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Canine Chronic Ulcerative Stomatitis is a spontaneously occurring inflammatory disease of the oral mucosa. An immune-mediated pathogenesis is suspected though not yet proven. We have recently reported on the clinical and histologic features, and identification of select leukocyte cell populations within the lesion. A clinical and histologic similarity to oral lichen planus of people was proposed. In the present study, these initial observations are extended by examining lesions from 24 dogs with clinical evidence of chronic ulcerative stomatitis. Because dogs with chronic ulcerative stomatitis often have concurrent periodontal disease, we wondered if dental plaque/biofilm may be a common instigator of inflammation in both lesions. We hypothesized that dogs with chronic ulcerative stomatitis would exhibit a spectrum of pathologic changes and phenotype of infiltrating leukocytes that would inform lesion pathogenesis and that these changes would differ from inflammatory phenotypes in periodontitis. Previously we identified chronic ulcerative stomatitis lesions to be rich in FoxP3+ and IL17+ cells. As such, we suspect that these leukocytes play an important role in lesion pathogenesis. The current study confirms the presence of moderate to large numbers of FoxP3+ T cells and IL17+ cells in all ulcerative stomatitis lesions using confocal immunofluorescence. Interestingly, the majority of IL17+ cells were determined to be non-T cells and IL17+ cell frequencies were negatively correlated with severity on the clinical scoring system. Three histologic subtypes of ulcerative stomatitis were determined; lichenoid, deep stomatitis and granulomatous. Periodontitis lesions, like stomatitis lesions, were B cell and plasma cell rich, but otherwise differed from the stomatitis lesions. Direct immunofluorescence results did not support an autoantibody-mediated autoimmune disease process. This investigation contributes to the body of literature regarding leukocyte involvement in canine idiopathic inflammatory disease pathogenesis.

Canine chronic ulcerative stomatitis, also known as chronic ulcerative paradental stomatitis, is a painful condition of the oral cavity. The purpose of this study was to determine if there are commonalities in clinical and radiographic features among patients, whether the histopathologic evaluation might inform the pathogenesis, and whether the condition appears similar to human oral mucosal diseases. To do this, we prospectively collected clinical, radiographic, and histopathologic data from 20 dogs diagnosed with the disease. Clinical data were based on a clinical disease activity index, oral and periodontal examination parameters, and full-mouth dental radiographs. The histopathological and immunohistochemical data were based on oral mucosal samples obtained from erosive or ulcerated areas. Our findings revealed that canine chronic stomatitis is clinically characterized by painful oral mucosal ulcers of varying size, pattern, appearance, and distribution, most often associated with teeth with early periodontitis. Histologic examination revealed a subepithelial lichenoid band (interface mucositis) where B cells, T cells, and Forkhead-box protein 3 (FoxP3)- and interleukin-17-expressing cells were present. These cells might play a role in the underlying immune response and an immune-mediated pathogenesis is suspected. The clinical and histopathologic features of this chronic inflammatory mucosal disease in dogs resemble those of oral lichen planus in humans.

Patient safety is an ongoing challenge in the design and delivery of health-care services. As registered nurses play an integral role in patient safety, further examination of the link between nursing work and patient safety is warranted. The present study examines the relationship between nurses' perceptions of job demands and nurses' perceptions of patient safety. Structural equation modeling is used to analyze the data collected from a survey of 430 registered nurses at two community hospitals in the USA. As hypothesized, nurses' perception of patient safety decreases as the job demands increase. The level of personal control over practice directly affects nurses' perception of the ability to assure patient well-being. Nurses who work full-time and are highly educated have a decreased perception of patient safety, as well. The significant relationship between job demands and patient safety confirms that nurses make a connection between their working conditions and the ability to deliver safe care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the effect of vaginal bleeding on the likelihood of coitus among adolescent women. METHODS: Participants were 191 sexually active women aged 14 to 21 years enrolled from a sexually transmitted disease clinic and three primary care adolescent clinics. Data were collected from diaries maintained for up to 7 months. Subjects recorded each occurrence of coitus, partner initials, condom use, and vaginal bleeding. Multivariable logistic regression was used for the analyses. Generalized estimating equations approach was used to adjust the estimated parameters for within-subject correlation. RESULTS: Subjects reported a total 21334 diary days, with 2684 days with coitus (12.6% of diary days) and 1433 days with bleeding (6.7% of diary days). Only 65/2684 (2.4%) coital events were associated with vaginal bleeding. Multivariable analysis showed that absence of bleeding was associated with increased likelihood (odds ratio = 4.2) of coitus, independent of age, race, and usual coital frequency. Younger age and higher coital frequency were associated with increased likelihood of any coitus during vaginal bleeding. CONCLUSIONS: For most sexually active adolescent women, bleeding is associated with avoidance of coitus. [ABSTRACT FROM AUTHOR]

Major efforts are being made to improve the teaching of human anatomy to foster cognition of visuospatial relationships. The Visible Human Project of the National Library of Medicine makes it possible to create virtual reality-based applications for teaching anatomy. Integration of traditional cadaver and illustration-based methods with Internet-based simulations brings us closer to this goal. Web-based three-dimensional Virtual Body Structures (W3D-VBS) is a next-generation immersive anatomical training system for teaching human anatomy over the Internet. It uses Visible Human data to dynamically explore, select, extract, visualize, manipulate, and stereoscopically palpate realistic virtual body structures with a haptic device. Tracking user's progress through evaluation tools helps customize lesson plans. A self-guided "virtual tour" of the whole body allows investigation of labeled virtual dissections repetitively, at any time and place a user requires it. [ABSTRACT FROM AUTHOR]

This study focuses on the cytotoxic effects of fumonisin B1 (FB1) on both immortalised and immortalised and subsequently transfected normal human bronchial epithelial (NHBE) cells of human origin using four bioassays. While the MTT, Neutral Red and hexosaminidase colorimetric assays showed little difference between the toxic effects on the two related cell lines, the clonogenic assay, measuring cell survival and proliferation, indicated that FB1 had a more toxic effect on the nontransfected cells. This kind of in vitro approach using cells which retain many characteristics of normal cell growth and differentiation can go some way to developing evaluation models for food safety in the case of mycotoxin contamination without resorting totally to whole animal testing. Nevertheless, one or two cytotoxicity tests may be inadequate for a complete appraisal of toxic potential: rather, as wide a range of methodologies as feasible should be employed initially before meaningful conclusions may be drawn. [ABSTRACT FROM AUTHOR]

Introduction: This retrospective study highlights the salient aspects of a series of feline patients affected with bisphosphonate related osteonecrosis of the jaw. Though more commonly published in human literature, this presentation is rare in cats. The authors hope that this study will assist in making this a more globally known entity with subsequent improved prognosis., Methods: Data was retrospectively obtained from the medical records between 2015 and 2021 of 20 cats with Medication Related Osteonecrosis of the Jaw. Data included patient information, clinical history, presenting complaint, systemic diseases, details referable to hypercalcemia and treatment thereof, bisphosphonate specifics (dose and duration), clinical presentation of the lesion, diagnostic testing including radiographic and histopathologic descriptions, treatment, and outcome., Results: Pertinent results include that all 20 cats who developed Medication Related Osteonecrosis of the Jaw had been treated for idiopathic hypercalcemia with the bisphosphonate medication alendronate. Eighty-five percent of the cases had prior dental extractions at the site of MRONJ lesion. Ninety-five percent of the affected cats required a surgical procedure to control the disease. Thirty-five percent of cases required at least one revision surgery after the initial procedure was performed. Diagnosis of MRONJ was made by a correlation of diagnostic findings and patient history. No single diagnostic, or combination was pathognomonic for lesion diagnosis. As well, there were no statistically significant associations between patient variables assessed and the overall patient outcome., Discussion: The case series reveals that cats with feline idiopathic hypercalcemia treated with alendronate may be at a risk for development of MRONJ, a serious oral condition with significant morbidity. Prior dental extraction sites in patients concurrently treated with bisphosphonate medications were often associated with MRONJ lesions. Therefore, any needed dental surgery should be performed prior to the use of bisphosphonates where possible. The authors have also included a relevant comparative literature review., Competing Interests: CB was employed by Speciality Oral Pathology for Animals, LLC. SH and BS were employed by Veterinary Dental Services, LLC. JA is an Adjunct Professor at the School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hatunen, Anderson, Bell, Campos, Finkelman and Shope.)

To test the hypothesis that an abiotic Earth and its inert atmosphere could form chemically reactive carbon- and nitrogen-containing compounds, we designed a plasma electrochemical setup to mimic lightning-induced electrochemistry under steady-state conditions of the early Earth. Air-gap electrochemical reactions at air-water-ground interfaces lead to remarkable yields, with up to 40 moles of carbon dioxide being reduced into carbon monoxide and formic acid, and 3 moles of gaseous nitrogen being fixed into nitrate, nitrite, and ammonium ions, per mole of transmitted electrons. Interfaces enable reactants (e.g., minerals) that may have been on land, in lakes, and in oceans to participate in radical and redox reactions, leading to higher yields compared to gas-phase-only reactions. Cloud-to-ground lightning strikes could have generated high concentrations of reactive molecules locally, establishing diverse feedstocks for early life to emerge and survive globally., Competing Interests: Competing interests statement:Harvard University has filed patent applications PCT/US2023/077332 and PCT/US2024/017763.

Caregiving is often associated with negative physical and mental health outcomes, and as the COVID-19 pandemic escalated, caregivers experienced more burden and provided more care with substantially less support. Digital resources may have been one way caregivers managed demands for care and needs for information. This mixed-methods study included surveys and semi-structured interviews with caregivers ( n = 11) to describe experiences and use of digital health resources during the COVID-19 pandemic. Caregivers most often provided significant physical care and experienced reduced or no social support during the pandemic. Caregivers reported the need for improving the quality of telehealth services and digital health resources. COVID-19 will not likely be the last pandemic faced by contemporary society. Measures should be taken to reduce the anticipated negative impacts on caregivers and those receiving care during future pandemics., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: The aim of this study was to explore unpaid carers' experiences of supporting people with dementia to use social media. Methods: Unpaid carers ( n  = 234) responded to an online survey about their attitudes towards people with dementia using social media and any experiences supporting this usage. Responses to closed questions were analysed using frequency analysis; qualitative data were analysed thematically. Results: Fifty-five carers (23.5%) cared for someone with dementia who used social media. Thematic analysis produced four themes: (1) carers as social media navigators; (2) social media supports care; (3) carers as social media guardians; and (4) labour-intensive work. Carers valued the social connectivity and stimulation social media provided but remained vigilant about online safety. They carefully managed the online experiences of people with dementia, balancing perceived benefits with safety, security, and caring demands. Conclusions: These findings shed light on the complexities of caring in the digital age. Many carers are supporting people with dementia in using social media, but there is little guidance on how best to do this. As older adults continue to embrace social media, carers, support organisations, and policymakers must adapt and work with technology developers to ensure safe and supportive online experiences.

The regional and rural intensivist workforce is vital to delivering high standards of healthcare to all Australians. Currently, there is an impending workforce disaster, with higher senior medical officer vacancy rates among regional and rural intensive care units, with these units being staffed by junior doctors who are in earlier stages of their training, which in turn increases supervisory burden. There is a lack of comprehensive literature on the barriers and enablers of training, recruiting and retaining regional and rural intensivists. To address this gap, a qualitative study was conducted, involving 13 in-depth, structured interviews with full-time and part-time intensivists from eight Australian regional and rural hospitals. Content analysis of the interview data resulted in the identification of four major categories: unique practice context, need for a broad generalist skill set, perks and challenges of working in a regional/rural area and workforce implications. The study findings revealed that regional and rural intensive care practice offers positive aspects, including work satisfaction, supportive local teams and an appealing lifestyle. However, these benefits are counterbalanced by challenges such as a heavier burden of on-call work, a higher proportion of junior staff which increase supervisory burden and limited access to subspecialist services. The implications of these findings are noteworthy and can be utilised to inform government policies, hospitals, the College of Intensive Care Medicine and the Australian and New Zealand College of Anaesthetists in developing strategies to enhance the provision of intensive care services and improve workforce planning in regional and rural areas., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Introduction: Past Alzheimer's disease and related dementias (ADRD) research has not considered ways to ensure the representation of diverse sexual and gender minorities. This study used concept mapping (CM) to identify strategies for engaging and recruiting LGBTQIA+ older adults living with memory loss and their caregivers into ADRD research., Methods: CM, involving brainstorming, thematic analysis, and rating of strategies, was conducted with 46 members from one national and three local community advisory boards. Data was analyzed using The Concept Systems Global MAX™ web platform., Results: One hundred twenty-two solutions were identified from June through December 2022, and represented five key themes: aging focused, LGBTQIA+ specific, memory loss and caregiving support focused, physical advertisements, and other media. Promising strategies included partnering with LGBTQIA+ health centers, attending social groups for older adults, and increasing community representation in marketing., Discussion: Tailored strategies, building trust, and community involvement are essential for engaging LGBTQIA+ individuals living with memory loss or ADRD and their caregivers in ADRD-focused research., Highlights: Innovative ways to ensure the inclusion of LGBTQIA+ older adults in Alzheimer's disease and related dementias (ADRD) research can be bolstered through collaboration with key community stakeholders.Promising strategies for recruitment and engagement include partnering with LGBTQIA+ centers, attending social groups for older adults, and ensuring diverse representation in marketing.Tailored recruitment and engagement strategies are crucial for building trust with LGBTQIA+ populations to increase participation in ADRD research., Competing Interests: Brittany Klenczar‐Castro is supported by NIA grants R01AG083177 and R24AG066599, and AARGD‐22‐929144. Dr. Krystal R. Kittle is supported by AARF‐22‐927069, NIA R01AG083177, and P30AG062429. Dr. Joel G. Anderson is supported by NIA R24AG066599 and R01AG083177 and serves on the Board of Directors of Healing Beyond Borders (unpaid). Dr. Whitney Wharton is supported by NIA R24AG066599, R01AG066203, RF1AG051514, R01AG083177, and P30AG064200. Dr. Andrea Gilmore‐Bykovskyi is an employee of the University of Wisconsin‐Madison and, in the last 36 months, reports grants from the NIH and the NIA. Dr. N. Maritza Dowling is supported by R24AG066599 and R01AG083177. Dr. Jaime Perales‐Puchalt is supported by K01MD014177 and P30AG062429. Dr. Jason D. Flatt is supported by NIA grants K01AG056669, R01AG083177 and R24AG066599, and AARGD‐22‐929144. Author disclosures are available in the supporting information., (© 2024 The Author(s). Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Bacterial contamination is the most prevalent infectious complication of blood transfusion in the developed world. To mitigate this, several ultraviolet light-based pathogen reduction technologies (PRTs), some of which require photo-chemicals, have been developed to minimize infection transmission. Relative to UV light, visible 405-nm light is safer and has shown potential to be developed as a PRT for the in situ treatment of ex vivo human plasma and platelet concentrates, without the need for photo-chemicals. This study investigates the effect of 405-nm light on human plasma, with focus on the compatibility of antimicrobial light doses with essential plasma clotting factors. To determine an effective antimicrobial dose that is compatible with plasma, prebagged human plasma (up to 300 mL) was seeded with common microbial contaminants and treated with increasing doses of 405-nm light (16 mW cm -2 ; ≤ 403 J cm -2 ). Post-exposure plasma protein integrity was investigated using an AOPP assay, in vitro coagulation tests, and ELISA-based measurement of fibrinogen and Protein S. Microbial contamination in 300 mL prebagged human plasma was significantly reduced (P ≤ 0.05) after exposure to ≤ 288 J cm -2 , with microbial loads reduced by > 96.2%. This dose did not significantly affect the plasma protein quality parameters tested (P > 0.05). Increased doses (≥ 345 J cm -2 ) resulted in a 4.3% increase in clot times with no statistically significant change in protein activity or levels. Overall, this study has demonstrated that the effective microbicidal 405 light dose shows little to no negative effect on plasma quality., (© 2024. The Author(s).)

Chemical and UV light-based pathogen reduction technologies are currently in use for human platelet concentrates (PCs) to enhance safety from transfusion-transmitted infections. Relative to UV light, 405 nm violet-blue light in the visible spectrum is known to be less harmful. Hence, in this report for the first time, we have assessed the global hemostasis activity of PCs stored in plasma and the activities of six plasma coagulation factors (CFs) as a measure of in vitro hemostatic activity following exposure to the microbicidal 405 nm light. Apheresis PC samples collected from each screened human donor (n = 22) were used for testing of PCs and platelet poor plasma (PPP). Both PCs and PPPs were treated for 5 h with 405 nm light to achieve a previously established microbicidal light dose of 270 J/cm 2 . Activated partial thromboplastin time and prothrombin time-based potency assays using a coagulation analyzer and hemostatic capacity via Thromboelastography were analyzed. Thromboelastography analysis of the light-treated PCs and plasma present in the PCs showed little difference between the treated and untreated samples. Further, plasma present in the PCs during the light treatment demonstrated a better stability in potency assays for several coagulation factors compared to the plasma alone prepared from PCs first and subjected to the light treatment separately. Overall, PCs stored in plasma treated with 405 nm violet-blue light retain activity for hemostasis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier B.V.)

Due to its increased safety over ultraviolet light, there is interest in the development of antimicrobial violet-blue light technologies for infection control applications. To ensure compatibility with exposed materials and tissue, the light irradiances and dose regimes used must be suitable for the target application. This study investigates the antimicrobial dose responses and germicidal efficiency of 405 nm violet-blue light when applied at a range of irradiance levels, for inactivation of surface-seeded and suspended bacteria. Bacteria were seeded onto agar surfaces (10 1 -10 8 CFUplate -1 ) or suspended in PBS (10 3 -10 9 CFUmL -1 ) and exposed to increasing doses of 405-nm light (≤ 288 Jcm -2 ) using various irradiances (0.5-150 mWcm -2 ), with susceptibility at equivalent light doses compared. Bacterial reductions ≥ 96% were demonstrated in all cases for lower irradiance (≤ 5 mWcm -2 ) exposures. Comparisons indicated, on a per unit dose basis, that significantly lower doses were required for significant reductions of all species when exposed at lower irradiances: 3-30 Jcm -2 /0.5 mWcm -2  compared to 9-75 Jcm -2 /50 mWcm -2  for low cell density (10 2  CFUplate -1 ) surface exposures and 22.5 Jcm -2 /5 mWcm -2  compared to 67.5 Jcm -2 /150 mWcm -2  for low density (10 3  CFUmL -1 ) liquid exposures (P ≤ 0.05). Similar patterns were observed at higher densities, excluding S. aureus exposed at 10 9  CFUmL -1 , suggesting bacterial density at predictable levels has minimal influence on decontamination efficacy. This study provides fundamental evidence of the greater energy efficacy of 405-nm light for inactivation of clinically-significant pathogens when lower irradiances are employed, further supporting its relevance for practical decontamination applications., (© 2024. The Author(s).)

Atomic emission spectra provide a means to identify and to gain insight into the electronic structure of emitting or absorbing matter. Detailed procedures are provided for the construction of low-pressure electrodeless discharge lamps that yield targeted emission in the vacuum ultraviolet for the spectroscopic study of water vapor and halogen species aboard an array of airborne observation platforms in the upper atmosphere, as well as in laboratory environments. While specific to the production of Lyman-alpha, atomic chlorine, and atomic bromine emissions in this study, the configuration of the lamps and their interchangeability with respect to operation lend these procedures to constructing sources engaging a wide selection of atomic and molecular spectra with straightforward modifications. The features and limitations of each type of lamp are discussed, as well as methods to improve spectral purity and factors affecting operational lifetime.

Class IV dental diode lasers have been introduced as a nonsurgical therapy for periodontal pockets in veterinary and human dentistry. This retrospective case series evaluates the use of Class IV dental diode laser therapy for abnormal periodontal pockets in a specialty veterinary dental practice. A hypothesis that the Class IV diode dental laser is a useful adjuvant modality in canine periodontal pocket therapy in the reduction of clinical pocket depth was made. This article discusses and demonstrates diode laser use in periodontal pocket therapy in a specialty veterinary dental practice and reviews the current literature. Inclusion in this study was limited to client-owned dogs with noted periodontal pocketing on any tooth type between 3 and 6 mm, which were treated with closed root planing (RP/C) and laser therapy who returned in 6 to 7 months for recheck of the pockets from the years 2017 to 2020. Twelve patients met the inclusion criteria. A total of 128 periodontal pockets were included in the study. Each periodontal pocket was a case receiving therapy. The mean periodontal pocket depth before the treatment is measured as 3.35 mm. The mean pocket depth of the periodontal pockets following treatment was 0.59 mm. The mean improvement in periodontal pocket depths after diode laser therapy when considering patient and tooth number using linear mixed-effects modeling was 2.63 mm (95% confidence interval [CI]: 1.81-3.46, P  < .0001). No statistically significant results were observed for pocket type, as P values were greater than .05., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

We applied Andersen's Behavioral Model of Health Services Use to investigate the health needs and use of digital health resources among sexual and/or gender minority (SGM) caregivers. Data were from the Caregiving in the U.S. 2020 survey. Regression analyses were used to describe associations between predisposing, enabling, and need factors and usage of digital health resources. SGM caregivers provided more hours of care per week, reported higher levels of care intensity, and reported higher physical, emotional, and financial strain compared with non-SGM caregivers. Regression analyses indicated SGM status was a significant predictor of overall use of digital health resources. Younger caregivers, racial minority caregivers, those providing higher levels of care, and those reporting a poorer health status were more likely to use digital health resources. Digital health resources may be useful tools for SGM caregivers of older adults. More research is needed to investigate the reasons SGM caregivers use these resources., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Mild cognitive impairment is a prodromal phase of Alzheimer's disease and related dementias. Cognitive and/or neuropsychiatric symptoms that could worsen over time cause challenges for patients and romantic partners, who often assume the role of informal caregivers. Although physical activity is beneficial, older adults with mild cognitive impairment and their romantic care partners are generally physically inactive. Our 16-week study was performed to see whether physical activity together is feasible to increase physical activity among four dyads (individuals with mild cognitive impairment and their spouses). Our dyadic intervention was feasible given more than 70 % of participants self-reported adherence to physical activity based on the guidelines for adults in the United States. In exit interviews, togetherness was highlighted as one of the biggest strengths of this study. Future studies with more representative samples are needed, as well as adopting a more tailored approach that accounts for individuals' levels of physical fitness., Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interest regarding the publication of this article., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Aims: To explore whether gait and/or balance disturbances are associated with the onset of Alzheimer's dementia (AD) among older adults with amnestic mild cognitive impairment (MCI)., Design: This study employed a longitudinal retrospective cohort design., Methods: We obtained data from the National Alzheimer's Coordinating Center's Uniform Data Set collected from 35 National Institute on Aging Alzheimer's Disease Research Centers between September 2005 and December 2021. The mean age of participants (n = 2692) was 74.5 years with women making up 47.2% of the sample. Risk of incident AD according to baseline gait and/or balance disturbances as measured using the Postural Instability and Gait Disturbance Score, a subscale of the Unified Parkinson's Disease Rating Scale Motor Score, was examined by the Cox proportional hazards regression models adjusting for baseline demographics, medical conditions and study sites. The mean follow-up duration was 4.0 years., Results: Among all the participants, the presence or the severity of gait and/or balance disturbances was associated with an increased risk of AD. The presence or the severity of gait and/or balance disturbances was associated with a higher risk of Alzheimer's dementia among the subgroups of female and male participants., Conclusion: Gait and/or balance disturbances may increase the risk of developing AD, regardless of sex., Impact: Gait and/or balance disturbances among community-dwelling older adults with amnestic MCI may need to be frequently assessed by nurses to identify potential risk factors for cognitive decline., No Patient or Public Contribution: Given the secondary analysis, patients, service users, caregivers or members of the public were not directly involved in this study., (© 2023 John Wiley & Sons Ltd.)

Feline chronic gingivostomatitis (FCGS) is a chronic mucosal and gingival inflammatory disease in which pathogenesis remains unclear. Interactions between the host inflammatory process, the host immune response, and the oral microbiome are implicated in this pathogenesis. To begin to understand this disease and the impact of the microbiome to host inflammatory disease states, we collected sterile noninvasive plaque biofilm samples from ten distinct sites within the oral cavity in cats with stomatitis ( n = 12), healthy cats ( n = 9), and cats with tooth resorption or periodontitis ( n = 11). Analysis of full-length 16S rRNA gene sequences indicated that the microbiomes of cats with FCGS presented marked dysbiosis at multiple oral sites. Additionally, microbiome beta diversity varied with oral condition, indicating that stomatitis, periodontitis, and/or tooth resorption influence the microbiome differently. Lastly, we found that the microbiomes of swabs taken from the oral cavity were comparable to those taken from plaque using endodontic paper points, validating this as another sampling method. Collectively, our work furthers our understanding of the dysbiosis and composition of bacteria in the oral microbiome in FCGS, with hopes of contributing to the prevention, diagnosis, and treatment of this challenging condition in felines.

The explosive eruption of the Hunga Tonga-Hunga Ha'apai (HTHH) volcano on 15 January 2022 injected more water vapor into the stratosphere and to higher altitudes than ever observed in the satellite era. Here, the evolution of the stratospherically injected water vapor is examined as a function of latitude, altitude, and time in the year following the eruption (February to December 2022), and perturbations to stratospheric chemical composition resulting from the increased sulfate aerosols and water vapor are identified and analyzed. The average calculated mass distribution of elevated water vapor between hemispheres is approximately 78% Southern Hemisphere (SH) and 22% Northern Hemisphere in 2022. Significant changes in stratospheric composition following the HTHH eruption are identified using observations from the Aura Microwave Limb Sounder satellite instrument. The dominant features in the monthly mean vertical profiles averaged over 15° latitude ranges are decreases in O 3 (-14%) and HCl (-22%) at SH midlatitudes and increases in ClO (>100%) and HNO 3 (43%) in the tropics, with peak pressure-level perturbations listed. Anomalies in column ozone from 1.2-100 hPa due to the HTHH eruption include widespread O 3 reductions in SH midlatitudes and O 3 increases in the tropics, with peak anomalies in 15° latitude-binned, monthly averages of approximately -7% and +5%, respectively, occurring in austral spring. Using a 3-dimensional chemistry-climate-aerosol model and observational tracer correlations, changes in stratospheric composition are found to be due to both dynamical and chemical factors.

The highly transmittable nature of SARS-CoV-2 has increased the necessity for novel strategies to safely decontaminate public areas. This study investigates the efficacy of a low irradiance 405-nm light environmental decontamination system for the inactivation of bacteriophage phi6 as a surrogate for SARS-CoV-2. Bacteriophage phi6 was exposed to increasing doses of low irradiance (~0.5 mW cm -2 ) 405-nm light while suspended in SM buffer and artificial human saliva at low (~10 3-4  PFU mL -1 ) and high (~10 7-8  PFU mL -1 ) seeding densities, to determine system efficacy for SARS-CoV-2 inactivation and establish the influence of biologically relevant suspension media on viral susceptibility. Complete/near-complete (≥99.4%) inactivation was demonstrated in all cases, with significantly enhanced reductions observed in biologically relevant media (P < 0.05). Doses of 43.2 and 172.8 J cm -2 were required to achieve ~3 log 10 reductions at low density, and 97.2 and 259.2 J cm -2 achieved ~6 log 10 reductions at high density, in saliva and SM buffer, respectively: 2.6-4 times less dose was required when suspended in saliva compared to SM buffer. Comparative exposure to higher irradiance (~50 mW cm -2 ) 405-nm light indicated that, on a per unit dose basis, 0.5 mW cm -2 treatments were capable of achieving up to 5.8 greater log 10 reductions with up to 28-fold greater germicidal efficiency than that of 50 mW cm -2 treatments. These findings establish the efficacy of low irradiance 405-nm light systems for inactivation of a SARS-CoV-2 surrogate and demonstrate the significant enhancement in susceptibility when suspended in saliva, which is a major vector in COVID-19 transmission., (© 2023 The Authors. Photochemistry and Photobiology published by Wiley Periodicals LLC on behalf of American Society for Photobiology.)

Lesions in the oral cavity of dogs can be erythematous, leukoplakic, or pigmented in coloration. The diagnosis of oral erosions, ulcers, and white lesions in contrast to pigmented lesions in veterinary practice can be challenging. The most benign-looking oral ulcers can be associated with local malignant or systemic disease. Many factors are important in the evaluation and correct diagnosis of oral lesions, including medical and drug history, description of the lesion, number of lesions, depth of the lesion, biopsy technique, and correct histologic interpretation. The goal of this paper is to create a decision tree to guide the classification and proper diagnosis of canine oral mucosal lesions.

Purpose: Lighting systems which use visible light blended with antimicrobial 405-nm violet-blue light have recently been developed for safe continuous decontamination of occupied healthcare environments. This paper characterises the optical output and antibacterial efficacy of a low irradiance 405-nm light system designed for environmental decontamination applications, under controlled laboratory conditions., Methods: In the current study, the irradiance output of a ceiling-mounted 405-nm light source was profiled within a 3×3×2 m (18 m 3 ) test area; with values ranging from 0.001-2.016 mWcm -2 . To evaluate antibacterial efficacy of the light source for environmental surface decontamination, irradiance levels within this range (0.021-1 mWcm -2 ) at various angular ( Δ ϴ=0-51.3) and linear (∆s=1.6-2.56 m) displacements from the source were used to generate inactivation kinetics, using the model organism, Staphylococcus aureus . Additionally, twelve bacterial species were surface-seeded and light-exposed at a fixed displacement below the source (1.5 m; 0.5 mWcm -2 ) to demonstrate broad-spectrum efficacy at heights typical of high touch surfaces within occupied settings., Results: Results demonstrate that significant (P≤0.05) inactivation was successfully achieved at all irradiance values investigated, with spatial positioning from the source affecting inactivation, with greater times required for inactivation as irradiance decreased. Complete/near-complete (≥93.28%) inactivation of all bacteria was achieved following exposure to 0.5 mWcm -2 within exposure times realistic of those utilised practically for whole-room decontamination (2-16 h)., Conclusion: This study provides fundamental evidence of the efficacy, and energy efficiency, of low irradiance 405-nm light for bacterial inactivation within a controlled laboratory setting, further justifying its benefits for practical infection control applications., Competing Interests: Conflict of interestThe intellectual property rights of the 405 nm light environmental decontamination system belong to the University of Strathclyde, and JGA, MM and SJM are co-inventors., (© The Author(s) 2023.)

Canine chronic ulcerative stomatitis (CCUS) is a spontaneously occurring, painful, and often debilitating condition of the oral cavity, with a suspected immune-mediated component. The response to pharmacological treatment is generally poor, thus the need to identify more effective medical therapies for this condition. This article describes a prospective clinical trial that was designed to evaluate the efficiency of a combination of cyclosporine and metronidazole in managing CCUS. The hypothesis was that a combination of cyclosporine and metronidazole would effectively minimize clinical signs associated with CCUS. Ten client-owned dogs with a biopsy-confirmed diagnosis consistent with CCUS were prescribed cyclosporine (5 mg/kg) for 1 week, followed by the addition of metronidazole (15-20 mg/kg), both administered orally once daily. The cyclosporine dosage interval was lengthened over time. Dogs were observed for a 6-month period and evaluated using a 32-point Canine Ulcerative Stomatitis Disease Activity Index (CUSDAI). Regular cyclosporine therapeutic drug monitoring was also conducted by the measurement of whole blood cyclosporine levels and the pharmacodynamic assessment of the T-cell expression of IL-2. The results demonstrated that a combination of cyclosporine and metronidazole was effective in minimizing the clinical signs of CCUS and in reducing CUSDAI scores. Neither blood cyclosporine levels nor the T-cell expression of IL-2 predicted improvement in clinical signs and CUSDAI scores, although there was a correlation between blood drug concentrations and the suppression of T-cell IL-2 expression. The evaluation of clinical signs and CUSDAI scores appears to be the most effective means of assessing response to therapy, and therapeutic drug level monitoring does not appear to be routinely indicated.

Immune-mediated and autoimmune diseases of the skin often present with oral cavity involvement. Autoimmune subepidermal blistering diseases and pemphigus vulgaris are classic examples. While the primary lesions (vesicles and bullae) are relatively specific, these fragile lesions evolve rapidly into erosions and ulcers, which are lesion types that overlap with many diseases. Furthermore, some immune-mediated diseases such as severe adverse drug reactions, lupus diseases, canine uveodermatological syndrome, and vasculitis, may or may not involve the oral cavity, and often nonoral clinical manifestations are more diagnostic. In these situations, disease knowledge combined with signalment, lesion distribution, and history help to narrow the differentials. Surgical biopsy is required for confirmation in most diseases, while immunosuppressive treatments most typically involve glucocorticoids with or without nonsteroidal immunosuppressants.

Antigen tests to detect SARS-CoV-2 have emerged as a promising rapid diagnostic method for COVID-19, but they are unable to differentiate between variants of concern (VOCs). Here, we report a rapid point-of-care test (POC-T), termed CoVariant-SPOT, that uses a set of antibodies that are either tolerant or intolerant to spike protein mutations to identify the likely SARS-CoV-2 strain concurrent with COVID-19 diagnosis using antibodies targeting the nucleocapsid protein. All reagents are incorporated into a portable, multiplexed, and sensitive diagnostic platform built upon a nonfouling polymer brush. To validate CoVariant-SPOT, we tested recombinant SARS-CoV-2 proteins, inactivated viruses, and nasopharyngeal swab samples from COVID-19 positive and negative individuals and showed that CoVariant-SPOT can readily distinguish between two VOCs: Delta and Omicron. We believe that CoVariant-SPOT can serve as a valuable adjunct to next-generation sequencing to rapidly identify variants using a scalable and deployable POC-T, thereby enhancing community surveillance efforts worldwide and informing treatment selection.

This review aimed to evaluate the effects of multi-domain interventions on cognition among individuals without dementia. Multi-domain interventions refer to those combining any single preventive measure such as physical activity, cognitive training, and/or nutrition to prevent dementia. Seventeen studies were included (n = 10,056 total participants; mean age = 73 years), eight of which were rated as strong in quality while the other nine showed moderate quality. The standardized mean difference (SMD; d ) was used to calculate the effect size for each included study. Multi-domain interventions consisting of physical activity, cognitive training, cardioprotective nutrition, and/or cardiovascular health education exerted beneficial effects on global cognition, episodic memory, and/or executive function with very small to moderate effect sizes (0.16-0.77). Nurses may consider combining these components to potentially stave off dementia. Future research is warranted to identify the optimal multi-domain intervention components that can induce clinically significant beneficial effects on cognition.

As the health care and well-being of sexual and gender minority (SGM; i.e., lesbian, gay, bisexual, and/or transgender or gender non-binary) people in the United States receive federal and local-level attention, SGM older adults and caregivers continue to be left out of important health policy and care conversations. The current article describes policy issues and affirmative strategies related to inclusive care practices among SGM older adults and caregivers. In addition to the broader policies considered related to health and well-being, we include a discussion of local-level policy strategies to mitigate discrimination and promote inclusive care for SGM older adults and caregivers. [ Journal of Gerontological Nursing, 48 (12), 6-15.].

Nearly 350,000 lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) adults in the U.S. are currently living with Alzheimer's disease and related dementias (ADRD). Informal caregivers face challenges impacting their ability to access and receive adequate and inclusive care for LGBTQ+ persons living with ADRD. The purpose of this study was to determine the feasibility and acceptability of the Savvy Caregiver Program for caregivers of LGBTQ+ individuals living with ADRD. Data for this secondary analysis come from caregivers ( n = 17) who completed 6 sessions of the Savvy program. Caregivers were very satisfied with tailored program activities. Analyses of trends suggest non-significant increases in positive aspects of caregiving and decreases in caregiver burden and depressive symptoms. This is the first known study assessing the feasibility of the Savvy Caregiver Program for caregivers of LGBTQ+ individuals living with ADRD. Future research on the Savvy Caregiver Program for caregivers of LGBTQ+ people living with ADRD is needed.

Worldwide, it is estimated that around 50 million older adults have Alzheimer's disease and related dementias (ADRD). Cognitive deficits associated with ADRD may affect a driver's perception and decision-making and potentially cause safety concerns. Despite much research, there lacks a comprehensive cognitive evaluation to determine the driving capability of a person with ADRD and it is unclear what are the most effective training and interventions that help to enhance driving performance for these individuals. The purpose of this article is to conduct a comprehensive literature survey to review and summarize studies of driving performance evaluation and intervention for people with ADRD and discuss perspectives for future studies. Although many studies have investigated the correlations between driving behaviors and cognitive performances for people with ADRD, it remains unclear how driving behaviors and cognitive performances are associated with psychophysiological measures. We discussed the need to develop regular driving evaluation and rehabilitation protocol for people with ADRD. We also highlighted the potential benefit to combine driving tests with psychophysiological measures to assist in characterizing personalized cognitive evaluation in the behavioral evaluation process., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Trauma nurses may experience secondary traumatic stress, compassion fatigue, and burnout as their clinical roles expose them to patients with traumatic injuries. Because traumatic events described as being most stressful for nurses involve sudden death or children and adolescents, multicasualty, school-associated shooting events are likely to be particularly stressful for nurses who care for the affected patients., Objective: This research examined the psychosocial effects of caring for patients in an inpatient trauma unit following a multicasualty, school-associated shooting event., Methods: This research was guided by a qualitative case series approach, a theory of secondary traumatic stress, and the compassion fatigue resilience model. Registered nurses who provided care in the trauma unit of a Level I trauma center to patients who were injured during a multicasualty, school-associated shooting event in the Southeastern United States were invited to participate., Results: The three themes identified by this research were (a) innocence of the patients, (b) trajectories of increased emotions, and (c) processing emotional stressors. Nurses reported the benefits of peer support and provided recommendations to increase the efficacy of formal debriefing sessions., Conclusions: Nurses value self-care routines and peer support as coping mechanisms to foster well-being following exposure to traumatic events. Hospitals should encourage active participation in timely critical incident stress debriefings and promote the use of employee assistance services to support nursing staff after these events., Competing Interests: The authors have no conflicts of interest or funding to declare., (Copyright © 2022 Society of Trauma Nurses.)