Bruunbrewer5073

Introduction A satisfactory light source is of paramount importance during an oral head and neck examination. It has become common practice for the light source on a smartphone to be used during inpatient intra-oral examination. We determined if patients identified the use of a smartphone as a light source, during head and neck examinations, as unprofessional.Methods and materials A clinical photograph illustrating professional errors was presented to patients as a pilot survey (n = 10); a smartphone camera flash being used as a light source was featured. Patients were then asked which aspects they considered unprofessional. Following staff training and improvements to the survey wording, the same photo was presented to patients (n = 150) as the main study.Results Of the patients surveyed, 97% considered the use of a smartphone in the staged clinical photograph as unprofessional. They also noted a clinician sitting on the bed (88%), clinicians not wearing gloves (81%), lack of privacy/curtain not drawn (62%), long hair not tied back (50%), a clinician's name badge not visible (23%), clinician bare below the elbows (15%) and clinician not wearing a tie (12%).Conclusions This is the first piece of research into the use of a smartphone light source within clinical examination. The use of a smart phone light source during clinical examination was the most reported 'error' and was recognised more than a clinician not wearing gloves. Eighty-five percent of patients considered the use of a smartphone light source unprofessional. learn more Authors, therefore, do not advocate the use of a smartphone light source in the clinical care of patients.Introduction The COVID-19 pandemic has posed many challenges, including provision of urgent dental care. This paper presents a prospective service evaluation during establishment of urgent dental care in the North East of England over a six-week period.Aim To monitor patient volumes, demographics and outcomes at the North East urgent dental care centre and confirm appropriate care pathways.Main outcome methods Data were collected on key characteristics of patients accessing urgent care from 23 March to 3 May 2020. Analysis was with descriptive statistics.Results There were 1,746 patient triages (1,595 telephone and 151 face-to-face), resulting in 1,322 clinical consultations. The most common diagnoses were symptomatic irreversible pulpitis or apical periodontitis. Sixty-five percent of clinical consultations resulted in extractions and 0.8% in an aerosol generating procedure. Patients travelled 25 km on average to access care; however, this reduced as more urgent care centres were established. The majority of patients were asymptomatic of COVID-19 and, to our knowledge, no staff acquired infection due to occupational exposure.Conclusion The urgent dental care centre effectively managed urgent and emergency dental care, with appropriate patient pathways established over the six-week period. Dental preparedness for future pandemic crises could be improved and informed by this data.Dental caries continues to affect the British population, despite advances in prevention and management options. There are many treatment and preventive treatment strategies to address dental caries. Silver diamine fluoride (SDF) is a colourless alkaline solution containing silver and fluoride, which forms a complex with ammonia and has proven to be effective in management of dental caries. Additional dental benefits of SDF continue to be explored and discussed in the literature. SDF is a relatively new material which can be used to reduce and crystallise dental caries in a simple non-invasive treatment modality without the use of local anaesthetic. It can thus be well tolerated by children as a treatment technique and can be quickly applied to the isolated tooth without the need for extensive excavation. Currently, SDF is classified in the UK as a desensitising agent; however, it may be reclassified as a caries treatment agent at some stage and thus provide an effective non-invasive treatment for children's tooth decay. This would prevent the multiple admissions for dental extraction under general anaesthetic, as a simpler approach can be provided. This article will evaluate and review the literature behind SDF and provide details on its use and clinical application.This opinion is borne out of my involvement in and experience with colleagues at the International Association for Dental Research (IADR), the International Dental Federation (FDI) and the World Health Organisation (WHO), and seeks to provide a strong rationale for the dental profession embracing the advantages of a primary preventive agenda. Five key actions are used to emphasise our role in health and wellbeing, addressing inequalities, engaging more with other healthcare colleagues, being trans-sectoral (beyond health) in our approach and being prepared to embrace change. The thrust of the argument is that dentistry has been significantly undervalued in the healthcare field in the past, and can play a unique and leading role in future health and wellbeing through primary prevention.Aftershock occurrence is characterized by scaling behaviors with quite universal exponents. At the same time, deviations from universality have been proposed as a tool to discriminate aftershocks from foreshocks. Here we show that the change in rheological behavior of the crust, from velocity weakening to velocity strengthening, represents a viable mechanism to explain statistical features of both aftershocks and foreshocks. More precisely, we present a model of the seismic fault described as a velocity weakening elastic layer coupled to a velocity strengthening visco-elastic layer. We show that the statistical properties of aftershocks in instrumental catalogs are recovered at a quantitative level, quite independently of the value of model parameters. We also find that large earthquakes are often anticipated by a preparatory phase characterized by the occurrence of foreshocks. Their magnitude distribution is significantly flatter than the aftershock one, in agreement with recent results for forecasting tools based on foreshocks.Featured with a plethora of electric and magnetic Mie resonances, high index dielectric nanostructures offer a versatile platform to concentrate light-matter interactions at the nanoscale. By integrating unique features of far-field scattering control and near-field concentration from radiationless anapole states, here, we demonstrate a giant photothermal nonlinearity in single subwavelength-sized silicon nanodisks. The nanoscale energy concentration and consequent near-field enhancements mediated by the anapole mode yield a reversible nonlinear scattering with a large modulation depth and a broad dynamic range, unveiling a record-high nonlinear index change up to 0.5 at mild incident light intensities on the order of MW/cm2. The observed photothermal nonlinearity showcases three orders of magnitude enhancement compared with that of unstructured bulk silicon, as well as nearly one order of magnitude higher than that through the radiative electric dipolar mode. Such nonlinear scattering can empower distinctive point spread functions in confocal reflectance imaging, offering the potential for far-field localization of nanostructured Si with an accuracy approaching 40 nm. Our findings shed new light on active silicon photonics based on optical anapoles.Inflammatory bowel disease (IBD), a chronic relapsing gastrointestinal inflammatory disease, mainly comprises ulcerative colitis (UC) and Crohn's disease (CD). Although the mechanisms and pathways of IBD have been widely examined in recent decades, its exact pathogenesis remains unclear. Studies have focused on the discovery of new therapeutic targets and application of precision medicine. Recently, a strong connection between IBD and noncoding RNAs (ncRNAs) has been reported. ncRNAs include microRNAs (miRNAs), long noncoding RNAs (lncRNAs), and circular RNAs (circRNAs). The contributions of lncRNAs and circRNAs in IBD are less well-studied compared with those of miRNAs. However, lncRNAs and circRNAs are likely to drive personalized therapy for IBD. They will enable accurate diagnosis, prognosis, and prediction of therapeutic responses and promote IBD therapy. Herein, we briefly describe the molecular functions of lncRNAs and circRNAs and provide an overview of the current knowledge of the altered expression profiles of lncRNAs and circRNAs in patients with IBD. Further, we discuss how these RNAs are involved in the nosogenesis of IBD and are emerging as biomarkers.An amendment to this paper has been published and can be accessed via a link at the top of the paper.Generating insulin-producing cells (IPCs) from human pluripotent stem cells is a promising method for studying the molecular mechanism underlying pancreas development and a potential treatment source for type 1 diabetes. Previous studies have shown that miR-181c-5p is highly enriched in adult islets; however, its role in pancreatic β cell differentiation is poorly understood. In this study, we differentiated human induced pluripotent stem cells (hiPSCs) into IPCs in a stepwise process that recapitulated pancreas organogenesis and observed that miR-181c-5p continuously accumulated throughout the entire differentiation process. hiPSCs were transduced with lentiviral vectors containing human miR-181c-5p precursor, which significantly increased the endodermal markers SOX17, FOXA2, CXCR4 and GATA4 and pancreatic endocrine-specific gene expression, including PDX1, NKX6.1, MAFA and Insulin. miR-181c-5p overexpression exerted little effect on the efficiency of definitive endoderm, whereas it promoted the differentiation of pancreatic progenitors and IPCs, especially for NKX6.1-positive and insulin-positive cells differentiation. Transplanted these cells exhibit glucose-stimulated C-peptide secretion in vivo and protect mice from chemically induced diabetes. It was found that miR-181c-5p directly targets the 3'UTR of smad7 and TGIF2 mRNA, which are known to be endogenous repressors of TGF-β-smad2/3 signaling, to decrease their mRNA and protein levels. Furthermore, overexpressed miR-181c-5p led to an elevation of the smad2/3 phosphorylation levels in hiPSC-derived cells, while treatment with smad2/3 inhibitors following miR-181c-5p overexpression had opposite effects on IPC formation. These results suggest that miR-181c-5p is critically involved in pancreatic lineage commitment through direct repression of smad7 and TGIF2 and that it modulates TGF-β-smad2/3 signaling activation and increases the feasibility of using patient-specific hiPSCs for β cell replacement therapy for type 1 diabetes.The subversion of endocytic routes leads to malignant transformation and has been implicated in human cancers. However, there is scarce evidence for genetic alterations of endocytic proteins as causative in high incidence human cancers. link2 Here, we report that Epsin 3 (EPN3) is an oncogene with prognostic and therapeutic relevance in breast cancer. Mechanistically, EPN3 drives breast tumorigenesis by increasing E-cadherin endocytosis, followed by the activation of a β-catenin/TCF4-dependent partial epithelial-to-mesenchymal transition (EMT), followed by the establishment of a TGFβ-dependent autocrine loop that sustains EMT. link3 EPN3-induced partial EMT is instrumental for the transition from in situ to invasive breast carcinoma, and, accordingly, high EPN3 levels are detected at the invasive front of human breast cancers and independently predict metastatic rather than loco-regional recurrence. Thus, we uncover an endocytic-based mechanism able to generate TGFβ-dependent regulatory loops conferring cellular plasticity and invasive behavior.