COVID-19 Management in Clinical Dental Care Part II: Personal Protective Equipment for the Dental Care Professional

Background: Facing the coronavirus disease 2019 (COVID-19) challenge on a global level, dental care professionals are encouraged to optimize universal precautions and adopt measures that ensure protection against infection by contaminated aerosols and droplets. Although aerosol transmission is possible, direct contact through large droplets is probably responsible for the vast majority of transmissions. Methods: This paper is the second of a series of 3 on the management of COVID-19 in clinical dental care settings and aims to describe the selection and use of personal protection equipment (PPE) by dental care professionals (DCP), with consideration of the level of risk associated with the planned procedures. PPE selection depends directly on the local epidemiological setting, the patient's characteristics, and the level of risk of the planned procedures. The procedures performed in the office environment are classified as low-, moderate-, or high-risk. Moderate risk includes 2 further sublevels associated with the cleaning, disinfection, and sterilization of materials for clinical procedures that do not generate aerosols. The training of DCP on how to properly don (put on) and doff (remove) PPE is as important as choosing the appropriate PPE because it can be associated with a risk of infection. Discussion: When there is limited availability of PPE, measures should be adjusted to the risk associated with the intervention. Assuming that an effective COVID-19 vaccine will be developed, once it becomes widely available for DCP, PPE requirements will likely be different. Conclusion: The proper use of PPE, together with the adoption of other operational procedures, can provide effective protection against microorganisms being transmitted via body fluids or in the air.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

An instability of higher-dimensional rotating black holes

We present the first example of a linearized gravitational instability of an asymptotically flat vacuum black hole. We study perturbations of a Myers-Perry black hole with equal angular momenta in an odd number of dimensions. We find no evidence of any instability in five or seven dimensions, but in nine dimensions, for sufficiently rapid rotation, we find perturbations that grow exponentially in time. The onset of instability is associated with the appearance of time-independent perturbations which generically break all but one of the rotational symmetries. This is interpreted as evidence for the existence of a new 70-parameter family of black hole solutions with only a single rotational symmetry. We also present results for the Gregory-Laflamme instability of rotating black strings, demonstrating that rotation makes black strings more unstable.Comment: 38 pages, 13 figure

Ultraspinning instability: the missing link

We study linearized perturbations of Myers-Perry black holes in d=7, with two of the three angular momenta set to be equal, and show that instabilities always appear before extremality. Analogous results are expected for all higher odd d. We determine numerically the stationary perturbations that mark the onset of instability for the modes that preserve the isometries of the background. The onset is continuously connected between the previously studied sectors of solutions with a single angular momentum and solutions with all angular momenta equal. This shows that the near-extremality instabilities are of the same nature as the ultraspinning instability of d>5 singly-spinning solutions, for which the angular momentum is unbounded. Our results raise the question of whether there are any extremal Myers-Perry black holes which are stable in d>5.Comment: 19 pages. 1 figur

The burden of dental care in Amelogenesis Imperfecta paediatric patients in the UK NHS: a retrospective, multi-centred analysis

PURPOSE: The burden of dental care in Amelogenesis Imperfecta (AI) has not been well described. This condition results in weak, discoloured and often sensitive teeth. Specialist paediatric care is available for AI patients in the UK, but treatment protocols and care provided are inconsistent. The aim of this study was therefore to analyse the provision of treatment and burden of care for children and families with AI across four Paediatric Dentistry centres in the UK. METHODS: A retrospective evaluation of AI patient clinical records across four UK consultant-led Paediatric Dentistry centres was completed. Frequency and duration of care were recorded along with treatment and experience of inhalation sedation, local and general anaesthetic. RESULTS: In total, 138 records were available for analysis. The average patient age at first referral was 7.7 years (range 1-16 years) and families travelled an average 21.8 miles per appointment (range 0.2-286 miles). Patients attended on average 4.5 appointments per year for 5.8 years. In total, 65.2% had experience of local anaesthetic, 27.5% inhalation sedation and 31.9% general anaesthetic. Dental treatment including restorations and extractions were commonly required on multiple teeth per patient. CONCLUSION: AI carries a high burden of specialist dental care to patients and families. Specialist centres are required to provide longitudinal, comprehensive care

Paclitaxel targets FOXM1 to regulate KIF20A in mitotic catastrophe and breast cancer paclitaxel resistance

FOXM1 has been implicated in taxane resistance, but the molecular mechanism involved remains elusive. In here, we show that FOXM1 depletion can sensitize breast cancer cells and mouse embryonic fibroblasts into entering paclitaxel-induced senescence, with the loss of clonogenic ability, and the induction of senescence-associated beta-galactosidase activity and flat cell morphology. We also demonstrate that FOXM1 regulates the expression of the microtubulin-associated kinesin KIF20A at the transcriptional level directly through a Forkhead response element (FHRE) in its promoter. Similar to FOXM1, KIF20A expression is downregulated by paclitaxel in the sensitive MCF-7 breast cancer cells and deregulated in the paclitaxel-resistant MCF-7TaxR cells. KIF20A depletion also renders MCF-7 and MCF-7TaxR cells more sensitive to paclitaxel-induced cellular senescence. Crucially, resembling paclitaxel treatment, silencing of FOXM1 and KIF20A similarly promotes abnormal mitotic spindle morphology and chromosome alignment, which have been shown to induce mitotic catastrophe-dependent senescence. The physiological relevance of the regulation of KIF20A by FOXM1 is further highlighted by the strong and significant correlations between FOXM1 and KIF20A expression in breast cancer patient samples. Statistical analysis reveals that both FOXM1 and KIF20A protein and mRNA expression significantly associates with poor survival, consistent with a role of FOXM1 and KIF20A in paclitaxel action and resistance. Collectively, our findings suggest that paclitaxel targets the FOXM1-KIF20A axis to drive abnormal mitotic spindle formation and mitotic catastrophe and that deregulated FOXM1 and KIF20A expression may confer paclitaxel resistance. These findings provide insights into the underlying mechanisms of paclitaxel resistance and have implications for the development of predictive biomarkers and novel chemotherapeutic strategies for paclitaxel resistance.Oncogene advance online publication, 11 May 2015; doi:10.1038/onc.2015.152.published_or_final_versio

Rotating black holes with equal-magnitude angular momenta in d=5 Einstein-Gauss-Bonnet theory

We construct rotating black hole solutions in Einstein-Gauss-Bonnet theory in five spacetime dimensions. These black holes are asymptotically flat, and possess a regular horizon of spherical topology and two equal-magnitude angular momenta associated with two distinct planes of rotation. The action and global charges of the solutions are obtained by using the quasilocal formalism with boundary counterterms generalized for the case of Einstein-Gauss-Bonnet theory. We discuss the general properties of these black holes and study their dependence on the Gauss-Bonnet coupling constant $\alpha$. We argue that most of the properties of the configurations are not affected by the higher derivative terms. For fixed $\alpha$ the set of black hole solutions terminates at an extremal black hole with a regular horizon, where the Hawking temperature vanishes and the angular momenta attain their extremal values. The domain of existence of regular black hole solutions is studied. The near horizon geometry of the extremal solutions is determined by employing the entropy function formalism.Comment: 25 pages, 7 figure

Ultraspinning instability of anti-de Sitter black holes

Myers-Perry black holes with a single spin in d>5 have been shown to be unstable if rotating sufficiently rapidly. We extend the numerical analysis which allowed for that result to the asymptotically AdS case. We determine numerically the stationary perturbations that mark the onset of the instabilities for the modes that preserve the rotational symmetries of the background. The parameter space of solutions is thoroughly analysed, and the onset of the instabilities is obtained as a function of the cosmological constant. Each of these perturbations has been conjectured to represent a bifurcation point to a new phase of stationary AdS black holes, and this is consistent with our results.Comment: 22 pages, 7 figures. v2: Reference added. Matches published versio

Assessment of the potential in vivo ecotoxicity of Double-Walled Carbon Nanotubes (DWNTs) in water, using the amphibian Ambystoma mexicanum

Because of their specific properties (mechanical, electrical, etc), carbon nanotubes (CNTs) are being assessed for inclusion in many manufactured products. Due to their massive production and number of potential applications, the impact of CNTs on the environment must be taken into consideration. The present investigation evaluates the ecotoxic potential of CNTs in the amphibian larvae (Ambystoma mexicanum). Acute toxicity and genotoxicity were analysed after 12 days of exposure in laboratory conditions. The genotoxic effects were analysed by scoring the micronucleated erythrocytes in the circulating blood of the larvae according to the French standard micronucleus assay. The results obtained in the present study demonstrated that CNTs are neither acutely toxic nor genotoxic to larvae whatever the CNTs concentration in the water, although black masses of CNTs were observed inside the gut. In the increasing economical context of CNTs, complementary studies must be undertaken, especially including mechanistic and environmental investigations

Thermodynamic instability of doubly spinning black objects

We investigate the thermodynamic stability of neutral black objects with (at least) two angular momenta. We use the quasilocal formalism to compute the grand canonical potential and show that the doubly spinning black ring is thermodynamically unstable. We consider the thermodynamic instabilities of ultra-spinning black objects and point out a subtle relation between the microcanonical and grand canonical ensembles. We also find the location of the black string/membrane phases of doubly spinning black objects.Comment: 25 pages, 7 figures v2: matches the published versio

A scalar field instability of rotating and charged black holes in (4+1)-dimensional Anti-de Sitter space-time

We study the stability of static as well as of rotating and charged black holes in (4+1)-dimensional Anti-de Sitter space-time which possess spherical horizon topology. We observe a non-linear instability related to the condensation of a charged, tachyonic scalar field and construct "hairy" black hole solutions of the full system of coupled Einstein, Maxwell and scalar field equations. We observe that the limiting solution for small horizon radius is either a hairy soliton solution or a singular solution that is not a regular extremal solution. Within the context of the gauge/gravity duality the condensation of the scalar field describes a holographic conductor/superconductor phase transition on the surface of a sphere.Comment: 16 pages including 8 figures, v2: discussion on soliton solutions extended; v3: matches version accepted for publication in JHE