Bayesian connective field modeling using a Markov Chain Monte Carlo approach.

The majority of neurons in the human brain process signals from neurons elsewhere in the brain. Connective Field (CF) modelling is a biologically-grounded method to describe this essential aspect of the brain's circuitry. It allows characterizing the response of a population of neurons in terms of the activity in another part of the brain. CF modelling translates the concept of the receptive field (RF) into the domain of connectivity by assessing, at the voxel level, the spatial dependency between signals in distinct cortical visual field areas. Thus, the approach enables to characterize the functional cortical circuitry of the human cortex. While already very useful, the present CF modelling approach has some intrinsic limitations due to the fact that it only estimates the model's explained variance and not the probability distribution associated with the estimated parameters. If we could resolve this, CF modelling would lend itself much better for statistical comparisons at the level of single voxels and individuals. This is important when trying to gain a detailed understanding of the neurobiology and pathophysiology of the visual cortex, notably in rare cases. To enable this, we present a Bayesian approach to CF modeling (bCF). Using a Markov Chain Monte Carlo (MCMC) procedure, it estimates the posterior probability distribution underlying the CF parameters. Based on this, bCF quantifies, at the voxel level, the uncertainty associated with each parameter estimate. This information can be used in various ways to increase confidence in the CF model predictions. We applied bCF to BOLD responses recorded in the early human visual cortex using 3T fMRI. We estimated both the CF parameters and their associated uncertainties and show they are only weakly correlated. Moreover, we show how bCF facilitates the use of effect size (beta) as a data-driven parameter that can be used to select the most reliable voxels for further analysis. Finally, to further illustrate the functionality gained by bCF, we apply it to perform a voxel-level comparison of a single, circular symmetric, Gaussian versus a Difference-of-Gaussian model. We conclude that our bCF framework provides a comprehensive tool to study human functional cortical circuitry in health and disease.

Diagnosis, risk assessment, and treatment decisions for tooth wear in daily practice: a case presentation survey among Belgian dentists.

This survey assessed the use of current concepts for tooth wear diagnosis, risk assessment, and treatment decisions in daily practice, and identified factors of significance for treatment decisions. A total of 104 dentists were presented with 10 cases representing varying degrees of tooth wear. The dentists were asked to answer six questions pertaining to the diagnosis, risk assessment, and treatment of each case. A benchmark was established by three experts and the agreement between dentists and the benchmark was calculated. At dentition level, the agreement was moderate for diagnosis (κ = 0.55) and risk assessment (κ = 0.54). At tooth/surface level, the agreement for clinical and radiographic severity of wear was moderate (κ = 0.57) and substantial (κ = 0.65), respectively. The agreement for treatment decision was fair (κ = 0.35). Multivariate logistic regression analysis showed that treatment decisions for operative treatment were associated with moderate to high case risk (OR = 10.1; 95% CI: 5.4-18.9). Belgian dentists performed reasonably well in applying current concepts and strategies for tooth wear diagnosis and risk assessments at dentition level, as well as for assessment of wear severity at tooth/surface level. Improvement is warranted concerning treatment decisions. This survey could be a useful tool for disseminating and improving current knowledge of tooth wear, and for training dentists in daily practice.

Are systemic antibiotics indicated in children presenting with an odontogenic abscess in the primary dentition? A systematic review of the literature.

OBJECTIVES: This systematic review aimed to assess (1) whether systemic antibiotics are beneficial or harmful in healthy children who present with an odontogenic abscess in the primary dentition with or without systemic involvement and (2) if antibiotics are beneficial, which type, dosage and duration are the most effective. MATERIALS AND METHODS: Electronic databases (Medline, Embase, and the Cochrane Library) were screened from 1948 up to August 2020. No filters with respect to study design were applied. Outcomes of interest included pain, swelling, pain relief, adverse effects, signs of infection, quality-of-life measurements and medication required for pain relief. RESULTS: Altogether, 352 titles and abstracts were screened for eligibility; of these, 19 were selected for full text assessment. All were excluded because none of them fulfilled the inclusion criteria and addressed the (adjunctive) use of antibiotics in children who present with an odontogenic abscess in the primary dentition. CONCLUSIONS: At present, there is no single randomised or non-randomised clinical study evaluating the effectiveness and harms of systemic antibiotics administered in children who present with an odontogenic abscess in the primary dentition. CLINICAL RELEVANCE: There is no clinical evidence to support nor to refute the use of antibiotics in children who present with an odontogenic abscess in the primary dentition without signs of local spread or systemic involvement. Given this lack of scientific evidence, the use of antibiotics cannot be recommended in these children. Well-designed clinical trials are indicated to fully understand the impact and necessity of antibiotics in these situations.

Mechanical and chemical plaque control in the simultaneous management of gingivitis and caries: a systematic review.

AIM: To report the evidence on the effect of mechanical and/or chemical plaque control in the simultaneous management of gingivitis and caries. MATERIAL AND METHODS: A protocol was designed to identify randomized (RCTs) and controlled (CCTs) clinical trials, cohort studies and prospective case series (PCS), with at least 6 months of follow-up, reporting on plaque, gingivitis and caries. Relevant information was extracted from full papers, including quality and risk of bias. Meta-analyses were performed whenever possible. RESULTS: After the screening of 1,373 titles, 15 RCTs, 10 CCTs and 2 PCS were included. Low to moderate evidence support that combined professional and self-performed mechanical plaque control significantly reduces standardized plaque index [n = 4; weighted mean difference (WMD) = 1.294; 95% CI (0.445; 2.144); p = 0.003] and gingivitis scores [n = 4; WMD = 1.728; 95% CI (0.631; 2.825); p = 0.002]. The addition of fluoride to mechanical plaque control is relevant for caries management [n = 5; WMD = 1.159; 95% CI (0.145; 2.172); p = 0.025] while chlorhexidine rinses are relevant for gingivitis. CONCLUSION: Mechanical plaque control procedures are effective in reducing plaque and gingivitis. The addition of fluoride to mechanical plaque control is significant for caries management. Chlorhexidine rinse has a positive effect on gingivitis and inconclusive role in caries.

Prevention and control of dental caries and periodontal diseases at individual and population level: consensus report of group 3 of joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases.

BACKGROUND: The non-communicable diseases dental caries and periodontal diseases pose an enormous burden on mankind. The dental biofilm is a major biological determinant common to the development of both diseases, and they share common risk factors and social determinants, important for their prevention and control. The remit of this working group was to review the current state of knowledge on epidemiology, socio-behavioural aspects as well as plaque control with regard to dental caries and periodontal diseases. METHODS: Discussions were informed by three systematic reviews on (i) the global burden of dental caries and periodontitis; (ii) socio-behavioural aspects in the prevention and control of dental caries and periodontal diseases at an individual and population level; and (iii) mechanical and chemical plaque control in the simultaneous management of gingivitis and dental caries. This consensus report is based on the outcomes of these systematic reviews and on expert opinion of the participants. RESULTS: Key findings included the following: (i) prevalence and experience of dental caries has decreased in many regions in all age groups over the last three decades; however, not all societal groups have benefitted equally from this decline; (ii) although some studies have indicated a possible decline in periodontitis prevalence, there is insufficient evidence to conclude that prevalence has changed over recent decades; (iii) because of global population growth and increased tooth retention, the number of people affected by dental caries and periodontitis has grown substantially, increasing the total burden of these diseases globally (by 37% for untreated caries and by 67% for severe periodontitis) as estimated between 1990 and 2013, with high global economic impact; (iv) there is robust evidence for an association of low socio-economic status with a higher risk of having dental caries/caries experience and also with higher prevalence of periodontitis; (v) the most important behavioural factor, affecting both dental caries and periodontal diseases, is routinely performed oral hygiene with fluoride; (vi) population-based interventions address behavioural factors to control dental caries and periodontitis through legislation (antismoking, reduced sugar content in foods and drinks), restrictions (taxes on sugar and tobacco) guidelines and campaigns; however, their efficacy remains to be evaluated; (vii) psychological approaches aimed at changing behaviour may improve the effectiveness of oral health education; (viii) different preventive strategies have proven to be effective during the course of life; (ix) management of both dental caries and gingivitis relies heavily on efficient self-performed oral hygiene, that is toothbrushing with a fluoride-containing toothpaste and interdental cleaning; (x) professional tooth cleaning, oral hygiene instruction and motivation, dietary advice and fluoride application are effective in managing dental caries and gingivitis. CONCLUSION: The prevention and control of dental caries and periodontal diseases and the prevention of ultimate tooth loss is a lifelong commitment employing population- and individual-based interventions.

Do oral health conditions adversely impact young adults?

This study assessed the extent to which clinically measured oral health conditions, adjusted for sociodemographic and oral health behavior determinants, impact adversely on the oral health-related quality of life (OHRQoL) in a sample of Belgian young adults. The null hypothesis was that, among young adults, the oral health conditions would have no impact on their quality of life. The participants were 611 new patients aged 16-32 years seeking consultation at the Saint-Luc University Hospital in Brussels in 2010-2011. The patients (56.0% female) were examined for their oral health conditions and answered a validated questionnaire about sociodemographic and oral health behavior determinants in addition to questions about their OHRQoL. The abridged Oral Health Impact Profile-14 was used to assess the OHRQoL. Interexaminer reliability for caries was 0.86 (95% CI 0.84-0.89, nonweighted κ). The outcome was a high score on the OHRQoL (median split). Hierarchical logistic regression analysis showed that young adults with clinical absolute D1MFS scores between 9 and 16 (OR = 2.14, p = 0.031) and between 17 and 24 (OR = 3.10, p = 0.003) were significantly more likely to report a high impact on their quality of life than those with lower scores. Also, periodontal conditions compromised significantly (OR = 1.79, p = 0.011) the quality of life of young adults. In conclusion, this study identified oral health conditions with a significant adverse effect on the OHRQoL of young adults. However, the prevalence of young adults reporting impacts on at least 1 performance affected fairly often or very often was limited to 18.7% of the sample.

Oral health determinants and caries outcome among non-privileged children.

The study aimed at identifying oral health determinants that are present in early childhood, are amenable to change and for which there is evidence of their modulation of the rate of caries progression in a sample of non-privileged children. The null hypothesis was that determinants associated with the child's institutional environment as evidenced by nursery policies significantly influenced the child's oral health. The sample was formed by 2,511 Brazilian 1-5-year-olds. Caries severity and activity were recorded. Parents were interviewed and nurseries answered a questionnaire. According to the case status d1efs, the final multilevel model (generalized linear mixed model) identified significant associations with determinants such as bottle-feeding the child during the night on demand, not assisting the child in toothbrushing, ensuring visit to the dentist in case of troubles with teeth only (p < 0.0001) and intake of sugary products 2-4 times daily at nursery (p = 0.026). The likelihood of caries outcomes was associated with determinants related to nursery policies, not promoting preventive oral health care for children of mothers with 4 years of education (OR = 2.14; p < 0.0015) and <4 years of education (OR = 2.6; p = 0.0010), as well as consumption of sugary products 2-4 times daily for children of mothers with 4 years of education (OR = 3.35; p = 0.0010) and <4 years of education (OR = 4.07; p = 0.0063). In conclusion, determinants related to parental negative practices and to nursery policies significantly influenced children's oral health. Of particular interest was the identification of determinants considered amenable to change in connection with nursery policies towards oral health.

The COVID-19 Pandemic and Dental Professionals' Infection Risk Perception: An International Survey.

A global survey among dentists was used to identify the various impacts of the COVID-19 pandemic on this professional group. Special attention was given to perception and assessment of infection risk. From May to August 2020, the questionnaire was delivered in 36 countries by respective research groups and was completed by 52,491 dental professionals. The survey was designed as a cross-sectional survey based on a previously standardized questionnaire. This study focuses on the part of the questionnaire that deals with the perception of the infection risk of COVID-19 by dentists and their patients. A logistic regression model was used, which consisted of four Likert items as response options and the additional self-reported routine or emergency treatment as the dependent variable. Analysis by continent found that European and Asian dentists were particularly likely to be infected at work (OR = 1.45 95%CI = 1.02/1.84 and OR = 2.68, 95%CI = 1.45/3.22, respectively), while it was likely that Australian dentists did not feel particularly at risk due to low infection rates. Three quarters of Americans treated only emergencies during this survey period, while Europeans (64.71%) and Asians (66.67%) provided mostly routine care. This could affect the Europeans' confidence that they would not be able to protect themselves from infections in the long-term. The COVID-19 pandemic and its impact on dental professionals' infection risk perception is determined by the geographical origin of dentists. This study shows that, especially in high-incidence countries, infection risk perception was higher when dentists tried to provide routine dental procedures to their patients. Dental professionals can offer themselves and their patients good protection by maintaining high standards of hygiene. However, their concerns should be taken seriously and the dental professionals' group that is of great importance for oral health care and prevention, should not be neglected in the future, even in the event of emerging pandemics.

Binocular Integrated Visual Field Deficits Are Associated With Changes in Local Network Function in Primary Open-Angle Glaucoma: A Resting-State fMRI Study.

In glaucoma participants, both structural and functional brain changes have been observed, but we still have insufficient understanding of how these changes also affect the integrity of cortical functional networks, and how these changes relate to visual function. This is relevant, as functional network integrity may affect the applicability of future treatments, as well as the options for rehabilitation or training. Here, we compare global and local functional connectivity in local and global brain networks between glaucoma and control participants. Moreover, we study the relationship between functional connectivity and visual field (VF) loss. For our study, 20 subjects with primary open-angle glaucoma (POAG) and 24 age-similar healthy participants were recruited to undergo an ophthalmic assessment followed by two resting-state (RS) (f)MRI scans. For each scan and for each group, the ROIs with eigenvector centrality (EC) values higher than the 95th percentile were considered the most central brain regions ("hubs"). Hubs for which we found a significant difference in EC in both scans between glaucoma and healthy participants were considered to provide evidence for network changes. In addition, we tested the notion that a brain region's hub function in POAG might relate to the severity of a participant's VF defect, irrespective of which eye contributed mostly to this. To determine this, for each participant, eye-independent scores were derived for: (1) sensitivity of the worse eye - indicating disease severity, (2) sensitivity of both eyes combined - with one eye potentially compensating for loss in the other, or (3) difference in eye sensitivity - potentially requiring additional network interactions. By correlating each of these VF scores and the EC values, we assessed whether VF defects could be associated with centrality alterations in POAG. Our results show that no functional connectivity disruptions were found at the global brain level in POAG participants. This indicates that in glaucoma global brain network communication is preserved. Furthermore, for the Lingual Gyrus, identified as a brain hub, we found a positive correlation between the EC value and the VF sensitivity of both eyes combined. The fact that reduced local network functioning is associated with reduced binocular VF sensitivity suggests the presence of local brain reorganization that has a bearing on functional visual abilities.

Are dental patients able to perceive erosive tooth wear on anterior teeth?: An internet-based survey assessing awareness and related action.

BACKGROUND: Erosive tooth wear (ETW) is irreversible loss of dental hard tissue. The authors examined patients' ability to recognize ETW relative to sound teeth and teeth with caries. METHODS: Using Amazon's crowdsourcing service, the authors recruited participants (N = 623) to view standardized images of buccal surfaces of teeth (sound, ETW, or caries). Participants reported whether a dental condition existed (yes or no), likelihood to seek care, and esthetic attractiveness for teeth with no, initial, moderate, or severe signs of ETW or caries. RESULTS: Dental patients showed poor recognition of cases of ETW, especially compared with sound and caries-affected teeth at each level of severity. Patients were less likely to schedule a dental appointment for care or treatment of teeth with ETW than for teeth with caries at each level of severity. Patients also found ETW more esthetically attractive than caries at each level of severity and found initial ETW more attractive than sound teeth. CONCLUSIONS: Dental patients struggle to recognize ETW, in general and compared with caries, at each level of severity and particularly for early stages of ETW. These recognition difficulties likely arise, in part, from tooth esthetic attractiveness standards (smooth and shiny teeth look more esthetic), possibly leading to lack of appropriate care-seeking behavior. PRACTICAL IMPLICATIONS: This internet-based tool may be used to assess dental patients' awareness and ability to recognize cases of ETW. Improved patient awareness might lead to seeking professional care to prevent or delay ETW progression.

Dentists clinical decision-making for erosive tooth wear: An online pilot study.

OBJECTIVE: Erosive tooth wear (ETW) is an irreversible loss of dental hard tissue. This pilot study examined dentists' ability to diagnose and manage ETW relative to sound and caries-affected teeth. METHODS: Dentists recruited through the Indiana Dental Association (N = 36) participated in an internet-based survey, containing twenty-two standardized images of buccal and occlusal surfaces of teeth (sound, ETW, or caries). For each image, they provided diagnosis (presence and differentiation) of dental condition, confidence in their judgment, management need, and likelihood to recommend specific management strategies. Dentists made these judgments for teeth with no, initial, moderate, or severe ETW/caries. RESULTS: Dentists demonstrated poor detection of ETW compared to sound teeth and caries at each level of severity. The dentists were less confident, less able to correctly diagnose and manage ETW, and less likely to recommend most management strategies for ETW than caries at each level of severity. CONCLUSIONS: Dentists had difficulty correctly diagnosing (both detection and differentiation) and managing ETW, across all severity levels and particularly in early stages. These difficulties were particularly apparent when compared to caries. The current results are clinically relevant given the importance of early diagnosis for ETW management.

Study Protocol for an Online Questionnaire Survey on Symptoms/Signs, Protective Measures, Level of Awareness and Perception Regarding COVID-19 Outbreak among Dentists. A Global Survey.

The Centres for Disease Control and Prevention and the World Health Organization have developed preparedness and prevention checklists for healthcare professionals regarding the containment of COVID-19. The aim of the present protocol is to evaluate the impact of the COVID-19 outbreak among dentists in different countries where various prevalence of the epidemic has been reported. Several research groups around the world were contacted by the central management team. The online anonymous survey will be conducted on a convenience sample of dentists working both in national health systems and in private or public clinics. In each country/area, a high (~5-20%) proportion of dentists working there will be invited to participate. The questionnaire, developed and standardized previously in Italy, has four domains: (1) personal data; (2) symptoms/signs relative to COVID-19; (3) working conditions and PPE (personal protective equipment) adopted after the infection's outbreak; (4) knowledge and self-perceived risk of infection. The methodology of this international survey will include translation, pilot testing, and semantic adjustment of the questionnaire. The data will be entered on an Excel spreadsheet and quality checked. Completely anonymous data analyses will be performed by the central management team. This survey will give an insight into the dental profession during COVID-19 pandemic globally.

Oral health and healthcare utilization in Belgian dentate adults.

OBJECTIVES: In 2012-2014, the Belgian National Oral Health Data Registration and Evaluation Survey, integrated in the Health Interview Survey (HIS), was carried out. The present study investigated, in a sample of 1340 dentate adults (≥25 years), the association between oral healthcare utilization, oral health status and sociodemographic status. METHODS: A multistage, stratified cluster sampling procedure was used. Oral examination for caries experience (World Health Organization, D3 MFT-Index), periodontal status (Dutch Periodontal Screening Index, DPS-Index), number of teeth present and occlusal contacts without wearing removable dentures was performed by calibrated examiners. Oral healthcare utilization data were retrieved from the records of the Belgian Intermutualistic Agency. Participants' oral health and sociodemographic data were linked to registered oral care utilization in the previous 5-year period. Regular attenders (annual attenders and those with at least one registered contact in three different years) were compared with irregular attenders (those having had dental visits but not according to the definition of regular attenders) and nonattenders. Data were weighted to compensate for sampling and participation bias. RESULTS: Six hundred and seventy-nine participants attended regularly, of whom 276 annually; 256 did not attend in the reference period. The overall D3 MFT-Index was not noticeably different between attendance patterns (varying between 11 and 13), although regular attenders had more restored teeth than nonattenders (P < 0.01). No difference was seen for DPS-Index and number of teeth/occluding pairs (χ2 test, P > 0.05). Females, participants with higher education, older participants and those in employment had higher rates of regular attendance. CONCLUSIONS: Regular attenders had fewer untreated caries lesions, but neither lower caries experience nor lower DPS-Index than irregular attenders. Regular attendance was associated with sociodemographic variables.

CORNICHON sorting and regulation of GLR channels underlie pollen tube Ca2+ homeostasis.

Compared to animals, evolution of plant calcium (Ca2+) physiology has led to a loss of proteins for influx and small ligand-operated control of cytosolic Ca2+, leaving many Ca2+ mechanisms unaccounted for. Here, we show a mechanism for sorting and activation of glutamate receptor-like channels (GLRs) by CORNICHON HOMOLOG (CNIH) proteins. Single mutants of pollen-expressed Arabidopsis thaliana GLRs (AtGLRs) showed growth and Ca2+ flux phenotypes expected for plasma membrane Ca2+ channels. However, higher-order mutants of AtGLR3.3 revealed phenotypes contradicting this assumption. These discrepancies could be explained by subcellular AtGLR localization, and we explored the implication of AtCNIHs in this sorting. We found that AtGLRs interact with AtCNIH pairs, yielding specific intracellular localizations. AtCNIHs further trigger AtGLR activity in mammalian cells without any ligand. These results reveal a regulatory mechanism underlying Ca2+ homeostasis by sorting and activation of AtGLRs by AtCNIHs.

Real-time imaging of suction blistering in human skin using optical coherence tomography.

Separation of skin epidermis from the dermis by suction blistering has been used with high success rate for autologous skin epidermal grafting in burns, chronic wounds and vitiligo transplantation treatment. Although commercial products that achieve epidermal grafting by suction blistering are presently available, there is still limited knowledge and understanding on the dynamic process of epidermal-dermal separation during suction blistering. In this report we integrated a suction system to an Optical Coherence Tomography (OCT) which allowed for the first time, real-time imaging of the suction blistering process in human skin. We describe in this report the evolution of a suction blister where the growth is modeled with a Boltzmann sigmoid function. We further investigated the relationship between onset and steady-state blister times, blister growth rate, applied suction pressure and applied local skin temperature. Our results show that while the blister time is inversely proportional to the applied suction pressure, the relationship between the blister time and the applied temperature is described by an exponential decay.

Caries reduction in belgian 12-year-old children related to socioeconomic status.

This study compares dental caries reduction in Belgian 12-year-old children of different socioeconomic status in 1983 and 1998. Moreover, the relative effect of dental health factors on caries reduction is estimated. In the region of Brussels, children in the 7th grade at the same schools participated in cohort 1983 (n = 533) and in cohort 1998 (n = 496). DMFT, DMFS, and dental fluorosis were clinically recorded. The socioeconomic status of the children was established on the basis of their parents' education and profession. Data on children's home-based and professional dental health care habits were registered. Caries reduction was observed in both privileged and non-privileged children. However, non-privileged children, in cohort 1983 and cohort 1998, had significantly higher DMF scores than privileged children (P < 0.01). Dental fluorosis was more often identified in privileged children than in non-privileged ones. Most of the dental factors relating to children's home based and professional care were associated with caries reduction. Caries reduction was strongly related to socioeconomic status; non-privileged children registered lower than their counterparts.