Antibodies against citrullinated proteins in relation to periodontitis with or without rheumatoid arthritis: a cross-sectional study.

BACKGROUND: Previous studies have reported conflicting findings between serum anti-citrullinated protein antibodies (ACPA) levels in rheumatoid arthritis (RA) participants with and without periodontitis (Pd). This study aimed to analyse possible correlations between serum ACPA levels and clinical parameters in Pd and RA participants. METHODS: Full mouth periodontal examination (probing pocket depth, clinical attachment levels, gingival bleeding index, visual plaque index) was conducted and serum samples obtained from 80 participants comprising RA, Pd, both RA and Pd (RAPd) and healthy individuals (HC). Erythrocyte sedimentation rates (ESR) and periodontal inflamed surface area (PISA) were obtained. Serum samples were analysed for ACPA quantification using enzyme-linked immunosorbent assay (ELISA). RESULTS: Median levels (IU/mL) of ACPA (interquartile range, IQR) in RAPd, RA, Pd and HC groups were 118.58(274.51), 102.02(252.89), 78.48(132.6) and 51.67(91.31) respectively. ACPA levels were significantly higher in RAPd and RA as compared to HC group (p < 0.05). However, ACPA levels of any of the groups were not correlated with any clinical periodontal and RA parameters within the respective groups. CONCLUSIONS: At individual level, the amount of serum ACPA seem to have an increasing trend with the diseased condition in the order of RAPd > RA > Pd > HC. However, lack of any significant correlation between the serum ACPA levels with the clinical Pd and RA parameters warrants further studies to investigate the causal link between RA and Pd for such a trend. Further studies involving more inflammatory biomarkers might be useful to establish the causal link between Pd in the development and progression of RA or vice versa.

Validation of Egalitarian Education Questionnaire using Rasch Measurement Model.

This paper describes the process of assessing the unidimensionality and validity of egalitarian education (EE) items based on the Rasch measurement model. Egalitarian education was measured by a self-developed 5 EE items of Likert-scale format. The process of assessing the validity of EE items involved a collection of data from 400 Malay teachers, who are teaching in government school around peninsular of Malaysia where the measurement of construct validity for the overall EE items were established using Winsteps. Various Rasch measurement tools were utilized to demonstrate the true unidimensionality and validity measure of the EE items and in meeting the needs of the Rasch measurement model. The findings show that the validity and unidimensionality of EE items can be truly established and can satisfy the characteristics of the Rasch measurement model.

Molecular Mechanisms of Stress-Responsive Changes in Collagen and Elastin Networks in Skin.

Collagen and elastin networks make up the majority of the extracellular matrix in many organs, such as the skin. The mechanisms which are involved in the maintenance of homeostatic equilibrium of these networks are numerous, involving the regulation of genetic expression, growth factor secretion, signalling pathways, secondary messaging systems, and ion channel activity. However, many factors are capable of disrupting these pathways, which leads to an imbalance of homeostatic equilibrium. Ultimately, this leads to changes in the physical nature of skin, both functionally and cosmetically. Although various factors have been identified, including carcinogenesis, ultraviolet exposure, and mechanical stretching of skin, it was discovered that many of them affect similar components of regulatory pathways, such as fibroblasts, lysyl oxidase, and fibronectin. Additionally, it was discovered that the various regulatory pathways intersect with each other at various stages instead of working independently of each other. This review paper proposes a model which elucidates how these molecular pathways intersect with one another, and how various internal and external factors can disrupt these pathways, ultimately leading to a disruption in collagen and elastin networks.

User acceptance of a touchless sterile system to control virtual orthodontic study models.

INTRODUCTION: In this article, we present an evaluation of user acceptance of our innovative hand-gesture-based touchless sterile system for interaction with and control of a set of 3-dimensional digitized orthodontic study models using the Kinect motion-capture sensor (Microsoft, Redmond, Wash). METHODS: The system was tested on a cohort of 201 participants. Using our validated questionnaire, the participants evaluated 7 hand-gesture-based commands that allowed the user to adjust the model in size, position, and aspect and to switch the image on the screen to view the maxillary arch, the mandibular arch, or models in occlusion. Participants' responses were assessed using Rasch analysis so that their perceptions of the usefulness of the hand gestures for the commands could be directly referenced against their acceptance of the gestures. Their perceptions of the potential value of this system for cross-infection control were also evaluated. RESULTS: Most participants endorsed these commands as accurate. Our designated hand gestures for these commands were generally accepted. We also found a positive and significant correlation between our participants' level of awareness of cross infection and their endorsement to use this system in clinical practice. CONCLUSIONS: This study supports the adoption of this promising development for a sterile touch-free patient record-management system.

Carica papaya induces in vitro thrombopoietic cytokines secretion by mesenchymal stem cells and haematopoietic cells.

BACKGROUND: Use of Carica papaya leaf extracts, reported to improve thrombocyte counts in dengue patients, demands further analysis on the underlying mechanism of its thrombopoietic cytokines induction METHODS: In vitro cultures of peripheral blood leukocytes (PBL) and stem cells from human exfoliated deciduous teeth (SHED) were treated with unripe papaya pulp juice (UPJ) to evaluate its potential to induce thrombopoietic cytokines (IL-6 and SCF) RESULTS: In vitro scratch gap closure was significantly faster (p < .05) in SHED culture treated with UPJ. IL-6 concentration was significantly increased (p < .05) in SHED and PBL culture supernatant when treated with UPJ. SCF synthesis in SHED culture was also significantly increased (p < .05) when treated with UPJ CONCLUSION: In vitro upregulated synthesis of IL -6 and SCF both in PBL and SHED reveals the potential mechanism of unripe papaya to induce thrombopoietic cytokines synthesis in cells of hematopoietic and mesenchymal origin.

Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence?

BACKGROUND: The urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community. METHODS: A random sampling of living quarters (households) in the selected areas was done. 586 adults over 19 years old living in these households were clinically examined using World Health Organization (WHO) Oral Health Survey criteria 4th edition (1997). RESULTS: The overall prevalence of dental caries, periodontal disease, denture wearers and temporomandibular joint problems were 70.5%, 97.1%, 16.7% and 26%, respectively. The majority (80.5%) needed some form of dental treatment. The highest treatment needs were found in the oldest age group while the lowest were in the youngest group (19-29 years) (p = 0.000). The most prevalent periodontal problem was calculus; regardless of gender, ethnicity and age. Significantly more females (20.5%) wore prosthesis than males (11.1%) (p = 0.003). Prosthetic status and need significantly increased with age (p = 0.000). About one in four adults had Temporo-Mandibular Joint (TMJ) problems. Overall, it was surprising to note that the oral disease burden related to caries, prosthetic status and treatment need were lower in this population as compared to the national average (NOHSA, 2010). However, their periodontal disease status and treatment needs were higher compared to the national average indicating a poor oral hygiene standard. CONCLUSIONS: The evidence does not show that the overall oral disease burden and treatment needs in this urban disadvantaged adult population as higher than the national average, except for periodontal disease. The older age groups and elderly were identified as the most in need for oral health intervention and promotion. An integrated health intervention programme through a multisectoral common risk factor approach in collaboration with the Faculties of Medicine, Dentistry and other agencies is needed for the identified target group.

Time-based changes in authorship trend in research-intensive universities in Malaysia.

Considering the fact that publications serve as an important criterion to evaluate the scientific accomplishments of an individual within respective fields in academia, there has been an increasing trend to publish scientific articles whereby multiple authors are defined as primary, co-, or corresponding authors according to the roles performed. This article analyzes the authorship pattern in 4,561 papers (including 60 single-authored papers) from 1990 till 2020 of 94 academics who hold a position as professors and are affiliated with the Faculty of Medicine at three different research universities in Malaysia. Only 708 papers (15.5% of 4,561 papers) were authored by less than three authors. In 3,080 papers (67.5% of 4,561 papers), those academics appeared as coauthors. Using different years as cutoff periods, it was observed that the appearance as coauthor in the papers had steeply risen around the years: 2006, 2007, 2008 and onwards. The increased number of authors in the multi-author papers and the appearance of the selected academics as coauthors reflect the extent of boosting of collaborative research in that period which corresponds to the adoption of the "publish or perish policy" by the Ministry of Higher Education in Malaysia.

Implementation of Refugees' Inclusion in National Viral Hepatitis B and Hepatitis C Screening Campaign in Mahama Refugee Camp, Rwanda.

INTRODUCTION: The World Health Organization has called for the elimination of hepatitis B virus (HBV) and hepatitis C virus (HCV) as public health threats by 2030. In response to the United Nations High Commissioner for Refugees requests, Rwanda became the first country to include refugees in its national viral hepatitis prevention and management program in 2019. We used secondary data to describe the implementation of the first HBV and HCV screening program among refugees in Rwanda. METHODS: Rapid diagnostic tests were used to screen for HBV surface antigen (HBsAg) and HCV antibody (anti-HCV). We used routine data collected during the HBV and HCV mass screening campaign among Burundian refugees living in Mahama camp and program records to estimate the screening coverage, the prevalence of HBV and HCV, and the cost of the campaign. RESULTS: Over 28 days in February and March 2020, 26,498 unique individuals were screened for HBV and HCV, reflecting a screening coverage of 77.9% (95% confidence interval [CI]=76.5%, 78.4%). Coverage was greater than 90% among women aged 30-64 years, but younger age groups and men were less likely to be screened. On average, 946 clients were screened per day. The prevalence of anti-HCV was 1.1% (95% CI=1.0%, 1.3%), and the prevalence of HBsAg was 3.8% (95% CI=3.6%, 4.0%). We estimate that the total cost of the campaign was US$177,336.60, reflecting a per-person-screened cost of US$6.69. CONCLUSION: Conducting a mass screening was a feasible and effective strategy to achieve high screening coverage and identify refugees who were eligible for HBV and HCV treatment. This screening program in the Mahama refugee camp can serve as a reference for other refugee camps in Rwanda and elsewhere.

Examining student rating of teaching effectiveness using FACETS.

Students' evaluations of teaching staff can be considered high-stakes, as they are often used to determine promotion, reappointment, and merit pay to academics. Using Facets, the reliability and validity of one student rating questionnaire is analyzed. A total of 13,940 respondents of the Human Science Division of International Islamic University Malaysia were involved in the study. The analysis shows that the student rating questionnaire used was valid and reliable, and it allows identification of staff for the institution's prestigious teaching excellence awards, and those needing in-service training. It was found that there was no significant difference in terms of rank, age and gender of the staff. The study also shows that the majority of staff have problems keeping the class interested and getting students to participate in class activities. Faculty also hardly discussed common errors in assignments and tests.

Contribution based author categorization to calculate author performance index.

Despite the widely used author contribution criteria, unethical authorship practices such as guest, ghost, and honorary authorship remain largely unsolved. We have identified six major reasons by analyzing 78 published papers addressing unethical authorship practice. Those are lack of: (i) awareness about and (ii) compliance with authorship criteria, (iii) universal definition and scope for determining authorship, (iv) common mechanisms for positioning an author in the list, (v) quantitative measures of intellectual contribution; and (vi) pressure to publish. As a  measure to control unethical practice, we have evaluated the possibility to adopt an author categorization scheme - proposed according to the common understanding of how first-, co-, principal-, or corresponding- author is perceived. Based on an online opinion survey, the scheme was supported by ~80% of the respondents (n=370). The impact of the proposed categorization was then evaluated using a novel mathematical tool to measure "Author Performance Index (API)" that can be higher for those who might have authored more papers as primary and/or principal authors than those as coauthors. Hence, if adopted, the proposed author categorization scheme together with the API would provide a better way to evaluate the credit of an individual as a primary and principal author.

Autologous serum supplement favours in vitro regenerative paracrine factors synthesis.

OBJECTIVES: Foetal bovine serum (FBS) is often the serum supplement of choice for in vitro human cell culture. This study compares the effect of FBS and autologous human serum (AuHS) supplement in human peripheral blood mononuclear cell (PBMC) culture to prepare secretome. MATERIALS AND METHODS: The PBMC (n = 7) were cultured either in RPMI-1640 containing L-glutamine and 50 units/ml Penicillin-Streptomycin (BM) or in BM with either AuHS or FBS. Viability, proliferation and differentiation of PBMC were evaluated. Paracrine factors present in the secretomes (n = 6) were analysed using ProcartaPlex Human Cytokine panel (17 plex). Ingenuity Pathway Analysis (IPA) was performed to predict activation or inhibition of biological functions related to tissue regeneration. RESULTS: The viability of PBMC that were cultured with FBS supplement was significantly reduced at 96 h compared to those at 0 and 24 h (P < .05). While the reduction of the viability of PBMC that were cultured with AuHS supplement was not significantly different compared to those at 0 and 24 h. The FBS secretomes prepared at 24 h was found to contain significantly higher amount of EGF (P < .05) compared to that in AuHS or BM secretome. The AuHS secretomes contained significantly higher amount of HGF at 24 (P < .05) and 96 h (P < .01), and VEGF-A at 24 h (P < .05) compared to those in the FBS secretomes. SDF-1 was not detected in the FBS secretomes prepared at either 24 or 96 hours. Double immunocytochemical staining revealed a marked increase in co-localization of SDF-1 and its receptor in PBMC that were cultured with AuHS supplement compared to that cultured with FBS supplement. CONCLUSION: In secretome preparation, AuHS supplement favours synthesis of paracrine factors that are needed for regenerative therapy.

Zinc Content in Cord Blood Is Associated with Maternal Age and Parity.

At childbirth (parturition), zinc (Zn) homeostasis in cord blood (CB) can be affected by a number of factors: Zn in maternal blood, parturition related stress as well as metallothionein (MT). Both Zn and stress are known inducers of MT which is primarily involved in Zn homeostasis. This study analyzed Zn concentration [Zn], in CB components and MT-2A transcription in CB mononuclear cells (MNC) in relation to primiparous and multiparous childbirth. [Zn] in CB (n = 47) plasma, erythrocytes, and MNCs were measured by atomic absorption spectrophotometry (λ = 213.9 nm). The MT-2A transcription in CB-MNC was quantified using real-time PCR. Significant correlations (Pearson r) were found between: plasma-[Zn] and erythrocyte-[Zn] (p = 0.002); [Zn] and MT-2A messenger RNA (mRNA) (p = 0.000) in CB-MNC. Student's t tests showed higher levels of MT-2A mRNA and MNC-[Zn] in CB of older (≥25 years) compared to younger mothers (≤24 years) (p = 0.043 and p = 0.016, respectively). Significantly higher [Zn] was found in CB plasma (p = 0.017) and MNC (p = 0.041) of older primiparous compared to the younger primiparous and older multiparous mothers respectively. MT-2A mRNA in CB-MNC was significantly lower in CB of younger primiparous mothers compared to their older counterparts (p = 0.001). Path analysis showed that MNC-[Zn] (ß = 0.83; p = 0.000) had a greater influence on MT-2A mRNA expression, compared to parity (ß = -0.14; p = 0.033). Higher [Zn] in CB of primiparous mothers could be linked to higher stress during parturition, however, might be beneficial for the growth and development of the child. Together MNC-[Zn] and parity contributed ~70 % of the MT-2A transcription in CB-MNC.

Influence of Immunology Knowledge on Healthcare and Healthy Lifestyle.

Completing a course in Immunology is expected to improve health care knowledge (HCK), which in turn is anticipated to influence a healthy lifestyle (HLS), controlled use of health care services (HCS) and an awareness of emerging health care concerns (HCC). This cross-sectional study was designed to determine whether these interrelationships are empirically supported. Participants involved in this study were government servants from two ministries in Malaysia (n = 356) and university students from a local university (n = 147). Participants were selected using the non-random purposive sampling method. Data were collected using a self-developed questionnaire, which had been validated in a pilot study involving similar subjects. The questionnaire items were analyzed using Rasch analysis, SPSS version 21 and AMOS version 22. Results have shown that participants who followed a course in Immunology (CoI) had a higher primary HCK (Mean = 0.69 logit, SD = 1.29 logits) compared with those who had not (Mean = -0.27logit, SD = 1.26 logits). Overall, there were significant correlations among the HLS, the awareness of emerging HCC, and the controlled use of HCS (p <0.001). However, no significant correlations were observed between primary HCK and the other variables. However, significant positive correlation was observed between primary HCK and controlled use of HCS for the group without CoI. Path analysis showed that the awareness of emerging HCC exerted a positive influence on controlled use of HCS (ß = 0.156, p < .001) and on HLS (ß = 0.224, p < .001). These findings suggest that having CoI helps increase primary HCK which influences controlled use of HCS but does not necessarily influence HLS. Hence, introducing Immunology at various levels of education and increasing the public awareness of emerging HCC might help to improve population health en masse. In addition, further investigations on the factors affecting HLS is required to provide a better understanding on the relationship between primary HCK and HLS.

Effect of operators' experience and cement space on the marginal fit of an in-office digitally produced monolithic ceramic crown system.

OBJECTIVES: To investigate the marginal accuracy of Cerec three-dimensional (3D) all-ceramic crowns, in terms of gap and overhang, and to analyze the "operators' experience" and "cement space" effects on the marginal fit. METHOD AND MATERIALS: Thirty virtual models were obtained from a metal master die by scanning by three different operators: operator 1 (novice), operator 2 (beginner), and operator 3 (expert) (n = 10). These were further divided into two subgroups of five each, based on the cement space settings: 10 µm and 20 µm. Monolithic ceramic crowns (n = 10) were designed and milled for each virtual model and subjected to marginal gap and overhang evaluation at six designated margin locations. The influence of operators' experience and cement space on the marginal fit of the crowns was assessed by performing Box tests and MANOVA (multiple analysis of variance) (α = .05). Kruskal Wallis test was also used to analyze the interactions between the operators' experience and the cement space. RESULTS: The overall mean ± SD marginal gaps and overhangs for the Cerec 3D crowns, were 154 ± 56 µm and 74 ± 74 µm for novice, 158 ± 53 µm and 86 ± 66 µm for beginner, and 155 ± 52 µm and 47 ± 76 µm for expert, respectively. The MANOVA and Kruskal Wallis tests found no significant differences (P > .05) between the operators, in terms of gap and overhang, for all cement settings. CONCLUSION: The operator experience did not seem to influence the marginal accuracy of Cerec 3D fabricated crowns.

Influence of support group intervention on quality of life of Malaysian breast cancer survivors.

Given that breast cancer is the most prevalent form of cancer affecting Malaysian women and its low survival rate, this study investigates the possible influence of support group intervention on quality of life (QOL). It also examines the interrelationships between QOL subdomains as research has shown the influence of emotional expression on psychological and physical well-being. Rasch analysis was implemented to examine perception of QOL and the comparability of the Functional Assessment of Cancer Therapy General and Breast Cancer scales (FACT-G and FACT-B) of the Functional Assessment of Chronic Illness Therapy inventory. Results indicated that perception of QOL may be influenced by factors other than support group intervention. The FACT-G and FACT-B scales were comparable in the measurement of QOL for breast cancer, and the interrelationships between the QOL subdomains were supported. The findings of this study accentuate the importance of focusing support group interventions on improvement of emotional well-being to maintain patients' QOL despite the cancer.

Clinical pairing revisited: a study at the University of Malaya, Malaysia.

This study is part of ongoing educational research conducted by the Department of Conservative Dentistry, University of Malaya, Malaysia, to evaluate the perception of clinical pairing. A thirteen-question survey was distributed to 148 dental students after they had experienced four-handed dentistry. The objectives were to identify the advantages, disadvantages, and the acceptance of the implementation of clinical pairing from the students' point of view. The responses from the open-ended questions were categorized into six main themes (areas of interest): quality-related (Q), patient-related (PT), partner-related (P), lecturer-related (T), infection control (IC), and learning environment (L). Data analysis was done using SPSS version 18. Results indicated that the students perceived they possessed enough knowledge regarding clinical pairing. However, it was found that they still preferred to work independently as compared to working in pairs. The benefits of clinical pairing may not be viewed in the same vein by both dental students and teachers. The quality-related theme was perceived by students as the main advantage of clinical pairing, whilst the partner-related theme was perceived otherwise. The study also revealed that students may have some preconceived notions about pairing that may have impaired their acceptance. As a consequence, some reluctance was seen in their responses.