bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Electronic Versus Print Textbooks by Chilean Dental Students: A National Survey
Authors: Aravena Pedro Christian , Schulz Karen , Parra Annemarie , Perez-Rojas Francisco , Rosas Cristian , Cartes-Velásquez Ricardo
Published: June 2020

Electronic textbooks have become available in recent decades as replacements or alternatives for print versions. The aim of this descriptive cross‐sectional study was to evaluate the use of electronic versus print textbooks by Chilean dental students. The target population was students from 14 Chilean dental schools. The questionnaire was adapted and translated to Spanish from a previous survey used in a similar study. It consisted of the following variables: preferred type, type used, frequency of use, source, electronic devices used to read, and disposal after use. The use of textbooks was analyzed and compared by gender and course (p≤0.05). The final sample consisted of 3,256 students (21.38±2.5 years of age, 50.8% women). Most of the participants reported using both types of texts, with most (63.9%) preferring print over electronic texts, including significantly more women (p<0.001) and first‐year students (p<0.001). Most of the participants (82.8%), more women (p<0.001), and with variations over years of study (p<0.001) reported that they printed out their electronic texts, and 91.8% kept their printed material. Most of the students used electronic books on a daily basis (47.3%) or at least twice a week (30.7%). The main source of electronic textbooks was the Internet (43.8%). A personal computer was the most widely used device for reading electronic texts (95.0%), followed by a cell phone (46.4%) and a tablet (24.5%). Overall, these Chilean dental students preferred print over electronic textbooks, despite having available electronic devices.
Developing a Relevant Taxonomy to Assess Dental School Clinic Patient Complaints
Authors: Fredericks-Younger Janine M. , Handelman-Yellin Marisa L. , York Jill A.
Published: June 2020

The aims of this study were to categorize and analyze the most frequent patient complaints at the Rutgers School of Dental Medicine (RSDM) clinic in an effort to identify areas in need of improvement. A retrospective review of patient complaints reported to the RSDM Office for Clinical Affairs from July 1, 2011 to June 30, 2015 was conducted. A total of 148 unduplicated patients were selected for evaluation because they made at least one official complaint. In total, 193 patient complaints were made during this period. A published complaint taxonomy was used to categorize RSDM patient complaints into domains, categories, and subcategories, highlighting frequent issues of complaint. Of the 193 complaints made, 256 issues were identified. The results showed that the most frequent domain of complaint was Management, followed by Clinical, then Relationships. Institutional Issues and Quality were the most recurring categories coded. Of the 26 subcategories, nearly 70% of the complaints were coded into one of four: Finance and Billing, Delays, Patient Journey, and Quality of Care. While the results were effective in identifying broad areas of improvement, there were limitations to using the traditional taxonomy in the dental school setting. Based on these data, the RSDM Patient Complaint Taxonomy, specific to the needs of a dental school environment, was created in an effort to gain increased specificity and further enhance quality improvement measures. It is the hope of the research team that this tool will be used across dental schools, opening the door for future collaborations and ultimately improving patient care.
Optimization and Preclinical Perception of an Artificial Simulator for Endodontic Training: A Preliminary Study
Authors: Robberecht Lieven , Hornez Jean-Christophe , Dehurtevent Marion , Dufour Thomas , Labreuche Julien , Deveaux Etienne , Chai Feng
Published: June 2020

The aim of this study was to evaluate the performance of ceramic, hybrid ceramic, and commercial plastic bloc root canal simulator (RCS) as preclinical training aids in the learning phase of endodontic treatments. A previously developed hydroxyapatite ceramic RCS was improved by adding epoxy resin to the ceramic matrix to more closely mimic the organic phase of dentin and to simulate the clinical situation as realistically as possible. The sintered hydroxyapatite ceramic RCS was vacuum infiltrated with epoxy resin, and the degree of infiltration was evaluated by methylene blue staining. The suitability of the resin‐infiltrated ceramic simulator (CR) for preclinical endodontic training was compared to that of a non‐infiltrated ceramic simulator (C) and a commercial epoxy bloc (P) using a cohort of 30 dental students at one dental school in France. The study was conducted in 2016. The students’ perceptions following the required exercises using the CR, C, and P were scored using a questionnaire. The learning outcomes were also assessed by examining the canal preparations that the students performed on extracted teeth using a master cone try‐in test. The vacuum process resulted in a good degree of resin infiltration into the ceramic. The questionnaire showed that the C and CR groups generally reported greater satisfaction, especially for radiographic visualizations, than the P group. The CR group had a higher score than the P group for tactile sensation. There was no significant difference among the three groups with respect to the canal preparations using extracted teeth. Resin infiltration improved the performance of the ceramic RCS, especially with respect to perception during root canal instrumentation. A larger scale student training investigation and an assessment by experienced endodontists are required to validate the model.
Using Standardized Patients to Teach Complete Denture Procedures in Second Year of Dental School
Authors: Johnson Gary M. , Halket Christine A. , Ferguson Gilda P. , Perry Jeffrey
Published: June 2020

Second‐year dental students are commonly instructed on the process of complete denture fabrication with a traditional didactic lecture and preclinical dental laboratory education model. The problem with this limited mode of instruction is that dental students often fail to understand the various chairside procedures required to fabricate a complete denture. The aim of this study was to investigate the use of standardized dental patients to enhance students’ understanding of the procedures involved with each appointment in the complete denture process. The Midwestern University College of Dental Medicine‐Arizona created an event using standardized patients in four simulated chairside dental appointments for complete denture instruction of second‐year dental students. Each appointment simulated the various sequential chairside procedures required to fabricate complete dentures. Following the didactic and dental laboratory instruction and the standardized patient event, a survey was conducted requesting the students’ response to six statements regarding their understanding of the denture fabrication process. Of the 110 students who participated in the instructional events, 107 responded to the survey (97% response rate). These students responded very favorably to the simulated appointments, with the majority agreeing or strongly agreeing that their best understanding of the complete denture process was obtained through the standardized patient experiences. The use of standardized patients in simulated denture fabrication appointments enhanced the educational experience of these students when added to the traditional didactic lecture and preclinical laboratory education format. The experience has since been incorporated into the school's second‐year oral health science laboratory curriculum.
Clinical Performance Measures and Quality Improvement System Considerations for Dental Education
Authors: Parkinson Joseph W. , Zeller Gregory G.
Published: June 2020

Quality improvement and quality assurance programs are an integral part of providing excellence in health care delivery. The Dental Quality Alliance and the Commission on Dental Accreditation recognize this and have created standards and recommendations to advise health care providers and health care delivery systems, including dental schools, on measuring the quality of the care delivered to patients. Overall health care expenditures have increased, and the Affordable Care Act has made health care, including dentistry, available to more people in the United States. These increases in cost and in the number of patients accessing care contribute to a heightened interest in measurable quality improvement outcomes that reflect efficiency, effectiveness, and overall value. Practitioners and administrators, both in academia and in the “real world,” need an understanding of various quality improvement methodologies available in order to select approaches that support effective monitoring of the quality of care delivered. This article compares and contrasts various quality improvement approaches, programs, and systems currently in use in order to assist dental providers and administrators in choosing quality improvement methodologies pertinent to their practice or institution.
Robotic process automation in accounting systems
Authors: Harrast Steven A.
Published: June 2020

Robotic process automation is rapidly transforming the world of work for accounting and other information professionals. Data collection and entry that used to occupy much of the workday is being automated by programmable software robots or bots. Automation using bots should begin with processes that are stable, repetitive, and consume sufficient resources to generate a solid return on investment. As bots are implemented, a number of governance, risk, and compliance issues need to be considered including appropriate controls on bot access to sensitive records and transactions. The bot development process also requires controls so that only tested and authorized bots are deployed. For many companies, RPA is exactly what they have been looking for to drive higher efficiency in information processing.
PCTR1 improves pulmonary edema fluid clearance through activating the sodium channel and lymphatic drainage in lipopolysaccharide‐induced ARDS
Authors: Zhang Pu‐hong , Han Jun , Cao Fei , Liu Yong‐jian , Tian Chao , Wu Cheng‐hua , Smith Fang Gao , Hao Yu , Jin Sheng‐wei
Published: June 2020

Acute respiratory distress syndrome (ARDS) is a lethal clinical syndrome characterized by damage of the epithelial barriers and accumulation of pulmonary edema fluid. Protectin conjugates in tissue regeneration 1 (PCTR1), an endogenously produced lipid mediator, are believed to exert anti‐inflammatory and pro‐resolution effects. PCTR1 (1 µg/kg) was injected at 8 hr after lipopolysaccharide (LPS; 14 mg/kg) administration, and the rate of pulmonary fluid clearance was measured in live rats at 1 hr after PCTR1 treatment. The primary type II alveolar epithelial cells were cultured with PCTR1 (10 nmol/ml) and LPS (1 μg/ml) for 8 hr. PCTR1 effectively improved pulmonary fluid clearance and ameliorated morphological damage and reduced inflammation of lung tissue, as well as improved the survival rate in the LPS‐induced acute lung injury (ALI) model. Moreover, PCTR1 markedly increased sodium channel expression as well as Na, K‐ATPase expression and activity in vivo and in vitro. In addition, PCTR1i also upregulated the expression of LYVE‐1 in vivo. Besides that, BOC‐2, HK7, and LY294002 blocked the promoted effect of PCTR1 on pulmonary fluid clearance. Taken together, PCTR1 upregulates sodium channels' expression via activating the ALX/cAMP/P‐Akt/Nedd4‐2 pathway and increases Na, K‐ATPase expression and activity to promote alveolar fluid clearance. Moreover, PCTR1 also promotes the expression of LYVE‐1 to recover the lymphatic drainage resulting in the increase of lung interstitial fluid clearance. In summary, these results highlight a novel systematic mechanism for PCTR1 in pulmonary edema fluid clearance after ALI/ARDS, suggesting its potential role in a therapeutic approach for ALI/ARDS.
Pten deletion in Dmp1‐expressing cells does not rescue the osteopenic effects of Wnt/β‐catenin suppression
Authors: Lim Kyung‐Eun , Hoggatt April M. , Bullock Whitney A. , Horan Daniel J. , Yokota Hiroki , Pavalko Frederick M. , Robling Alexander G.
Published: June 2020

Skeletal homeostasis is sensitive to perturbations in Wnt signaling. Beyond its role in the bone, Wnt is a major target for pharmaceutical inhibition in a wide range of diseases, most notably cancers. Numerous clinical trials for Wnt‐based candidates are currently underway, and Wnt inhibitors will likely soon be approved for clinical use. Given the bone‐suppressive effects accompanying Wnt inhibition, there is a need to expose alternate pathways/molecules that can be targeted to counter the deleterious effects of Wnt inhibition on bone properties. Activation of the Pi3k/Akt pathway via Pten deletion is one possible osteoanabolic pathway to exploit. We investigated whether the osteopenic effects of β‐catenin deletion from bone cells could be rescued by Pten deletion in the same cells. Mice carrying floxed alleles for Pten and β‐catenin were bred to Dmp1‐Cre mice to delete Pten alone, β‐catenin alone, or both genes from the late‐stage osteoblast/osteocyte population. The mice were assessed for bone mass, density, strength, and formation parameters to evaluate the potential rescue effect of Pten deletion in Wnt‐impaired mice. Pten deletion resulted in high bone mass and β‐catenin deletion resulted in low bone mass. Compound mutants had bone properties similar to β‐catenin mutant mice, or surprisingly in some assays, were further compromised beyond β‐catenin mutants. Pten inhibition, or one of its downstream nodes, is unlikely to protect against the bone‐wasting effects of Wnt/βcat inhibition. Other avenues for preserving bone mass in the presence of Wnt inhibition should be explored to alleviate the skeletal side effects of Wnt inhibitor‐based therapies.
Expression profile of lncRNAs and miRNAs in esophageal cancer: Implications in diagnosis, prognosis, and therapeutic response
Authors: Ghafouri‐Fard Soudeh , Shoorei Hamed , Dashti Sepideh , Branicki Wojciech , Taheri Mohammad
Published: June 2020

Esophageal cancer is the seventh most common cancer worldwide. Although a number of environmental and lifestyle‐related risk factors have been identified for this kind of cancer, the exact molecular mechanisms of tumor evolution have not been clarified yet. Long noncoding RNAs (lncRNAs) and microRNAs (miRNAs) as important regulators of gene expression and chromatin configuration have essential roles in the pathogenesis of esophageal cancer. They have been shown to alter the function of cancer‐related signaling pathways such as phosphoinositide 3‐kinase/protein kinase B and Wnt pathway, thus they might modulate the response of patients to pathway‐targeted therapies. Moreover, a number of lncRNAs, such as AFAP1‐AS1, UCA1, HOTAIR, LOC285194, and TUSC7, are involved in conferring chemoresistant/radioresistant in esophageal cancer cells. A complex network of interaction exists between lncRNAs and miRNAs in the context of esophageal cancer. Finally, various panels of lncRNAs and miRNAs have been introduced that can predict the survival of esophageal cancer patients. In this review article, we summarize the recent findings regarding the role of miRNAs and lncRNAs in the pathogenesis of esophageal cancer with the special focus on their regulatory roles on signaling pathways, their potential as diagnostic/prognostic markers, and their relevance with therapeutic response.
Psychometric properties of an instrument to assess critical thinking disposition and metacognition in dental students
Authors: Anders Patrick L. , Davis Elaine L. , McCall W.D.
Published: June 2020

Objective

The purpose of this study was to determine the psychometric properties of instruments designed to assess the critical thinking domains of disposition and metacognition in a dental student population.

Methods

Two instruments originally developed to assess disposition and metacognition domains in undergraduate student populations were administered to dental students from 3 classes in the Spring of 2019. The overall response rate was 73%. Sampling adequacy was established for both domains. Exploratory factor analysis was used to determine underlying dimensions. Criterion validity was established by correlation with traditional measures of academic achievement.

Results

Kaiser–Meyer–Olkin index (>0.80) and Bartlett's test of sphericity (P < 0.005) indicated sampling adequacy for both domains. Factor analysis supported a 2‐factor solution for Disposition (Level of Open Mindedness and Tolerance for Cognitive Complexity) and a 2‐factor solution for Metacognition (Metacognitive Thinking and Metacognitive Strategies). Items loading at 0.4 or higher were retained. Cronbach's alpha was above 0.8 for all but the Metacognitive Thinking subscale, which nonetheless showed adequate reliability (0.65). Reliability for Disposition and Metacognition scales was also above 0.8.

Conclusion

These results indicate that the instrument has sufficient validity and reliability to support further use in dental education.
Assessment of a student peer‐tutoring program focusing on the benefits to the tutors
Authors: Wankiiri‐Hale Christine , Maloney Cara , Seger Nicholas , Horvath Zsuzsa
Published: June 2020

Context

The University of Pittsburgh School of Dental Medicine incorporates a voluntary student peer‐tutoring program as 1 resource available to pre‐doctoral students. It uses peer‐tutoring in didactic and preclinical courses in order to provide additional help to struggling students.

Objective

The goal of this article is to describe an initial program assessment using data collected between 2015 and 2017. In addition to assessing the program, this report also investigates the benefits of the program to the tutors.

Design

Data were collected using surveys from tutors (N = 133) and tutees (N = 115), as well as reflective journals written by the tutors (response rate varies across instruments and questions). Responses to the surveys were analyzed using quantitative analysis, and content analysis was completed for coding the open‐ended short responses and reflective journals.

Results

Results show tutors' increased preparedness at the end of the term to provide tutoring, an increase in communication and teaching skills due to participation in the program, and other cited benefits to the tutor.

Conclusions

In addition to academic credit, tutors benefit from reviewing the course materials and practicing skills relevant to their future careers. Tutees provided overwhelmingly positive feedback on the tutors’ strengths and effectiveness, the program in general, and the extent to which tutoring helped their performance in the class. Based on the initial program assessment, the program provides benefits to both tutors and tutees; the tutors gain a valuable experience impacting them both academically and personally.
Steps towards validation of the Dental Education Clinical Learning Instrument (DECLEI) in American dental schools (DECLEI‐USA)
Authors: Krois Nicole R. , Kossioni Anastassia E. , Barlow Patrick B. , Tabrizi Maryam , Marchini Leonardo
Published: June 2020

Purposes/Objectives

Few tools assess the dental school clinical learning environment from students' perspectives. Considering previous efforts to validate the Dental Education Clinical Learning Instrument (DECLEI) in the United States, the goal of this study was to look for the fewest number of items that accounted for the most amount of variability in responses and/or had the highest correlation to the total DECLEI score using a larger, multi‐center sample.

Methods

The DECLEI was distributed to 286 students in two dental schools (University of Iowa and University of Texas at Houston) during the 2017‐2018 academic year. Two alternative methods were applied. In the first approach, all 24‐items were regressed on the total composite score using a forward conditional method. In the second approach, the item‐total correlation for the full scale was calculated and then items with relatively poor coefficients were eliminated. A cutoff of 0.30 or less was used.

Results

The first approach, Total R2 by Regression Model, produced a 9‐item scale accounting for 90% of the variance in total score and a Cronbach's α coefficient of 0.79. The second approach, Item‐Total Correlation, produced a larger scale (20 items), as well as a higher Cronbach's α coefficient of 0.89. The instrument also presented appropriate sensitivity to measure differences between race groups and school of origin.

Conclusion

DECLEI may have the potential to be used as an instrument to measure clinical learning environments for U.S. dental students using either a smaller, concise scale (Mini DECLEI‐USA) or a larger (DECLEI‐USA), more thorough scale.
What are the effects of photographic self‐assessment on students' risk for musculoskeletal disorders using Rapid Upper Limb Assessment
Authors: Mills Mary E. , Smilyanski Irina , Giblin‐Scanlon Lori , Vineyard Jared
Published: June 2020

Purposes/objectives

Musculoskeletal disorders (MSD) affect the careers of dental professionals. Research suggests symptoms of MSD begin during educational careers. This sequential explanatory study aimed to determine if dental hygiene students’ self‐assessment using the Rapid Upper Limb Assessment (RULA) tool reduced the risk of MSD development and explore students’ experiences using a risk tool.

Methods

Dental hygiene students (n = 21) in the last 2 of 4 sequential clinical semesters completed self‐assessment using the RULA, employing photographs taken during patient care. Initial photographs were taken before students participated in a workshop about ergonomics and application of the RULA tool. Using a within‐subjects repeated measures design, student risk scores were calculated for pre‐ and post‐workshop photographs over 4 consecutive weeks. Students (n = 10) participated in a focus group to share their experiences with the risk tool.

Results

Repeated measures one‐way analysis of variance compared differences in student RULA scores between weeks. There was a statistically significant effect of time on student self‐reported RULA scores, F(3, 60) = 7.04, P < .001. Emergent themes from the focus group were practice using RULA, video versus photographs, adjust tool for dental hygiene practice, increased self‐awareness, and connect theory to practice.

Conclusions

Results suggested using self‐assessment utilizing a risk tool increased self‐awareness for ergonomics, thus reducing the risk of developing MSDs for dental hygiene students.
Evaluation of advocacy projects in undergraduate and graduate dental hygiene leadership courses
Authors: Rogo Ellen J.
Published: June 2020

Purpose

The intent of this investigation was to describe learners’ outcomes regarding a Legislative Advocacy Project and Health Policy Advocacy Project in required leadership courses in dental hygiene curricula.

Methods

The 7‐week legislative project was completed by Bachelor of Science (BS) in a traditional classroom setting and Master of Science (MS) degree dental hygiene students in an online course. The course requirement was a written paper all enrolled students completed, which comprised a significant portion of the final grade. Objectives were developed for topics presented and active learning strategies engaged students to extend learning to a higher level. Weekly activities provided a mechanism for formative assessment, and a rubric determined whether the objectives were met for the summative assessment. In 2016, the BS course was revised to include health policy, and the policy project was implemented.

Results

The majority of students earned A or B grades on the assignments. The overall mean for the BS legislative projects based on 4 years was 89.1 (n = 104); the MS mean based on 12 years was 92 (n = 81). The mean for the BS policy projects, based on 4 years, was 91.9 (n = 111).

Conclusions

The instructional design of both advocacy projects’ objectives, active learning strategies, and summative assessment were strategically aligned and created an effective environment for learning. Oral health practitioners who are empowered to engage in advocacy initiatives are needed in the next generation. Administrators and faculty are called to action to become leaders and advocates for advocacy education in all oral healthcare programs.
Are dental schools adequately preparing dental students to face outbreaks of infectious diseases such as COVID‐19?
Authors: Ghai Suhani
Published: June 2020

The recent 2019‐novel coronavirus (2019‐nCoV, also known as SARS‐CoV‐2) has caused >2,622,571 confirmed cases of coronavirus disease 2019 (COVID‐19) in >185 countries, and >182,359 deaths globally. More than 9000 healthcare workers have also been infected by 2019‐nCoV. Prior to the present pandemic of COVID‐19, there have been multiple large‐scale epidemics and pandemics of other viral respiratory infections, such as seasonal flu, Spanish flu (H1N1), severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and others. Dental professionals are at an increased risk for contracting these viruses from dental patients, as dental practice involves face‐to‐face communication with the patients and frequent exposure to saliva, blood, and other body fluids. Dental education can play an important role in the training of dentists, helping them to adopt adequate knowledge and attitudes related to infection control measures. The current dental curriculum does not cover infection control adequately, especially from airborne pathogens. Infection control education needs to be included in the dental curriculum itself, and students should be trained adequately to protect them and prevent the infection from disseminating even before they see their first patient.
Investigation of inter‐ and intra‐rater reliability using digital dental software for prosthodontics crown preparations
Authors: Shih Wen , Tran Kenny , Yang Vivian , El Masoud Bilal , Sexton Christopher , Zafar Sobia
Published: June 2020

Introduction

Since the introduction of the digital dental assessment systems, there has been a shift towards this trend as it appears to provide a more accurate, reliable, time efficient, and reproducible assessment. The Planmeca Emerald scanner coupled with Romexis Compare software allows students and staff to objectively assess individual crown preparations, receive numerical values of key dimensions, and subsequently undergo comparison with ideal crown preparation dimensions.

Objectives

To measure the inter‐ and intra‐rater reliability using the intra‐oral scanner and Romexis Compare for prosthodontic crown preparations, and to evaluate the possible implementation of this software as a grading and self‐assessment tool in a preclinical setting.

Methods

The Planmeca scanner and Romexis Compare were used to compare the difference between 30 experimental preparations (n = 15 anterior teeth, n = 15 posterior teeth) with their respective unprepared typodont teeth. Three student examiners (W., K., V.) independently scanned the typodont teeth in pre‐formed standardized and non‐standardized putty jigs. Each preparation was measured from facial, lingual, incisal/occlusal, and margin surfaces. A second trial was completed after 2 weeks to assess intra‐rater reliability. The data were tabulated, graphed, and analyzed using SPSS and GraphPad Prism.

Results

The results of the study show greater consistencies in inter‐operator measurements for anterior teeth. Some variations, however, were found in posterior teeth measurements between the operators. The results of the intra‐rater measurements appear to be relatively consistent.

Conclusion

With some limitations, Romexis Compare can be used as a reliable and repeatable method for objective and consistent evaluation of student prosthodontic preparations in a preclinical setting.
Pilot study implementing mixed media and animation into the Preclinical Dental Anesthesia Course
Authors: Fa Bernadette Alvear , Interrante Michael A. , Castagna Daniel M
Published: June 2020

Purpose/Objectives

During 2019, the "perfect intersection" of collaboration and innovative education using live video merged with animation was launched in the preclinical local anesthesia curriculum at the University of the Pacific, Arthur A. Dugoni School of Dentistry. This article includes the audible video created and describes the software used to blend dynamic animation for content delivery. This mixed‐media approach merges animation with live video resulting with innovative teaching and student learning. Further, outcomes are discussed from voluntary postassessment surveys regarding how students perceived this innovation when introduced into preclinical local anesthesia curriculum. Within the advancements for the preclinical local anesthesia curriculum, development of short videos is introduced to students reviewing armamentarium and injection delivery to address patients’ pain management.

Design

Within the advancements for this preclinical local anesthesia curriculum, short video development was introduced to students through online assessments. Afterward, students were given a voluntary postassessment survey. The 2017 results served as the genesis for the 2019 pilot study implementing mixed media and animation into assessments.

Results/Conclusion

Results determined 78.6% agreed they would like to see more assessments made with integrated animation and mixed media. Additionally, 77% agreed they would like to see other courses use mixed media assessments. The pilot study implementing mixed media and animation into the preclinical dental anesthesia course was a unique addition to the curriculum engaging students for assessments.
Frontline Science: P2Y11 receptors support T cell activation by directing mitochondrial trafficking to the immune synapse
Authors: Ledderose Carola , Bromberger Sophie , Slubowski Christian J , Sueyoshi Koichiro , Junger Wolfgang G
Published: June 2020

T cells form an immune synapse (IS) with antigen-presenting cells (APCs) to detect antigens that match their TCR. Mitochondria, pannexin-1 (panx1) channels, and P2X4 receptors congregate at the IS where mitochondria produce the ATP that panx1 channels release in order to stimulate P2X4 receptors. P2X4 receptor stimulation causes cellular Ca2+ influx that up-regulates mitochondrial metabolism and localized ATP production at the IS. Here we show that P2Y11 receptors are essential players that sustain these T cell activation mechanisms. We found that P2Y11 receptors retract from the IS toward the back of cells where their stimulation by extracellular ATP induces cAMP/PKA signaling that redirects mitochondrial trafficking to the IS. P2Y11 receptors thus reinforce IS signaling by promoting the aggregation of mitochondria with panx1 ATP release channels and P2X4 receptors at the IS. This dual purinergic signaling mechanism involving P2X4 and P2Y11 receptors focuses mitochondrial metabolism to the IS where localized ATP production sustains synaptic activity in order to allow successful completion of T cell activation responses. Our findings have practical implications because rodents lack P2Y11 receptors, raising concerns as to the validity of rodent models to study treatment of infections and inflammatory conditions.
Tensile force transmitted through LFA-1 bonds mechanoregulate neutrophil inflammatory response
Authors: Morikis Vasilios A , Masadeh Eman , Simon Scott I
Published: June 2020

Recruitment of leukocytes to sites of acute inflammation is guided by spatial and temporal cues that ensure appropriate cell numbers infiltrate the tissue at precise locations to protect it from infection and initiate repair. On inflamed endothelium, neutrophil rolling via selectins elicits cytosolic calcium release from endoplasmic reticulum (ER)-stores that are synergistic with chemokine signaling to activate formation of high affinity (HA) LFA-1 bonds to ICAM-1, which is necessary to anchor cells against the drag force of blood flow. Bond tension on LFA-1 within the area of adhesive contact with endothelium elicits calcium entry through calcium release-activated calcium channel protein 1 (Orai-1) membrane channels that in turn activate neutrophil shape change and migration. We hypothesized that mechanotransduction via LFA-1 is mediated by assembly of a cytosolic molecular complex consisting of Kindlin-3, receptor for activated C kinase 1 (RACK1), and Orai1. Initiation of Ca2+ flux at sites of adhesive contact required a threshold level of shear stress and increased with the magnitude of bond tension transduced across as few as 200 HA LFA-1. A sequential mechanism triggered by force acting on LFA-1/Kindlin-3 precipitated dissociation of RACK1, which formed a concentration gradient above LFA-1 bond clusters. This directed translocation of ER proximal to Orai1, where binding of inositol 1,4,5-triphosphate receptor type 1 and activation via stromal interaction molecule 1 elicited Ca flux and subsequent neutrophil shape change and motility. We conclude that neutrophils sense adhesive traction on LFA-1 bonds on a submicron scale to direct calcium influx, thereby ensuring sufficient shear stress of blood flow is present to trigger cell arrest and initiate transmigration at precise regions of vascular inflammation.
Increasing complexity of NLRP3 inflammasome regulation
Authors: Moretti Julien , Blander J Magarian
Published: June 2020

Inflammasomes are multiprotein complexes that assemble upon detection of danger signals to activate the inflammatory enzyme caspase-1, trigger secretion of the highly proinflammatory cytokine IL-1β, and induce an inflammatory cell death called pyroptosis. Distinctiveness of the nucleotide-binding oligomerization (NOD), Leucine-rich repeat (LRR)-containing protein (NLRP3) inflammasome resides in the diversity of molecules that induce its activation, indicating a certain intricacy. Furthermore, besides the canonical activation of NLRP3 in response to various stimuli, caspase-11-dependent detection of intracellular LPS activates NLRP3 through a noncanonical pathway. Several aspects of the NLRP3 inflammasome are not characterized or remain unclear. In this review, we summarize the different modes of NLRP3 activation. We describe recent insights into post-translational and cellular regulation that confer further complexity to NLRP3 inflammasomes.
Trauma induces expansion and activation of a memory-like Treg population
Authors: Yamakawa Kazuma , Tajima Goro , Keegan Joshua W , Nakahori Yasutaka , Guo Fei , Seshadri Anupamaa J , Cahill Laura A , Lederer James A
Published: June 2020

CD4+ regulatory T cells (Tregs) are acutely activated by traumatic injury, which suggests that they may react to injury with similar kinetics as memory T cells. Here, we used a mouse burn trauma model to screen for memory-like T cell responses to injury by transferring T cells from sham or burn CD45.1 mice into CD45.2 mice and performing secondary injuries in recipient mice. Among all T cell subsets that were measured, only Tregs expanded in response to secondary injury. The expanded Tregs were a CD44high/CD62Llow subpopulation, markers indicative of memory T cells. CyTOF (cytometry by time-of-flight) mass cytometry was used to demonstrate that injury-expanded Tregs expressed higher levels of CD44, CTLA-4, ICOS, GITR, and Helios than Tregs from noninjured mice. Next, we tested whether a similar population of Tregs might react acutely to burn trauma. We observed that Tregs with a phenotype that matched the injury-expanded Tregs were activated by 6 h after injury. To test if Treg activation by trauma requires functional MHC class II, we measured trauma-induced Treg activation in MHC class II gene deficient (MHCII−/−) mice or in mice that were given Fab fragment of anti-MHC class II antibody to block TCR activation. Injury-induced Treg activation occurred in normal mice but only partial activation was detected in MHCII−/− mice or in mice that were given Fab anti-MHCII antibody. These findings demonstrate that trauma activates a memory-like Treg subpopulation and that Treg activation by injury is partially dependent on TCR signaling by an MHC class II dependent mechanism.
The epidemiology and clinical characteristics of co‐infection of SARS‐CoV‐2 and influenza viruses in patients during COVID‐19 outbreak
Authors: Yue Huihui , Zhang Ming , Xing Lihua , Wang Ke , Rao Xiaoling , Liu Hong , Tian Jianbo , Zhou Peng , Deng Yan , Shang Jin
Published: June 2020

In this study, we performed a single‐centered study of 307 severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infected patients. It was found that co‐infection of SARS‐CoV‐2 and influenza virus was common during COVID‐19 outbreak. And patients coinfected with SARS‐CoV‐2 and influenza B virus have a higher risk of developing poor outcomes so a detection of both viruses was recommended during COVID‐19 outbreak.
Can steroids reverse the severe COVID‐19 induced “cytokine storm”?
Authors: Kolilekas Lykourgos , Loverdos Konstantinos , Giannakaki Styliani , Vlassi Lamprini , Levounets Anastasia , Zervas Eleftherios , Gaga Mina
Published: June 2020

Severe coronavirus disease (COVID‐19) is characterized by an excessive proinflammatory cytokine storm, resulting in acute lung injury and development of acute respiratory distress syndrome (ARDS). The role of corticosteroids is controversial in severe COVID‐19 pneumonia and associated hyper‐inflammatory syndrome. We reported a case series of six consecutive COVID‐19 patients with severe pneumonia, ARDS and laboratory indices of hyper‐inflammatory syndrome. All patients were treated early with a short course of corticosteroids, and clinical outcomes were compared before and after corticosteroids administration. All patients evaded intubation and intensive care admission, ARDS resolved within 11.8 days (median), viral clearance was achieved in four patients within 17.2 days (median), and all patients were discharged from the hospital in 16.8 days (median). Early administration of short course corticosteroids improves clinical outcome of patients with severe COVID‐19 pneumonia and evidence of immune hyperreactivity.
Environmental and decontamination issues for human coronaviruses and their potential surrogates
Authors: Cimolai Nevio
Published: June 2020

Pandemic coronavirus disease‐2019 (COVID‐19) gives ample reason to generally review coronavirus (CoV) containment. For establishing some preliminary views on decontamination and disinfection, surrogate CoVs have commonly been assessed. This review serves to examine the existing science in regard to CoV containment generically and then to translate these findings into timely applications for COVID‐19. There is widespread dissemination of CoVs in the immediate patient environment, and CoVs can potentially be spread via respiratory secretions, urine, and stool. Interpretations of the spread however must consider whether studies examine for viral RNA, virus viability by culture, or both. Presymptomatic, asymptomatic, and post‐14 day virus excretion from patients may complicate the epidemiology. Whereas droplet spread is accepted, there continues to be controversy over the extent of possible airborne spread and especially now for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). CoVs are stable in body secretions and sewage at reduced temperatures. In addition to temperature, dryness or relative humidity, initial viral burden, concomitant presence of bioburden, and the type of surface can all affect stability. Generalizing, CoVs can be susceptible to radiation, temperature extremes, pH extremes, peroxides, halogens, aldehydes, many solvents, and several alcohols. Whereas detergent surfactants can have some direct activity, these agents are better used as complements to a complex disinfectant solution. Disinfectants with multiple agents and adverse pH are more likely to be best active at higher water temperatures. Real‐life assessments should be encouraged with working dilutions. The use of decontamination and disinfection should be balanced with considerations of patient and caregiver safety. Processes should also be balanced with considerations for other potential pathogens that must be targeted. Given some CoV differences and given that surrogate testing provides experimental correlates at best, direct assessments with SARS‐CoV, Middle East respiratory syndrome‐related coronavirus (MERS‐CoV), and SARS‐CoV‐2 are required.
A simple method for detection of a novel coronavirus (SARS‐CoV‐2) using one‐step RT‐PCR followed by restriction fragment length polymorphism
Authors: Son Ho Anh , Hang Dinh Thi Thu , Thuan Nghiem Duc , Quyen Le Thi Bao , Thuong Luong Thi Hoai , Nga Vu Thi , Quang Le Bach , Hung Trinh Thanh , Son Nguyen Thai , Linh Nguyen Tung , Nam Le Van , Van Ba Nguyen , Tien Tran Viet , Quyet Do , Van Luong Hoang , Su Hoang Xuan
Published: June 2020

A novel coronavirus associated with acute respiratory disease (named SARS‐CoV‐2) is recently identified in Wuhan city, China, spread rapidly worldwide. Early identification of this novel coronavirus by molecular tools is critical for surveillance and control of the epidemic outbreak. We aimed to establish a simple method for the detection of SARS‐CoV‐2 in differentiating with SARS‐CoV. Primers of our in‐house reverse transcription polymerase chain reaction (RT‐PCR) assays were designed to target conserved regions of the RdRP gene and E gene, selected restriction enzymes EcoRI, Tsp45I, and AluI to distinguish between SARS‐CoV‐2 and SARS‐CoV. In this report, a 396‐bp fragment of the RdRp gene and 345‐bp fragment of the E gene were amplified by one‐step RT‐PCR. Enzyme Tsp45I cuts the RdRP‐amplified product of SARS‐CoV‐2 generating three fragments of 45, 154, and 197 bp, but it did not cut the amplicon of SARS‐CoV. In contrast, the amplified product of SARS‐CoV was digested with EcoRI producing two fragments of 76 and 320 bp, whereas the amplicon of SARS‐CoV‐2 was undigested by Tsp45I help to distinguish clearly SARS‐CoV‐2 from SARS‐CoV on gel electrophoresis. In addition, AluI cut the amplicon of the E gene of SARS‐CoV‐2 generating two fragments of 248 and 97 bp without cutting to SARS‐CoV. The accuracy of the assay was confirmed by sequencing and phylogenetic analysis. When evaluated on clinical samples showed a high sensitivity of 95%, specificity of our assay was 100% and clinical performance for detection of SARS‐CoV‐2 in comparison with other reference assays. In conclusion, in the present study, we successfully developed a simple method for molecular detection of SARS‐CoV‐2 in differentiating with SARS‐CoV.
Simple methods to remove microbes from leaf surfaces
Authors: Saldierna Guzmán J. Paola , Nguyen Kennedy , Hart Stephen C.
Published: June 2020

Endophytes have been defined as microorganisms living inside plant tissues without causing negative effects on their hosts. Endophytic microbes have been extensively studied for their plant growth‐promoting traits. However, analyses of endophytes require complete removal of epiphytic microorganisms. We found that the established tests to evaluate surface sterility, polymerase chain reaction, and leaf imprints, are unreliable. Therefore, we used scanning electron microscopy (SEM) as an additional assessment of epiphyte removal. We used a diverse suite of sterilization protocols to remove epiphytic microorganisms from the leaves of a gymnosperm and an angiosperm tree to test the influence of leaf morphology on the efficacy of these methods. Additionally, leaf tissue damage was also evaluated by SEM, as damaging the leaves might have an impact on endophytes and could lead to inaccurate assessment of endophytic communities. Our study indicates, that complete removal of the leaf cuticle by the sterilization technique assures loss of epiphytic microbes, and that leaves of different tree species may require different sterilization protocols. Furthermore, our study demonstrates the importance of choosing the appropriate sterilization protocol to prevent erroneous interpretation of host‐endophyte interactions. Moreover, it shows the utility of SEM for evaluating the effectiveness of surface sterilization methods and their impact on leaf tissue integrity.
Post‐discharge venous thromboembolism after pancreatectomy for malignancy: Predicting risk based on preoperative, intraoperative, and postoperative factors
Authors: Schlick Cary Jo R. , Merkow Ryan P. , Yang Anthony D. , Bentrem David J.
Published: June 2020

Background and Objectives

Extended chemoprophylaxis is recommended for high‐risk patients following pancreatectomy for malignancy. However, quantifying risk remains difficult. We sought to (a) identify factors associated with post‐discharge venous thromboembolism (VTE) following pancreatectomy for malignancy and (b) develop a post‐discharge VTE risk calculator to identify high‐risk patients.

Methods

Patients who underwent pancreatectomy for malignant histology from 2014 to 2018 were identified from the ACS NSQIP pancreatectomy procedure targeted dataset. Preoperative, intraoperative, and postoperative factors known at hospital discharge were evaluated for association with post‐discharge VTE via multivariable logistic regression. A post‐discharge VTE risk calculator was developed and validated.

Results

Of 19 340 analyzed patients, 280 (1.5%) developed post‐discharge VTE. Post‐discharge VTE was associated with increasing body mass index (BMI; eg, morbidly obese BMI odds ratio [OR]: 1.99 [95% confidence interval {CI}: 1.30‐3.02] vs normal BMI), procedure type (distal pancreatectomy OR: 1.47 [95% CI: 1.02‐2.12] vs pancreaticoduodenectomy), pancreatic fistula (OR: 1.59 [95% CI: 1.19‐2.13]) and delayed gastric emptying (OR: 1.81 [95% CI: 1.29‐2.52]). Patients’ predicted probability of post‐discharge VTE ranged from 0.7% to 9.0%. Twenty iterations of 10‐fold cross‐validation demonstrated internal validity.

Conclusions

Preoperative, intraoperative, and postoperative factors were associated with post‐discharge VTE following pancreatectomy for malignancy. This post‐discharge VTE risk calculator allows for quantification of individual post‐discharge VTE risk, which ranged from 0.7% to 9.0%.
Long‐term survival following minimally invasive extended cholecystectomy for gallbladder cancer: A 7‐year experience from the National Cancer Database
Authors: AlMasri Samer , Nassour Ibrahim , Tohme Samer , Adam Mohamed Abdelgadir , Hoehn Richard S. , Bartlett David L. , Lee Kenneth K. , Zureikat Amer H. , Paniccia Alessandro
Published: June 2020

Background

Open extended cholecystectomy (O‐EC) has long been the recommended treatment for resectable gallbladder cancer (GBC), while the minimally‐invasive approach for EC (MIS‐EC) remains controversial. Our aim was to analyze overall survival of GBC patients treated with MIS‐EC vs O‐EC at the national level.

Methods

A retrospective review of the National Cancer Database of patients with resectable GBC (2010‐2016) and treated with either MIS‐EC or O‐EC was performed. Overall survival (OS) was compared by the surgical approach.

Results

A total of 680 patients were identified, of whom 235 (34.6%) underwent MIS‐EC. There were no differences in the rates of positive margins between MIS‐EC and O‐EC (14% vs 19%, respectively; P = .278), and in the mean lymph node yield (6.54 vs 6.66, respectively; P = .914). The median survival following MIS‐EC was significantly higher than that of O‐EC (39 vs 26 months; P = .048). After stratification by pathological stage and after adjustment, there was no significant difference in OS between the groups (HR = 0.9, 95% CI, 0.6‐1.5).

Conclusion

In this large national cohort, MIS‐EC oncologic outcomes were noninferior to the O‐EC. Proficiency with MIS techniques, proper patient selection, and referral to specialized centers may allow a greater benefit from this treatment modality.