Comparative evaluation of the effect of impregnated retraction cord versus laser on gingival attachment level and pain perception following retraction for subgingival margins - A prospective, split-mouth, controlled, clinical study.

AIM: To evaluate and compare the effect of impregnated retraction cord vs Laser on gingival attachment level and pain perception following retraction for subgingival margins. SETTINGS AND DESIGN: Many methods for achieving and measuring the amount of gingival retraction in fixed prosthodontic work have been advocated. Though the gingival attachment level is crucial in Periodontology, the literature available regarding the effect of these retraction methods on the same is scarce. Hence, this clinical study was designed to compare the pain perception and amount of gingival recession when impregnated cord and laser were used for retraction. MATERIALS AND METHODS: In 40 subjects (age range of 20 to 40 years) with single missing maxillary incisor, the abutments were prepared with subgingival margins, to receive a full coverage metal-ceramic fixed dental prosthesis. The gingiva was retracted on one of the abutments with impregnated retraction cord and on the other with diode laser. Gingival attachment levels were compared at six sites per abutment using superimposition of digital scans, preoperative and four weeks after cementation of final prosthesis. STATISTICAL ANALYSIS USED: Statistical analysis of the data for gingival recession was done using t-test. Pain perception was analysed with Chi-square test. Pain perception by patients following retraction was compared with VAS scale. RESULTS: The average values of gingival recession on buccal side were 0.61 mm and 0.38 mm and on the palatal side were 0.58 mm and 0.35 mm for impregnated retraction cord and laser respectively. The P values of <0.01 indicated a highly significant difference between the two groups. Intragroup comparison did not show significant differences between various sites. Pain and discomfort produced by cord method was moderate in comparison with mild/no pain with diode laser and the difference was highly significant.Conclusion: Retraction cord produced more gingival recession than the diode laser, which was statistically highly significant on both buccal and palatal aspects of the teeth. Patients experience with diode laser technique was less painful in comparison with retraction cord method.

STING dependent BAX-IRF3 signaling results in apoptosis during late-stage Coxiella burnetii infection.

STING (STimulator of Interferon Genes) is a cytosolic sensor for cyclic dinucleotides (CDNs) and initiates an innate immune response upon binding to CDNs. Coxiella burnetii is a Gram-negative obligate intracellular bacterium and the causative agent of the zoonotic disease Q fever. The ability of C. burnetii to inhibit host cell death is a critical factor in disease development. Previous studies have shown that C. burnetii inhibits host cell apoptosis at early stages of infection. However, during the late-stages of infection, there is host cell lysis resulting in the release of bacteria to infect bystander cells. Thus, we investigated the role of STING during late-stages of C. burnetii infection and examined STING's impact on host cell death. We show that the loss of STING results in higher bacterial loads and abrogates IFNß and IL6 induction at 12 days post-infection. The absence of STING during C. burnetii infection significantly reduces apoptosis through decreased caspase-8 and -3 activation. During infection, STING activates IRF3 which interacts with BAX. BAX then translocates to the mitochondria, which is followed by mitochondrial membrane depolarization. This results in increased cytosolic mtDNA in a STING-dependent manner. The presence of increased cytosolic mtDNA results in greater cytosolic 2'-3' cGAMP, creating a positive feedback loop and leading to further increases in STING activation and its downstream signaling. Taken together, we show that STING signaling is critical for BAX-IRF3-mediated mitochondria-induced apoptosis during late-stage C. burnetii infection.

Gauging the knowledge, attitude and practice of interns and dentists about obstructive sleep apnoea-A cross-sectional study.

CONTEXT: Obstructive sleep apnoea is less known and lesser practised in dentistry. Dentists often struggle to educate, diagnose or offer treatment to the patient. Hence, the disorder of the patient and the opportunity for the dentist both go unnoticed. AIM: To assess the knowledge, attitude and practice regarding aspects of obstructive sleep apnoea among dental practitioners, faculty and interns in India. METHODS AND MATERIAL: A self-constructed validated questionnaire was prepared and circulated online among dental interns and professionals in India. Responses received from 237 participants were evaluated and statistically analysed. RESULTS: Only questions about diagnosis and symptoms of OSA were correctly answered by more than 50% of the participants. In all other questions, the knowledge was poor. Only 11.4% of respondents felt that they are well equipped to diagnose OSA. The general attitude of the participants was favourable but with poor practice. Only 5.1% of participants were ever involved in the treatment of OSA. CONCLUSIONS: Given the high prevalence of OSA among the population, along with widespread ignorance among dentists for the same as found in our study, there is an urgent need to spotlight OSA in the dental curriculum at an undergraduate level. To complement this, extensive training and motivation must also be provided so that dental graduates can identify, refer and participate in the treatment of OSA.

Atmospheric pressure pin-to-plate cold plasma effect on physicochemical, functional, pasting, thermal, and structural characteristics of proso-millet starch.

The present work aimed to study the influence of atmospheric pressure pin-to-plate cold plasma on the physicochemical (pH, moisture, and amylose content), functional (water & oil binding capacity, solubility & swelling power, paste clarity on storage, pasting), powder flow, thermal and structural (FTIR, XRD, and SEM) characteristics at an input voltage of 170-230 V for 5-15 min. The starch surface modification by cold plasma was seen in the SEM images which cause the surge in WBC (1.54 g/g to 1.93 g/g), OBC (2.22 g/g to 2.79 g/g), solubility (3.05-5.38% at 70 °C; 37.11-52.98% at 90 °C) and swelling power (5.39-7.83% at 70 °C; 25.67-35.33% at 90 °C) of starch. Reduction in the amylose content (27.82% to 25.07%) via plasma-induced depolymerization resists the retrogradation tendency, thereby increasing the paste clarity (up to Ì´ 39%) during the 5 days of refrigerated storage. However, the paste viscosity is reduced after cold plasma treatment yielding low-strength starch pastes. The relative crystallinity of starch increased (37.35% to 45.36%) by the plasma-induced fragmented starch granules which would aggregate and broaden the gelatinization temperature, but these starch fragments reduced the gelatinization enthalpy. The fundamental starch structure is conserved as seen in FTIR spectra. Thus, cold plasma aids in the production of soluble, low-viscous, stable, and clear paste-forming depolymerized proso-millet starch.

An Origami-Based Soft Robotic Actuator for Upper Gastrointestinal Endoscopic Applications.

Soft pneumatic actuators have been explored for endoscopic applications, but challenges in fabricating complex geometry with desirable dimensions and compliance remain. The addition of an endoscopic camera or tool channel is generally not possible without significant change in the diameter of the actuator. Radial expansion and ballooning of actuator walls during bending is undesirable for endoscopic applications. The inclusion of strain limiting methods like, wound fibre, mesh, or multi-material molding have been explored, but the integration of these design approaches with endoscopic requirements drastically increases fabrication complexity, precluding reliable translation into functional endoscopes. For the first time in soft robotics, we present a multi-channel, single material elastomeric actuator with a fully corrugated design (inspired by origami); offering specific functionality for endoscopic applications. The features introduced in this design include i) fabrication of multi-channel monolithic structure of 8.5 mm diameter, ii) incorporation of the benefits of corrugated design in a single material (i.e., limited radial expansion and improved bending efficiency), iii) design scalability (length and diameter), and iv) incorporation of a central hollow channel for the inclusion of an endoscopic camera. Two variants of the actuator are fabricated which have different corrugated or origami length, i.e., 30 mm and 40 mm respectively). Each of the three actuator channels is evaluated under varying volumetric (0.5 mls-1 and 1.5 mls-1 feed rate) and pressurized control to achieve a similar bending profile with the maximum bending angle of 150°. With the intended use for single use upper gastrointestinal endoscopic application, it is desirable to have linear relationships between actuation and angular position in soft pneumatic actuators with high bending response at low pressures; this is where the origami actuator offers contribution. The soft pneumatic actuator has been demonstrated to achieve a maximum bending angle of 200° when integrated with manually driven endoscope. The simple 3-step fabrication technique produces a complex origami pattern in a soft robotic structure, which promotes low pressure bending through the opening of the corrugation while retaining a small diameter and a central lumen, required for successful endoscope integration.

Plasmodium falciparum DDX17 is an RNA helicase crucial for parasite development.

Malaria is one of the major global health concerns still prevailing in this 21st century. Even the effect of artemisinin combination therapies (ACT) have declined and causing more mortality across the globe. Therefore, it is important to understand the basic biology of malaria parasite in order to find novel drug targets. Helicases play important role in nucleic acid metabolism and are components of cellular machinery in various organisms. In this manuscript we have performed the biochemical characterization of homologue of DDX17 from Plasmodium falciparum (PfDDX17). Our results show that PfDDX17 is an active RNA helicase and uses mostly ATP for its function. The qRT-PCR experiment results suggest that PfDDX17 is highly expressed in the trophozoite stage and it is localised mainly in the cytoplasm and in infected RBC (iRBC) membrane mostly in the trophozoite stage. The dsRNA knockdown study suggests that PfDDX17 is important for cell cycle progression. These studies report the biochemical functions of PfDDX17 helicase and further augment the fundamental knowledge about helicase families of P. falciparum.

A Clinical Comparative Evaluation Of The Wear Of Enamel Antagonist To Monolithic Zirconia And Metal-Ceramic Crowns.

PURPOSE: To evaluate and compare the wear of natural enamel against a metal-ceramic and a monolithic zirconia crown, with the null hypothesis that there is no difference in the wear of enamel between antagonist metal-ceramic and monolithic zirconia crowns. MATERIALS AND METHODS: In 30 subjects (irrespective of sex and within the age range of 18 to 40 years), two bilaterally opposing molars (maxillary/mandibular) were prepared to receive monolithic zirconia or metal-ceramic crowns with feldspathic porcelain veneer. A polyvinyl siloxane impression of the opposing arch was taken at the time of cementation and 1 year after cementation. Casts were poured in type III gypsum and scanned, and the images were superimposed on each other. AutoCAD was used to calculate the difference between two images, which corresponded to the linear wear of the antagonist teeth. Statistical analysis of the data was done using one-way analysis of variance (ANOVA) and post hoc Tukey honest significant difference test for intergroup comparison. The P value obtained by one-way ANOVA was 1.1102e-16 (< .05), and by post hoc Tukey test was .001 (< .01). RESULTS: The mean wear of enamel against enamel was 14.8 ± 1.3 µm, enamel against metal-ceramic was 87.1 ± 18.3 µm, and enamel against monolithic zirconia was 59.4 ± 13.6 µm. The P values obtained; ie, 1.1102e-16 (one-way ANOVA) and 0.001 (post hoc Tukey), indicated that the difference in wear of the antagonist tooth between monolithic zirconia and feldspathic porcelain was significant. CONCLUSION: It can be concluded that monolithic zirconia causes less wear of the antagonist tooth than feldspathic porcelain.

Parallel Helix Actuators for Soft Robotic Applications.

Fabrication of soft pneumatic bending actuators typically involves multiple steps to accommodate the formation of complex internal geometry and the alignment and bonding between soft and inextensible materials. The complexity of these processes intensifies when applied to multi-chamber and small-scale (~10 mm diameter) designs, resulting in poor repeatability. Designs regularly rely on combining multiple prefabricated single chamber actuators or are limited to simple (fixed cross-section) internal chamber geometry, which can result in excessive ballooning and reduced bending efficiency, compelling the addition of constraining materials. In this work, we address existing limitations by presenting a single material molding technique that uses parallel cores with helical features. We demonstrate that through specific orientation and alignment of these internal structures, small diameter actuators may be fabricated with complex internal geometry in a single material-without- additional design-critical steps. The helix design produces wall profiles that restrict radial expansion while allowing compact designs through chamber interlocking, and simplified demolding. We present and evaluate three-chambered designs with varied helical features, demonstrating appreciable bending angles (>180°), three-dimensional workspace coverage, and three-times bodyweight carrying capability. Through application and validation of the constant curvature assumption, forward kinematic models are presented for the actuator and calibrated to account for chamber-specific bending characteristics, resulting in a mean model tip error of 4.1 mm. This simple and inexpensive fabrication technique has potential to be scaled in size and chamber numbers, allowing for application-specific designs for soft, high-mobility actuators especially for surgical, or locomotion applications.

Plasmodium falciparum DDX31 is DNA helicase localized in nucleolus.

Malaria is a major infectious disease and is responsible for millions of infections every year. As drug resistance strains of Plasmodium species are emerging, there is an urgent need to understand the parasite biology and identify new drug targets. Helicases are very important enzymes that participate in various nucleic acid metabolic processes. Previously we have reported several putative DEAD box helicases in the genome of Plasmodium falciparum 3D7 strain. In this study, we present biochemical characterization of one of the members of Has1 (Helicase associated with SET1) family of DEAD box proteins from P. falciparum 3D7 strain. PfDDX31 is a homologue of human DDX31 helicase and contains all the conserved characteristics motifs. The core PfDDX31C exhibits DNA and RNA dependent ATPase activity and unwinds partially duplex DNA by utilizing ATP or dATP only. The immunofluorescence assay results show that PfDDX31 is expressed throughout all the intraerythrocytic developmental stages in P. falciparum 3D7 strain. The co-localization with nucleolar marker PfNop1 further suggests that PfDDX31 is mostly present in nucleolus, a discrete nuclear compartment.

Biochemical characterization of Plasmodium falciparum parasite specific helicase 1 (PfPSH1).

Malaria, a disease caused by infection with parasites of the genus Plasmodium, causes millions of deaths worldwide annually. Of the five Plasmodium species that can infect humans, Plasmodium falciparum causes the most serious parasitic infection. The emergence of drug resistance and the ineffectiveness of old therapeutic regimes against malaria mean there is an urgent need to better understand the basic biology of the malaria parasite. Previously, we have reported the presence of parasite-specific helicases identified through genome-wide analysis of the P. falciparum (3D7) strain. Helicases are involved in various biological pathways in addition to nucleic acid metabolism, making them an important target of study. Here, we report the detailed biochemical characterization of P. falciparum parasite-specific helicase 1 (PfPSH1) and the effect of phosphorylation on its biochemical activities. The C-terminal of PfPSH1 (PfPSH1C) containing all conserved domains was used for biochemical characterization. PfPSH1C exhibits DNA- or ribonucleic acid (RNA)-stimulated ATPase activity, and it can unwind DNA and RNA duplex substrates. It shows bipolar directionality because it can translocate in both (3'-5' and 5'-3') directions. PfPSH1 is mainly localized to the cytoplasm during early stages (including ring and trophozoite stages of intraerythrocytic development), but at late stages, it is partially located in the cytoplasm. The biochemical activities of PfPSH1 are upregulated after phosphorylation with PKC. The detailed biochemical characterization of PfPSH1 will help us understand its functional role in the parasite and pave the way for future studies.

Plasmodium falciparum specific helicase 2 is a dual, bipolar helicase and is crucial for parasite growth.

Human malaria infection is a major challenge across the globe and is responsible for millions of deaths annually. Rapidly emerging drug resistant strains against the new class of anti-malarial drugs are major threat to control the disease burden worldwide. Helicases are present in every organism and have important role in various nucleic acid metabolic processes. Previously we have reported the presence of three parasite specific helicases (PSH) in Plasmodium falciparum 3D7 strain. Here we present the detailed biochemical characterization of PfPSH2. PfPSH2 is DNA and RNA stimulated ATPase and is able to unwind partially duplex DNA and RNA substrates. It can translocate in both 3' to 5' and 5' to 3' directions. PfPSH2 is expressed in all the stages of intraerythrocytic development and it is localized in cytoplasm in P. falciparum 3D7 strain. The dsRNA mediated inhibition study suggests that PfPSH2 is important for the growth and survival of the parasite. This study presents the detailed characterization of PfPSH2 and lays the foundation for future development of PfPSH2 as drug target.

A robotic microsurgical forceps for transoral laser microsurgery.

PURPOSE: In transoral laser microsurgery (TLM), the close curved cylindrical structure of the laryngeal region offers functional challenges to surgeons who operate on its malignancies with rigid, single degree-of-freedom (DOF) forceps. These challenges include surgeon hand tremors, poor reachability, poor tissue surface perception, and reduced ergonomy in design. The integrated robotic microsurgical forceps presented here is capable of addressing the above challenges through tele-operated tissue manipulation in TLM. METHODS: The proposed device is designed in compliance with the spatial constraints in TLM. It incorporates a novel 2-DOF motorized microsurgical forceps end-effector, which is integrated with a commercial 6-DOF serial robotic manipulator. The integrated device is tele-operated through the haptic master interface, Omega.7. The device is augmented with a force sensor to measure tissue gripping force. The device is called RMF-2F, i.e. robotic microsurgical forceps with 2-DOF end-effector and force sensing. RMF-2F is evaluated through validation trials and pick-n-place experiments with subjects. Furthermore, the device is trialled with expert surgeons through preliminary tasks in a simulated surgical scenario. RESULTS: RMF-2F shows a motion tracking error of less than 400 µm. User trials demonstrate the device's accuracy in task completion and ease of manoeuvrability using the Omega.7 through improved trajectory following and execution times. The tissue gripping force shows better regulation with haptic feedback (1.624 N) than without haptic feedback (2.116 N). Surgeons positively evaluated the device with appreciation for improved access in the larynx and gripping force feedback. CONCLUSIONS: RMF-2F offers an ergonomic and intuitive interface for intraoperative tissue manipulation in TLM. The device performance, usability, and haptic feedback capability were positively evaluated by users as well as expert surgeons. RMF-2F introduces the benefits of robotic teleoperation including, (i) overcoming hand tremors and wrist excursions, (ii) improved reachability and accuracy, and (iii) tissue gripping feedback for safe tissue manipulation.

Multivariate box spline wavelets in higher-dimensional Sobolev spaces.

We construct wavelets and derive a density condition of MRA in a higher-dimensional Sobolev space. We give necessary and sufficient conditions for orthonormality of wavelets in H s ( R d ) . We construct nonseparable orthonormal wavelets in a higher-dimensional Sobolev space by using multivariate box spline.

Plasmodium falciparum specific helicase 3 is nucleocytoplasmic protein and unwinds DNA duplex in 3' to 5' direction.

Plasmodium falciparum is responsible for most dangerous and prevalent form of malaria. The emergence of multi drug resistant parasite hindered the prevention of malaria burden worldwide. Helicases are omnipresent enzymes, which play important role in nucleic acid metabolism and can be used as potential targets for development of novel therapeutics. The genome wide analysis of P. falciparum 3D7 strain revealed some novel parasite specific helicases, which are not present in human host. Here we report the detailed biochemical characterization of P. falciparum parasite specific helicase 3 (PfPSH3). The characteristic ATPase and helicase activities of PfPSH3 reside in its N-terminal region (PfPSH3N) as it contains all the conserved signature motifs whereas the C-terminal does not show any detectable biochemical activity. PfPSH3N also shows DNA helicase activity in the 3'-5' direction. The immunofluorescence microscopy results show that PSH3 is localized in nucleus as well as in cytoplasm during different stages such as trophozoite and early schizont stages of intraerythrocytic development. This report sets the foundation for further study of parasite specific helicases and will be helpful in understanding the parasite biology.

Genome Wide In silico Analysis of the Mismatch Repair Components of Plasmodium falciparum and Their Comparison with Human Host.

Malaria a major parasitic infection globally particularly in tropical and sub-tropical regions of the world is responsible for about 198 million cases and estimated deaths due to this disease are about 0.6 million. The emergence of drug resistance in the malaria parasite is alarming and it is necessary to understand its underlying cause and molecular mechanisms. It has been established that drug resistant malaria parasites have defective mismatch repair (MMR) therefore it is essential to study this pathway and its components in detail. Recently a number of non-synonymous Single Nucleotide Polymorphisms have been reported in genes involved in MMR pathways. PfMLH is an endonuclease essential to restore the MMR in drug resistant strains of Plasmodium falciparum. Considering all these facts about the role of MMR in emergence of drug resistant parasite, in this manuscript we report a genome wide analysis of the components of the MMR pathway such as MLH, Pms1, MSH2-1, MSH2-2, MSH6, and UvrD using in silico bioinformatics based approaches. The phylogenetic analysis revealed evolutionary closeness with the MMR components of various organisms. It is noteworthy that P. falciparum contains two homologs of MSH2, which are located on different chromosomes. The structural modeling of these components showed their similarity with the human/yeast MMR components. The docking studies reveal that PfUvrD and PfMLH interact with each other. The in silico identification of interacting partners of the major MMR components identified numerous P. falciparum specific proteins. In line with our previous studies the present study will also contribute significantly to understand the MMR pathway of malaria parasite.

ATPase activity of Plasmodium falciparum MLH is inhibited by DNA-interacting ligands and dsRNAs of MLH along with UvrD curtail malaria parasite growth.

Malaria caused by Plasmodium falciparum is the major disease burden all over the world. Recently, the situation has deteriorated because the malarial parasites are becoming progressively more resistant to numerous commonly used antimalarial drugs. Thus, there is a critical requirement to find other means to restrict and eliminate malaria. The mismatch repair (MMR) machinery of parasite is quite unique in several ways, and it can be exploited for finding new drug targets. MutL homolog (MLH) is one of the major components of MMR machinery, and along with UvrD, it helps in unwinding the DNA. We have screened several DNA-interacting ligands for their effect on intrinsic ATPase activity of PfMLH protein. This screening suggested that several ligands such as daunorubicin, etoposide, ethidium bromide, netropsin, and nogalamycin are inhibitors of the ATPase activity of PfMLH, and their apparent IC50 values range from 2.1 to 9.35 µM. In the presence of nogalamycin and netropsin, the effect was significant because in their presence, the V max value dropped from 1.024 µM of hydrolyzed ATP/min to 0.596 and 0.643 µM of hydrolyzed ATP/min, respectively. The effect of double-stranded RNAs of PfMLH and PfUvrD on growth of P. falciparum 3D7 strain was studied. The parasite growth was significantly inhibited suggesting that these components belonging to MMR pathway are crucial for the survival of the parasite.

Robot-assisted microsurgical forceps with haptic feedback for transoral laser microsurgery.

In this paper, a novel, motorized, multi-degrees-of-freedom (DoF), microsurgical forceps tool is presented, which is based on a master-slave teleoperation architecture. The slave device is a 7-DoF manipulator with: (i) 6-DoF positioning and orientation, (ii) 1 open/close gripper DoF; and (iii) an integrated force/torque sensor for tissue grip-force measurement. The master device is a 7-DoF haptic interface which teleoperates the slave device, and provides haptic feedback in its gripper interface. The combination of the device and the surgeon interface replaces the manual, hand-held device providing easy-to-use and ergonomic tissue control, simplifying the surgical tasks. This makes the system suitable to real surgical scenarios in the operating room (OR). The performance of the system was analysed through the evaluation of teleoperation control and characterization of gripping force. The new system offers an overall positioning error of less than 400 µm demonstrating its safety and accuracy. Improved system precision, usability, and ergonomics point to the potential suitability of the device for the OR and its ability to advance haptic-feedback-enhanced transoral laser microsurgeries.

Novel modular 2-DOF microsurgical forceps for transoral laser microsurgeries: Ergonomic design and preliminary evaluation.

Transoral Laser Microsurgeries (TLM) demand a great level of control and precision in intraoperative tissue manipulation. The optimal eradication of the diseased tissue is possible only with coordinated control of the laser aiming for incision and the microsurgical tools for orienting and stretching the tissue. However, the traditional microsurgical tools are long, single purpose, one degree-of-freedom (DOF), rigid tools with small range of motion and a normal grasping handle inducing non-ergonomic usage. This paper presents a novel, modular microsurgical tool to overcome the challenges of the traditional tools and improve the surgeon-tool usage experience. The novel design adds a rotational DOF to expand the reach and functionality of the tool. The device is provided with an ergonomic grasping handle that avoids extreme wrist excursions and is capable of adapting to the variety of tools used in TLM within the same design. The performance of the new microsurgical tool was evaluated through a subjective assessment with both medical students and expert surgeons. The evaluation demonstrated a general acceptance of the new forceps tool, with the expert surgeons providing positive appraisals for the improved functionality and user experience with the tool, which indicates towards the potential suitability of the device for TLM. The parameters assessed in the preliminary evaluation not only provide a sense of the advantages of the novel design, but also guide future evolution of the tool design.