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A randomized double-blind clinical trial evaluating comparative plaque and gingival health associated with commercially available stannous fluoride-containing dentifrices as compared to a sodium fluoride control dentifrice

J Periodontol. 2023 Apr 4. doi: 10.1002/JPER.22-0675. Online ahead of print.

ABSTRACT

BACKGROUND: Gingivitis is a non-specific inflammatory lesion in response to accumulation of oral biofilm and is a necessary precursor to periodontitis. Enhanced oral hygiene practices, including utilization of a dentifrice that could significantly improve plaque accumulation and gingival inflammation, is desirable to prevent and treat gingivitis and potentially prevent progression to periodontitis. This clinical study aimed to investigate the effect of a new stannous fluoride-containing dentifrice with 2.6% ethylenediamine tetra acetic acid (EDTA) as an anti-tartar agent to reduce plaque index and gingival index over a 3-month study period compared to other commercially-available fluoride-containing dentifrices.

METHODS: This double-blind, randomized controlled clinical study evaluated plaque, gingival inflammation, and sulcular bleeding in patients using one of five commercially available fluoride-containing dentifrices The dentifrices tested contained: 0.454% stannous fluoride and 2.6% EDTA (D1), 0.24% sodium fluoride (C), and 0.454% stannous fluoride (D2-D4). 150 subjects participated over a 3-month period. Co-primary endpoints were improvements in plaque index (PI) and modified gingival index (mGI) from baseline values. No professional cleaning was performed during the study period.

RESULTS: All subjects in the study demonstrated statistically significant improvements in all measures of oral hygiene over the 3-month study period. Subjects using dentifrice 1 (D1) showed statistically significantly greater reductions in PI, mGI, and modified sulcular bleeding index (mSBI) compared with all other commercially-available dentifrices tested (p<0.00001).

CONCLUSIONS: A new dentifrice with 0.454% stannous fluoride and 2.6% EDTA demonstrated significant improvements in clinical parameters associated with gingivitis compared to other sodium and stannous fluoride containing dentifrices. This article is protected by copyright. All rights reserved.

PMID:37016272 | DOI:10.1002/JPER.22-0675

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The Clinical Effectiveness of Denosumab (Prolia®) for the Treatment of Osteoporosis in Postmenopausal Women, Compared to Bisphosphonates, Selective Estrogen Receptor Modulators (SERM), and Placebo: A Systematic Review and Network Meta-Analysis

Calcif Tissue Int. 2023 Apr 5. doi: 10.1007/s00223-023-01078-z. Online ahead of print.

ABSTRACT

To assess the effectiveness and safety of denosumab (Prolia®) compared to bisphosphonates (alendronate, ibandronate, risedronate, zoledronate), selective estrogen receptor modulators (SERMs; bazedoxifene, raloxifene) or placebo, for the treatment of osteoporosis in postmenopausal women (PMW). Systematic searches were run in PubMed, Embase & Cochrane Library on 27-April-2022. Randomized controlled trials (RCTs) that included osteoporotic PMW allocated to denosumab, SERMs, bisphosphonates, or placebo were eligible for inclusion. RCTs were appraised using Cochrane Risk of Bias 2.0. Bayesian network and/or pairwise meta-analyses were conducted on predetermined outcomes (i.e. vertebral/nonvertebral fractures, bone mineral density [BMD], mortality, adverse events [AEs], serious AEs (SAEs), withdrawals due to AEs, AEs caused by denosumab discontinuation). A total of 12 RCTs (k = 22 publications; n = 25,879 participants) were included in the analyses. Denosumab, reported a statistically significant increase in lumbar spine (LS) and total hip (TH) BMD, compared to placebo. Similarly, denosumab also resulted in a statistically significant increase in TH BMD compared to the raloxifene and bazedoxifene. However, relative to denosumab, alendronate, ibandronate and risedronate resulted in significant improvements in both femoral neck (FN) and LS BMD. With regards to vertebral fractures and all safety outcomes, there were no statistically significant differences between denosumab and any of the comparator. Relative to placebo, denosumab was associated with significant benefits in both LS and TH BMD. Additionally, denosumab (compared to placebo) was not associated with reductions in vertebral and nonvertebral fractures. Finally, denosumab was not associated with improvement in safety outcomes, compared to placebo. These findings should be interpreted with caution as some analyses suffered from statistical imprecision.

PMID:37016189 | DOI:10.1007/s00223-023-01078-z

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DDIT4 Facilitates Lymph Node Metastasis via the Activation of NF-κB Pathway and Epithelial-Mesenchymal Transition

Reprod Sci. 2023 Apr 4. doi: 10.1007/s43032-023-01230-y. Online ahead of print.

ABSTRACT

This study was aimed to identify a novel metastasis-promoting molecule and elucidate its functional and prognostic roles in cervical cancer. DDIT4 (DNA-damage-inducible transcript 4), a hypoxia-inducible gene, was identified by analyzing multiple microarray databases. The correlation between DDIT4 expression in immunohistochemistry and clinicopathological characteristics in the public database and our cohort was evaluated by statistical analysis. Transwell® assay and wound-healing assay to determine cell migration and invasion were performed. DDIT4 was knocked down using siRNA or lentiviral vectors. The potential downstream pathways of DDIT4 were explored and verified by a gene set enrichment analysis and western blotting. The in vivo metastatic capability was determined with the use of an intraperitoneal injection mouse model. In the analysis of the public database and our cohort, DDIT4 high expression was significantly related to short overall survival and lymph node metastasis in patients with early-stage cervical cancer. The knockdown of DDIT4 attenuated the migration and invasion activity of tumor cells in vitro and reduced the expression of epithelial-mesenchymal transition (EMT)-related proteins and the NF-κB pathway in cervical cancer cells. DDIT4 also promoted tumor progression in the mouse model. Our results indicate that DDIT4 can be a prognostic indicator in cervical cancer and promote lymph node metastasis, augmenting malignancy via the EMT and NF-kB pathways.

PMID:37016173 | DOI:10.1007/s43032-023-01230-y

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Statistical Approaches for Establishing Appropriate Immunogenicity Assay Cut Points: Impact of Sample Distribution, Sample Size, and Outlier Removal

AAPS J. 2023 Apr 4;25(3):37. doi: 10.1208/s12248-023-00806-5.

ABSTRACT

The statistical assessments needed to establish anti-drug antibody (ADA) assay cut points (CPs) can be challenging for bioanalytical scientists. Poorly established CPs that are too high could potentially miss treatment emergent ADA or, when set too low, result in detection of responses that may have no clinical relevance. We evaluated 16 validation CP datasets generated with ADA assays at Regeneron’s bioanalytical laboratory and compared results obtained from different CP calculation tools. We systematically evaluated the impact of various factors on CP determination including biological and analytical variability, number of samples for capturing biological variability, outlier removal methods, and the use of parametric vs. non-parametric CP determination. In every study, biological factors were the major component of assay response variability, far outweighing the contribution from analytical variability. Non-parametric CP estimations resulted in screening positivity in drug-naïve samples closer to the targeted rate (5%) and were less impacted by skewness. Outlier removal using the boxplot method with an interquartile range (IQR) factor of 3.0 resulted in screening positivity close to the 5% targeted rate when applied to entire drug-naïve dataset. In silico analysis of CPs calculated using different sample sizes showed that using larger numbers of individuals resulted in CP estimates closer to the CP of the entire population, indicating a larger sample size (~ 150) for CP determination better represents the diversity of the study population. Finally, simpler CP calculations, such as the boxplot method performed in Excel, resulted in CPs similar to those determined using complex methods, such as random-effects ANOVA.

PMID:37016171 | DOI:10.1208/s12248-023-00806-5

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Genetic polymorphisms rs1800871 and rs1800872 of IL-10 gene are associated with dengue infection, especially with serotype 1 and DwoWS in Mexican population

Cytokine. 2023 Apr 2;166:156194. doi: 10.1016/j.cyto.2023.156194. Online ahead of print.

ABSTRACT

INTRODUCTION: Dengue infection is generated by a complex interaction between DENV (Dengue Virus) and the host’s immune response. Interleukin-10 is an immunoregulatory cytokine during DENV infection. The objective of this study was to investigate whether genetic variants in IL-10 could be useful as a predictive and susceptibility marker in the prognosis of DENV infection, particularly with serotype 1, and in participants with dengue without warning signs.

MATERIAL AND METHODS: A study of cases (n = 365) and controls (n = 364) was carried out. Genotyping was performed by real-time PCR using TaqMan probes. Sample size power was calculated using Quanto software RESULTS: This is the first report showing the independent association of the T allele of rs1800871 (P = 0.023) and the A allele of rs1800872 (P = 0.010) with the risk of dengue infection. Statistical analysis established the genotypic association of IL-10 SNPs with DENV infection under different inheritance models. Our results also showed the association of the CC, TC, and CA haplotypes (P = 0.0064, P = 0.0032, and P = 0.0010 respectively) with infection. Furthermore, both polymorphic sites were associated with the risk of DwoWS and serotype 1 (Den-1) under different inheritance models. Finally, under the dominant model, we identified a positive correlation between IL-10 levels vs. IFN-γ and IL-8.

CONCLUSION: Our results show the first independent association of the T and A alleles of the polymorphic sites rs1800871 and rs1800872, with dengue infection, particularly with Den-1, and in participants with DwoWs.

PMID:37015157 | DOI:10.1016/j.cyto.2023.156194

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Development and optimization of geopolymer adsorbent for water treatment: Application of mixture design approach

J Environ Manage. 2023 Apr 2;338:117853. doi: 10.1016/j.jenvman.2023.117853. Online ahead of print.

ABSTRACT

The current paper refers to the study of a new approach to optimizing the adsorptive properties of geopolymers by varying the aluminosilicate precursors from kaolin (K), metakaolin (MK), and coal fly ash (CFA) as internal synthesis factors. The simplex-augmented-centroid mixture design was applied to identify the optimal formulation from the three aluminosilicate precursors to develop a geopolymer (GP) with a distinctive structure that positively affects its dye adsorption efficiency. The variously formulated GP samples were tested for the removal of both methylene blue (MB-dye) and crystal violet dye (CV-dye) from an aqueous solution. The mathematical-statistical analysis of the experimental readings suggested that the generated special cubic models were significant, and thus the chosen approach was adequate for determining the optimum blending proportion. The optimization tools indicated that the optimal mixture from the three aluminosilicate precursors for developing a GP with high adsorption efficiency was 58% MK, 42% K, and 0% CFA. The optimized geopolymer (GPO) was synthesized and then analyzed using a variety of physicochemical techniques, which revealed the presence of an amorphous N-A-S-H gel-rich porous structure as an influencing property on the geopolymer’s organic dye adsorption efficiency. The dependence of the adsorption mechanism of both MB-dye and CV-dye by GPO on the adsorbent dosage, contact time, initial dye concentration, temperature, and solution pH was evaluated. The isothermic and kinetic experimental readings for MB and CV-dyes adsorption by GPO were well fitted to the pseudo-second-order and Freundlich models, with an exothermic, favorable, and spontaneous adsorption reaction thermodynamically. The experimental studies in the lab scale on GPO produce comparable results. From these results, it has been concluded that the accuracy and feasibility of the mixture design simulation succeeded in optimizing and developing a geopolymeric sorbent material with great potential as an excellent economical agent for removing cationic dyes from aqueous media. This point represents an added value compared to traditional non-optimized geopolymer absorbents. Besides, this geopolymer material represents a significant application possibility for water treatment and remediation of hazardous dye pollutants.

PMID:37015145 | DOI:10.1016/j.jenvman.2023.117853

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Familial neuromyelitis optica spectrum disorders: Case series and systematic review

Mult Scler Relat Disord. 2023 Mar 21;73:104627. doi: 10.1016/j.msard.2023.104627. Online ahead of print.

ABSTRACT

BACKGROUND: Neuromyelitis optica spectrum disorders (NMOSD) is considered a complex multifactorial disorder. Most cases are sporadic, and familial NMOSD is assumed as a rare occurrence. However, few studies reported familial aggregation of the disorder.

OBJECTIVES: To report familial NMOSD cases in Thailand and conduct a systematic review of familial NMOSD.

METHODS: A retrospective chart review of familial NMOSD patients at the university hospital was performed. Articles related to “genetic” and “NMOSD” were systematically searched and reviewed. We included NMOSD patients whose one or more relatives were diagnosed with the same disease or multiple sclerosis (MS). Data regarding demographics, clinical features, disease outcomes, and genetic testing were collected and analyzed using descriptive statistics.

RESULTS: We identified 6 familial cases from 165 NMOSD cases (3.6%) at our hospital and gathered 77 cases from a systematic review, totaling 83 cases from 40 families. The mean (SD) age at onset was 37.2 (18.0) years. Familial NMOSD involved 1-2 generations with mainly 2 affected individuals. The most common kinship pattern was siblingship in 21 families (52.5%). Initial syndromes were mostly optic neuritis and transverse myelitis. Serum aquaporin-4 IgG was positive in 79.7% of cases. Median number of relapses was 3 (range 1-26). Median expanded disability status scale in the last visit was 2 (range 0-8). Reported human leukocyte antigens (HLA) alleles shared between familial cases were HLA-A*01 and HLA-DRB1*03.

CONCLUSION: Familial clustering of NMOSD is more common than would be expected in the general population. The demographic, clinical, and outcome profiles of familial cases were not different from sporadic cases. Certain specific HLA haplotypes were shared among familial cases. Our systematic review highlighted complex genetic predisposition to NMOSD.

PMID:37015139 | DOI:10.1016/j.msard.2023.104627

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The Association Between Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder Symptoms in Medical Students

J Nerv Ment Dis. 2023 Apr 4. doi: 10.1097/NMD.0000000000001645. Online ahead of print.

ABSTRACT

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are the two most prevalent neurodevelopmental disorders affecting communication and behavior. The co-occurrence of these conditions is probable and can contribute to several challenges in adaptive functioning and academic achievement.In this cross-sectional study, 168 Iranian medical students (107 female, 61 male) studying at Tehran University of Medical Sciences in 2021 were enrolled. We administered the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R) and Adult ADHD Self-Report Scale (ASRS) questionnaires online to assess different symptoms of ASD and ADHD in our sample. In this study, the RAADS-R was translated into Persian and validated for the first time in Iran.The correlation tests demonstrated a significant association between the total score and different subscales’ scores of the RAADS-R and the total score and the two subscales’ scores of the ASRS questionnaire (p < 0.001, 0.27 < Spearman correlation coefficient < 0.51). This study also illustrated a high prevalence of ASD and ADHD symptoms among the participants. Moreover, male respondents had a significantly higher prevalence of ASD symptoms (57.3% in males vs. 28.03% in females, p < 0.001).This study indicated that the distinct impairments in behavior and cognition attributed to ASD and ADHD could be common manifestations in medical students. Given that the co-occurrence of these disorders may lead to significant challenges in their professional life, the early diagnosis and subsequent support for medical students with co-occurring expressions of ASD and ADHD could be extremely helpful, as it could indirectly improve the medical services provided to patients by future physicians, leading to an improvement in public health.

PMID:37015108 | DOI:10.1097/NMD.0000000000001645

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Childhood, adolescent, and adulthood adiposity are associated with risk of PCOS: a Mendelian randomization study with meta-analysis

Hum Reprod. 2023 Apr 4:dead053. doi: 10.1093/humrep/dead053. Online ahead of print.

ABSTRACT

STUDY QUESTION: What is the influence of body composition during childhood, adolescence, and adulthood, as well as metabolic parameters, on incident polycystic ovary syndrome (PCOS)?

SUMMARY ANSWER: Excess body fat, even during childhood/adolescence, and metabolic parameters, suggestive of hyperinsulinaemia/insulin resistance, significantly impact the risk of PCOS in a linear fashion.

WHAT IS KNOWN ALREADY: Observational and Mendelian randomization (MR) data have demonstrated an association between adulthood overweight/obesity and development of PCOS. However, the contribution of body composition in childhood/adolescence to incident PCOS is unclear, as is the influence of childhood overweight/obesity.

STUDY DESIGN, SIZE, DURATION: We conducted a systematic review and meta-analysis and integrated our results with a previously published systematic review. Two blinded investigators screened abstracts published between November 2010 and May 2021. Furthermore, we incorporated summary statistics from genome-wide association study (GWAS) data in subjects of European ancestry. Adult overweight was defined as BMI ≥ 25 kg/m2 and obesity as BMI ≥ 30 kg/m2; in Asian subjects, overweight was defined as BMI ≥ 23 kg/m2 and obesity as BMI ≥ 25 kg/m2.

PARTICIPANTS/MATERIALS, SETTING, METHODS: We utilized meta-analysis and MR together to allow synthesis of genetic and observational data. For the systematic review, the search revealed 71 studies, of which 63 were included in meta-analysis by calculating odds ratios (ORs) using the random-effects model. Furthermore, we conducted a two-sample MR study of GWAS data to determine the impact of childhood and adult body size (defined categorically by BMI and childhood body size proportions), abnormal body composition and metabolic parameters (higher fasting serum insulin or lower sex hormone-binding globulin (SHBG) concentration) on the odds of incident PCOS via the inverse-variance weighted method.

MAIN RESULTS AND THE ROLE OF CHANCE: Significant associations were shown between body composition and PCOS incidence. From the systematic review/meta-analysis, women with overweight (OR 3.80, 2.87-5.03), obesity (OR 4.99, 3.74-6.67), and central obesity (OR 2.93, 2.08-4.12) had increased odds of PCOS. For adolescents with overweight and/or obesity, the PCOS odds were greater than for adults. From MR, for every standard deviation increase in BMI (4.8 kg/m2), the odds of PCOS increased by 2.76 (2.27-3.35). Childhood body size had an independent effect on PCOS odds after adjusting for adult body size (OR: 2.56, 1.57-4.20). Genetically determined body fat percentage (OR 3.05, 2.24-4.15), whole body fat mass (OR 2.53, 2.04-3.14), fasting serum insulin (OR 6.98, 2.02-24.13), and SHBG concentration (OR 0.74, 0.64-0.87) were all significantly associated with PCOS in a linear relation.

LIMITATIONS, REASONS FOR CAUTION: The meta-analysis included studies which were cross-sectional and retrospective, limiting our ability to determine causality. MR was limited by interrogating subjects only of European ancestry and including cases classified by either self-diagnosis or diagnostic criteria.

WIDER IMPLICATIONS OF THE FINDINGS: Our study demonstrates for the first time a critical role of the impact of excess childhood/adolescent adiposity on the pathophysiology of adult PCOS. Our results, driven by genetically determined childhood/adolescent body composition, higher BMI, hyperinsulinaemia, and lower SHBG, clearly favour obesity driving the metabolic, but not reproductive, PCOS phenotype. Overall, effective weight maintenance, even from the early years, is likely to reduce the risk of this reproductive endocrine disorder.

STUDY FUNDING/COMPETING INTEREST(S): S.S.Z. was funded by a National Institute for Health and Care Research (NIHR) Academic Clinical Lectureship. U.A. is chair of the NIHR Steering Committee Trial-CASSANDRA-DN. No other authors declare any sources of funding or relevant conflicts of interest. The authors declare that the research was conducted in the absence of any commercial or financial relations that could be construed as a potential conflict of interest.

TRIAL REGISTRATION NUMBER: N/A.

PMID:37015099 | DOI:10.1093/humrep/dead053

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The stability of blood gases and CO-oximetry under slushed ice and room temperature conditions

Clin Chem Lab Med. 2023 Apr 6. doi: 10.1515/cclm-2022-1085. Online ahead of print.

ABSTRACT

OBJECTIVES: Human blood gas stability data is limited to small sample sizes and questionable statistical techniques. We sought to determine the stability of blood gases under room temperature and slushed iced conditions in patients using survival analyses.

METHODS: Whole blood samples from ∼200 patients were stored in plastic syringes and kept at room temperature (22-24 °C) or in slushed ice (0.1-0.2 °C) before analysis. Arterial and venous pO2 (15-150 mmHg), pCO2 (16-72 mmHg), pH (6.73-7.52), and the CO-oximetry panel [total hemoglobin (5.4-19.3 g/dL), percentages of oxyhemoglobin (O2Hb%, 20-99%), carboxyhemoglobin (COHb, 0.1-5.4%) and methemoglobin (MetHb, 0.2-4.6%)], were measured over 5-time points. The Royal College of Pathologists of Australasia’s (RCPA’s) criteria determined analyte instability. Survival analyses identified storage times at which 5% of the samples for various analytes became unstable.

RESULTS: COHb and MetHb were stable up to 3 h in slushed ice and at room temperature; pCO2, pH was stable at room temperature for about 60 min and 3 h in slushed ice. Slushed ice shortened the storage time before pO2 became unstable (from 40 to 20 min), and the instability increased when baseline pO2 was ≥60 mmHg. The storage time for pO2, pCO2, pH, and CO-oximetry, when measured together, were limited by the pO2.

CONCLUSIONS: When assessing pO2 in plastic syringes, samples kept in slushed ice harm their stability. For simplicity’s sake, the data support storage times for blood gas and CO-oximetry panels of up to 40 min at room temperature if following RCPA guidelines.

PMID:37015069 | DOI:10.1515/cclm-2022-1085