Mass spectrometry-based proteomics profiling of dogs with and without oral diseases: a systematic review

BACKGROUND

Understanding the distinct proteomics profiles in dogs' oral biofluids enhances diagnostic and therapeutic insights for canine oral diseases, fostering cross-species translational research in dentistry and medicine. This study aimed to conduct a systematic review to investigate the similarities and differences between the oral biofluids' proteomics profile of dogs with and without oral diseases.

METHODS

PubMed, Web of Science, and Scopus were searched with no restrictions on publication language or year to address the following focused question: "What is the proteome signature of healthy versus diseased (oral) dogs' biofluids?" Gene Ontology enrichment and the Kyoto Encyclopedia of Genes and Genomes pathway analyses of the most abundant proteins were performed. Moreover, protein-protein interaction analysis was conducted. The risk of bias (RoB) among the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data.

RESULTS

In healthy dogs, the proteomic analysis identified 5,451 proteins, with 137 being the most abundant, predominantly associated with 'innate immune response'. Dogs with oral diseases displayed 6,470 proteins, with distinct associations: 'defense response to bacterium' (periodontal diseases), 'negative regulation of transcription' (dental calculus), and 'positive regulation of transcription' (oral tumors). Clustering revealed significant protein clusters in each case, emphasizing the diverse molecular profiles in health and oral diseases. Only six studies were provided to the JBI tool, as they encompassed case-control evaluations that compared healthy dogs to dogs with oral disease(s). All included studies were found to have low RoB (high quality).

CONCLUSION

Significant differences in the proteomics profiles of oral biofluids between dogs with and without oral diseases were found. The synergy of animal proteomics and bioinformatics offers a promising avenue for cross-species research, despite persistent challenges in result validation.

Salivary protein homology between humans and dogs: Mass spectrometry-based proteomics analysis

OBJECTIVE

This benchmark study aimed to investigate sex-related differences based on the identification and characterization of the salivary proteome of healthy male and female dogs using mass spectrometry (MS) technique and a homology-driven approach to analyze salivary proteins in both human and dog species utilizing protein sequence alignment technique.

METHODS

Unstimulated whole saliva was collected from 10 healthy Beagles. After processing the samples and determining the total protein content, in-solution protein digestion was performed involving denaturation, reduction of disulfide bonds, alkylation, and removal of interfering compounds. Samples were analyzed using LC-ESI-MS/MS.

RESULTS

LC-ESI-MS/MS analysis identified 327 and 341 unique proteins in male and female dog saliva, respectively, of which 318 (97.25 %) in male dogs and 326 (95.60 %) in female dogs were characterized. Abundant shared proteins included albumin, BPI fold-containing family A member 2, and VWFD domain-containing protein. A notable uncharacterized protein, VWFD domain-containing protein, was among the most abundant in both sexes. Comparative analysis of 69 abundant shared proteins indicated an upregulation of CES5A, EFHD, GC, IGHM, LOC100653049, KRT10, LCP1, PGD, TPI1 in male dogs, while LOC100855593 was upregulated in female dogs. In total, 84 % (n = 229/274) and 86 % (n = 235/275) salivary proteins identified in male and female dogs, respectively, were homologous to human proteins, with an overall homology of 86 % (n = 364/423), including 15 with 100 % homology.

CONCLUSION

The study revealed clear differences in the salivary proteomics profile of healthy male and female dogs. However, most of the salivary proteins in both male and female dogs showed homology with human salivary proteins.

CLINICAL RELEVANCE

The identification of unique salivary proteome profiles in male and female dogs, coupled with substantial homology to human proteins, provides promising biomarkers for health assessment, highlighting its clinical significance for diagnostics and therapeutic exploration not only in veterinary and human dentistry, but across mammalian species.

Polymorphism of salivary proteins and risk of periodontal diseases: A systematic review and meta-analysis of clinical studies

OBJECTIVES

The present systematic review and meta-analysis aimed to assess the association between salivary protein polymorphisms and the risk of periodontal diseases (PD).

DATA

The review incorporated cross-sectional, case-control, retrospective/prospective cohort, and randomized controlled trials assessing the influence of salivary protein polymorphisms on the risk of PD development were included in this review.

SOURCES

A thorough literature search was conducted across electronic databases, namely PubMed, Scopus, Embase, and Web of Science, without any restrictions on publication language and year.

STUDY SELECTION

A total of 168 studies were identified, of which 19 were eligible for inclusion. The risk of bias (RoB) assessment of the included studies was conducted at the methodological level.

RESULTS

A total of 16 studies were included. Polymorphism in the gene encoding TNF-α was found to be protective against gingivitis, while those encoding IL-1α and IL-1β were associated with developing gingivitis. Of the 42 proteins investigated, various gene polymorphisms were identified as protective or risk factors for periodontitis. Protective genes include CFH, DNMT1, OPRM1, and TLR9. Conversely, certain salivary protein genes (e.g., CRP, ERN1, FAM5C, IDH2, LTA, TET2, MPA, NLRP3, TLR4) were associated with periodontitis risk. Notably, IL6, MMP9, and MUC7 genes showed no association with PD, while MMP13 was linked to early implant loss. Overall, the meta-analysis found a statistically significant association between salivary proteins' polymorphisms and risk of PD.

CONCLUSIONS

Salivary protein polymorphisms significantly influence PD, revealing protective and risk-associated genotypes. Despite limitations, findings suggest therapeutic targets, emphasizing the complex genetics-periodontal health interplay.

CLINICAL SIGNIFICANCE

This study unveils salivary protein polymorphisms as pivotal factors in PD. Protective genes including CFH and TLR9, and risk-associated genes including CRP and TLR4, indicate a genetic basis for PD susceptibility.

Mass spectrometry-based proteomic approaches for salivary protein biomarkers discovery and dental caries diagnosis: A critical review

Dental caries is a multifactorial chronic disease resulting from the intricate interplay among acid-generating bacteria, fermentable carbohydrates, and several host factors such as saliva. Saliva comprises several proteins which could be utilized as biomarkers for caries prevention, diagnosis, and prognosis. Mass spectrometry-based salivary proteomics approaches, owing to their sensitivity, provide the opportunity to investigate and unveil crucial cariogenic pathogen activity and host indicators and may demonstrate clinically relevant biomarkers to improve caries diagnosis and management. The present review outlines the published literature of human clinical proteomics investigations on caries and extensively elucidates frequently reported salivary proteins as biomarkers. This review also discusses important aspects while designing an experimental proteomics workflow. The protein-protein interactions and the clinical relevance of salivary proteins as biomarkers for caries, together with uninvestigated domains of the discipline are also discussed critically.

Salivary Proteins as Dental Caries Biomarkers: A Systematic Review

Salivary proteins play an important role in repairing mechanisms of damaged tissues and the maintenance of oral health. However, there is a dearth of information in the literature regarding the concentrations of salivary proteins in caries-free (CF) and caries-active (CA) subjects. Hence, this systematic review was conducted to update our previous systematic review published in 2013 that aimed to assess the association between caries and salivary proteins by comparing CF and CA individuals. Thereby, evaluating the possibility of whether salivary proteins can be regarded as biomarkers for caries. An extensive search of studies was conducted using PubMed, EMBASE, Clarivate Analytics' Web of Science, and Elsevier's Scopus between July 2012 and January 2022, without any language restriction. Manual searching in Google Scholar and evaluation of bibliographies of the included studies were also undertaken. The Newcastle-Ottawa Scale was used to assess the risk of bias (RoB) within the included studies. Of 22 included studies, 1,551 human subjects (range: 30-213 participants) were recruited, of which 848 individuals (54.7%) were CA and 703 (45.3%) were CF. Regarding the utilization of DMFT as the caries index, high variability was observed across different articles. A statistically significant increase in the salivary levels of alpha-amylase, acidic proline-rich protein-1, histatin-5, lactoperoxidase, and mucin-1 was found in CA patients, while the salivary levels of carbonic anhydrase 6, proteinase-3, and statherin were observed to be significantly increased in CF subjects. Conflicting results were found regarding the salivary levels of immunoglobulin A and total proteins among CA and CF subjects. The included studies were categorized as low RoB (n = 15), medium RoB (n = 4), and high RoB (n = 3). Due to significant heterogeneity among the included studies, no meta-analysis could be performed. In conclusion, the salivary levels of protein(s) might be a useful biomarker for caries diagnosis, especially alpha-amylase, acidic proline-rich protein-1, histatin-5, lactoperoxidase, mucin-1, carbonic anhydrase 6, proteinase-3, and statherin. However, their diagnostic value must be verified by large-scale prospective studies.

Current State and Challenges of the Global Outcomes of Dental Caries Research in the Meta-Omics Era

Despite significant healthcare advances in the 21st century, the exact etiology of dental caries remains unsolved. The past two decades have witnessed a tremendous growth in our understanding of dental caries amid the advent of revolutionary omics technologies. Accordingly, a consensus has been reached that dental caries is a community-scale metabolic disorder, and its etiology is beyond a single causative organism. This conclusion was based on a variety of microbiome studies following the flow of information along the central dogma of biology from genomic data to the end products of metabolism. These studies were facilitated by the unprecedented growth of the next- generation sequencing tools and omics techniques, such as metagenomics and metatranscriptomics, to estimate the community composition of oral microbiome and its functional potential. Furthermore, the rapidly evolving proteomics and metabolomics platforms, including nuclear magnetic resonance spectroscopy and/or mass spectrometry coupled with chromatography, have enabled precise quantification of the translational outcomes. Although the majority supports ‘conserved functional changes’ as indicators of dysbiosis, it remains unclear how caries dynamics impact the microbiota functions and vice versa, over the course of disease onset and progression. What compounds the situation is the host-microbiota crosstalk. Genome-wide association studies have been undertaken to elucidate the interaction of host genetic variation with the microbiome. However, these studies are challenged by the complex interaction of host genetics and environmental factors. All these complementary approaches need to be orchestrated to capture the key players in this multifactorial disease. Herein, we critically review the milestones in caries research focusing on the state-of-art singular and integrative omics studies, supplemented with a bibliographic network analysis to address the oral microbiome, the host factors, and their interactions. Additionally, we highlight gaps in the dental literature and shed light on critical future research questions and study designs that could unravel the complexities of dental caries, the most globally widespread disease.

Small molecules of herbal origin for osteoarthritis treatment: in vitro and in vivo evidence

Osteoarthritis (OA) is one of the most common musculoskeletal degenerative diseases and contributes to heavy socioeconomic burden. Current pharmacological and conventional non-pharmacological therapies aim at relieving the symptoms like pain and disability rather than modifying the underlying disease. Surgical treatment and ultimately joint replacement arthroplasty are indicated in advanced stages of OA. Since the underlying mechanisms of OA onset and progression have not been fully elucidated yet, the development of novel therapeutics to prevent, halt, or reverse the disease is laborious. Recently, small molecules of herbal origin have been reported to show potent anti-inflammatory, anti-catabolic, and anabolic effects, implying their potential for treatment of OA. Herein, the molecular mechanisms of these small molecules, their effect on physiological or pathological signaling pathways, the advancement of the extraction methods, and their potential clinical translation based on in vitro and in vivo evidence are comprehensively reviewed.

Risk analysis of factors in clinical anxiety among undergraduate and postgraduate students in dentistry

BACKGROUND

When anxiety is persistent among dental students, the consequence could be poor academic performance, ill health, lack of empathy, and exhaustion.

OBJECTIVE

This study aimed to determine the level of anxiety along with anxiety-provoking factors among clinical dental students.

METHODS

This study included dental undergraduate and postgraduate clinical students from a public university. A modified version of the self-administered Moss and McManus questionnaire, which consisted of 50 items, was utilized to evaluate the levels of anxiety. The results were analyzed using SPSS ® version 24. The significance level was set at p <  0.05.

RESULTS

Within 180 participants, 140 (77.77%) were undergraduate students, while 40 (22.22%) were postgraduate dental students. Overall, the top clinical anxiety-provoking factor included failure to pass the final examination, whereas the least clinical anxiety-provoking element was communicating with the opposite gender. Significant differences existed among male and female participants in the seven anxiety-provoking factors among the participants namely dealing with elderly patients, fail to pass finals, arresting post-extraction bleeding, patients asking difficult questions, fear of accidental pulp exposure, dealing with a child or non-cooperative patient, and fear of taking an incorrect impression. Postgraduate students showed lower anxiety scores in various clinical tasks as compared to undergraduate students.

CONCLUSIONS

Postgraduate dental students share largely the same perspectives with undergraduate dental students on the clinical anxiety-provoking situations with slight variations. Being the future healthcare providers, dental students must learn techniques to help them manage their dental anxiety and fear as well as deal with anxiety related to treating patients.

Risk factors associated with the mortality rate of oral squamous cell carcinoma patients: A 10-year retrospective study

In Malaysia, oral cancer is very common and the reported 5-year survival of such patients is nearly 50% after treatment with surgery and radiotherapy, much lower than most of the developed countries. This study aimed to investigate the socio-demographic and clinicopathological parameters that influence the mortality rate of the patients suffering from oral squamous cell carcinoma (OSCC) in the Kelantanse population.In this retrospective study, data regarding socio-demographic, clinicopathological factors, and treatment outcome associated with OSCC were gathered from the archives of the medical records office of Hospital Universiti Sains Malaysia. For statistical analysis, simple and multiple logistic regression were performed. The significance level was set to P < .25.A total of 211 OSCC cases were registered in Hospital Universiti Sains Malaysia from January 1, 2000 to December 31, 2018. Majority of them were male (57.82%), non-smoker (54.97%), non-alcohol consumer (91.94%), and non-betel quid chewer (93.83%) Malay (60.66%) patients. The tongue was the most commonly involved part of the oral cavity (41.52%). Histologically, the majority of the cases had moderately-differentiated OSCC (52.82%). Most of the patients were diagnosed at stage IV at the time of diagnosis (61.61%). When this study was performed, the survival status of the majority of the patients was alive (68.24%).Within the analyzed socio-demographic and clinicopathological parameters, gender, alcohol consumption, T-classification, histological grading, and treatment status have been demonstrated as an independent risk factors for mortality rate in multivariate analysis. Hence, these parameters need to be taken into account for the individualized therapy management of OSCC patients.

Pattern of third molar impactions in north-eastern peninsular Malaysia: A 10-year retrospective study

Background

Third molar impaction, if left untreated, has the potential to cause several complications. The evaluation of surgical difficulty of impacted third molar extraction aids in better formulation of treatment plan by minimizing surgical complications.

Objective

This study aimed to determine the prevalence of third molar impaction and related pathologic conditions in a cohort of patients living in North-eastern Peninsular Malaysia.

Methods

In this retrospective study, 490 orthopantomograms (OPGs) of patients who were referred to the Oral and Maxillofacial Surgery department between January 2010 and December 2019 were assessed. Data including age, gender, ethnicity, frequency of third molar impactions, their angulations and levels of eruption, retromolar space, and associated pathologic conditions were collected. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 24.0. The significance level was set to P < 0.05.

Results

A total of 490 patients with a mean age of 28.87 years (range: 20-64) demonstrated 1957 impacted third molars (1022 mandibular + 935 maxillary). Impacted third molars were more likely present in females than males (1:2.20) (p < 0.05); and in Malay-ethnic (44.49%) patients followed by Chinese (34.45%) and Indians (21.02%). Mesioangular was the most common angulation of impaction both in the maxilla (24.68%) and mandible (18.34%). The most common pattern of third molar impaction was IIA (61.67%), and the retromolar space was significantly larger in males (13.6 mm; P < 0.05) than females (11.6 mm). The most frequently occurring pathological condition associated with third molars impaction is dental caries in the second or third molar (15.38%).

Conclusions

This study highlights mesioangular impaction with their occlusal plane at the same level as the occlusal plane of the adjacent tooth being the most prevalent pattern of third molar impaction in North-eastern Peninsular Malaysia.

The Psychological Impact of the COVID-19 Pandemic on Oral Health Care Workers and its Impact on Their Willingness to Work During this Pandemic

This study was aimed to investigate the relationship between the psychological status of oral health care workers (OHCWs) and the willingness to treat a patient during the COVID-19 pandemic. This cross-sectional study was carried out on oral health care workers at ten different dental hospitals in Pakistan from March to July 2020. Information on the socio-demographic status, and willingness to report for duty and treat patients during the COVID-19 pandemic were assessed using a self-administered questionnaire. The psychological impact of the COVID-19 pandemic was assessed using the Urdu version of the Generalized Anxiety Disorder Scale and Impact of Events Scale. Simple and multiple linear regression tests were used for analysis. A total of 392 OHCWs participated in this study and 25% of them had moderate to severe anxiety levels and only 14% had post-traumatic stress disorder. About 26% of the OHCWs were willing to work and treat patients during the COVID-19 pandemic and they had lower anxiety and stress scores. Greater anxiety and stress were associated with participants who were older, female, single, married, living with family and friends. The adjusted coefficients of GAD and IES scores were greater in participants who were not willing and unsure to work compared to their colleagues who were willing. The OHCWs are anxious and stressed because of the COVID-19 outbreak and that affects the perception of whether they should work and treat patients during the pandemic.

Dexamethasone Induces Changes in Osteogenic Differentiation of Human Mesenchymal Stromal Cells via SOX9 and PPARG, but Not RUNX2

Despite the huge body of research on osteogenic differentiation and bone tissue engineering, the translation potential of in vitro results still does not match the effort employed. One reason might be that the protocols used for in vitro research have inherent pitfalls. The synthetic glucocorticoid dexamethasone is commonly used in protocols for trilineage differentiation of human bone marrow mesenchymal stromal cells (hBMSCs). However, in the case of osteogenic commitment, dexamethasone has the main pitfall of inhibiting terminal osteoblast differentiation, and its pro-adipogenic effect is well known. In this work, we aimed to clarify the role of dexamethasone in the osteogenesis of hBMSCs, with a particular focus on off-target differentiation. The results showed that dexamethasone does induce osteogenic differentiation by inhibiting SOX9 expression, but not directly through RUNX2 upregulation as it is commonly thought. Rather, PPARG is concomitantly and strongly upregulated, leading to the formation of adipocyte-like cells within osteogenic cultures. Limiting the exposure to dexamethasone to the first week of differentiation did not affect the mineralization potential. Gene expression levels of RUNX2, SOX9, and PPARG were simulated using approximate Bayesian computation based on a simplified theoretical model, which was able to reproduce the observed experimental trends but with a different range of responses, indicating that other factors should be integrated to fully understand how dexamethasone influences cell fate. In summary, this work provides evidence that current in vitro differentiation protocols based on dexamethasone do not represent a good model, and further research is warranted in this field.

The Role of Noncoding RNAs in Osteogenic Differentiation of Human Periodontal Ligament Stem Cells

Chronic inflammatory diseases, including periodontitis, are the most common causes of bone tissue destruction. Periodontitis often leads to loss of connective tissue homeostasis and reduced alveolar bone levels. Human periodontal ligament stem cells (PDLSCs), a population of multipotent stem cells derived from periodontal ligament tissues, are considered as candidate cells for the regeneration of alveolar bone and periodontal tissues. Periodontitis impairs the osteogenic differentiation of human PDLSCs. Noncoding RNAs (ncRNAs), including long noncoding RNA (lncRNA), microRNA (miRNA), and circular RNA (circRNA), have been proposed as vital regulators influencing several differentiation processes including bone regeneration. Still, the molecular mechanisms of ncRNAs regulating osteogenic differentiation of human PDLSCs remain poorly understood. Exploring the influence of ncRNAs in the process of osteogenic differentiation of human PDLSCs may provide novel therapeutic strategies for tissue regeneration as the regeneration of the lost periodontium is the ultimate goal of periodontal therapy.

A bibliometric analysis of periodontology

This bibliometric study assessed periodontal/implant articles that were part of the five most-cited dental articles in each of the years 2005-2019. Periodontal/implant articles made up one to four articles in each of 14 years and totaled 40% of the yearly five most-cited dental articles. The three core periodontal journals (Journal of Clinical Periodontology, Journal of Periodontology, and Periodontology 2000) increased ~50%-100% in Journal Impact Factor from 2005 to 2015 and were among the 10 most-cited dental journals in the 2015-2019 period. The Journal of Clinical Periodontology and Periodontology 2000 were in several years assigned the highest Journal Impact Factor in dentistry. In summary, periodontal journals continue to publish high-impact articles that are relevant for both oral health care and medicine.

Concerns, perceived impact, and preparedness of oral healthcare workers in their working environment during COVID-19 pandemic

OBJECTIVE

The aim of the study was to evaluate the oral healthcare workers' concerns, perceived impact, and preparedness in COVID-19 pandemic.

METHODS

This cross-sectional study was carried out at 10 different dental hospitals in Pakistan from March to June 2020. A 35 items valid and reliable questionnaire was used to assess the concerns, perceived impact, and preparedness of oral healthcare workers (OHCW) in COVID-19 pandemic. Chi-squared test and logistic regression were used for analysis.

RESULTS

A total of 583 OHCW participated in this study. The odds of having the awareness about the risk of exposure and fear of getting infected, were greater in the clinical than non-clinical OHCW (OR: 52.6; OR: 15.9). For social network concerns, the clinical OHCW were more likely to be concerned about their colleagues (OR: 6.0). The clinical OHCW have greater odds of worrying about telling the family/friends about the risk exposed to (OR: 2.55), being avoided because of the job (OR: 3.20) and more likely to be feeling stressed (OR: 4.31). Less than 50% of the participants felt that their institutions are well prepared and only 12.6% had attended an infection control training session. Most participants practiced self-preparation such as buying masks and disinfection (94.3%, 98.3%).

CONCLUSION

The majority of OHCW felt concerned about their risk of exposure to infection and falling ill from exposure and infecting friends/family. There is a need for training of infection control and PPE and minimizing fear and psychological impact on OHCW should be the priority in any preparedness and planning for combating COVID-19.

Citation Classics in the Journal of Endodontics and a Comparative Bibliometric Analysis with the Most Downloaded Articles in 2017 and 2018

INTRODUCTION

Bibliometric analysis is the quantitative measure of the impact of a scientific article in its respective field of research. The aim of this study was to identify and analyze the main features of the top 50 most cited articles published in the Journal of Endodontics since its inception as well as the top 50 most downloaded articles in 2017 and 2018 in order to evaluate the changing trends and other bibliometric parameters of the contemporary literature compared with the classic literature.

METHODS

An electronic search was conducted on the Clarivate Analytics Web of Science "All Databases" to identify and analyze the top 50 most frequently cited scientific articles. After ranking the articles in a descending order based on their citation counts, each article was then crossmatched with the citation counts in Scopus, Google Scholar, and PubMed.

RESULTS

The citation counts of the 50 selected most cited articles ranged between 218 and 731 (Clarivate Analytics Web of Science). The years in which most top 50 articles were published were 2004 and 2008 (n = 5). Among 131 authors, the greatest contribution was made by M. Torabinejad (n = 14). Most of the articles originated from the United States (n = 38) with the greatest contributions from the School of Dentistry, Loma Linda University, Loma Linda, CA (n = 15). Basic research-technology was the most frequent study design (n = 18). A negative, significant correlation occurred between citation density and publication age (correlation coefficient = -0.708, P < .01).

CONCLUSIONS

Several interesting differences were found between the main characteristics of the most cited articles and the most downloaded articles.

Antibiotics: A Bibliometric Analysis of top 100 classics.. [DOI: 10.20944/preprints202004.0416.v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Citation frequencies represent the most significant contributions in any respective field. This bibliometric analysis aimed to identify and analyze the 100 most-cited publications in the field of antibiotics and to highlight the trends of research in this field. “All databases” of Clarivate Analytics' Web of Science was used to identify and analyze the 100 publications. The articles were then cross-matched with Scopus and Google Scholar. The frequency of citation ranged from 940 to 11051 for the Web of Science, 1053 to 10740 for Scopus, and 1162 to 20041 for Google Scholar. Five hundred thirteen authors made contributions to the ranked list, and Robert E.W. Hancock contributed in six articles, which made it to the ranked list. Sixty-six scientific contributions originated from the United States of America. In contrast, five publications were linked to the University of Manitoba, Canada, that was identified as the educational organization, which made the most contributions (n=5). According to the methodological design, 26 of the most cited works were review-type closely followed by 23 expert opinions/perspectives. Eight articles were published in Nature journal, making it the journal with the most scientific contribution in this field. Correlation analysis between the publication age and citation frequency was found statistically significant (P = .012).

Citation Classics on Dental Caries: A Systematic Review

Objective  A systematic search was performed for the identification and analysis of the 100 most often cited articles on dental caries and to highlight the changing trends in the field of dentistry over time.

Materials and Methods  The search was performed without any restriction on the study design, publication year, or language using the Web of Science (WoS) group of Clarivate Analytics enabling the search through “All Databases.” Based on the citation count as available in WoS, the articles were sorted in a descending manner. Information regarding each article was then extracted, which included its authorship, counts of citation (in other databases), citation density, current citation index (2019), publication year, country of publication, journal of article, evidence level based on study design, and keywords description.

Results  The count of citation for each article varied in each database, that is, 175 to 2,003 in WoS, 89 to 1,981 in Scopus, and 126 to 3,492 when searched in Google Scholar. The highest number of articles ( n = 10) related to dental caries were published in 2004. A total of 301 authors made valuable contributions to this field, out of which J.D. Featherstone had coauthored 6 articles. A significant negative correlation ( p < 0.01) was found between the age of the article and the citation density ( r =–0.545). However, a nonsignificant correlation ( p = 0.952) occurred between the age of publication and the citation count ( r = 0.006).

Conclusion  The results of this systematic review provide a critical appraisal of the context underpinning scientific developments in the field of dental caries and also highlighted trends in clinical management and research.

100 Years of the Journal of Dental Research: A Bibliometric Analysis

Since its inception in 1919, the Journal of Dental Research has continually published high-quality articles that span the breadth of research topics relevant to dentistry, oral surgery, and medicine. As part of the journal’s centennial celebration, we conducted an electronic search on Scopus to identify and analyze the top 100 most cited articles from 1919 to 2018. Since Scopus does not capture older citations, we conducted an additional analysis by Google Scholar to identify key articles published in the first 50 y of the journal. Based on Scopus, the articles were ranked in descending order per their citation counts. The citation counts of the 100 most cited articles varied from 262 to 1,503. The year in which the largest number of top 100 articles were published was 2004 ( n = 6). Within the top 100, the majority of articles originated from the United States ( n = 52). Research Reports–Biomaterials & Bioengineering was the most frequent category of cited articles ( n = 35). There was no significant association between total citation count and time since publication (correlation coefficient = –0.051, P = 0.656). However, there was a significant negative association of citation density (correlation coefficient = –0.610, P < 0.01) with time since publication. Our analyses demonstrate the broad reach of the journal and the dynamics in citation patterns and research agenda over its 100-y history. There is considerable evidence of the high variance in research output, when measured via citations, across the globe. Moreover, it remains unclear how patients’ priorities and dental health care needs are aligned with the perceived influence of single research pieces identified by our search. Our findings may help to inspire future research in tackling these inequalities and highlight the need for conceptualizing research priorities.

Effect of Tumor Size and p16 Status on Treatment Outcomes - Achievement of Complete Remission in Prospectively Followed Patients with Oropharyngeal Tumors

BACKGROUND

Oropharyngeal squamous cell tumors associated with human papillomavirus infection (p16 positive tumors) have better prognosis than p16 negative tumors regardless of the more advanced stage of the disease. Tumor volume (GTVt+n) is generally an important factor affecting treatment results of ionizing radiation. The aim of this prospective non-randomized study is to evaluate the effect of tumor volume on the (chemo)radiation treatment results in a group of patients with p16 negative and p16 positive oropharyngeal tumors.

PATIENTS AND METHODS

Patients with confirmed squamous cell tumor of the oropharynx of stages III and IV, according to the 7th version of the TNM (tumor-nodes-metastases) classification, were eligible for this study. The main exclusion criteria were palliative treatment, neoadjuvant chemotherapy or planned concomitant therapy with cetuximab. Patients were treated according to standardized protocols with curative intent. Primary tumor volume (GTVt) and involved nodes volume (GTVn) were obtained from radiotherapy planning system for further statistical analysis. The differences in tumor volumes between the groups according to p16 expression were assessed with subsequent testing of probability to achieve complete remission (CR) of the disease in both groups.

RESULTS

In total, 49 patients - 84% men, median age 60.5 years, 25 (51%) patients p16 positive, 40 (82%) underwent concomitant chemoradiotherapy. Median of GTVt in the whole patients group is 40.2 ccm, GTVn 11.78 ccm and median volume of the whole tumor burden (GTVt+n) 70.21 ccm (range 11.05-249). Median of GTVn was greater in the p16 positive cohort (p = 0.041). In the entire group, the median time to reach CR was 91 days (95% CI 86-107 days) from the end of radiotherapy. In the group of p16 negative patients, 14 achieved CR (61%) out of 23 patients, in p16 positive group 20 (80%) out of 25 patients (p = 0.111). P16 negative patients had a longer time to CR (p = 0.196, HR 1.58, 95% CI 0.79-3.18). None of the independently assessed volumetric parameters of the tumor (GTVt, GTVn, GTVt+n) affected CR in the p16 positive patients group, while there was a significant impact of the whole tumor burden (GTVt+n) in the p16 negative cohort (median 58.1 ccm in CR patients vs. 101.9 ccm, p = 0.018).

CONCLUSION

We have showed less GTVt+n dependence to achieve CR in p16 positive tumors in comparison with p16 negative tumors. Thus, p16 positive oropharyngeal squamous cell cancers should not be withdrawn from the curative treatment intent based on the greater GTVt+n. Key words oropharyngeal neoplasms - p16 status - treatment outcome - tumor burden - complete remission This work was supported by grant of the Ministry of Health of the Czech Republic AZV 15-31627A and by grant of the Ministry of Health of the Czech Republic - Conceptual development of a research organization (MMCI 00209805). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 2. 11. 2018 Accepted: 11. 11. 2018.

[MicroRNAs in Prediction of Response to Radiotherapy in Head and Neck Cancer Patients - Pilot Study]

BACKGROUND

Radiotherapy plays a key role in the treatment of squamous cell head and neck cancers (HNSCC). The effectivity of radiation therapy is often limited by radioresistance of these tumours. microRNAs (miRNAs) are endogenous, evolutionary conserved, small non-coding RNAs involved in regulation of cellular processes associated with radioresistance. The objective of this study was to identify miRNA profile enabling to predict the radiation treatment outcomes in HNSCC patients.

MATERIAL AND METHODS

The retrospective study included HNSCC patients who underwent a definitive radiotherapy. Patients were divided into two groups according to loco-regional control (LRC) as follows - short LRC (n = 22; median 5.1 months (min. 1.3, max, 18.6)) vs. long LRC (n = 21; 60.4 (min. 46.8, max. 98.8)) group. Global miRNA expression profiles were obtained by use of Affymetrix microarray technology (GeneChip miRNA 4.0 Array).

RESULTS

We identified 24 miRNAs to be significantly associated with LRC (p < 0.05), all of these miRNAs were upregulated in patients with short LRC. Out of these miRNAs, 12 miRNAs with p < 0.025 and 4 miRNAs with p < 0.01 have been identified.

CONCLUSION

miRNAs seems to be promising as potential biomarkers predicting radiotherapy treatment outcomes in patients with HNSCC.Key words: microRNAs - radiotherapy - head and neck cancer The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Supported by Ministry of Health of the Czech Republic, grant No. 15-31627A. All rights reserved.Submitted: 19. 3. 2018Accepted: 20. 3. 2018.

Helminthic infestation in children of Kupwara district: a prospective study

The present study deals with the investigation of the frequency of intestinal helminth parasites in children of Kupwara, Kashmir, India. Three hundred and twelve children in the age group of 4-15 years were examined for different intestinal helminths in three schools located in rural areas. Two hundred and twenty two of 312 (71.15%) tested positive for various intestinal helminths. The various helminth parasites included Ascaris lumbricoides , Trichuris trichiura , Enterobius vermicularis and Taenia saginata . By far, the highest frequency of 69.23% (216/312) was noted for Ascaris lumbricoides followed by Trichuris trichiura 30.76% (96/312), Enterobius vermicularis 7.69% (24/312) and Taenia saginata 7.69% (24/312). Single infection was found in 33.65% (105/312) and mixed infection was seen in 37.5% (117/312) children. This study emphasizes the need for improved environmental conditions, i.e., clean water supplies, enhanced sanitation and chemotherapy of school-age children in rural areas.

Impact of sedation and resident teaching on complications of colonoscopy

There is controversy regarding the frequency of sedation-related complications of colonoscopies and whether these procedures are safely performed by physicians-in-training. We retrospectively reviewed the safety of 1,004 consecutive outpatient colonoscopies. No perforations occurred. No patients were hospitalized for sedation-related complications. Seventeen percent of patients had significant changes in vital signs that lasted less than 5 min. These changes were less common in patients receiving </=3 mg midazolam intravenously without meperidine (p < 0.005). Complications were slightly more frequent in procedures performed by trainees (23%) than by gastroenterologists (12%) and by surgeons (18%) (p = 0.01). These data support the safety of colonoscopy under intravenous sedation, even when performed by trainees.

Iron deficiency anaemia: continuous versus intermittent treatment in anaemic children

Iron deficiency anaemia is a common disorder among paediatric population. Traditionally, oral iron is given for treatment on daily basis. We undertook this study to compare the results of intermittent with continuous oral iron therapy in children. The study was conducted at Combined Military Hospital (CMH), Lahore. Children (aged 1 to 6) with iron deficiency anaemia (Hb 11 g/dl) were allocated at random into two groups, A (n = 27) and B (n = 28). The mean Hb of group A, before treatment, was 8.56 (+/- 1.51) g/dl and that of group B was 8.32 (+/- 1.68) g/dl. Group A was given daily oral dosage of 6 mg/kg of elementAL iron whereas group B was given the same dosage of iron but only 3 days a week. After 2 months of treatment the Hb of group A rose to a mean of 11.06 (+/- 0.72) g/dl and that of group B was increased to 11.3 (+/- 0.90) g/dl, respectively. The difference, in the rise of Hb of two groups, was not statistically significant. It was concluded that in our sample of population, the results of intermittent and continuous oral iron therapy, for iron deficiency anaemia in children aged 1 to 6 years, were identical.

A numerical investigation of the mechanics of swelling-type intramedullary hip implants

The novel concept of swelling-type intramedullary hip implants that attain self-fixation by an expansion-fit mechanism resulting from controlled swelling of the implant (by absorption of body fluids) was examined in detail using a finite element model of the implant-femur system. Some of the potential advantages of this technique over traditional techniques include enhanced fixation, lower relative micromotions, improved bony ingrowth, and elimination of acrylic cement. The finite element model created in this study incorporated: (i) the major aspects of the three-dimensional geometry of the implant and femur, (ii) the anisotropic elastic properties of bone and implant materials and the changes in orientation of the principal axes of anisotropy along the length of the implant-femur system, (iii) a layer of cancellous bone between the implant and cortical bone in the proximal femoral region, and (iv) frictional sliding between the bone and implant. The model was used to study quantitatively the parametric influence of various material design variables on the micromotions and stress fields in the bone-swelling-type implant system. The results of the finite element analyses were used to establish material behavior goals and provide targets for a material development study.

Prognostic factors influencing mortality in meningococcal meningitis

The clinical features and some laboratory parameters of 247 cases of meningococcal meningitis admitted between January 1983 and April 1990 to a paediatric ward in Jawahar Lal Nehru Medical College Hospital, India were analyzed retrospectively. A total of 189 (76.5%) were more than 5 years of age. The maximum number of cases occurred between October and April each year. Complications included bleeding tendencies, neurological deficits, gangrene of limbs, arthritis, uveitis and cataract. The overall mortality rate was 16%. A scoring system based on some clinical characteristics correctly predicted a fatal outcome in all but three children.

C-reactive protein in CNS infection

Serum and CSF levels of CRP were measured by radial immunoassay in 99 subjects consisting of 20 controls, 34 pyogenic meningitis (PM), 21 tuberculous meningitis (TBM) and 24 viral encephalitis (VE). There was significant difference in the CRP levels (p less than 0.01) depending on the type of disease in both serum and CSF. The initial serum and CSF levels of CRP in patients with TBM was intermediate between those of PM and VE and were found to be significantly (p less than 0.001) low when compared with three days post treatment levels in children with PM. Both serum and CSF-CRP levels were significantly high (p less than 0.001) in patients succumbing to death than those who survived. Measurement of CRP in serum and CSF is a useful parameter in differentiating partially treated PM from TBM.

Use of flagellin-enriched antigens in a rapid, simple and specific quantitative enzyme immunoassay for Lyme disease antibodies in human serum samples

An enzyme immunoassay (EIA, ELISA) using microwells coated with a flagellin-enriched fraction of B. burgdorferi and absorbent-containing sample diluent for the quantitative determination of Lyme disease (LD) IgG and IgM antibodies in human serum samples was described. This LD EIA required three 15-minute incubations at room temperature, followed by a 1-step normalization of photometer readings to EIA units (EU/ml). Compared with tests using the whole bacterial extract as antigens and a sample diluent containing 6% BSA, this new LD EIA revealed lower values for 20 syphilis (SS) and 21 normal serum samples (NS) but about the same for 21 Lyme disease (LD) samples, allowing lower cut-off points which would place almost all these SS and NS samples below while almost all LD samples above the positive cut-off point. The LD EIA results of larger numbers (67 to 291) of mixed samples correlated with results of four reference EIA. However, the LD EIA gave lower (2 to 4 fold) reactivities (index values) with SS and NS samples but higher values with positive serum samples than reference EIA. Thus, this LD EIA showed improvements in both specificity and sensitivity over other tests compared.

Increased oxidative metabolism in phytohemagglutinin-stimulated lymphocytes from patients with systemic lupus erythematosus is associated with serum SSA antibody

We have examined oxidative metabolism in phytohemagglutinin (PHA)-stimulated lymphocytes from patients with systemic lupus erythematosus (SLE) because increased oxygen free radicals would explain the DNA abnormality previously observed in these cells. Almost no oxidative activity was found in freshly isolated control or lupus lymphocytes or control lymphocytes stimulated with PHA. However, increased oxidative metabolism, measured by nitroblue tetrazolium (NBT) conversion to formazan, was found in PHA-stimulated lymphocytes from 14 of 21 lupus patients. A time course study showed that NBT activity appeared in positive lupus lymphocytes at 1-2 days of PHA stimulation, increased to a maximum at 2-4 days, and diminished thereafter. NBT activity was not related to specific disease symptoms, drug therapy, or serum dsDNA, Sm, RNP, or SSB (La) antibodies. The selected population of lupus patients studied precluded conclusions about NBT activity and disease severity. However, the intensity of NBT response in stimulated lupus lymphocytes was positively correlated with the presence of serum SSA (Ro) antibody. We suggest that increased oxidative activity of SLE lymphocytes generates a chemical change in endogenous DNA in vivo and may be a primary event in the pathogenesis of autoimmunity. Absence of detectable oxidative activity in stimulated lymphocytes in a subgroup of lupus patients suggests that at least two different mechanisms are associated with the altered DNA profiles observed in this disorder.

Circulating immune complexes in tuberculosis--an indicator of activity

Circulating immune complexes (CIC) were assayed in 100 cases of tuberculosis and 30 age matched control children. The estimation was done by PEG assay before the commencement of antitubercular therapy. CIC were present in only 3.3% of the control children as compared to 68% of children with tuberculosis. The presence of CIC was observed to vary with the type of tuberculosis. The percentage positivity was highest (100%) in children with miliary tuberculosis. Subsequent estimation of CIC done after one and three months of antitubercular therapy showed a marked decrease in the percentage of positive cases (6.1 and zero percent respectively).

Prognostic value of 'C' reactive protein in tuberculosis

'C' reactive protein (CRP) levels were determined in 100 cases of tuberculosis and 30 age and sex matched children. Serial estimations, one and 3 to 6 months after initiation of therapy was done in 81 and 41 of these patients, respectively. Mean initial levels of CRP in tuberculosis group was 18.52 micrograms/ml while in the control group it was 2.77 micrograms/ml (p less than 0.001). The elevated CRP levels fell significantly to 5.93 micrograms/ml after one month of treatment (p less than 0.001) and by 3 to 6 months of treatment had fallen to normal values. The fall in CRP levels correlated with clinical response. It is concluded that CRP can serve as a sensitive indicator of activity of the disease and the return to normal values of initially elevated CRP levels may indicate a good therapeutic response.

Cell-mediated immune responses in malnourished host

One hundred children in the age group 6 months to 5 years were investigated for cell-mediated immune response in relation to their nutrition. The nutritional status was assessed by the Wellcome classification. The majority (54 per cent) of children had marasmus. Absolute lymphocyte count was found to be significantly low (P less than 0.01) in all malnourished groups except in mild forms of undernutrition. Small lymphocytes were also found to be significantly decreased (P less than 0.001) in malnourished children. A significant depression (P less than 0.001) was observed in the percentage and absolute T cells in all the malnourished children with kwashiorkor who showed the maximum depression of counts. All the control children showed DNCB skin reactions above grade 2+ while only 39 per cent of malnourished children showed reaction of this grade. After 4-6 weeks of dietary therapy, T cell counts were comparable with control values and DNCB skin test returned to normal in more than 75 per cent of cases.

Phagocyte metabolic functions in iron deficiency anaemia of Indian children

Nitroblue tetrazolium test (NBT) and bactericidal activity of polymorphonuclear leucocytes was studied in 40 patients with iron deficiency anaemia (aged 0-12 years). NBT test had a significant correlation with serum iron (P less than 0.001) in all cases of iron deficiency anemia. Haemoglobin levels less than 4 g/dl also correlated significantly with NBT score. Bactericidal activity with opsonin-coated Staphylococcus aureus was considerably decreased in severe anaemia, but no significant correlation was found with serum iron concentration (P less than 0.1). The phagocytic and bactericidal activity of polymorphonuclear leucocytes is dependent upon serum iron levels and is considerably reduced in iron deficient state in anaemic children.

Blood-Pb and hair-Pb levels in donor-matched samples

Lead concentrations in blood and scalp hair of 200 school boys, aged 6-8 years, were measured by electrothermal atomic absorption spectrometry. The mean blood-Pb concentration was 6.8 microg dl(-1) and the mean hair-Pb concentration was 9.7 microg g(-1) (dry weight). These values are well within the normal range for the respective tissues, indicating that the children studied are presently at relatively low risk from environmental lead pollution. A correlation analysis carried out on the data failed to show any statistically significant correlation (r = 0.13, p < 0.05) between the blood-Pb and hair-Pb concentrations.