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Background. The aim of this study was to evaluate the changing levels of stress among dental students during 8 months of a basic manual skills course in the preclinical year and to examine the association between stress and dental performance. Methods. A longitudinal study was conducted in the 2023 academic year in a total of 58 (male = 17 and female = 41; mean age = 26.43, range 22–33) undergraduate dental students at Tel Aviv University of dentistry during their fourth year of study. Depression Anxiety Stress Scale (DASS‐21) and Dental Environment Stress (DES) questionnaires were used to assess the psychological well‐being and the severity of DASS symptoms experienced by the students. The students' dental performances were assessed using two manual tests on plastic teeth. The questionnaires and the manual tests were used at three periods of time, T0, T1, and T2. Wilcoxon signed‐rank tests were performed to compare the DASS scores and DES stressors of dental students between T0, T1, and T2. Kendall's nonparametric correlations were calculated to investigate the relationships of DES stressors and depression, anxiety, and stress scores with manual performance. Conclusions. The perception of high stress by dental students is due to the stressful education process of the preclinical year. There is an inverse correlation between the lower level of anxiety and the increase level of dental performance with 74% of the variance in dental performance explained by the anxiety score. Work‐related stressors such as manual skills might reduce dental performance in contrast to non‐work‐related factors such as financial obligations, personal issues, and family factors, which might increase student dental performance. [ABSTRACT FROM AUTHOR]

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The aim of this study is to investigate whether the genetic, epigenetic and environmental factors that give rise to supernumeraries in the maxillary incisor region and larger dimensions of the adjacent maxillary incisors are also associated with variations in the morphology of the mandibular incisors. If so, this would contribute to understanding the distribution and interactions of factors during dental development and how these can be modelled. The sample consisted of 34 patients with supernumerary teeth in the maxillary anterior region, matched for gender, age and White Caucasian ethnicity with 34 control subjects. The average ages of the supernumerary and control groups were 12.8 and 12.2 years, respectively. Study models of all subjects were constructed and imaged using a previously validated system. Using custom software, each of the mandibular incisor teeth were measured to obtain 17 parameters from the labial view and 17 from the occlusal view. Principal component analysis (PCA) was used to summarize the measurements into a smaller set representing distinct features of the clinical crowns, followed by a comparison between the supernumerary and control groups using 2-way ANOVA. Seven factors of tooth size of the mandibular central incisors and six factors of the mandibular lateral incisors were identified as major features of the clinical crowns. All parameters of both mandibular incisors were greater in the supernumerary group than in the control, with three of these, located in the incisal and cervical regions of the mandibular lateral incisors, being statistically significantly larger. The findings of this study indicate that the aetiological factors associated with supernumerary teeth in the maxillary anterior region also affect tooth crown dimensions of mandibular incisors. This new evidence enhances several models of the interactions of genetic, epigenetic and environmental components of dental development and supports a multi-model approach to increase understanding of this process and its variations. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) recently alerted the emergence of new pathogens causing acute hepatitis in children across several countries. This new situation directs us to the screening of neglected pathogens that cause acute hepatitis. Q-fever is a zoonotic disease, caused by Coxiella burnetii. Although a high seroprevalence of Coxiella burnetii was recorded in animals present in Egypt, Q-fever is still a neglected disease, and the diagnosis of Q-fever is not routinely performed in Egyptian hospitals. In this study, we performed a retrospective assessment for Coxiella burnetii in cases of hepatitis of unknown causes (HUC) enrolled in Assiut University hospitals, in Egypt. Out of 64 samples of HUC, 54 samples were negative for all hepatitis markers, labeled as acute hepatitis of unknown etiology (AHUE), and 10 samples tested positive for adenovirus and Hepatitis E virus (HEV). Q-fever was detected in 3 out of 54 (5.6%) of AHUE, and one sample was confirmed as coinfection of HEV/Q-fever. Jaundice was the most common clinical symptom developed in the patients. In conclusion, Coxiella burnetii was found to be a potential cause of acute hepatitis in HUC. The diagnosis of Q-fever should be considered in acute hepatitis cases in Egyptian hospitals. [ABSTRACT FROM AUTHOR]

Patients with hypodontia appear to have a different craniofacial morphology as compared with controls. They tend to have more class III skeletal pattern and retroclined upper and lower soft tissue lips as a consequence of retroclined upper and lower incisors. These features are more pronounced as the severity of the hypodontia increases. In addition to changes in craniofacial and soft tissue morphology, various dental anomalies are commonly associated with hypodontia such as microdontia of the remaining dentition, anomalies in tooth shape, particularly peg-shaped upper lateral incisors, smaller root dimensions of some of the permanent teeth, and decreased maxillary and mandibular dental arch widths and lengths measurements. Other dental anomalies which are seen in association with hypodontia are taurodontism of molars, retained deciduous molars, delayed development of the permanent teeth, distoangulation of the mandibular second premolar, and infraocclusion of the deciduous molars. [ABSTRACT FROM AUTHOR]

HEV-Ag ELISA assay is a reliable diagnostic test in resource-limited areas. HEV genotype 1 (HEV-1) infections are either self-limited or progress to fulminant hepatic failure (FHF) and death if anti-HEV therapy is delayed. Limited data is available about the diagnostic utility of HEV Ag on HEV-1 infections. Herein we aimed to study the kinetics of HEV Ag during HEV-1 infections at different stages, i.e., acute HEV infection, recovery, and progression to FHF. Also, we evaluated the diagnostic utility of this marker to predict the outcomes of HEV-1 infections. Plasma of acute hepatitis E (AHE) patients were assessed for HEV RNA by RT-qPCR, HEV Ag, and anti-HEV IgM by ELISA. The kinetics of HEV Ag was monitored at different time points; acute phase of infection, recovery, FHF stage, and post-recovery. Our results showed that the level of HEV Ag was elevated in AHE patients with a significantly higher level in FHF patients than recovered patients. We identified a plasma HEV Ag threshold that can differentiate between self-limiting infection and FHF progression with 100% sensitivity and 88.89% specificity. HEV Ag and HEV RNA have similar kinetics during the acute phase and self-limiting infection. In the FHF stage, HEV Ag and anti-HEV IgM have similar patterns of kinetics which could be the cause of liver damage. In conclusion, the HEV Ag assay can be used as a biomarker for predicting the consequences of HEV-1 infections which could be diagnostically useful for taking the appropriate measures to reduce the complications, especially for high-risk groups. [ABSTRACT FROM AUTHOR]

Prior research has demonstrated that motor skill learning is often disrupted by self-focus and attempts to control movement. The propensity for reinvestment (i.e., self-focus and movement control) has been associated with poor motor skill learning in sport and surgery, but it has not yet been examined in dental education. Therefore, the aim of this study was to evaluate the propensity for disruptive reinvestment among dental students so as to optimize their learning needs. Volunteer dental students (210) completed three reinvestment surveys to investigate their self-reported propensity to engage in conscious self-monitoring and control of their movements and decisions. We used analysis of variance (ANOVA), with post-hoc analyses as appropriate, to assess the effect of various participant demographics on their reinvestment scores. Male participants had a lower mean reinvestment scale score than females (p <.05). Older participants were found to have a lower mean movement reinvestment score, compared to younger reinvesters (p <.05). On the other hand, younger reinvesters had a lower mean decision reinvestment score compared to the older age group (p <.05). When compared with participants in previous studies our participants obtained a significantly higher reinvestment score (p <.05). In conclusion, gender and age may be related to dental students' self-reported propensity to reinvest. Moreover, dental students were found to be more self-conscious when compared with individuals who perform gross motor skill tasks. These results provide insight into the acquisition of dental skills that may assist in designing pre-clinical training curriculum in dental education. [ABSTRACT FROM AUTHOR]

Background: Opioids have historically been a first-line therapy for surgical pain control. They were considered optimum and the mainstay for balanced anesthesia but recently the concerns about their side effects were raised. The concept of opioid free anesthesia (OFA) was introduced to provide a safer alternative that would provide benefits to selective group of patients as well as enhance recovery after surgery. Methods: The current study compares the use of a mixture of dexmedetomidine and ketamine infusion with traditional fentanyl infusion intra-operative on many variables both intra-operative and post- operative in laparoscopic surgeries. Number of patients who will need rescue narcotics after extubation and total nalbuphine consumption, hemodynamic events (bradycardia, hypotension and hypertension), time to extubation, time to reach Alderete score of 9, post-operative hypoxemia, vomiting, pain scores were recorded and compared with the traditional balanced anesthesia (TBA). Results: Forty patients were enrolled in the study, 20 patients in each group. The 2 groups, TBA and OFA, were comparable in demographic data (age, sex, body mass index (BMI), lean body weight (LBW)) and duration of surgery. There was significant decrease in pain scores, number of patients who will need rescue narcotics after extubation and nalbuphine consumption in the OFA group that extended to 24 h post-operative. TBA group showed statistically significant less time needed for extubation (P-value 0.018) and reaching Aldrete score of 9 (P-value 0.02). Conclusions: OFA has a better profile than TBA as regard to post-operative pain score and opioid consumption post-operative but they have relative increase in time to extubation and time to reach Aldrete score of 9, and they were equally safe regarding post operative hypoxia and hemodynamics. [ABSTRACT FROM AUTHOR]

Background: Hepatitis E virus (HEV) causes about 14 million infections with 300,000 deaths and 5,200 stillbirths worldwide annually. Extrahepatic manifestations are reported with HEV infections, such as renal, neurological, and hematological disorders. Recently, we reported that stool-derived HEV-1 replicates efficiently in human monocytes and macrophages in vitro. However, another study reports the presence of viral RNA but no evidence of replication in the PBMCs of acute hepatitis E (AHE) patients. Therefore, the replication of HEV in PBMCs during AHE infection is not completely understood. Methods: PBMCs were isolated from AHE patients (n = 17) enrolled in Assiut University Hospitals, Egypt. The viral load, positive (+) and negative (−) HEV RNA strands and viral protein were assessed. The gene expression profile of PBMCs from AHE patients was assessed. In addition, the level of cytokines was measured in the plasma of the patients. Results: HEV RNA was detected in the PBMCs of AHE patients. The median HEV load in the PBMCs was 1.34 × 103 IU/ml. A negative HEV RNA strand and HEV open reading frame 2 protein were recorded in 4/17 (23.5%) of the PBMCs. Upregulation of inflammatory transcripts and increased plasma cytokines were recorded in the AHE patients compared with healthy individuals with significantly elevated transcripts and plasma cytokines in the AHE with detectable (+) and (−) RNA strands compared with the AHE with the detectable (+) RNA strand only. There was no significant difference in terms of age, sex, and liver function tests between AHE patients with detectable (+) and (−) RNA strands in the PBMCs and AHE patients with the (+) RNA strand only. Conclusion: Our study shows evidence for in vivo HEV persistence and replication in the PBMCs of AHE patients. The replication of HEV in the PBMCs was associated with an enhanced immune response, which could affect the pathogenesis of HEV. Flow of the study design: Blood collected from acute HEV patients were fractiontated into plasma and PBMCs. Plasma was used for cytokine assay. RNA was extracted from the PBMCs and used for determinaton of viral load, detection of (+) and (−) HEV RNA strands, and gene expression assay. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the impact of errorless and errorful learning, on acquisition of root canal hand‐instrumentation skills. Dental students prepared standardised canals of different diameters and curvatures. Learning involved minimising (errorless: n = 21) or maximising errors (errorful: n = 21). Students who had completed accredited pre‐clinical activities provided comparative data (n = 17). During testing, the distal canal of a plastic mandibular molar was prepared, first as a single task and then under multi‐tasking conditions. Performance was assessed by preparation accuracy and time. Differences were assessed using anova (P < 0.05). Performance in the experimental groups was similar during learning. When multi‐tasking, errorful learners showed a deterioration in preparation accuracy (P < 0.05). In contrast, preparation accuracy and completion times for the errorless and comparative groups remained stable when multi‐tasking. Errorless learning resulted in stable performance under multi‐tasking conditions. Investigation of alternative approaches to learning motor skills in dentistry is warranted as such approaches may provide better outcomes, especially under demanding conditions. [ABSTRACT FROM AUTHOR]

Dental education involves teaching and assessing the acquisition of verifiable domains that require superior psychomotor, communication, and cognitive skills. Evolving technologies and methods of assessment could enhance student learning environment and improve tutor assessment experience. The aim of this study was to introduce the application of a comprehensive high-stakes online exam to final-year dental students during the COVID-19 pandemic and evaluate its effectiveness. A high-stakes exam was introduced and implemented online to the final-year dental students prior to their graduation. The exam consisted of four components: MEQs, MCQs, OSCE and an oral exam. The exam and invigilation were conducted using Blackboard and MS Teams programs. Stakeholders' views of the exam were obtained using two tailored surveys, one for students and another for faculty; both included closed- and open-ended questions. The exam was run successfully without untoward events. Both students and staff were satisfied with the online exam with the latter being more satisfied than the former. Students with previous experience in online learning system were more satisfied with the online exam compared with those with less experience (p < 0.05). The main issues raised by students' satisfaction with the exam were: inadequacy of time for the MEQ part, prevention of back tracking in the MCQ part and minor technological issues, whereas those raised by faculty members were increased time required to complete the exam setup and grading compared to the paper-based exam and minor technological issues. A newly introduced, multi-format, online high-stakes exam was implemented successfully to final-year dental students with minor technological issues and good satisfaction by students and staff alike. [ABSTRACT FROM AUTHOR]

Objectives. The aim of the study was to evaluate the perception of smile aesthetics in patients with varying degrees of anterior crowding and spacing among dental specialists, dentists, dental students, and laypersons and to assess the effect of the lips position. Materials and Methods. Clinical photos of cases of anterior crowding (mild, moderate, and severe) and spacing (mild, moderate, and severe) with and without the associated lips were used. The images were evaluated by 250 persons including dental specialists, dentists, dental students, and laypersons using the rating scale method, (extremely unaesthetic to extremely aesthetic, 1 to 5, respectively). Nonparametric tests were used to analyse the data on SPSS version 24. Results. According to the 250 responses, the aesthetic perception of all severities of anterior crowding and mild and moderate spacing was found to be more aesthetic when displayed with the lips (p < 0.05). Additionally, the higher the level of dental education, the lower the aesthetic perception with and without the lips (p < 0.05). Conclusions. The lips play a significant role in improving the aesthetics of crowded anterior teeth and spaced anterior teeth. Dental educational level influences the aesthetic perception of anterior crowding and spacing. This may have an impact on treatment planning and need for orthodontic intervention. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effectiveness of an upper removable appliance in the treatment of an anterior crossbite in term of quality of life, effectiveness, treatment time, long term stability and cost minimization.Design: Systematic reviewData source: A search strategy was implemented using both manual hand search and electronic databases, including Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, ScienceDirect, Scopus and Ebsco.Study eligibility criteria: Randomized controlled clinical trialsParticipants: Children in the early or late mixed dentition with an anterior crossbite affecting one or more incisors, and no underlying skeletal class III pattern.Interventions: Upper removable appliance compared with other orthodontic appliances.Study appraisal and synthesis: All potential articles were checked against the inclusion criteria independently, and in duplicate by two investigators. Risk of bias of eligible studies to be included in the final analysis was assessed independently by two authors using Cochrane risk of bias tool.Results: A total of 524 articles were identified in both manual and electronic searches as well as by checking the reference lists of the final articles to be included in the study. Only 7 reports of 3 RCTs met the inclusion criteria and thus were included in the final analysis. All but one of the 3 RCTs were judged to be of very low quality. No statistical methods were employed to combine the studies due to the heterogeneity of the studies.Conclusion: A fixed appliance was more cost-effective than a removable appliance in the correction of an anterior crossbite with a functional shift. There was no significant difference in terms of quality of life, pain intensity or long-term stability between the two appliances. On the other hand, both a removable appliance and cemented bite-pads were equally effective in the correction of an anterior dental crossbite without having any side effect. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate variations in the number of roots and root canals in first permanent lower molars (FPLMs) using cone beam computed tomography (CBCT). Materials and Methods: A total of 640 CBCT images were analyzed using SIDEXIS XG software version 2.62 (Sirona Dental Systems, Bensheim, Germany). The entire root anatomy of FPLMs was investigated in three dimensions and the number of roots, root canals, and the number of canals per root were recorded. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software, version 24, (IBM Corporation, USA) to determine the relationship between root anatomy and gender, age, or tooth location (right or left side). Results: The majority of FPLMs had two roots (96%), whereas the remaining 32 FPLMs (4%) had three roots. Almost two-thirds of the sample (62.7%) had three root canals, whereas only three cases (0.4%) of the FPLMs had six canals. When comparing bilateral differences in the distribution of root canals, it was determined that a quarter of FPLMs (24.1%) had an unequal number of canals. Moreover, there were differences in the number of additional canals between the mesial and distal roots with 17.5% of the former having three canals as compared with only 0.5% of the distal root. Interestingly, not more than one canal was observed in all additional root cases. No significant differences were observed in the number of canals between males and females or between right and left sides of the examined FPLMs (P > 0.05). Conclusion: Dental clinicians should be aware of the presence of an additional root in 4% of FPLMs, and about a quarter of the cases (27%) had an extra middle mesial canal in the mesial root, which was found to be more prevalent in middle age groups. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Poor oral health is not uncommon among the population of Pakistan. Malocclusion may be one of the causes known so far. This study has evaluated the association of anterior teeth crowding with plaque, bleeding on probing and gingivitis and has noted the trend in families. METHODOLOGY: Eleven families comprising of 41 members aged 30.3±15.3 (12-55) years were recruited for this cross-sectional study. Crowding of anterior teeth (canine-canine) of upper and lower jaws was recorded on study casts. Oral hygiene parameters of plaque, bleeding on probing and gingivitis were noted for the anterior teeth. Variables were analyzed in means and percentages and study participants were compared for differences in study parameters using the t-test and Chisquired test. Statistical significance was set at p<0.050. RESULTS: Forty eight percent showed severe crowding, 34% had severe plaque, 100% showed mild to moderate gingivitis, 24% exhibited bleeding on probing. Significant difference (p=0.003) was noted among orthodontic cases and family members. No significant difference was observed between inter- and intra-family regarding oral hygiene parameters. Comparison between parents and siblings showed no difference in all study parameters. CONCLUSION: A significant association was found between the presence of anterior crowding and gingival index. This study has supported the notion that an association exists between crowding of anterior teeth and gingivitis. [ABSTRACT FROM AUTHOR]

An eight-way phased-array TRX front-end with RF phase shifting and on-chip transmit/receive switching is implemented in 28-nm CMOS. The TX $P_{\mathbf {1dBout}}$ and RX noise figure (NF) are 10 dBm and 6.8 dB, respectively. The active phase shifter shows less than 5° phase resolution and amplitude errors within ± 0.35 dB. The 9.6-mm2chip consumes 231 mW in RX and 508 mW in the TX mode from a 0.9-V supply. When combined with PCB antennas, a ±46° scan angle is obtained with <0.4 dB peak-to-peak gain ripples without calibration. We also present an approach to express the noise performance of a phased-array receiver in terms of the effective isotropic NF, as an extension to the NF, which is only defined for a two-port system. [ABSTRACT FROM AUTHOR]