The role of proprotein convertase subtilisin/kexin type 9 inhibitors in managing cardiovascular risk

Hypercholesterolaemia and dyslipidaemia, marked by decreased levels of high-density lipoprotein and elevated levels of lowdensity lipoprotein (LDL), increase the risk of cardiovascular disease. Familial hypercholesterolaemia (FH), diagnosed based on the clinical features seen in patients with a positive family history, constitutes a heritable disorder involving a single gene. FH can exist in either the heterozygous or homozygous form, and may be differentiated based on clinical features and genetic studies. A novel drug target, proprotein convertase subtilisin/kexin type 9 (PCSK9), has resulted in the development and subsequent approval of new, targeted monoclonal antibodies in the treatment of FH. Targeting PCSK9 with monoclonal antibodies, i.e. evolocumab and alirocumab, inhibits the degradation of LDL receptors, and against a background of optimised statin therapy, increases the life expectancy of patients with hypercholesterolaemia by reducing the incidence and severity of coronary artery disease.Keywords: alirocumab, evolocumab, cardiovascular risk factors, familial hypercholesterolaemia, PCSK9, proprotein convertase subtilisin/kexin type 9, LDL cholesterol, LDL recepto

Wear behavior of a microhybrid composite vs. a nanocomposite in the treatment of severe tooth wear patients:A 5-year clinical study

Item does not contain fulltex

Priming T2 in a visual and auditory attentional blink task

Participants performed an attentional blink (AB) task including digits as targets and letters as distractors within the visual and auditory domains. Prior to the rapid serial visual presentation, a visual or auditory prime was presented in the form of a digit that was identical to the second target (T2) on 50% of the trials. In addition to the "classic" AB effect, an overall drop in performance on T2 was observed for the trials on which the stream was preceded by an identical prime from the same modality. No cross-modal priming was evident, suggesting that the observed inhibitory priming effects are modality specific. We argue that the present findings represent a special type of negative priming operating at a low feature level. Copyright 2008 Psychonomic Society, Inc

Pip and pop: Nonspatial auditory signals improve spatial visual search

Searching for an object within a cluttered, continuously changing environment can be a very time-consuming process. The authors show that a simple auditory pip drastically decreases search times for a synchronized visual object that is normally very difficult to find. This effect occurs even though the pip contains no information on the location or identity of the visual object. The experiments also show that the effect is not due to general alerting (because it does not occur with visual cues), nor is it due to top-down cuing of the visual change (because it still occurs when the pip is synchronized with distractors on the majority of trials). Instead, we propose that the temporal information of the auditory signal is integrated with the visual signal, generating a relatively salient emergent feature that automatically draws attention. Phenomenally, the synchronous pip makes the visual object pop out from its complex environment, providing a direct demonstration of spatially nonspecific sounds affecting competition in spatial visual processing. Keywords: attention, visual search, multisensory integration, audition, visio

Assessing caries status according to the CAST instrument and WHO criterion in epidemiological studies

ABSTRACT: Background: The Caries Assessment Spectrum and Treatment (CAST) is a new epidemiological instrument for detection and treatment of dental caries. Worldwide, the WHO criterion constitutes the epidemiological tool most commonly used for caries detection. The objective of the present study is to determine the levels of similarity and difference between the CAST instrument and WHO criterion on the basis of caries prevalence, dmf/DMF counts, examination time and reporting of results. Methods: An epidemiological survey was carried out in Brazil among 6-11-year-old schoolchildren. Time of examinations was recorded. dmft, dmfs, DMFT and DMFS counts and dental caries prevalence were obtained according to the WHO criterion and the CAST instrument, as well the correlation coefficient between the two instruments. Results: Four hundred nineteen children were examined. dmft and dmfs counts were 1.92 and 5.31 (CAST), 1.99 and 5.34 (WHO) with correlation coefficients (r) of 0.95 and 0.93, respectively. DMFT and DMFS counts were 0.20 and 0.33 (CAST), 0.19 and 0.30 (WHO), with r = 0.78 and r=0.72, respectively. Kappa coefficient values for intra-examiner consistency were CAST = 0.91-0.92; WHO = 0.95-0.96 and those for inter-examiner consistency were CAST = 0.90-0.96; WHO = 0.94-1.00. Mean time spent on applying CAST and WHO were 66.3 and 64.7 sec, respectively p = 0.26. The prevalence of dental caries using CAST (codes 2, 5-8) and the WHO criterion for the primary dentition were 63.0% and 65.9%, respectively, and for the permanent dentition they were 12.7% and 12.8%, respectively. Conclusions: The CAST instrument provided similar prevalence of dental caries values and dmf/DMF counts as the WHO criterion in this age group. Time spent on examining children was identical for both caries assessment methods. Presentation of results from use of the CAST instrument, in comparison to WHO criterion, allowed a more detailed reporting of stages of dental caries, which will be useful for oral health planners

Shining new light on mammalian diving physiology using wearable near-infrared spectroscopy

Investigation of marine mammal dive-by-dive blood distribution and oxygenation has been limited by a lack of non-invasive technology for use in freely diving animals. Here, we developed a non-invasive near-infrared spectroscopy (NIRS) device to measure relative changes in blood volume and haemoglobin oxygenation continuously in the blubber and brain of voluntarily diving harbour seals. Our results show that seals routinely exhibit preparatory peripheral vasoconstriction accompanied by increased cerebral blood volume approximately 15 s before submersion. These anticipatory adjustments confirm that blood redistribution in seals is under some degree of cognitive control that precedes the mammalian dive response. Seals also routinely increase cerebral oxygenation at a consistent time during each dive, despite a lack of access to ambient air. We suggest that this frequent and reproducible reoxygenation pattern, without access to ambient air, is underpinned by previously unrecognised changes in cerebral drainage. The ability to track blood volume and oxygenation in different tissues using NIRS will facilitate a more accurate understanding of physiological plasticity in diving animals in an increasingly disturbed and exploited environment

Index of Complexity, Outcome and Need scored on plaster and digital models

The aim of this study was to compare standard plaster models with their digital counterparts for the applicability of the Index of Complexity, Outcome, and Need (ICON). Generated study models of 30 randomly selected patients: 30 pre- (T0) and 30 post- (T1) treatment. Two examiners, calibrated in the ICON, scored the digital and plaster models. The overall ICON scores were evaluated for reliability and reproducibility using kappa statistics and reliability coefficients. The values for reliability of the total and weighted ICON scores were generally high for the T0 sample (range 0.83-0.95) but less high for the T1 sample (range 0.55-0.85). Differences in total ICON score between plaster and digital models resulted in mostly statistically insignificant values (P values ranging from 0.07 to 0.19), except for observer 1 in the T1 sample. No statistically different values were found for the total ICON score on either plaster or digital models. ICON scores performed on computer-based models appear to be as accurate and reliable as ICON scores on plaster model

Large scale analysis of expressed genes in common wheat

To assess associations between occlusal tooth wear and shortened dental arches (SDA) in Chinese 40 years and older subjects. From a sample of 1462 urban and rural adults, those presenting with SDA (n = 150) were compared with a control group of 65 randomly selected subjects with complete dentitions (CDA). Occlusal wear was assessed using a modified Smith and Knight index - the occlusal tooth wear index (OWTI) - and analysed using multivariate (logistic) regression. There was no significant effect from SDA on severe occlusal wear (OTWI score 3 or 4: OR = 2.016; 95% CI = 0.960-4.231; P = 0.064). Higher age was associated with severe occlusal wear (P values </=0.007) and with higher mean OTWI scores; urban had less often severe occlusal wear than rural residents (OR = 0.519; P = 0.008). Higher mean OTWI scores were associated with rural residents, except for anterior teeth. Females had lower mean OTWI score for anterior teeth (effect = -0.153; P = 0.030). Premolars in SDA had higher mean OTWI scores compared with those in CDA (effect = +0.213; P = 0.006). In SDA, more posterior occluding pairs (POPs) were associated with lower mean OTWI sores for anterior teeth (effect: -0.158; P = 0.008) and higher scores for molars (effect: +0.249, P = 0.003). Subjects with SDA or CDA presented comparable occlusal wear, but premolars in SDA tend to have higher probability for having occlusal wear. Fewer numbers of POPs were associated with more wear in anterior teeth

Tooth loss and oral health-related quality of life: a systematic review and meta-analysis

Contains fulltext : 87677.pdf (publisher's version ) (Open Access)BACKGROUND: It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is likely that tooth loss, in most cases being a consequence of oral diseases, affects Oral Health-Related Quality of Life (OHRQoL). The aim of the present study is to systematically review the literature and to analyse the relationship between the number and location of missing teeth and oral health-related quality of life (OHRQoL). It was hypothesized that tooth loss is associated with an impairment of OHRQoL. Secondly, it was hypothesized that location and distribution of remaining teeth play an important role in this. METHODS: Relevant databases were searched for papers in English, published from 1990 to July 2009 following a broad search strategy. Relevant papers were selected by two independent readers using predefined exclusion criteria, firstly on the basis of abstracts, secondly by assessing full-text papers. Selected studies were grouped on the basis of OHRQoL instruments used and assessed for feasibility for quantitative synthesis. Comparable outcomes were subjected to meta-analysis; remaining outcomes were subjected to a qualitative synthesis only. RESULTS: From a total of 924 references, 35 were eligible for synthesis (inter-reader agreement abstracts kappa = 0.84 +/- 0.03; full-texts: kappa = 0.68 +/- 0.06). Meta-analysis was feasible for 10 studies reporting on 13 different samples, resulting in 6 separate analyses. All studies showed that tooth loss is associated with unfavourable OHRQoL scores, independent of study location and OHRQoL instrument used. Qualitative synthesis showed that all 9 studies investigating a possible relationship between number of occluding pairs of teeth present and OHRQoL reported significant positive correlations. Five studies presented separate data regarding OHRQoL and location of tooth loss (anterior tooth loss vs. posterior tooth loss). Four of these reported highest impact for anterior tooth loss; one study indicated a similar impact for both locations of tooth loss. CONCLUSIONS: This study provides fairly strong evidence that tooth loss is associated with impairment of OHRQoL and location and distribution of tooth loss affect the severity of the impairment. This association seems to be independent from the OHRQoL instrument used and context of the included samples

Using neurophysiological signals that reflect cognitive or affective state: Six recommendations to avoid common pitfalls

Estimating cognitive or affective state from neurophysiological signals and designing applications that make use of this information requires expertise in many disciplines such as neurophysiology, machine learning, experimental psychology, and human factors. This makes it difficult to perform research that is strong in all its aspects as well as to judge a study or application on its merits. On the occasion of the special topic “Using neurophysiological signals that reflect cognitive or affective state” we here summarize often occurring pitfalls and recommendations on how to avoid them, both for authors (researchers) and readers. They relate to defining the state of interest, the neurophysiological processes that are expected to be involved in the state of interest, confounding factors, inadvertently “cheating” with classification analyses, insight on what underlies successful state estimation, and finally, the added value of neurophysiological measures in the context of an application. We hope that this paper will support the community in producing high quality studies and well-validated, useful applications