Nevin Manimala

Genomics Proteomics Bioinformatics. 2021 Sep 24:S1672-0229(21)00207-2. doi: 10.1016/j.gpb.2021.07.004. Online ahead of print.

ABSTRACT

Type 2 diabetes (T2D), characterized by the malfunction of pancreatic β cells, is affected by multiple factors, including sex differences. However, the mechanisms of sex differences in T2D susceptibility and pathogenesis remain unclear. Using single-cell RNA sequencing (scRNA-seq), we show sexually dimorphic transcriptomes exist in mouse β cells. Using a high-fat diet induced T2D mouse model, our work reveals the existence of sex-dependent T2D altered genes, suggesting sex-based differences in the pathological mechanisms of T2D. Our results, including sex-matched and sex-mismatched islet transplantation experiments in mice, suggest sex should be considered when treating T2D. As compared to sex-matched transplants, sex-mismatched transplants showed downregulation of genes involved in the longevity regulating pathway of β cells and led to impaired glucose tolerance in diabetic mice. Taken together, our findings further implicate sexual dimorphism in T2D pathogenicity and provides novel insights towards the development of precision medicine in T2D.

PMID:34571259 | DOI:10.1016/j.gpb.2021.07.004

Clin Otolaryngol. 2021 Sep 27. doi: 10.1111/coa.13867. Online ahead of print.

ABSTRACT

OBJECTIVES: In most cases, suspension laryngoscopy (SL) is efficient, bloodless and with minimal post-procedure discomfort. We aimed to identify predictive patient factors for acceptable surgical views at SL as well as quantify our tertiary airway unit’s complication rates.

DESIGN: Prospective cohort study of 150 consecutive microlaryngoscopy procedures involving SL over an 8-month period between November 2019 and July 2020. Patients were assessed pre-operatively for pre-existing oral, temporomandibular, dental, pharyngeal or laryngeal pathology, interincisor distance and qualitative gross limitations to neck extension and forward head posture. Intraoperatively, the laryngoscopic view was graded by anaesthetic and surgical teams, and complications were recorded on patient interview in recovery.

SETTING: Tertiary adult airway service for predominantly benign pathology.

RESULTS: Adequate surgical views were obtained in 149/150 procedures. BMI had a weak positive correlation with a more difficult view (r=0.22, p=0.008;) but did not correlate with a statistically significant increase in any complication. There was a weak negative correlation between age and interincisor gap (r=-0.20, p=0.014), and wider mouth opening correlated very weakly with a lower incidence of sore throat (r=-0.19, p=0.023). Gross macroglossia showed a significant moderate positive correlation with tongue symptoms (r=0.45, p=1.611×10^-8 ).

CONCLUSION: In the context of an experienced airway unit with a high caseload of predominantly benign pathology, SL is very effective and safe with low associated morbidity and no mortality. The most common complication of SL is temporary sore throat and there remain recognised risks of temporary tongue and dental symptoms.

PMID:34570956 | DOI:10.1111/coa.13867

Int J Paediatr Dent. 2021 Sep 27. doi: 10.1111/ipd.12930. Online ahead of print.

ABSTRACT

BACKGROUND: The association of breastmilk feeding and dental caries risk in children remains controversial. Moreover, it is unclear whether caries risk factors differ between breastmilk-fed and formula-milk-fed infants.

AIM: To investigate dental caries in 13-18-month-old infants receiving breastmilk or formula milk feeding and associated risk factors.

DESIGN: One hundred and sixty-six 13-18-month-old infants were recruited from a tertiary hospital in xxx, xxx. Information on feeding practices, demography and potential risk factors was collected using a caregiver questionnaire. Carious lesions were identified by visual and tactile examination. Chi-square, Mann-Whitney-U tests and Logistic regression were used for statistical analyses.

RESULTS: Caries prevalence in breastmilk- and formula-milk-fed infants was 31.8% and 36.0%, respectively, with no statistically significant difference (p=0.579). Among all children, having dental plaque deposition on more than 1/3 of the crown (adjusted OR(aOR)15.11, 95%CI 6.11-37.35) and sleeping while milk feeding (aOR2.20, 95%CI 1.01-4.77) were associated with dental caries. However, in subgroup analysis, sleeping while milk feeding increased caries risk in formula-milk-fed group only (aOR2.95, 95%CI 1.07-8.12).

CONCLUSIONS: Type of milk feeding was not associated with dental caries, while dental plaque and sleeping while milk feeding increased the odds of having dental caries in this population.

PMID:34570950 | DOI:10.1111/ipd.12930

Int Endod J. 2021 Sep 27. doi: 10.1111/iej.13636. Online ahead of print.

ABSTRACT

AIM: To explore the presence of the cGAS-STING inflammatory pathway in human pulp tissue and human dental pulp cells (HDPCs).

METHODOLOGY: Pulp tissue was collected from freshly extracted human healthy third molars or third molars with irreversible pulpitis. Quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunoassay (ELISA) was performed to assess IFN-β, TNF, and IL-6. HDPCs prepared from healthy human pulp tissues were transfected with interferon stimulatory DNA (ISD), bacterial genomic DNA, bacterial cyclic dinucleotides c-di-AMP, c-di-GMP, or host cyclic dinucleotide cGAMP. SiRNA was used to knockdown the endogenous cGAS or STING. G140 and H-151 were used to inhibit cGAS and STING, respectively. Amlexanox and BAY 11-7082 were used to inhibit TBK1 and NF-κB, respectively. qRT-PCR and ELISA was performed to detect the level of IFN-β, TNF, and IL-6. Western blot was performed to evaluate the TBK1, IRF3, and p65 phosphorylation. The Student’s t-test and one-way ANOVA were used for statistical analysis RESULTS: IFN-β, TNF, and IL-6 were upregulated in the inflamed human dental pulp tissue. CGAS and STING mRNA were increased in the inflamed human dental pulp tissue and detected in HDPCs prepared from healthy human pulp tissues. ISD transfection induced TBK1, IRF3, and p65 phosphorylation as well as IFN-β, TNF, and IL-6 production. IFN-β, TNF, and IL-6 production were also induced by transfection of bacterial and host cyclic dinucleotides or bacteria DNA. ISD or bacteria DNA transfection elevated the intracellular levels of cGAMP. Knockdown of cGAS or STING, as well as using cGAS inhibitor G140 or STING inhibitor H-151 abolished the IFN-β, TNF, and IL-6 production induced by ISD transfection. Knockdown of STING or using STING inhibitor H-151 abolished the IFN-β, TNF, and IL-6 induction by transfection of bacterial and host cyclic dinucleotides. Both Amlexanox and BAY 11-7082 inhibited IFN-β, TNF, and IL-6 production triggered by ISD and cyclic dinucleotides transfection.

CONCLUSIONS: HDPCs expressed an intact cGAS-STING signaling axis. The cGAS-STING signaling axis may play an important role in pulp inflammation and immune defense.

PMID:34570917 | DOI:10.1111/iej.13636

Acta Anaesthesiol Scand. 2021 Sep 27. doi: 10.1111/aas.13983. Online ahead of print.

ABSTRACT

BACKGROUND: We sought to provide a description of surge response strategies and characteristics, clinical management and outcomes of patients with severe COVID-19 in the intensive care unit (ICU) during the first wave of the pandemic in Denmark, Finland, Iceland, Norway and Sweden.

METHODS: Representatives from the national ICU registries for each of the five countries provided clinical data and a description of the strategies to allocate ICU resources and increase the ICU capacity during the pandemic. All adult patients admitted to the ICU for COVID-19 disease during the first wave of COVID-19 were included. The clinical characteristics, ICU management and outcomes of individual countries were described with descriptive statistics.

RESULTS: Most countries more than doubled their ICU capacity during the pandemic. For patients positive for SARS-CoV-2, the ratio of requiring ICU admission for COVID-19 varied substantially (1.6-6.7%). Apart from age (proportion of patients aged 65 years or over between 29-62%), baseline characteristics, chronic comorbidity burden and acute presentations of COVID-19 disease were similar among the five countries. While utilization of invasive mechanical ventilation was high (59-85%) in all countries, the proportion of patients receiving renal replacement therapy (7-26%) and various experimental therapies for COVID-19 disease varied substantially (e.g. use of hydroxychloroquine 0-85%). Crude ICU mortality ranged from 11% to 33%.

CONCLUSION: There was substantial variability in the critical care response in Nordic ICUs to the first wave of COVID-19 pandemic, including usage of experimental medications. While ICU mortality was low in all countries, the observed variability warrants further attention.

PMID:34570897 | DOI:10.1111/aas.13983

Eur J Public Health. 2021 Sep 27:ckab162. doi: 10.1093/eurpub/ckab162. Online ahead of print.

ABSTRACT

BACKGROUND: Studies have found an association between problem gambling and poverty. However, there is relatively little research on social inequalities and problem gambling using population representative data.

METHODS: A population-representative self-report web-based and postal survey with register-based linkage was conducted in the three geographical areas of Finland. Participants (n = 7186, aged 18 or older) were randomly selected from the population register. Sociodemographic factors and social welfare benefits were studied among gambling groups and their statistical difference were examined by χ2 test. Seven logistic regression models were calculated, where unemployment, social security benefits and low income were treated as dependent variables and where sex, age, family structure and education were controlled as covariates. The results were presented as odds ratios (OR) with 95% confidence intervals (CIs).

RESULTS: Problem and at-risk gambling (ARG) was more common among people who were unemployed [PG: χ2=6.4 (1), P < 0.01, ARG: χ2=12.4 (1), P < 0.001] or had received social security benefits [PG: χ2=41.6 (1), P < 0.001, ARG: χ2=22.9 (1), P < 0.001]. The OR for problem gambling was high as 5.6 (CI: 3.22-9.61) among respondents who had received social assistance even when covariates were taking into count. Almost a third of those experiencing problem or at-risk gambling received at least one form of social security benefit.

CONCLUSIONS: The most important task of gambling policy should be reducing gambling-related harms and diminishing social inequality. However, even in government organized system where gambling profits are used for common good, profits come from the most socially disadvantaged people thereby exacerbating inequality.

PMID:34570872 | DOI:10.1093/eurpub/ckab162

Rev Esc Enferm USP. 2021 Sep 24;55:e20210195. doi: 10.1590/1980-220X-REEUSP-2021-0195. eCollection 2021.

ABSTRACT

OBJECTIVE: To evaluate the effect of training on intravenous medication administration in pediatric patients on nursing staff ‘s learning and response.

METHOD: This is a quasi-experimental study (pre- and post-test), with 38 nursing professionals who participated in training on administration of intravenous (IV) medication in pediatric patients with heart disease. For data collection, a questionnaire with 19 items was applied to evaluate participants’ learning before (pre-test) and after (post-test) training. Data were analyzed by descriptive and analytical statistics (binomial and Friedman tests).

RESULTS: Nurses predominated (52.6%), mean age 41.2 years and 9.8 years of professional experience in pediatrics. For learning evaluation, there was an increase in the rate of hits from the pre-test to the post-test in 13 items, with a significant difference (p < 0.05) in the items: removing adornments to sanitize hands; wearing gloves when administering medication; administering medication with gloves, mask and goggles; and checking patient name by asking their companion.

CONCLUSION: Training had positive effects on nursing professionals’ learning and reaction.

PMID:34570871 | DOI:10.1590/1980-220X-REEUSP-2021-0195

Acta Odontol Latinoam. 2021 Aug 1;34(2):166-172.

ABSTRACT

Adhesively cemented fiber-reinforced composite posts are commonly used to reconstruct endodontically treated teeth. Adhesion to intraradicular dentin is complex, and close contact between the resin cements and the dentin is essential. The removal of the smear layer following post space preparation (secondary smear layer) can improve this integration. Different mechanical systems have been used to activate the irrigant inside the root canal. The purpose of this study was to compare, ex-vivo, the removal of the smear layer from the walls of the immediate post space preparation by the action of three mechanized instruments. Forty premolar specimens with a single root canal were selected, endodontically treated, and shaped for glass fiber post cementation with Peeso reamer #1 (Dentsply Sirona, Switzerland) and Macrolock finishing drill #3 (RTD, France). The specimens were randomly divided into 4 groups (n=10): Group C (control); Group PUI (passive ultrasonic irrigation); Group CEP (Rotoprox brush, Hager Werken, Germany) and Group XP (XP-endo Finisher, FKG Dentaire, Switzerland). Post space surfaces were cleaned with 3mL of distilled water; each specimen root split longitudinally to expose the root canals, and prepared for examination in a scanning electron microscope at magnification 350X. The results were analyzed using the Kruskal-Wallis and Friedman tests (p>0.05). RESULTS: Statistically significant differences (p<0.05) were found between Groups C and XP in all three root regions, but not between Groups C, CEP and PIU. Of these, Group CEP showed a better trend in the results of the coronary and middle thirds, without significant difference with Group XP. Although it was difficult to achieve a clean dentin surface after preparation for the fiberglass post, the XP-endo Finisher was the most efficient in removing secondary smear layer, followed by the Rotoprox conical brush.

PMID:34570865

Acta Odontol Latinoam. 2021 Aug 1;34(2):149-155.

ABSTRACT

The aim of this study was to determine prevalence and describe the clinical and radiographic findings of three-rooted primary mandibular first and second molars in a Mexican population. Intraoral periapical radiograph, orthopantomogram or cone beam computed tomography (CBCT) were obtained. A total 2284 children from the state of Puebla, Mexico were examined, of whom 20 presented an anatomic variant in tooth crown shape. Of the total teeth with crown alterations, 10 first and 5 second primary mandibular molars were found to have supernumerary roots. In one case, it was possible to obtain micro-CT images. The study recorded prevalence, unilateral or bilateral occurrence, and ratio between sexes. Data were analyzed using descriptive statistics. Clinical findings were presence of an anatomical variation (tuberculum paramolare / right and/or left cervical convexity) in primary mandibular first molars. Second molars presented conventional crown morphology. Prevalence of three-rooted primary mandibular first and second molars was 0.44% and 0.22%, respectively. Male: female ratio for presence of threerooted primary mandibular first molars was 4:1, showing genetic predisposition in males, and for second molars it was 1.5:1, with no predisposition according to sex. The clinical and radiographic anatomical variants in primary molars should be considered by pediatric dentists during routine care because they may cause difficulties in restorations.

PMID:34570863

Acta Odontol Latinoam. 2021 Aug 1;34(2):143-148.

ABSTRACT

The aim of this study was to evaluate the amount of radiating energy transmitted through lithium disilicate discs of different thicknesses and opacities with different curing units (CU). Discshaped specimens 8 mm in diameter and 1.5 mm or 0.7 mm thick were designed with Zbrush® and Cura 3D® software, milled from HT and MO IPS e-maxCAD blocks (Ivoclar Vivadent) with Ceramill Mikro 4 (Amann Girrbach, Austria) and processed according to manufacturer instructions. Thickness was checked with a Mitutoyo (México) caliper. Four groups (n=4) were formed: G1(HT/1.5 mm), G2(MO/1.5 mm), G3(HT/0.7 mm) y G4(MO/0.7 mm), and the effect of three CUs: Coltolux (Coltene- Whaledent), LED.C, (Woodpecker Medical Instrument Co.Ltd) and Deepcure L(3M-ESPE) was tested Measurements were taken with a halogen and LED radiometer (Woodpecker® LM-1-Guilin Woodpecker Medical Instrument Co.Ltd) after applying the guide of each CU directly on the reading window (d) and after interposing each of the specimens. The ratio of transmitted energy was determined in each case and data was analyzed with repeated measures ANOVA and Tukey test for multiple comparisons. LED.C: d:1600 mW/cm2, G1: 0.31(0.00), G2: 0.14(0.00) G3: 0.54(0.01), G4: 0.38(0.01); Deepcure L: d:1500 mW/cm2, G1: 0.34(0.01), G2: 0.20(0,00), G3: 0.56(0.01), G4: 0.41(0.02); Coltolux: d:1275 mW/cm2, G1: 0.44(0.01), G2: 0.24(0,00), G3: 0.65(0.01), G4: 0.47(0,00). Statistically significant differences were found among the curing units (P<0.001) and for the interaction CU-thickness (P<0.001) and CU-opacity (P=0.023). Within the conditions of this study, the ratio of light transmitted through lithium disilicate structures is related to their thickness and opacity, and to the curing unit employed.

PMID:34570862