"Outcome of non-surgical periodontal treatment on Gal-1 and Gal-3 GCF levels in periodontitis patients: a case-control study"

OBJECTIVES

This study aimed to explore the effect of nonsurgical periodontal treatment on Galectin-1 and -3 GCF levels in gingivitis and periodontitis stage III compared to periodontally healthy individuals, to determine whether they could serve as diagnostic markers / therapeutic targets for periodontitis and revealing their possible role in periodontal disease.

MATERIALS AND METHODS

Forty-five systemically healthy participants were included and equally subdivided into three groups: gingivitis, periodontitis (stage III), and a periodontally healthy control group. The clinical parameters were recorded. Galectin-1 and -3 GCF levels were evaluated (before and after non-surgical treatment for periodontitis) using an enzyme linked immune-sorbent assay (ELISA) kit. Receiver operating characteristic (ROC) curve was performed to reveal sensitivity, specificity, predictive value, and diagnostic accuracy of both markers.

RESULTS

The study showed statistical significance between different groups regarding Galectin-3 with higher values in periodontitis and the lowest values in healthy control. Also, Galectin-1 was significantly higher in the periodontitis/gingivitis groups than in the control group. Moreover, non-surgical periodontal treatment in periodontitis patients caused a statistical reduction in clinical parameters and biomarkers. ROC analysis revealed excellent diagnostic ability of both biomarkers in discriminating periodontitis/gingivitis against healthy individuals (100% diagnostic accuracy for Galectin-1 and 93% for Galectin-3, AUC > 0.9) and acceptable diagnostic ability between periodontitis participants against gingivitis (73% diagnostic accuracy for Gal-1 and 80% for Gal-3, AUC > 0.7).

CONCLUSIONS

Both Galectin-1 and Galectin-3 seem to have outstanding diagnostic accuracy for the identification of periodontal disease, an acceptable ability to measure periodontal disease activity and the severity of inflammatory status. Additionally, they could serve as therapeutic targets to monitor treatment efficiency.

CLINICALTRIAL

GOV REGISTRATION NUMBER: (NCT06038812).

Effectiveness of secondary furlow palatoplasty with buccal myomucosal flap in correction of velopharyngeal insufficiency in patients with cleft palate

OBJECTIVES

The main purpose of this study was evaluation of the effectiveness of secondary furlow palatoplasty with buccal myomucosal flap (FPBF) for the treatment of velopharyngeal insufficiency (VPI) in patients with a cleft palate who were treated with two flap palatoplasty (TFP) in their primary palate repair.

MATERIAL AND METHODS

Twenty-three medically free children aged 4-8 years with non-syndromic and previously repaired cleft palate via TFP participated in the study. All patients received secondary surgery following the technique of FPBF. Preoperative speech evaluation was done before the secondary repair and 3 months after the surgery using a hypernasal speech scale, speech intelligibility scale, and nasopharyngoscopy.

RESULTS

A statistically significant improvement was observed regarding the degree of hypernasality and speech intelligibility while comparing the preoperative scores after the primary surgery to the postoperative scores after the secondary surgery. In addition, a statistically significant improvement was found in the nasopharyngoscopic assessment.

CONCLUSIONS

The incorporation of a buccal myomucosal flap with Furlow palatoplasty was successful in improving hypernasality, speech intelligibility, and nasopharyngoscopic scores in patients with cleft palate.

TRIAL REGISTRATION

clinicaltrials.gov (NCT05626933).

CLINICAL RELEVANCE

This technique might be the surgical technique of choice while treating patients who are suffering from VPI after cleft palate repair.

Clinical characteristics and surgical outcomes of transcutaneous versus transconjunctival excision of Wolfring gland ductal cysts

PURPOSE

To analyze the clinicopathological characteristics and surgical outcomes of patients with Wolfring gland ductal cysts (WGDCs).

METHODS

A retrospective, consecutive, interventional comparative case series was performed over a period of 7 years. Data on demographic and clinical characteristics, pathological findings and outcomes of surgically excised cysts were collected. A comparison between the transconjunctival and transcutaneous approaches was also assessed.

RESULTS

Forty-eight patients (48 eyelids) were included in the final analysis. The most common presenting symptom was painless eyelid swelling (81.3%). The median symptom duration was 11.5 months (IQR, 18.25). The upper eyelid was involved in 31 (64.6%) patients, 29/31 of whom had cysts in a medial or centromedial location. Forty-five (93.8%) cysts were bluish gray and transilluminable with clear contents on lid eversion and a median largest dimension of 22 mm (IQR, 8). A transverse conjunctival fibrotic band was observed along the proximal tarsal border in the cyst area in all patients. Signs of chronic trachoma were noted in 38 (79.2%) patients. Preoperative significant ptosis was present in 28/31 (90.3%) of the upper eyelid cysts. Thirty cysts (62.5%) were excised through the skin, and 18 cysts (37.5%) were excised transconjunctivally. Intraoperative cyst rupture, the need for conjunctival grafting and postoperative residual upper lid ptosis were significantly greater in the transconjunctival group (p = 0.009, p < 0.001, and p = 0.016, respectively).

CONCLUSION

The present study highlights the clinicopathological characteristics of a relatively large series of surgically excised WGDCs. Transcutaneous excision of WGDCs has proven to be an effective treatment with fewer adverse sequelae than the transconjunctival approach.

Modified Fields-Backofen and Zerilli-Armstrong constitutive models to predict the hot deformation behavior in titanium-based alloys

This work presents modifications for two constitutive models for the prediction of the flow behavior of titanium-based alloys during hot deformation. The modified models are the phenomenological-based Fields-Backofen and the physical-based Zerilli-Armstrong. The modifications are derived and suggested by studying the hot deformation of titanium-based alloy Ti55531. The predictability of the modified models along with the original Fields-Backofen and another modified Zerilli-Armstong models is assessed and evaluated using the well-known statistical parameters correlation coefficient (R), Average Absolute Relative Error (AARE), and Root Mean Square Error (RMSE), for the Ti55531 alloy, and validated with other two different titanium-based alloys SP700 and TC4. The results show that the modified Fields-Backofen gives the best performance with R value of 0.996, AARE value of 3.34%, and RMSE value of 5.64 MPa, and the improved version of the modified Zerilli-Armstrong model comes in the second-best place with R value of 0.992, AARE value of 3.52%, and RMSE value of 9.15 MPa for the Ti55531 alloy.

SARS-CoV-2 outbreak: role of viral proteins and genomic diversity in virus infection and COVID-19 progression

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is the cause of coronavirus disease 2019 (COVID-19); a severe respiratory distress that has emerged from the city of Wuhan, Hubei province, China during December 2019. COVID-19 is currently the major global health problem and the disease has now spread to most countries in the world. COVID-19 has profoundly impacted human health and activities worldwide. Genetic mutation is one of the essential characteristics of viruses. They do so to adapt to their host or to move to another one. Viral genetic mutations have a high potentiality to impact human health as these mutations grant viruses unique unpredicted characteristics. The difficulty in predicting viral genetic mutations is a significant obstacle in the field. Evidence indicates that SARS-CoV-2 has a variety of genetic mutations and genomic diversity with obvious clinical consequences and implications. In this review, we comprehensively summarized and discussed the currently available knowledge regarding SARS-CoV-2 outbreaks with a fundamental focus on the role of the viral proteins and their mutations in viral infection and COVID-19 progression. We also summarized the clinical implications of SARS-CoV-2 variants and how they affect the disease severity and hinder vaccine development. Finally, we provided a massive phylogenetic analysis of the spike gene of 214 SARS-CoV-2 isolates from different geographical regions all over the world and their associated clinical implications.

Synthesis, structural, optical, and thermal properties of LaFeO3/Poly(methyl methacrylate)/Poly(vinyl acetate) nanocomposites for radiation shielding

This work is an attempt to develop flexible radiation shielding based on a blend of polymethyl methacrylate (PMMA)/polyvinyl acetate (PVAc) and LaFeO3 nanoparticles (NPs). LaFeO3 and LaFeO3/PMMA/PVAc were made using simple chemical techniques. A high-resolution transmission electron microscope (HR-TEM) and X-ray diffraction (XRD) showed that well-crystallized LaFeO3 NPs with particles 79 nm in size and an orthorhombic shape were obtained. In addition, XRD confirmed the existence of PMMA, PVAc, and LaFeO3 in the nanocomposite films. Fourier transform infrared (FTIR) confirmed that the LaFeO3 NPs and the reactive functional groups in the blend interacted with each other. Field emission-scan electron microscope (FE-SEM) analysis showed that PMMA and PVAc form a homogenous blend and that the LaFeO3 NPs were spread out inside and on the blend surface. The samples showed transmittance in the range of 30-74% and a small extinction coefficient (≤ 0.08). The samples exhibited a dual-band gap structure, and the direct (indirect) band gap shrank from 5.1 to 4.7 eV (4.9 to 4.4 eV). The thermal analyses showed that the samples are thermally stable up to 260 °C. The Phy-X/PSD software was used to figure out the theoretical gamma-ray attenuation parameters, such as the mass attenuation coefficient, the mean free path, and the half-value layer, for different PMMA/PVAc + x% LaFeO3 composites. It is demonstrated that the PMMA/PVAc + 10 wt% LaFeO3 sample exhibits much better shielding effectiveness than PMMA/PVAc, and hence it is suitable for protecting against radiation.

Altered expression of serum lncRNA CASC2 and miRNA-21-5p in COVID-19 patients

Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has a high incidence of spread. On January 30, 2020, the World Health Organization proclaimed a public health emergency of worldwide concern. More than 6.9 million deaths and more than 768 million confirmed cases had been reported worldwide as of June 18, 2023. This study included 51 patients and 50 age- and sex-matched healthy subjects. The present study aimed to identify the expression levels of lncRNA CASC2 and miRNA-21-5p (also known as miRNA-21) in COVID-19 patients and their relation to the clinicopathological characteristics of the disease. The expression levels of noncoding RNAs were measured by RT-PCR technique. Results detected that CASC2 was significantly downregulated while miRNA-21-5p was significantly upregulated in COVID-19 patients compared to healthy subjects. A significant negative correlation was found between CASC2 and miRNA-21-5p. ROC curve analysis used to distinguish COVID-19 patients from controls. MiRNA-21-p serum expression level had a significant positive association with temperature and PO2 (p = 0.04 for each). These findings indicate that CASC2 and miRNA-21-p might be used as potential diagnostic and therapeutic biomarkers in COVID-19.

The diagnostic utility of heparin-binding protein among patients with bacterial infections: a systematic review and meta-analysis

BACKGROUND

Bacterial infections are considered a leading cause of hospitalization and death globally. There is still a need for a rapid and feasible biomarker for bacterial infections. Heparin-binding protein (HBP) was shown to be related to bacterial infections. The objective of the study is to investigate the diagnostic accuracy of HBP in bacterial infections.

METHODS

Articles were screened in PubMed, SCOPUS, Web of Science, and Cochrane to recognize eligible studies. We included studies investigating the diagnostic accuracy of HBP and reported the necessary data to construct 2 × 2 tables. A univariate analysis was conducted to determine the pooled sensitivity and specificity, and a bivariate diagnostic random-effects model was used to calculate the optimal cut-off point.

RESULTS

The analysis comprised sixteen studies in total. Plasma HBP showed a sensitivity of 0.90 (95% CI: [0.79, 0.96]) and a specificity of 0.87 (95% CI: [0.66, 0.96]) in diagnosing bacterial infections using blood samples. Pooling data from seven studies revealed that HBP in cerebrospinal fluid (CSF) has sensitivity and specificity of 96% (95% CI: [0.85, 0.99]), and 95% (95% CI: [0.89, 0.97]), respectively, for the diagnosis of bacterial meningitis. In urinary tract infections (UTI), urine-HBP was revealed to have a high diagnostic value in discriminating bacterial from non-bacterial UTI infection at a cut-off value of 32.868 ng/ml with sensitivity and specificity of 87%.

CONCLUSION

HBP has shown a high diagnostic accuracy of bacterial infections, including UTI and meningitis. Further studies are needed to determine its prognostic value and whether it could guide antibiotic therapy.

IL-39 and IL-35 gingival crevicular fluid levels in diabetic patients with generalized periodontitis

OBJECTIVES

This research was performed to investigate if there is a role for IL-39 in immunopathogenesis of both systemically healthy and diabetic periodontitis patients. Additionally, to explore if we can consider IL-39 and IL-35 as biomarkers for periodontitis activity.

MATERIALS AND METHODS

A total of 38 periodontitis patients and 19 control volunteers were included in our study. The periodontitis patients were divided equally into (Group I), 19 patients with stage III grade C periodontitis with diabetes mellitus and (Group II), 19 patients with stage III grade B periodontitis and systemically healthy. Gingival crevicular fluid levels of each interleukin were measured pre- and postoperatively for all periodontitis patients as well as control subjects using ELISA.

RESULTS

Our study results showed that the highest level for IL-39 was in diabetic periodontitis patients that decreased significantly postoperatively. However, the highest level for IL-35 was revealed in control group while the lowest value was registered in diabetic periodontitis patients and statistically increased after periodontal treatment.

CONCLUSIONS

Based on the results of our research, both investigated biomarkers may have a potent role in pathogenesis of periodontitis.

CLINICAL RELEVANCE

We could consider both interleukins as accurate diagnostic markers for periodontitis patients, regardless of diabetes mellitus association, as well as promising markers that can aid in the prevention and treatment of periodontitis patients worldwide.

The effectiveness of the psychosocial empowerment program in early adjustment among adult burn survivors

BACKGROUND

Burns constitute a major global health challenge, causing not only physical trauma, but also significant psychosocial and emotional disturbances. The complexity of these injuries requires comprehensive rehabilitation programs that address both the physical and psychosocial aspects of recovery. Despite advances in medical care, there is a lack of standardized, accessible, and sustainable psychosocial interventions for burn survivors, particularly in the transition from hospital to home. This study aimed to develop and evaluate a nurse-led psychosocial empowerment intervention for early adjustment among burn survivors after hospital discharge.

METHODS

The study adopted a quasi-experimental framework. A convenient sample of 80 adult burn survivors was randomly divided into an intervention group, receiving the psychosocial empowerment program, and a control group, continuing standard care from November 2022 to May 2023. The effectiveness of the program was evaluated using various tools that measure satisfaction with appearance, coping abilities, and symptoms of post-traumatic stress disorder (PTSD). The intervention focused on enhancing resilience, self-efficacy, and adaptive coping, through targeted skill building in stress management, adaptability to coping, social reintegration, emotion regulation, and problem-solving.

RESULTS

Participants in the intervention group demonstrated significant improvements in body image satisfaction, coping abilities, and symptoms of PTSD compared to the control group.

CONCLUSIONS

The psychosocial empowerment program effectively addressed the psychosocial needs of burn survivors and enhanced their early adjustment after hospital discharge. The findings highlight the critical role of psychosocial support in the rehabilitation of burn survivors and underscore the need to integrate such interventions into standard post-discharge care. Future research should focus on the long-term effects of these interventions and their applicability in diverse settings.

Role of finite element analysis for selection of single point fixation in zygomaticomaxillary complex fracture

BACKGROUND

One-point fixation was superior to the two and three-points fixation in minimally displaced zygomaticomaxillary complex (ZMC) fracture regarding the cost, invasiveness, scaring, number of wounds, and operation time. Accordingly, this study aimed to predict which one-point fixation is the most stable in managing minimally displaced ZMC fracture.

MATERIAL & METHODS

This study simulated the different one-point fixation approaches on three ZMC models after fracture reduction and application of all forces exerted on the fractured area. The findings were represented as stress impact on the ZMC fracture and plating system as well as the inter-fragments micro-motion.

RESULTS

The von misses stresses of plates for the zygomaticofrontal, infra-orbital rim, and zygomaticomaxillary buttress model were (66.508, 1.285, and1.16 MPa) respectively. While the screws' von misses for the infraorbital rim, zygomaticofrontal, and zygomaticomaxillary buttress models were (13.8, 4.05, and 1.60 MPa) respectively. Whereas, the maximum principles stress at zygomaticofrontal, zygomaticomaxillary buttress, and infraorbital rim models were (37.03, 37.01, and 34.46 MPa) respectively. In addition, the inter-fragment micro-motion for zygomaticomaxillary buttress, infraorbital rim, and zygomaticofrontal models were (0.26, 0.25, and 0.15 mm) respectively.

CONCLUSION

One-point fixation at zygomaticomaxillary buttress is the preferred point because it is exposed to low stresses, and the inter-fragment micro-motion is within the approved limit with the elements in the same direction of fixation which indicates the rigid fixation. In addition, it is less palpable and scarless.

TRIAL REGISTRATION

clinical trial.gov (NCT05819372) at 19/04/2023.

"Salivary LINC00657 and miRNA-106a as diagnostic biomarkers for oral squamous cell carcinoma, an observational diagnostic study"

BACKGROUND

Early detection and diagnosis of malignant tumors is critical for improving the survival rate and treatment outcomes of oral cancer. Thus, the current prospective investigation was designed to verify the role, sensitivity, and specificity of salivary LINC00657 and miRNA-106a as diagnostic markers in oral squamous cell carcinoma patients as compared to oral lichen planus (as an example of oral potentially malignant disorders) and normal individuals, and to show LINC00657 relation to miR-106a.

METHODS

A total of 36 participants were included, subdivided into 3 groups: Group I: 12 patients diagnosed with oral squamous cell carcinoma (OSCC). Group II: 12 patients diagnosed with oral lichen planus (OLP). Group III: 12 systemically free individuals with no oral mucosal lesions. Unstimulated salivary samples were collected from all participants to evaluate level of LINC00657 and miR-106a in different groups using quantitative real-time PCR.

RESULTS

OSCC showed the highest LINC00657 and lowest miR-106a fold change among included groups. Receiver Operating Characteristic (ROC) curve analysis of the two biomarkers for detecting OSCC revealed that LINC00657 had higher diagnostic accuracy (DA) (83.3%) compared to miR-106a (80.4%). As for detecting OLP, ROC analysis showed that miR-106a had higher (DA) (61%) compared to LINC00657 (52.5%). To discriminate OSCC from OLP, the diagnostic accuracy of both markers is the same (75%). Moreover, differentiating OSCC grades II and III, ROC analysis showed that miR-106a had lower (DA) (60%) compared to LINC00657 (DA) (83.3%).

CONCLUSIONS

Salivary LINC00657 and miR-106a could be promising diagnostic markers for oral squamous cell carcinoma. Salivary LINC00657 may differentiate oral squamous cell carcinoma from oral potentially malignant disorders with considerable diagnostic accuracy. Moreover, low levels of salivary miR-106a could have the potential to indicate malignancy.

TRIAL REGISTRATION

The study was retrospectively registered on clinicaltrial.gov with NCT05821179 (first trial registration in 26/3/2023), date of registration: 19/4/2023.

Alveolar cleft reconstruction using bone marrow aspirate concentrate and iliac cancellous bone: A 12-month randomized clinical study

OBJECTIVE

This study aimed to compare the bone density and volume in patients with alveolar cleft reconstructions utilizing bone marrow aspirate concentrate with iliac graft versus iliac graft alone.

MATERIAL AND METHODS

Thirty-six patients with unilateral alveolar cleft were randomly allocated into either an intervention group receiving an iliac bone graft mixed with bone marrow concentrate or a control group receiving an iliac bone graft. Cone beam CT was obtained preoperative, 6 and 12 months postoperatively to assess the bone density of the graft and bone volume of the alveolar defect, and then, the bone loss ratio was calculated.

RESULTS

Bone volume and bone density demonstrated a statistically significant increase in the intervention group at 6 and 12 months. In contrast, the bone loss ratio decreased significantly in the intervention group throughout the follow-up period.

CONCLUSION

A combination of bone marrow concentrate and iliac cancellous bone in alveolar cleft reconstruction may improve bone densities and volume in addition to decreasing graft loss rate.

CLINICAL SIGNIFICANCE

Using of bone marrow aspirate concentrate will decrease the amount of the graft needed and decrease the ratio of bone loss at the grafted site by the time. Trial registration ClinicalTrials.org ( NCT04414423 ) 4/6/2020.

The effect of antipsychotic medication and the associated hyperprolactinemia as a risk factor for periodontal diseases in schizophrenic patients: a cohort retrospective study

BACKGROUND

Periodontal disease is a major health problem that results in tooth loss and thus affects oral health, which affects quality of life. In particular, schizophrenic patients are at higher risk for periodontal disease due to several factors, including the effect of antipsychotic medications received by those patients. Accordingly, the aim of the present cohort retrospective study is to explore the effect of antipsychotics on periodontal health and the possible effect of antipsychotic-induced hyperprolactinemia as a risk factor for periodontal disease progression in schizophrenic patients.

METHODS AND OUTCOMES

The study population consisted of three groups: Group A (n = 21): schizophrenic patients that have been taking "prolactin-inducing" antipsychotics for at least 1 year; Group B (n = 21): schizophrenic patients who have been taking "prolactin-sparing" antipsychotics for at least 1 year; and Group C (n = 22): newly diagnosed schizophrenic patients and/or patients who did not receive any psychiatric treatment for at least 1 year. The study groups underwent assessment of periodontal conditions in terms of pocket depth (PD), clinical attachment loss (CAL), gingival recession, tooth mobility, and bleeding on probing (BOP). Also, bone mineral density was evaluated using DEXA scans, and the serum prolactin level was measured by automated immunoassay.

RESULTS

Results revealed a statistically significant difference in PD, CAL, and serum prolactin levels (P ≤ 0.001, P = 0.001, and P ≤ 0.001, respectively) among the 3 study groups. For both PD and CAL measurements, group A has shown significantly higher values than both groups B and C, whereas there was no statistically significant difference between the values of groups C and B. Concerning serum prolactin levels, group A had significantly higher values than groups B and C (P ≤ 0.001 and P ≤ 0.001 respectively). There was a statistically significant difference (P ≤ 0.001) between the 3 study groups in terms of bone mineral density. Moreover, there was a statistically significant direct relation between serum prolactin level and other parameters including clinical attachment loss, pocket depth measurements and bone mineral density.

CONCLUSION

According to our results, it could be concluded that all antipsychotics contribute to the progression of periodontal disease, with a higher risk for prolactin-inducing antipsychotics. However, further long term, large sampled, interventional and controlled studies are required to reach definitive guidelines to allow clinicians properly manage this group of patients.

Experimental, analytical, and simulation studies of modified concrete mix for radiation shielding in a mixed radiation field

The current study assessed two concrete mixes prepared using dolomite and barite/limonite aggregates to shield against both energetic photons and neutrons. After that, a designed mix which comprised barite/goethite aggregates plus fine-powdered boron carbide additive, was proposed to improve the overall radiation shielding properties and in the same time, doesn't compromise or even improve the physic-mechanical properties of the mature concrete. The assessment started first with intensive experimental investigations to investigate the prepared mixes' shielding capabilities against both γ-rays and fast neutrons. Then, analytical computations were performed via number of reliable software programs such as; Phy-X, NXCom, MRCsC, JANIS-4, and MCNP5, in order to confirm the experimental results and to validate the created Monte-Carlo models. Finally, an intensive radiation shielding assessment for all concrete mixes understudy using, mainly, the validated MCNP models, was performed. The obtained results have revealed the superiority of barite mixes over the dolomite mix concerning attenuating photons moreover, the proposed designed mix has shown superiority over the other two prepared mixes considering shielding against; energetic photons, fast/thermal neutrons, and secondary emitted γ-rays, which nominates this mix to be a suitable universal shield that can be used even in mixed radiation fields.

Effect of silver diamine fluoride activation on bond strength to root dentin

BACKGROUND

To investigate the effect of silver diamine fluoride (SDF) application and activation on the bond strength of gutta-percha to dentin and resin bonded post to dentin.

METHODS

Thirty-six human premolar teeth were used. The coronal part tooth was removed, and endodontic mechanical preparation was performed for all the teeth. The teeth were divided according to final rinse protocol (n = 9) as follows: Control group; no SDF application, SDF/NA; 38% SDF as a final rinse with no activation, SDF/MDA; 38% SDF as a final rinse with manual dynamic activation and SDF/US; 38% SDF as a final rinse with ultrasonic activation. Root canal obturation using lateral condensation technique followed by fiber post insertion after 48 h in the root canal after corresponding preparations. The roots were cut with a low-speed precision saw creating 2 mm thickness sections. A total of 4 sections were obtained from each tooth, 2 coronal specimens (with post) and 2 apical specimens (with Gutta percha). Each specimen was subjected to push-out bond strength test with a universal testing machine. Data were analyzed using two-way ANOVA.

RESULTS

The Push-out bond strength at the apical root section was significantly higher in SDF/MDA and SDF/US groups compared to control group. While for the coronal part, all SDF treated specimen showed reduced Push-out bond strength.

CONCLUSION

SDF application as final rinse may reduce the bonding performance between fiber post and dentine. Activation with manual and ultrasonic methods improved the bond strength at the apical root section.

Antiseptics and mupirocin resistance in clinical, environmental, and colonizing coagulase negative Staphylococcus isolates

BACKGROUND

Coagulase-Negative Staphylococci (CoNS) are opportunistic and nosocomial pathogens. The excessive use of antimicrobial agents, including antiseptics, represents one of the world's major public health problems. This study aimed to test the susceptibility of CoNS to antiseptics.

METHODS

Out of 250 specimens collected from different sections of the hospital, 55 samples were identified as CoNS, categorized into three groups based on their sources: environmental samples (n = 32), healthcare worker carriers samples (n = 14), and clinical infection samples (n = 9). Isolates were examined for susceptibility to antibiotics and antiseptics, such as benzalkonium chloride (BC), cetyltrimethylammonium bromide (CTAB), and chlorhexidine digluconate (CHDG). Mupirocin and antiseptic resistance genes, as well as the mecA gene, were detected using polymerase chain reaction. CoNS isolates with notable resistance to antiseptics and antibiotics were identified using the API-Staph system.

RESULTS

A high frequency of multidrug resistance among CoNS clinical infection isolates was observed. Approximately half of the CoNS isolates from healthcare workers were susceptible to CHDG, but 93% were resistant to BC and CTAB. The frequency of antiseptics and antibiotics resistance genes in CoNS isolates was as follows: qacA/B (51/55; 92.7%), smr (22/55; 40.0%), qacG (1/55; 1.8%), qacH (6/55; 10.9%), qacJ (4/55; 7.3%), mecA (35/55; 63.6%), mupB (10/55; 18.2%), and mupA (7/55; 12.7%). A significant difference in the prevalence of smr gene and qacJ genes between CoNS isolates from healthcare workers and other isolates was reported (P value = 0.032 and ˂0.001, respectively). Four different CoNS species; S. epidermidis, S. chromogene, S. haemolyticus, and S. hominis, were identified by API.

CONCLUSIONS

CoNS isolates colonizing healthcare workers showed a high prevalence of antiseptic resistance genes, while clinical infection samples were more resistant to antibiotics. CHDG demonstrated greater efficacy than BC and CTAB in our hospital.

Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study

BACKGROUND

The plethysmography variability index (PVI) is a non-invasive, real-time, and automated parameter for evaluating fluid responsiveness, but it does not reliably predict fluid responsiveness during low tidal volume (VT) ventilation. We hypothesized that in a 'tidal volume challenge' with a transient increase in tidal volume from 6 to 8 ml Kg- 1, the changes in PVI could predict fluid responsiveness reliably.

METHOD

We performed a prospective interventional study in adult patients undergoing hepatobiliary or pancreatic tumor resections and receiving controlled low VT ventilation. The values for PVI, perfusion index, stroke volume variation, and stroke volume index (SVI) were recorded at baseline VT of 6 ml Kg- 1, 1 min after the VT challenge (8 ml Kg- 1), 1 min after VT 6 ml Kg- 1 reduced back again, and then 5 min after crystalloid fluid bolus 6 ml kg- 1 (actual body weight) administered over 10 min. The fluid responders were identified by SVI rise ≥ 10% after the fluid bolus.

RESULTS

The area under the receiver operating characteristic curve for PVI value change (ΔPVI6-8) after increasing VT from 6 to 8 ml Kg- 1 was 0.86 (95% confidence interval, 0.76-0.96), P < 0.001, 95% sensitivity, 68% specificity, and with best cut-off value of absolute change (ΔPVI6-8) = 2.5%.

CONCLUSION

In hepatobiliary and pancreatic surgeries, tidal volume challenge improves the reliability of PVI for predicting fluid responsiveness and changes in PVI values obtained after tidal volume challenge are comparable to the changes in SVI.

Color stability of two different resin matrix ceramics: randomized clinical trial

BACKGROUND

One of the most common causes of aesthetic failure and restoration replacement is the tooth restorations color mismatch specifically after aging.

METHODS

One hundred and two participants with endodontically treated first molar were selected clinically. The patients were randomly splited into two groups and restored either with Cerasmart hybrid ceramic or Vita Enamic polymer infiltrated ceramic network (PICN) crowns and cemented using dual cure adhesive cement. The color difference (ΔE) values after cementation at 0 (Baseline), 6, and 12 months of use were obtained by quantification of L*, a*, and b* values with a digital spectrophotometer. Mann-Whitney test used to compare between tested groups at each time point and between (α = 0.05).

RESULTS

At 6 months follow-up intervals, Vita Enamic group showed the highest significant ∆L* (p = 0.035) and ∆a* (p < 0.001) compared to Cerasmart group. ∆b* and ∆E showed no significant difference between both groups (p > 0.05). Furthermore, all color parameters of both groups showed statistically significant difference at 12 months follow-up intervals. After 12 months, Vita Enamic restorations presented higher color change compared to Cerasmart restorations with a (p-value of 0.0120). When comparing the total color difference ∆Et through-out the follow-up intervals of Vita Enamic & Cerasmart groups, there were insignificant difference (p = 0.263).

CONCLUSION

Both hybrid materials demonstrated comparable color stability after 1 year of clinical service within clinical acceptance range. However, Cerasmart demonstrated a better colour stability after 1 year.

TRIAL REGISTRATION

ClinicalTrials.gov (ID: NCT05501808) 15/8/ 2022- 'retrospectively registered'.

Validity of a novel optical coherence tomography angiography flow index in a cohort of primary open angle glaucoma

BACKGROUND

Vascular mechanisms are implicated in many ocular diseases. Therefore, different vascular imaging modalities are used in management of such conditions. Optical coherence tomography angiography (OCTA) has high spatial resolution and segmentable 3D volumetric sampling enabling isolation of retinal and peripapillary vascular beds. However, OCTA only indirectly derives quantitative flow data i.e. velocimetry through methods and algorithms liable to limitations like signal saturation. This study introduces and validates novel mathematical OCTA flow indices that may compensate for some OCTA velocimetric limitations.

METHODS

Thirty-seven eyes of 23 POAG patients were included. Each underwent baseline and follow-up assessment one month thereafter. Assessment comprised full ophthalmological examination, intraocular pressure (IOP), systemic arterial blood pressure (SABP) and OCTA macula and ONH. Angiograms were processed using ImageJ to calculate OCTA intensity-based flow indices (FIOs), for superficial vascular plexus (SVP), deep vascular plexus (DVP) and optic nerve head vascular plexus (ONH-RPC), i.e. SFIO, DFIO and ONHFIO respectively. Mean ocular perfusion pressure (MOPP) was calculated using IOP and SABP. OCTA vascular densities (VD) and MOPP were used to calculate three respective mathematical flow indices (FIMs) for SVP, DVP and ONH-RPC, based on Hagen-Poiseuille law, i.e. SFIM, DFIM, ONHFIM respectively. Pearson test was used for correlation between the two sets of indices. Intraclass correlation coefficient (ICC) was tested for baseline and follow-up values for each index.

RESULTS

There was positive correlation between the three FIMs and their respective FIOs at baseline and follow-up ranging between high and moderate. Correlation coefficients (CCs) were 0.773 and 0.609 for SFIM and SFIO P-value < 0.001, 0.829 and 0.624 for DFIM and DFIO P-value < 0.001 and 0.516 and 0.737 for ONHFIM P-value = 0.001 for baseline and follow-up respectively. ICCs were 0.772 P-value < 0.001, 0.328 P-value = 0.022 and 0.888 P-value < 0.001 for SFIM, DFIM and ONHFIM respectively. For SFIO, DFIO and ONHFIO, ICCs were 0.420 P-value = 0.004, 0.079 P-value = 0.320 and 0.833 P-value < 0.001 respectively.

CONCLUSION

The novel FIMs are reliable alternatives to FIOs and may compensate for OCTA signal saturation in extremes of MOPP. SFIM and ONHFIM showed high ICCs with excellent reliability. While DFIM demonstrated low ICC indicating poor reliability, it still performed better than its corresponding DFIO.

Effects of two flap palatoplasty versus furlow palatoplasty with buccal myomucosal flap on maxillary arch dimensions in patients with cleft palate at the primary dentition stage: a cohort study

OBJECTIVE

The objective of this study was to evaluate the effect of two flap palatoplasty (TFP) versus Furlow palatoplasty with buccal myomucosal flap (FPBF) on maxillary arch dimensions in children at the primary dentition stage with cleft palate, in comparison to matching subjects without any craniofacial anomalies.

MATERIAL AND METHODS

This study included 28 subjects with an age range of 5-6 years; 10 non-cleft subjects were included in the control group, 9 patients treated with TFP, and 9 patients treated with FPBF. For the included patients, the maxillary models were scanned using a desktop scanner to produce virtual models, and the maxillary dimension measurements were virtually completed. The produced measurements were compared between the 3 groups. Maxillary models of the 28 participants were evaluated.

RESULTS

Statistically insignificant differences were detected between the 3 groups for arch symmetry measurements. Differences were detected in the inter-canine width between the 2 surgical groups and non-cleft group. Both arch length and posterior palatal depth significantly differ while comparing the TFP to the control group, with no differences between FPBF and the non-cleft group.

CONCLUSION

Furlow palatoplasty with buccal myomucosal flap might be considered a better surgical option than two flap palatoplasty for patients with cleft palate while evaluating maxillary arch dimensions at the primary dentition stage as a surgical outcome.

CLINICAL RELEVANCE

This study gives insight into the surgical technique that has limited effect on the maxillary growth and dental arch dimension. Therefore, it decreases the need for orthodontic treatment and orthognathic surgery.

TRIAL REGISTRATION

clinicaltrials.gov ( NCT05405738 ).

Frequency and risk factors of H. pylori infection among dental students: an observational cross-sectional study

Despite Helicobacter pylori infection remains asymptomatic in most people, it is associated with an increased risk of gastric cancer. Considering Egypt had the highest prevalence of H. pylori in healthy asymptomatic population in adults and pediatric age in past studies and currently salivary ELISA could be used for diagnosis of Oral H. pylori infection. Moreover, some researchers speculated that dentists and dental students might be at a higher risk for oral H. pylori infection because they are the most frequently exposed ones to saliva and dental plaque. This study aimed to determine risk factors associated with frequency of H. pylori among a sample of dental students for better management of the disease. 83 participants, with age (21-25 years), attending Faculty of Dentistry, Fayoum University were recruited. A structured questionnaire was used to collect information on sociodemographic parameters and risk factors for H. pylori. Direct inquiry about dyspeptic symptoms were done. Saliva samples were collected and tested for H. pylori antibodies. Overall seroprevalence was 22.9%. Participants in internship were more prone to be positive (p = 0.005). 32.6% of urban residents versus 10.8% of rural were H. pylori positive (p = 0.019). 75.0% of previous history of H. pylori infection versus 14.1% of those with no history were H. pylori positive p < 0.001. 70% of positive H. pylori participants reported positive clinical symptoms that were statistically significant. This study suggests that middle income, previous history of H. pylori and clinical symptoms of dyspepsia are risk factors of oral H. pylori with a decline in its prevalence in Egypt.

Articaine versus Lidocaine in only buccal infiltration anesthesia for the extraction of mandibular anterior teeth. A prospective split-mouth randomized-controlled clinical study

OBJECTIVE

To investigate the effectiveness of a single labial infiltration of 4% articaine versus 2% lidocaine for the extraction of mandibular anterior teeth without an additional lingual injection.

PATIENTS AND METHODS

A prospective, randomized-controlled, split-mouth clinical study was implemented. Healthy adult patients seeking bilateral extraction of mandibular anterior teeth were included in this study. Teeth extractions were randomly assigned to two equal groups, where one mandibular anterior tooth was extracted using a solitary labial infiltration of either 4% articaine (the study group) or 2% lidocaine (the control group). After 14 days, the other mandibular anterior tooth was extracted using the other local anesthetic agent. The selection of the anesthetic agent injected in the first session was done in a randomized fashion. After 5 min of local anesthetic injection, the tooth was extracted, and each patient was asked to record the intensity of the extraction pain using the Visual Analogue Scale (VAS).

RESULTS

Thirty-one patients were included in the study. The efficacy of a single labial injection for mandibular anterior teeth extraction was established by the fact that none of the patients in the study or control group required re-administration of local anesthesia. The mean VAS for pain control during tooth extraction was 1.16 ± 0.93 for the articaine group and 1.71 ± 0.90 for the lidocaine group. The pain score showed a statistically significant decrease in the articaine group compared to that in the lidocaine group (P = 0.017).

CONCLUSION

Although the anesthetic effects of only buccal infiltration of 4% articaine and 2% lidocaine for extraction of mandibular anterior teeth were comparable, the use of 4% articaine would have more effective and predictable outcomes.

CLINICALTRIALS

ORG: (ID: NCT05223075) 3/2/2022.

Oxytocin versus a combination of tranexamic acid and ethamsylate in reducing intraoperative bleeding during abdominal myomectomy: a randomized clinical trial

OBJECTIVE

Myomectomy is the preferred surgical approach to manage uterine fibroids. However, uterine fibroids are highly vascular tumors and, consequently, extremely susceptible to problems from myomectomy-related hemorrhage. Hence, we aim to compare oxytocin efficacy and safety profile versus tranexamic acid (TA) with ethamsylate for reducing bleeding during myomectomy.

METHODS

This randomized, double-blinded multicenter study was performed between 20th August 2020 and 20th October 2020 at El-Galaa Teaching Hospital, El Hussein University Hospital, Al-Azhar University Hospitals of Assiut, and Al-Azhar University Hospitals of Damietta. One hundred and eighty patients were enrolled and divided into three groups: group (1) received an injection of 30 IU of oxytocin in 500 ml of normal saline; group (2) received injections of 1 g of TA, 250 mg of Ethamsylate, and 110 ml of normal saline IV; and group (3) received an injection of 110 ml of normal saline IV just before surgical incision.

RESULTS

In 180 premenopausal women, oxytocin and TA with ethamsylate had no significant value in lowering intraoperative blood loss compared with the placebo for abdominal myomectomy (666.25 ± 183.03, 630.72 ± 145.83, and 646.67 ± 168.92, respectively (P = 0.506)). Non-significant trends were observed for a reduction in operation time (P = 0.760), intra/postoperative blood transfusion (P = 0.624), hospital stay (P = 0.986), postoperative fever (P = 0.659), and wound infection (P = 1).

CONCLUSION

Oxytocin and TA with ethamsylate had no significant value in lowering intraoperative blood loss compared with the placebo for abdominal myomectomy which opens a new question about the role of the use of the hemostatic drug during myomectomy especially in centers with limited resources and had higher rates.

TRIAL REGISTRATION

The study was registered on Pan African Clinical Trials Registry with the following number: PACTR202008739887429 and was approved on 24/08/2020.

The impact of stress-coping strategies on perceived stress during the COVID-19 pandemic among university students an interventional study

BACKGROUND

Coronavirus (COVID-19) pandemic is a public health emergency. During the outbreak, a broad range of psychological disorders affected people at the individual, community, and international levels. This study aimed to assess the role of stress-coping strategies in relieving perceived stress among university students during the COVID-19 pandemic.

METHODS

This interventional study was nested on a cross-sectional design and involved students at Faiyum University in 2022.

RESULTS

Out of a sample of 2640 students, 2176 (82.4%) experienced moderate perceived stress, while 56 (2.1%) had more severe levels. Being female, nonmedical students, and rural inhabitants having a low socioeconomic status were associated with scores for severe and moderate levels of perceived stress. Among the interventional group, Modified Perceived Stress Scale scores significantly decreased after the implementation of the stress-coping program, with a p value < 0.001. Improvements in perceived stress levels were observed among male, medical, and high-socioeconomic-status students.

CONCLUSION

Perceived stress levels were associated with being female, engaging in nonmedical study, and having low socioeconomic status and decreased after a stress-coping program was implemented. These findings assert the need to develop regular campaigns to provide psychological support and stress-coping strategies that may help students overcome different stressors.

Integrative Soil Application of Humic Acid and Foliar Plant Growth Stimulants Improves Soil Properties and Wheat Yield and Quality in Nutrient-Poor Sandy Soil of a Semiarid Region

Sandy soils (containing > 50% sand) are widely distributed worldwide and are characterized by their poor structure, low organic matter, weak hydraulic and nutritional properties, and low crop productivity. Using a 2-year pot experiment, in this study, we investigated the effects of humic acid (HA) as a soil amendment and study two plant growth stimulants (PGSs), zinc oxide nanoparticles (ZnONPs), and L-tryptophan (L-TRP), as a foliar application on wheat grown in nutrient-poor sandy soil. Three HA rates (0 (HA₀), 0.2 (HA_0.2), and 0.4 (HA_0.4) g kg^-1 soil) and five PGS levels [control, 50 mg l^-1 (ZnONPs₅₀), 100 mg l^-1 (ZnONPs₁₀₀), 0.25 mmol l^-1 (L-TRP_0.25), and 0.5 mmol l^-1 (L-TRP_0.5)] were used. The soil hydro-physico-chemical properties, morpho-physiological responses, yield, and quality were measured. HA addition amended the soil structure by allowing rapid macroaggregate formation, decreasing bulk density and pH, and increasing porosity and electrical conductivity, thereby improving soil hydraulic properties. HA_0.2 and HA_0.4 additions improved growth, yield components, and grain minerals, resulting in higher grain yield by 28.3-54.4%, grain protein by 10.2-13.4%, wet gluten by 18.2-23.3%, and dry gluten by 23.5-29.5%, respectively, than HA₀. Foliar application of ZnONPs or L-TRP, especially at higher concentrations compared to the control, noticeably recorded the same positive results as HA treatments. The best results were achieved through the integration of HA_0.4 + ZnONPs₁₀₀ or L-TRP_0.5 to the tested nutrient-poor sandy soil. The interactive application of HA_0.4 + ZnONPs₁₀₀ or L-TRP_0.5 and the use of mineral fertilizer, which is considered a surplus point in permaculture, can be recommended for sustainable wheat production in nutrient-poor sandy soil.

Plant Growth-Promoting Rhizobacteria Improve Growth, Morph-Physiological Responses, Water Productivity, and Yield of Rice Plants Under Full and Deficit Drip Irrigation

Inoculating rice plants by plant growth promoting rhizobacteria (PGPR) may be used as a practical and eco-friendly approach to sustain the growth and yield of drought stressed rice plants. The effect of rice inoculation using plant growth hormones was investigated under drip full irrigation (FI; 100% of evapotranspiration (ETc), and deficit irrigation (DI; 80% of ETc) on growth, physiological responses, yields and water productivities under saline soil (ECe = 6.87 dS m^-1) for 2017 and 2018 seasons. Growth (i.e. shoot length and shoot dry weight), leaf photosynthetic pigments (chlorophyll 'a' and chlorophyll 'b' content), air-canopy temperature (Tc-Ta), membrane stability index (MSI%), and relative water content, (RWC%) chlorophyll fluorescence (F_v/F_m) stomatal conductance (gs), total phenols, peroxidase (PO), polyphenol oxidase (PPO), nitrogen contents and water productivities (grain water productivity; G-WP and straw water productivity; S-WP) were positively affected and significantly (p < 0.05) differed in two seasons in response to the applied PGPR treatments. The highest yields (3.35 and 6.7 t ha^-1 for grain and straw yields) as the average for both years were recorded under full irrigation and plants inoculated by PGPR. The results indicated that under water scarcity, application of (I₈₀ + PGPR) treatment was found to be favorable to save 20% of the applied irrigation water, to produce not only the same yields, approximately, but also to save more water as compared to I_100%.

Genetic analysis toward more nutritious barley grains for a food secure world

BACKGROUND

Understanding the relationships between nutrition, human health and plant food source is among the highest priorities for public health. Therefore, enhancing the minerals content such as iron (Fe), zinc (Zn) and selenium (Se) in barley (Hordeum vulgare L.) grains is an urgent need to improve the nutritive value of barley grains in overcoming malnutrition and its potential consequencing. This study aimed to expedite biofortification of barley grains by elucidating the genetic basis of Zn, Fe, and Se accumulation in the grains, which will contribute to improved barley nutritional quality.

RESULTS

A genome-wide association study (GWAS) was conducted to detect the genetic architecture for grain Zn, Fe, and Se accumulations in 216 spring barley accessions across two years. All the accessions were genotyped by single nucleotide polymorphisms (SNPs) molecular markers. Mineral heritability values ranging from moderate to high were revealed in both environments. Remarkably, there was a high natural phenotypic variation for all micronutrient accumulation in the used population. High-LD SNP markers (222 SNPs) were detected to be associated with all micronutrients in barley grains across the two environments plus BLUEs. Three genomic regions were detected based on LD, which were identified for the most effective markers that had associations with more than one trait. The strongest SNP-trait associations were found to be physically located within genes that may be involved in grain Zn and Fe homeostasis. Two putative candidate genes were annotated as Basic helix loop helix (BHLH) family transcription factor and Squamosa promoter binding-like protein, respectively, and have been suggested as candidates for increased grain Zn, Fe, and Se accumulation.

CONCLUSIONS

These findings shed a light on the genetic basis of Zn, Fe, and Se accumulation in barley grains and have the potential to assist plant breeders in selecting accessions with high micronutrient concentrations to enhance grain quality and, ultimately human health.

Copyright protection of deep neural network models using digital watermarking: a comparative study

Nowadays, deep learning achieves higher levels of accuracy than ever before. This evolution makes deep learning crucial for applications that care for safety, like self-driving cars and helps consumers to meet most of their expectations. Further, Deep Neural Networks (DNNs) are powerful approaches that employed to solve several issues. These issues include healthcare, advertising, marketing, computer vision, speech processing, natural language processing. The DNNs have marvelous progress in these different fields, but training such DNN models requires a lot of time, a vast amount of data and in most cases a lot of computational steps. Selling such pre-trained models is a profitable business model. But, sharing them without the owner permission is a serious threat. Unfortunately, once the models are sold, they can be easily copied and redistributed. This paper first presents a review of how digital watermarking technologies are really very helpful in the copyright protection of the DNNs. Then, a comparative study between the latest techniques is presented. Also, several optimizers are proposed to improve the accuracy against the fine-tuning attack. Finally, several experiments are performed with black-box settings using several optimizers and the results are compared with the SGD optimizer.