bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Three Evidence‐Based Practice Learning Assessment Methods in Dental Curricula
Authors: Al‐Ansari Asim A. , El Tantawi Maha M.A.
Published: June 2020

Incorporating evidence‐based practice (EBP) training in dental curricula is now an accreditation requirement for dental schools, but questions remain about the most effective ways to assess learning outcomes. The purpose of this study was to evaluate and compare three assessment methods for EBP training and to assess their relation to students’ overall course grades. Participants in the study were dental students from two classes who received training in appraising randomized controlled trials (RCTs) and systematic reviews in 2013 at the University of Dammam, Saudi Arabia. Repeated measures analysis of variance was used to compare students’ scores on appraisal assignments, scores on multiple‐choice question (MCQ) exams in which EBP concepts were applied to clinical scenarios, and scores for self‐reported efficacy in appraisal. Regression analysis was used to assess the relationship among the three assessment methods, gender, program level, and overall grade. The instructors had acceptable reliability in scoring the assignments (overall intraclass correlation coefficient=0.60). The MCQ exams had acceptable discrimination indices although their reliability was less satisfactory (Cronbach's alpha=0.46). Statistically significant differences were observed among the three methods with MCQ exams having the lowest overall scores. Variation in the overall course grades was explained by scores on the appraisal assignment and MCQ exams (partial eta‐squared=0.52 and 0.24, respectively), whereas score on the self‐efficacy questionnaire was not significantly associated with overall grade. The results suggest that self‐reported efficacy is not a valid method to assess dental students’ RCT appraisal skills, whereas instructor‐graded appraisal assignments explained a greater portion of variation in grade and had inherent validity and acceptable consistency and MCQ exams had good construct validity but low internal consistency.
Impact of Reflective Writing Assignments on Dental Students’ Views of Cultural Competence and Diversity
Authors: Isaac Carol , Behar‐Horenstein Linda , Lee Barbara , Catalanotto Frank
Published: June 2020

To respond to widespread disparities in access to oral health care, the Institute of Medicine, the Commission on Dental Accreditation (CODA), and the U.S. surgeon general have stressed that prospective dentists should become culturally competent, socially responsible practitioners. The aim of this study was to examine linguistic differences in dental students’ reflective writing assignments before and after interviewing an individual who was culturally different from themselves. The authors analyzed 160 documents from 80 first‐year dental students at the University of Florida in 2012. This cohort consisted of 36 male (45%) and 44 female (55%) students; 26 (32%) were from underrepresented minority (URM) groups and 54 (68%) were identified as white non‐minority. Text analysis software identified word counts, categories, frequencies, and contexts. Significantly positive differences occurred for interviews between assignments 1 and 2 (p=0.005 to p<0.001) in five areas of cultural diversity. Differences were observed for Factor 1 (“important others’ influence”) between assignments (p<0.001), assignments by interview categories (p=0.033), and URM/majority participants by assignments by interview category (p=0.018). Factor 4 (“my social world in relation to others”) was statistically different between assignments for URM/majority participants (p=0.019). Factor 5 (“wrong because”) was statistically different for gender (p=0.041), suggesting that males may have experienced a rebound effect from stereotype suppression. The findings suggest that the use of reflective writing and interviews affected the students’ awareness of how important others had influenced their lives and attitudes and facilitated their questioning preconceived assumptions. Reactions to coursework focusing on social and personal domains warrant further investigation.
A Competency Matrix for Global Oral Health
Authors: Benzian Habib , Greenspan John S. , Barrow Jane , Hutter Jeffrey W. , Loomer Peter M. , Stauf Nicole , Perry Dorothy A.
Published: June 2020

The Lancet Commission on Education of Health Professionals for the 21st Century calls for enhancing health education for the needs and challenges of the 21st century to improve health status globally. To complement the Lancet report, this article makes recommendations for including core global health competencies in the education of health care professionals and specific groups of the public who are relevant to oral health in a global context in order to tackle the burden of oral diseases. Experts from various professional backgrounds developed global oral health competencies for four target groups: Group 1 was defined as dental students, residents/trainee specialists (or equivalent), and dentists; Group 2 was community health workers, dental hygienists, and dental therapists (or the equivalent); Group 3 was health professionals such as physicians, physician assistants, nurses, nurse practitioners, and pharmacists; and Group 4 was non‐health professionals in the public arena such as parents, teachers, decision makers, key opinion leaders, and health and consumer advocates. Key competencies for members of each of the four target groups are presented in a matrix. The suggested competency matrix shows that many other health professions and groups in society have potentially crucial roles in the prevention, control, and management of oral diseases globally. Workforce models including a wider range of professionals working together as a team will be needed to tackle the burden of oral diseases in an integrated way in the broader context of non‐communicable diseases. Further discussion and research should be conducted to validate or improve the competencies proposed here with regard to their relevance, appropriateness, and completeness.
Anticipated and Actual Implementation of Case‐Based Learning by Dental Faculty Members During and After Training
Authors: Behar‐Horenstein Linda S. , Catalanotto Frank A. , Nascimento Marcelle M.
Published: June 2020

The aims of this study were to describe the processes used to train dental faculty members in case‐based learning (CBL) and to determine their beliefs about the anticipated implementation of CBL and perceptions of actual implementation following use of the CBL approach. Participants were dental faculty members at the University of Florida who received a four‐day intensive training course in the use of CBL. Two focus groups were conducted. The first occurred during training to assess how the participants anticipated using CBL. The second was conducted during the faculty members’ implementation of CBL. All 19 trainees participated in focus group 1 (100%). During the course of the study, two faculty members left the school; of the remaining 17, 12 participated in focus group 2 (participation rate of 71%). The findings showed that initially the faculty members were hesitant and uncertain about using CBL. Following implementation, those issues dissipated, as the participants began to consider how to optimize the effectiveness of CBL as a legitimate method for fostering student ownership of learning and active participation. Understanding what CBL means for individual educators at varying stages of change will likely allow the dental education community to better anticipate and address tensions and challenges that faculty members are likely to experience.
Community‐Based Dental Education Models: An Analysis of Current Practices at U.S. Dental Schools
Authors: Mays Keith A.
Published: June 2020

Community‐based dental education (CBDE) enhances students’ clinical expertise, improves their cultural competence, increases access to care, and fosters community engagement. As emphasis on CBDE has increased over the last decades, the aim of this survey study was to determine how CBDE is currently being implemented in U.S. dental schools. The study used a 20‐item, author‐designed survey emailed in April to August 2015 to 60 of the 65 U.S. dental schools, excluding those that had been recently established. Of the 60 schools, representatives of 33 responded, resulting in a 55% response rate: 70% public and 30% private. These respondents reported that the extramural sites being used the most were community clinics (90.9%), Federally Qualified Health Clinics (66.7%), public health clinics (54.5%), and Indian Health Service clinics (42.4%). The majority of responding schools (63.6%) had ten or more sites available for rotations, and the rotation lengths were 1–2 weeks (29%), 2–4 weeks (25%), 4–6 weeks (29%), 6–8 weeks (3.2%), and 8–10 weeks (12.9%). Most of the respondents (78.8%) reported that their students were unable to be assessed for clinical competencies at external clinical sites, but roughly half allowed students to receive clinical credit. After students completed their rotations, the majority of the respondents (81.8%) reported that students were required to produce a reflection, and 87.9% reported that students completed a post‐rotation survey. Considering the benefits of CBDE for students’ education and for improving access to oral health care, it is encouraging that over 45% of the responding schools required their students to spend four weeks or longer on external rotations.
Can Multiple Mini‐Interviews Predict Academic Performance of Dental Students? A Two‐Year Follow‐Up
Authors: Alaki Sumer M. , Yamany Ibrahim A. , Shinawi Lana A. , Hassan Mona H.A. , Tekian Ara
Published: June 2020

Prior research has shown that students’ previous grade point average (GPA) is the best predictor for future academic success. However, it can only partly predict the variability in dental school performance. The aim of this study was to assess the predictive value of multiple mini‐interviews (MMI) as an admission criterion by comparing them with the academic performance of dental students over a two‐year period. All incoming undergraduate dental students at the King Abdulaziz University Faculty of Dentistry (KAUFD) during academic year 2013–14 were invited to participate in MMI. Students rotated through six objective structured clinical exam (OSCE)‐like stations for 30 minutes total and were interviewed by two trained faculty interviewers at each station. The stations were focused on noncognitive skills thought to be essential to academic performance at KAUFD. The academic performance of these students was then followed for two years and linked to their MMI scores. A total of 146 students (71 males and 75 females) participated in an interview (response rate=92.9%). Most students scored in the acceptable range at each MMI station. Students’ total MMI score, ambitions, and motives were significant predictors of GPA during the two years of follow‐up (p<0.038 and p<0.001, respectively). In this study, MMI was found to be able to predict future academic performance of undergraduate dental students.
The Global Footprint of Oral Medicine Specialists: The University of Pennsylvania Experience
Authors: Stoopler Eric T. , De Rossi Scott S. , Greenberg Martin S. , Sollecito Thomas P.
Published: June 2020

The aim of this study was to analyze the global footprint of oral medicine specialists who graduated from the University of Pennsylvania oral medicine residency program. In 2016, a cross‐sectional electronic survey was distributed to 53 graduates of that program, asking about their current geographical location and professional status. Of those 53 graduates, 23 (43%) completed the survey with 22 reporting their current location and 21 reporting their current professional status. The results showed that 17 graduates were located within the U.S., and five were located internationally. Twelve graduates were in full‐time academic positions, three were in part‐time academic positions/part‐time private practice, three were in full‐time private practice, two were in postdoctoral training programs, and one was not employed. This study found that oral medicine specialists trained at the University of Pennsylvania were located both domestically and internationally. The majority held faculty positions at academic institutions with fewer involved in private practice. This program may thus be considered a source of future dental academicians.
Should Lecture Recordings Be Mandated in Dental Schools? Two Viewpoints
Authors: Zandona Andrea Ferreira , Kinney Janet , Seong WookJin , Kumar Vandana , Bendayan Alexander , Hewlett Edmond
Published: June 2020

Transcription or recording of lectures has been in use for many years, and with the availability of high‐fidelity recording, the practice is now ubiquitous in higher education. Since technology has permeated education and today's tech‐savvy students have expectations for on‐demand learning, dental schools are motivated to record lectures, albeit with positive and negative implications. This Point/Counterpoint article addresses the question of whether lecture recording should be mandatory in U.S. dental schools. Viewpoint 1 supports the statement that lecture recording should be mandatory. Proponents of this viewpoint argue that the benefits—notably, student satisfaction and potential for improvement in student performance—outweigh concerns. Viewpoint 2 takes the opposite position, arguing that lecture recording decreases students’ classroom attendance and adversely affects the morale of educators. Additional arguments against mandatory lecture recordings involve the expense of incorporating technology that requires ongoing support.
Integration of Basic‐Clinical Sciences, PBL, CBL, and IPE in U.S. Dental Schools’ Curricula and a Proposed Integrated Curriculum Model for the Future
Authors: Elangovan Satheesh , Venugopalan Shankar Rengasamy , Srinivasan Sreedevi , Karimbux Nadeem Y. , Weistroffer Paula , Allareddy Veerasathpurush
Published: June 2020

The integration of basic and clinical sciences in dental curricula enhances the application of basic science principles to clinical decision making and improves students’ critical thinking. The aim of this study was to define the characteristics of U.S. dental schools’ curricula with regard to level of course integration and degree of incorporation of problem‐based and case‐based learning. A second aim was to propose a dental curriculum that supports effective integration of courses and addresses some of the concerns facing academic dentistry. A survey was sent to 58 academic deans in U.S. dental schools. The survey included questions about integrating courses in the schools’ curricula and major changes in curricular structure or teaching pedagogy that respondents anticipated in the immediate future. A total of 31 schools responded to the survey, for a 53.4% response rate. The results showed that three‐quarters of the responding schools still teach basic and clinical sciences separately, although 61.3% reported having an integrated curriculum. Among the responding schools, 16 had a PBL component integrated into their curricula (two had integrated PBL in all courses and 14 used a hybrid PBL approach). Two schools had CBL integrated in all courses, and ten had CBL integrated in >75% of courses. Only slightly more than half agreed that their curricula foster students’ thinking “outside the box.” Faculty shortages and lack of protected time and resources were the most frequent reasons given for a lack of integrated courses. The integrated model proposed in this article has the potential to provide a low stress environment for students and to address important issues like faculty shortages.
Dental Students’ Perceived Value of Peer‐Mentoring Clinical Leadership Experiences
Authors: Sheridan Rachel A. , Hammaker Daniel J. , de Peralta Tracy L. , Fitzgerald Mark
Published: June 2020

This pilot study compared second‐ and fourth‐year dental students’ perceived values of newly implemented clinical leadership experiences (CLEs) at one U.S. dental school during the 2012–13 academic year. In the CLEs, fourth‐year (D4) students mentored second‐year (D2) dental students during faculty‐supervised patient treatment. The two cohorts’ perceived value of the experiences was measured with questionnaires consisting of five‐point Likert scale questions and open text responses. Out of a total of 114 D2 and 109 D4 students, 46 D2 students and 35 D4 students participated (response rates of 40.4% and 32.1%, respectively). While responses from both cohorts showed they highly valued the CLEs, the D2s perceived greater value: 4.07 (0.53) v. 3.51 (0.95), p<0.003. Both cohorts reported feeling that D4s were prepared to mentor D2s, that the CLEs had educational benefits, and that the CLEs increased their comfort with peer communication. Theme analysis of open text questions revealed that the respondents perceived the D4s were more accessible than faculty and provided guidance and individual attention; the CLEs increased student comfort; the CLEs reinforced D4 skills, knowledge, and confidence; and the CLEs provided management, leadership, and collaborative work experience. Theme analysis also highlighted student concerns about a lack of program structure. Overall, the majority of both groups valued CLEs in their dental education. Particular advantages they perceived were increased comfort, guidance, and attention. Further program development should address student concerns. These results suggest that similar programs should be considered and/or expanded in other dental schools’ curricula.
Comparing Integrated and Disciplinary Clinical Training Patterns for Dental Interns: Advantages, Disadvantages, and Effect on Students’ Self‐Confidence
Authors: Wu Junrong , Feng Xiaoli , Chen Aijie , Zhang Yanli , Liu Qi , Shao Longquan
Published: June 2020

In China, the five‐year program of undergraduate education for stomatology consists of four years of lecture courses and one year of internship focused on clinical training. Dental schools provide this clinical training either in their own clinics (referred to as the one‐stage pattern because all forms of practice are completed together) or by placing students in external clinics usually at non‐affiliated hospitals (referred to as the three‐stage program because the three primary areas are taught separately). The aims of this study were to investigate differences in teaching effect between the one‐stage and the three‐stage patterns and to evaluate advantages and disadvantages of the two patterns. A three‐section, 31‐item questionnaire was designed to assess basic and clinic information about the interns’ training and their self‐confidence in performing clinical procedures. The survey was administered to graduates who finished the fifth‐year internship in 2012–14. Of the 356 individuals invited to participate, 303 graduates who spent their intern years in 43 academic dental institutions returned completed surveys (response rate of 85%). The one‐stage group (n=121) reported longer independent operation time than the three‐stage group (n=182) (p<0.01). No significant difference was found between the groups for assessment of clinic infrastructure (p=0.121). The interns were most confident in oral hygiene instruction and scale and polish (overall median=5), but showed low confidence in rubber dam placement and four other procedures (overall median=2). The one‐stage group rated their confidence level higher than the three‐stage group on comprehensive skills such as arranging appointments and managing patients and procedures needing long treatment periods such as molar endodontics. The three‐stage group showed higher confidence on more specialized procedures such as surgical extractions and suturing. This study found that both of the two intern patterns had advantages and shortcomings in clinical training in various procedures. Combining the two could be a way to improve clinical education in China.
Annual ADEA Survey of Dental School Seniors: 2015 Graduating Class
Authors: Wanchek Tanya , Cook Bryan J. , Anderson Eugene L. , Valachovic Richard W.
Published: June 2020

This report summarizes and analyzes the results of the American Dental Education Association (ADEA) Survey of Dental School Seniors administered to seniors graduating in 2015. Data were collected from 60 of 61 U.S. dental schools with graduating seniors. The response rate was 83% (4,827 respondents). Where appropriate, results from prior years are included in this report to allow for comparisons over time. The survey asked students a range of questions concerning their motivations for attending dental school, experience while in dental school, educational debt incurred before and during dental school, and plans following graduation. The results provide insight into the future dental workforce and how well students perceive that schools are meeting their needs. Over the past 15 years, educational debt has nearly tripled at public schools and more than doubled at private schools. However, 12.4% of 2015 seniors reported graduating with no educational debt, an increase from 10.7% in 2014. Nearly half of the 2015 seniors planned to enter private practice dentistry (49.3%), and 34.3% planned to enter graduate school/residence/internship. Although very few seniors planned to teach immediately, the majority planned to teach later in their careers. Over half of American Indian/Alaska Native seniors planned to locate in rural areas or small towns, while over half of Black/African American seniors planned to work in mid‐sized cities or the urban fringe. A majority (53.7%) responded that they would definitely or probably work with underserved populations at some point after graduation. Together these, as well as other results from the survey, provide a window into the dental school experience as perceived by the graduating class of 2015.
Career and Professional Satisfaction of Oral and Maxillofacial Surgery Residents, Academic Surgeons, and Private Practitioners: Does Gender Matter?
Authors: Marti Kyriaki C. , Lanzon Jesse , Edwards Sean P. , Inglehart Marita R.
Published: June 2020

The aims of this study were to determine whether male vs. female oral and maxillofacial surgery (OMS) residents, academic surgeons (i.e., faculty members), and private practitioners in the U.S. differed in their general career satisfaction and job/professional satisfaction. Survey data were collected in 2011–12 from 267 OMS residents (response rate 55%), 271 OMS academic surgeons (response rate 31%), and 417 OMS private practitioners (response rates 13% web‐based survey and 29% postal mail survey). The results showed that while the male vs. female OMS private practitioners and academic surgeons did not differ in their career satisfaction, the female residents had a lower career satisfaction than the male residents (on four‐point scale with 4=most satisfied: 3.03 vs. 3.65; p<0.01). The male vs. female OMS private practitioners and academic surgeons also did not differ in their job satisfaction. However, the female residents agreed on average less that they were able to practice OMS in the way they want, felt less proud to be an oral and maxillofacial surgeon, were less satisfied with their career, and were more likely to consider a career change in the next five years than the male residents. While these male and female oral and maxillofacial surgeons in private practice and academia did not differ in their career and job satisfaction, the male and female residents differed significantly, with female residents reporting a significantly poorer career and job satisfaction than male residents. Future research needs to explore ways to improve career and professional satisfaction of female OMS residents.
Training to Care for Limited English Proficient Patients and Provision of Interpreter Services at U.S. Dental School Clinics
Authors: Simon Lisa , Hum Lauren , Nalliah Romesh
Published: June 2020

Legal protections in the United States mandate that individuals with limited English proficiency (LEP) have equal access to health care. However, LEP populations are at higher risk of poor health. Dental school clinics offer lower cost care by supervised dental students and often provide care for LEP patients. The aims of this study were to survey dental students about their clinical experience with LEP patients, the interpreter resources available at their dental school clinics, and the extent of instruction on these topics. Academic deans at 19 dental schools (30.6% of 62 invited schools) distributed the survey to their students, and the survey was completed by 325 students (4.2% of students at the 19 participating schools). Among the responding students, 44% reported their dental school clinic lacked formal interpreter services, and most of the respondents reported receiving minimal instruction on caring for LEP patients. Only 54% of the responding students reported feeling adequately prepared to manage LEP patients following graduation. These results suggest there is limited access to interpreter services for students while in dental school. A large proportion of these dental students thus reported feeling unprepared to treat LEP patients after graduation.
Implementation and outcomes of a therapeutic drug monitoring program for antifungal and antiretroviral agents in a tertiary medical center in Taiwan
Authors: Lin Shu‐Wen , Kuo Ching‐Hua , Shen Li‐Jiuan , Chen Yee‐Chun , Hung Chien‐Ching , Wu Fe‐Lin Lin
Published: June 2020

Introduction

Therapeutic drug monitoring (TDM) of antifungal and antiretroviral agents was recently initiated at National Taiwan University (NTU) Hospital based on a collaboration between clinicians at NTU Hospital and faculty at the NTU School of Pharmacy since 2009. Interim analyses were conducted to evaluate its effects on treatment outcomes.

Objectives

The purpose of this study was to establish and evaluate the impact of the TDM service on effectiveness and safety over a 10‐year period.

Methods

The TDM program was initiated as a research‐based pharmacy service. This prospective observational study enrolled all patients who were prescribed voriconazole, posaconazole, and efavirenz. Three interim analyses were conducted: (1) Identification of the cutoff points of voriconazole plasma concentrations associated with hepatotoxicity and hallucinations during 2009‐2010, (2) Examination of whether TDM‐guided posaconazole dosing adjustment increased the target attainment of plasma concentrations and the response rate during 2012‐2013, and (3) Evaluation of the clinical outcomes of TDM‐guided efavirenz dosing regimens during 2009‐2016.

Results

TDM of voriconazole, posaconazole, and efavirenz was performed in 792, 237, and 901 patients, respectively. Voriconazole trough concentration was associated with hepatotoxicity and hallucinations in 40 patients. Trough concentrations above 4.5 mcg/mL may increase the risk of hepatotoxicity. Adverse events and response rates were improved by TDM followed by dosing adjustment. TDM‐guided posaconazole dosing adjustment increased the target attainment of trough concentrations and the response rate in 41 patients. The mid‐dosing concentration of efavirenz in 171 patients was 2.82 mcg/mL (range: 0.98‐10 mcg/mL) during the initial monitoring period (2009‐2012). A TDM‐guided half‐dose regimen containing efavirenz tested on 203 patients in 2013‐2016 mitigated adverse events while maintaining effectiveness.

Conclusion

The interim analyses of this TDM service demonstrated an improvement in the quality of care and favorable outcomes in the treatment of fungal and HIV infections.
LOBSTER: Local orbital projections, atomic charges, and chemical‐bonding analysis from projector‐augmented‐wave‐based density‐functional theory
Authors: Nelson Ryky , Ertural Christina , George Janine , Deringer Volker L. , Hautier Geoffroy , Dronskowski Richard
Published: June 2020

We present an update on recently developed methodology and functionality in the computer program Local Orbital Basis Suite Toward Electronic‐Structure Reconstruction (LOBSTER) for chemical‐bonding analysis in periodic systems. LOBSTER is based on an analytic projection from projector‐augmented wave (PAW) density‐functional theory (DFT) computations (Maintz et al., J. Comput. Chem. 2013, 34, 2557), reconstructing chemical information in terms of local, auxiliary atomic orbitals and thereby opening the output of PAW‐based DFT codes to chemical interpretation. We demonstrate how LOBSTER has been improved by taking into account time‐reversal symmetry, thereby speeding up the DFT and LOBSTER calculations by a factor of 2. Over the recent years, the functionalities have also been continually expanded, including accurate projected densities of states (DOSs), crystal orbital Hamilton population (COHP) analysis, atomic and orbital charges, gross populations, and the recently introduced k‐dependent COHP. The software is offered free‐of‐charge for non‐commercial research.
Diagnostic and prognostic value of circulating miRNA‐499 and miRNA‐22 in acute myocardial infarction
Authors: Wang Xiaoqing , Tian Lu , Sun Qiyu
Published: June 2020

Background

Currently, acute myocardial infarction (AMI) represents a serious cardiovascular disease with high morbidity and mortality. Therefore, this study aimed to systematically evaluate the roles of miRNA‐499 and miRNA‐22 as potential biomarkers for AMI.

Methods

According to the inclusion and exclusion criteria, we measured circulating levels of miRNAs in 50 AMI patients and 50 non‐MI populations. The expression levels of plasma miRNA‐499 and miRNA‐22 were analyzed by real‐time fluorescent quantitative polymerase chain reaction (qRT‐PCR). A statistical analysis of clinical data of AMI patients was conducted by 90‐day follow‐up.

Results

Real‐time PCR analysis showed that the relative expression level of miRNA‐499 increased gradually among the three groups (P < .05). However, the expression of miRNA‐22 showed a downward trend (P < .05). According to logistic analysis, the relative levels of miRNA‐499 and miRNA‐22 were important predictors of AMI. When the miRNA‐499 and miRNA‐22 levels were 0.377 and 0.946 separately, the diagnostic value of miRNA‐499 and miRNA‐22 for AMI was 86.00% and 86.00% for sensitivity, and 98.00% and 94.00% for specificity, respectively. In addition, compared to the baseline GRACE scoring system, the combination of miRNA‐499, miRNA‐22, and GRACE scores had a stronger discriminating power for MACE occurrence, with a sensitivity of 100.00% and a specificity of 79.40%.

Conclusions

The results showed that plasma miRNA‐499 and miRNA‐22 were more sensitive and specific for the diagnosis of AMI, suggesting that they can be used as potential biomarkers for clinical diagnosis of AMI.
ADEA‐ADEE Shaping the Future of Dental Education III
Authors: Field James , Hervey Tamara , Walsh Steve , Davis Joan , Garcia Lily T. , Valachovic Richard W.
Published: June 2020

The World Health Organization has indicated that Interprofessional Education (IPE) occurs when “students from two or more professions learn about, from, and with each other”.1 These IPE experiences are widely thought to provide students with the opportunity to learn and practice the knowledge, skills, behaviors and attitudes that will ultimately translate into the provision of safer, higher quality, team‐based patient care when they become health care practitioners in collaborative care environments. At the joint American Dental Education Association (ADEA) and Association for Dental Education in Europe (ADEE) 2019 Shaping the Future of Dental Education III conference in Brescia, Italy, delegates explored the concept of transprofessional learning, where students learn skills across a wider range of professions than health professions alone. The workshop continued the dialogue that began during the 2017 ADEA‐ADEE Shaping the Future of Dental Education II conference in London, England as previously reported by Davis et al.,2 and explored the use of transprofessional learning through the lenses of dental education, applied linguistics education and law education focusing on the use of reflective practices. The workshop brought together educators from around the globe in a highly interactive setting where they had the opportunity to discuss and develop tools and practices for teaching reflective practice by using a transprofessional learning approach.
Attitudes and behaviors regarding public health of dental school graduates from A. T. Still University
Authors: Howell Scott E. I.
Published: June 2020

Purpose

To survey A. T. Still University, Arizona School of Dentistry & Oral Health (ATSU‐ASDOH) graduates and evaluate the impact of completing a Master of Public Health (MPH) degree during dental school on a dentist's practice behaviors, volunteerism, and attitudes toward dental education, practice preparedness, and the dental profession.

Methods

In 2018, a 35‐question survey was emailed to 637 (ATSU‐ASDOH) graduates from 2007 to 2017. Questions were related to demographics, obtaining an MPH, postgraduate education, practice setting, and attitudes regarding dental education on practice preparedness and the dental profession.

Results

One hundred and seven dentists completed the survey for a response rate of 16.8%. Of those, 40 respondents received an MPH from (ATSU‐ASDOH) at the same time as graduating with a DMD or within 5 years following graduation. Dentists with an MPH were more likely to practice in public health settings (P = 0.028). However, the MPH did not appear to influence attitudes toward the dental profession.

Conclusion

Dentists from (ATSU‐ASDOH) who obtained an MPH and those who entered dental school wanting to work with the underserved are more likely to practice within public health settings. This study begins to paint a picture of a dual degree graduate. Future studies should explore which variables are more likely to result in a graduate working within a public health setting.
Prescribing patterns in a US dental school from 2010 to 2017
Authors: Ticku Shenam , Starr Jacqueline R. , Da Silva John D. , Elani Hawazin W.
Published: June 2020

Objective

Dental education has an essential role in helping combat the opioid and antibiotic resistance crises. This study evaluates the prescribing practices of clinical instructors, advanced graduate residents, and predoctoral students in an academic dental setting.

Methods

A retrospective chart review was conducted of electronic dental records from the years 2010 to 2017. The proportions of prescriptions for each drug group was calculated by prescribers’ training level and specialty. Descriptive statistics were calculated for the daily opioid Morphine Milligram Equivalent (MME) dose prescribed across years and provider characteristics.

Results

Over the 8 years, 65,160 prescriptions were written for 10,374 patients by 625 prescribers. The most commonly prescribed drugs were for fluoride‐based medications (30%) and antibiotics (24%). Periodontists had the greatest absolute number of opioid analgesics prescriptions (n = 2712); oral maxillofacial surgeons (OMFS) prescribed more opioids than other classes of drug (49%) as a proportion of within‐specialty prescriptions. Antibiotics were the most common drugs prescribed by endodontists (46%) and second most common drugs prescribed by periodontists (25%), OMFS (28%), and prosthodontists (21%). From 2010 to 2017, the proportion of prescriptions for antibiotics remained unchanged, while that of fluoride‐based drugs increased from 2010 to 2014 and plateaued thereafter. The proportion of prescriptions for opioid analgesics decreased from 18% to 7%. The median daily MME dose across year and provider characteristics stayed constant (<50 MME).

Conclusion

These results demonstrate encouraging prescription trends for opioid and fluoride‐based drugs. Due to the high prevalence of antibiotic prescriptions in academic dental settings, stewardship approaches should be emphasized.
Pre‐doctoral special healthcare needs education: Lost in a crowded curriculum
Authors: Inclan Meagan L. , Meyer Beau D.
Published: June 2020

We explored academicians’ experiences with pre‐doctoral special healthcare needs (SHCN) education using one‐on‐one interviews with academic leaders. We assessed their personal experience with SHCN, the current state of SHCN education at their institution, and their opinions about SHCN education in the pre‐doctoral curriculum. Interviews were transcribed verbatim and analyzed using a qualitative descriptive framework to identify emerging themes. Twelve faculty members were interviewed from 10 institutions. All participants acknowledged that the bulk of their training and experience treating patients with SHCN occurred during residency. Participants identified inconsistent pre‐doctoral SHCN curricular experiences attributed to time constraints imposed by an increasingly crowded curriculum. Questions remain regarding the place of SHCN education in future pre‐doctoral curricula, as well as how to create sustainable systems and programs for dental graduates to gain this experience.
Virtual education: Dental morphologies in a virtual teaching environment
Authors: Liebermann Anja , Erdelt Kurt
Published: June 2020

Objectives

Digital technology is already playing an increasingly important role in the education of students. The present investigation examined the acceptance of preclinical students for learning dental morphologies in virtual reality (VR).

Methods

The creation of the VR dental teaching environment was divided into 3 sections: (a) generation of the digital data; (b) creation of the VR dental learning environment for tooth morphologies; and (c) evaluation by preclinical students through questionnaires combined with visual analogue scale and fixed‐answer options. Students of the Department of Prosthetic Dentistry of the University Hospital Munich were able to stay/interact in the VR dental learning environment for 10 minutes with VR headsets and hand controllers. The data were analyzed using the Kolmogorov−Smirnov test and exploratory data analysis using the median value and interquartile range.

Results

Of the students, 34.9% stated that they understand dental morphologies much better, 57.1% better, and 7.9% equally well compared to using the traditional textbook. The students would be willing to spend about 500 euros privately for the VR equipment. The haptic and auditive teaching elements were evaluated more positively than the purely visual ones of the integrated information boards.

Conclusions

Learning in the VR dental learning environment showed a high level of acceptance among all students and should be integrated as a fixed element in the dental curriculum. A further development for use independent of time and place is desirable.
The neutrophil subset defined by CD177 expression is preferentially recruited to gingival crevicular fluid in periodontitis
Authors: Dahlstrand Rudin Agnes , Amirbeagi Firoozeh , Davidsson Lisa , Khamzeh Arsham , Thorbert Mros Sara , Thulin Pontus , Welin Amanda , Björkman Lena , Christenson Karin , Bylund Johan
Published: June 2020

In recent years, the concept of distinct subpopulations of human neutrophils has attracted much attention. One bona fide subset marker, exclusively expressed by a proportion of circulating neutrophils in a given individual, and therefore dividing neutrophils in two distinct subpopulations, is the glycoprotein CD177. CD177 is expressed on the plasma and granule membranes of 0–100% of circulating neutrophils depending on the donor. Several in vitro studies have linked CD177 to neutrophil transmigration, yet very few have looked at the role of CD177 for tissue recruitment in vivo. We investigate whether the CD177+ and CD177– neutrophil subsets differ in their propensity to migrate to both aseptic- and microbe-triggered inflamed human tissues. Microbe-triggered neutrophil migration was evaluated in samples of gingival crevicular fluid (GCF) from patients with periodontitis, whereas neutrophil migration to aseptic inflammation was evaluated in synovial fluid from patients with inflammatory arthritis, as well as in exudate from experimental skin chambers applied on healthy donors. We found that the proportion of CD177+ neutrophils was significantly higher in GCF from patients with periodontitis, as compared to blood from the same individuals. Such accumulation of CD177+ neutrophils was not seen in the two models of aseptic inflammation. Moreover, the proportion of CD177+ neutrophils in circulation was significantly higher in the periodontitis patient group, as compared to healthy donors. Our data indicate that the CD177+ neutrophil subset is preferentially recruited to the gingival crevice of periodontitis patients, and may imply that this subtype is of particular importance for situations of microbe-driven inflammation.
IL-17a exacerbates hepatic ischemia–reperfusion injury in fatty liver by promoting neutrophil infiltration and mitochondria-driven apoptosis
Authors: Yang Xinxiang , Li Changxian , Ng Kevin Tak-Pan , Liu Jiang , Liu Hui , Zhang Weiyi , Xiao Fan , Li Xiangcheng , Lo Chung Mau , Lu Liwei , Man Kwan
Published: June 2020

Hepatic ischemia–reperfusion (IR) injury is a critical issue during liver transplantation (LT). Recent studies have demonstrated that IL-17a contributes to IR injury and steatohepatitis. However, the underlying mechanism is not understood. This study aimed to examine the role of IL-17a on hepatic IR injury in fatty liver and to investigate the underlying mechanisms. The correlation between serum IL-17a levels and liver function was analyzed in LT patients receiving fatty (n = 42) and normal grafts (n = 44). Rat LT model was applied to validate the clinical findings. IL-17a knockout (KO) and wild-type mice were fed with high-fat diets to induce fatty liver and subjected to hepatic IR injury with major hepatectomy. Frequency of circulating neutrophils and IL-17a expression on PBMCs were analyzed by flow cytometry. Mitochondrial outer membrane permeabilization (MOMP) was examined by a living intravital image system. Serum IL-17a was elevated after human LT, especially with fatty grafts. The aspartate aminotransferase and alanine transaminase levels were increased in recipients with fatty grafts compared with normal grafts. In rat LT model, the intragraft IL-17a expression was significantly higher in fatty grafts than normal ones post-LT. KO of IL-17a in mice notably attenuated liver damage after IR injury in fatty liver, characterized by better-preserved liver architecture, improved liver function, and reduced neutrophil infiltration. MOMP triggered cell death after hepatic IR injury in a caspase-independent way via IL-17a/NF-κB signaling pathway. KO of IL-17a protected the fatty liver against IR injury through the suppression of neutrophil infiltration and mitochondria-driven apoptosis.
NLRC4 biology in immunity and inflammation
Authors: Andrade Warrison A , Zamboni Dario S
Published: June 2020

Inflammasomes are cytosolic multiprotein complexes that sense microbial infections or host cell damage, triggering cytokine production and a proinflammatory form of cell death, called pyroptosis. Whereas pyroptosis and cytokine production may often promote host resistance to infections, uncontrolled inflammasome activation leads to autoinflammatory diseases in humans. Among the multiple inflammasomes described, the neuronal apoptosis inhibitory protein/nucleotide-binding domain leucine-rich repeat-containing protein family caspase activation and recruitment domain-containing protein 4 (NLRC4) inflammasome emerged as a critical component for the restriction of bacterial infections. Accordingly, our understanding of this inflammasome advanced remarkably over the last 10 yr, expanding our knowledge about ligand-receptor interaction; cryo-EM structure; and downstream effectors and substrates, such as gasdermin-D, caspase-1, caspase-8, and caspase-7. In this review, we discuss recent advances on the biology of the NLRC4 inflammasome, in terms of structure and activation mechanisms, importance in bacterial and nonbacterial diseases, and the identification of NLRC4 gain-of-function mutations leading to NLRC4-associated autoinflammatory diseases in humans.
High tolerance to instrument drifts by differential chemical isotope labeling LC‐MS: A case study of the effect of LC leak in long‐term sample runs on quantitative metabolome analysis
Authors: Chen Deying , Zhao Shuang , Han Wei , Lo Elvis , Su Xiaoling , Li Liang , Li Lanjuan
Published: June 2020

Metabolomics study of a biological system often involves the analysis of many comparative samples over a period of several days or weeks. This process of long‐term sample runs can encounter unexpected instrument drifts such as small leaks in liquid chromatography‐mass spectrometry (LC‐MS), degradation of column performance, and MS signal intensity change. A robust analytical method should ideally tolerate these instrumental drifts as much as possible. In this work, we report a case study to demonstrate the high tolerance of differential chemical isotope labeling (CIL) LC‐MS method for quantitative metabolome analysis. In a study of using a rat model to examine the metabolome changes during rheumatoid arthritis (RA) disease development and treatment, over 468 samples were analyzed over a period of 15 days in three batches. During the sample runs, a small leak in LC was discovered after a batch of analyses was completed. Reanalysis of these samples was not an option as sample amounts were limited. To overcome the problem caused by the small leak, we applied a method of retention time correction to the LC‐MS data to align peak pairs from different runs with different degrees of leak, followed by peak ratio calculation and analysis. Herein, we illustrate that using 12C‐/13C‐peak pair intensity values in CIL LC‐MS as a measurement of concentration changes in different samples could tolerate the signal drifts, while using the absolute intensity values (ie, 12C‐peak as in conventional LC‐MS) was not as reliable. We hope that the case study illustrated and the method of overcoming the small‐leak‐caused signal drifts can be helpful to others who may encounter this kind of situation in long‐term sample runs.
Using electrospray ionization‐tandem mass spectrometry to explore formation and gas‐phase chemistry of silver nanoclusters generated from the reaction of silver salts with NaBH4 in the presence of bis(diphenylarsino)methane
Authors: Ma Howard Z. , McKay Alasdair I. , Canty Allan J. , O’Hair Richard A. J.
Published: June 2020

Electrospray ionization‐mass spectrometry (ESI‐MS) of mixtures of AgBF4 or AgNO3 with the capping ligand bis(diphenylarsino)methane ((Ph2As)2CH2 = dpam) in a solution of acetonitrile revealed the formation of the following cations: [Ag(CH3CN)(dpam)]+, [Ag(dpam)2]+, [Ag2(Cl)(dpam)2]+, and [Ag3(Cl)2(dpam)3]+. Addition of NaBH4 to these solutions results in the formation of the cluster cations [Ag2(BH4)(dpam)2]+, [Ag2(BH4)(dpam)3]+, [Ag3(H)(BH4)(dpam)3]+, [Ag3(BH4)2(dpam)3]+, [Ag3(H)(Cl)(dpam)3]+, and [Ag3(I)(BH4)(dpam)3]+, as established by ESI‐MS. Use of NaBD4 confirmed that borohydride is the source of the hydride in these clusters. An Orbitrap Fusion LUMOS mass spectrometer was used to explore the gas‐phase unimolecular chemistry of selected clusters via multistage mass spectrometry (MSn) experiments employing low‐energy collision‐induced dissociation (CID) and high‐energy collision‐induced dissociation (HCD) experiments. The borohydride containing clusters fragment via two competing pathways: (i) ligand loss and (ii) B–H bond activation involving BH3 loss. Density functional theory (DFT) calculations were used to calculate the energetics of the optimized structures for all precursor ions, fragment ions, and neutrals and to estimate the reaction endothermicities. Generally, there is reasonable agreement between the most abundant product ion formed and the predicted endothermicity of the associated reaction channel. The DFT calculations predicted that the novel dimer [Ag2(BH4)(dpam)2]+ has a paddlewheel structure in which the dpam and BH4− ligands bridge both silver centers.