The fluorosis conundrum: bridging the gap between science and public health.

Fluorosis, a chronic condition brought on by excessive fluoride ingestion which, has drawn much scientific attention and public health concern. It is a complex and multifaceted issue that affects millions of people worldwide. Despite decades of scientific research elucidating the causes, mechanisms, and prevention strategies for fluorosis, there remains a significant gap between scientific understanding and public health implementation. While the scientific community has made significant strides in understanding the etiology and prevention of fluorosis, effectively translating this knowledge into public health policies and practices remains challenging. This review explores the gap between scientific research on fluorosis and its practical implementation in public health initiatives. It suggests developing evidence-based guidelines for fluoride exposure and recommends comprehensive educational campaigns targeting the public and healthcare providers. Furthermore, it emphasizes the need for further research to fill the existing knowledge gaps and promote evidence-based decision-making. By fostering collaboration, communication, and evidence-based practices, policymakers, healthcare professionals, and the public can work together to implement preventive measures and mitigate the burden of fluorosis on affected communities. This review highlighted several vital strategies to bridge the gap between science and public health in the context of fluorosis. It emphasizes the importance of translating scientific evidence into actionable guidelines, raising public awareness about fluoride consumption, and promoting preventive measures at individual and community levels.

Development, Characterization, and Antibacterial Analysis of the Selenium-Doped Bio-Glass-Collagen-Gelatin Composite Scaffold for Guided Bone Regeneration.

Background Guided bone regeneration (GBR) is an often-used technique to aid the successful placement of dental implants in sites with deficient bone. The search for the ideal GBR membrane with bioactive components improving the regenerative outcomes is still on. In this study, a novel composite GBR membrane was developed using selenium-doped bio-glass, collagen, and gelatin. It was further characterized for surface, chemical, biocompatibility, and antibacterial properties. Methodology Selenium-doped bio-glass was prepared using the sol-gel method. The membrane was fabricated using an equal ratio of collagen and gelatin mixed with 1% selenium-doped bio-glass. The solution was poured to obtain a thin layer of the material which was lyophilized to obtain the final GBR membrane. The membrane was analyzed with scanning electron microscopy, energy dispersive X-ray (EDX) analysis, attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), zebrafish cytotoxicity test, and antibacterial assay. Results The membrane revealed good surface roughness with lamellar and fibrillar arrangement with a minute granular surface ideal for cell attachment and proliferation. The EDX analysis revealed the presence of carbon, oxygen, and nitrogen as predominant components with trace amounts of calcium, phosphorus, silica, and selenium. Fourier transform infrared spectroscopy analysis also proved the presence of collagen, gelatin, and bio-glass. The membrane revealed excellent biocompatibility with zebrafish growth at a normal rate with 90% viability maintained at 48, 72, and 96 hours and 95% viability at 120 hours. It also exhibited excellent antibacterial activity against Staphylococcus aureus and Escherichia coli with minimal growth of bacterial colonies. Conclusion The developed novel selenium bio-glass collagen and gelatin composite scaffold has a good surface and antibacterial properties along with excellent biocompatibility. Further cell line and in vivo studies should be conducted to explore its role in bone regeneration.

Fabrication and Characterization of an Innovative Silver- and Gadolinium-Doped Bioglass for Bone Regeneration.

Background Periodontal regeneration aims for the three-dimensional reconstruction of bone defects, and over the years, bone grafts with or without barrier membranes have provided us with promising results. Particulate bone grafts can be classified according to the source of procurement as autografts, allografts, xenografts, and alloplasts. Bioglass, an innovative alloplast that uses silica particles as a matrix incorporated with calcium and phosphorus, has been extensively used as a propitious material for bone regeneration owing to its inherent osteogenic ability and biocompatibility but presents with various disadvantages such as slow degradation rate, low mechanical strength, and fracture resistance. A novel silver (Ag)-gadolinium (Gd)-doped bioglass was fabricated to improve the mechanical properties, biocompatibility, and osteogenic ability when compared with bioglass (control). Materials and methods The Ag- and Gd-doped bioglass network was prepared and assessed for the morphological and structural properties by scanning electron microscopy (SEM) analysis, X-ray diffraction (XRD), and attenuated total reflectance (ATR)-infrared (IR). The cytotoxicity of Gd and Ag-doped bioglass was assessed using the MG63 cell line through the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide) assay at various concentrations and the absorbance of the solution was measured at 570 nm using a microplate reader. The osteogenic ability of the material was assessed by alkaline phosphatase activity and collagen estimation. Results ATR-IR spectroscopy, SEM, and XRD were used to examine the bioglass network doped with Gd and Ag. ATR-IR exhibited classic silicate bands, whereas SEM indicated particles bigger than 5 µm. XRD analysis revealed the production of Na2Ca2Si3O9, Na2Ca4(PO4)2SiO4, and wollastonite. The excellent crystallinity of Na2Ca2Si3O9 provided the bioglass network with good mechanical characteristics. The Gd-Ag-bioglass did not exhibit any toxicity towards the living cells at increasing concentrations from 12.5 µg to 100 µg. The alkaline phosphatase activity was increased by 10% and the collagen estimation remained consistent with bioglass (control). Conclusion In conclusion, the fabrication of the novel Gd-Ag-doped bioglass shows good cytocompatibility and osteogenic ability and shows great potential to enhance bone regeneration.

An Efficient AP-ANN-Based Multimethod Fusion Model to Detect Stress through EEG Signal Analysis.

Stress is a universal emotion that every human experiences daily. Psychologists say stress may lead to heart attack, depression, hypertension, strokes, or even sudden death. Many technical explorations like stress detection through facial expression, speech, text, physical behaviors, etc., were explored, but no consensus has been reached on the best method. The advancement in biomedical engineering yielded a rapid development of electroencephalogram (EEG) signal analysis that has inspired the idea of a multimethod fusion approach for the first time which employs multiple techniques such as discrete wavelet transform (DWT) for de-noising, adaptive synthetic sampling (ADASYN) for class balancing, and affinity propagation (AP) as a stratified sampling model along with the artificial neural network (ANN) as the classifier model for human emotion classification. From the EEG recordings of the DEAP dataset, the artifacts are removed, the signal is decomposed using a DWT, and features are extracted and fused to form the feature vector. As the dataset is high-dimensional, feature selection is done and ADASYN is used to address the imbalance of classes resulting in large-scale data. The innovative idea of the proposed system is to perform sampling using affinity propagation as a stratified sampling-based clustering algorithm as it determines the number of representative samples automatically which makes it superior to the K-Means, K-Medoid, that requires the K-value. Those samples are used as inputs to various classification models, the comparison of the AP-ANN, AP-SVM, and AP-RF is done, and their most important five performance metrics such as accuracy, precision, recall, F1-score, and specificity were compared. From our experiment, the AP-ANN model provides better accuracy of 86.8% and greater precision of 85.7%, a higher F1 score of 84.9%, a recall rate of 84.1%, and a specificity value of 89.2% which altogether provides better results than the other existing algorithms.

COVID-19-Associated mucormycosis: Case series from a tertiary care hospital in South India.

The pandemic coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is a global health problem. COVID-19 has given rise to a number of secondary bacterial or fungal infections. During the second wave of COVID-19, India experienced an epidemic of mucormycosis in COVID-19 patients. In this paper, we discuss the clinical features, investigations and management of four patients having COVID-19-associated mucormycosis (CAM), especially rhino-orbital mucormycosis (ROM) caused by Rhizopus arrhizus and Mucor species. We also compare the cases and their risk factors with previously reported CAM cases in India. Three patients had mucormycosis after recovering from COVID-19. They were successfully treated with surgical debridement and early initiation of anti-fungal therapy with systemic amphotericin B and other supportive measures such as broad-spectrum antibiotics, insulin infusion, antihypertensives and analgesics. The remaining patient had mucormycosis during COVID-19. He was admitted in the intensive care unit due to COVID-pneumonia and was on mechanical ventilation. In spite of all supportive measures, the patient succumbed to death due to cardiogenic shock. Three out of our four patients had diabetes mellitus. All patients were treated with systemic steroid during COVID-19 treatment. Diabetes mellitus and steroid treatment are the major risk factors for CAM. Early diagnosis of this life-threatening infection along with strict control of hyperglycemia is necessary for optimal treatment and better outcomes.

Green Synthesis of High Temperature Stable Anatase Titanium Dioxide Nanoparticles Using Gum Kondagogu: Characterization and Solar Driven Photocatalytic Degradation of Organic Dye.

The present study reports a green and sustainable method for the synthesis of titanium dioxide (TiO2) nanoparticles (NPs) from titanium oxysulfate solution using Kondagogu gum (Cochlospermum gossypium), a carbohydrate polymer, as the NPs formation agent. The synthesized TiO2 NPs were categorized by techniques such as X-Ray Diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy analysis, Raman spectroscopy, scanning electron microscope- Energy-dispersive X-ray spectroscopy (SEM-EDX), Transmission electron microscopy (TEM), High-resolution transmission electron microscopy (HR-TEM), UV-visible spectroscopy, Brunauer-Emmett-Teller (BET) surface area and particle size analysis. Additionally, the photocatalytic actions of TiO2 NPs were assessed with regard to their ability to degrade an organic dye (methylene blue) from aqueous solution in the presence of solar light. Various parameters affecting the photocatalytic activity of the TiO2 NPs were examined, including catalyst loading, reaction time, pH value and calcination temperature of the aforementioned particles. This green synthesis method involving TiO2 NPs explores the advantages of inexpensive and non-toxic precursors, the TiO2 NPs themselves exhibiting excellent photocatalytic activity against dye molecules.

Risk of perimetric blindness among juvenile glaucoma patients.

AIM: To estimate rates of progression and to asssess the projected lifetime risk of blindness among treated eyes of juvenile-onset primary open glaucoma (JOAG) patients. METHODS: Rates of change of the visual field index of JOAG patients (diagnosed between the age of 10-40 years), with at least 5 year follow up, were used to estimate the lifetime risk of perimetric blindness. Both the eyes of patients were included in the analysis wherever possible. Average life expectancy of the population was used to calculate the lifetime risk of perimetric blindness. A regression analysis of factors contributing to faster rates of progression was performed. RESULTS: One hundred and two eyes of 54 patients were included in the study. Mean age at the time of baseline visual field was 26.6 ± 9.8 years (15-40 years). The average visual field index change per year was -0.9% (range -6.4 to +2.0% per year) and 18 eyes (17%) showed a progression greater than -2% per year. The cumulative risk of an eye losing 50% and 100% of its visual field index was 30% and 22% respectively over the patients' lifetime. The projected risk of bilateral blindness among JOAG patients over their lifetime was 10%. Long term IOP fluctuation was significantly associated with faster rates of progression (Odds ratio = 2.74; p = 0.012). CONCLUSIONS: Though the rate of visual field deterioration with treatment, among juvenile glaucoma patients is lower compared to that among other types of primary glaucoma, the projected lifetime risk of perimetric blindness in these eyes is similar, despite the longer duration of disease in this age group.