Effectiveness of Denture Cleansers on Candida albicans Biofilm on Conventionally Fabricated, Computer-Aided Design/Computer-Aided Manufacturing-Milled, and Rapid-Prototyped Denture Base Resins: An In Vitro Study.

INTRODUCTION: Conventionally fabricated denture base resins have been used for over 150 years. Newer denture base resins can provide a superior fit and may be customized to the patient's characteristics, but the literature on their cleansibility remains limited. The oral cavity can be a hub for thousands of microflora. The maintenance of complete dentures by edentulous patients depends not only on the maintenance of the patient but also on the material used, biofilm adherence, and polishability. MATERIALS AND METHODS: Cuboid specimens of 10 × 5 × 2 mm were designed using the Meshmixer version 3.5 software (Meshmixer, Australia). The standard tessellation (STL) file was imported and sent for printing (NextDent, Netherlands) (Group 1), milling in polymethyl methacrylate (PMMA) (Ivotion, Ivoclar, Schaan, Liechtenstein) (Group 2), and wax milling (Upcera, China), followed by flasking, counter flasking, and packing using heat-cured acrylic resin (DPI, India) (Group 3). The obtained specimens were polished using pumice and sterilized using a UV sterilization unit. The specimens were then immersed in a suspension of candida broth. After three days of biofilm formation, a colony count was performed and noted as colony-forming units per milliliter (CFU/mL). Specimens were treated using Secure denture cleansing tablets (Ghent, New York), table salt (iodized table salt, Tata, India), Clinsodent (ICPA, Mumbai, India), and Polident denture cleansing powder (Polident, Ontario, Canada). A colony count was done after treatment, and the data were tabulated. Statistical analysis was done using SPSS software to compare the efficiency of denture cleansers in all three groups, and statistical significance was set at 0.05. The Kolmogorov-Smirnov test was done to confirm the normality of the data, followed by a one-way analysis of variance (ANOVA) test to compare the efficiency of denture cleansers on the removal of candida colonies. RESULTS: Milled denture base resins showed a significantly lower colony count when compared to printed and conventionally fabricated denture base resins. The denture cleansers showed high efficacy in all groups, with the most significant being Secure, which showed a mean difference ranging from 8.114 to 9.887 CFU/mL, followed by Clinsodent, showing a mean of 6.699-9.863 CFU/mL, followed closely by Polident, showing 4.964-7.114 CFU/mL, followed by table salt, being 5.254-8.920 CFU/mL. The 95% confidence interval confirmed statistical significance. CONCLUSION: The highest candida colony count was demonstrated by the conventional, followed by rapid prototyping, and was least with milled denture base resins. Following treatment with denture cleansers, Secure demonstrated almost complete eradication of colonies, making it the most effective option. Salt exhibited the lowest efficiency, followed closely by Polident and Clinsodent, and the most effective was Secure denture cleanser.

A Systematic Review on Maxillofacial Prosthesis with Respect to Their Color Stability.

The aim of this systematic review was to identify and analyze the findings of various studies that analyzed the changes in the color stability of maxillofacial prosthetic materials after the addition of various colorants and nanoparticles and assess the change in color after being subjected to either natural or artificial accelerated aging as well as outdoor aging. This systematic review was conducted in accordance with the guidelines of transparent reporting of systematic reviews and meta-analysis (PRISMA Statement). The primary objective of this systematic review was to evaluate the color stability of maxillofacial prosthesis. The secondary objective was to assess the effect of various colorants; pigments; opacifiers; UV absorbers-such as inorganic colorants (dry earth pigments); metal oxides; and organic colorants. The time period of the included studies extended from 2013 to 2023. Electronic database search identified a total of 217 studies. Ten studies were included to meet the research question. All 10 included studies analyzed the effect of various colorants and their exposure to various aging and weathering conditions. It was found that various pigments and nanoparticles had an effect on the color stability. Also weathering and aging conditions had a direct effect on the color stability as well. In terms of disinfection, although there was not much color difference observed, highest change in color stability was observed when rubbing or brushing of the prosthesis was carried out. In conclusion, the color stability of maxillofacial prosthetics is a critical factor that influences both patient satisfaction and the overall cosmetic look. The potential of pigments and nanoparticles to enhance the color stability of silicone-based maxillofacial prosthesis has received much research. By avoiding color fading and discoloration brought on by environmental variables including UV radiation, aging, and chemical exposure, the inclusion of various pigments and nanoparticles has been demonstrated to improve the color stability of silicone maxillofacial prostheses.

The prevalence of major depressive disorder and anxiety disorders among asylum seekers in South Florida.

The rapidly growing population of asylum seekers in the United States often seeks asylum following persecution and severe traumatic events. Asylum evaluations play an influential role in the process by objectively documenting human rights abuses. The purpose of this study was to describe the prevalence of major depressive disorder (MDD) and anxiety disorders among asylum seekers and analyze differences in the severity of disease by time and sub-group. Data was collected from a retrospective review of medical affidavits written from 2017 to 2020 following asylum evaluations in South Florida. Decision trees were utilized to make diagnoses for each individual's current mental health status in the U.S. and retrospectively for while in their home country. These diagnoses were recorded according to the Global Burden of Disease study criteria and utilizing validated mental health screeners. The prevalence of MDD was found to significantly decrease from 75.8% in patients' home countries to 46.7% in the U.S. Similarly, prevalence of anxiety disorders significantly fell from 85.8% to 64.2%. Gender and being a victim of sexual assault were significantly associated with severity of MDD and anxiety disorders. This reduction in the burden of mental health disease after relocation to the United States demonstrate the benefit of asylum not only as a human right, but also as a mental health intervention. Through their connection with higher application success rates and referrals to follow-up care, physician-performed asylum evaluations can thus be linked to improved health outcomes.

Assessment of the mineralisation stages of third molars and validation of Mincer et al.'s age estimation method: A retrospective, cross-sectional study in Western India population.

Context: Age estimation is one of the prime requisites in forensic human identification cases and the criminal justice system. There are several age estimation methods using dental parameters. A method proposed by Mincer et al. which uses the mineralization stages of third molars based on Demirjian's developmental stages is less tested in the Indian population. Aim: The present study aimed to assess the developmental status of the third molars and to apply and validate Mincer et al.'s method on the Western India population. Methods and Material: A total of 306 orthopantomograms (OPGs) from 128 males and 178 females with a mean age of 16.89 years ± 3.68 were analysed. Demirjian's A-H staging was applied to record the developmental stages of 1100 third molars. Mincer et al.'s mean age of attainment was applied based on the American Whites (Caucasian) population for males and females separately using stages of #18 and #38. Results: There was a slight overestimation of the chronological age (CA) in both #18 and #38. The females showed more accurate estimated age (EA) than males. Conclusions: Mincer et al.'s method is a convenient age estimation method using the third molar's developmental stage. The mean age of attainment mentioned in the original Mincer et al.'s study can be used in the Western Indian population, with a residual value ranging from 0.21 to 0.25 years.

Assessment of Knowledge on Implant Abutment and Platform Switching among Dental Specialists Practicing Implantology.

Implant abutment connection has proven to have a significant impact on the success of the prosthetic rehabilitation for an implant-supported restoration. This connection not only provides the base on which the restoration is supported but also maintains the integrity of the hard and the soft tissues surrounding the implant. A wide range of implants and their implant abutments are now widely available in the market. Such a wide range would undoubtedly put the clinician in a quandary when it comes to selecting an acceptable abutment, one that is scientifically based and also has a high clinical rate of success. As a result, this study is a straightforward attempt to assess the knowledge of the dental specialists practicing implantology on the areas of implant abutment connections as well as platform switching. The aim of this study was to assess the knowledge on various implant abutment and platform switching among various dental specialists practicing implantology. An online multiple-choice questionnaire based survey was circulated amongst a total of 100 dental specialists with questions assessing their knowledge about implant-abutment connections, platform switching and its significance. Although the degree of information about implant-abutment connection and platform switching appears to be appropriate among various dental specialists practicing implantology, there is a dearth of understanding regarding the mechanical, biological and technical considerations. With the advent of various implant manufacturer and their production of implants as well as their components, the clinicians are undoubtedly put in a quandary when it comes to selecting an acceptable abutment, one that is scientifically based and also has a high clinical rate of success. Therefore, more light must be thrown not only on the surgical aspects of implant dentistry, but also on the prosthetic rehabilitation and its components, in order to ensure clinical success in terms of restoring a patient's function as well as aesthetic.

A Literature Review on Implant Abutment Types, Materials, and Fabrication Processes.

Dental implantology has made great strides since Dr. Brånemark introduced it to the world of dentistry. In terms of materials and fabrication processes, a wide range of implants and their implant abutments are now widely available in the market. Such a wide range would undoubtedly put the clinician in a quandary when it comes to selecting an acceptable abutment, one that is scientifically based and also has a high clinical rate of success. As a result, this literature review is a straightforward attempt to shed light on the wide range of implant-abutment types, materials and fabrications that are now easily accessible on the market, as well as offer an overview of each specific type to avoid further dilemma for its clinical intent.

Developing Awareness and Allies: Simulating Difficult Conversations about Microaggressions for Faculty and Students.

OBJECTIVES: Discrimination and bias in clinical training often take the form of microaggressions, which, albeit unintentional, are detrimental to the learning environment and well-being of students. Although there are a few reports of medical schools training students to respond to microaggressions, none have included a complementery student-led faculty training module. The aim of this study was to develop and evaluate a case-based approach to improving student resilience and increasing faculty awareness of microaggressions in the clinical setting. METHODS: We created four realistic cases of microaggressions and uncomfortable conversations, based on students' experiences on the wards, to implement training for incoming third-year students and their core faculty. Standardized patients were trained to effectively portray discriminatory faculty, residents, and patients. Institutional review board-approved surveys were administered and statistically analyzed to evaluate for efficacy. RESULTS: Students had greater mean confidence scores for responding to microaggressions immediately and at 6 months after the sessions (P < 0.05). Faculty showed improved mean confidence and understanding of the definition of a microaggression (P < 0.05). CONCLUSIONS: This approach had results similar to other studies, with the additional benefit of training faculty with the same scenarios. We believe that this method helped bridge the gap between students' notions of discrimination and faculty understanding of microaggressions.

Scheimpflug Corneal Densitometry Values and Severity of Guttae in Relation to Visual Acuity in Fuchs Endothelial Corneal Dystrophy.

PURPOSE: The purpose of this study was to investigate the association between corneal densitometry (CD) values from Scheimpflug tomography imaging, severity of guttae, and visual acuity in eyes with Fuchs endothelial corneal dystrophy (FECD). METHODS: This was a retrospective, cross-sectional study. Patients with FECD were examined at the Bascom Palmer Eye Institute from January 2015 to September 2019. We extracted CD values at central annuli of 0-2, 2-6, 6-10 and 10-12 mm from Scheimpflug tomography images. We investigated the association of corrected distance visual acuity (CDVA) with CD values, severity of guttae, central corneal thickness (CCT), cataract grade, refractive error, corneal edema grade, age, and gender using multivariate generalized estimating equation regression models. RESULTS: One hundred ninety-two eyes from 110 patients were included in this study. Increase in central CD values at the 0 to 2 mm zone (P < 0.001), severity of guttae (P = 0.046), age (P < 0.001), cataract grade (P < 0.001), corneal edema grade (P < 0.001), and type of refractive error (P = 0.008) were significantly associated with decreased CDVA. Central corneal thickness, sex, and the peripheral CD values (2-6, 6-10, and 10-12 mm) were not significantly associated with CDVA (P > 0.05) in the final multivariate regression model. CONCLUSIONS: Our study demonstrates that central CD values at 0 to 2 mm and severity of guttae are each associated with decreased CDVA in FECD. These findings carry implications for patients with FECD considering surgical intervention for phacoemulsification alone, Descemet stripping only, or endothelial cell transplantation and provide a multifactorial perspective on vision loss in FECD.

The association of fingerprint patterns with oral potentially malignant disorders and oral cancer: A dermatoglyphic study.

Background: Dermatoglyphics play an important role in the identification of a person as well as identifying a person with a genetic abnormality. Hence, the present study was conducted with an aim to explore the association between the fingerprint patterns and oral potentially malignant disorders, oral squamous cell carcinoma (OSCC), individuals with habit and without lesion and the control group. Materials and Methods: A cross-sectional study comprising of 100 individuals divided into 5 groups with 20 individuals in each group based on their habit and the presence of oral lesions. Group 1 included individuals with oral leukoplakia (OL), Group 2 included individuals with oral submucous fibrosis (OSMF), Group 3 included individuals who had OSCC, Group 4 individuals had tobacco habits but without lesion and Group 5 comprised of control individuals. The fingerprints of all the study subjects were recorded using a standard ink method. They were analyzed qualitatively and quantitively. Results: The present study showed a predominance of that loop patterns in all the groups. The frequency of the whorled pattern was higher in subjects with OSMF as compared to OL and OSCC. The arch pattern was comparatively lesser in subjects with OL than OSMF subjects. The right-left comparison of the fingerprint patterns in all the five groups, except Group 4, showed a significant association and correlation. The Group 4 individuals were showing the least correlation between sides. Conclusion: The study concluded that dermatoglyphics can be used as a potential marker to identify the subjects with risk for potentially malignant oral disorders and oral cancers.

Impact of the coronavirus pandemic on pediatric eye-related emergency department services.

Literature describing the trends and utilization of pediatric eye-related emergency department (ED) visits is limited. We performed a retrospective cohort study of 311 pediatric patients visiting Bascom Palmer Eye Institute (BPEI) ED between March and May 2020 to quantify the effect of the coronavirus (COVID-19) on ophthalmology care utilization. In our study, pediatric ED visits declined by half at the onset of the pandemic in March. The number of visits reached the lowest point in early April and increased to 48% of the pre-COVID volume by the end of May. Despite changes in volume, patient demographics and clinical diagnoses were relatively consistent throughout the pandemic.

Pediatric Eye Care: We Cannot Lose Sight of Its Importance despite the COVID-19 Pandemic.

Visual impairment affects over 19 million children globally and, if left untreated, can result in significant ocular morbidity. Due to the treatable nature of many childhood visual disturbances, pediatric vision screening is essential for optimization of health and developmental outcomes. The coronavirus disease 2019 (COVID-19) pandemic has inevitably disrupted the provision of routine pediatric health care as evidenced by reduced adherence to vaccination schedules. Further, the home environment, which many children have now become confined to, is known to pose risk for eye trauma which may result in irreversible vision loss. Therefore, it is imperative for pediatricians and pediatric ophthalmologists to focus on eye health and safety, despite the backdrop of a global pandemic.

Recurrent Bacteremia in the Setting of a Coronary Artery Fistula.

We present an interesting case of a 31-year-old female with recurrent Staphylococcus lugdunensis bacteremia in the setting of a coronary artery fistula (CAF). Over the course of several months, the patient was admitted to the hospital on three separate occasions with an unclear source of bacteremia. She suffered from numerous complications, including cavitary pneumonia, osteomyelitis, synovitis and septic emboli. On each admission, the patient received intravenous (IV) antibiotic therapy. CT scan of the chest with contrast on the third admission revealed a prominent tortuous vessel coursing from the ascending aorta and main pulmonary artery to the left atrium. Coronary CT angiogram confirmed the presence of a fistula connecting the left circumflex artery to the coronary sinus. Common complications of CAF include infective endocarditis and myocardial ischemia; however, we report a novel case of recurrent bacteremia in the context of an anomalous coronary artery. Two months after diagnosis, surgical closure of the CAF was performed. This case illustrates the importance of utilizing different cardiac imaging modalities in order to diagnose congenital cardiac anomalies in a timely fashion and intervene appropriately.

The association between vision impairment and social participation in community-dwelling adults: a systematic review.

Vision impairment (VI) is an important contributor to the global burden of disability and is associated with decreased well-being. Recent research has attempted to devise a conceptual framework to explain the health consequences of VI. One proposed mechanism by which VI leads to declines in well-being and other adverse health and disability outcomes is through limitations in social participation (SP). SP is an integral component of overall functioning, optimal aging, and well-being, and reductions in SP are associated with lower health-related quality of life. The purpose of this systematic review was to appraise the existing literature on the relationship between VI and SP. The protocol for this review was registered on PROSPERO (CRD42018102767) and adhered to PRISMA guidelines. A comprehensive search of five databases (MEDLINE, EMBASE, PsycINFO, Scopus, Sociology Database) yielded 881 unique studies, of which 19 met inclusion criteria. Among the 19 included studies, 18 concluded that VI was associated with reduced SP and one reported mixed results. Bias was assessed using the Effective Public Health Practice Project Quality Assessment. In the quality assessment, four studies were rated "moderate" and fifteen were rated "weak." There was wide variation in study populations and measurement of VI and SP. In conclusion, there is consensus that VI is associated with reduced SP. However, more rigorous study design and better standardization in the assessment of VI and SP could facilitate valid comparisons across populations, diseases, and levels of VI. Attempts to provide vision rehabilitation and mitigate the effects of VI on overall health and well-being might consider strategies to improve SP.

Self-reported Vision Impairment and Subjective Well-being in Older Adults: A Longitudinal Mediation Analysis.

BACKGROUND: Vision impairment (VI) in older adults is associated with declines in well-being. However, the pathways through which poor vision leads to declines in well-being have not been well-described. The purpose of this study was to determine whether activity limitations and social participation restrictions mediate the impact of self-reported VI on subjective well-being. METHODS: The National Health and Aging Trends Study (NHATS) is a nationally representative longitudinal study of Medicare beneficiaries 65 and older that includes detailed measures of the disablement process. A longitudinal mediation model was conceptualized linking self-reported VI and subjective well-being. Structural equation modeling was used to test the mediating effects of activity limitations and social participation restrictions while adjusting for relevant covariates. RESULTS: The final sample included 5,431 respondents. At baseline, 8.0% of Medicare beneficiaries had self-reported VI. Subjective well-being scores were significantly lower among respondents with self-reported VI (15.7; 95% confidence interval [CI]: 15.2, 16.2) compared with those without VI (17.6; 95% CI: 17.5, 17.7). Self-reported VI had a significant indirect effect on subjective well-being through limiting mobility (ß = -0.04; 95% CI: -0.07, -0.03) and household activities (ß = -0.05; 95% CI: -0.08, -0.03), but not self-care limitations (ß = 0.0; 95% CI = 0.0, 0.0) or participation restrictions (ß = 0.0; 95% CI = -0.01, 0.00). Total indirect effects from all mediation paths accounted for 42% of the effect of VI on well-being. CONCLUSIONS: Mobility and household activity limitations are significant mediators that explain a considerable portion of the impact of poor vision on well-being. Interventions to promote successful accommodation may result in greater overall well-being for older adults with poor vision.

Constructing bioactive peptides with pH-dependent activities.

Many bioactive peptides are featured by their arginine and lysine rich contents. In this study, lysine and arginine residues in lytic peptides were selectively replaced by histidines. Although resulting histidine-containing lytic peptides had decreased activity, they did show pH-dependent cytotoxicity. The activity of the constructed histidine-containing lytic peptides increased 2-8 times as the solution pH changed from 7.4 to 5.5. More importantly, these histidine-containing peptides maintain the same cell killing mechanism as their parent peptides by causing cell lysis. Both the activity and pH-sensitivity of histidine-containing peptides are tunable by adjusting histidine substitution numbers and positions. This study has presented a general strategy to create bioactive peptides with desired pH-sensitivity to meet the needs of various applications such as cancer treatments.