Test Group Participants Research Articles

Effect of ethinyl estradiol/norethisterone acetate with and without scaling on periodontal status and high-sensitivity C-reactive protein levels in women with polycystic ovary syndrome having gingivitis: a randomized controlled trial.

Combined oral contraceptives are used for the management of hyperandrogenism and menstrual abnormalities in polycystic ovary syndrome (PCOS). There is a dearth of literature addressing the effect of ethinyl estradiol/norethisterone acetate (EE/NETA) on gingival and systemic inflammation in these patients. This randomized trial aimed to evaluate the effect of EE/NETA with and without scaling on periodontium and high-sensitivity C-reactive protein (hsCRP) levels in women with PCOS having gingivitis. Women having PCOS along with gingivitis were randomly divided into two groups: test group (n = 30) received EE/NETA + scaling with oral hygiene instructions, and control group 1 (n = 30) received EE/NETA with oral hygiene instructions. Another control group (control group 2, n = 30) consisting of systemically healthy females having gingivitis and who were age- and BMI-matched with the test group participants received scaling along with oral hygiene instructions. Periodontal and anthropometric parameters were measured at baseline, and 3 months and 6 months follow-up. Serum hsCRP levels were also estimated. Serum hsCRP levels and periodontal parameters were significantly decreased in all the groups after 6 months (P ≤ .05). The decrease in hsCRP levels was similar among the groups (P > .05). Significantly more reduction in gingival inflammation was observed in the test group compared to control group 1 (P ≤ .05). EE/NETA used alone and with scaling showed no detrimental effect on gingiva and could reduce systemic and gingival inflammation in women with PCOS having gingivitis.

Effect of scaling on serum high-sensitivity C-reactive protein levels and periodontal parameters in systemically healthy women of reproductive age group with gingivitis.

Varying levels of sex hormones across the menstrual cycle in young systemically healthy females may alter tissue responses to plaque, resulting in increased gingival inflammation. Also, higher severity and prevalence of gingivitis has been demonstrated in adult women than men, attributed to hormonal changes. Further, it has been reported that gingivitis raises the levels of systemic inflammatory markers such as C-reactive protein. This interventional trial aimed to evaluate the effect of supragingival scaling on serum high-sensitivity C-reactive protein (hsCRP) levels along with periodontal parameters in systemically healthy women of reproductive age with natural gingivitis. In total, 57 women of reproductive age were enrolled into two groups. The test group (n = 30) comprised systemically healthy women with gingivitis who received supragingival scaling. The control group (n = 27) included systemically and periodontally healthy women. Periodontal parameters (Gingival Index, Plaque Index, pocket probing depth, bleeding on probing) and serum hsCRP levels were recorded at baseline for both the groups. Follow-up of test group participants was done at 3 and 6 months. Serum hsCRP and periodontal parameters were significantly higher in the test group than in the control group at baseline, and this decreased significantly after treatment in the test group at the 6-month follow-up (P ≤ .05). Gingival Index, bleeding on probing, and hsCRP in the test group at 6 months were reduced to the baseline levels of systemically and periodontally healthy women. Treatment of gingival inflammation can help in lowering the systemic and local inflammation to the levels of systemically and periodontally healthy women.

Effect of immediate all-digital restoration of single posterior implants: The SafetyCrown concept on patient-reported outcome measures, accuracy, and treatment time-A randomized clinical trial.

The SafetyCrown workflow facilitates the immediate restoration of posterior single sites with the one-abutment/one-time concept. This randomized clinical trial aimed to assess the direct effect of immediate restoration on dental patient-reported outcomes (dPROs), feasibility, implant accuracy, and time. Participants with a single posterior edentulous site for late implant placement underwent optical impressions, shade selection, and cone beam computed tomography. After virtual treatment planning, they were randomized into the test group and the control group. For the test group, individual definitive hybrid abutments were prefabricated. The next step was a fully guided surgery with printed guides. After the implant was placed using guided surgery, the abutment was inserted. A chairside CAD/CAM workflow was used to provide the patient with a provisional restoration. Implants in the control group were left submerged to heal. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-G14, and dPRO was measured using a 10-item visual analog scale (VAS) questionnaire. Additional measurements of implant accuracy and time were performed. Follow-up was performed 7 to 10 days after implant placement. Thirty-nine participants with 45 restorations were included (test group: 23, control: 22). Immediate restoration was successful in 21 out of 23 implants (91.3%) in the test group. Both groups exhibited decreased OHRQoL without significant intergroup differences, while patient satisfaction was high overall. Test group participants perceived higher benefits and satisfaction with immediate loading than participants in the control group. Implant accuracy averaged 0.60 mm at the shoulder and 0.95 mm at the apex. Operative time was longer in the immediate loading group (61.9 min) than in the control group (32.1 min) (p < 0.001). Considering the limitations, the immediate restoration of late placed posterior implants using the described workflow proved feasible in 21 out of 23 cases. Both groups achieved high patient satisfaction with no differences in OHRQoL during the first week. Patients who received immediate loading rated the benefits very highly and were satisfied with the provisional restoration during the healing period.

Machine learning for automating subjective clinical assessment of gait impairment in people with acquired brain injury – a comparison of an image extraction and classification system to expert scoring

BackgroundWalking impairment is a common disability post acquired brain injury (ABI), with visually evident arm movement abnormality identified as negatively impacting a multitude of psychological factors. The International Classification of Functioning, Disability and Health (ICF) qualifiers scale has been used to subjectively assess arm movement abnormality, showing strong intra-rater and test-retest reliability, however, only moderate inter-rater reliability. This impacts clinical utility, limiting its use as a measurement tool. To both automate the analysis and overcome these errors, the primary aim of this study was to evaluate the ability of a novel two-level machine learning model to assess arm movement abnormality during walking in people with ABI.MethodsFrontal plane gait videos were used to train four networks with 50%, 75%, 90%, and 100% of participants (ABI: n = 42, healthy controls: n = 34) to automatically identify anatomical landmarks using DeepLabCut™ and calculate two-dimensional kinematic joint angles. Assessment scores from three experienced neurorehabilitation clinicians were used with these joint angles to train random forest networks with nested cross-validation to predict assessor scores for all videos. Agreement between unseen participant (i.e. test group participants that were not used to train the model) predictions and each individual assessor’s scores were compared using quadratic weighted kappa. One sample t-tests (to determine over/underprediction against clinician ratings) and one-way ANOVA (to determine differences between networks) were applied to the four networks.ResultsThe machine learning predictions have similar agreement to experienced human assessors, with no statistically significant (p < 0.05) difference for any match contingency. There was no statistically significant difference between the predictions from the four networks (F = 0.119; p = 0.949). The four networks did however under-predict scores with small effect sizes (p range = 0.007 to 0.040; Cohen’s d range = 0.156 to 0.217).ConclusionsThis study demonstrated that machine learning can perform similarly to experienced clinicians when subjectively assessing arm movement abnormality in people with ABI. The relatively small sample size may have resulted in under-prediction of some scores, albeit with small effect sizes. Studies with larger sample sizes that objectively and automatically assess dynamic movement in both local and telerehabilitation assessments, for example using smartphones and edge-based machine learning, to reduce measurement error and healthcare access inequality are needed.

The impact of hydrogen inhalation therapy on blood reactive oxygen species levels: A randomized controlled study

Reactive Oxygen Species (ROS) play a key role in physiological processes. However, the imbalance between ROS and antioxidants in favor of the former causes oxidative stress linked to numerous pathologies. Due to its unique attributes, including distinguished permeability and selective antioxidant capability, molecular hydrogen (H2) has become an essential therapeutic agent. Hydrogen Inhalation Therapy (HIT) has come to light as a promising strategy to counteract oxidative stress.In this randomized controlled study, we aimed to evaluate the effectiveness of HIT in reducing blood ROS levels. 37 participants with elevated ROS levels (d-ROMs value > 350 U.CARR) were enrolled in the study. Participants were divided into test and control groups. The test group participants received HIT, and then their blood ROS levels were measured immediately post-treatment and after 24 h. Their results were compared to those of the control group participants who did not undergo HIT. The test group demonstrated a significant reduction in blood ROS levels after the treatment. These findings suggested the efficacy of HIT in reducing oxidative stress.

Training Finnish morphology with a smartphone application in adult beginner level learners

The rich inflectional grammar of Finnish is often considered a challenge for second language (L2) learners. However, the inflectional variation is based on relatively systematic morphological and morphophonological rules. Smartphone applications could offer an effective way to train these rules by utilizing adaptive spaced repetition exercises. Currently there is little research on morphology learning via Mobile Assisted Language Learning (MALL) applications in morphologically rich languages. The present study introduces a newly developed Finnish Morphology Application (FMA) that aims to teach beginner-level Finnish morphology. In a randomized controlled trial, the test group participants (n = 33) practiced Finnish morphology with the FMA during a three-week period, and their improvements were compared to those of an active control group using a general Finnish language learning application (n = 38). The practiced morphological operations comprised transparent and semi-transparent inflections. Pre- and posttests included a visual lexical decision task and a morphological production task. In comparison to the control group, the FMA group improved substantially in written morphological production skills, especially in transparent inflections. In visual lexical decision task, there was an improvement in accuracy for trained words in the FMA group, but this improvement applied to both transparent and semi-transparent inflections as well as monomorphemic nouns. In reaction times, there were no differences between the groups. Self-ratings of perceived efficacy of the FMA regarding grammar and vocabulary varied from neutral to positive. The results suggest that the FMA is particularly useful for learning inflectional production skills in Finnish by adult beginner level learners but can also be used to train word recognition.

Tissue changes around dental implants installed in alveolar ridge preservation sites: A 1-year follow-up randomized controlled clinical trial.

This study aimed to assess radiographic marginal bone changes 22 months post extraction, which is 1 year after implant loading in alveolar ridge preservation (ARP) sites grafted with a combination of collagen-embedded xenogenic bone substitute (DBBM-C) and collagen matrix (CMX), comparing them with implants placed in naturally healed sites. This randomized controlled clinical trial was conducted over 22 months. Patients who needed a single tooth extraction and subsequent implant placement in nonmolar areas were enrolled. The test group received deproteinized bovine bone mineral with 10% collagen covered by a procaine collagen membrane, while the control group allowed spontaneous healing. Radiographic bone level changes were documented using periapical radiographs at implant placement and follow-up visits (6, 10, and 22 months postextraction). Early implant soft tissue exposure, clinical parameters, and patient-reported outcomes were recorded. Twenty-two out of 28 participants completed a 22-month follow-up, 9 in the test group and 13 in the control group. At 10-month postextraction follow-up, the mean MBL was 1.01 ± 1.04 mm in the treatment group and 0.81 ± 0.93 mm in the control group (p = 0.804). At 22 months, the mean MBL was 2.09 ± 1.03 mm in the treatment group and 1.58 ± 0.73 mm in the control group (p = 0.339). No statistically significant differences in probing depth (PD) and bleeding on probing (BOP) were found at the 22 -month follow-up as well. Soft tissue mean recession was observed in the control group (0.36 ± 0.84 mm), while no recession was found in the test group (p = 0.2). Early implant soft tissue exposure occurred in 33% of test group participants, while none was observed in the control group (p = 0.047). One year after implant loading, no significant differences in marginal bone resorption were found between implants placed in ARP-treated and naturally healed sites. However, ARP-treated sites exhibited early implant soft-tissue exposure, suggesting a possible impairment in soft tissue healing.

Monolithic Zirconia Single Crowns Supported by Narrow- or Standard-Diameter Titanium-Zirconia Implants in Posterior Sites: 1-Year Results of a Randomized Controlled Trial.

To compare the prosthetic outcomes of screw-retained monolithic zirconia (Zr) single crowns supported by either narrow-diameter (3.3 mm) or standard-diameter (4.1 mm) tissue-level titanium-zirconia (TiZr) implants in posterior sites. A total of 18 participants, each with a missing molar or premolar tooth requiring an implantsupported single crown, were randomly assigned to either the test or control group. All participants received screwretained monolithic Zr single crowns supported by single tissue-level TiZr implants. Test group participants received narrow-diameter implants (3.3 mm), whereas control group participants received standard-diameter implants (4.1 mm). A modified version of the United States Public Health Service (USPHS) criteria was used to assess the prosthetic outcome across 12 parameters after 1 year of function. Data were analyzed descriptively, and statistical analysis was performed using a statistical software (SPSS, Version 28.0; IBM) with the level of significance set at P < .05. Of the 18 single crowns delivered, 16 were available for review at the 1-year follow-up, including 7 in the test group and 9 in the control group. Patient characteristics and crown site distribution were similar, with no significant differences observed between the two groups (chi-square test; P < .05). There were no crown failures, meaning a crown survival rate of 100% was achieved after 1 year. The prosthetic outcome based on USPHS criteria was comparable between the two groups with no significant differences observed (chi-square test; P < .05). There were 19 prosthetic events in total (10 in the test group and 9 in the control group), with no significant differences between the groups (chi-square test; P < .05). Loss of proximal contact was the dominant event, with a total of eight events (three in the test group and five in the control group). Patient satisfaction after 1 year was high in both treatment groups, with no significant differences detected. Screw-retained monolithic Zr single crowns supported by either narrow- or standard-diameter tissue-level TiZr implants in posterior sites have comparable prosthetic outcomes after 1 year. Long-term results from well-designed trials are still needed to validate the findings of the present study.

Метилирование промоторов генов клеточного цикла и апоптоза у облученных лиц, впоследствии заболевших злокачественными новообразованиями

DNA methylation plays an important role in carcinogenesis; there are many studies that investigate the degree of methylation of the entire genome, gene promoters, and non-coding elements in cancer cells, but much less information about changes of the methylation patterns in blood cells and links with the development of malignant neoplasms (MN). This study aimed to investigate the degree of methylation of promoter regions of cell cycle control and apoptosis genes (BAX, MDM2, TP53, NFkB1) in peripheral blood cells of persons chronically exposed to radiation with MN developing latently. The study included 200 persons chronically exposed to radiation from the Techa River, contaminated with nuclear wastes dumped into it. The level of methylation was assessed by real-time PCR. The participants were divided into exposed and control groups; comparing them, we found that in the former, the distribution of exposed individuals with latent MN by the degree of methylation of promoter regions of BAX, MDM2 and NFkB1 genes was significantly different from that in the latter (p &lt; 0.001; p &lt; 0.001; p = 0.004, respectively). It was established that, compared to the control group, the share of the test group participants with subsequent MN who had up to 10% of the BAX gene promoter regions methylated was significantly higher, and amounted to 98%, while in the control group this figure did not exceed 73% (p &lt; 0.00001).

Digital vs. physical ear-nose-and-throat specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid treatment: a randomized controlled trial.

This study introduces a digital assessment tool for asynchronous and remote ear-nose-and-throat (ENT) specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid (HA) treatment. The +60 population will nearly double from 12% to 22% between 2015 and 2050 increasing the incidence of age-induced hearing impairment and the need for hearing rehabilitation. If un-diagnosed, age-related hearing loss negatively affects quality of life by accelerating social distancing and early retirement as well as increasing risk of anxiety, depression, and dementia. Therefore, innovative measures are essential to provide timely diagnostics and treatment. A total of 751 hearing-impaired adults without previous HA usage or experience were randomly assigned to digital or physical ENT specialist assessment screening prior to HA treatment initiation in 20 public and private hearing rehabilitation and ENT specialist clinics in the North Denmark Region. A total of 501 test group participants were assigned to digital assessment screening and 250 control group participants to physical assessment screening prior to HA treatment. In all, 658 (88%) participants completed the trial and were eligible for analysis. Digital screening sensitivity (0.85, 95% confidence interval (CI) 0.71-0.94) was significantly higher than physical screening sensitivity (0.2, 95% CI: 0.03-0.56). Screening specificity was high for both assessment methods. In a setting where hearing-impaired adults were assessed for HA treatment, digital ENT specialist assessment screening did not compromise patient safety or increase the risk of misdiagnosis in patients with complicated hearing loss and/or serious ear disorders when compared to physical ENT specialist assessment screening. https://clinicaltrials.gov/ct2/show/NCT05154539, identifier: NCT05154539.

Evaluation of efficacy of 0.1% of chlorine dioxide mouthwash against oral malodor – A pilot study

BACKGROUND: Oral malodor, also known as halitosis or bad breath can be defined as an offensive odor that emerges from the oral cavity and can be easily detected by others. The etiology of halitosis is multifactorial and can include several intra- and extraoral factors such as gingivitis, periodontitis, chronic sinusitis, nasal inflammation, diabetes mellitus, lung carcinoma, liver insufficiency, cirrhosis, uremia, trimethylaminuria, and postnasal drip. Chlorine dioxide associated with chlorite anion results in the oxidative consumption of amino acids such as cysteine and methionine, which are precursors of volatile sulfur compounds (VSC). Thus, it can reduce the concentrations of VSCs which help in the reduction of oral malodor. Due to the lesser availability of literature to prove the effectiveness of this chlorine dioxide formula, this study is conducted to evaluate the inhibiting effect of commercially available chlorine dioxide-containing mouthwash – FRESHCLOR to combat oral malodor in patients.MATERIALS AND METHODS: The study was conducted among the patients reporting at the outpatient department of periodontics who visited with the chief complaint of bad breath and bleeding gums at KAHER'S VK Institute of Dental Sciences, Belagavi. Patients were selected according to inclusion criteria and divided into test and control groups. Post scaling Freshclor mouthwash was distributed to all test group participants. The organoleptic ratings for halitosis, gingival index (given by Loe H and Silness J, 1963), and plaque index (given by Loe H and Silness J, 1964) were recorded at baseline and 2 weeks for the group.RESULTS: There was a statistically significant reduction in halitosis with a reduction of gingival and plaque indices at 2 weeks from baseline in the test group.CONCLUSION: With the results, it can be concluded that chlorine dioxide-containing mouthwash – freshclor is effective in reducing halitosis.

The construction of knowledge through visual perceptual training in visual arts

Background: Visual perception and observational skills are an essential part of Visual Arts education, through which young learners, in the primary school, acquire important and necessary skills to create artworks during their creative projects. These skills provide learners in the primary school the opportunity to overcome their self-imposed criticism to their own works of art. Similar research projects highlight the inability of learners in the middle childhood to creatively express what they visually perceive. Aim: The study sought to assist learners in the middle childhood to overcome the slump in their creative attempts through a series of visual sharpening exercises, in the form of an Art intervention. Setting: A qualitative case study with elements of action research was conducted at a single site at a primary school in the Northern Suburbs of Cape Town. Methods: The participants of the study comprised of four grade 5 classes divided into a test group and control group. The intervention was administered to the test group in the form of visual sharpening exercises. The practical projects of four grade 5 classes were assessed, analysed, compared, and the findings were discussed according to the themes identified during the study. Results: The results indicate factors that might influence the visual perceptual skills of learners in middle childhood, while completing Visual Art projects. Analysis of the research data revealed an increase in the test group’s score compared to the control group. There was a marked effect on the test group participants’ ability to record what they visually perceived. Conclusion: This study investigated and highlights shortcomings in the CAPS Visual Art curriculum for Grade 5. Bridging the gap between practice and curriculum shortfalls is important. The study suggests that the Department of Education (DoE) should supplement the Visual Arts curriculum with visual perceptual training for middle childhood learners.

A pilot study to evaluate the impact of digital imaging on the delivery of oral hygiene instruction

AimsTo determine whether personalised Oral Hygiene Advice (OHA) using an intra-oral-camera (IOC) combined with standard OHA as provided in general dental practice reduces plaque levels after 4 weeks more than the provision of standard OHA. Materials and Methods22 healthy adult participants diagnosed with gingivitis took part in this pilot parallel-designed, randomised, examiner-blind, 2x-treatment, study regarding their home-care oral hygiene habits and attitudes to oral health. An IOC-image was taken and plaque, gingival and bleeding scores were recorded. Test group participants received standard OHA with IOC-images to indicate areas for improvement, control group participants received standard OHA. Questionnaires and plaque, gingival and bleeding scores were repeated after 4 weeks. Plaque was scored from the IOC-images and scores compared to clinical plaque scores. ResultsLifestyle habits, attitudes to oral health, plaque (0.63vs0.61, control vs test) and bleeding scores (1.17vs0.96, control vs test) were similar at baseline. After 4-weeks, plaque scores improved more in test as compared to control group (39.4vs20.6%, p<0.05, while gingival and bleeding scores approached significance. There was no difference in lifestyle habits between groups, but the test group reported significantly greater confidence in adhering to their bespoke oral health plan. Agreement between the clinical and IOC plaque scores was good. ConclusionsUse of IOC further personalises the prevailing standard of oral hygiene advice and generates great patient engagement with pictorial reports to facilitate a more in-depth patient explanation of their gingival health, resulting in significant plaque reduction and improved gingival health compared to the standard OHA alone.

Assisted Movement With Proprioceptive Stimulation Augments Recovery From Moderate-To-Severe Upper Limb Impairment During Subacute Stroke Period: A Randomized Clinical Trial

Background Robotic assisted movement has become an accepted method of treating the moderately-to-mildly impaired upper limb after stroke. Objective To determine whether, during the subacute phase of recovery, a novel type of robotic assisted training reduces moderate-to-severe impairment in the upper limb beyond that resulting from spontaneous recovery and prescribed outpatient therapy. Methods A prospective, randomized, double-blinded, placebo-controlled, semi-crossover study of 83 participants. Over 6- to 9-weeks, participants received 18, 30-min training sessions of the hand and wrist. The test intervention consisted of assisted motion, biofeedback, and antagonist muscle vibration delivered by a robotic device. Test Group participants received the test intervention, and Control Group participants received a placebo intervention designed to have no effect. Subsequently, Control Group participants crossed over to receive the test intervention. Results At enrollment, the average age (±SD) of participants was 57.0 ± 12.8 year and weeks since stroke was 11.6 ± 5.4. The average Fugl-Meyer baseline score of Test Group participants was 20.9, increasing by 10.8 with training, and in Control Group participants was 23.7 increasing by 6.4 with training, representing a significant difference (4.4) in change scores (P = .01). During the crossover phase, Control Group participants showed a significant increase in FMA-UL score (i.e., 4.7 ± 6.7 points, P = .003) as well as in other, more specific measures of impairment. Conclusions Robotic impairment-oriented training, as used in this study, can significantly enhance recovery during the subacute phase of recovery. Spontaneous recovery and prescribed outpatient therapy during this phase do not fully exploit the potential for remediating moderate-to-severe upper limb impairment. ClinicalTrials.gov Registry: NCT00609115–Subacute stroke rehabilitation with AMES

Validation of the portable virtual reality training system for robotic surgery (PoLaRS): a randomized controlled trial

BackgroundAs global use of surgical robotic systems is steadily increasing, surgical simulation can be an excellent way for robotic surgeons to acquire and retain their skills in a safe environment. To address the need for training in less wealthy parts of the world, an affordable surgical robot simulator (PoLaRS) was designed.MethodsThe aim of this pilot study is to compare learning curve data of the PoLaRS prototype with those of Intuitive Surgical’s da Vinci Skills Simulator (dVSS) and to establish face- and construct validity. Medical students were divided into two groups; the test group (n = 18) performing tasks on PoLaRS and dVSS, and the control group (n = 20) only performing tasks on the dVSS. The performance parameters were Time, Path length, and the number of collisions. Afterwards, the test group participants filled in a questionnaire regarding both systems.ResultsA total of 528 trials executed by 38 participants were measured and included for analyses. The test group significantly improved in Time, Path Length and Collisions during the PoLaRS test phase (P ≤ 0.028). No differences was found between the test group and the control group in the dVSS performances during the post-test phase. Learning curves showed similar shapes between both systems, and between both groups. Participants recognized the potential benefits of simulation training on the PoLaRS system.ConclusionsRobotic surgical skills improved during training with PoLaRS. This shows the potential of PoLaRS to become an affordable alternative to current surgical robot simulators. Validation with similar tasks and different expert levels is needed before implementing the training system into robotic training curricula.

Brain volumetric changes in the general population following the COVID-19 outbreak and lockdown

The coronavirus disease 2019 (COVID-19) outbreak introduced unprecedented health-risks, as well as pressure on the economy, society, and psychological well-being due to the response to the outbreak. In a preregistered study, we hypothesized that the intense experience of the outbreak potentially induced stress-related brain modifications in the healthy population, not infected with the virus. We examined volumetric changes in 50 participants who underwent MRI scans before and after the COVID-19 outbreak and lockdown in Israel. Their scans were compared with those of 50 control participants who were scanned twice prior to the pandemic. Following COVID-19 outbreak and lockdown, the test group participants uniquely showed volumetric increases in bilateral amygdalae, putamen, and the anterior temporal cortices. Changes in the amygdalae diminished as time elapsed from lockdown relief, suggesting that the intense experience associated with the pandemic induced transient volumetric changes in brain regions commonly associated with stress and anxiety. The current work utilizes a rare opportunity for real-life natural experiment, showing evidence for brain plasticity following the COVID-19 global pandemic. These findings have broad implications, relevant both for the scientific community as well as the general public.

Effects of an individualised training course in endodontics on the knowledge and insights of dentists in Public Dental Service in Norway

Objective To evaluate the knowledge and insights of general dental practitioners regarding endodontic diagnosis and treatment principles before and after attending a 2-days continuing education course. Materials and methods Sixty-seven dentists employed in the Public Dental Service in Møre and Romsdal county, Norway, were invited to a continuing education course in endodontics. Before and after the course, they answered a questionnaire weighing the importance of factors influencing the prognosis of endodontic treatment. The same questionnaire was answered by specialists in endodontics (n = 56; Spec Group) and a reference group consisting of general dental practitioners from both private and public practice (n = 21; Ref Group). The Test Group answered both before and after the course, while the Spec and Ref Groups completed the questionnaire once. The responses were compared using the Wilcoxon Sign test and Mann–Whitey U test. Results Of the 67 dentists in the Test Group, 49 (73%) completed the course and answered both questionnaires. Before attending the course, the Test Group differed significantly from the Spec Group in 18 out of 27 prognostic factors (p ≤ .05). After the course, there was only moderate improvement in the Test Group responses. On only three factors, they agreed significantly more with the specialists than before attending the course (p ≤ .05). After the Test Group participants had attended the course, their responses were comparable to the responses of the Ref Group. Conclusions A two-days continuing education course only marginally improved dentists’ level of knowledge and insights regarding the influence of prognostic factors in endodontics.

Human clinical trial to assess the effect ofconsumption ofmultigrain Indian bread on glycemic regulation intype 2 diabetic participants.

The efficacy of multigrain flatbread in regulating the lipid profile and carbohydrate homeostasis among type 2 diabetic patients was studied in 100 type 2 diabetic participants. The results revealed that the anthropometric parameters remained unaltered in both test and control groups. The fasting blood glucose levels (140.70±8.43 versus 132.89±5.63mg/dl) did not significantly decrease. In contrast, the insulin levels (12.96±1.06 versus 10.83±1.03 μIU/ml) and HbA1c levels (8.01±0.27 versus 7.40±0.21%) in the test group decreased significantly, and it was associated with a decrease in insulin resistance. The LDL levels in the test group decreased after the intervention (116.0±5.67 versus 98.7±5.68mg/dl), while triglycerides and VLDL increased significantly and HDL levels remained unaltered. A significant decrease in average blood pressure (systolic/diastolic) was noticed among the test group participants. The human RBP4 and hs-CRP remained unaltered. PRACTICAL APPLICATIONS: Millets are rich in fibers, has complex carbohydrate, protein, and is lower in fat content. Millets provide a wide range of nutrients, phytochemicals, and are gluten-free with low glycemic nature. Their intake can reduce factors such as insulin resistance and oxidative stress responsible for the pathogenesis of type 2 diabetes and cardiovascular diseases. Our study indicated the use of multigrain flatbreads prepared from millets helped reduce serum insulin, LDL cholesterol, HbA1c levels, and incidentally blood pressure levels with a significant increase in insulin sensitivity in type 2 diabetes participants. The results suggest using the multigrain flatbread meal as a food supplement or meal replacer in diabetic participants in terms of glucose control and insulin sensitivity.

Treatment Success and User-Friendliness of An Electric Toothbrush App: A Pilot Study.

Electronic and mobile health (eHealth/mHealth) are rapidly growing areas in medicine and digital technologies are gaining importance. In dentistry, digitalization is also an emerging topic, whereby more and more applications are being offered. As an example, using real-time feedback, digital application software (an app) was designed to help users brush their teeth more accurately. However, there is no data on the effectiveness and haptic of such apps. Therefore, a single-blinded, randomized controlled clinical trial was designed: twenty volunteers received an electric toothbrush with an associated app to assess whether the app-assisted toothbrushing is better than without. After a short period of familiarization with the electric toothbrush, plaque index (O‘Leary et al. 1972) was recorded and subjects were assigned to the test (with app; n = 10) or the control group (no app; n = 10). At the end of the 2-week pilot study period, plaque was again assessed and participants in the test group completed a questionnaire about the app’s user-friendliness. Statistical analysis revealed no significant differences between the test and control groups. The plaque index improved on average by 8.5% points in the test and 4.7% points in the control group. Fifty percent of the test group participants were of the opinion that they had achieved better cleaning results and would recommend the app to others, although the app contributed only marginally to increased plaque removal. However, such apps may nevertheless be helpful as motivational tools, especially when tracking and monitoring cleaning data. Therefore, more development and research on this topic is indicated.

Antioxidant therapy (lycopene and green tea extract) in periodontal disease: A promising paradigm.

Background:Increased oxidative stress has emerged as one of the prime factors in the pathogenesis of periodontitis. Hence, antioxidant therapy may become a promising tool in the treatment of periodontal disease. Uric acid (UA) being a major antioxidant in saliva can be used as a marker to assess the total antioxidant capacity.Aim:The aim of the study was to investigate the influence of orally administered antioxidants (lycopene and green tea extract) on periodontal health and salivary UA levels in gingivitis patients as an adjunct to scaling and root planing (SRP).Materials and Methods:Thirty systemically healthy participants having generalized gingivitis were randomly distributed into two groups. Control group participants received full mouth oral prophylaxis, while test group participants received oral lycopene and green tea extract (CLIK®) for 45 days along with complete oral prophylaxis. Plaque index (PI), sulcular bleeding index (SBI), and salivary UA levels were evaluated at baseline and 45 days after SRP. Data were analyzed with t-test, using SPSS software (PASW, Windows version 18.0).Results:Both treatment groups demonstrated statistically highly significant (P ≤ 0.001) reduction in plaque and SBI. After treatment, a highly significant increase (P ≤ 0.001) in the test group and significant (P ≤ 0.05) increase in the control group was observed for salivary UA levels. Posttreatment comparison between test and control group delineated statistically significant results in PI (P ≤ 0.001), SBI (P ≤ 0.001), and salivary UA levels (P ≤ 0.01).Conclusion:Lycopene with green tea extract may prove to be a promising adjunctive prophylactic and therapeutic modality in the treatment of gingivitis patients. However, further studies are needed to evaluate the additive effect of antioxidants with routine oral prophylaxis therapy.