Assessing the Impact of Multidisciplinary Collaboration on Quality of Life in Older Patients Receiving Primary Care: Cross Sectional Study.

The growing aging population presents unique challenges in maintaining their quality of life (QoL), which encompasses physical, psychological, and social wellbeing. This study aimed to assess the impact of multidisciplinary collaboration on QoL among older patients receiving primary care. A cross-sectional study was conducted involving a purposive sampling of 200 participants aged 60 years and above from Primary Healthcare Centers in Al-Ahsa, Saudi Arabia, between March and May 2024. Data were collected using standardized tools: SF-36 for health-related QoL, Multidisciplinary Collaboration Evaluation Tool (MCET), and Lubben Social Network Scale (LSNS). Multivariate regression analyses were performed to examine the associations between multidisciplinary collaboration, social support, and QoL outcomes. Multidisciplinary collaboration exhibited a significant positive association with improvements in physical functioning (ß = 2.35, p < 0.001), mental health (ß = 3.01, p < 0.001), and general health perceptions (ß = 2.12, p < 0.001). Key drivers of effective collaboration included effective communication (ß = 0.48, p < 0.001), coordination (ß = 0.42, p < 0.001), and patient involvement (ß = 0.40, p < 0.001). Social support, particularly from friends (ß = 0.33, p < 0.001) and family (ß = 0.28, p < 0.001), was also a robust predictor of better QoL. Younger age, female gender, married status, and absence of chronic conditions were associated with greater QoL improvements from multidisciplinary care. Multidisciplinary collaboration and social support networks significantly enhance QoL among older primary care patients. Healthcare systems should prioritize developing collaborative care models, fostering interdisciplinary teamwork, and integrating strategies to promote social connectedness for the aging population.

A Rare Case of Gas Forming Enterobacter cloacae Leading to Bleeding Mycotic Pseudoaneurysm of Transplant Renal Artery Culminating in Graft Nephrectomy.

Enterobacter cloacae belongs to Enterobacter genus. It is a common gram-negative, facultative anaerobic, rod-shaped organism. It causes a variety of nosocomial infections including urinary tract infection, pneumonia, wound infection, osteomyelitis and endocarditis. Over time Enterobacter cloacae complex (ECC) has developed to be resistant to antibiotics including carbapenem. It has been rarely reported to cause gas gangrene and never been reported to cause pseudoaneurysm (PA) of transplant renal artery. We report and share our experience with this rare case of gas forming and muti-drug resistant ECC which led to mycotic PA of transplant renal artery, complicated by bleeding and infected hematoma and which resulted in graft nephrectomy.

Publications in Plastic Surgery and Reconstruction: A Review from a Developing Country, Sudan.

Background: Plastic and reconstructive surgery services need to be improved in developing African countries. Research and article publications from those countries are limited. This review was conducted to identify published articles from Sudan in the area of plastic and reconstructive surgery. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used for the preparation of this systematic review. A comprehensive systematic search was performed using PubMed, ScienceDirect, and Web of Science databases. Articles published in Sudan, specifically in the area of plastic and reconstructive surgery, and written in English were included in this review. Results: The total number of articles that fulfilled the inclusion criteria was 23. The articles were written from 1969 to 2023. Only two articles were published in the 20th century. The most common study type was a retrospective study of eight articles, and the most common study area was Khartoum Teaching Hospital. Regarding the publishing journals, the number of subscription journals was six (30%), whereas open access was 17 (70%). Conclusion: This review demonstrates the lack of articles published on plastic surgery in Sudan. Further investigation is needed to determine the challenges and problems associated with possible clarifications.

Adaptation of cobalt chromium frameworks fabricated by conventional versus selective laser melting techniques: An in vitro and clinical assessment.

STATEMENT OF PROBLEM: Three-dimensional (3D) printing of cobalt chromium (Co-Cr) removable partial dentures (RPDs)by selective laser melting (SLM) has been claimed to be less challenging than by conventional casting and provides significant improvements. However, the adaptation and fit of the SLM framework and the optimum build orientation are still unclear. PURPOSE: The purpose of this in vitro and clinical study was to evaluate the effect of different build orientations on the adaptation of removable partial denture frameworks fabricated by SLM technology in vitro and to compare the adaptation of the SLM and conventional RPD frameworks clinically. MATERIAL AND METHODS: A master model simulating a maxillary arch of Kennedy class III modification 1 was scanned and duplicated to create a virtual 3D cast and reference cast. Four groups (n=40) of Co-Cr RPD frameworks were fabricated. For the SLM groups, the Co-Cr framework was virtually designed and exported for SLM printing. The SLM printing was done in 3 different build orientations: 0-degree (n=10), 45-degree (n=10), and 90-degree (n=10) groups. Other Co-Cr frameworks were conventionally cast (n=10). All Co-Cr frameworks were scanned and virtually superimposed with the master model using a surface-matching software program. The gap under 9 selected points in the palatal major connectors was analyzed and calculated. A smaller gap indicates more surface adaptation and close contact between the palatal major connector and the master model. The data were analyzed using the Kruskal-Wallis and Dunnett T3 tests (α=.05). Three patients with a partially dentate maxillary arch were enrolled in the clinical part based on inclusion criteria. Two RPD frameworks were provided for each patient (conventional casting and SLM printing). The adaptation of each framework was assessed by measuring the gap between the palatal major connector of the framework and the palate with light-body silicone. The differences in adaptation between the conventional and SLM frameworks were compared by using independent t tests (α=.05). RESULTS: The in vitro study identified significant differences in the adaptation of the palatal major connector among the 4 groups (P<.001), except for conventional and 0-degree SLM printing (P=.999). The conventional and 0-degree SLM frameworks exhibited the best adaptation, with the lowest gap underneath the palatal major connector of the RPD framework (0.01 ±0.02 mm and 0.01 ±0.01 mm, respectively). In the clinical part of the study, no significant difference was found between the adaptation of SLM and the conventional framework (P=.430) CONCLUSIONS: The adaptation of SLM printing can be maximized with less gap under the palatal major connector of the RPD framework when using the 0-degree build orientation. Co-Cr frameworks produced with SLM printing technology were comparable with conventionally produced frameworks; hence, SLM printed frameworks can be an alternative for clinical applications when optimum SLM parameters are applied.

Failure and complication rates of different materials, designs, and bonding techniques of ceramic cantilever resin-bonded fixed dental prostheses for restoring missing anterior teeth: A systematic review and meta-analysis.

OBJECTIVES: The objective of this review was to assess clinical trials that have examined the materials, design, and bonding of ceramic cantilevered resin-bonded fixed dental prostheses (RBFDPs) as a potential option for replacing missing anterior teeth. The evaluation primarily focuses on the rate of restoration failure and clinical complications. MATERIALS AND METHODS: A thorough search of databases including PubMed/MEDLINE, Scopus, and the Cochrane Library, was conducted. The most recent search was performed in October 2023. Clinical studies that compared ceramic cantilevered RBFDPs with double retainers or cantilevered RBFDPs using different ceramic materials or bonding systems were included. The outcome measures considered were restoration failure and complication rates. RESULTS: Twelve studies met the eligibility criteria. The pooled data showed a statistically significant decrease in complication events when using cantilever designs compared with double retainer designs (p < 0.05); however, there were no differences found between the two designs in terms of restoration failure. The complication and failure rate of cantilever RBFDPs did not show a statistically significant difference with or without ceramic primer application before luting with phosphate monomer-containing luting resin (p > 0.05). CONCLUSIONS: Ceramic cantilevered RBFDPs have lower complication rates compared with those with double retainers. The use of a ceramic primer prior to luting composite resin for ceramic cantilevered RBFDPs decreases the occurrence of complications and failures, although this effect was not statistically significant. Additional research is required to confirm these findings. Glass ceramic cantilever RBFDPs showed a decrease in success after 6 years, requiring ongoing monitoring, but both zirconia and glass-infiltrated alumina cantilever RBFDPs have demonstrated durability with excellent long-term success and survival rates for up to 10 and 15 years. CLINICAL SIGNIFICANCE: Cantilever ceramic RBFDPs in the anterior region are a less invasive and valuable treatment option, providing good esthetic results.

Dental implant planning using artificial intelligence: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Data on the role of artificial intelligence (AI) in dental implant planning is insufficient. PURPOSE: The purpose of this systematic review with meta-analysis was to analyze and evaluate articles that assess the effectiveness of AI algorithms in dental implant planning, specifically in detecting edentulous areas and evaluating bone dimensions. MATERIAL AND METHODS: A systematic review was conducted across the MEDLINE/PubMed, Web of Science, Cochrane, and Scopus databases. In addition, a manual search was performed. The inclusion criteria consisted of peer-reviewed studies that examined the accuracy of AI-based diagnostic tools on dental radiographs for dental implant planning. The most recent search was conducted in January 2024. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included articles. RESULTS: Twelve articles met the inclusion criteria for this review and focused on the application of AI in dental implant planning using cone beam computed tomography (CBCT) images. The pooled data indicated an overall accuracy of 96% (95% CI=94% to 98%) for the mandible and 83% (95% CI=82% to 84%) for the maxilla in identifying edentulous areas for implant planning. Eight studies had a low risk of bias, 2 studies had some concern of bias, and 2 studies had a high risk of bias. CONCLUSIONS: AI models have the potential to identify edentulous areas and provide measurements of bone as part of dental implant planning using CBCT images. However, additional well-conducted research is needed to enhance the accuracy, generalizability, and applicability of AI-based approaches.

Adhesion of Candida Albicans to digital versus conventional acrylic resins: a systematic review and meta-analysis.

BACKGROUND: The present systematic review and meta-analysis investigated the available evidence about the adherence of Candida Albicans to the digitally-fabricated acrylic resins (both milled and 3D-printed) compared to the conventional heat-polymerized acrylic resins. METHODS: This study followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). A comprehensive search of online databases/search tools (Web of Science, Scopus, PubMed, Ovid, and Google Scholar) was conducted for all relevant studies published up until May 29, 2023. Only in-vitro studies comparing the adherence of Candida albicans to the digital and conventional acrylic resins were included. The quantitative analyses were performed using RevMan v5.3 software. RESULTS: Fourteen studies were included, 11 of which were meta-analyzed based on Colony Forming Unit (CFU) and Optical Density (OD) outcome measures. The pooled data revealed significantly lower candida colonization on the milled digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (MD = - 0.36; 95%CI = - 0.69, - 0.03; P = 0.03 and MD = - 0.04; 95%CI = - 0.06, - 0.01; P = 0.0008; as measured by CFU and OD respectively). However, no differences were found in the adhesion of Candida albicans between the 3D-printed digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (CFU: P = 0.11, and OD: P = 0.20). CONCLUSION: The available evidence suggests that candida is less likely to adhere to the milled digitally-fabricated acrylic resins compared to the conventional ones.

Quantitative and qualitative 3D analysis of mandibular lingual concavities: Implications for dental implant planning in the posterior mandible.

OBJECTIVE: The purpose of this study is to investigate the type of ridge (degree of angulation of the lingual concavity) and the buccolingual dimensions in the area of the first and second molars in both genders of different ages and how this will affect implant placement in the posterior mandible. MATERIALS AND METHODS: This retrospective cross-sectional study comprised cone beam computed tomography images of 150 dental patients (75 males and 71 aged ≥30). The following were measured/reported: type (morphology) of the ridge (convex [C], parallel [P], or undercut [U]), buccolingual width at the base and the crest of the ridge, and ridge height. The concavity angle, depth, and length of the U-shaped ridge were measured too. RESULTS: The prevalence of type U ridge ranged from 32.7% in the first molar region to 62.7% in the second molar region. Almost all measurements and ridge type distributions were comparable amongst the age groups (p > .05). Very few significant differences were found when comparing #36 versus #37 and #46 versus #47 teeth, with no differences in the distribution of the ridge types (p > .05). Quite the inverse, all measurements were statistically different when comparing #36 versus #37 and #46 versus #47 teeth, and type U ridge was more frequent in second molar compared to the first molar regions, respectively (p < .05). Many measurements were statistically higher in females; the inverse was true for a few measurements (p < .05). Type U ridge in #36 and #37 was found more frequently among males (p < .001). In contrast, the ridge types in #37 and #47 were not statistically different gender-wise. CONCLUSIONS: The U type of ridge was more prevalent in the investigated population, encountered more frequently in the second molars generally and in the first molars of males than females. Most posterior mandibular measurements are similar age- and side-wise but seem different gender- and tooth-wise.

An inappropriate decline in ribosome levels drives a diverse set of neurodevelopmental disorders.

Many neurodevelopmental defects are linked to perturbations in genes involved in housekeeping functions, such as those encoding ribosome biogenesis factors. However, how reductions in ribosome biogenesis can result in tissue and developmental specific defects remains a mystery. Here we describe new allelic variants in the ribosome biogenesis factor AIRIM primarily associated with neurodevelopmental disorders. Using human cerebral organoids in combination with proteomic analysis, single-cell transcriptome analysis across multiple developmental stages, and single organoid translatome analysis, we identify a previously unappreciated mechanism linking changes in ribosome levels and the timing of cell fate specification during early brain development. We find ribosome levels decrease during neuroepithelial differentiation, making differentiating cells particularly vulnerable to perturbations in ribosome biogenesis during this time. Reduced ribosome availability more profoundly impacts the translation of specific transcripts, disrupting both survival and cell fate commitment of transitioning neuroepithelia. Enhancing mTOR activity by both genetic and pharmacologic approaches ameliorates the growth and developmental defects associated with intellectual disability linked variants, identifying potential treatment options for specific brain ribosomopathies. This work reveals the cellular and molecular origins of protein synthesis defect-related disorders of human brain development. Highlights: AIRIM variants reduce ribosome levels specifically in neural progenitor cells. Inappropriately low ribosome levels cause a transient delay in radial glia fate commitment.Reduced ribosome levels impair translation of a selected subset of mRNAs.Genetic and pharmacologic activation of mTORC1 suppresses AIRIM-linked phenotypes.

Enhancement of soybean tolerance to water stress through regulation of nitrogen and antioxidant defence mechanisms mediated by the synergistic role of salicylic acid and thiourea.

Water stress (WS) poses a significant threat to global food and energy security by adversely affecting soybean growth and nitrogen metabolism. This study explores the synergistic effects of exogenous salicylic acid (SA, 0.5 mM) and thiourea (TU, 400 mg L-1), potent plant growth regulators, on soybean responses under WS conditions. The treatments involved foliar spraying for 3 days before inducing WS by reducing soil moisture to 50% of field capacity, followed by 2 weeks of cultivation under normal or WS conditions. WS significantly reduced plant biomass, chlorophyll content, photosynthetic efficiency, water status, protein content, and total nitrogen content in roots and leaves. Concurrently, it elevated levels of leaf malondialdehyde, H2O2, proline, nitrate, and ammonium. WS also triggered an increase in antioxidant enzyme activity and osmolyte accumulation in soybean plants. Application of SA and TU enhanced the activities of key enzymes crucial for nitrogen assimilation and amino acid synthesis. Moreover, SA and TU improved plant growth, water status, chlorophyll content, photosynthetic efficiency, protein content, and total nitrogen content, while reducing oxidative stress and leaf proline levels. Indeed, the simultaneous application of SA and TU demonstrated a heightened impact compared to their separate use, suggesting a synergistic interaction. This study underscores the potential of SA and TU to enhance WS tolerance in soybean plants by modulating nitrogen metabolism and mitigating oxidative damage. These findings hold significant promise for improving crop productivity and quality in the face of escalating water limitations due to climate change.

Efficacy of photodynamic therapy on candida colonization and clinical symptoms in denture stomatitis: a systematic review and meta-analysis.

BACKGROUND: Photodynamic therapy (PDT) has been recently proposed as a promising alternative therapy for Denture Stomatitis (DS). The present systematic review and meta-analysis investigated the current available evidence regarding the efficacy of PDT in the management of DS. MATERIALS AND METHODS: PubMed, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 7, 2023. All relevant clinical trials were included. RevMan software was used for the statistical analyses. RESULTS: Elven randomized clinical trials (460 DS patients) were included. Eight studies assessed the efficacy of PDT vs. topical antifungal therapy, while three studies assessed the adjunctive use of PDT (PDT + antifungal therapy) vs. topical antifungal therapy alone. The results revealed comparable efficacy of PDT and conventional antifungal therapy on candida colonization at 15 days (MD: 0.95, 95% CI: -0.28, 2.19, p = 0.13) and at the end of follow-up (MD: -0.17, 95% CI: -1.33, 0.98, p = 0.77). The pooled two studies revealed relatively better efficacy of adjunctive use of PDT with antifungal therapy on candida colonization compared to antifungal therapy alone at 15 days (MD: -6.67, 95% CI: -15.15, 1.82, p = 0.12), and at the end of follow-up (MD: -7.14, 95% CI: -19.78, 5.50, p = 0.27). Additionally, the results revealed comparable efficacy of PDT and topical antifungal therapy on the clinical outcomes. CONCLUSIONS: PDT might be considered a viable option for DS either as an adjunct or as an alternative to the topical antifungal medications. Further studies with adequate sample sizes and standardized PDT parameters are warranted.

Emerging Role of the IL-36/IL-36R Axis in Multiple Inflammatory Skin Diseases.

IL-36 is a most recent member of the IL-1 cytokine family, primarily expressed at barrier sites of the body such as the skin, lungs, and intestine. It plays a vital role in inflammation and is implicated in the development of various cutaneous; intestinal; and pulmonary disorders, including psoriasis, inflammatory bowel disease, and chronic obstructive pulmonary disease. IL-36 comprises 4 isoforms: the proinflammatory IL-36α, IL-36ß, and IL-36γ and the anti-inflammatory IL-36R antagonist. An imbalance between proinflammatory and anti-inflammatory IL-36 isoforms can contribute to the inflammatory fate of cells and tissues. IL-36 cytokines signal through an IL-36R heterodimer mediating their function through canonical signaling cacade, including the NF-B pathway. Prominent for its role in psoriasis, IL-36 has recently been associated with disease mechanisms in atopic dermatitis, hidradenitis suppurativa, neutrophilic dermatoses, autoimmune blistering disease, and Netherton syndrome. The major cutaneous source of IL-36 cytokines is keratinocytes, pointing to its role in the communication between the epidermis, innate (neutrophils, dendritic cells) immune system, and adaptive (T helper [Th]1 cells, Th17) immune system. Thus, cutaneous IL-36 signaling is crucial for the immunopathological outcome of various skin diseases. Consequently, the IL-36/IL-36R axis has recently been recognized as a promising drug target for the treatment of inflammatory disorders beyond psoriasis. This review summarizes the current update on IL-36 cytokines in inflammatory skin diseases.

Mitigating salt toxicity and overcoming phosphate deficiency alone and in combination in pepper (Capsicum annuum L.) plants through supplementation of hydrogen sulfide.

While it is widely recognized that hydrogen sulfide (H2S) promotes plant stress tolerance, the precise processes through which H2S modulates this process remains unclear. The processes by which H2S promotes phosphorus deficiency (PD) and salinity stress (SS) tolerance, simulated individually or together, were examined in this study. The adverse impacts on plant biomass, total chlorophyll and chlorophyll fluorescence were more pronounced with joint occurrence of PD and SS than with individual application. Malondialdehyde (MDA), hydrogen peroxide (H2O2), and electrolyte leakage (EL) levels in plant leaves were higher in plants exposed to joint stresses than in plants grown under an individual stress. When plants were exposed to a single stress as opposed to both stressors, sodium hydrosulfide (NaHS) treatment more efficiently decreased EL, MDA, and H2O2 concentrations. Superoxide dismutase, peroxidase, glutathione reductase and ascorbate peroxidase activities were increased by SS alone or in conjunction with PD, whereas catalase activity decreased significantly. The favorable impact of NaHS on all the evaluated attributes was reversed by supplementation with 0.2 mM hypotaurine (HT), a H2S scavenger. Overall, the unfavorable effects caused to NaHS-supplied plants by a single stress were less severe compared with those caused by the combined administration of both stressors.

Microbial screening of animal skin bags used in traditional cheesemaking.

Bouhezza is a traditional Algerian cheese produced and ripened in goatskin bags called Djeld. The aim of this study was to characterize the microbial ecosystem from Djeld (fresh and dried Djeld for making Bouhezza cheese) and the changes introduced by Lben microflora during its preparation and to identify its role in cheesemaking and its safety. Two replicates of fresh and dried skin bags (FS and DS) were sampled and analyzed before and after contact with Lben. The microbiological results showed no pathogens. Skins observed before the addition of Lben were less populated 2.86 and 3.20 log CFU cm-2 than skins examined after the addition of Lben (approximately 6.0 log CFU cm-2), suggesting a potential role of Lben in releasing some microorganisms into the skin during its time in the Djeld. However, an increase in mesophilic lactic acid bacteria and yeasts was observed in Lben after different periods of interaction with the skin. PCR-TTGE revealed the predominance of lactic acid bacteria (Lactiplantibacillus plantarum, Limosilactobacillus fermentum, Staphylococcus equorum subsp. linens, Lactococcus cremoris, Streptococcus thermophilus) and a few high-GC-content bacteria (Lacticaseibacillus paracasei, Brevibacterium casei). Transfer of several microbial species was observed between the goatskin bag biofilm and Lben during the overnight interaction. Bands corresponding to Lacticaseibacillus paracasei, Brevibacterium casei, and Lactobacillus delbrueckii subsp. lactis were detected in the fresh skin profile and in Lben after contact with the fresh skin. Lacticaseibacillus paracasei was found in dried skin and Lben after contact with dry skin. Lactobacillus helveticus and Enterococcus faecalis appeared in the Lben profile and persisted in Lben and the biofilm-covered dry skin after interaction. These results demonstrate an exchange of specific microbial populations between goatskin bag biofilm and Lben during the traditional preparation method, suggesting that the diversity of goatskin biofilm contributes to the microbial diversity of Lben used in the production of Bouhezza cheese.

Patients' perception towards digital health services in Saudi Arabia: A cross-sectional study.

The COVID-19 pandemic has highlighted the importance of the widespread use of digital health services (DHS). Despite evidence of the benefits of DHS, there are many barriers to their adaptation worldwide. This study aimed to measure the effectiveness of DHS from the patient perspective. A cross-sectional study was conducted in the Jazan region of Saudi Arabia from December 2022 to March 2023. Of the 323 participants who completed the online questionnaire, 63.5% were female, and 55.4% of participants found that DHS was satisfactory. 34% of the participants preferred DHS via telephone calls and 40.2% found that DHS was comparable to direct regular services in building trust between patients and doctors. A total of 79.2% agreed that DHS could reduce unnecessary outpatient visits and 70.9% agreed that it could be used effectively to follow patients with chronic diseases. DHS was found to be cost-effective in 76.8%. Digital healthcare has the potential to significantly improve health care outcomes and effectiveness in Saudi Arabia. Therefore, the use of a DHS for monitoring and dispensing care would be advantageous. However, difficulties such as lack of time or a packed schedule have prevented patients in Saudi Arabia from using telemedicine.

The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis.

BACKGROUND: A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes. MATERIALS AND METHODS: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software. RESULTS: A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001). CONCLUSIONS: The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.

Citric acid and hydrogen sulfide cooperate to mitigate chromium stress in tomato plants by modulating the ascorbate-glutathione cycle, chromium sequestration, and subcellular allocation of chromium.

The study aimed to investigate the role of hydrogen sulfide (H2S) in regulating chromium stress (Cr-S) tolerance of tomato plants treated with citric acid (CA). Prior to the Cr treatment, tomato plants were foliar-fed with CA (100 µM) daily for 3 days. Subsequently, the plants were grown for another ten days in a hydroponic system in a 50 µM Cr (VI) solution. Chromium treatment reduced photosynthetic pigments and plant biomass, but boosted the levels of hydrogen peroxide (H2O2) malondialdehyde (MDA), H2S, phytochelatins (PCs), and glutathione (GSH), electrolyte leakage (EL), and antioxidant enzyme activity in tomato plants. However, the foliar spray of CA mitigated the levels of H2O2, MDA, and EL, promoted plant growth and chlorophyll content, enhanced antioxidant enzymes' activities, and increased H2S production in Cr-S-tomato plants. CA also increased the levels of GSH and PCs, potentially reducing the toxicity of Cr through regulated sequestration. Additionally, the application of sodium hydrogen sulfide (NaHS), a donor of H2S, improved CA-induced Cr stress tolerance. The addition of CA promoted Cr accumulation in root cell wall and leaf vacuoles to suppress its toxicity. To assess the involvement of H2S in CA-mediated Cr-S tolerance, 0.1 mM hypotaurine (HT), an H2S scavenger, was provided to the control and Cr-S-plants along with CA and CA + NaHS. HT reduced the beneficial effects of CA by decreasing H2S production in tomato plants. However, the NaHS addition with CA + HT inverted the adverse impacts of HT, indicating that H2S is required for CA-induced Cr-S tolerance in tomato plants.

Interactive effect of silicon and zinc on cadmium toxicity alleviation in wheat plants.

Silicon (Si) and Zinc (Zn) have been frequently used to alleviate cadmium (Cd) toxicity, which are feasible strategies for crop safety production. However, the mechanisms underlying the interaction of Si and Zn on alleviating Cd toxicity are not well understood. A hydroponic system was adopted to evaluate morphological, physiological-biochemical responses, and related gene expression of wheat seedlings to Si (1 mM) and Zn (50 µM) addition under Cd stress (10 µM). Cd induced obvious inhibition of wheat growth by disturbing photosynthesis and chlorophyll synthesis, provoking generation of reactive oxygen species (ROS) and interfering ion homeostasis. Cd concentration was decreased by 68.3%, 43.1% and 73.3% in shoot, and 78.9%, 44.1% and 85.8% in root by Si, Zn, and combination of Si with Zn, relative to Cd only, respectively. Si and Zn effectively ameliorated Cd toxicity and enhanced wheat growth; but single Si or combination of Si with Zn had more efficient ability on alleviating Cd stress than only Zn, indicating Si and Zn have synergistic effect on Cd toxicity; Interaction of them alleviated oxidative stress by reducing ROS content, improving AsA-GSH cycle and antioxidant enzymes activities, and regulating Cd into vacuole through PC-Cd complexes transported by HMA3 transporter. Our results suggest that fertilizers including Si and Zn should be made to reduce Cd content, which will beneficial for food production and safety.

Melatonin enhanced the heavy metal-stress tolerance of pepper by mitigating the oxidative damage and reducing the heavy metal accumulation.

Heavy metals (HMs), like vanadium (V), chromium (Cr), cadmium (Cd), and nickel (Ni) toxicity due to anthropogenic, impair plant growth and yield, which is a challenging issue for agricultural production. Melatonin (ME) is a stress mitigating molecule, which alleviates HM-induced phytotoxicity, but the possible underlying mechanism of ME functions under HMs' phytotoxicity is still unclear. Current study uncovered key mechanisms for ME-mediated HMs-stress tolerance in pepper. HMs toxicity greatly reduced growth by impeding leaf photosynthesis, root architecture system, and nutrient uptake. Conversely, ME supplementation markedly enhanced growth attributes, mineral nutrient uptake, photosynthetic efficiency, as measured by chlorophyll content, gas exchange elements, chlorophyll photosynthesis genes' upregulation, and reduced HMs accumulation. ME treatment showed a significant decline in the leaf/root V, Cr, Ni, and Cd concentration which was about 38.1/33.2%, 38.5/25.9%, 34.8/24.9%, and 26.6/25.1%, respectively, when compared with respective HM treatment. Furthermore, ME remarkably reduced the ROS (reactive oxygen species) accumulation, and reinstated the integrity of cellular membrane via activating antioxidant enzymes (SOD, superoxide dismutase; CAT, catalase; APX, ascorbate peroxidase; GR, glutathione reductase; POD, peroxidase; GST, glutathione S-transferase; DHAR, dehydroascorbate reductase; MDHAR, monodehydroascorbate reductase) and as well as regulating ascorbate-glutathione (AsA-GSH) cycle. Importantly, oxidative damage showed efficient alleviations through upregulating the genes related to key defense such as SOD, CAT, POD, GR, GST, APX, GPX, DHAR, and MDHAR; along with the genes related to ME biosynthesis. ME supplementation also enhanced the level of proline and secondary metabolites, and their encoding genes expression, which may control excessive H2O2 (hydrogen peroxide) production. Finally, ME supplementation enhanced the HM stress tolerance of pepper seedlings.

Evaluating COVID-19 vaccination intentions and vaccine hesitancy among parents of children with autism spectrum disorder.

As the global vaccination mass campaign against COVID-19 extended to children aged 5 to 11 years, some parents remained hesitant about their children being administered the vaccine despite data supporting its safety. Parent vaccine hesitancy (PVH) may have predisposed certain groups of children, particularly those with autism spectrum disorder (ASD), to COVID-19 when other neurotypical children would have been vaccinated. We investigated the current PVH in 243 parents of children with ASD and 245 controls using the Parent Attitudes about Childhood Vaccines (PACV) scale. The study was conducted in Qatar from May to October 2022. Overall, 15.0% [95% CI 11.7%; 18.3%] of parents were vaccine-hesitant, with no difference (p = 0.054) between groups (ASD children [18.2%] vs. controls [11.7%]). The only sociodemographic factor associated with higher vaccine hesitancy was being a mother (as compared to being a father). The COVID-19 vaccine receipt rate at the time of the study did not differ between ASD (24.3%) and non-ASD groups (27.8%). Around two-thirds of parents of children with ASD refused or were unsure about vaccinating their children against COVID-19. We found that the intent to vaccinate against COVID-19 was higher in parents who were married and in those with a lower PACV total score. Continued public health efforts are needed to address vaccine hesitancy among parents.