Links between conspiracy beliefs, vaccine knowledge, and trust: Anti-vaccine behavior of Serbian adults.

RATIONALE: Immunization is a critical tool in the fight against infectious disease epidemics. Understanding hesitancy towards immunization is even more important nowadays, with the continuous threat of COVID-19 pandemic. Medical conspiracy beliefs, scientific skepticism, as well as low trust in governmental institutions, and evidence-based knowledge all have troubling effects on immunization. OBJECTIVE: To examine how these factors cross-react to influence vaccine behavior against any vaccine preventable disease (VPD), we hypothesized a model consisting of the belief in conspiracy theories as the predictor, and as the mediators subjective and objective vaccine knowledge, and trust in the health care system and science. The model was tested by examining the vaccine intentions for the children and self for any VPD. METHODS: Two separate studies were conducted on the representative samples of Serbian population; the first study investigated the intentions for child vaccination and the second study examined the vaccine intentions against any VPD, including adult vaccination. We used path analysis followed by logistic regression to analyze the data. RESULTS: The results revealed high vaccine hesitancy motivated by the belief in the vaccine conspiracy theories, through its effect on reduced trust in medical science and institutions, and low objective vaccine knowledge. CONCLUSIONS: The results of this study may be used to implement appropriate policy changes and implementation of the public health campaigns to promote immunization with a wide range of vaccines against common diseases, such as measles, human papillomaviruses, or pertussis, and novel diseases, such as COVID.

The Potassium Channel Kv1.5 Expression Alters During Experimental Autoimmune Encephalomyelitis.

Multiple sclerosis (MS) is a chronic, inflammatory, neurodegenerative disease with an autoimmune component. It was suggested that potassium channels, which are involved in crucial biological functions may have a role in different diseases, including MS and its animal model, experimental autoimmune encephalomyelitis (EAE). It was shown that voltage-gated potassium channels Kv1.5 are responsible for fine-tuning in the immune physiology and influence proliferation and differentiation in microglia and astrocytes. Here, we explored the cellular distribution of the Kv1.5 channel, together with its transcript and protein expression in the male rat spinal cord during different stages of EAE. Our results reveal a decrease of Kv1.5 transcript and protein level at the peak of disease, where massive infiltration of myeloid cells occurs, together with reactive astrogliosis and demyelination. Also, we revealed that the presence of this channel is not found in infiltrating macrophages/microglia during EAE. It is interesting to note that Kv1.5 channel is expressed only in resting microglia in the naïve animals. Predominant expression of Kv1.5 channel was found in the astrocytes in all experimental groups, while some vimentin+ cells, resembling macrophages, are devoid of Kv1.5 expression. Our results point to the possible link between Kv1.5 channel and the pathophysiological processes in EAE.

Clinical guidance and an evidence-based approach for restoration of worn dentition by direct composite resin.

This paper aims to provide the dentist with practical guidance on the technique for direct composite restoration of worn teeth. It is based on current evidence and includes practical advice regarding type of composite, enamel and dentine preparation, dentine bonding and stent design. The application of direct composite has the advantage of being additive, conserving as much of the remaining worn tooth as possible, ease of placement and adjustment, low maintenance and reversibility. A pragmatic approach to management is advocated, particularly as many of the cases are older patients with advanced wear. Several cases restored by direct composite build-ups illustrate what can be achieved. The restoration of the worn dentition may be challenging for many dentists. Careful planning and simple treatment strategies, however, can prove to be highly effective and rewarding. By keeping any intervention as simple as possible, problems with high maintenance are avoided and management of future failure is made easier. An additive rather than a subtractive treatment approach is more intuitive for worn down teeth. Traditional approaches of full-mouth rehabilitation with indirect cast or milled restorations may still have their place but complex treatment modalities will inevitably be more time consuming, more costly, possibly require specialist care and still have an unpredictable outcome. Composite resin restorations are a universal restorative material familiar to dentists from early-on in the undergraduate curriculum. This review paper discusses the application of composite to restore the worn dentition.

A novel approach to study in situ enamel erosion and abrasion lesions.

OBJECTIVES: This study investigated previous hypotheses that the tongue can abrade acid softened/eroded enamel surfaces. METHODS: Twelve upper removable appliances each retaining 2 anterior and 2 posterior human enamel specimens were constructed. Each specimen was exposed to acid on both surfaces, but only one surface was allowed contact with the tongue. Therefore, 96 surfaces were assessed. Appliances were worn from 9.30 to 17.00 Monday to Friday for 22days. Acid eroded lesions were created by immersing the specimens for 5min in 50ml orange juice three times daily. Enamel loss was measured using Quantitative light- induced fluorescence (QLF) and Non- contact profilometry (NCLP) and the differences (D) between tongue (Dt) and palate facing (DP) surfaces determined. RESULTS: %ΔFD(t-p) from the two anterior specimens were greater than from those placed posteriorly with mean values of 15.9% (±9.1) and 14.4% (±8.4), 5.6% (±8.7) and 4.5% (±6.6) respectively. Similarly, NCLP data showed anterior specimens had greater differences for mean step height (MSH) between tongue- facing and the palate- facing (control) surfaces than posterior specimens. MSHD(t-p) values were 59.4µm (±30.3) for anterior tongue facing surfaces and 55.5µm (±29.4) for posterior palate facing surfaces. For the posterior specimens MSH was 48.1µm (±26.1) and 51.7µm (±30.4) respectively (p<0.05). CONCLUSION: The greater enamel surface loss of the anterior specimens demonstrates that abrasion by the tongue on acid softened/eroded enamel in situ is likely.

The survival of direct composite restorations in the management of severe tooth wear including attrition and erosion: A prospective 8-year study.

OBJECTIVES: Survival of directly placed composite to restore worn teeth has been reported in studies with small sample sizes, short observation periods and different materials. This study aimed to estimate survival for a hybrid composite placed by one clinician up to 8-years follow-up. METHODS: All patients were referred and recruited for a prospective observational cohort study. One composite was used: Spectrum(®) (DentsplyDeTrey). Most restorations were placed on the maxillary anterior teeth using a Dahl approach. RESULTS: A total of 1010 direct composites were placed in 164 patients. Mean follow-up time was 33.8 months (s.d. 27.7). 71 of 1010 restorations failed during follow-up. The estimated failure rate in the first year was 5.4% (95% CI 3.7-7.0%). Time to failure was significantly greater in older subjects (p=0.005) and when a lack of posterior support was present (p=0.003). Bruxism and an increase in the occlusal vertical dimension were not associated with failure. The proportion of failures was greater in patients with a Class 3 or edge-to-edge incisal relationship than in Class 1 and Class 2 cases but this was not statistically significant. More failures occurred in the lower arch (9.6%) compared to the upper arch (6%) with the largest number of composites having been placed on the maxillary incisors (n=519). CONCLUSION: The worn dentition presents a restorative challenge but composite is an appropriate restorative material. CLINICAL SIGNIFICANCE: This study shows that posterior occlusal support is necessary to optimise survival.

The clinical features and their impact on the prosthodontic management in a case of Gardner's syndrome.

Gardner's syndrome is a variant of Familial Adenomatous Polyposis (FAP), a condition that manifests as hundreds of colorectal polyps likely to undergo malignant change by the fourth decade. Early diagnosis of this condition has the potential to be life saving for individuals and due to its inherited nature other family members can often also be affected. Additional features of Gardner's Syndrome include multiple jaw osteomas with missing teeth that can make prosthodontic treatment a challenge. This case report highlights the presenting features and the prosthodontic problems faced when treating a patient with Gardner's syndrome.

Reproductive differentiation into sexual and apomictic polyploid cytotypes in Potentilla puberula (Potentilleae, Rosaceae).

BACKGROUND AND AIMS: Intraspecific reproductive differentiation into sexual and apomictic cytotypes of differing ploidy is a common phenomenon. However, mechanisms enabling the maintenance of both reproductive modes and integrity of cytotypes in sympatry are as yet poorly understood. This study examined the association of sexual and apomictic seed formation with ploidy as well as gene flow towards sexuals within populations of purely polyploid Potentilla puberula. METHODS: The study is based on 22 populations representing various combinations of five polyploid cytotypes (tetraploid-octoploid) from East Tyrol, Austria. Embryo ploidy and the endosperm/embryo ploidy ratio obtained by a flow cytometric seed screen were used to infer reproductive modes of seed formation and to calculate the male and female genomic contributions to the embryo and endosperm. Self-incompatibility (SI) patterns were assessed and a new indirect approach was used to test for the occurrence of intercytotype matings based on the variation in the male genomic contribution to sexually derived embryos on the level of developed seed. KEY RESULTS: Tetraploids formed seeds almost exclusively via sexual reproduction, whereas penta- to octoploids were preferentially apomictic. Non-random distribution of reproductive modes within maternal plants further revealed a tendency to separate the sexual from the apomictic mode among individuals. Self-incompatibility of sexuals indicated functionality of the gametophytic SI system despite tetraploidy of the nuclear genome. We found no indication for significant cross-fertilization of tetraploids by the high polyploids. CONCLUSIONS: The study revealed a rare example of intraspecific differentiation into sexual and apomictic cytotypes at the polyploid level. The integrity of the sexual tetraploids was maintained due to reproductive isolation from the apomictic higher polyploids. Functionality of the gametophytic SI system suggested that the tetraploids are functional diploids.

The prevalence and associated risk factors for tooth wear and dental erosion in 15- to 16-year-old schoolchildren in Amman, Jordan.

BACKGROUND: Tooth wear and acid erosion have not been previously investigated in Jordanian schoolchildren. AIM: To determine the prevalence of tooth wear and associations for a range of dietary and behavioural risk factors. METHODS: A sample of 1,602 children aged between 15 and 16 years were randomly selected from 32 schools in Amman, Jordan. Tooth wear was measured using the modified Tooth Wear Index and dichotomised on the presence or absence of exposed dentine. Analysis of questionnaire items was performed by multiple logistic regression analysis. RESULTS: Dentine was exposed in 51 % of children, and males (59 %) had significantly more tooth wear than females (42 %), OR = 1.9, 95 % CI 1.6, 2.4, p < 0.0001. Over 40 % of children had dentine exposed occlusally, mainly the lower first molars, and less than 1 % of the children had dentine exposed palatally. Daily consumption of oranges, ketchup, olives and sweetened coffee was associated with tooth wear through enamel to expose dentine. Carbonated drinks (fizzy) were on the borderline of significance at p = 0.055. The mean DMFT (5.52) was significantly greater in children without tooth wear compared to children with tooth wear (4.13) (p < 0.001). DMFT, gender, daily consumption of oranges and daily consumption of ketchup were significantly associated with tooth wear in the multiple regression model. CONCLUSION: In this sample of children resident in Amman, Jordan, males had significantly more tooth wear than females. The acidic dietary items associated with tooth wear and, thus, dental erosion included oranges, olives and tomato ketchup.

The signs and symptoms of tooth wear in a referred group of patients.

AIM: To determine the prevalence of signs and symptoms in a group of tooth wear patients referred to a hospital-based consultant clinic. METHOD: The clinical records of 290 patients referred to the Liverpool University Dental Hospital for tooth wear were reviewed retrospectively. A systematic sampling technique was used to select every alternate patient held on the consultant database. RESULTS: There were significantly more males than females in a ratio of 2.3:1. Significantly more males (56%) presented with severe tooth wear compared with females (31%) (p <0.001). Aesthetic concerns were the most prevalent presenting complaint (59%) and sensitivity was the second most common presenting complaint (40%). Functional problems and pain were less prevalent at 17% and 14% respectively. Subjects who had lost posterior support had more severe wear and more worn anterior teeth, which was statistically significant (p = 0.001). The proportion of subjects with undiagnosed apical pathology on worn teeth was 13%. CONCLUSIONS: Tooth wear predominated in males in this study. Patient dissatisfaction with appearance is the most common complaint and endodontic signs and symptoms are low in prevalence. Contrary to previous studies, lack of posterior support resulted in greater severity of wear, therefore restoring support is recommended.

The problem with an epidemiological index for dental erosion.

This article reviews and discusses the difficulties posed by the application of epidemiological indices for the measurement of dental erosion. It covers several aspects of index design.

Prevalence and risk indicators of erosion in thirteen- to fourteen-year-olds on the Isle of Man.

AIMS: The aim was to determine the prevalence of erosion in 13- to 14-year-old children on the Isle of Man and to investigate the strength of association with dietary risk factors. METHODS: Exposed dentine was assessed on smooth surfaces of incisors/canines and occlusal surfaces of first molars. A questionnaire assessed the consumption frequency of foodstuffs. RESULTS: Of 629 children examined, 124 (20%) had dentine exposed labially, palatally or occlusally. More males had dentine exposed on these surfaces (OR = 1.7, 95% CI = 1.2-2.6). Palatal dentine exposure was present in 3% of the children and occlusal dentine exposure in 18%. In bivariate analyses, drinking fizzy drinks more than once a day was associated with erosion (OR = 1.6, 95% CI = 1.1-2.3). The mean DMFT scores were not statistically different for the children with smooth surface/occlusally exposed dentine (1.37) compared to those without (1.58). Multiple regression analysis showed age, gender and toothbrushing to be significant predictors of erosion. CONCLUSION: This study has found a higher proportion of 13- to 14-year-old children with exposed dentine in molars than previous studies. The results corroborate previous reports that males have more erosion than females.

The erosive potential of some alcopops using bovine enamel: an in vitro study.

OBJECTIVES: Alcoholic soft drinks have become increasingly popular and have high concentrations of citric acid and alcohol so might have the potential to cause dental erosion. This study aimed to investigate the erosive potential of alcopops on bovine enamel in vitro. METHODS: Six bovine upper incisors were prepared and sectioned to give six slabs per tooth, 4mm x 4mm each. Each slab was covered with nail varnish, leaving an exposed window (2mm x 2mm). Samples were immersed in 20ml of each of the test solutions for 20min, 1h, and 24h under gentle agitation (100rpm). Enamel surface loss was determined using Quantitative Laser Fluorescence (QLF), Non-contact Profilometry (NCP) and Transverse Microradiography (TMR). RESULTS: Enamel loss occurred with all test drinks and the positive control (p<0.05), and the depth of lesion correlated with pH and time. No significant difference was observed between 20min and 1h exposure, although both times had significantly (p<0.05) greater erosion when compared with baseline. Within each alcopops group significant erosion had occurred at 24h exposure compared with the baseline and previous times. CONCLUSION: All the tested alcopops resulted in significant enamel loss at 24h (p<0.001) with direct correlation between degree of enamel loss and both pH and increasing exposure time.

UK National Clinical Guidelines in Paediatric Dentistry: diagnosis, prevention and management of dental erosion.

This revised Clinical Guideline in Paediatric Dentistry replaces the previously published ninth guideline (Shaw L, O'Sullivan E. Int J Paediatr Dent 2000; 10: 356-365). The process of guideline production began in 1994, resulting in first publication in 1997. Each guideline has been circulated widely for consultation to all UK consultants in paediatric dentistry, council members of the British Society of Paediatric Dentistry (BSPD), and to people of related specialities recognized to have expertise in the subject. The final version of this guideline is produced from a combination of this input and thorough review of the published literature. In the case of the present guideline, an internationally recognized expert in the field was invited to be a co-author (AM). The intention is to encourage improvement in clinical practice and to stimulate research and clinical audit in areas where scientific evidence is inadequate. Evidence underlying recommendations is scored according to the SIGN classification and guidelines should be read in this context. Further details regarding the process of paediatric dentistry guideline production in the UK is described in the Int J Paediatr Dent 1997; 7: 267-268.

Bleeding after dental extractions in patients taking warfarin.

OBJECTIVE: To assess the incidence of bleeding after dental extractions in subjects taking warfarin continuously before and after extractions whose International Normalised Ratio (INR) was below 4.0 at the time of extraction. METHODS: This was a case series study of 150 patients without controls who required extraction of at least one tooth under local anaesthetic. All sockets were subsequently packed with absorbable oxycellulose and sutured. RESULTS: A total of 58 women and 92 men were included (mean age 66 years); their ages were similar. The mean INR (S.D.) was 2.5 (0.56), although most patients had an INR less than 2.5 (n=101). Ten patients (7%) bled after extraction, enough to require a return to hospital. Five patients of 101 with an INR2.5 out of 49 bled after extraction (p=0.29). Bleeding after extraction was not associated with operative antibiotics. All patients who bled were managed conservatively and none was admitted to hospital. CONCLUSION: Patients taking warfarin whose INR is up to 4.0 and who have dental extractions in hospital do not have clinically significant bleeds post-operatively.

Epidemiological studies of tooth wear and dental erosion in 14-year old children in North West England. Part 2: The association of diet and habits.

OBJECTIVE: To determine the strength of association (expressed as Odds Ratios) of potential risk factors with erosion and tooth wear in 14-year-old schoolchildren. DESIGN: A random sample of 2,385 children were selected by a stratified two-stage technique based on schools and children. SETTING: Schools in NW England. METHODS: Tooth wear was assessed by one examiner on three surfaces of all 12 anterior teeth (labial, incisal and palatal) and the occlusal surface of all four first molars using a four-point scale. Enamel wear was scored 0, dentine exposure <1/3 scored 1, >1/3 scored 2 and secondary dentine or pulpal exposure, scored 3. A questionnaire enquired about general health, dental health, habits and the frequency of intake of a wide range of foods and drinks. RESULTS: The Odds Ratios for tooth wear on any surface for habits, reflux and certain foods were: bruxism, 1.10; stomach upset, 1.45; pickles 1.86; vinegar 1.36; salt and vinegar crisps 1.33; brown/other sauces 1.57. Similarly, the odds ratios for potentially erosive drinks were: fizzy drinks 1.32; sport drinks 1.58; herbal/lemon tea 3.97. The frequency of intake was bi-modal with 397 children drinking a can per day and 207 drinking two cans per day. A significant number drank acidic beverages at bedtime but this was not associated with dental erosion. CONCLUSION: Although odds ratios greater than unity indicate an association, this was not high for carbonated beverages and many other acidic foods or drinks. Examining at fourteen years may not be ideal, as the determinants of erosion/tooth wear have not acted for long, the indices do not discriminate sufficiently and proportionately few subjects have dentine exposed on smooth surfaces.

Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England. Part 1: The relationship with water fluoridation and social deprivation.

OBJECTIVE: The effect of water fluoridation upon dental erosion/tooth wear in the UK has not been investigated. This study aimed to compare the prevalence of tooth wear in 14-year-old schoolchildren in non-fluoridated and fluoridated districts of North West (NW) England. The influence of deprivation and tooth brushing was also investigated. DESIGN: A random sample of 10% of the 14-year-old population in NW England was selected and stratified according to fluoridation status as determined from water authority postcode listings. METHODS: Tooth wear was scored on the labial, incisal and palatal/lingual surfaces of the 12 anterior teeth and the occlusal surfaces of the first molars. Enamel wear was scored 0, dentine was scored 1 or 2, dependent on whether less than or more than a third of the surface had exposed dentine. Secondary dentine or pulpal exposure scored 3. Townsend deprivation scores were gained from residential post codes. RESULTS: A total of 2,351 children were examined, of which 637 (27%) lived in the one fluoridated district of South Cheshire and 1,714 (73%) lived in 11 non-fluoridated districts. Fifty-three per cent of the children had exposed dentine with significantly more males affected than females (p<0.001). In the fluoridated district, significantly fewer children had exposed dentine on labial and palatal smooth surfaces (p<0.001) but no differences were found for incisal and occlusal surfaces. The interaction of fluoridation and tooth brushing twice per day resulted in a significant (30%) reduction in erosion. Smooth surface wear was more prevalent in children resident in affluent areas. CONCLUSION: Children in non-fluoridated districts are 1.5 times more likely to have smooth surface wear compared with children in fluoridated districts. Fluoridation and use of fluoridated toothpaste twice a day provide added protection from dental erosion. The risk of tooth wear is greater with increasing affluence.

[Effect of vitamin E on erythrocyte enzymes and total antioxidant status in diabetic patients with ischemic heart disease]. / Dejstvo vitamina E na enzime eritrocita i ukupni antioksidantni status kod dijabeticnih bolesnika s ishemijskom bolescu srca.

Lipid peroxidation is thought to be one of the major factors involved in atherogenesis. There is an increasing evidence is increasing that oxidation of LDL cholesterol may be instrumental in atherogenesis. Diabetics are known to be at increased risk of cardiovascular diseases, a phenomenon which has previously been linked to the lipid peroxidation process. As a result, a number of studies have been undertaken to evaluate the effects of antioxidant vitamins on coronary heart disease and risks factors of ischaemic heart disease such as diabetes mellitus. Lipid peroxidation and antioxidant status were studied in 51 patients with ischaemic heart disease and some of with having diabetes mellitus (18%). Results were compared before and after supplementation of 450 mg of tocopherol acetate for three months. SOD were found to be elevated in patients with diabetes and in whole groups of patients after supplementation of tocopherol acetate. Also, TAS was found to be elevated in a subgroup of patients without diabetes and no significant changes were found in glutathion-peroxidase after supplementation. We found statistically significantly decreased mean values of glucose after supplementation in all groups of patients. The monitoring of antioxidant parameters in diabetic patients could be of vital importance in the study of the disease.

The importance of antioxidant enzyme and total antioxidant status of patients with acute myocardial infarction on thrombolytic therapy.

It is believed that intensive production of free radicals occurs immediately after reperfusion, and that it explains a series of adverse effects of reperfusion. The aim of the study was to establish the importance of the antioxidative enzymes superoxide dismutase (SOD), glutathione peroxidase (GPX) and the total antioxidant status (TAS) in patients with acute myocardial infarction according to success or failure of reperfusion. Enzyme activities in erythrocyte hemolysate and concentration of TAS in plasma were determined by Randox kits in 50 patients with acute myocardial infarction. No significant differences in TAS between the mean values against either clinical status or the 10 time intervals were recorded. The SOD and GPX values were significantly influenced by the presence or absence of reperfusion (p<0.05). Monitoring of SOD and GPX at ten time points: before administration of streptokinase, 1, 3, 6, 12, 18, 24 hours, 2, 3 and 5 days after administration of streptokinase revealed the lowest SOD levels up to one hour before administration of streptokinase, supporting the fact that the maximum production of free radicals is achieved at that time. GPX values differed for 24 hours according to whether reperfusion was achieved or not. The obtained results suggest that free radical production is increased after reperfusion, and monitoring of antioxidant enzymes may help to evaluate the success of thrombolytic therapy.

Comparison of three facebow/semi-adjustable articulator systems for planning orthognathic surgery.

Our aim was to measure the steepness of the occlusal plane produced by three different semi-adjustable articulators: the Dentatus Type ARL, Denar MkII, and the Whipmix Quickmount 8800, and to assess the influence of possible systematic errors in positioning of study casts on articulators that are used to plan orthognathic surgery. Twenty patients (10 skeletal class II, and 10 skeletal class III) who were having pre-surgical orthodontics at Liverpool University Dental Hospital were studied. The measurement of the steepness of the occlusal plane was taken as the angle between the facebow bite-fork and the horizontal arm of the articulator. This was compared with the angle of the maxillary occlusal plane to the Frankfort plane as measured on lateral cephalometry (the gold standard). The Whipmix was closest to the gold standard as it flattened the occlusal plane by only 2 degrees (P<0.05). The results of the Denar and Dentatus differed significantly from those of the cephalogram as they flattened the occlusal plane by 5 degrees and 6. 5 degrees (P<0.01), respectively. Clinicians are encouraged to verify the steepness of the occlusal plane on mounted study casts before the technician makes the model.