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Identifying genetic risk factors for highly heterogeneous disorders like epilepsy remains challenging. Here, we present the largest whole-exome sequencing study of epilepsy to date, with >54,000 human exomes, comprising 20,979 deeply phenotyped patients from multiple genetic ancestry groups with diverse epilepsy subtypes and 33,444 controls, to investigate rare variants that confer disease risk. These analyses implicate seven individual genes, three gene sets, and four copy number variants at exome-wide significance. Genes encoding ion channels show strong association with multiple epilepsy subtypes, including epileptic encephalopathies, generalized and focal epilepsies, while most other gene discoveries are subtype-specific, highlighting distinct genetic contributions to different epilepsies. Combining results from rare single nucleotide/short indel-, copy number-, and common variants, we offer an expanded view of the genetic architecture of epilepsy, with growing evidence of convergence among different genetic risk loci on the same genes. Top candidate genes are enriched for roles in synaptic transmission and neuronal excitability, particularly postnatally and in the neocortex. We also identify shared rare variant risk between epilepsy and other neurodevelopmental disorders. Our data can be accessed via an interactive browser, hopefully facilitating diagnostic efforts and accelerating the development of follow-up studies., Competing Interests: Competing Interests B.M.N is a member of the scientific advisory board at Deep Genomics and Neumora. No other authors have competing interests to declare

Introduction: This study evaluates the impact of decontamination methods on Microtensile bond strength (μTBS) between resin cement and resin blocks., Methods: Twenty CAD/CAM resin blocks from two manufacturers were wet-polished, sandblasted, and ultrasonically cleaned. After blood and saliva contamination, blocks were divided into subgroups: control, water rinsing, acid etching, alkaline cleaning paste, or 10-MDP containing cleaner. Resin-based cement was then applied. After 24 hours, the blocks were sectioned to obtain bars for testing. Half of the specimens were tested immediately for μTBS, and the other half underwent artificial aging. The surfaces of the blocks were inspected with a scanning electron microscope (SEM). Three-way ANOVA was performed for μTBS values (α=0.05)., Results: In one of the substrates, the positive control subgroup obtained the highest value (56,01 MPa, SD:6,96) followed by 10-MDP cleaner and universal cleaning paste, when immediately tested, with significant differences respect to the water rinsing (p⟨0.041) and acid etching (p⟨0.048) groups. After thermocycling, higher values were found in the 10-MDP cleaner (47,57 MPa, SD:8,15), but differences were not significant. In the other substrate group, the 10-MDP cleaner subgroup showed highest bond strengths (64,46 MPa SD: 10,92) at the initial test. After thermocycling, 10-MDP cleaner (58,66 MPa, SD: 9,93) gave the highest μTBS value. Significant differences between water rinsing group and the rest of subgroups (p⟨0.001), and between 10-MDP cleaner and the positive control group (p⟨0.006) were observed., Conclusion: Cleaning after contamination improves bonding. 10-MDP containing cleaner can help to restore initial μTBS value and maintain it in the long-term., (Copyright© 2024 Dennis Barber Ltd.)

Objectives: To examine whether dentin-etching extension and/or the hydrophobic-rich content of hybrid layers would affect fatigue strengths of a mild universal adhesive after long-term aging., Methods: Twin-bonded resin-dentin interfaces were produced by etching sound midcoronal dentin beams with 32 % ortho-phosphoric acid for 15 s (OPA15s), 3 s (OPA3s) or 10 % meta-phosphoric acid for 15 s (MPA15s). Samples were bonded with a mild universal adhesive with or without additional coating using a solvent-free bisGMA-based bonding resin. Self-etch application served as control. Composite buildups were made with a nanofilled composite. Bar-shaped twin-bonded interfaces (0.9 × 0.9 × 12 mm) were aged for two years in artificial saliva at 37 ℃ and tested under 4-point flexure at quasi-static (n = 16) and cyclic loads (n = 35) until failure. The stress-life fatigue behavior was evaluated using the staircase method at 4 Hz. Crack initiation and fracture patterns were evaluated by SEM. Cyclic-loaded data was analyzed by Kruskal-Wallis on Ranks (α = 0.05)., Results: Significantly higher fatigue life distributions and higher endurance limits were observed for less aggressive etch-and-rinse protocols (OPA3s and MPA15s) after long-term ageing. Hydrophobic-rich coating produced 20-32 % higher endurance limits, prevented micrometer-sized porosities at bonded interfaces, reduced etching-associated variability and lowered crack formation. Significance Long-term hydrolysis produces detrimental effects on the fatigue strength of resin-dentin interfaces. The bond-promotion effect of less aggressive etch-and-rinse protocols and the creation of hybrid layers with higher hydrophobic-rich content are critical to extend the durability of mild universal adhesives. Therefore, current oversimplification trends in adhesive dentistry may limit resin-dentin bonding performance., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Learning tooth preparation techniques and the finesse required is an important part of preclinical dental education. Being able to practice surgical skills without loss of Frasaco® teeth while being provided with performance analysis data is a boon to students and educators. We investigated the combination of haptics-enhanced virtual reality (Simodont®) and conventional phantom head practice in a preclinical dental course, evaluating the students' performances and perceptions. Forty students were randomized into two groups: Group One began within a VR-haptic setting while Group Two worked with Frasaco® teeth. Halfway through the course the scenarios were switched. A crown preparation test on Frasaco® teeth was conducted at the end of the course. Students' performances and satisfaction were assessed anonymously. Analysis of the students' performances included clinical metrics (occlusal and axial reduction, convergence angle, damage to adjacent teeth). The perceived usefulness of VR-haptic and phantom head simulations was assessed. In Group One, the tooth preparation metrics were more in line with the requested parameters compared to Group Two. All students ranked VR-haptics highly regarding manual dexterity improvement. In conclusion, this study shows that by combining VR-haptics with conventional dental procedures, it is possible to improve important preparation metrics in fixed prosthodontics tooth preparation.

POU3F3 variants cause developmental delay, behavioral problems, hypotonia and dysmorphic features. We investigated the phenotypic and genetic landscape, and genotype-phenotype correlations in individuals with POU3F3-related disorders. We recruited unpublished individuals with POU3F3 variants through international collaborations and obtained updated clinical data on previously published individuals. Trio exome sequencing or single exome sequencing followed by segregation analysis were performed in the novel cohort. Functional effects of missense variants were investigated with 3D protein modeling. We included 28 individuals (5 previously published) from 26 families carrying POU3F3 variants; 23 de novo and one inherited from an affected parent. Median age at study inclusion was 7.4 years. All had developmental delay mainly affecting speech, behavioral difficulties, psychiatric comorbidities and dysmorphisms. Additional features included gastrointestinal comorbidities, hearing loss, ophthalmological anomalies, epilepsy, sleep disturbances and joint hypermobility. Autism, hearing and eye comorbidities, dysmorphisms were more common in individuals with truncating variants, whereas epilepsy was only associated with missense variants. In silico structural modeling predicted that all (likely) pathogenic variants destabilize the DNA-binding region of POU3F3. Our study refined the phenotypic and genetic landscape of POU3F3-related disorders, it reports the functional properties of the identified pathogenic variants, and delineates some genotype-phenotype correlations., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Due to favourable biological and physical properties, calcium silicate-based cements (CSCs) are biocompatible materials used widely for vital pulp therapies. Sealing efficacy between the adhesive system and CSC determines the clinical success of treatment. This study aimed to evaluate the shear bond strength (SBS) of CSC to composite resin with different adhesive systems and to analyse the CSC-composite interface. Mineral trioxide aggregate (MTA) (ProRoot MTA; Dentsply Tulsa Dental, Tulsa, OK), Biodentine (Septodont, Saint-Maur-des-Fossés, France) and NeoMTA Plus (Avalon Biomed Inc., Bradenton, FL) samples (n = 90) were placed in the cavities and divided into three subgroups according to the adhesive family (n = 10). SBSs were measured using a universal testing machine. The interfaces were examined using a scanning electron microscope (SEM) (×1000). NeoMTA Plus showed significantly higher SBS values than MTA and Biodentine (P < 0.0001). The application of total-etch adhesive system over Biodentine and NeoMTA Plus provided the statistically highest bond strength (P < 0.05). However, when the SBS values of MTA subgroups were compared, different adhesive families applied over MTA did not make a significant difference in SBS values (P > 0.05). Based on SEM analyses, the specimens exhibit no gaps, cracks or delamination within the adhesive layer, which indicates a good adhesion between the CSC-composite interface in all subgroups. In conclusion, the different adhesive families used over CSC did not influence interfacial gap formation., (© 2021 Australian Society of Endodontology Inc.)

Objective: To determine whether smear layer management, via conservative etching protocols, and the hydrophobic-rich content of hybrid layers would affect the fatigue strength of resin-dentin interfaces., Methods: Bar-shaped dentin beams obtained from sound third molars were wet-polished for 30 s. Dentin was etched with 32 % ortho-phosphoric acid for 3 or 15 s, 10 % meta-phosphoric acid for 15 s or by a prime-and-rinse application using a mild universal adhesive (Scotchbond Universal, 3M ESPE). Self-etch application served as control. Coating was performed with a solvent-free bisGMA-based resin. Composite buildups were made with a nanofilled composite. Resin-dentin beams with twin-bonded interfaces were sectioned and stored in deionized water for 24 h at 37 ℃ before 4-point flexural quasi-static monotonic testing (n = 16). Stress-life fatigue behavior was evaluated under cyclic loading (n = 35) by the staircase method at 4 Hz. The tension side of cyclic-loaded unfractured beams were evaluated under SEM, along with the micro-morphology of etched dentin surfaces. Monotonic data was analyzed by two-way ANOVA followed by the Tukey Test and cyclic-loaded data by Kruskal-Wallis on Ranks (α = 0.05)., Results: Etching protocols and higher hydrophobic-rich content produced significantly higher fatigue life distributions (p < 0.05). Dentin demineralization was ranked as OPA 15 s > MPA 15 s > OPA 3 s > P + R > SE. Less aggressive etching and coating reduced crack formation at hybrid layers., Significance: Current oversimplification trends in resin-dentin bonding constitute a trade-off between hybridization quality and easier adhesive handling. Controlled dentin etching and increasing the hydrophobic-rich content of hybrid layers may be necessary to extend the longevity of mild universal adhesives., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to determine caries prevalence, oral health practices/behaviours and dental anxiety levels amongst dental hygiene students., Materials and Methods: A self-administered questionnaire was used to determine students' oral hygiene practices/behaviours. The students were subjected to oral examinations to determine their decayed, missing, filled teeth (DMFT) scores according to the WHO criteria. In addition, the Corah's Dental Anxiety Scale (CDAS) was used to measure the students' dental anxiety levels., Results: A total of 280 students (mean age: 20.8 years) participated in this study. Amongst the students, 52.8% brush their teeth twice a day, and 17.48% and 15.17% use floss and mouthwash daily, respectively. Moreover, the defined smoking rate was 22.85%. The mean DMFT scores of the preclinical and clinical students were 3.39 ± 3.22 and 3.55 ± 3.19, respectively. Most of the students (82.6%) preferred fluoride toothpaste, and the DMFT scores of those who use and do not use fluoride toothpaste significantly differed (p = 0.031). Furthermore, junk-food consumption affected the scores for decayed teeth (p = 0.048) and missing teeth (p = 0.039). Most students had low or moderate CDAS scores (CDAS <13), and anxiety scores were lower amongst the clinical students than amongst the preclinical students., Conclusions: Although the students demonstrated favourable oral health behaviours/practices and low caries prevalence, their adherence to oral hygiene instructions and to healthy dietary and lifestyle habits should improve. The importance of this topic should be strongly emphasized in the undergraduate curriculum. For this purpose, professional behavioural control methods that suit students' individual capacities, motivations and therapeutic needs may be employed. The principal findings of similar studies should be evaluated by lecturers to help students adopt optimal oral health practices/behaviours, reducing their dental anxiety levels and improving their professional competencies., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: This study aimed to evaluate the educational concerns and awareness level among dental hygiene students during the COVID-19 pandemic., Materials and Methods: A questionnaire, created via Google Forms, was sent electronically to 240 dental hygiene students from Turkey, of which 223 replied to the survey. The questionnaire was divided into 4 parts and consisted of 24 close-ended questions., Results: The main symptoms of COVID-19 were correctly recognized by 71% of the students, and 40.2% of the students were aware of the transmission routes. Of all, 77.1% of the students expressed fear of getting infected, 96.9% believed that they would more likely get infected while performing dental procedures, and 91% believed that dental hygienists' cross-contamination risk was high. Furthermore, 69.5% of the students stated that their undergraduate education process was negatively affected, 59.6% appreciated ongoing online education, and 31.8% wanted face-to-face clinical internships., Conclusions: Although most of the students were aware of the transmission routes and preventive measures of COVID-19, concerns regarding disease transmission among them remain. Students appreciated the ongoing online education and believed that face-to-face education is risky during this current pandemic. However, they believe that this process can adversely affect their professional knowledge and especially practical skills. A balance must be struck between sustaining an effective dental hygiene education process and containing the spread of COVID-19., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Human mitochondrial disease exhibits large variation of clinical phenotypes, even in patients with the same causative gene defect. We illustrate this heterogeneity by confronting clinical and biochemical data of two patients with the uncommon pathogenic homoplasmic NC&#95;012920.1(MT-ATP6):m.9035T>C variant in MT-ATP6 . Patient 1 presented as a toddler with severe motor and speech delay and spastic ataxia without extra-neurologic involvement. Patient 2 presented in adolescence with ataxia and ophthalmoplegia without cognitive or motor impairment. Respiratory chain complex activities were normal in cultured skin fibroblasts from both patients when calculated as ratios over citrate synthase activity. Native gels found presence of subcomplexes of complex V in fibroblast and/or skeletal muscle. Bioenergetic measurements in fibroblasts from both patients detected reduced spare respiratory capacities and altered extracellular acidification rates, revealing a switch from mitochondrial respiration to glycolysis to uphold ATP production. Thus, in contrast to the differing disease presentation, biochemical evidence of mitochondrial deficiency turned out quite similar. We conclude that biochemical analysis remains a valuable tool to confirm the genetic diagnosis of mitochondrial disease, especially in patients with new gene variants or atypical clinical presentation.

Autosomal recessive cerebellar ataxias (ARCA) are characterized by the abnormal structure of the cerebellum and spinal cord. Spinocerebellar ataxia type 18 (MIM 616204), one of the ARCA, is caused by the loss-of-function mutations of the GRID2 gene due to deletions. Missense mutations in the GRID2 cause ataxia with the gain-of-function mechanism. We report a homozygous GRID2  duplication in childhood-onset ataxia in two siblings. The clinical exome sequencing was performed on one of the siblings. No disease-causing mutations were reported as a result of the clinical exome test. Chromosomal microarray analysis was performed on the entire family using Affymetrix Optima ® chips. Chromosomal microarray analysis showed a ~ 121-kb homozygous duplication of GRID2 (arr[GRCh37]4q22.2(94426536&#95;94613158) × 4), including exon 14, in both siblings. Previously, GRID2 has been associated with an autosomal recessive (loss-of-function) and autosomal semi-dominant (gain-of-function) forms of ataxia. To the best of our knowledge, this is the first study to identify a homozygous duplication of GRID2 causing loss of function of the GluRD2 protein. These findings provide us with the conclusion that copy number variation analyses should be in the diagnostic process of autosomal recessive ataxia types., (© 2020. Belgian Neurological Society.)

Kabuki syndrome (KS) is a disease characterized by distinctive facial features, skeletal anomalies and delay in neuromotor development. KS 1 is an autosomal dominant condition caused by mutations in the KMT2D gene, whereas KS 2 is an X-linked disorder caused by mutations in the KDM6A gene. In the majority of KS patients who present with hypoglycemia, KDM6A is the defective gene. A 9-month old girl was admitted to our emergency department due to a seizure. On physical examination, hypotonia, mild facial dysmorphism, brachydactyly of the 5 th finger, prominent finger pads and pansystolic murmur were detected. A fasting glucose tolerance test was performed the next day due to her history of hypoglycemia, but she had convulsions at the fifth hour of the test. Her serum glucose was 24 mg/dL, insulin 1.94 mIU/L, C-peptide 0.94 ng/mL, growth hormone 11 ng/mL, anti-insulin antibody 4.2 IU/mL, cortisol 19.8 μg/dL, and adrenocorticotropic hormone 9.3 pg/mL. A diagnosis of hyperinsulinemic hypoglycemia was considered. Given the abnormalities, genetic analysis for congenital hyperinsulinism, including the genes causing KS was performed. A heterozygous frameshift mutation (c.2579del, p.Leu860Argfs*70) was detected in the KMT2D gene. Epilepsy and other neurological symptoms may be seen in KS patients and in some of these the neurological symptoms are the result of hypoglycemia. In such cases, the detection and prevention of hypoglycemia can help prevent the progression of neurological symptoms. We suggest considering the diagnosis of KS for patients with hypoglycemia and dysmorphic features, even if the patient does not manifest all features of KS.

Objectives: The aim of this study was to evaluate the effect of the work environment and expertise/specialty degree  of dentists on their behavior, awareness, and  attitudes regarding cross-infection control during the COVID-19 pandemic., Design: The study population consisted of Turkish dentists who work in private clinics, public clinics and university hospitals. The demographic information of the participants, their awareness of the COVID-19 acute respiratory disease, and clinical measures taken against cross-infection were evaluated with an online survey. Between the 10 th  and 20 th  of November 2020, 2,400 surveys were e-mailed to dentists., Results: A total 454 professionals answered the survey. According to the results, 29.3% of the participants performed only urgent care during the pandemic period, whereas 59.9% of them performed both urgent and routine treatments. Among the responding dentists, 90.6% stated that they were worried about aerosol-generating dental procedures, but there was no differences between genders (p = 0.119). Most participants, especially specialists (p = 0.160) , applied strict cross-infection control methods during the COVID-19  pandemic (77.2%). These dentists used personal protective equipment (PPE) at rates that varied between 75.5% and 98.4%. Nonetheless, the rate of PPE use was different between genders and degrees of expertise: women used PPE more frequently than men (p = 0.025), and specialists used PPE more often than the other dentists (p = 0.04). Finally, there was a weak positive correlation between the level of PPE use and expertise (r = 0.121; p = 0.010)., Conclusions: Despite the overall knowledge of the participants regarding COVID-19 symptoms, transmission routes, and the guidelines needed to prevent the virus from spreading, the dental specialists followed infection control methods more strictly. Even though the participants were concerned about dental practices that create microbial aerosols during the pandemic period, they continued their clinical routines using high PPE levels and taking extra clinical precautions to avoid cross-infection., Competing Interests: Conflicts of interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2021 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: To characterize whether the bonding performance and fatigue strength of resin-dentin interfaces created by a universal adhesive would be affected by different H 3 PO 4 -application times to more accurately assess long-term durability., Methods: Mid-coronal flat dentin surfaces with standardized smear-layers were produced on sound third molars, etched with 32% H 3 PO 4 for 0, 3 and 15 s, bonded with a mild universal adhesive (3M-ESPE) and restored with a nanofilled composite. Bonded specimens (0.9 × 0.9 mm) were stored in deionized water for 24 h and sectioned into beams for microtensile testing (n = 10). Resin-dentin beams were tested under tension until failure (0.5 mm/min) after 24 h or 6 month storage in artificial saliva at 37 ̊C. Bar-shaped resin-dentin beams (0.9 × 0.9 × 12 mm) were tested under 4-point-flexure initially at quasi-static loads (n = 22) and then under cyclic loads (n > 50). The stress-life fatigue behavior was evaluated using the twin-bonded interface approach by the staircase method at 4 Hz. Fractured interfaces and the tension side of unfractured beams were evaluated under SEM, along with the micro-morphology of the etched dentin surfaces and hybrid layers. Data were analyzed by ANOVA and Tukey test and Wilcoxon Rank Sum Test (α = 0.05)., Results: Quasi-static loads were limited to discriminate the bonding performance of resin-dentin interfaces. Application modes significantly affected etching patterns, fatigue strength, endurance limits and hybrid layer morphology (p < 0.001)., Significance: Reductions in fatigue strength of self-etched bonded interfaces raise concerns about the true ability of universal adhesives to properly bond to dentin., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: As a measure of the leadership diversity in prosthodontics, the number and percentage of women and nonwhite Presidents of prosthodontics organizations is unknown., Purpose: The purpose of this observational study was to calculate and compare the number and percentage of women and nonwhite Presidents of 10 selected prosthodontic organizations over the past 20 years and to determine whether the number of women and nonwhite Presidents has changed over the time frame of 2000-2019 in comparison to male and white Presidents., Material and Methods: The number of women and nonwhite Presidents of the Academy of Prosthodontics (AP), American Academy of Fixed Prosthodontics (AAFP), American Academy of Maxillofacial Prosthetics (AAMP), American College of Prosthodontists (ACP), American Prosthodontic Society (APS), European Prosthodontic Association (EPA), International Association of Dental Research - Prosthodontics group (IADR-P), International College of Prosthodontists (ICP), Greater New York Academy of Prosthodontics (GNYAP), and Pacific Coast Society for Prosthodontics (PCSP) was recorded. The chi-square test was used to determine differences in the percentage of women and nonwhite Presidents over time and between organizations., Results: The range of women Presidents in the selected years was 20% (EPA) to 0% (APS) with a mean of 10%. No statistically significant differences over time and between organizations were observed. The range of nonwhite Presidents in the selected years was 25% (ICP) to 0% (AAFP, AAMP, ACP, and GNYAP) with a mean of 7.5%. No statistically significant difference over time was observed while a statistically significant difference between organizations was observed (P=.015). Multiple comparisons revealed the ICP had significantly more nonwhite Presidents in the selected years., Conclusions: The relatively low numbers of women and nonwhite Presidents in the organizations studied is compelling evidence that there are an insufficient number of women and nonwhite role models in prosthodontics and that important voices representing the diversity of members of the prosthodontic community remain unheard., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Neonatal diabetes mellitus (NDM) is a monogenic form of diabetes, usually occurring in the first 6 months of life. Here, we present a newborn, which was admitted with epileptic seizure on the postnatal second day of life. Sepsis and meningitis were ruled out. Cranial imaging and electroencephalography revealed normal. She developed transient NDM on the follow-up and was diagnosed to carry an ABCC8 mutation. Although the neurological features are more common in patients with KCJN11 mutations, patients with ABCC8 mutations could also represent with subtle neurodevelopmental changes or even with epileptic seizures. The genetic testing and appropriate therapy is important in this patient group for predicting clinical course and possible additional features., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)

This study evaluated the cytotoxicity of methacrylate-based resins containing dimethyl sulfoxide (DMSO). DMSO was incorporated into hydrophobic (R2) and hydrophilic (R5) resins at weight concentrations of 0, 0.01, 0.1, 1, 5, or 10 w/w %. Resin discs (n = 10/group) were prepared. Human gingival fibroblasts (HGF-1) were exposed to resin eluates for 24 h. Furthermore, dentin barrier test was performed using 3-D cultures of odontoblast-like cells (SV40 transfected pulp derived cells) with dentin slices of 400 µm thickness (n = 8). After acid etching of dentin, DMSO-modified resins were applied into the cavity part of the device and light-cured for 20 s. Cell viability (%) was assessed by MTT and analyzed spectrometrically. Data were analyzed by ANOVA and Tukey test (α = 0.05). Resin eluates showed statistically significantly lower % cell viability for all neat and DMSO-modified resins than seen for the negative control. Moreover, DMSO-R5 eluates resulted in significantly lower % cell viability than DMSO-R2 emulates. The dentin barrier test showed that DMSO-R2 did not result in significantly lower % cell viability, whereas incorporation of 1-10 w/w % DMSO into R5 resulted in significantly lower % of cell viability. Incorporating DMSO into hydrophilic self-etching resins may increase cytotoxicity. The biocompatibility is not influenced by the addition of DMSO into hydrophobic resin., (© 2021 European Journal of Oral Sciences.)

Background: Little is known about the relationship between sensory processing and motor development in very preterm infants. The purpose of this study was to explore the relationship of motor development with sensory processing among such infants with developmental delay and those who had typical development at the ages of 8 and 12 months., Methods: This prospective case-control study included 61 preterm infants (31 males, 30 females, mean gestational age: 29.1 weeks). The infants had a gestational age of 32 weeks or less and a current corrected age of 8 months, and they had spent at least 15 days in the neonatal intensive care unit. Motor development was assessed with the Neuro-sensory Motor Developmental Assessment (NSMDA), and sensory processing was evaluated with the Test of Sensory Functions in Infants (TSFI)., Results: There were very strong positive correlations between the gross and fine motor scores of the NSMDA and the TSFI`s subdomain scores and total scores (r=0.85-0.93, p < 0.001). There were also very strong negative correlations between the functional level according to the NSMDA and the subdomain scores and total scores of the TSFI (r=-0.89-0.94, p < 0.001)., Conclusions: The results show that sensory processing and motor development are related parts of the development of very preterm infants. In the early rehabilitation process, therapists should comprehensively take motor and sensory development into consideration.

Background/purpose: MS and LB, the primary bacteria groups responsible for dental caries, and high levels of these bacteria in the mother promote transmission from mother to infant. The aim of this study was prevention of maternal MS and LB transmission on infants by using different preventive strategies and inhibition of early childhood caries proggession., Materials and Methods: This study was conducted with 50 mother-child pairs who were randomly allocated into either a study group or a control group (n = 25 each). Mothers in the study group were enrolled in a detailed preventive program that included elimination of dental caries with restorative and antibacterial procedures, whereas those in the control group received only a single episode of oral-health education., Results: After 18 months, significant MS and LB inhibition was observed in the study group (p < 0.0001). In addition, caries prevalence in the infants in the study and control groups was 0% and 20% respectively, and the difference between the two groups was statistically significant (p = 0.020)., Conclusion: These results indicate that primary preventive intervention and oral-health instruction can significantly inhibit the MS and LB levels of mothers and prevent caries in their children during the early years of life., Competing Interests: The authors declare that they have no conflict of interest., (© 2020 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.)

Statement of Problem: Leadership platforms in the professions include invitations to speak at the meetings of major organizations. However, the percentage of women speakers at prosthodontic meetings is lower than that of women prosthodontists overall. Recommendations or reporting requirements to address this deficiency are lacking., Purpose: The purpose of this observational study was to determine the probability of the number of women speakers at any scientific meetings of 6 different prosthodontic organizations over the past decade occurring by chance alone and to make recommendations for scientific program committees and organizations regarding the number of women speakers at future meetings., Material and Methods: The number of men and women speakers at the 2009-2018 annual meetings of the Academy of Prosthodontics (AP), American Academy of Fixed Prosthodontics (AAFP), American College of Prosthodontics (ACP), American Prosthodontic Society (APS), Greater New York Academy of Prosthodontics (GNYAP), and Pacific Coast Society for Prosthodontics (PCSP) was recorded. The chi-square test was used to determine differences in the percentage of women speakers over time and between organizations. The BINOM.DIST function was used to calculate the probability of selecting the exact number of women speakers at each meeting (α=.05)., Results: The mean percentage of women speakers across all organizations and all years was 10.80%. The percentage ranged from 0.00% (AAFP 2013; ACP 2013; APS 2012, 2015; GNYAP 2009, 2014; and PCSP 2009, 2010, 2011) to 42.86% (AP 2013). No change in women speaker presence was observed over the time frame investigated. The AP had significantly more women speakers than the other organizations. Of the 60 meetings included, 25 meetings had a statistically significantly low number of women speakers, and 1 meeting had a statistically significantly high number of women speakers., Conclusions: The number of women speakers at the scientific meetings of the organizations analyzed was significantly low and has not changed significantly over the years from 2009 to 2018. There were significantly more women speakers at the scientific meetings of the Academy of Prosthodontics than in the 5 other major prosthodontic organizations over the years 2009 to 2018. A recommendation is made that prosthodontic organizations include more women speakers on scientific programs. Specifically, a minimum of 25% of speakers should be women (rolling 3-year average) or 25% of podium time should be for women speakers (rolling 3-year average)., (Copyright © 2019 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Phosphomannomutase 2 deficiency (PMM2-CDG) is an autosomal recessive congenital disorder of glycosylation, characterized by multisystem phenotypes, mostly including neurological involvement. In Turkey, due to high rates of consanguinity, many patients with autosomal recessive disorders have homozygous variants and these diseases are more common, compared to Europe. However, published reports of PMM2-CDG from Turkey are scarce. Here, we describe clinical and molecular characteristics of PMM2-CDG patients diagnosed in three centers in Turkey, using data obtained retrospectively from hospital records. We also analyzed an in-house exome database of 1,313 individuals for PMM2 variants and estimated allele, carrier and disease frequencies, using the Hardy-Weinberg law. Eleven patients were identified from 10 families, displaying similar characteristics to previous publications, with the exception of the first report of epilepsia partialis continua and increased prevalence of sensorineural hearing loss. p.Val231Met was the most common variant, and was homozygous in four patients. This novel genotype results in a neurological phenotype with subclinical visceral involvement. Exome database analysis showed an estimated prevalence of 1:286,726 for PMM2-CDG, which is much lower than expected (1:20,000 in Europe) because of the lack of predominance of the common European p.Asp141His allele, associated with a severe phenotype (allele frequency of 1:2,622 compared to 1:252 in gnomAD). These data suggest that prevalence, phenotypes and genotypes of PMM2-CDG in Turkey differ significantly from those in Europe: Milder phenotypes may be more common, but the disease itself rarer, requiring a higher clinical suspicion for diagnosis. The association of sensorineural hearing loss with PMM2-CDG warrants further study., (© 2020 Wiley Periodicals, Inc.)

Aim: To investigate the relationship between motor and sensory development in the first 4 months of life in preterm infants born at 32 gestational weeks and below., Material and Methods: The study consisted of 56 high-risk infants with a corrected age of 1 month who were born at 32 gestational weeks and stayed in the neonatal intensive care unit for at least 15 days. Neuro Sensory Motor Developmental Assessment and Infant Sensory Profile-2 were used for evaluation. These assessments were applied to preterm infants at the 1 st and 4 th months. The results of assessments were analyzed using the Wilcoxon test. The relationship between the results of motor and sensory assessments was analyzed using Spearman's correlation test., Results: The mean gestational age of the infants was 29.58±2.09 weeks, their birth weights were 1233.87±251.22 grams, and their duration of stay in the neonatal intensive care unit was 26.48±9.58 days. There was a statistically significant difference between the Neuro Sensory Motor Developmental Assessment and Infant Sensory Profile-2 scores between the 1 st and 4 th months (p<0.05). It was found that there was a risk in terms of sensory development in 86-91% of the preterm infants at the 1 st month and in 69-85% at the 4 th month. There was moderate-strong degree of significant relationship between motor and sensory development., Conclusion: Considering the findings of our study, preterm infants are at risk for motor and sensory development. There is, therefore, a need for future research to investigate the effect of early sensory-based intervention approaches on preterm infants., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (Copyright: © 2020 Turkish Archives of Pediatrics.)

Statement of Problem: Leadership platforms in the professions include invitations to speak at major organization meetings. However, speaker profiles from underrepresented groups at annual scientific meetings of prosthodontic organizations have not been reported., Purpose: The purpose of this observational study was to determine the percentage of women invited to speak at selected prosthodontic organization meetings., Material and Methods: The number of men and women speakers at the 2009, 2014, 2015, 2016, 2017, and 2018 annual meetings of the Academy of Prosthodontics, American Academy of Fixed Prosthodontics, American College of Prosthodontics, American Prosthodontic Society, Greater New York Academy of Prosthodontics, and Pacific Coast Society for Prosthodontics were recorded. The chi-square test was used to determine differences in the percentage of women speakers over time and between organizations., Results: A total of 781 speakers in the years 2009 and 2014 to 2018 from the scientific meetings of the 6 prosthodontic organizations reviewed met the inclusion criteria. Of the 781 speakers, 693 (88.7%) were men and 88 (11.3%) were women. No significant differences were noted between organizations nor did the number of women speakers change significantly over time., Conclusions: The number of women speakers at scientific meetings is lower than that of women prosthodontists and has not changed significantly over the past decade., (Copyright © 2019 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: The effectiveness of leadership education for prosthodontists is unknown., Purpose: The purpose of this survey study was to evaluate the self-perceived impact a 2- to 2.5-day leadership education workshop in prosthodontics had on participants' professional, leadership, and management development., Material and Methods: Participants who attended a leadership workshop for future leaders in prosthodontics (FLIP) were surveyed to assess their self-reported improvements in different leadership domains. The survey was administered to 89 participants using an online survey tool, and demographic data about participants were also collected. Results were tabulated for descriptive presentation. Where applicable, the Spearman correlation coefficients were calculated., Results: Seventy-two individuals responded to the invitation for a response rate of 80.9%. Improvement in all 11 leadership capabilities assessed in the survey was noted by over 75% of respondents. Over 90% of respondents reported improvement in overall leadership, career management, team management, self-awareness, problem-solving, and conflict resolution. No significant (P>.13) relationships were found among demographic data such as age, sex, home continent, or primary career focus (academics or private practice)., Conclusions: Within the limitations of this survey study, participants in a leadership workshop noted improvement in a variety of leadership capabilities., (Copyright © 2019 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives:  The purpose of this in vitro study was to investigate the effects of different disinfection methods on microleakage of Class V Giomer restorations., Materials and Methods:  Class V cavity preparation was performed on 40 sound permanent central incisors. Class V cavities (3 x 2 x 2 mm) were prepared on the buccal surfaces of the selected teeth. The teeth were randomly divided into four groups, each to be disinfected with a different method: Group 1-Disinfection with 2% chlorhexidine, Group 2-Disinfection with 6% sodium hypochlorite, Group 3-Disinfection with erbium, chromium: yttrium-scandium-gallium-garnet laser, Group 4-Control (distilled water). BeautiBond adhesive and Beautifil II Giomer restoration materials were applied to all surfaces of the cavities after the disinfection of all groups. The teeth were thermocycled 5,000 times (5-55°C), and then were immersed in 0.5% methylene blue for 24 hours. After rinsing, the teeth were longitudinally sectioned and dye penetration was assessed under a stereomicroscope (40x) to evaluate microleakage., Statistical Analysis:  The results were statistically evaluated by using the Kruskal-Wallis and Mann-Whitney U tests., Results:  Statistically, no significant difference was found between all four groups ( p > 0.05). There was no statistically significant difference in microleakage scores of study groups ( p > 0.05). Also, the microleakage scores of the gingival margins were significantly higher than the incisal margins ( p < 0.0001)., Conclusions:  Application of the different cavity disinfectants has no effect on the microleakage of Class V Giomer restorations., Competing Interests: None declared., (Dental Investigation Society.)

Objective: To understand dimethyl sulfoxide (DMSO) interaction with distinct methacrylate monomer blends and the impact on polymer formation by investigating the combined relationship among degree of resin hydrophilicity, presence of DMSO and specific physico/mechanical properties., Methods: One hydrophobic (R2) and one hydrophilic (R5) methacrylate-based resins with different monomer compositions were solvated in ascending DMSO concentrations (0, 0.01, 0.1, 1, 5, and 10 w/w %). Neat resins (0 w/w % DMSO) were used as controls. The degree of conversion was determined by Fourier-transform infrared spectroscopy. Polymer crosslinking density was indirectly measured by a modified ethanol-water two-stage solvation technique and the biaxial flexural strength was measured after 24 h and 30 days of water storage at 37 ̊C. Water sorption and solubility were gravimetrically assisted during 28 days of water storage to determine the kinetics of water-polymer interactions. Data were analyzed by ANOVA and Tukey test (α = 0.05)., Results: Incorporation of high DMSO-concentrations significantly increased the degree of conversion of all tested formulations, specifically for the hydrophobic resin (p < 0.05). Despite the increase in degree of monomer conversion, higher water sorption/solubility values and lower biaxial flexure strengths were detected as a result of reductions in polymer crosslink density (p < 0.05). In general, low DMSO-concentrations had no impact on the biaxial flexural strength, crosslinking density and water sorption/solubility (p < 0.05)., Conclusion: DMSO-monomer ratio and monomer composition are critical for new dental methacrylate-based adhesive formulations. High DMSO incorporation hampers physico/mechanical properties of methacrylate bonding resins, albeit to a lesser extend when hydrophilic resins are employed. Nonetheless, DMSO-solvated hydrophobic adhesives extensively outperform their hydrophilic correspondents. DMSO incorporation of 1w/w % may constitute a secure threshold regardless of monomer composition., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Matrix metalloproteinases (MMPs) and cysteine cathepsins (CCs) can break down unprotected type I collagen fibrils in dentin matrix. This study investigated the use of potassium fluoride (KF) as a potential inhibitor of MMPs and CCs in dentin. Demineralized dentin beams were divided into groups (n = 10 in each group) and incubated in artificial saliva (AS, control), either alone or with one of seven concentrations of KF (6-238 mM fluoride) for 1, 7, and 21 d. After 21 d, all groups were further aged in AS for 6 months. Total MMP activity was screened using the colorimetric MMP assay. The activities of MMP-2 and MMP-9 were investigated using gelatin zymography. At the end of each incubation, changes in loss of dry mass and CC-mediated or total dissolution of collagen peptides were measured via precision weighing, C-terminal crosslinked telopeptide of type I collagen (CTX), and hydroxyproline (HYP) assays. The beams were examined using scanning electron microscopy. After 21 d, total MMP activities, dry mass loss, and CTX release for the groups exposed to 179 and 238 mM fluoride were significantly lower compared with the control group. After 6 months, all groups showed similar total MMP activity, dry mass loss, and HYP release, and CTX levels were significantly lower when the fluoride concentration was ≥24 mM. Calcium fluoride (CaF 2 )-like precipitates were observed over the beams. In summary, KF significantly inhibited the catalytic activity of dentin matrix-bound CCs but did not seem to be effective for MMP-mediated activity., (© 2018 Eur J Oral Sci.)

Objective: Matrix metalloproteinases (MMPs) and cysteine cathepsins (CCs) are two distinct enzymatic pathways responsible for the degradation of collagen fibrils in demineralized dentin. NaF and KF have been shown to inhibit salivary MMP-2, -9 and CCs. This study investigated the inhibitory effect of calcium fluoride (CaF 2 ) on the dentin matrix-bound MMPs and CCs., Design: Phosphoric acid (10%)-demineralized dentin beams (1 × 2×6 mm) were incubated at 37 °C in an 1 ml of artificial saliva (AS, control), or AS with 6, 12, 24, 48, 120. 179 and 238 mM F containing CaF 2 (n = 10/group) for 1, 7 and 21 days. All groups were further incubated in AS only for 6 months. Total MMP activity, dry mass loss, CTX and hydroxyproline (HYP) analyses were performed after each incubation. The beams were examined under scanning electron microscopy (SEM). MMP-2 and MMP-9 activities were screened with gelatin zymography. Data were analyzed by using ANOVA and Tukey HSD tests (p = .05)., Results: The total MMP activity was similar for all groups after 21 days and 6 months. After 21 days, the cumulative mass loss and CTX levels were lower compared to control for the CaF 2 ≥48 and CaF 2 ≥120 mM, respectively (p < .05). After 6 months, no significant difference was detected in the dry mass loss and CTX compared to the control (p > .05), whereas HYP level was higher with F 24 and 238 mM groups. CaF 2 -like minerals were observed on the beams under SEM. There was no gelatinase inhibition in zymography., Conclusion: CaF 2 does not prevent the degradation of demineralized dentin matrices due to the catalytic activity of MMPs and CCs., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The objective was to evaluate effect of dimethyl sulfoxide (DMSO) on microtensile bond strength (µTBS) and nanoleakage (NL). Superficial dentin was acid-etched and pretreated with DMSO. Etch-and-rinse adhesive was applied and restored with resin composite incrementally. After 24 h, teeth were sectioned, stored in artificial saliva for 24-h or 6-months before µTBS evaluation. Failure modes were examined. Six beams per group were submitted to nanoleakage evaluation using SEM. Data were analyzed using ANOVA and Tukey's test (α=0.05). Pretreatment had no significant effect on µTBS after 24 h (p>0.05). After 6 months storage, µTBS of control decreased significantly, more than with the groups treated with 0.01% or higher (p<0.05). DMSO-pretreated groups preserved µTBS in all groups. After 6-months, all groups except 0.001% showed significantly lower nanoleakege compared to control (p<0.05). DMSO (0.01-20%) may improve the hybrid layer integrity and bonding durability. The best results were seen with low (1-5%) of DMSO concentrations.

Background: Results of epidemiologic studies have determined several risk factors for asthma in school-age children., Objective: To examine whether parental and perinatal risk factors, along with infantile feeding patterns, were associated with asthma in children with grass pollen allergy and allergic rhinitis., Methods: We retrospectively analyzed the data of our cohort, which consisted of children with allergic rhinitis. Only children with grass pollen sensitization were enrolled. A detailed questionnaire regarding demographic features and perinatal events was given to the parents., Results: A total of 293 children (200 boys [68.3%]; with median age, 10.2 years [interquartile range {IQR}, 7.4-13.0 years]) were included. A total of 109 children (37.2%) had accompanying asthma. The median age of onset of rhinitis symptoms was earlier (5.3 years [IQR, 4.0-8.0 years] versus 7.0 years [IQR, 5.0-10.0 years]; p = 0.001), histories of prematurity (16.7 versus 6.5%; p = 0.006), preeclampsia (5.5 versus 0%; p = 0.001), neonatal intensive care unit admission (15.1 versus 6.0%; p = 0.01), phototherapy (17.9 versus 7.1%; p = 0.004), early formula feeding (58.7 versus 41.2%; p = 0.006), and parental asthma (25.0 versus 11.4%; p = 0.002) were more frequent in children with asthma. Multivariate logistic regression analysis revealed prematurity (odds ratio [OR] 2.78 [95% confidence interval [CI],1.24-6.24]; p = 0.013), history of formula feeding (OR 1.81 [95% CI, 1.09-3.01]; p = 0.022), and parental asthma (OR 2.37 [95% CI, 1.22-4.63]; p = 0.011) were associated with asthma in school-age children with grass pollen-induced allergic rhinitis., Conclusion: Close monitoring of patients with these risk factors may help with an earlier diagnosis of asthma and prompt initiation of therapeutic interventions in children with allergic rhinitis and who were sensitized to grass pollen.

Bone modeling is a process that starts with fetal life and continues during adolescence. Complex factors such as hormones, nutritional and environmental factors affect this process. In addition to these factors, physical conditioning and medications that have toxic effects on bony tissue should be carefully considered in patient follow-up. Osteoporosis is a significant problem in pediatric population because of ongoing growth and development of skeletal system. Two types of osteoporosis are primary and secondary types and children with neuromuscular disabilities constitute a major group with secondary osteoporosis. Low bone mass in patients with cerebral palsy, spina bifida, and Duchenne muscular dystrophy cause increased bone fragility in even slight traumas. Maximizing peak bone mass and prevention of bone loss are very important to reduce the fracture risk in neuromuscular diseases. This article aims to review the determinants of bone physiology and bone loss in children with cerebral palsy, spina bifida, and Duchenne muscular dystrophy., (Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.)

This study investigated the antimicrobial efficacy and mechanical strength of hard and soft denture liners modified with benzalkonium chloride (BAC). The specimens (1 mm thickness, 8 mm diameter) were prepared by mixing 0.5, 1, 2 and 5 wt% BAC with soft (Sofreliner Medium, Tokuyama) and hard (Rebase II, Tokuyama) denture liners (n = 5/group). BAC was not added to the controls. Candida albicans ATCC 28366 (A 550  = 0.5) and Streptococcus mutans Ingbritt suspensions (A 550  = 0.35) were pipetted onto the specimens, and incubated for 4 h. The viable cells were collected, and determined by plate-culturing (CFU). The tests were repeated after the specimens were soaked in distilled water for 7 days. The mechanical strengths were evaluated by tear and 4-point flexural strength tests for soft and hard liners, respectively. The data were analyzed with ANOVA and Tukey's HSD tests at p = 0.05. C. albicans viability was lost in all groups of BAC-modified soft liners (p < 0.001), and S. mutans viability was reduced (p < 0.01), except of soaked BAC 0.5 wt% group (p > 0.05). For the hard liner, BAC 5 wt% killed the C. albicans and S. mutans cells both before and after soaked in water (p < 0.001). BAC 2 wt% showed comparable tear strength with the soft liner control (p > 0.05). BAC did not reduce the flexural strength of the hard liner (p > 0.05), except of BAC 5 wt% group (p < 0.01). BAC can be a promising agent reducing the C. albicans and S. mutans viability on the soft and hard denture liner surfaces.

Purpose: The purpose of this study was to determine in primary molars with carious exposures whether hemostasis at the exposure site and pulp orifice reflected inflammatory status of the pulp at the canal orifice based on cytokine levels., Methods: Forty mandibular primary molars with deep caries were included in the study. Teeth were divided into two groups: group A had teeth where hemostasis at the exposure site was achieved within five minutes, and group B had teeth where hemostasis at the exposure site could not be achieved within five minutes. Blood samples were harvested from the exposure sites and canal orifices. Cytokine levels for IL-1β, IL-2, IL-6, IL-8, IL-10, TNF-α, and PGE2 were measured using ELISA for all sample sites., Results: The IL-6 levels at the exposure sites were found to be significantly higher in group A when compared to group B, but there was no statistically significant differences in any of the cytokine levels at the canal orifices between the two groups., Conclusions: Controlling bleeding at the exposure site or canal orifices does not provide accurate assessment of inflammation at the canal orifice and may be misleading for diagnosing vital pulp treatment in primary teeth with a carious pulp exposure.

Objective: To investigate the repair bond strength of fresh and aged nanohybrid and hybrid composite resins using a universal adhesive (UA). Materials and methods: Fresh and aged substrates were prepared using two nanohybrid (Venus Pearl, Heraus Kulzer; Filtek Supreme XTE, 3 M ESPE) and one hybrid (Z100, 3 M ESPE) composite resin, and randomly assigned to different surface treatments: (1) no treatment (control), (2) surface roughening with 320-grit (SR), (3) SR + UA (iBOND, Heraus Kulzer), (4) SR + Silane (Signum, Ceramic Bond I, Heraeus Kulzer) + UA, (5) SR + Sandblasting (CoJet, 3 M ESPE) + Silane + UA. After surface treatment, fresh composite resin was added to the substrates at 2 mm layer increments to a height of 5 mm, and light cured. Restored specimens were water-stored for 24 h and sectioned to obtain 1.0 × 1.0 mm beams ( n  = 12), and were either water-stored for 24 h at 37 °C, or water-stored for 24 h, and then thermocycled for 6000 cycles before microtensile bond strength (µTBS) testing. Data were analyzed with ANOVA and Tukey's HSD tests ( p  = .05). Results: Combined treatment of SR, sandblasting, silane and UA provided repair bond strength values comparable to the cohesive strength of each tested resin material ( p  < .05). Thermocycling significantly reduced the cohesive strength of the composite resins upto 65% ( p  < .05). Repair bond strengths of UA-treated groups were more stable under thermocycling. Conclusions: Universal adhesive application is a reliable method for composite repair. Sandblasting and silane application slightly increases the repair strength for all substrate types., Competing Interests: The authors declare no conflict of interest.

The application of a cross-linker to demineralized dentin is reportedly effective at extending the durability of dentin bonds., Objective: To compare the effect of a cross-linker pretreatment on the fatigue crack growth resistance of resin-dentin bonds prepared with a two- vs. three-step adhesive system., Methods: Bonded interface Compact Tension (CT) specimens were prepared using commercial two- and three-step etch-and-rinse adhesives and compatible hybrid resin-composite. For the treated groups, adhesive bonding was preceded by a 1min application of an experimental carbodiimide (EDC) conditioner to the acid-etched dentin. The control groups received no such treatment. The fatigue crack growth resistance was examined after storage in artificial saliva at 37°C for 0, 3 and 6 months., Results: There was no significant difference in the immediate fatigue crack growth resistance the control and EDC-treated groups at 0 months for either adhesive system. After 3 and 6 months of storage, the EDC-treated groups exhibited significantly greater (p≤0.05) fatigue crack growth resistance than the controls. Although the EDC treatment was equally effective in deterring degradation for both adhesives, bonds prepared with the three-step system exhibited the lowest resistance to fatigue crack growth overall., Significance: An EDC treatment applied during dentin bonding could help maintain the durability of bonds prepared with two or three-step adhesive bonding systems., (Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Background: Childhood obesity may lead to neuronal impairment in both the peripheral and the central nervous system. This study aimed to investigate the impact of obesity and insulin resistance (IR) on the central nervous system and neurocognitive functions in children., Methods: Seventy-three obese children (38 male and 35 female) and 42 healthy children (21 male and 21 female) were recruited. Standard biochemical indices and IR were evaluated. The Wechsler Intelligence Scale for Children-Revised (WISC-R) and electroencephalography (EEG) were administered to all participants. The obese participants were divided into two groups based on the presence or absence of IR, and the data were compared between the subgroups., Results: Only verbal scores on the WISC-R in the IR+ group were significantly lower than those of the control and IR- groups. There were no differences between the groups with respect to other parameters of the WISC-R or the EEG. Verbal scores of the WISC-R were negatively correlated with obesity duration and homeostatic model assessment-insulin resistance (HOMA-IR) values. EEGs showed significantly more frequent 'slowing during hyperventilation' (SDHs) in obese children than non-obese children., Conclusions: Neurocognitive functions, particularly verbal abilities, were impaired in obese children with IR. An early examination of cognitive functions may help identify and correct such abnormalities in obese children.

Recently, de novo mutations in the gene KCNA2, causing either a dominant-negative loss-of-function or a gain-of-function of the voltage-gated K+ channel Kv1.2, were described to cause a new molecular entity within the epileptic encephalopathies. Here, we report a cohort of 23 patients (eight previously described) with epileptic encephalopathy carrying either novel or known KCNA2 mutations, with the aim to detail the clinical phenotype associated with each of them, to characterize the functional effects of the newly identified mutations, and to assess genotype-phenotype associations. We identified five novel and confirmed six known mutations, three of which recurred in three, five and seven patients, respectively. Ten mutations were missense and one was a truncation mutation; de novo occurrence could be shown in 20 patients. Functional studies using a Xenopus oocyte two-microelectrode voltage clamp system revealed mutations with only loss-of-function effects (mostly dominant-negative current amplitude reduction) in eight patients or only gain-of-function effects (hyperpolarizing shift of voltage-dependent activation, increased amplitude) in nine patients. In six patients, the gain-of-function was diminished by an additional loss-of-function (gain-and loss-of-function) due to a hyperpolarizing shift of voltage-dependent activation combined with either decreased amplitudes or an additional hyperpolarizing shift of the inactivation curve. These electrophysiological findings correlated with distinct phenotypic features. The main differences were (i) predominant focal (loss-of-function) versus generalized (gain-of-function) seizures and corresponding epileptic discharges with prominent sleep activation in most cases with loss-of-function mutations; (ii) more severe epilepsy, developmental problems and ataxia, and atrophy of the cerebellum or even the whole brain in about half of the patients with gain-of-function mutations; and (iii) most severe early-onset phenotypes, occasionally with neonatal onset epilepsy and developmental impairment, as well as generalized and focal seizures and EEG abnormalities for patients with gain- and loss-of-function mutations. Our study thus indicates well represented genotype-phenotype associations between three subgroups of patients with KCNA2 encephalopathy according to the electrophysiological features of the mutations., (© The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Application of collagen cross-linkers to demineralized dentin improves bond durability. While the benefits of cross-linking treatments to bond strength and fatigue resistance have been explored, changes in hybrid layer stiffness with aging have not been examined., Objective: To examine the influence of a cross-linking treatment using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) on hybrid layer stiffness of resin-dentin adhesive bonds, using spatially-resolved nanoscopic Dynamic Mechanical Analysis (nanoDMA)., Methods: Bonded interface specimens were prepared using a two-step (SB) or three-step (SBMP) etch-and-rinse adhesive. Adhesive bonding of the treated groups was preceded by a 1min application of an experimental EDC conditioner to the acid-etched dentin. Control specimens did not receive EDC treatment. The bonded interfaces were evaluated using nanoDMA to determine the dynamic mechanical properties after storage in artificial saliva at 37°C for 0, 3 and 6 months., Results: The EDC treatment had no influence on the dynamic mechanical properties of the hybrid layer immediately after bonding. There was also no reduction in the hybrid layer stiffness after 3 and 6 months aging as defined by the complex modulus and storage modulus. However, there was a significant reduction in the loss modulus and tanδ components (i.e. viscous behavior) of the hybrid layers with aging. Degradation occurred to both adhesive systems with storage, but was greatest for SB. Without EDC treatment, the reduction in tanδ of the hybrid layer prepared with SB exceeded 80% in 6 months., Significance: The application of EDC to acid-etched dentin helps maintain the viscoelasticity of hybrid layers., (Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Background: Childhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity., Objective: To investigate the correlation between anthropometric indices and pulmonary function test results in children without asthma., Methods: Children without any respiratory disorders were enrolled in this study. Anthropometric measurements, such as height, weight, neck circumference (NC), and waist circumference, were obtained from the enrollees and body mass index was calculated. Afterward, pulmonary function tests were performed using spirometry., Results: A total of 178 children (106 boys, 59.5%) with a mean age of 9.7 years were included the study. NC was above the 90th percentile in 65 children. Importantly, pulmonary parameters, such as forced expiratory volume during the first second (FEV 1 ) and the ratio of FEV 1 to forced vital capacity (FVC), were lower in subjects with a large NC. Similarly, waist circumference was above the 90th percentile in 67 children, and FEV 1 /FVC was significantly lower in children with a large waist circumference. Moreover, there was a statistically significant negative correlation among FEV 1 , FEV 1 /FVC, and body mass index SD score. Also, multivariable linear regression analysis showed that an NC above the 90th percentile was associated with lower FEV 1 and FEV 1 /FVC values., Conclusion: We identified NC as a novel anthropometric index that is strongly correlated with respiratory functions in children. Therefore, close monitoring of respiratory symptoms, particularly in children with obesity and a large NC, could help with early and prompt determination of respiratory complications of obesity., (Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Soft polymers used under tissue-supported prostheses have limited service life because of surface degradation., Purpose: This paper evaluates the changes in surface properties and softness of soft relining materials after cyclic loading in water., Materials and Methods: 3 polysiloxane (Silagum AM Comfort, Molloplast B, Mollosil Plus) and 2 acrylic-based (Vertex Soft, Astron LC Soft) proprietary soft relining materials and a vinyl polysiloxane (Imprint 2 Garant) as the reference impression material evaluated. A stainless steel block for detail reproduction was used on the basis of the apparatus recommended by the ISO 4823:1992 test method for preparing a standardized surface. A control group from each material was only subjected to water immersion. Non-destructive cyclic loading was carried out with a strain of 16.6 % and a frequency of 1.6 Hz 200,000 times in distilled water at 37 °C. The specimens were then duplicated and compared with the controls using roughness measurements, detail reproduction and Scanning Electron Microscope. Shore A hardness values before and after cycling were also measured., Results: After degradation in the form of mechanical cycling in water, loss of substance and loss of surface detail was observed. Surface properties and Shore A hardness values of acrylic-based soft liners changed significantly (p < 0.05)., Conclusions: The chemical composition of the soft relining materials seemed to affect their potential of preserving the surface texture and softness after mechanical cycling. Mechanical cycling influences the surface degradation process leading to changes of the surface texture. Polysiloxane-based materials preserved their softness, surface texture and surface smoothness better under cyclic loading compared to acrylic resin -based plasticized materials.

Aim: The objective of our study was to investigate nerve conduction in normoglycemic obese children., Methods: A total of 60 children with obesity (30 female and 30 male) and 30 healthy children (15 female and 15 male) were enrolled in the study. Insulin resistance (IR) and other metabolic disturbances were investigated and nerve conduction was measured in all participants. Obese children were divided into groups according to the presence of IR. All results were compared between these subgroups., Results: The nerve conduction velocity (NCV) of motor median nerves in the IR+ group was significantly higher than that in the IR- group and lower than that in the control group. The NCV of the motor peroneal nerve in the IR+ group was significantly lower than that in the IR- group. The sensory nerve action potential (SNAP) of the sensory median nerve was significantly lower in the IR+ group compared to that in the IR- group. The sensory sural nerve's SNAP was significantly lower in the IR+ group than that in the control group., Conclusion: Nerve conduction tests may help to detect early pathologies in peripheral nerves and to decrease morbidities in obese children.

Purpose: The SCN1A gene is one of the most commonly mutated human epilepsy genes associated with a spectrum of phenotypes with variable degrees of severity. Despite over 1200 distinct mutations reported, it is still hard to draw clear genotype-phenotype relationships, since genetic and environmental modifiers contribute to the development of a particular disease caused by an SCN1A mutation. We aimed to initiate mutational screening of the SCN1A gene in Turkey and advance further our understanding of the relationship between the SCN1A sequence alterations and disease phenotypes such as GEFS+, DS and related epileptic encephalopathies., Methods: Mutational analysis of the SCN1A gene was carried out in 46 patients with DS, late-onset DS, GEFS+ and unspecified EE using either direct Sanger sequencing of the coding regions and exon/intron boundaries or massively parallel sequencing., Results: Nineteen point mutations, 12 of which were novel were identified, confirming the clinical diagnosis of the patients. Patients with a mutation (either truncating or missense) on linker regions had significantly later disease onset than patients with mutations in homology regions. The presence of SCN1A mutations in two clinically unclassified patients supported the association of SCN1A mutations with a wide range of phenotypes., Conclusion: The conventional Sanger sequencing method was successfully initiated for the detection of SCN1A point mutations in Turkey in epilepsy patients. Furthermore, a modified strategy of massively parallel pyro-sequencing was also established as a rapid and effective mutation detection method for large genes as SCN1A., (Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Background: Obesity is a well-established risk factor for asthma. Previous studies have reported that central obesity is associated with asthma., Objective: To investigate the association between fat distribution, which is determined by anthropometric measures, including neck circumference (NC), and asthma in school-aged children., Methods: Children diagnosed as having asthma were enrolled along with controls who were admitted to our outpatient department with allergic symptoms, such as rhinitis, urticaria and atopic dermatitis. Anthropometric measures, including height, weight, NC, waist circumference, and hip circumference, were obtained. Skin prick tests, blood eosinophil counts, and serum total IgE level measurements were performed., Results: A total of 196 children (92 male [46.9%]) were included. Asthma was present in 102 patients (52.1%). Ninety-one of the patients (46.4%) were overweight, and 45 patients (22.9%) were obese. The NC of children with asthma was significantly higher than that of children in the control group. Grades defined according to NC percentiles were also significantly different between groups. In children with asthma, the prevalence of children with an NC higher than the 90th percentile (grade 6) was more frequent when compared with controls. The median NC of obese-overweight children with asthma was significantly higher compared with obese-overweight controls without asthma. Results of multivariable logistic regression analysis revealed that the presence of an NC in the greater than 90th percentile was associated with asthma in obese-overweight children., Conclusion: This study found that NC, which is a simple anthropometric measure, is associated with asthma in obese children., (Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Background: Melatonin modulates central nervous system neuronal activity. We compared the melatonin levels of patients with febrile and afebrile seizures during and after seizure with those of healthy controls., Methods: We enrolled 59 individuals with afebrile and febrile seizures (mean age, 6.09 ± 4.46 years) and 28 age-, sex-, and weight-matched healthy children. Melatonin levels were measured near the time of a seizure (0 to 1 hour) and at 12 and 24 hours post-seizure, and control melatonin levels were measured from a single venous blood sample., Results: Plasma melatonin levels increased during seizures in the study group (P < 0.001). Post-seizure plasma melatonin levels were significantly lower in the study group than in the control group (P < 0.05). Plasma melatonin levels did not differ between patients with afebrile seizures who had and had not used antiepileptic drugs. Daytime (8 AM to 8 PM) and nighttime (8 PM to 8 AM) post-seizure melatonin levels were not significantly different., Conclusions: Melatonin levels were lower in pediatric patients prone to seizures than in healthy children and increased during seizures. Further research is needed to test the role of melatonin in the pathophysiology and treatment of epilepsy., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Aims: The aim of our study is to investigate alterations in visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) in children with obesity., Methods: A total of 96 children, with a mean age of 12.1±2.0 years (range 9-17 years, 63 obese and 33 age and sex-matched control subjects) were included in the study. Laboratory tests were performed to detect insulin resistance (IR) and dyslipidemia. The latencies and amplitudes of VEP and BAEP were measured in healthy and obese subjects., Results: The VEP P100, BAEP interpeak latency (IPL) I-III and IPL I-V averages of obese children were significantly longer than the control subjects. When the obese group was divided into two subgroups, those with IR and without IR, BAEP wave I, wave III and P100 wave latencies were found to be longer in the group with IR. A statistically significant correlation was observed between BAEP wave I latency, IPL I-V, IPL I-III and the homeostatic model assessment insulin resistance (HOMA IR) index and fasting insulin level., Conclusions: Our findings suggest that VEP and BAEP can be used to determine early subclinical on auditory and visual functions of obese children with insulin resistance., (Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Unlabelled: Recent studies have shown that ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) inactivates endogenous dentin proteases, thereby preventing collagen degradation and improving the durability of adhesive bonds to dentin. Bond durability is routinely assessed by monotonic microtensile testing, which does not consider the cyclic nature of mastication., Objective: To characterize the effect of an EDC pretreatment on the fatigue crack growth behavior of resin-dentin bonds., Methods: Bonded interface Compact Tension (CT) specimens were prepared using a three-step etch-and-rinse adhesive and hybrid resin-composite. Adhesive bonding of the treated groups included a 1 min application of an experimental EDC conditioner to the acid-etched dentin. The control groups did not receive EDC treatment. The fatigue crack growth resistance was examined after storage in artificial saliva for 0, 3 and 6 months., Results: There was no significant difference in the immediate fatigue crack growth resistance of the EDC-treated and control groups at 0 months. However, after the 3 and 6 months storage periods the EDC-treated groups exhibited significantly greater (p≤0.05) fatigue crack growth resistance than the control specimens., Significance: Although the EDC treatment maintained the fatigue crack growth resistance of the dentin bonds through 6 months of storage, additional studies are needed to assess its effectiveness over longer periods and in relation to other cross-linking agents., (Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)