Unveiling the Impact of Electronic Cigarettes (EC) on Health: An Evidence-Based Review of EC as an Alternative to Combustible Cigarettes

Cigarette smoking has been considered a major public health concern due to its serious impact on health. However, smokers intending to quit may find long-term abstinence challenging. When smoking an electronic cigarette (EC), users can experience a sensation and taste similar to that of smoking a combustible cigarette. Therefore, manufacturers promote these products as a viable substitute for combustible cigarettes. However, several researchers report the serious health impacts experienced by EC users. Therefore, this review aims to examine the health impacts of EC use. Based on the findings of the research papers reported in the literature, the role of EC as a smoking cessation tool is unclear. Several researchers have also reported a significant association between EC usage among non-smokers at baseline and the future initiation of combustible cigarette smoking. EC use significantly impacts user health. The nicotine that is present in EC e-liquids can elevate blood pressure, resulting in blood vessel constriction and an increase in heart rate, ultimately leading the body to an ischemic condition, resulting in myocardial infarction (MI), stroke, and increased arterial stiffness. Researchers report a higher likelihood of prediabetes among EC users; its usage was associated with higher OR of having asthma attacks and higher OR of reporting depression and has an impact on birth outcomes among pregnant women. Men using EC are more likely to report erectile dysfunction than non-users. EC also has a significant impact on oral health, which includes periodontal diseases, mucosal lesions, irritation in the mouth and throat, reduced salivary flow, and an increased risk of developing cancer. The physical injury resulting from exploding EC is another health concern. The frequently burned areas included the hands, face, genitalia, and thighs. Marketers promote EC as an alternative to combustible cigarettes and a tool for quitting smoking. However, the Food and Drug Administration has not approved them for smoking cessation. EC can have a serious impact on the health of their users; hence, the findings of this paper have several implications, including the need for regulation of the sales and marketing of these products and educating the users on the impact of these products on their health and safety.

Two-Dimensional Tandem Mass Spectrometry for Biopolymer Structural Analysis

Biopolymer analysis, including proteomics and glycomics, relies heavily on the use of mass spectrometry for structural elucidation, including sequence determination. Novel methods to improve sample workup, instrument performance, and data analysis continue to be developed to address shortcomings associated with sample preparation, analysis time, data quality, and data interpretation. Here, we present a new method that couples in-source collision-induced dissociation (IS-CID) with two-dimensional tandem mass spectrometry (2D MS/MS) as a way to simplify proteomics and glycomics workflows while also providing additional insight into analyte structures over traditional MS/MS experiments. Specifically, IS-CID is employed as a gas-phase digestion method, i.e., to break down intact full-length polysaccharide or peptide ions prior to mass analysis. The resulting mixtures of oligomeric ions are analyzed by 2D-MS/MS, a technique that allows association of product ions with their precursor ions without isolation of the latter. A novel data analysis strategy is introduced to leverage the second dimension of 2D MS/MS spectra, in which stairstep patterns, representing outputs of a molecule's MSn scans, are extracted for structural interconnectivity information on the oligomer. The results demonstrate the potential applicability of 2D MS/MS strategies to the modern omics workflow and structural analysis of various classes of biopolymers.

A Bibliometric Analysis of Most Cited Papers on Vesiculobullous Oral Lesions

Aim

A well-known method for quantitatively evaluating scholarly work is bibliometric analysis. Best-cited papers raise awareness of the influential publications and patterns in the literature on a specific subject. The aim was to conduct bibliometric analysis to determine most cited articles on vesiculobullous oral lesions. This is the first study on citation analysis with respect to vesiculobullous oral lesions.

Materials and Methods

A retrospective data search was explored on December 2022 using the Scopus database. The articles were evaluated, and fundamental data for bibliometric analysis was reviewed. Standard details about the author, linked organizations, publishing year, and place of origin were noted. Statistical analysis was performed using Chi-square analysis. VOSviewer software was used to determine the bibliometric network analysis for co-occurrence among coauthors and commonly used keywords.

Results

A total of 344 articles published from 1971 to 2022 were included in the study. A total of 6680 citations and 19.41 citations per article were observed. The journal Archives of Dermatology received the most citation. There was a significant association between the number of citations and the journal type (open access vs. non-open access) (P < 0.05). Four to five highly related clusters with the help of VOSviewer software were found during co-occurrence network analysis.

Conclusions

The top 10 articles on vesiculobullous oral lesions that received the most citations were listed in detail in the present study. This will be a valuable resource for academics, clinicians, and researchers in the fields of dermatology, general pathology, oral pathology, and oral medicine.

Association of Maternal Sense of Coherence With Oral Health Behavior of Children With Special Health Care Needs: A Cross-Sectional Study

BACKGROUND

Sense of coherence (SOC) has been adopted to analyze stress coping skills as well as to find its association with health and oral health behavior. The Arabic version of SOC has not been developed and adopted in the Saudi Arabian population; furthermore, few studies have attempted to analyze the association of a mother's sense of coherence with the oral health behavior of Special Care Health Needs (SCHN) children. Hence, this study aimed to observe the association of mothers' SOC scores with their children's oral health behavior, along with the validation of the scale.

MATERIALS AND METHODS

A cross-sectional study was conducted among 170 mothers of children with SCHN. Participants were recruited from two schools in Riyadh City and one school in Makkah, respectively. Descriptive statistics, validation, reliability, factor analysis, and multinomial logistic regression were carried out using the Statistical Package for the Social Sciences (SPSS, Version 20, 2011; IBM Corp., Armonk, USA).

RESULTS

The mean SOC-13 score was 61.6 (±10.1), with a median value of 61. The SOC scale elicited a Cronbach's alpha value of 0.77. The Spearman-Brown-Brownuttman split-half reliability coefficients were found to be 0.70, respectively. The analysis confirmed a three-factor solution, which explains about 51.9% of the total variance. Mothers with higher SOC tend to utilize dental services for children [OR 5.69, P = 0.029, CI 1.19-27.02] and restrict sugary drinks to once a day [OR 9.31, P = 0.00, CI 1.95-44.44].

CONCLUSION

The reliability of the Arabic scale that was adopted after translation in the present study was found to be high; the scale confirms the three-factor solution. Mothers who scored low on the SOC scale tended to utilize less dental service for their children as well as overlook the sugary drink/day intake of the children.

Bibliometric Evaluation of the 100 Top-Cited Articles on Anesthesiology

This review is a bibliometric analysis based on anesthesiology, which is a medical specialty that deals with a patient's complete preoperative, intraoperative, and postoperative care. The objective of the review attempts to analyze the bibliometric characteristics of the 100 most top-cited articles on anesthesiology. The meta-data of the study were collected from the Core Collection of Web of Science database. A title search option was employed, and "Anesthesia" and "Anesthesiology" were typed in two different search boxes separated with the Boolean operator ''OR''. Further, the data were sorted by highest citation order; later, "article" was selected from the filter of document type, and all other types of documents were excluded. Finally, downloaded the bibliographic details of the 100 top-cited articles. VOSviewer Software (version 1.6.10 by van Eck and Waltman) was used for bibliometric network analysis for co-authors and keywords. Pearson chi-square test was used for statistical analysis. The 100 top-cited articles were published between the years of 1971 and 2018. These articles gained a maximum of 1006 to a minimum of 276 citations with an average of 384.57 cites/article. Open accessed articles gained a slightly higher ratio of citations, while more than half of the articles were published in the two leading journals of "Anesthesiology" and "Anesthesia and Analgesia". There was no statistically significant difference in both citation analysis among open and closed access journals and Anesthesia vs Non-Anesthesia journals. Thirty-six articles were published in journals not specifically related to Anesthesia. Most of the top-cited articles were contributed by the United States, whereas Surgery and General Anesthesia were the two most occurred keywords.  We conclude that all the top-cited articles in anesthesiology were contributed by authors who belonged to the developed nations and the United States outclassed the rest of the world. This bibliometric analysis would be valuable to practitioners, academics, researchers, and students to understand the dynamics of progress in the field of anesthesiology.

Assessment of Knowledge, Attitude, and Practice (KAP) Among Nurses on Oral Care for Intensive Care Unit Patients in Riyadh, Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Oral care of intensive care unit (ICU) bound individuals is essential for overall health outcomes and to prevent complications. Nurses, who are the primary caregivers, should possess adequate knowledge, attitude, and practice (KAP) in this regard to provide optimal care to these patients. There are no standardized guidelines existing at present in this regard, making the practice of oral care more challenging. There is a diversified representation of nurses who practice in this region of the world and have not been analyzed in the past. This study would like to address this paucity of data. Hence, the aim of the present study was to evaluate the knowledge, attitude, and practice of nurses regarding oral health care in ICU patients along with analyzing any existing hospital-based policies related to oral care.

MATERIALS AND METHODS

A cross-sectional study was conducted among 230 nurses practicing at ICU of the National Guard Health Affairs (NGHAs) Hospital, King Abdulaziz Medical City, in Riyadh City, Saudi Arabia. Nurses responded to 22 closed-ended questionnaires, which were adopted after content validation and reliability assessment. Descriptive statistics, chi-square analysis, and multinomial logistic regression were carried out using the Statistical Package for the Social Sciences (SPSS, Version 20, 2011; IBM Corp., Armonk, USA).

RESULTS

A total of 230 (51.1%) nurses responded. The mean working experience of 12.6 (±7.5) years and ICU experience of 10.6 (±6.7) years were observed. Seventy-four (32.2%) nurses mentioned they received oral care training for ICU patients as part of their degree. A significant variation (p=0.03) in response was observed based on qualification concerning the knowledge of nurses if improper oral care among ICU patients could cause systemic complications. Nurses with less than five years' experience were more likely to provide oral care only once per day compared to nurses with higher experience (>10 years) (OR: 2.97, p=0.00, 95% CI: 2.40-12.2).

CONCLUSION

There were certain knowledge, attitude, and practice-based questions that elicited significant differences in responses based on the qualifications and experience of the nurses. Overall, the nurses did possess fair knowledge and favorable attitudes towards oral care in these patients.

Clinical and histopathological correlation of oral malignancy and potentially malignant disorders based on a screening program at high-risk population in Tamil Nadu, India

Background

There is a high incidence of oral cancer and oral potential malignant disorder observed in southeast Asian countries such as India. Our study aimed to assess the correlation between screening and histopathological diagnosis and to predict the specificity and sensitivity of chair-side/field-based assessment of the oral lesion.

Materials and methods

A total of 40,852 subjects aged between 20 and 60 years were screened in the 1st phase of the study, suspected lesions were stained with toluidine blue (Manufactured by Otto Chemicals private limited, India) at two time points, those who stained positively during the two points were taken up for biopsy. Provisional diagnosis was later correlated with histopathological diagnosis.

Results

Subjects who underwent biopsy had a mean age of (49.01 ± 9.8 years), Leukoplakia (1.5%) was the most common lesion observed among tobacco users, interestingly it had the least correlation (39.6%) in diagnosis, Overall sensitivity (88%) and a positive predictive value (80%) was high for clinical diagnosis of OPMD in our study.

Conclusion

Correlation of clinical and histopathological diagnosis observed in our study confirms higher yield of true positives while screening in remote and vulnerable populations, which would assure a better quality of life for these subjects.

Management Protocols of the Hot Tooth-A KAP Survey among General Dentists and Endodontists

Aim

Pain management is a cornerstone in the practice of endodontics. However, optimum pain control has been a challenge in cases of symptomatic irreversible pulpitis resulting in a "hot tooth." Thus, the objective of the study is to assess the knowledge and attitude and to determine the clinical protocols of "hot tooth" management followed among general practitioners and specialists.

Materials and Methods

The KAP questionnaire contained 05 knowledge, 04 attitudes, and 06 practice-related items. The questionnaire was pretested among 10 randomly selected general dentists and endodontists. Testing-retesting was also performed. The questionnaire was self-administered and the acceptance to answer the questionnaire was considered consent to participate in the study. The sample size was calculated to be 200 with a 95% level of confidence. Descriptive statistics were used. For significance level, P < 0.05 was considered statistically significant. The Chi-square test was used for comparison between the endodontists and the general dentists.

Results

The anesthetic techniques that clinicians are most skilled in are infiltration and inferior alveolar nerve block (IANB) - 96.6% and 98.5% respectively. The intraosseous technique (IO) was the least preferred technique (6.8%). The most common supplementary injection used among both the BDS and MDS graduates was intrapulpal anesthesia. In cases of acute pulpitis, 54% of the respondents prescribed NSAIDs as a pre-anesthetic medication.

Conclusion

The current study shows that supplemental injections like intraosseous and intraligamental techniques are underutilized. Also, the benefits of preanesthetic medication for hot tooth management are not harnessed among clinicians despite the sufficient body of evidence.

Research Performance of Saudi Arabia in Endodontics: A Bibliometric Analysis

Endodontics is a subdivision of dentistry that deals with diseases and injury of the soft tissues inside the teeth. The current study aimed to investigate the bibliometric properties of endodontics publications contributed by Saudi Arabia from 2010 to 2022. The quantitative bibliometric research method was applied to the meta-data retrieved from the Web of Science on December 7, 2022. The word Endodonti* was written in the main search bar, and from the year's filter, selected starting year 2010 to the date of data collection. In the first phase, to access the global publication growth of endodontics, no country/region filter was used. After getting the summary of the global intellectual landscape, we selected Saudi Arabia from the country/region filter to analyze certain characteristics of endodontics documents. Periodical growth, accessibility modes, collaboration patterns, influential institutions, frequently used sources, international research collaboration, and most-cited documents were analyzed by using Microsoft Excel (v.16) and SPSS (v.20). The authors affiliated with Brazil contributed the highest number of documents and Saudi Arabia stood in the eighth rank in endodontics research. The growing tendency was observed in Saudi Arabia from 1.29% in 2010 to 7.60% in 2022 from a global perspective. The quality of nonopen-accessed documents was higher than open-accessed as per citation impact, similarly, the documents written on international collaboration got a higher ratio of citations compared with national collaboration. King Saud University was found the most prolific institution and the Journal of Endodontics was the most preferred source of publications. The maximum research collaboration at the international level was performed with the authors of the United States. Fifteen most-cited papers obtained 21.42% of the citations. The findings show that endodontics research in Saudi Arabia has increased significantly over the years. The research collaboration at the national level has increased, which shows that teams of national researchers in endodontics have been prepared and conducting valuable research in a national context.

Effectiveness of Organic and Inorganic Fluoridated Dentifrice on Dental Caries Progression Among Institutionalized Geriatrics: A Randomized Intervention

Purpose

To assess the effects of two commercially available organic and inorganic fluoridated dentifrices on dental caries progression amongst the institutionalized geriatric population.

Materials and methods

A total of 80 participants were selected and randomly allocated using the coin toss method into two groups, viz. Group I with subjects receiving organic fluoridated dentifrice and Group II with subjects receiving inorganic fluoridated dentifrice. Allocation concealment was done using the Sequentially-Numbered, Opaque, Sealed Envelopes (SNOSE) method. Participants were blinded using analogous dentifrice tubes. They brushed their teeth with the dentifrices twice daily using the modified Bass technique for a period of six months. Their compliance with the intervention was monitored regularly. The outcome measure was susceptibility to dental caries assessed by a cariogram. A single, trained, and calibrated investigator assessed the cariogram at baseline and after six months. Collected data were compiled and analyzed.

Results

The mean age was found to be 67.75 ± 4.1 years, 70.05 ±7.4 years among Group I and Group II participants, respectively. The results showed that the efficacy of avoiding new carious lesions was higher (75.85%) in Group I participants as compared to Group II (73.4%) participants, but no significant difference in the mean cariogram sectors was observed. However, there was a statistically significant reduction in the Streptococcus (S.) mutans and Lactobacillus colony-forming unit (CFU) (p<0.05) with a considerable increase in salivary pH in Group I participants.

Conclusion

There is a marked increase in the possibility of avoiding new carious lesions with a reduction in S. mutans and Lactobacillus CFU and an increase in saliva buffer capacity over six months of use of organic fluoride dentifrices. Thus, organic fluoride dentifrice can be an effective agent for institutionalized geriatrics in the prevention of dental caries and oral diseases.

Effectiveness of two sensory-based health education methods on oral hygiene of adolescent with autism spectrum disorders: An interventional study

AIM

This study was undertaken with an aim to evaluate the effectiveness of two sensory-based interventions namely - Visual pedagogy and Mobile based application (Brush Up) on oral health education in promoting oral health status among 13-17 year old school going adolescents with Autism Spectrum Disorder (ASD) in Chennai city.

METHODOLOGY

An interventional parallel arm study consisting of 13- to 17-year-old school going adolescent with ASD in Chennai city. Plaque Index (Sillness and Loe, 1964) and gingival index (Loe and Sillness, 1963) were assessed at baseline, 6th week and after 12th week.

RESULTS

A significant difference in plaque (p = < 0.001) and gingival scores (p = < 0.001) were seen among the groups after 6 and 12 weeks post-intervention. There was no statistically significant difference in dental plaque (p = 0.912, 1.023, 0.812) and gingival scores (p = 0.932, 0.264, 0.283) between the groups at all the timelines.

CONCLUSION

In this present study we found that both the visual cards and mobile based application (Brush Up) had significantly reduced the dental plaque and gingival scores; hence both the modalities can be used as an effective tool in educating these children and thus improve their oral hygiene.

Clinical evaluation of hydrophobic and hydrophilic pit and fissure sealants among 7-10 year old school children: a split mouth study design

Introduction: The study was done to compare the effectiveness of hydrophobic and hydrophilic pit and fissure sealant retention among 7-10 year old school children. Material and Methods: The present split mouth randomized trial was conducted on the occlusal surfaces of permanent first mandibular molars to compare and assess the retention along with other outcome variables like colour match, marginal discolouration, marginal adaptation, anatomic form, postoperative sensitivity, caries formation and surface roughness properties of Hydrophobic and Hydrophilic pit and fissure sealants at 3rd and 6th month. The data was compiled and analyzed using SPSS software and results were generated. Results: In the present study among the 50 restorations in the hydrophobic pit and fissure sealants (Group I), 48 (96%) restorations were retained at the end of third month and 45(90%) were retained at the end of sixth month. Among the 50 restorations in the hydrophilic pit and fissure sealants (Group II), 49(98%) restorations were retained at the end of third month, and 46(92%) at the end of sixth month were retained. There was no significant difference in the number of completely retained restorations at the end of six months (p = 1.00) among both the groups. The assessment of all the other outcome variables between both the interventions showed that the difference was not statistically significant. Conclusion: The study concluded that the hydrophilic pit and fissure sealant was similar to the hydrophobic pit and fissure sealant in terms of retention, colour match, marginal discolouration, marginal adaptation, anatomic form and surface roughness properties with.   Keywords Pit and fissure sealants; Moisture tolerant; 7-10 years; School children; Mandibular teeth.

Multiphase CT Angiography: A Useful Technique in Acute Stroke Imaging-Collaterals and Beyond

Multiphase CTA offers several important advantages over the traditional single-phase CTA technique in acute ischemic stroke, including improved detection of large-vessel occlusion, improved characterization of collateral status, improved tolerance of patient motion and poor hemodynamics, and higher interrater reliability. These benefits are gleaned at little additional cost in terms of time, risk to the patient, and capital expense. Existing data suggest that there are important benefits to using multiphase CTA in lieu of single-phase CTA in the initial vessel assessment of patients with acute stroke.

Barriers to utilisation of dental care services among children with special needs: A systematic review

Background

Disabled population accounts for 2.86 Crore of total Indian population. Among these 27.4% of population consists of children within age group of age 0 to 19 years. Studies have shown oral health status of children with special needs is lower than children without special needs. Though there are various attributing factors, access to dental care delivery and difficulties faced during dental treatment delivery are of major concern. Therefore the aim of this systematic review was set to assess the barriers faced by children with special needs during utilization of dental services; through caregiver's perception.

Materials and Methods

For this review MEDLINE, EBSCO, COCHRANE, EMBASE and Google Scholar were the electronic data bases searched based on the PICO. PRISMA guidelines were followed for final inclusion of articles.

Results

The search generated a total of 259 articles from five different electronic bases: PUBMED, EMBASE, EBSCO, COCHRANE and GOOGLE SCHOLAR. Based on inclusion criteria, 7 articles made it to final analysis. All the 7 studies reported that dentist were unwilling to treat children with special needs as a major barrier followed by fear towards dentist by the children with special needs.

Conclusion

The cross sectional studies of this review were assessed for quality using a modified Newcastle Ottawa Scale, proposed by Egger et al. in 2003. Even though the available literature forms a lower standard of evidence, further evaluation of barriers are recommended using better designed studies to substantiate the in equal access to healthcare facilities by these marginalized population.

Evaluation of mast cells and burning sensation in various stages of Oral Submucous Fibrosis

Background

Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder and burning sensation is the initial complaint among these patients. Scientific literature has established that mast cells play a major role in various inflammatory disorders. However, OSMF being an inflammatory disorder, the role of mast cells is yet to be established. Hence the aim of this study was to evaluate mast cells and burning sensation in various stages of Oral Submucous Fibrosis.

Methods

The study population comprised of forty subjects, thirty were clinically confirmed cases of OSMF and ten healthy individuals served as control. A complete history and clinical examination followed by an incisional biopsy was performed. Samples obtained were subjected to routine histopathological examination and mast cells evaluation.

Results

Mean number of total mast cells in Stage I, II and III OSMF were 8.5 ± 0.7, 11.31 ± 8.8 and 24.7 ± 21.2 respectively. There was a significant difference in total mast cell count between cases and controls. Degranulated mast cells was a significant predictor (p = 0.028), indicating role in clinical staging of OSMF. Degranulated mast cells had a significant role and was a positive predictor (B = 0.763, OR 2.145[95%CI 1.055-4.630]) at moderate levels of burning sensation. A significant difference (p = 0.029) in burning sensation across histopathological grades was also observed in the study.

Conclusion

Degranulated mast cells were found to have a significant influence in mild to moderate levels of burning sensation among OSMF patients. Role of degranulated mast cells were also found to be significant in various clinical stages of OSMF.

Tobacco - Use Prevalence, Exposure, Attitudes, Behaviour/Cessation, Curriculum among Health Professional Students in Mangalore City, Karnataka, India

Background

Tobacco use is one of the leading preventable causes of premature death, disease and disability around the world. Medical and Dental graduates have an important role to play in tobacco cessation and prevention. Hence, the present study was undertaken to assess the tobacco use prevalence, practice, attitudes towards policy making and curriculum in medical and dental interns (house surgeons).

Methods

A cross sectional questionnaire based survey was carried out among interns in all the medical and dental colleges of Mangalore city. Global Health Professional Students Survey (GHPSS) questionnaire given by the Center for Disease Control (CDC) was modified and adopted.

Results

In the present study among 512 interns, 263 and 249 interns belonged to dental and medical fraternity respectively The prevalence of current smokers of cigarette was significantly higher among medical interns (32.1%) than the dental interns (20.2%), whereas no significant difference was evident amongst the dental (44.9%) and medical (41.8%) interns under the ever smokers category. A significant difference (p < 0.001) in the attitude of dental and medical college interns was observed towards tobacco use, policy making and their knowledge about the curriculum.

Conclusion

This study shows health professionals lacking specific training in tobacco counseling, all of which indicate a need for including a standardized syllabus to train health professionals in medical and dental schools related to tobacco its ill-effects, cessation and policy making.

Ion Manipulation in Open Air Using 3D-Printed Electrodes

Ambient ionization techniques provide a way to sample materials via creation of ions in the air. However, transferring and focusing of these ions is typically done in the reduced pressure environment of the mass spectrometer. Spray-based ambient ionization sources require relatively large distances between the source and mass spectrometer inlet for effective desolvation, resulting in a small fraction of the ions being collected. To increase the efficiency of ion transfer from atmosphere to vacuum, 3D-printed focusing devices made of conductive carbon nanotube doped polymers have been designed and evaluated for ion focusing in air. Three main classes of electrodes are considered: (i) conic section electrodes (conical, ellipsoidal, and cylindrical), (ii) simple conductive and non-conductive apertures, and (iii) electrodes with complex geometries (straight, chicane, and curved). Simulations of ion trajectories performed using the statistical diffusion simulation (SDS) model in SIMION showed a measure of agreement with experiment. Cross-sectional images of ion beams were captured using an ion detecting charge-coupled device (IonCCD). After optimization, the best arrangements of electrodes were coupled to an Agilent Ultivo triple quadrupole to record mass spectra. Observations suggest that electrode geometry strongly influences ion trajectories in air. Non-conductive electrodes also assisted in focusing, due to charge buildup from ion deposition. We also observed minimal spreading of the ion packet after exiting the focusing electrodes indicating that atmospheric collisions do not reduce collimation of the beam. The study suggests that high pressures need not be viewed as a hindrance to ion transport, but as a potentially useful force.

Screening of the Suzuki Cross-Coupling Reaction Using Desorption Electrospray Ionization in High-Throughput and in Leidenfrost Droplet Experiments

Suzuki cross-coupling is a widely performed reaction, typically using metal catalysts under heated conditions. Acceleration of the Suzuki cross-coupling reaction has been previously explored in microdroplets using desorption electrospray ionization mass spectrometry (DESI-MS). Building upon previous work, presented here is the use of a high-throughput DESI-MS screening system to identify optimal reaction conditions. Multiple reagents, bases, and stoichiometries were screened using the automated system at rates that approach 10,000 reaction mixture systems per hour. The DESI-MS system utilizes reaction acceleration in microdroplets to allow rapid screening. The results of screening of an array of reaction mixtures using this technique are presented as product ion images via standard MS imaging software, facilitating quick readout. Instructive comparisons are provided with another method of generating droplets for reaction acceleration-the Leidenfrost technique. Acceleration factors greater than 200 were measured for brominated substrates, paralleling the DESI-MS results. Acceleration factors dropped to near unity with highly substituted pyridines, attributable to a steric effect. The reaction proceeded in the absence of a base in Leidenfrost droplets although no product formation was seen without base in the bulk or in the DESI-MS screening experiments. These differences between Leidenfrost chemistry and the bulk and in droplets formed in high-throughput DESI are tentatively attributed to extremes of pH associated with the surfaces of Leidenfrost droplets.

Reaction Acceleration in Electrospray Droplets: Size, Distance, and Surfactant Effects

Phenylhydrazone formation from isatin is used to examine the effects on the reaction rate of (i) electrospray emitter distance from the mass spectrometer (MS) inlet, (ii) emitter tip diameter, and (iii) presence of surfactant. Reaction rates are characterized through measurement of conversion ratios. It is found that there is an increase in the conversion ratio as (i) the electrospray source is moved further from the inlet of the mass spectrometer, (ii) smaller sprayer diameters are used, and (iii) when surfactants are present. Each of these experimental operations is associated with an increase in reaction rate and with a decrease in average droplet sizes. The size measurements are made using super resolution microscopy from the "splash" on a collector surface produced by a fluorescent marker sprayed using conditions similar to those used for the reaction mixture. This measurement showed that droplets undergo significant evaporation as a function of distance of flight, thereby increasing their surface to volume ratios. Similarly, the effect of nanoelectrospray emitter size on conversion ratio is also found to be associated with changes in droplet size for which a 4 to 10 times increase in reaction rate is seen using tip diameters ranging from 20 μm down to 1 μm. Finally, the effects of surfactants in producing smaller droplets with corresponding large increases in reaction rate are demonstrated by splash microscopy. These findings point to reaction acceleration being strongly associated with reactions at the surfaces of microdroplets.

Effectiveness of musical toothbrush on oral debris and gingival bleeding among 6-10-year-old children: A randomized controlled trial

Context

Motivation serves to be an integral part of health promotion to children at the learning phase of their life.

Aim

Evaluation of the effectiveness of musical toothbrush over regular toothbrush in the debris and gingival bleeding scores among children.

Settings and Design

This was a single-blinded parallel, randomized controlled trial conducted among 6-10-year-old schoolchildren in Chennai.

Methods

One hundred participants with allocation ratio of 1:1 were assigned to musical and regular toothbrush group by simple randomization. After baseline evaluation (T0) of Debris Index-Simplified (DI-S) and Gingival Bleeding Index (GBI), outcome variables were assessed for a period of 3 months (T1, T2, and T3).

Statistical Analysis Used

Friedman test and Mann-Whitney statistical test were used to compare the outcome variables within and across the two groups.

Results

Thirty-two boys and 68 girls (mean age: 8.53 years) participated in the study. Statistically significant difference was seen in DI-S score among musical toothbrush group (mean: 0.50 [T3] and GBI score: 8.18% [T3]) when compared to regular toothbrush group (mean: 1.59 [T3] and GBI score: 23.54 [T3]) at the end of the 3^rd month.

Conclusion

Although both the musical and regular toothbrushes effectively reduced the DI-S and GBI scores, former showed effective change among children when compared to the latter.

Oral health taking a back seat at primary health centers of Bangalore urban district, India - A situation analysis

Background:

Even though a dramatic change in pattern of oral diseases has been observed at a global level, oral health equality still remains as a dream to achieve. Studies have documented disparities in delivery and utilisation of oral health services among urban, suburban, and rural regions of India. Therefore, the aim of the present study was to conduct a situation analysis at PHCs to understand resource availability and oral health seeking behavior from perspective of medical officers of Bangalore City, India.

Materials and Methods:

A structured questionnaire was validated using Lawshe technique and was given across medical and dental officers present at 65 Primary Health Centers. Data collected was entered in Excel sheet and further subjected to Descriptive statistics using SPSS version 20.

Results:

Among 65 PHCs, about 18 PHCs had dental officers posted. In those 18 PHCs only 2 were maintained by the state government and others by Private dental college. In the 65 PHCs , only one PHC maintained a separate register for dental complaints, whereas 48 of them had maintained a combined register for both general and oral complaints. With regard to the management of tooth-related complaints, about 48 of medical officers reported that they dispense the patients affected by providing antibiotics and pain killers (analgesics) and recall, whereas 12 medical officers reported that they get the existing condition treated and refer and the rest refer the patients directly to hospitals. clinics.

Conclusion:

The results highlight the challenges experienced by nondental primary-care providers and their views on access to oral health to be improved. It is high time that the state government should put oral health policies into practice by recruiting adequate dental officers and providing separate dental infrastructure at the urban PHCs for better utilisation of dental care services.

Remineralizing potential of CPP-ACP in white spot lesions - A systematic review

Objective

The aim of this systematic review was to assess the long term remineralizing potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) only in paste form compared with fluoride varnish, and or placebo in both naturally occurring and post-orthodontic white spot lesions in vivo.

Data Sources

The literature search covered the electronic databases: PubMed and Google scholar from 2005-2016. Only articles published in English were included. Randomized control trials in which CPP-ACP delivered by paste form were included. All studies which met inclusion criteria underwent two independent reviews.

Study Selection

Two ninety five articles were identified from the search after excluding duplications. Abstracts of forty one articles were reviewed independently. Twenty nine articles were excluded after reading abstract. Full text articles were retrieved for fifteen relevant studies. After reviewing articles independently, three articles were excluded after full text reading. Finally twelve studies were selected based on the eligibility criteria. The remineralizing effect of CPP-ACP were compared with placebo and fluoridated toothpaste and fluoride varnish in randomized control trial.

Conclusion

A high level evidence of remineralizing potential of CPP-ACP on naturally occurring white spot lesion and WSL post orthodontic treatment was found in comparison with placebo/fluoridated toothpaste and fluoride varnish without any statistically significant difference. Well-designed RCTs are, therefore, required to improve the level of evidence in this area.

An EEG coherence-based analysis approach for investigating response conflict processes in 7 and 9-year old children

Understanding the development of the brain's neural networks can reveal critical insights into the cognitive changes that occur from infancy to late childhood. Behavioural metrics including: task accuracy, stimuli recognition, and reaction time show dramatic changes over childhood. In this study we investigated response control using the Erikson Flanker task. In a dataset of 45 EEG recordings, we calculated spectral coherence to measure connectivity between all possible electrode pairs. Coherence measures were performed on two different trial conditions -congruent (where there is no response conflict) and incongruent (where response conflict is induced). The increase in incongruent coherence compared to the congruent was investigated for each electrode pair over 45 healthy subjects aged seven years. The same calculation was then performed on the same group of subjects two years later when they were aged nine years. The results revealed that at age seven years, increased coherence was detected in the left prefrontal to right and left parieto-occipital - i.e. an anatomical region located between the parietal and occipital lobes - within theta band. No increase was found for the older group-at age nine years- which may indicate cognitive development in conflict processing mechanism.

Oral Health and Brain Injury: Causal or Casual Relation?

Background

To systematically review the current literature investigating the association between oral health and acquired brain injury.

Methods

A structured search strategy was applied to PubMed, Embase, Web of Science, and CENTRAL electronic databases until March 2017 by 2 independent reviewers. The preferred reporting items for systematic review and meta-analysis guidelines were used for systematic review.

Results

Even though the objective was to assess the association between oral health and acquired brain injury, eligible studies focused solely on different forms of stroke and stroke subtypes. Stroke prediction was associated with various factors such as number of teeth, periodontal conditions (even after controlling for confounding factors), clinical attachment loss, antibody levels to Aggregatibacter actinomycetemcomitans and Prevotella intermedia. The literature showed no consensus on the possible association between gingivitis and stroke. Patients with stroke generally had poorer oral hygiene practices and oral health. Dental prophylaxis and professional intervention reduced the incidence of stroke.

Conclusions

Overall, oral health and stroke were related. Periodontitis and tooth loss were independently associated with stroke. However, prevention and timely intervention may reduce the risk of stroke. Stroke was the main cerebral lesion studied in the literature, with almost no publications on other brain lesions.

Sizing sub-diffraction limit electrosprayed droplets by structured illumination microscopy

Electrosprayed droplets are widely studied for their role in the formation of ions at atmospheric pressure.

Accelerated multi-reagent copper catalysed coupling reactions in micro droplets and thin films

Electrospray (ES) and paper spray (PS) mass spectrometry were used to create confined liquid volumes in which accelerated air and water sensitive, heterogeneous, copper catalysed C–O and C–N coupling reactions occur.

Response conflict processes' classification in 7 and 9 year old children using EEG brain connectivity measures

Investigating cognitive development of children poses interesting challenges pertaining to emergence of children's' ability to think and understand. Psychological tasks that involve conflict, like the Flanker task, are widely used to understand development of response conflict processes. In this study, EEG signals were used to examine the coherence and imaginary part of coherency within the delta, theta, alpha and beta bands across different conditions of the Flanker task. Longitudinal data were collected from a group of typically developing children at ages of seven and nine. We found that the imaginary part of coherency was more helpful in distinguishing between stimuli - alpha and beta bands resulted in 90.90% classification rate in seven year old children. The beta and theta bands were found to be more effective for stimuli classification in nine year old children - more than 84.09% classification accuracy was achieved.

Notch1 endocytosis is induced by ligand and is required for signal transduction

The Notch signalling pathway is widely utilised during embryogenesis in situations where cell-cell interactions are important for cell fate specification and differentiation. DSL ligand endocytosis into the ligand-expressing cell is an important aspect of Notch signalling because it is thought to supply the force needed to separate the Notch heterodimer to initiate signal transduction. A functional role for receptor endocytosis during Notch signal transduction is more controversial. Here we have used live-cell imaging to examine trafficking of the Notch1 receptor in response to ligand binding. Contact with cells expressing ligands induced internalisation and intracellular trafficking of Notch1. Notch1 endocytosis was accompanied by transendocytosis of ligand into the Notch1-expressing signal-receiving cell. Ligand caused Notch1 endocytosis into SARA-positive endosomes in a manner dependent on clathrin and dynamin function. Moreover, inhibition of endocytosis in the receptor-expressing cell impaired ligand-induced Notch1 signalling. Our findings resolve conflicting observations from mammalian and Drosophila studies by demonstrating that ligand-dependent activation of Notch1 signalling requires receptor endocytosis. Endocytosis of Notch1 may provide a force on the ligand:receptor complex that is important for potent signal transduction.

Intestinal transplant registry report: global activity and trends

The Registry has gathered information on intestine transplantation (IT) since 1985. During this time, individual centers have reported progress but small case volumes potentially limit the generalizability of this information. The present study was undertaken to examine recent global IT activity. Activity was assessed with descriptive statistics, Kaplan-Meier survival curves and a multiple variable analysis. Eighty-two programs reported 2887 transplants in 2699 patients. Regional practices and outcomes are now similar worldwide. Current actuarial patient survival rates are 76%, 56% and 43% at 1, 5 and 10 years, respectively. Rates of graft loss beyond 1 year have not improved. Grafts that included a colon segment had better function. Waiting at home for IT, the use of induction immune-suppression therapy, inclusion of a liver component and maintenance therapy with rapamycin were associated with better graft survival. Outcomes of IT have modestly improved over the past decade. Case volumes have recently declined. Identifying the root reasons for late graft loss is difficult due to the low case volumes at most centers. The high participation rate in the Registry provides unique opportunities to study these issues.

Notch4 reveals a novel mechanism regulating Notch signal transduction

Notch4 is a divergent member of the Notch family of receptors that is primarily expressed in the vasculature. Its expression implies an important role for Notch4 in the vasculature; however, mice homozygous for the Notch4(d1) knockout allele are viable. Since little is known about the role of Notch4 in the vasculature and how it functions, we further investigated Notch4 in mice and in cultured cells. We found that the Notch4(d1) allele is not null as it expresses a truncated transcript encoding most of the NOTCH4 extracellular domain. In cultured cells, NOTCH4 did not signal in response to ligand. Moreover, NOTCH4 inhibited signalling from the NOTCH1 receptor. This is the first report of cis-inhibition of signalling by another Notch receptor. The NOTCH4 extracellular domain also inhibits NOTCH1 signalling when expressed in cis, raising the possibility that reported Notch4 phenotypes may not be due to loss of NOTCH4 function. To better address the role of NOTCH4 in vivo, we generated a Notch4 null mouse in which the entire coding region was deleted. Notch4 null mice exhibited slightly delayed vessel growth in the retina, consistent with our novel finding that NOTCH4 protein is expressed in the newly formed vasculature. These findings indicate a role of NOTCH4 in fine-tuning the forming vascular plexus.

Defluoridation techniques implemented by the government of karnataka, india - the current situation

INTRODUCTION

Karnataka is an Indian state which has regions with endemic fluorosis.

OBJECTIVE

To assess the various defluoridation techniques and units implemented by the Government of Karnataka, along with the cost of installation, maintenance and repair, to mitigate the problem of fluorosis.

METHODS

Information regarding the various defluoridation units was obtained from the Panchyath Raj Engineering office before they were visited. Local authorities and residents were interviewed regarding the reasons behind the success or failure of the units.

RESULTS

Of the 100 reverse osmosis units installed, 77% are defunct, only one of the two state-of-the-art solar-based technique units is currently functioning but none of the activated alumina or Nalgonda technique units.

CONCLUSION

Defluoridation units suitable for Indian conditions and operation by unskilled villagers have yet to be developed.

Evaluation of cranial capacity by mustard seed technique

The volume of the cranium is used as a rough indicator of the size of the brain. In the present study Breitinger's mustard seeds technique was applied for the measurement of cranial capacity. Grossly normal 75 male skulls of Gujarat population were studied at Kesar SAL Medical College, Ahmedabad (Gujarat) in the year 2010. The mean cranial capacity among the study group was recorded to be 1256 cc with a minimum of 1110 cc and maximum of 1430 cc. The results were compared with the similar studies by different authors from different geographical areas.