ri An Allergist Offers His Expert Advice for a Sneeze-Free Spring By www.medicinenet.com Published On :: Mon, 9 Mar 2020 00:00:00 PDT Title: An Allergist Offers His Expert Advice for a Sneeze-Free SpringCategory: Health NewsCreated: 3/7/2020 12:00:00 AMLast Editorial Review: 3/9/2020 12:00:00 AM Full Article
ri Perimenopause By www.medicinenet.com Published On :: Tue, 17 Sep 2019 00:00:00 PDT Title: PerimenopauseCategory: Diseases and ConditionsCreated: 7/5/2005 12:00:00 AMLast Editorial Review: 9/17/2019 12:00:00 AM Full Article
ri AHA News: Estrogen Therapy in Early Menopause May Help Keep Arteries Clear By www.medicinenet.com Published On :: Wed, 4 Mar 2020 00:00:00 PDT Title: AHA News: Estrogen Therapy in Early Menopause May Help Keep Arteries ClearCategory: Health NewsCreated: 3/3/2020 12:00:00 AMLast Editorial Review: 3/4/2020 12:00:00 AM Full Article
ri Sleepy Seniors Have Higher Health Risks By www.medicinenet.com Published On :: Tue, 3 Mar 2020 00:00:00 PDT Title: Sleepy Seniors Have Higher Health RisksCategory: Health NewsCreated: 3/2/2020 12:00:00 AMLast Editorial Review: 3/3/2020 12:00:00 AM Full Article
ri Seniors, Getting Off the Sofa Brings Big Health Benefits By www.medicinenet.com Published On :: Fri, 6 Mar 2020 00:00:00 PDT Title: Seniors, Getting Off the Sofa Brings Big Health BenefitsCategory: Health NewsCreated: 3/5/2020 12:00:00 AMLast Editorial Review: 3/6/2020 12:00:00 AM Full Article
ri Heavy Drinking Into Old Age Ups Health Risks: Study By www.medicinenet.com Published On :: Wed, 8 Apr 2020 00:00:00 PDT Title: Heavy Drinking Into Old Age Ups Health Risks: StudyCategory: Health NewsCreated: 4/7/2020 12:00:00 AMLast Editorial Review: 4/8/2020 12:00:00 AM Full Article
ri Long Periods in Space Alter Astronauts' Brains By www.medicinenet.com Published On :: Wed, 15 Apr 2020 00:00:00 PDT Title: Long Periods in Space Alter Astronauts' BrainsCategory: Health NewsCreated: 4/14/2020 12:00:00 AMLast Editorial Review: 4/15/2020 12:00:00 AM Full Article
ri What Is the Pringle Maneuver Procedure? By www.medicinenet.com Published On :: Wed, 22 Apr 2020 00:00:00 PDT Title: What Is the Pringle Maneuver Procedure?Category: Procedures and TestsCreated: 4/22/2020 12:00:00 AMLast Editorial Review: 4/22/2020 12:00:00 AM Full Article
ri What Is Nasogastric Intubation Used For? By www.medicinenet.com Published On :: Mon, 4 May 2020 00:00:00 PDT Title: What Is Nasogastric Intubation Used For?Category: Procedures and TestsCreated: 5/4/2020 12:00:00 AMLast Editorial Review: 5/4/2020 12:00:00 AM Full Article
ri Is a 'Universal' Flu Vaccine on the Horizon? By www.medicinenet.com Published On :: Tue, 10 Mar 2020 00:00:00 PDT Title: Is a 'Universal' Flu Vaccine on the Horizon?Category: Health NewsCreated: 3/9/2020 12:00:00 AMLast Editorial Review: 3/10/2020 12:00:00 AM Full Article
ri The Doctor Gap: In Areas of Greatest Need, Primary Care Is a Team Effort By www.medicinenet.com Published On :: Fri, 20 Mar 2020 00:00:00 PDT Title: The Doctor Gap: In Areas of Greatest Need, Primary Care Is a Team EffortCategory: Health NewsCreated: 3/19/2020 12:00:00 AMLast Editorial Review: 3/20/2020 12:00:00 AM Full Article
ri Women Are Much Safer Drivers Than Men, British Study Finds By www.medicinenet.com Published On :: Tue, 7 Apr 2020 00:00:00 PDT Title: Women Are Much Safer Drivers Than Men, British Study FindsCategory: Health NewsCreated: 4/7/2020 12:00:00 AMLast Editorial Review: 4/7/2020 12:00:00 AM Full Article
ri Ride-Sharing Services Tied to Rise in Car Crashes By www.medicinenet.com Published On :: Wed, 8 Apr 2020 00:00:00 PDT Title: Ride-Sharing Services Tied to Rise in Car CrashesCategory: Health NewsCreated: 4/7/2020 12:00:00 AMLast Editorial Review: 4/8/2020 12:00:00 AM Full Article
ri When Booze Labels Carry Health Warnings, Drinking Declines: Study By www.medicinenet.com Published On :: Mon, 4 May 2020 00:00:00 PDT Title: When Booze Labels Carry Health Warnings, Drinking Declines: StudyCategory: Health NewsCreated: 5/4/2020 12:00:00 AMLast Editorial Review: 5/4/2020 12:00:00 AM Full Article
ri Wellbutrin (bupropion) By www.medicinenet.com Published On :: Wed, 12 Feb 2020 00:00:00 PDT Title: Wellbutrin (bupropion)Category: MedicationsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 2/12/2020 12:00:00 AM Full Article
ri Teen Moms at High Risk for Depression, Anxiety By www.medicinenet.com Published On :: Mon, 2 Mar 2020 00:00:00 PDT Title: Teen Moms at High Risk for Depression, AnxietyCategory: Health NewsCreated: 2/28/2020 12:00:00 AMLast Editorial Review: 3/2/2020 12:00:00 AM Full Article
ri Kisqali (ribociclib) By www.medicinenet.com Published On :: Wed, 22 Apr 2020 00:00:00 PDT Title: Kisqali (ribociclib)Category: MedicationsCreated: 4/22/2020 12:00:00 AMLast Editorial Review: 4/22/2020 12:00:00 AM Full Article
ri Bacterial Blood Infections Tied to Heightened Colon Cancer Risk By www.medicinenet.com Published On :: Thu, 23 Apr 2020 00:00:00 PDT Title: Bacterial Blood Infections Tied to Heightened Colon Cancer RiskCategory: Health NewsCreated: 4/22/2020 12:00:00 AMLast Editorial Review: 4/23/2020 12:00:00 AM Full Article
ri FDA Approves Trodelvy for Metastatic Triple-Negative Breast Cancer By www.medicinenet.com Published On :: Fri, 24 Apr 2020 00:00:00 PDT Title: FDA Approves Trodelvy for Metastatic Triple-Negative Breast CancerCategory: Health NewsCreated: 4/24/2020 12:00:00 AMLast Editorial Review: 4/24/2020 12:00:00 AM Full Article
ri Fewer Kids in Cancer Trials, Which Might Not Be a Bad Thing By www.medicinenet.com Published On :: Wed, 6 May 2020 00:00:00 PDT Title: Fewer Kids in Cancer Trials, Which Might Not Be a Bad ThingCategory: Health NewsCreated: 5/5/2020 12:00:00 AMLast Editorial Review: 5/6/2020 12:00:00 AM Full Article
ri Malaria By www.medicinenet.com Published On :: Fri, 15 Nov 2019 00:00:00 PDT Title: MalariaCategory: Diseases and ConditionsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 11/15/2019 12:00:00 AM Full Article
ri Spring Time Change Tied to More Fatal Car Crashes By www.medicinenet.com Published On :: Fri, 31 Jan 2020 00:00:00 PDT Title: Spring Time Change Tied to More Fatal Car CrashesCategory: Health NewsCreated: 1/30/2020 12:00:00 AMLast Editorial Review: 1/31/2020 12:00:00 AM Full Article
ri Untreated Sleep Apnea Puts Your Heart at High Risk By www.medicinenet.com Published On :: Tue, 4 Feb 2020 00:00:00 PDT Title: Untreated Sleep Apnea Puts Your Heart at High RiskCategory: Health NewsCreated: 2/3/2020 12:00:00 AMLast Editorial Review: 2/4/2020 12:00:00 AM Full Article
ri Erratic Sleep Habits May Boost Risk of Heart Problems: Study By www.medicinenet.com Published On :: Thu, 5 Mar 2020 00:00:00 PDT Title: Erratic Sleep Habits May Boost Risk of Heart Problems: StudyCategory: Health NewsCreated: 3/4/2020 12:00:00 AMLast Editorial Review: 3/5/2020 12:00:00 AM Full Article
ri Get Ready for Clocks to 'Spring Ahead' By www.medicinenet.com Published On :: Fri, 6 Mar 2020 00:00:00 PDT Title: Get Ready for Clocks to 'Spring Ahead'Category: Health NewsCreated: 3/6/2020 12:00:00 AMLast Editorial Review: 3/6/2020 12:00:00 AM Full Article
ri Long Noncoding RNA MALAT1 Contributes to Sorafenib Resistance by Targeting miR-140-5p/Aurora-A Signaling in Hepatocellular Carcinoma By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 Long noncoding RNAs (lncRNA) have been found to play critical roles in tumorigenesis and the development of various cancers, including hepatocellular carcinoma (HCC). Metastasis associated with lung adenocarcinoma transcript-1 (MALAT1) has been identified as an oncogene and prognostic biomarker in HCC. Here, we demonstrated that MALAT1 expression was obviously high in sorafenib-resistant HCC cells. Furthermore, knockdown of MALAT1 increased sorafenib sensitivity in nonresponsive HCC cells, whereas forced expression of MALAT1 conferred sorafenib resistance to responsive HCC cells in vitro. In addition, loss/gain-of-function assays revealed that MALAT1 promoted cell proliferation, migration, and epithelial–mesenchymal transition in HCC cells. Mechanistically, MALAT1 regulated Aurora-A expression by sponging miR-140-5p, thus promoting sorafenib resistance in HCC cells. Moreover, MALAT1 inhibition enhanced the antitumor efficacy of sorafenib in vivo. Clinically, we found that MALAT1 expression was negatively correlated with miR-140-5p expression but positively correlated with Aurora-A expression in patients with HCC and that upregulated MALAT1 was closely correlated with poor survival outcomes in patients with HCC. These findings indicated that MALAT1 may be a novel target for prognosis prediction and therapeutic strategies in patients with HCC treated with sorafenib. Full Article
ri CDK9 Blockade Exploits Context-dependent Transcriptional Changes to Improve Activity and Limit Toxicity of Mithramycin for Ewing Sarcoma By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 There is a need to develop novel approaches to improve the balance between efficacy and toxicity for transcription factor–targeted therapies. In this study, we exploit context-dependent differences in RNA polymerase II processivity as an approach to improve the activity and limit the toxicity of the EWS-FLI1–targeted small molecule, mithramycin, for Ewing sarcoma. The clinical activity of mithramycin for Ewing sarcoma is limited by off-target liver toxicity that restricts the serum concentration to levels insufficient to inhibit EWS-FLI1. In this study, we perform an siRNA screen of the druggable genome followed by a matrix drug screen to identify mithramycin potentiators and a synergistic "class" effect with cyclin-dependent kinase 9 (CDK9) inhibitors. These CDK9 inhibitors enhanced the mithramycin-mediated suppression of the EWS-FLI1 transcriptional program leading to a shift in the IC50 and striking regressions of Ewing sarcoma xenografts. To determine whether these compounds may also be liver protective, we performed a qPCR screen of all known liver toxicity genes in HepG2 cells to identify mithramycin-driven transcriptional changes that contribute to the liver toxicity. Mithramycin induces expression of the BTG2 gene in HepG2 but not Ewing sarcoma cells, which leads to a liver-specific accumulation of reactive oxygen species (ROS). siRNA silencing of BTG2 rescues the induction of ROS and the cytotoxicity of mithramycin in these cells. Furthermore, CDK9 inhibition blocked the induction of BTG2 to limit cytotoxicity in HepG2, but not Ewing sarcoma cells. These studies provide the basis for a synergistic and less toxic EWS-FLI1–targeted combination therapy for Ewing sarcoma. Full Article
ri Genomics, Morphoproteomics, and Treatment Patterns of Patients with Alveolar Soft Part Sarcoma and Response to Multiple Experimental Therapies By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 Overexpression of transcription factor 3 in alveolar soft part sarcoma(ASPS) results in upregulation of cell proliferation pathways. No standard treatment algorithm exists for ASPS; multikinase inhibitors[tyrosine kinase inhibitor (TKI)] and immune checkpoint inhibitors (ICI) have shown clinical benefit. To date, no studies have reported on management strategies or sequencing of therapy. We evaluated ASPS treatment patterns and responses in an experimental therapeutics clinic. Genomic and morphoproteomic analysis was performed to further elucidate novel targets. We retrospectively reviewed patients with ASPS treated on clinical trials. Demographic and clinical next-generation sequencing (NGS) profiles were collected. AACR GENIE database was queried to further evaluate aberrations in ASPS. Morphoproteomic analysis was carried out to better define the biology of ASPS with integration of genomic and proteomic findings. Eleven patients with ASPS were identified; 7 received NGS testing and mutations in CDKN2A (n = 1) and hepatocyte growth factor (n = 1) were present. Ten patients were treated with TKIs with stable disease as best response and 4 patients with ICI (three partial responses). Within GENIE, 20 patients were identified harboring 3 called pathogenic mutations. Tumor mutation burden was low in all samples. Morphoproteomic analysis confirmed the expression of phosphorylated c-Met. In addition, fatty acid synthase and phosphorylated-STAT3 were detected in tumor cell cytoplasm and nuclei. Patients with ASPS have a quiescent genome and derive clinical benefit from VEGF-targeting TKIs. Morphoproteomic analysis has provided both additional correlative pathways and angiogenic mechanisms that are targetable for patients with ASPS. Our study suggests that sequential therapy with TKIs and immune checkpoint inhibitors is a reasonable management strategy. Full Article
ri Elucidation of Pelareorep Pharmacodynamics in A Phase I Trial in Patients with KRAS-Mutated Colorectal Cancer By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 KRAS mutation is a negative predictive biomarker of anti-EGFR agents in patients with metastatic colorectal cancer (mCRC), and remains an elusive target. Pelareorep, a double-stranded RNA virus selectively replicates in KRAS-mutated cells, and is synergistic with irinotecan. A dose escalation trial of FOLFIRI/bevacizumab [irinotecan (150–180 mg/m2) and pelareorep (1 x 1010 TCID50–3 x 1010 TCID50)] was implemented in adult patients with oxaliplatin refractory/intolerant, KRAS-mutant mCRC. Pelareorep was administered intravenously over 1 hour on days 1–5 every 4 weeks. Additional studies included pharmacokinetics, tumor morphology, and immune responses. Among FOLFIRI-naïve patients, the highest dose of FOLFIRI/bevacizumab (180 mg/m2 irinotecan) and pelareorep (3 x 1010 TCID50) was well tolerated, without a dose-limiting toxicity. At the recommended phase II dose, 3 of 6 patients (50%) had a partial response; the median progression-free and overall survival (PFS, OS) were 65.6 weeks and 25.1 months, respectively. Toxicities included myelosuppression, fatigue, and diarrhea. Transmission electron microscopy revealed viral factories (viral collections forming vesicular structures), at various stages of development. Immunogold staining against viral capsid -1 protein demonstrated viral "homing" in the tumor cells. The nucleus displayed sufficient euchromatin regions suggestive of active transcription. Flow cytometry revealed rapid dendritic cell maturation (48 hours) with subsequent activation of cytotoxic T cells (7 days). The combination of pelareorep with FOLFIRI/bevacizumab is safe. The PFS and OS data are encouraging and deserve further exploration. Pelareorep leads to a clear recurrent immune stimulatory response with cytotoxic T-cell activation, and homes and replicates in the tumor. Full Article
ri Yorkshire Geological Society Registered Charity No. 220014 Society Proceedings 2018 By pygs.lyellcollection.org Published On :: 2019-11-22T06:43:26-08:00 Full Article
ri Glacial lake terraces at the eastern end of the Vale of Pickering, North Yorkshire, UK By pygs.lyellcollection.org Published On :: 2019-11-22T06:43:26-08:00 Detailed landform mapping of key areas in the Vale of Pickering, supported by LiDAR interpretation, has produced sufficient evidence to establish a reinterpretation of the Mid to Late Pleistocene chronology of the Vale of Pickering by defining the margins of two temporally distinct proglacial lakes and reaching a new understanding of the origin of some well-documented geomorphological features. The main significance of the mapping has been to establish that the Hutton Buscel terrace probably originated by lateral erosion along the southern edge of the Corallian Group dip slope of the North York Moors prior to deposition of a broad alluvial plain below a 70 m strandline. Traces of a comparable feature were also located below the Chalk Group escarpment on the southern side of the Vale of Pickering. Perhaps of equal significance has been confirmation that the younger of the two lakes, which has a 45 m shoreline, was possibly connected to Lake Humber in the Vale of York through the Derwent Valley. Evidence for such a lake was provided by mapped shorelines at Malton and Pickering that appear compatible with shorelines in Lake Humber. To account for deep erosion of the Derwent and Mere valleys and the occurrence of laminated clays at c. 65 m, below a 70 m shoreline above Crambe, regional uplift has been evoked post the older 70 m lake. In-valley alluvial fans have been mapped for the first time in Newton Dale and Thornton Dale. Full Article
ri Two previously unrecorded xiphosurid trace fossils, Selenichnites rossendalensis and Crescentichnus tesiltus, from the Middle Jurassic of Yorkshire, UK By pygs.lyellcollection.org Published On :: 2019-11-22T06:43:26-08:00 The invertebrate trace fossils Selenichnites rossendalensis and Crescentichnus tesiltus are recorded and described from the Middle Jurassic Gristhorpe Member of the Cloughton Formation of the Cleveland Basin. This is the first record of these ichnospecies from the basin and now completes the occurrence of these and other traces assumed to have been made by limulids from all three non-marine formations of the Ravenscar Group. Full Article
ri 3D Printed Teeth with Enamel and Dentin Layer for Educating Dental Students in Crown Preparation By www.jdentaled.org Published On :: 2019-12-01T06:00:19-08:00 Commonly used model teeth are so far uniform in color and hardness. There is no discrimination between enamel and dentin part of a tooth. This condition makes it difficult to train a preparation technique, which is adapted to real tooth substance. The aim of this study was to design and establish a 3D printed tooth with different layers for enamel and dentin for education in crown preparation. A printable tooth with different layers for enamel and dentin was designed, and all 38 fourth-year dental students in the first clinical course in prosthodontics and 30 experienced dentists were trained during a voluntary hands-on course in 2019. Prior to the study, the students had used standard model teeth and real-teeth models in their preclinical education. They had experience in caries removal and preparation on real patients. The perceived benefits of the 3D printed tooth were evaluated by a questionnaire. All individuals in both groups completed the questionnaire, for a 100% response rate. The results showed that the printed tooth was given an overall mean grade of 2.3 (students) and 2.0 (experts) on a scale from 1=excellent to 5=poor. The difference in hardness between the dentin and enamel layer was given a mean of 2.4 (students and experts) and the difference in color a 1.7 (students) and 1.8 (experts). The tooth model with the prepared tooth illustrating an ideal preparation was graded 1.6 (students and experts). In this study, the students had the opportunity to learn a correct crown preparation on a printed tooth with different material properties for enamel and dentin. The learning effect with this tooth model was rated as good on the questionnaire by both students and expert dentists. Full Article
ri Redefining Medical Competencies for an Oral Medicine Specialty Training Curriculum Using a Modified Delphi Technique By www.jdentaled.org Published On :: 2019-12-01T06:00:19-08:00 This article describes the development of medical competencies for oral medicine specialty training in the UK and Ireland by a collaborative working group using a modified Delphi technique. The current specialty training curriculum for oral medicine (OM) in the UK was developed by a working group including members of the British Society for Oral Medicine (BSOM) and members of the Specialty Advisory Committee for Additional Dental Specialties (SACADS) and adopted by the UK General Dental Council (GDC) in 2010. When the curriculum was developed, the entry requirements for specialty training in OM included undergraduate degrees in both dentistry and medicine. At the time of adoption, the requirement for a medical degree was removed. Medical competencies were assumed to have been delivered in medical undergraduate and postgraduate training. Accordingly, there was a need to define the medical competencies for OM specialty training to benefit trainees, trainers, and assessors. In 2018, a group comprising specialty trainers, recent former specialty trainees, and current specialty trainees in OM held face-to-face meetings in addition to email discussions and developed an updated curriculum document to better reflect the medical competencies required in specialty training. A collaborative modified Delphi approach was used to evaluate medical foundation competencies and to include only those that were considered relevant to OM specialty training. A list of relevant and achievable medical competencies was determined that has been approved by SACADS and will be incorporated into a revised OM curriculum from the UK GDC. The newly agreed-upon document for medical competencies in OM specialty training will serve as a reference for trainees, trainers, and assessors and reflects a successful use of a modified Delphi approach. Full Article
ri Evaluation of Faculty Mentoring Practices in Seven U.S. Dental Schools By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 The aim of this cross-sectional study was to examine the faculty mentoring practices in seven dental schools in the U.S. A 34-item survey was administered electronically to dental faculty members of all ranks, tracks, and job categories in seven dental schools using faculty listservs. Survey questions addressed current mentoring practices in which the faculty members were involved; their perceptions of those mentoring practices; their perceived characteristics of an ideal mentoring program, mentor, and mentee; perceived best practices; and respondents’ demographics. The survey was conducted from October 2017 to February 2018. A total of 154 surveys were completed (response rate 22%). Over 58% (90/154) of the respondents reported receiving no mentoring; 31.9% (49/154) said they received informal mentoring; and 9.7% (15/154) received formal mentoring. Of the 64 respondents who received mentoring, both formal and informal, 92.2% (59/64) were full-time faculty, and 7.8% (5/64) were part-time faculty (p=0.001). Approximately 39% of the respondents indicated that their mentoring program was not overseen by anyone and that participation was voluntary. The top three perceived benefits of mentoring were increased overall professional development, development of a career plan, and increased professional networks. The three most important characteristics of an ideal mentoring program for the respondents were a program based on the needs of the mentee, a mentor who has the desire to help the mentee, and a mentee who is eager to learn. The results of this study showed a very low level of formal or informal faculty mentoring programs in the dental schools surveyed. Future studies are needed to determine best practices and strategies to expand and enhance mentoring of faculty members. Full Article
ri Top-Cited Articles from Dental Education Journals, 2009 to 2018: A Bibliometric Analysis By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 The number of citations an article receives is an important indicator to quantify its influence in its field. The aim of this study was to identify and analyze the characteristics of the 50 top-cited articles addressing dental education published in two journals dedicated to dental education (European Journal of Dental Education and Journal of Dental Education). The Web of Science database was searched to retrieve the 50 most-cited articles from the two journals in December 2018. The top-cited articles were analyzed for journal of publication, number of citations, institution and country of origin, year of publication, study type, keywords, theme and subtheme, and international collaborations. The results showed the 50 top-cited articles were cited between 24 and 146 times each. The majority of these top-cited articles (n=34) were published in the Journal of Dental Education. Half (n=25) of the articles were by authors in the U.S. The most common study types were surveys (n=26) and reviews (n=10). The main themes of these top-cited articles were curriculum and learner characteristics. This bibliometric analysis can serve as a reference for recognizing studies with the most impact in the scholarship of dental education. Full Article
ri Entrustable Professional Activities in Oral Health for Primary Care Providers Based on a Scoping Review By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 Despite advances in oral health care, inequalities in oral health outcomes persist due to problems in access. With proper training, primary care providers can mitigate this inequality by providing oral health education, screening, and referral to advanced dental treatment. Diverging sets of oral health competencies and guidelines have been released or endorsed by multiple primary care disciplines. The aim of this study was to transform multiple sets of competencies into Entrustable Professional Activities (EPAs) for oral health integration into primary care training. A scoping review of the literature between January 2000 and December 2016 was conducted according to PRISMA methodology to identify all existing sets of competencies. The following primary care disciplines were included in the search: allopathic/osteopathic medical schools and residency programs in family medicine, internal medicine, and pediatrics; physician assistant programs; and nurse practitioner programs. Competencies were compared using the Health Resources and Services Administration Integration of Oral Health and Primary Care Practice competencies as the foundational set and translated into EPAs. The resulting EPAs were tested with a reactor panel. The scoping review produced 1,466 references, of which 114 were selected for full text review. Fourteen competencies were identified as being central to the integration of oral health into primary care. These were converted to seven EPAs for oral health integration into primary care and were mapped onto Accreditation Council for Graduate Medical Education residency competency domains as well to the Association of American Medical Colleges EPAs for graduating medical students. The resulting EPAs delineate the essential, observable work required of primary care providers to ensure that oral health is treated as a critical determinant of overall health. Full Article
ri Knowledge, Attitudes and Practices of Dental Hygienists Regarding Diabetes Risk Assessments and Screenings By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Purpose: Untreated and poorly controlled diabetes causes increased levels of blood glucose associated with poor periodontal disease outcomes. Dental hygienists can play a significant role in screening patients for diabetes mellitus, leading to referral and early diagnosis. The purpose of this study was to determine the knowledge, attitudes, practices, and barriers faced by clinical dental hygienists regarding diabetes risk assessment and screenings.Methods: A mixed method design was used with a convenience sample of dental hygienists in clinical practice (n=316). A 32 item, electronic survey was validated at item-level, and participants were recruited through multiple dental hygiene Facebook groups. Descriptive statistics were used to analyze the data. The survey also included two open-ended attitude questions that were interpreted using thematic analysis to pinpoint common patterns within the data.Results: Dental hygienists had high knowledge scores regarding diabetes and oral health, although many were unaware of their states' specific statutes and regulations for screening practices. Nearly all (95.9%), were likely to educate and refer patients (82%), although fewer than half (40.9%), were likely to perform chairside screening for diabetes. Emergent themes for barriers to screening were time, money, patient acceptance/willingness, lack of education, not having the proper tools, and states' rules and regulations.Conclusion: Despite high knowledge scores regarding diabetes and oral health, there is a gap in regards to dental hygienists' willingness to perform diabetes screenings in a clinical setting. Dental hygienists should be capable of integrating chairside diabetes screening practices into the process of care with proper training. Full Article
ri Evaluation of an Automated Digital Scoring System of Dental Plaque By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Purpose: Measurement of dental plaque is frequently used as an indicator of overall oral health. The purpose of this study was to compare a manual (visual) plaque scoring system (University of Mississippi Oral Hygiene Index, UM-OHI) with an innovative automated digital scoring system.Methods: Mechanically ventilated, intensive care unit (ICU) patients (n=79) were the study population. Informed consent was given by the subject's legally authorized representative. Digital images of dental plaque were taken using an intraoral camera; and the quantity of dental plaque was scored using the UM-OHI and with a digitized automated scoring system. Distributions of dental plaque scores from both methods were plotted. Pearson correlation coefficients and intra-class coefficients were calculated between the two methods.Results: Participant mean age was 57.3 years; respiratory failure was the most prevalent admission diagnosis (55.7%). The mean percentage of dental plaque calculated by the manual method was found to be remarkably higher (67.3% ± 18.7%) than the percentage of dental plaque calculated by the automated scoring method (23.7% ± 15.2%) (p<0.0001). Despite remarkably different distributions of plaque scores, both the automated and manual scoring systems demostrated relatively high correlation (r=0.62) and good reliability (ICC=0.63).Conclusion: The automated digital scoring system resulted in a significantly lower overall percentage of total dental plaque as compared to the UM-OHI manual scoring system. While the automated digital scoring system may be more precise than a manual (visual) scoring system, its use should be weighed against the added effort, cost, and expertise required for the method. Further study is needed to determine whether an automated digital scoring system can be commercialized and is warranted for use outside of research settings. Full Article
ri Measuring Oral Health Literacy of Refugees: Associations with Dental Care Utilization and Oral Health Self-Efficacy By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Purpose: The purpose of this study was to analyze associations between the oral health literacy of refugees and two oral health outcomes: dental care utilization and oral health self-efficacy.Methods: A convenience sample of refugees in the greater Los Angeles area attending English as a second language (ESL) classes sponsored by two refugee assistance organizations was used for this cross-sectional, correlational study. Participants responded to a questionnaire using items from the Health Literacy in Dentistry (HeLD) scale, in addition to items concerning dental care utilization and oral health self-efficacy. Descriptive statistics, chi-square and Fisher's Exact tests were used to analyze results.Results: Sixty-two refugees volunteered to participate (n=62). A majority of the respondents were female from Iraq or Syria, and selected the item “with little difficulty” for all oral health literacy tasks. In regards to dental care utilization, more than half of the respondents were considered high utilizers (63%, n=34) meaning they had visited a dental office within the last year; while a little more than one-third (37%, n=20), were low utilizers, indicating they had either never been to a dental office or it had been more than one year since they had dental treatment. Statistical analysis showed associations between oral health literacy and dental care utilization. However, few associations between oral health literacy and oral health self-efficacy were identified (p=0.0045).Conclusions: Results support the provision of easily obtainable and understandable oral health information to increase oral health literacy and dental care utilization among refugee populations. Future research is needed to examine the oral health literacy among refugees resettling in the United States. Full Article
ri Nanodomains can persist at physiologic temperature in plasma membrane vesicles and be modulated by altering cell lipids [Research Articles] By www.jlr.org Published On :: 2020-05-01T00:05:27-07:00 The formation and properties of liquid-ordered (Lo) lipid domains (rafts) in the plasma membrane are still poorly understood. This limits our ability to manipulate ordered lipid domain-dependent biological functions. Giant plasma membrane vesicles (GPMVs) undergo large-scale phase separations into coexisting Lo and liquid-disordered lipid domains. However, large-scale phase separation in GPMVs detected by light microscopy is observed only at low temperatures. Comparing Förster resonance energy transfer-detected versus light microscopy-detected domain formation, we found that nanodomains, domains of nanometer size, persist at temperatures up to 20°C higher than large-scale phases, up to physiologic temperature. The persistence of nanodomains at higher temperatures is consistent with previously reported theoretical calculations. To investigate the sensitivity of nanodomains to lipid composition, GPMVs were prepared from mammalian cells in which sterol, phospholipid, or sphingolipid composition in the plasma membrane outer leaflet had been altered by cyclodextrin-catalyzed lipid exchange. Lipid substitutions that stabilize or destabilize ordered domain formation in artificial lipid vesicles had a similar effect on the thermal stability of nanodomains and large-scale phase separation in GPMVs, with nanodomains persisting at higher temperatures than large-scale phases for a wide range of lipid compositions. This indicates that it is likely that plasma membrane nanodomains can form under physiologic conditions more readily than large-scale phase separation. We also conclude that membrane lipid substitutions carried out in intact cells are able to modulate the propensity of plasma membranes to form ordered domains. This implies lipid substitutions can be used to alter biological processes dependent upon ordered domains. Full Article
ri The grease trap: uncovering the mechanism of the hydrophobic lid in Cutibacterium acnes lipase [Research Articles] By www.jlr.org Published On :: 2020-05-01T00:05:27-07:00 Acne is one of the most common dermatological conditions, but the details of its pathology are unclear, and current management regimens often have adverse effects. Cutibacterium acnes is known as a major acne-associated bacterium that derives energy from lipase-mediated sebum lipid degradation. C. acnes is commensal, but lipase activity has been observed to differ among C. acnes types. For example, higher populations of the type IA strains are present in acne lesions with higher lipase activity. In the present study, we examined a conserved lipase in types IB and II that was truncated in type IA C. acnes strains. Closed, blocked, and open structures of C. acnes ATCC11828 lipases were elucidated by X-ray crystallography at 1.6–2.4 Å. The closed crystal structure, which is the most common form in aqueous solution, revealed that a hydrophobic lid domain shields the active site. By comparing closed, blocked, and open structures, we found that the lid domain-opening mechanisms of C. acnes lipases (CAlipases) involve the lid-opening residues, Phe-179 and Phe-211. To the best of our knowledge, this is the first structure-function study of CAlipases, which may help to shed light on the mechanisms involved in acne development and may aid in future drug design. Full Article
ri Biology of Lipid Rafts: Introduction to the Thematic Review Series [Thematic Reviews] By www.jlr.org Published On :: 2020-05-01T00:05:27-07:00 Lipid rafts are organized plasma membrane microdomains, which provide a distinct level of regulation of cellular metabolism and response to extracellular stimuli, affecting a diverse range of physiologic and pathologic processes. This Thematic Review Series focuses on Biology of Lipid Rafts rather than on their composition or structure. The aim is to provide an overview of ideas on how lipid rafts are involved in regulation of different pathways and how they interact with other layers of metabolic regulation. Articles in the series will review the involvement of lipid rafts in regulation of hematopoiesis, production of extracellular vesicles, host interaction with infection, and the development and progression of cancer, neuroinflammation, and neurodegeneration, as well as the current outlook on therapeutic targeting of lipid rafts. Full Article
ri Commentary on SSO and other putative inhibitors of FA transport across membranes by CD36 disrupt intracellular metabolism, but do not affect fatty acid translocation [Commentaries] By www.jlr.org Published On :: 2020-05-01T00:05:27-07:00 Full Article
ri Membrane domains beyond the reach of microscopy [Commentaries] By www.jlr.org Published On :: 2020-05-01T00:05:27-07:00 Full Article
ri Images in Lipid Research [Editorials] By www.jlr.org Published On :: 2020-05-01T00:05:27-07:00 Full Article
ri Using Colonization Assays and Comparative Genomics To Discover Symbiosis Behaviors and Factors in Vibrio fischeri By mbio.asm.org Published On :: 2020-03-03T01:30:27-08:00 ABSTRACT The luminous marine Gram-negative bacterium Vibrio (Aliivibrio) fischeri is the natural light organ symbiont of several squid species, including the Hawaiian bobtail squid, Euprymna scolopes, and the Japanese bobtail squid, Euprymna morsei. Work with E. scolopes has shown how the bacteria establish their niche in the light organ of the newly hatched host. Two types of V. fischeri strains have been distinguished based upon their behavior in cocolonization competition assays in juvenile E. scolopes, i.e., (i) niche-sharing or (ii) niche-dominant behavior. This study aimed to determine whether these behaviors are observed with other V. fischeri strains or whether they are specific to those isolated from E. scolopes light organs. Cocolonization competition assays between V. fischeri strains isolated from the congeneric squid E. morsei or from other marine animals revealed the same sharing or dominant behaviors. In addition, whole-genome sequencing of these strains showed that the dominant behavior is polyphyletic and not associated with the presence or absence of a single gene or genes. Comparative genomics of 44 squid light organ isolates from around the globe led to the identification of symbiosis-specific candidates in the genomes of these strains. Colonization assays using genetic derivatives with deletions of these candidates established the importance of two such genes in colonization. This study has allowed us to expand the concept of distinct colonization behaviors to strains isolated from a number of squid and fish hosts. IMPORTANCE There is an increasing recognition of the importance of strain differences in the ecology of a symbiotic bacterial species and, in particular, how these differences underlie crucial interactions with their host. Nevertheless, little is known about the genetic bases for these differences, how they manifest themselves in specific behaviors, and their distribution among symbionts of different host species. In this study, we sequenced the genomes of Vibrio fischeri isolated from the tissues of squids and fishes and applied comparative genomics approaches to look for patterns between symbiont lineages and host colonization behavior. In addition, we identified the only two genes that were exclusively present in all V. fischeri strains isolated from the light organs of sepiolid squid species. Mutational studies of these genes indicated that they both played a role in colonization of the squid light organ, emphasizing the value of applying a comparative genomics approach in the study of symbioses. Full Article
ri Modulation of Monocyte-Driven Myositis in Alphavirus Infection Reveals a Role for CX3CR1+ Macrophages in Tissue Repair By mbio.asm.org Published On :: 2020-03-03T01:30:27-08:00 ABSTRACT Arthritogenic alphaviruses such as Ross River and Chikungunya viruses cause debilitating muscle and joint pain and pose significant challenges in the light of recent outbreaks. How host immune responses are orchestrated after alphaviral infections and lead to musculoskeletal inflammation remains poorly understood. Here, we show that myositis induced by Ross River virus (RRV) infection is driven by CD11bhi Ly6Chi inflammatory monocytes and followed by the establishment of a CD11bhi Ly6Clo CX3CR1+ macrophage population in the muscle upon recovery. Selective modulation of CD11bhi Ly6Chi monocyte migration to infected muscle using immune-modifying microparticles (IMP) reduced disease score, tissue damage, and inflammation and promoted the accumulation of CX3CR1+ macrophages, enhancing recovery and resolution. Here, we detail the role of immune pathology, describing a poorly characterized muscle macrophage subset as part of the dynamics of alphavirus-induced myositis and tissue recovery and identify IMP as an effective immunomodulatory approach. Given the lack of specific treatments available for alphavirus-induced pathologies, this study highlights a therapeutic potential for simple immune modulation by IMP in infected individuals in the event of large alphavirus outbreaks. IMPORTANCE Arthritogenic alphaviruses cause debilitating inflammatory disease, and current therapies are restricted to palliative approaches. Here, we show that following monocyte-driven muscle inflammation, tissue recovery is associated with the accumulation of CX3CR1+ macrophages in the muscle. Modulating inflammatory monocyte infiltration using immune-modifying microparticles (IMP) reduced tissue damage and inflammation and enhanced the formation of tissue repair-associated CX3CR1+ macrophages in the muscle. This shows that modulating key effectors of viral inflammation using microparticles can alter the outcome of disease by facilitating the accumulation of macrophage subsets associated with tissue repair. Full Article
ri Peptidoglycan Hydrolases RipA and Ami1 Are Critical for Replication and Persistence of Mycobacterium tuberculosis in the Host By mbio.asm.org Published On :: 2020-03-03T01:30:27-08:00 ABSTRACT Synthesis and cleavage of the cell wall polymer peptidoglycan (PG) are carefully orchestrated processes and are essential for the growth and survival of bacteria. Yet, the function and importance of many enzymes that act on PG in Mycobacterium tuberculosis remain to be elucidated. We demonstrate that the activity of the N-acetylmuramyl-l-alanine amidase Ami1 is dispensable for cell division in M. tuberculosis in vitro yet contributes to the bacterium’s ability to persist during chronic infection in mice. Furthermore, the d,l-endopeptidase RipA, a predicted essential enzyme, is dispensable for the viability of M. tuberculosis but required for efficient cell division in vitro and in vivo. Depletion of RipA sensitizes M. tuberculosis to rifampin and to cell envelope-targeting antibiotics. Ami1 helps sustain residual cell division in cells lacking RipA, but the partial redundancy provided by Ami1 is not sufficient during infection, as depletion of RipA prevents M. tuberculosis from replicating in macrophages and leads to dramatic killing of the bacteria in mice. Notably, RipA is essential for persistence of M. tuberculosis in mice, suggesting that cell division is required during chronic mouse infection. Despite the multiplicity of enzymes acting on PG with redundant functions, we have identified two PG hydrolases that are important for M. tuberculosis to replicate and persist in the host. IMPORTANCE Tuberculosis (TB) is a major global heath burden, with 1.6 million people succumbing to the disease every year. The search for new drugs to improve the current chemotherapeutic regimen is crucial to reducing this global health burden. The cell wall polymer peptidoglycan (PG) has emerged as a very successful drug target in bacterial pathogens, as many currently used antibiotics target the synthesis of this macromolecule. However, the multitude of genes encoding PG-synthesizing and PG-modifying enzymes with apparent redundant functions has hindered the identification of novel drug targets in PG synthesis in Mycobacterium tuberculosis. Here, we demonstrate that two PG-cleaving enzymes are important for virulence of M. tuberculosis. In particular, the d,l-endopeptidase RipA represents a potentially attractive drug target, as its depletion results in the clearance of M. tuberculosis from the host and renders the bacteria hypersusceptible to rifampin, a frontline TB drug, and to several cell wall-targeting antibiotics. Full Article
ri Mycobacterium tuberculosis Reactivates HIV-1 via Exosome-Mediated Resetting of Cellular Redox Potential and Bioenergetics By mbio.asm.org Published On :: 2020-03-03T01:30:27-08:00 ABSTRACT The synergy between Mycobacterium tuberculosis and human immunodeficiency virus-1 (HIV-1) interferes with therapy and facilitates the pathogenesis of both human pathogens. Fundamental mechanisms by which M. tuberculosis exacerbates HIV-1 infection are not clear. Here, we show that exosomes secreted by macrophages infected with M. tuberculosis, including drug-resistant clinical strains, reactivated HIV-1 by inducing oxidative stress. Mechanistically, M. tuberculosis-specific exosomes realigned mitochondrial and nonmitochondrial oxygen consumption rates (OCR) and modulated the expression of host genes mediating oxidative stress response, inflammation, and HIV-1 transactivation. Proteomics analyses revealed the enrichment of several host factors (e.g., HIF-1α, galectins, and Hsp90) known to promote HIV-1 reactivation in M. tuberculosis-specific exosomes. Treatment with a known antioxidant—N-acetyl cysteine (NAC)—or with inhibitors of host factors—galectins and Hsp90—attenuated HIV-1 reactivation by M. tuberculosis-specific exosomes. Our findings uncover new paradigms for understanding the redox and bioenergetics bases of HIV-M. tuberculosis coinfection, which will enable the design of effective therapeutic strategies. IMPORTANCE Globally, individuals coinfected with the AIDS virus (HIV-1) and with M. tuberculosis (causative agent of tuberculosis [TB]) pose major obstacles in the clinical management of both diseases. At the heart of this issue is the apparent synergy between the two human pathogens. On the one hand, mechanisms induced by HIV-1 for reactivation of TB in AIDS patients are well characterized. On the other hand, while clinical findings clearly identified TB as a risk factor for HIV-1 reactivation and associated mortality, basic mechanisms by which M. tuberculosis exacerbates HIV-1 replication and infection remain poorly characterized. The significance of our research is in identifying the role of fundamental mechanisms such as redox and energy metabolism in catalyzing HIV-M. tuberculosis synergy. The quantification of redox and respiratory parameters affected by M. tuberculosis in stimulating HIV-1 will greatly enhance our understanding of HIV-M. tuberculosis coinfection, leading to a wider impact on the biomedical research community and creating new translational opportunities. Full Article