Evaluation of the Linear Relationship of the Inferior Alveolar Nerve Canal to the Lateral Cortex and the Alveolar Crest in the Posterior Mandible: A Computed Tomographic Study.

Background and Objective: A cross-sectional study was conducted to evaluate a clinically relevant position of the inferior alveolar nerve and canal with respect to the lateral cortex, alveolar crest, and first and second molar root apices in adult dentate patients. Methods: The study was conducted in the patients who reported various oral and maxillofacial surgical procedures at the Department of Oral and Maxillofacial Surgery for whom preoperative computed tomography (CT) scan was taken for the required surgical procedures. CTs were selected based on the selection criteria, and a total of 50 CTs were evaluated. Predictor variables were gender and side. Outcome variables were the average linear buccal measurements from the lateral cortex to the outer cortical margin of the inferior alveolar canal from below the mandibular foramen till the mental foramen, linear vertical measurements from the alveolar crest to the superior crest of the inferior alveolar canal in the third, second and first molar regions, and linear vertical distance from the superior aspect of inferior alveolar canal till the apices of second and third molars. Descriptive statistics were analysed with t test and paired t test. P value < 0.05 was taken as significant. Results: The study sample was composed of 27 male and 23 female patients with a mean age of 29 ± 4.6 years. The mean value of linear measurements of IAN to the right lateral cortex at the mandibular foramen was 4.96 ± 1.13, and for the left side, it was 4.79 ± 1.33. The mean values of linear measurements from the superior aspect of IAN canal to the alveolar crest at third, second and first molar regions obtained in this study were 18.5 ± 3.79, 19 + 3.83 and 19.5 + 3.48 for the right side and 17.8 + 3.86, 18.8 + 3.54 and 19.143.31 for the left side, respectively. The average linear measurements of IAN to the root apex of first molar were 10.8 3.89 for the right side and 10.868 + 3.85 for the left side; for second molars, they were 10.5 + 3.62 for the right side and 10.52 + 3.62 for the left side. Gender and side influenced the outcome with varying statistical significance. Conclusion: The study has identified the average linear measurements of the buccal cortical bone along the path of IAN in the mandible, average height of alveolar bone above the IAN and average distance between the IAN with the first and second molar root apices. This will be useful guide while planning and performing various mandibular surgical procedures close to the IAN nerve and procedures that can disturb the IAN. The implications of these findings will influence the course of surgery.

"I Have Constant Fear": A National Qualitative Study on the Impact of COVID-19 on Cancer Care and Potential Solutions to Improve the Cancer Care Experience During the COVID-19 Pandemic.

PURPOSE: The COVID-19 pandemic has greatly affected cancer care delivery for patients, including cancellation or delays in surveillance imaging, clinic visits, and treatments. Yet, gaps remain in understanding the extent of the impact of the COVID-19 pandemic on patients with cancer and potential ways to overcome these impacts. METHODS: We conducted semistructured, in-depth, one-on-one qualitative interviews among adults with a past or current history of cancer in the United States. Participants from a parent quantitative survey were purposively sampled to participate in a qualitative interview. Interview questions addressed (1) experiences with cancer care delivery during the COVID-19 pandemic; (2) unmet concerns regarding care and other impacts; and (3) approaches to improve patient experiences. We conducted inductive thematic analysis. RESULTS: Fifty-seven interviews were conducted. Four themes emerged: (1) concern regarding the risk of COVID-19 infection among patients with cancer and their families; (2) disruptions in care increased patients' anxiety about poor cancer outcomes and death from cancer; (3) significant social and economic impacts; and (4) increased social isolation and anxiety about the future. Suggestions for current clinical practice include (1) clear communication on patients' health risks; (2) increased attention to mental health needs and access to mental health services; and (3) routine use of telemedicine as frequently as possible when clinically appropriate. CONCLUSION: These rich findings reveal the significant impact of the COVID-19 pandemic on patients with cancer and potential approaches to mitigate the impact from the patient perspective. The findings not only inform current cancer care delivery but also health system responses to future public health or environmental crises that may pose a unique health risk for patients with cancer or disrupt their care.

Examining Associations Among Sexual Health, Unmet Care Needs, and Distress in Breast and Gynecologic Cancer Survivors.

OBJECTIVES: This study evaluated breast and gynecologic cancer patients' sexual function, unmet needs related to sexuality, and distress. DATA SOURCES: Secondary analyses of a cross-sectional survey study evaluated measures of sexual function (Female Sexual Function Index [FSFI]), unmet needs (Supportive Care Needs Scale), and distress (Patient Health Questionnaire). χ2 test, t tests, and analysis of variances (ANOVAs) tested bivariate relationships. Subgroup comparisons were made based on the Female Sexual Function Index sexual dysfunction diagnostic cut-off score (<26.55; lower scores indicate greater dysfunction). A regression model tested associations between sexual function and unmet needs with distress as the outcome variable. CONCLUSION: Clinically significant sexual dysfunction was common in this cohort of women. In multivariate modeling, worse sexual function and greater unmet sexuality needs related to greater distress. Future work should explore reasons behind the high levels of sexual dysfunction and unmet needs in female survivors. IMPLICATIONS FOR NURSING PRACTICE: It is important to routinely screen for sexual health concerns among female cancer survivors at all phases of the cancer trajectory including years posttreatment.

The Impact of Early COVID-19 Pandemic on the Presentation and Management of Urinary Calculi Across the Globe: A Systematic Review.

Introduction: It is acknowledged that the COVID-19 pandemic has had a major impact on health care services around the globe with possible worse outcomes. It has resulted in stretch of resources with canceled or delayed procedures. Patients with urinary calculi have also suffered the negative impact. This systematic review aims to assess the impact of the early COVID-19 pandemic on the presentation and management of urinary calculi around the globe. Methods: We reviewed the impact of early COVID-19 on the clinically important aspects of stone disease using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We searched Medline, Embase, and Central databases using themes of COVID-19 OR Sars-Cov-2 OR pandemic OR coronavirus AND kidney stone, urinary calculi, urolithiasis, and similar allied terms. Inclusion criteria were studies with data on both pre- and COVID-19 period covering one or more of eight clinical domains. Results: Our search returned 231 studies, after removal of duplicates, of which 18 studies were included for analysis. The number of patients presenting to hospital declined by 21%-70% at the beginning of the pandemic, whereas majority of studies reported increased associated complications. There are mixed reports in terms of delay to presentation and use of conservative management. There was a consistent trend toward reduction in elective procedures with wide variations (shockwave lithotripsy 38%-98%, percutaneous nephrolithotomy 94%-100%, and ureteroscopy 8%-98%). There was a trend toward increased nephrostomy insertion with the onset of the pandemic. Conclusion: This review demonstrated the differences in the number of patients presenting to hospital, complication rates, and management of urinary calculi, including surgical interventions, with the onset of the COVID-19 pandemic. It offers baseline global information that would help understand the impact of early pandemic, variations in practices, and be useful for future comparisons.

Possible evidence for morning and evening oscillators in Drosophila melanogaster populations selected for early and late adult emergence.

In this paper, we report the results of our study aimed at a systematic analysis of the circadian phenotypes of fruit flies Drosophila melanogaster selected for early and late adult emergence, in light of the "morning and evening oscillator" (M and E) model for circadian clocks. We monitored adult emergence and activity/rest rhythms in these flies under light/dark (LD) cycles with short (8:16 h), normal (12:12 h) and long (16:8 h) photoperiods, as well as under constant darkness (DD). Across all the three LD cycles, the early populations displayed a morning phenotype with peak of emergence and activity occurring earlier than the controls and greater anticipation to "lights-on" and weak anticipation to "lights-off", while the late populations showed an evening phenotype with peak of emergence and activity occurring later than the controls and greater anticipation to lights-off and weak anticipation to lights-on. The gate of adult emergence and duration of activity in the early populations was narrower than the controls, while those of the late populations were wider than the controls. In addition, the circadian periodicities of adult emergence and activity/rest rhythms of the early flies were significantly shorter than the controls, while those of the late flies were significantly longer than the controls. In summary, the circadian phenotypes indicate that the early populations have evolved a dominant M oscillator, while the late populations have evolved a dominant E oscillator, thus providing an empirical support for the M and E model in Drosophila.

Selection on the timing of adult emergence results in altered circadian clocks in fruit flies Drosophila melanogaster.

To investigate whether circadian clocks in fruit flies Drosophila melanogaster evolve as a consequence of selection on the timing of adult emergence, we raised four replicate populations each of early (early(1..4)) and late (late(1..4)) emerging flies by selecting for adults that emerged during the morning and the evening hours. We estimated the percentage of flies that emerged during the two selection windows to evaluate the direct response to selection, and the circadian phenotypes of adult emergence and locomotor activity rhythms under light/dark (LD) and constant darkness (DD) to assess the correlated response to selection. After 55 generations, the percentage of flies emerging during the morning window increased in the early populations, but decreased in the late populations. The percentage of flies emerging during the evening window increased in the late populations, but decreased in the early populations. The time course and waveform of emergence and locomotor activity rhythms of the selected populations diverged from each other as well as from the controls. Further, the circadian periodicity of the early populations was significantly shorter than the controls, while that of the late populations was significantly longer than the controls. The light-induced phase response curve of the selected populations differed significantly within groups as well as from the controls. Such modifications in the circadian phenotypes of the selected populations due to heritable changes in genetic architecture, in response to imposed selection pressure, suggest that the circadian clocks underlying emergence and locomotor activity rhythms in D. melanogaster evolve as a correlated response to selection on the timing of adult emergence.

Selection for early and late adult emergence alters the rate of pre-adult development in Drosophila melanogaster.

BACKGROUND: Circadian clocks have been implicated in the regulation of pre-adult development of fruit flies Drosophila melanogaster. It is believed that faster clocks speed up development and slower clocks slow it down. We established three sets of D. melanogaster populations (early, control and late). The early and late populations were raised by selecting for flies that emerged either in the morning or in the evening under 12:12 hr light/dark (LD) cycles. After 75 generations of selection, the time course and waveform of the adult emergence and activity rhythms of the early and the late populations diverged from each other as well as from the controls. In this paper, we report the consequence of this selection on the rate of pre-adult development. RESULTS: We assayed the pre-adult development time of the selected and control populations under 12:12 hr LD cycles and constant darkness (DD). Under LD cycles, the early populations develop faster than the controls, while the late populations develop slower than the controls. Although flies take longer to develop under DD than in LD, the relative differences between the mean development times of the selected and control populations remain unaltered in DD. In a separate experiment designed to investigate the effect of time of egg collection and experimental conditions on the duration of pre-adult stage, we assayed the development time of the selected and control populations by collecting eggs at different times of the day (morning and evening) and by assaying their pre-adult development time under constant light (LL), LD, and DD conditions. Irrespective of the time of egg collection and assay light regime, the late flies continue to develop slower than the early flies. CONCLUSION: The results of our study clearly indicate that selection on the timing of adult emergence alters the rate of pre-adult development in D. melanogaster. The timing of egg collection as well as assay light regime does not have any measurable effect on the relative differences between the developmental rates of the early and the late flies. Taken together these results appear to suggest that pleiotropic effects of clock genes mediate correlated changes in the timing of adult emergence and the rate of pre-adult development in D. melanogaster.

Simian foamy virus infection by whole-blood transfer in rhesus macaques: potential for transfusion transmission in humans.

BACKGROUND: Cross-species infection of humans with simian foamy virus (SFV) has been reported in European and North American nonhuman primate (NHP) handlers, primarily due to wound injuries involving infected animals in research centers and zoos. Additionally, African hunters have been found to be infected with SFV by exposure to body fluids, blood, or tissues of infected NHPs in the wild. The persistence of infectious virus in peripheral blood mononuclear cells (PBMNC) and the recent identification of some infected blood donors has raised safety concerns regarding potential virus transmission by blood transfusion. STUDY DESIGN AND METHODS: SFV infection by blood transfusion was evaluated by whole-blood transfer from two naturally-infected rhesus macaques (designated as D1 and D2) to retrovirus-free monkeys. Blood from D1 was transfused to two recipient monkeys R1 and R2 and from D2 to monkeys R3 and R4. Virus transmission was evaluated by immunoassays, polymerase chain reaction assays, and coculture of PBMNC for SFV isolation. RESULTS: SFV infection was seen in R1 and R2 based on development of virus-specific antibodies, identification of SFV sequences in monkey PBMNC, and isolation of infectious virus from PBMNC. Furthermore, both R1 and R2 remained SFV-positive at about 1 year after transfusion, which was the last time tested. No evidence of SFV infection was seen in R3 and R4. CONCLUSION: SFV transmission in macaques occurred by transfusion of blood from one of two infected donor animals. These results indicate the potential of SFV transfusion transmission in humans, which may depend on virus-specific or donor-related factors.

Entrainment of eclosion rhythm in Drosophila melanogaster populations reared for more than 700 generations in constant light environment.

In this paper, we report the results of our extensive study on eclosion rhythm of four independent populations of Drosophila melanogaster that were reared in constant light (LL) environment of the laboratory for more than 700 generations. The eclosion rhythm of these flies was assayed under LL, constant darkness (DD) and three periodic light-dark (LD) cycles (T20, T24, and T28). The percentage of vials from each population that exhibited circadian rhythm of eclosion in DD and in LL (intensity of approximately 100 lux) was about 90% and 18%, respectively. The mean free-running period (tau) of eclosion rhythm in DD was 22.85 +/- 0.87 h (mean +/- SD). Eclosion rhythm of these flies entrained to all the three periodic LD cycles, and the phase relationship (psi) of the peak of eclosion with respect to "lights-on" of the LD cycle was significantly different in the three periodic light regimes (T20, T24, and T28). The results thus clearly demonstrate that these flies have preserved the ability to exhibit circadian rhythm of eclosion and the ability to entrain to a wide range of periodic LD cycles even after being in an aperiodic environment for several hundred generations. This suggests that circadian clocks may have intrinsic adaptive value accrued perhaps from coordinating internal metabolic cycles in constant conditions, and that the entrainment mechanisms of circadian clocks are possibly an integral part of the clockwork.