Clinical performance of light-cured orthodontic adhesives for bonding brackets – an in-vitro study. [version 1; peer review: 1 approved, 2 approved with reservations]

Background The dental profession is seeing a constant influx of new adhesive systems from manufacturers, each claiming to be more dependable than the last. This study assessed the bond strength and adhesive remnants of different light-cured adhesives used for bonding metal brackets to teeth. Methods 80 extracted maxillary premolars with the sound crown structure were acid etched and bonded with brackets on their buccal surfaces utilizing primer and light-cured adhesives into four equal groups, which are Transbond XT, Heliosit, Enlight, and Bracepaste. Shear bond strength (SBS) for de-bonding the brackets were evaluated with Instron- testing machine after 48 hours. The de-bonded samples’ adhesive remnant index (ARI) scores were also measured. Results The maximum mean SBS was found for Transbond XT (12.91 ± 2.0 MPa), followed by Bracepaste (12.87 ± 1.59 MPa), Enlight (11.77 ± 1.87 MPa), and lowest for Heliosit (10.93 ± 1.71 MPa). According to the four point scale, adhesive remnant index (ARI), Transbond XT has the least adhesive residue left on the tooth, followed by Heliosit. Enlight and Bracepaste have a similar distribution of adhesive, with both having a maximum amount left. Conclusion It can be inferred that all groups involved demonstrated a satisfactory level of bond strength from a clinical perspective. Transbond XT is the preferred orthodontic adhesive over the other three adhesives due to its superior SBS and ARI properties

A crowdsourced analysis to identify ab initio molecular signatures predictive of susceptibility to viral infection

The response to respiratory viruses varies substantially between individuals, and there are currently no known molecular predictors from the early stages of infection. Here we conduct a community-based analysis to determine whether pre- or early post-exposure molecular factors could predict physiologic responses to viral exposure. Using peripheral blood gene expression profiles collected from healthy subjects prior to exposure to one of four respiratory viruses (H1N1, H3N2, Rhinovirus, and RSV), as well as up to 24 h following exposure, we find that it is possible to construct models predictive of symptomatic response using profiles even prior to viral exposure. Analysis of predictive gene features reveal little overlap among models; however, in aggregate, these genes are enriched for common pathways. Heme metabolism, the most significantly enriched pathway, is associated with a higher risk of developing symptoms following viral exposure. This study demonstrates that pre-exposure molecular predictors can be identified and improves our understanding of the mechanisms of response to respiratory viruses

Risk Perception and Preparedness of Undergraduate Dental Students to Treat Patients in View of COVID-19 Pandemic: A Questionnaire Survey

With the gradual resumption of dental services worldwide, it is crucial to focus on returning dental undergraduates to their clinical postings. The assessment of foreseeable concerns from a student’s point of view will help the dental schools tailor a comprehensive plan of action that would be in the best interest of everyone. Aim. Hence, this survey was planned to assess dental undergraduates’ risk perception and preparedness to provide patient care amidst the COVID-19 pandemic crisis. Material and Methods. It was an online survey carried out among students involved in clinical work at two dental colleges in Manipal and Mangalore, respectively, in Karnataka, India. The online questionnaire was sent to approximately 500 students, with responses from 301 students. The survey comprised 21 closed-ended questions about demographics, risk perception, and preparedness. The descriptive statistics were done on the data. Results. It was found that all the students (99.7%) perceived COVID-19 to be dangerous, and 73.4% chose to avoid treating those patients suspected to have an active COVID-19 infection. The fear of being infected was perceived by 55.1% of students, while 46.2% feared transmitting the infection to friends and family. A majority (87.7%) believed standard infection controls practiced prior to the pandemic were insufficient to work in the current scenario. Nearly 33.6% could not view the guidelines for dental procedures during the pandemic. A majority (87.7%) were not/little confident, and 61.7% were unsure/unprepared to manage suspected patients. Conclusion. It is the prime need of the hour for dental schools to instill self-reliance within students in managing patient care under these circumstances by strictly reinforcing the official protective care guidelines

Effect of oil gum massage therapy on common pathogenic oral microorganisms - A randomized controlled trial

Objectives: (i) To assess reduction in Streptococcus mutans and Lactobacillus species count in saliva sample after ten minutes of oil gum massage therapy (massage of gingival tissues) per day for three weeks with sesame oil, olive oil, and coconut oil in three different groups of subjects. (ii) To compare the efficacy between three different oils and the "gold standard" chlorhexidine gel. (iii) To assess reduction in gingival scores and plaque scores of study subjects. Materials and Methods: Study design - Single center, parallel design, and triple blind randomized clinical study with four treatment groups. Participants: 32 of the 40 study subjects working as housekeeping personnel at Kasturba Hospital, Manipal; aged 18-55 years completed the three-week study period. Interventions: Subjects were randomly assigned to massage their gingiva everyday for three weeks with sesame oil, olive oil, coconut oil (tests), and Chlorhexidine gel (control). Oral health status and paraffin stimulated saliva samples were obtained at baseline and after three weeks of oil gum massage therapy. Outcome measures: Microbial culture, plaque index, and gingival index. Statistical analysis: Paired t test and Kruskal Wallis test. Results: There was a significant reduction in mean Streptococcus mutans count, Lactobacillus count, plaque scores, and gingival scores in all four groups after the study. However, there was no significant difference found in percentage reduction of these variables between the four groups. Conclusion: These oils can be used as valuable preventive agents in maintaining and improving oral health in low socioeconomic status population. However, it is recommended that further research should be conducted in other populations with a larger sample and longer duration of follow-up period

OGA-UCT: On-the-Go Abstractions in UCT

Recent work has begun exploring the value of domain abstractions in Monte-Carlo Tree Search (MCTS) algorithms for probabilistic planning. These algorithms automatically aggregate symmetric search nodes (states or state-action pairs) saving valuable planning time. Existing algorithms alternate between two phases: (1) abstraction computation forcomputing node aggregations, and (2) modified MCTS that use aggregate nodes. We believe that these algorithms do not achieve the full potential of abstractions because of disjoint phases – e.g., it can take a while to recover from erroneous abstractions, or compute better abstractions based on newly found knowledge.In response, we propose On-the-Go Abstractions (OGA), a novel approach in which abstraction computation is tightlyintegrated into the MCTS algorithm. We implement these on top of UCT and name the resulting algorithm OGA-UCT.It has several desirable properties, including (1) rapid use of new information in modifying existing abstractions, (2) elimination of the expensive batch abstraction computationphase, and (3) focusing abstraction computation on important part of the sampled search space. We experimentally compare OGA-UCT against ASAP-UCT, a recent state-of-the-art MDP algorithm as well as vanilla UCT algorithm. We find that OGA-UCT is robust across a suite of planning competition and other MDP domains, and obtains up to 28 % quality improvements

The impact of lifestyles on the periodontal health of adults in Udupi district: A cross sectional study

Objectives: (1) To assess the impact of different lifestyle factors on periodontal health of adults. (2) To assess the impact of overall/combined lifestyle variable (calculated by health practice index [HPI]) on periodontal health of adults. Materials and Methods: A cross-sectional study consisting of a structured questionnaire on HPI, oral health-related behavior, and personal habits as well as sociodemographic variables was conducted on 800 subjects aged 20–50 years attending dental outreach set-ups of Manipal College of Dental Sciences, Manipal. Clinical examination for periodontal status was done by recording loss of attachment scores using community periodontal index (FDI/WHO-1982). Statistical analysis was done by bivariate analysis using Chi-square followed by multivariate analysis to obtain adjusted odds ratio with 95% confidence interval. Results: After adjusting for all the confounding variables in multivariate logistic regression analysis, the variables that showed an independent association with periodontitis were age, location, marital status, smoking, hours of sleep per night, physical activity, and overall poor lifestyles. Conclusion: Our results support studying a combined approach using various lifestyle behaviors for controlling chronic periodontitis. Necessary public health action on conditions which determine unhealthy lifestyle behaviors across population is needed which is possible by patient's involvement in self-care by promoting healthy lifestyles

Outcomes in morbidly obese adolescent patients undergoing laparoscopic sleeve gastrectomy in the Indian subcontinent: A retrospective review

Introduction: There is a worldwide increase in the prevalence of obesity among the adolescent population in India from 16.3% in 2001 to 19.3% in 2010. Recent evidence suggests that bariatric surgery leads to resolution of comorbidities and associated long-term complications in adolescent patients with morbid obesity. Aim: The aim of this study is to determine the impact of bariatric surgery on the weight loss and comorbidities of morbidly obese adolescents. Materials and Methods: A retrospective review of the data of 10 adolescent patients, who underwent Laparoscopic Sleeve Gastrectomy at our institute (tertiary care hospital), from July 2009 to July 2016 was carried out. Results: Of the 10 patients, 4 patients had syndromic forms of obesity. The median age was 16.54 years. The median pre-operative weight and height were 112 kg and 154 cm, respectively, with a body mass index of 47.2 kg/m2. There was no intra-operative or post-operative complication except for suspected methylene blue toxicity in one patient which was treated conservatively. Median follow-up period was 1 year (0–5 years). The patients had an increase in excess weight loss (EWL) of 54.5% until the end of 1 year. There was a regain of weight between the 1st and 2nd year, followed by a sustained weight loss achieving 44.8% EWL at 3 years and 60% at the end of 5 years (only two patients followed up at 5 years). Similar results were found in syndromic patients. Among the four diabetic patients, three had complete resolution and one had improvement in diabetes status. Among the three patients with obstructive sleep apnoea, two patients had complete resolution, while one patient had improvement in symptoms. One patient with hypocortisolism improved after surgery with a decrease in the steroid requirement. Among the hypothyroid patients, one patient had a complete resolution, one patient had improvement in hypothyroid status while two patients had no change. Conclusion: Bariatric surgery is effective for morbidly obese adolescents, leading to significant resolutions of comorbid illness

Endoscopic Ultrasound-Guided Choledochoduodenostomy for Biliary Drainage in Patients with Lower End Common Bile Duct Block: A Single-Center Experience

Objective: Endoscopic ultrasound (EUS)-guided biliary drainage is evolving as an alternative technique in patients with failed endoscopic retrograde cholangiopancreatography. The objective of this study was to find out the outcome of EUS-guided choledochoduodenostomy in patients with malignant mid and lower end biliary obstruction with inaccessible papilla presenting at our center. Methods: The present study was a single-center prospective observational study. Data of all the patients who underwent choledochoduodensotomy from January 2014 to December 2015 were recorded. Outcome measures were technical success and clinical success. Technical success was defined as successful placement of stent in the biliary system; clinical success was defined as 50% reduction in bilirubin at 2 weeks. Complications during the procedure and follow-up were recorded. Results: A total of 10 patients underwent EUS-guided choledochoduodenostomy. Cause of biliary obstruction was pancreatic cancer in eight patients, two patients had carcinoma gallbladder with mid-common bile duct (CBD) block due to compression by metastatic lymph nodes, and one patient had ampullary carcinoma. Mean bilirubin value was 16.4 mg/dL (±3.2 mg/dL). Technical and clinical success were 100% and 90%, respectively. No immediate procedure-related complication was noticed. Two patients had stent migration during the follow-up. Conclusion: EUS-guided choledochoduodenostomy is an effective and safe alternative for rescuing biliary drainage in patients with mid and lower end malignant CBD block with inaccessible papilla