gases (NH3 and NF3). Furthermore, the recovery time of NH3@C6N8 and NF3@C6N8 shows that C6N8 can be a better choice for sensing NH3 and NF3 gases.

The burden of musculoskeletal pain, associated sociodemographic factors, and disability in Pakistan.

OBJECTIVE: The objective of this survey was to determine the burden of musculoskeletal (MSK) pain, its association with sociodemographic factors and disability in the semi-urban community of Nain-Sukh, Lahore. METHODS: The current article's data is taken from the COPCORD survey conducted in the community of Nain-Sukh. After formal IRB approval, data collection was done via interview by a trained team using validated Urdu translation of COPCORD core questionnaires. Participants of both genders, >16 years, were enrolled through a random walk and quota sampling. In phase 1, sociodemographic factors were recorded. In phase 2, the impact of MSK pain on functional disability was assessed by the Modified Health Assessment Questionnaire (MHAQ). The data was compiled and analyzed using software SPSS version 25. The Chi-square test was applied to determine association while generalized linear regression models to see the dependence of sociodemographic factors and MSK pain. RESULTS: Out of 4922 participants, 1425 (28.9%) had MSK pain, with a mean age of 35 ± 14 years, with female predominance. Illiteracy, marital status, and household work with moderate intensity were significantly associated with MSK pain. Based on the MHAQ score, the majority 769 (82.9%) had a mild disability. Odds of advancing age, illiteracy, and moderate intensity of work were statistically significant for MSK pain. CONCLUSION: Every fourth subject in the surveyed population had MSK pain. Musculoskeletal pain was found to be significantly associated with female gender, advancing age, household work, illiteracy, married status, and moderate nature of work. More than two-thirds of the subjects with MSK pain had some degree of disability.

Does green HRM really matter for sustainable performance? The role of environmental consciousness and green intellectual capital.

The purpose of this study is to investigate the impact of a set of green human resource management (HRM) practices on sustainable performance in Pakistani higher education institutions (HEIs), while also taking into account the mediating influence of environmental consciousness and green intellectual capital. Furthermore, the study aims to assess the association between environmental consciousness and green intellectual capital, along with the sustainable outcome. The study data was collected from 250 HR managers and executive officers who were responsible for implementing green HRM practices and sustainable performance in the education sector of Pakistan. Smart PLS-4 software was used to perform the statistical analysis of the data. According to the results of this study, green HRM practices play a substantial role in enhancing sustainable performance. The study also identified a link between green HRM practices and sustainable performance via environmental awareness and green intellectual capital. The research contributes to the theoretical paradigm's social cognitive theory by offering information on green HRM practice bundles and sustainable performance. The research also demonstrates that green intellectual capital and environmental consciousness operate as a bridge between green HRM practices and long-term sustainable performance. The study's findings have real-world applications for education, policymakers, and human resource managers at the highest levels. In order to achieve sustainable performance, the study emphasizes the significance of developing green intellectual capital and implementing green HRM practices.

Perception of dental students regarding possible career challenges and associated factors towards working in rural areas: A questionnaire based survey.

OBJECTIVE: The shortage of health care professionals in rural areas contributes toward discriminatory health care delivery. The present study was planned with a similar intent and aimed to evaluate the perception of dental students regarding their future in rural areas. MATERIALS AND METHODS: The present study was designed as a cross-sectional study comprising of a 30-item questionnaire survey instrument distributed among a total of 550 dental students while the results obtained were subjected to statistical analysis. Statistical analysis was done using SPSS version 12.0 (SPSS Inc., Chicago, IL, USA). Independent student's t-test and one-way analysis of variance (ANOVA) were used for comparison among the variables while the Chi-square test was used to determine the association between the variables. P < 0.05 was considered statistically significant. RESULTS: No significant difference was observed in the attitude based on gender (P = 0.43), although, a statistically significant difference was observed in the attitude of students based on the year of their education with a positive attitude toward rural dental practice generally noted in the first year Bachelor of Dental Surgery (BDS) students which significantly declined with the increasing level of education (P = 0.01). CONCLUSIONS: Dental students were more influenced by the negative aspects of rural dental practice though they had, in their mind, a positive approach for the same at the beginning of their education, but this significantly declined with the increasing level of their education.

Development and Implementation of an Academic and Professional Nursing Organization Partnership to Enhance Leadership Skills and Knowledge About HIV-Related Nursing Care Among Diverse, Prelicensure, Clinical Nurse Leader Scholars.

ABSTRACT: Historically, racial discrimination, few role models, and a general lack of support both in academic and professional contexts has hindered the education and career advancement of minority nursing students. The American Association of Colleges of Nursing (AACN), in its G uiding Principles for Academic-Practice Partnerships , describes the creation of an academic-professional nursing organization partnership to address barriers to the success of nursing students from underrepresented groups. In keeping with the AACN's guiding principles, the University of Maryland School of Nursing and the Association of Nurses in AIDS Care (ANAC) developed a partnership to deliver a multifaceted program for prelicensure, second-degree, Master of Science in Nursing, Clinical Nurse Leader Scholars which prepares them to address the health care needs of people living with HIV/AIDS and bolsters student leadership knowledge and skills. The objective of this article is to describe the program components, outcomes, and lessons learned from this academic-professional nursing organization partnership. The approach described may be useful for future partnerships designed to enhance leadership experiences and skills for minority nursing students and will hopefully be used to advocate for their success.

The impact of entrepreneurial education on the propensity of business students to support new ventures: A moderated mediation model.

This research aims to investigate the role of financial self-efficacy in mediating the relationship between entrepreneurial education and venture capital intention, as well as the moderating influence of government support on the relationship between financial self-efficacy and venture capital intention. The target population consists of Lahore students from public and private universities who have already studied entrepreneurship. Based on the 250 responses to the online survey the findings show the mediating role of financial self-efficacy between entrepreneurial education and intention toward venture capital. Moreover, it also indicates the moderated effect of government support on the relationship between financial self-efficacy and intention toward venture capital. This study will not only help the curriculum committees in business schools to design entrepreneurial education outlines that enable the students to explore the different financing modes by including financial knowledge to cope with financial challenges but also to the government officials in devising financing plans accompanied by their expertise in the development of a business.

Ceramic Inlays: A Case Report.

Aesthetic dentistry continues to evolve via advances in bonding agents, restorative materials, and conservative preparation methods. Alternatives to dental amalgam and gold include ceramic dental restorative materials. The lifespan of ceramic inlay repairs is still up for debate. When it comes to durability, colour matching, and anatomical shape stability, ceramic inlay restorations top the list of options. More predictable long-term performance may be achieved by strategically placing ceramic inlays in teeth that are not subjected to significant occlusal stress. Preparation design for ceramic inlay materials is necessary to avoid flexure. This case report discusses the ceramic inlay practice for functional and aesthetic restoration in a patient.

Panoramic Indices: An Aid to Early Detection of Patients with Low Bone Mineral Density.

Objective An early identification of patients who are at an obvious increased risk of osteoporosis and subsequent high risk of pathological bone fractures is important to prevent morbidity and its subsequent impact on the quality of life of the affected patients. Dental professionals have a chance of identifying such cases in their very initial stages through routinely prescribed dental radiographs. The aim of this study was to assess the influence of gender and age on different parameters of alveolar bone loss using orthopantomograph (OPG) as an aid to identify patients with low bone mineral density (BMD). Materials and Methods This study included eighty subjects in whom after taking OPGs, mandibular cortical index (MCI), mandibular cortical width (MCW), and panoramic mandibular index were assessed, while the results obtained were subjected to statistical analysis. One-way analysis of variance followed by Tukey's test was used to compare the means, while p -value less than 0.05 was considered statistically significant. Results The findings of this study revealed a significant association between MCI and age for females, with C2 and C3 categories being more common with advancing age. Also, a significant difference could be seen in relation to gender ( p -value = 0.0315) for MCW with a concomitant decrease in the values of MCW in females over 60 years of age. Conclusion Panoramic radiographic measurements could provide valuable information and help in screening patients with low BMD.

Influence of Occlusal Bite Forces on Teeth with Altered Periodontal Support: A Three-Dimensional Finite Element Stress Analysis.

BACKGROUND: Masticatory forces generate various degrees of stress and strain in the periodontium of teeth which determine the clinical functions and load-bearing capacity of the teeth. There are few in vitro studies that have analyzed stress generated due to combined forces acting on the teeth. Thus, the objective of the present study was to do a comparative analysis of the influence of various stresses on the periodontal ligament and alveolar bone of maxillary central incisor with normal bone height and reduced bone height under simulated standard masticatory using finite element stress analysis. METHODOLOGY: A 3D model of the tooth was obtained with the help of ANSYS software. These models were subjected to various oblique forces, i.e., 100N and 235.9N, applied at 45° angle on the lingual surface of the maxillary central incisor and stress values were recorded in three dimensions. The results from FE analysis were analyzed using 3D Von Mises Criteria. RESULTS: It was observed that in healthy periodontium; it was observed that among the periodontal structure studied, the maximum stress levels were exerted on root followed by cortical bone, cancellous bone, and PDL, irrespective of the force, as compared to the diseased periodontium, in which the bone height was reduced, the maximum stresses were on root followed by cortical bone, PDL, and cancellous bone. CONCLUSION: The main factor governing the success of any periodontal procedure depends on the height of the remaining bone and the amount of force exerted on to the tooth and the stress generated within the tooth. The finite element method could be of substantial importance in this respect as it can assess the stresses of various occlusal forces on the periodontal ligament, root, cortical bone, and cancellous bone of teeth in a periodontally healthy and diseased state.

Assessment of Periodontal Status in Pre- and Postmenopausal Women with Chronic Periodontitis: A Cross-Sectional Study.

INTRODUCTION: Periodontitis is inflammation of periodontium. Periodontal disease is associated with various risk factors among which female hormonal alterations such as menopause have been found to be connected with periodontal breakdown and osteoporosis in women. The aim of this study was to determine the periodontal status in pre- and postmenopausal females. MATERIALS AND METHODS: In this study, 60 female patients were analyzed aged between 40 and 60 years. Group 1 (test) comprised 30 premenopausal women with/without chronic periodontitis and Group II (control) comprised 30 postmenopausal women with/without chronic periodontitis. After recording clinical parameters, the scores were provided using Orthopantomograph for each patient. Paired t-test was applied for intragroup comparison and independent sample t-test was applied for intergroup comparison. The value of P < 0.05 was considered statistically significant. RESULTS: The mean plaque index, gingival index, calculus index, pocket probing depth, and clinical attachment loss scores in the premenopausal group were less as compared to postmenopausal group. Both the groups showed statistically significant differences with T=15.28 and P = 0.01. CONCLUSION: Postmenopausal women are more susceptible to periodontitis. Hence, precaution and initial management of oral diseases should be the utmost priority in women's health. The effect of sex hormones can be reduced with regular dental examination, maintaining good oral hygiene, and hormonal replacement therapies.

Prevalence of inflammatory back pain and radiographic axial spondyloarthritis in a semi-urban community of Lahore, Pakistan.

AIMS: To determine the prevalence of inflammatory back pain (IBP) and radiographic axial spondyloarthritis (SpA) in a semi-urban community of Lahore, Pakistan. METHODS: This cross-sectional household survey was designed as per the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) model. In Phase 1, the subjects were interviewed for musculoskeletal (MSK) pain in the last 7 days by clinical assistants. In Phase 2, physiotherapists identified subjects with spinal/back pain and interviewed for Assessment in Spondyloarthritis International Working Group (ASAS) criteria for IBP. In Phase 3 subjects having IBP or chronic back pain (CBP) with an age at onset ≤45 years, were assessed and further investigated. RESULTS: A total of 4922 subjects with a mean age of 35.3 ± 14.5 years, including 2770 (56%) women were surveyed in Phase 1. MSK pain in last 7 days was reported by 1407 (28.6%) of whom 1034 (21%) had spinal pain. The ASAS criteria for IBP were met in 329 (6.7%, 95% CI 6.0-7.0). In Phase 3, 222 with IBP and 83 having CBP with age at onset ≤45 years were evaluated. Out of this total of 305, 144 (2.9%) were confirmed to have IBP by rheumatologists as per at least 1 of the 3 criteria. ASAS criteria were met in 107 (2.2%, 95% CI 1.8-2.6). ASAS criteria for radiographic axial SpA were met in 47 (1%, 95% CI 0.7-1.3) of the surveyed population. CONCLUSION: Inflammatory back pain was reported in 6.7% by physiotherapists, confirmed in 3% by rheumatologists. The prevalence of radiographic axial SpA was 1%.

Hypertension and obesity in community of Nain-Sukh.

OBJECTIVE: To determine the frequency of factors related to hypertension in a peri-urban community. METHODS: It was a cross-sectional survey conducted from January to August, 2016, in Nain Sukh, Sheikhupura, near Lahore comprised household individuals of either gender aged 15-69 years. Data was collected through interviews by using a structured questionnaire focussing on socio-demography, history and factors associated with hypertension, like body mass index and lifestyle modifications. Hypertensive patients were identified by using clinical and medication history. SPSS 21 was used to analyse data. RESULTS: Of the 1080 subjects, 871(80.6%) were females and 209(19.4%) were males. The overall mean age was 33.5±14 years. Hypertension was found in 307(28.4%) subjects. Hypertension was significantly associated with lifestyle modification factors, like weight reduction, reduction in salt intake and smoking cessation (p<0.05), and with body mass index categories (p<0.05). CONCLUSIONS: Hypertension was found to be significantly high among overweight and obese participants, especially females.

Knowledge about the importance of antenatal care among females of child bearing age living in a suburban community of Lahore.

BACKGROUND AND OBJECTIVES: During the past few decades, females had been making conscious decision to have antenatal checkup from skilled health care provider due to improved education which had played a vital role to enhance their awareness regarding the importance of this comprehensive health service. The objective was to find out the perception of females of child bearing age about the importance of antenatal care during their last pregnancy, living in a suburban community of Kot-Lakhodare Lahore. METHODS: Females of reproductive age (15-49 years) living in Kot-Lakhodare were enrolled. Through a structured questionnaire, using convenient sampling technique, 1224 females of childbearing were interviewed through a cross sectional survey. The study was completed between January till August 2016. Question pertaining to their sociodemographic characteristics, perception about the importance of antenatal care services and comorbid conditions during the last pregnancy were asked. Data was analyzed by using SPSS version 21. The ethical approval both institutional and individual were duly taken. RESULTS: Mean age was 32 ±7.8SD years with education up to primary. Three quarter of females were un- employed with monthly income less than rupees 25,000 / month. All females 869(73%) who had perception about importance of antenatal checkup during their last pregnancy had no history of anemia, hypertension, diabetes and abortion (p<0.05). These females coming for the antenatal checkup delivered uneventfully by normal vaginal route and preferred government and private hospital for delivery and were vaccinated against Tetanus Toxoid (p<0.05). CONCLUSION: The females of child bearing age during the last pregnancy had adequate knowledge about the importance of antenatal care which played an important role in prevention of comorbid conditions like anemia, hypertension, diabetes and risk of abortion. Moreover, they had the perception of importance of institutionalized deliveries, tetanus Toxoid vaccination coverage during pregnancy.

Degenerative mitral regurgitation predicts worse outcomes in patients undergoing transcatheter aortic valve replacement.

OBJECTIVES: To evaluate the role mitral regurgitation (MR) etiology and severity play in outcomes for patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Multiple prior studies have investigated the influence of MR severity on outcomes for patients undergoing TAVR. Less has been published regarding the effects of MR etiology on outcomes, including its impact on heart failure hospitalization. METHODS: Two hundred and seventy patients undergoing TAVR at 2 hospitals were enrolled. Each patient had a baseline and follow-up (within 30 days of TAVR) echocardiogram that was analyzed. MR was graded as none, mild, moderate, or severe, as well as functional or degenerative. We compared patient outcomes, including death and heart failure hospitalization, among none-mild MR, moderate-severe functional MR, and moderate-severe degenerative MR groups. RESULTS: Two hundred and seventy patients underwent TAVR, reducing mean aortic valve gradients from 45 ± 15 mm Hg to 9 ± 4 mm Hg. On multivariable analysis, only patients with moderate-severe degenerative MR had decreased survival free of death or CHF hospitalization compared to those with none-mild MR (P = .011). Subanalysis showed patients with moderate-severe degenerative MR were more likely to be hospitalized for heart failure at 2 years compared to those with moderate-severe functional MR (P = .02). Patients with moderate-severe degenerative MR were also less likely to have improvement in MR severity at follow up (P = .01). CONCLUSIONS: Special consideration should be given to patients with moderate-severe degenerative MR undergoing TAVR. As transcatheter approaches for mitral valve repair and replacement continue to evolve, moderate-severe degenerative MR patients may benefit from consideration of double valve intervention.

Evaluation and Comparison between Formocresol and Sodium Hypochlorite as Pulpotomy Medicament: A Randomized Study.

INTRODUCTION: Pulpotomy is the most common treatment to preserve vitality of cariously exposed molars. Various pulpotomy medicaments used should be antimicrobial, should help in healing without damaging surrounding tissue, and should not affect eruption of permanent teeth. Thus, this study was conducted to evaluate and compare the clinical and radiographic outcomes of formocresol (FC) and sodium hypochlorite (NaOCl) in primary molars. The aim of this randomized study was to compare the clinical and radiographic success rate of FC and 5% NaOCl as a pulpotomy medicament in primary molars. MATERIALS AND METHODS: Forty children aged 4 to 9 years with primary carious molar were selected and randomly assigned into two groups: FC and NaOCl. Pulpotomy procedure was then performed followed by restoration with stainless steel crowns. Clinical and radiographic evaluation was done at an interval of 3 to 6 months. RESULTS: Clinical success rate at 3 and 6 months was 100% for both groups. Radiographic success rate for FC was 95% at 3 months and 90% at 6 months, whereas for NaOCl, it was 90% at 3 months and 85% at 6 months. CONCLUSION: Based on this study, result of 5% NaOCl and FC showed no significant difference in their success rate. Hence, NaOCl can be used as pulpotomy medicament; however, further clinical trials with long follow-up period are required. CLINICAL SIGNIFICANCE: Sodium hypochlorite is a potential clinical substitute of FC for vital pulpotomy treatment in primary teeth because of its exceptional biological compatibility and to evade carcinogenic effect of FC.

Cardiovascular Disease Biomarkers and suPAR in Predicting Decline in Renal Function: A Prospective Cohort Study.

INTRODUCTION: Soluble urokinase-type plasminogen activator receptor (suPAR) strongly predicts outcomes and incident chronic kidney disease (CKD) in patients with cardiovascular disease (CVD). Whether the association between suPAR and CKD is a reflection of its overall association with chronic inflammation and poor CVD outcomes is unclear. We examined whether CVD biomarkers, including high-sensitivity C-reactive protein (hs-CRP), fibrin-degradation products (FDPs), heat-shock protein 70 (HSP-70), and high-sensitivity troponin I (hs-TnI) were associated with a decline in kidney function in the Emory Cardiovascular Biobank cohort, in which suPAR levels were shown to be predictive of both incident CKD and CVD outcomes. METHODS: We measured suPAR, hs-CRP, HSP-70, FDP, and hs-TnI plasma levels in 3282 adults (mean age 63 years, 64% male, 75% estimated glomerular filtration rate [eGFR] >60 ml/min per 1.73 m2). Glomerular filtration rate was estimated using Chronic Kidney Disease-Epidemiology Collaboration (eGFR) at enrollment (n = 3282) and follow-up (n = 2672; median 3.5 years). Urine protein by dipstick at baseline was available for 1335 subjects. RESULTS: There was a weak correlation among biomarkers (r range: 0.17-0.28). hs-CRP, FDPs, hs-TnI, and suPAR were independently associated with baseline eGFR and proteinuria. The median yearly decline in eGFR was -0.6 ml/min per 1.73 m2. hs-CRP (ß: -0.04; P = 0.46), FDPs (ß: -0.13; P = 0.08), HSP-70 (ß: 0.05; P = 0.84), or hs-TnI (ß: -0.01; P = 0.76) were associated with eGFR decline. suPAR remained predictive of eGFR decline even after adjusting for all biomarkers. DISCUSSION: hs-CRP, FDP, HSP-70, and hs-TnI were not associated with eGFR decline. The specific association of suPAR with eGFR decline supported its involvement in pathways specific to the pathogenesis of kidney disease.

Association Between Living in Food Deserts and Cardiovascular Risk.

BACKGROUND: Food deserts (FD), neighborhoods defined as low-income areas with low access to healthy food, are a public health concern. We evaluated the impact of living in FD on cardiovascular risk factors and subclinical cardiovascular disease (CVD) with the hypothesis that people living in FD will have an unfavorable CVD risk profile. We further assessed whether the impact of FD on these measures is driven by area income, individual household income, or area access to healthy food. METHODS AND RESULTS: We studied 1421 subjects residing in the Atlanta metropolitan area who participated in the META-Health study (Morehouse and Emory Team up to Eliminate Health Disparities; n=712) and the Predictive Health study (n=709). Participants' zip codes were entered into the United States Food Access Research Atlas for FD status. Demographic data, metabolic profiles, hs-CRP (high-sensitivity C-reactive protein) levels, oxidative stress markers (glutathione and cystine), and arterial stiffness were evaluated. Mean age was 49.4 years, 38.5% male and 36.6% black. Compared with those not living in FD, subjects living in FD (n=187, 13.2%) had a higher prevalence of hypertension and smoking, higher body mass index, fasting glucose, and 10-year risk for CVD. They also had higher hs-CRP (P=0.014), higher central augmentation index (P=0.015), and lower glutathione level (P=0.003), indicative of increased oxidative stress. Area income and individual income, rather than food access, were associated with CVD risk measures. In a multivariate analysis that included food access, area income and individual income, both low-income area and low individual household income, were independent predictors of a higher 10-year risk for CVD. Only low individual income was an independent predictor of higher hs-CRP and augmentation index. CONCLUSIONS: Although living in FD is associated with a higher burden of cardiovascular risk factors and preclinical indices of CVD, these associations are mainly driven by area income and individual income rather than access to healthy food.

Bioactive Lipids and Circulating Progenitor Cells in Patients with Cardiovascular Disease.

Bone marrow-derived progenitor cells are mobilized into the peripheral blood after acute myocardial injury and in chronic ischemic heart disease. However, the mechanisms responsible for this mobilization are poorly understood. We examined the relationship between plasma levels of bioactive lipids and number of circulating progenitor cells (CPCs) in patients (N = 437) undergoing elective or emergent cardiac catheterization. Plasma levels of sphingosine-1 phosphate (S1P) and ceramide-1 phosphate (C1P) were quantified using mass spectrometry. CPCs were assessed using flow cytometry. S1P levels correlated with the numbers of CD34+, CD34+/CD133+, and CD34+/CXCR4+ CPCs even after adjustment for potential confounding factors. However, no significant correlation was observed between C1P levels and CPC count. Plasma levels of S1P correlated with the number of CPCs in patients with coronary artery disease, suggesting an important mechanistic role for S1P in stem cell mobilization. The therapeutic effects of adjunctive S1P therapy to mobilize endogenous stem cells need to be investigated. Stem Cells Translational Medicine 2017;6:731-735.

Depression and chest pain in patients with coronary artery disease.

BACKGROUND: Depression is common in patients with coronary artery disease (CAD) and is associated with more frequent chest pain. It is however unclear whether this is due to differences in underlying CAD severity. We sought to determine [1] whether depressive symptoms are associated with chest pain independently of CAD severity, [2] whether improvement in depressive symptoms over time is associated with improvement in chest pain and [3] whether the impact of revascularization on chest pain differs between patients with and without depression. METHODS AND RESULTS: 5158 patients (mean age 63±12years, 65% male, 20% African American) undergoing cardiac catheterization completed the Seattle Angina Questionnaire (SAQ) and Patient Health Questionnaire-8 (PHQ-8) to assess angina severity and screen for depression, respectively, both at baseline and between 6 and 24months of follow-up. We found significant correlations between PHQ-8 scores and angina frequency (SAQ-AF, r=-0.28), physical limitation (SAQ-PL, r=-0.32) and disease perception (SAQ-DS r=-0.37, all P<0.001), which remained significant after adjustment for clinical characteristics, CAD severity, and anti-depressant use. Improvement in depressive symptoms at follow-up was associated with improvement in angina subscales (SAQ-AF ß 1.34, P<0.001), SAQ-PL ß 1.85, P<0.001), and SAQ-DS (ß 2.12, P<0.001), independently of CAD severity or revascularization. Patients with depression who underwent revascularization had less improvement in chest pain frequency than those without depressive symptoms. CONCLUSIONS: Depression is associated with angina, independently of CAD severity. Patients with depression may not derive as adequate symptomatic benefit from revascularization as those without. Whether treatment of underlying depression improves chest pain needs to be further studied.