io Pot Use Among U.S. Seniors Nearly Doubled in 3 Years By www.medicinenet.com Published On :: Tue, 25 Feb 2020 00:00:00 PDT Title: Pot Use Among U.S. Seniors Nearly Doubled in 3 YearsCategory: Health NewsCreated: 2/24/2020 12:00:00 AMLast Editorial Review: 2/25/2020 12:00:00 AM Full Article
io Many Seniors Leave Hospital With New Disabilities By www.medicinenet.com Published On :: Tue, 3 Mar 2020 00:00:00 PDT Title: Many Seniors Leave Hospital With New DisabilitiesCategory: Health NewsCreated: 3/2/2020 12:00:00 AMLast Editorial Review: 3/3/2020 12:00:00 AM Full Article
io Sleepy Seniors Have Higher Health Risks By www.medicinenet.com Published On :: Tue, 3 Mar 2020 00:00:00 PDT Title: Sleepy Seniors Have Higher Health RisksCategory: Health NewsCreated: 3/2/2020 12:00:00 AMLast Editorial Review: 3/3/2020 12:00:00 AM Full Article
io Helping Seniors Manage Meds After Hospital Reduces Readmission: Study By www.medicinenet.com Published On :: Wed, 4 Mar 2020 00:00:00 PDT Title: Helping Seniors Manage Meds After Hospital Reduces Readmission: StudyCategory: Health NewsCreated: 3/3/2020 12:00:00 AMLast Editorial Review: 3/4/2020 12:00:00 AM Full Article
io Seniors, Getting Off the Sofa Brings Big Health Benefits By www.medicinenet.com Published On :: Fri, 6 Mar 2020 00:00:00 PDT Title: Seniors, Getting Off the Sofa Brings Big Health BenefitsCategory: Health NewsCreated: 3/5/2020 12:00:00 AMLast Editorial Review: 3/6/2020 12:00:00 AM Full Article
io How Pets Can Be True Lifesavers for Seniors By www.medicinenet.com Published On :: Fri, 3 Apr 2020 00:00:00 PDT Title: How Pets Can Be True Lifesavers for SeniorsCategory: Health NewsCreated: 4/3/2020 12:00:00 AMLast Editorial Review: 4/3/2020 12:00:00 AM Full Article
io Avonex (interferon beta 1a injection) By www.medicinenet.com Published On :: Wed, 8 Apr 2020 00:00:00 PDT Title: Avonex (interferon beta 1a injection) Category: MedicationsCreated: 3/2/2005 12:00:00 AMLast Editorial Review: 4/8/2020 12:00:00 AM Full Article
io Therapy by Phone Helps Parkinson's Patients Manage Depression By www.medicinenet.com Published On :: Mon, 13 Apr 2020 00:00:00 PDT Title: Therapy by Phone Helps Parkinson's Patients Manage DepressionCategory: Health NewsCreated: 4/10/2020 12:00:00 AMLast Editorial Review: 4/13/2020 12:00:00 AM Full Article
io Long Periods in Space Alter Astronauts' Brains By www.medicinenet.com Published On :: Wed, 15 Apr 2020 00:00:00 PDT Title: Long Periods in Space Alter Astronauts' BrainsCategory: Health NewsCreated: 4/14/2020 12:00:00 AMLast Editorial Review: 4/15/2020 12:00:00 AM Full Article
io Entyvio (vedolizumab) By www.medicinenet.com Published On :: Fri, 17 Apr 2020 00:00:00 PDT Title: Entyvio (vedolizumab)Category: MedicationsCreated: 4/17/2020 12:00:00 AMLast Editorial Review: 4/17/2020 12:00:00 AM Full Article
io How Long Does a Laparoscopic Nissen Fundoplication Last? By www.medicinenet.com Published On :: Wed, 29 Apr 2020 00:00:00 PDT Title: How Long Does a Laparoscopic Nissen Fundoplication Last?Category: Procedures and TestsCreated: 4/29/2020 12:00:00 AMLast Editorial Review: 4/29/2020 12:00:00 AM Full Article
io What Is Nasogastric Intubation Used For? By www.medicinenet.com Published On :: Mon, 4 May 2020 00:00:00 PDT Title: What Is Nasogastric Intubation Used For?Category: Procedures and TestsCreated: 5/4/2020 12:00:00 AMLast Editorial Review: 5/4/2020 12:00:00 AM Full Article
io How Is a Transjugular Liver Biopsy Done? By www.medicinenet.com Published On :: Wed, 6 May 2020 00:00:00 PDT Title: How Is a Transjugular Liver Biopsy Done?Category: Procedures and TestsCreated: 5/6/2020 12:00:00 AMLast Editorial Review: 5/6/2020 12:00:00 AM Full Article
io Supreme Court Justice Ginsberg Treated for Gallbladder Infection By www.medicinenet.com Published On :: Wed, 6 May 2020 00:00:00 PDT Title: Supreme Court Justice Ginsberg Treated for Gallbladder InfectionCategory: Health NewsCreated: 5/5/2020 12:00:00 AMLast Editorial Review: 5/6/2020 12:00:00 AM Full Article
io Got Flu? Deal Quickly With Complications By www.medicinenet.com Published On :: Mon, 3 Feb 2020 00:00:00 PDT Title: Got Flu? Deal Quickly With ComplicationsCategory: Health NewsCreated: 2/2/2020 12:00:00 AMLast Editorial Review: 2/3/2020 12:00:00 AM Full Article
io Flu Season That's Sickened 26 Million May Be at Its Peak By www.medicinenet.com Published On :: Fri, 21 Feb 2020 00:00:00 PDT Title: Flu Season That's Sickened 26 Million May Be at Its PeakCategory: Health NewsCreated: 2/21/2020 12:00:00 AMLast Editorial Review: 2/21/2020 12:00:00 AM Full Article
io High Heat, Humidity Could Affect More Than 1.2 Billion People by End of Century By www.medicinenet.com Published On :: Wed, 25 Mar 2020 00:00:00 PDT Title: High Heat, Humidity Could Affect More Than 1.2 Billion People by End of CenturyCategory: Health NewsCreated: 3/24/2020 12:00:00 AMLast Editorial Review: 3/25/2020 12:00:00 AM Full Article
io Wellbutrin (bupropion) By www.medicinenet.com Published On :: Wed, 12 Feb 2020 00:00:00 PDT Title: Wellbutrin (bupropion)Category: MedicationsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 2/12/2020 12:00:00 AM Full Article
io AHA News: Stroke Survivors Might Need Better Screening for Depression By www.medicinenet.com Published On :: Thu, 13 Feb 2020 00:00:00 PDT Title: AHA News: Stroke Survivors Might Need Better Screening for DepressionCategory: Health NewsCreated: 2/12/2020 12:00:00 AMLast Editorial Review: 2/13/2020 12:00:00 AM Full Article
io Teen Moms at High Risk for Depression, Anxiety By www.medicinenet.com Published On :: Mon, 2 Mar 2020 00:00:00 PDT Title: Teen Moms at High Risk for Depression, AnxietyCategory: Health NewsCreated: 2/28/2020 12:00:00 AMLast Editorial Review: 3/2/2020 12:00:00 AM Full Article
io Magnetic Brain 'Zap' Shows Promise Against Severe Depression By www.medicinenet.com Published On :: Wed, 8 Apr 2020 00:00:00 PDT Title: Magnetic Brain 'Zap' Shows Promise Against Severe DepressionCategory: Health NewsCreated: 4/7/2020 12:00:00 AMLast Editorial Review: 4/8/2020 12:00:00 AM Full Article
io Bacterial Blood Infections Tied to Heightened Colon Cancer Risk By www.medicinenet.com Published On :: Thu, 23 Apr 2020 00:00:00 PDT Title: Bacterial Blood Infections Tied to Heightened Colon Cancer RiskCategory: Health NewsCreated: 4/22/2020 12:00:00 AMLast Editorial Review: 4/23/2020 12:00:00 AM Full Article
io Unplugging From Social Media on Vacation? It's Tough at First By www.medicinenet.com Published On :: Wed, 14 Aug 2019 00:00:00 PDT Title: Unplugging From Social Media on Vacation? It's Tough at FirstCategory: Health NewsCreated: 8/14/2019 12:00:00 AMLast Editorial Review: 8/14/2019 12:00:00 AM Full Article
io Health Tip: Planning a Stress-Reducing Vacation By www.medicinenet.com Published On :: Fri, 18 Oct 2019 00:00:00 PDT Title: Health Tip: Planning a Stress-Reducing VacationCategory: Health NewsCreated: 10/18/2019 12:00:00 AMLast Editorial Review: 10/18/2019 12:00:00 AM Full Article
io Some Cities' Smog Can Ruin Your Vacation By www.medicinenet.com Published On :: Tue, 3 Dec 2019 00:00:00 PDT Title: Some Cities' Smog Can Ruin Your VacationCategory: Health NewsCreated: 12/3/2019 12:00:00 AMLast Editorial Review: 12/3/2019 12:00:00 AM Full Article
io Phase I Dose-Escalation and -Expansion Study of Telisotuzumab (ABT-700), an Anti-c-Met Antibody, in Patients with Advanced Solid Tumors By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 This first-in-human phase I study evaluated the pharmacokinetics, safety, and preliminary efficacy of telisotuzumab, formerly called ABT-700, an antagonistic antibody directed against c-Met. For dose escalation (3+3 design), 3 to 6 patients with advanced solid tumors were enrolled into four dose cohorts (5–25 mg/kg). In the dose-expansion phase, a subset of patients was prospectively selected for MET amplification (FISH screening). Patients received telisotuzumab intravenously on day 1 every 21 days. For dose expansion, 15 mg/kg was chosen as the dose on the basis of safety, pharmacokinetics, and other data from the escalation cohorts. Forty-five patients were enrolled and received at least one dose of telisotuzumab (dose escalation, n = 15; dose expansion, n = 30). Telisotuzumab showed a linear pharmacokinetics profile; peak plasma concentration was proportional to dose level. There were no acute infusion reactions and no dose-limiting toxicities were observed. The most common treatment-related adverse events included hypoalbuminemia (n = 9, 20.0%) and fatigue (n = 5, 11.1%). By Response Evaluation Criteria In Solid Tumors (RECIST), 4 of 10 (40.0%) patients with MET-amplified tumors had confirmed partial response in target lesions (one ovarian, two gastric, and one esophageal), two (20.0%) had stable disease, three (30.0%) had progressive disease; one patient was unable to be evaluated. Among patients with nonamplified tumors (n = 35), no objective responses were observed; however, 11 patients had stable disease per RECIST criteria. In conclusion, telisotuzumab has an acceptable safety profile with clinical activity observed in patients with MET-amplified advanced solid tumors. Full Article
io CDK9 Blockade Exploits Context-dependent Transcriptional Changes to Improve Activity and Limit Toxicity of Mithramycin for Ewing Sarcoma By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 There is a need to develop novel approaches to improve the balance between efficacy and toxicity for transcription factor–targeted therapies. In this study, we exploit context-dependent differences in RNA polymerase II processivity as an approach to improve the activity and limit the toxicity of the EWS-FLI1–targeted small molecule, mithramycin, for Ewing sarcoma. The clinical activity of mithramycin for Ewing sarcoma is limited by off-target liver toxicity that restricts the serum concentration to levels insufficient to inhibit EWS-FLI1. In this study, we perform an siRNA screen of the druggable genome followed by a matrix drug screen to identify mithramycin potentiators and a synergistic "class" effect with cyclin-dependent kinase 9 (CDK9) inhibitors. These CDK9 inhibitors enhanced the mithramycin-mediated suppression of the EWS-FLI1 transcriptional program leading to a shift in the IC50 and striking regressions of Ewing sarcoma xenografts. To determine whether these compounds may also be liver protective, we performed a qPCR screen of all known liver toxicity genes in HepG2 cells to identify mithramycin-driven transcriptional changes that contribute to the liver toxicity. Mithramycin induces expression of the BTG2 gene in HepG2 but not Ewing sarcoma cells, which leads to a liver-specific accumulation of reactive oxygen species (ROS). siRNA silencing of BTG2 rescues the induction of ROS and the cytotoxicity of mithramycin in these cells. Furthermore, CDK9 inhibition blocked the induction of BTG2 to limit cytotoxicity in HepG2, but not Ewing sarcoma cells. These studies provide the basis for a synergistic and less toxic EWS-FLI1–targeted combination therapy for Ewing sarcoma. Full Article
io SLFN11 Expression in Advanced Prostate Cancer and Response to Platinum-based Chemotherapy By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 Expression of the DNA/RNA helicase schlafen family member 11 (SLFN11) has been identified as a sensitizer of tumor cells to DNA-damaging agents including platinum chemotherapy. We assessed the impact of SLFN11 expression on response to platinum chemotherapy and outcomes in patients with metastatic castration-resistant prostate cancer (CRPC). Tumor expression of SLFN11 was assessed in 41 patients with CRPC treated with platinum chemotherapy by RNA sequencing (RNA-seq) of metastatic biopsy tissue (n = 27) and/or immunofluorescence in circulating tumor cells (CTC; n = 20). Cox regression and Kaplan–Meier methods were used to evaluate the association of SLFN11 expression with radiographic progression-free survival (rPFS) and overall survival (OS). Multivariate analysis included tumor histology (i.e., adenocarcinoma or neuroendocrine) and the presence or absence of DNA repair aberrations. Patient-derived organoids with SLFN11 expression and after knockout by CRISPR-Cas9 were treated with platinum and assessed for changes in dose response. Patients were treated with platinum combination (N = 38) or platinum monotherapy (N = 3). Median lines of prior therapy for CRPC was two. Median OS was 8.7 months. Overexpression of SLFN11 in metastatic tumors by RNA-seq was associated with longer rPFS compared with those without overexpression (6.9 vs. 2.8 months, HR = 3.72; 95% confidence interval (CI), 1.56–8.87; P < 0.001); similar results were observed for patients with SLFN11-positive versus SLFN11-negative CTCs (rPFS 6.0 vs. 2.2 months, HR = 4.02; 95% CI, 0.77–20.86; P = 0.002). A prostate-specific antigen (PSA) decline of ≥50% was observed in all patients with SLFN11 overexpression. No association was observed between SLFN11 expression and OS. On multivariable analysis, SLFN11 was an independent factor associated with rPFS on platinum therapy. Platinum response of organoids expressing SLFN11 was reduced after SLFN11 knockout. Our data suggest that SLFN11 expression might identify patients with CRPC with a better response to platinum chemotherapy independent of histology or other genomic alterations. Additional studies, also in the context of PARP inhibitors, are warranted. Full Article
io Elucidation of Pelareorep Pharmacodynamics in A Phase I Trial in Patients with KRAS-Mutated Colorectal Cancer By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 KRAS mutation is a negative predictive biomarker of anti-EGFR agents in patients with metastatic colorectal cancer (mCRC), and remains an elusive target. Pelareorep, a double-stranded RNA virus selectively replicates in KRAS-mutated cells, and is synergistic with irinotecan. A dose escalation trial of FOLFIRI/bevacizumab [irinotecan (150–180 mg/m2) and pelareorep (1 x 1010 TCID50–3 x 1010 TCID50)] was implemented in adult patients with oxaliplatin refractory/intolerant, KRAS-mutant mCRC. Pelareorep was administered intravenously over 1 hour on days 1–5 every 4 weeks. Additional studies included pharmacokinetics, tumor morphology, and immune responses. Among FOLFIRI-naïve patients, the highest dose of FOLFIRI/bevacizumab (180 mg/m2 irinotecan) and pelareorep (3 x 1010 TCID50) was well tolerated, without a dose-limiting toxicity. At the recommended phase II dose, 3 of 6 patients (50%) had a partial response; the median progression-free and overall survival (PFS, OS) were 65.6 weeks and 25.1 months, respectively. Toxicities included myelosuppression, fatigue, and diarrhea. Transmission electron microscopy revealed viral factories (viral collections forming vesicular structures), at various stages of development. Immunogold staining against viral capsid -1 protein demonstrated viral "homing" in the tumor cells. The nucleus displayed sufficient euchromatin regions suggestive of active transcription. Flow cytometry revealed rapid dendritic cell maturation (48 hours) with subsequent activation of cytotoxic T cells (7 days). The combination of pelareorep with FOLFIRI/bevacizumab is safe. The PFS and OS data are encouraging and deserve further exploration. Pelareorep leads to a clear recurrent immune stimulatory response with cytotoxic T-cell activation, and homes and replicates in the tumor. Full Article
io Identification of ALDH1A3 as a Viable Therapeutic Target in Breast Cancer Metastasis-Initiating Cells By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 The development of efficacious therapies targeting metastatic spread of breast cancer to the brain represents an unmet clinical need. Accordingly, an improved understanding of the molecular underpinnings of central nervous system spread and progression of breast cancer brain metastases (BCBM) is required. In this study, the clinical burden of disease in BCBM was investigated, as well as the role of aldehyde dehydrogenase 1A3 (ALDH1A3) in the metastatic cascade leading to BCBM development. Initial analysis of clinical survival trends for breast cancer and BCBM determined improvement of breast cancer survival rates; however, this has failed to positively affect the prognostic milestones of triple-negative breast cancer (TNBC) brain metastases (BM). ALDH1A3 and a representative epithelial–mesenchymal transition (EMT) gene signature (mesenchymal markers, CD44 or Vimentin) were compared in tumors derived from BM, lung metastases (LM), or bone metastases (BoM) of patients as well as mice after injection of TNBC cells. Selective elevation of the EMT signature and ALDH1A3 were observed in BM, unlike LM and BoM, especially in the tumor edge. Furthermore, ALDH1A3 was determined to play a role in BCBM establishment via regulation of circulating tumor cell adhesion and migration phases in the BCBM cascade. Validation through genetic and pharmacologic inhibition of ALDH1A3 via lentiviral shRNA knockdown and a novel small-molecule inhibitor demonstrated selective inhibition of BCBM formation with prolonged survival of tumor-bearing mice. Given the survival benefits via targeting ALDH1A3, it may prove an effective therapeutic strategy for BCBM prevention and/or treatment. Full Article
io Inhibition of Importin {beta}1 Augments the Anticancer Effect of Agonistic Anti-Death Receptor 5 Antibody in TRAIL-resistant Tumor Cells By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 TNF-related apoptosis-inducing ligand (TRAIL) and an agonistic antibody against the death-inducing TRAIL receptor 5, DR5, are thought to selectively induce tumor cell death and therefore, have gained attention as potential therapeutics currently under investigation in several clinical trials. However, some tumor cells are resistant to TRAIL/DR5–induced cell death, even though they express DR5. Previously, we reported that DR5 is transported into the nucleus by importin β1, and knockdown of importin β1 upregulates cell surface expression of DR5 resulting in increased TRAIL sensitivity in vitro. Here, we examined the impact of importin β1 knockdown on agonistic anti-human DR5 (hDR5) antibody therapy. Drug-inducible importin β1 knockdown sensitizes HeLa cells to TRAIL-induced cell death in vitro, and exerts an antitumor effect when combined with agonistic anti-hDR5 antibody administration in vivo. Therapeutic importin β1 knockdown, administered via the atelocollagen delivery system, as well as treatment with the importin β inhibitor, importazole, induced regression and/or eradication of two human TRAIL-resistant tumor cells when combined with agonistic anti-hDR5 antibody treatment. Thus, these findings suggest that the inhibition of importin β1 would be useful to improve the therapeutic effects of agonistic anti-hDR5 antibody against TRAIL-resistant cancers. Full Article
io Therapeutic and Prophylactic Antitumor Activity of an Oral Inhibitor of Fucosylation in Spontaneous Mammary Cancers By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 2-fluorofucose (2FF) inhibits protein and cellular fucosylation. Afucosylation of IgG antibodies enhances antibody-dependent cell-mediated cytotoxicity by modulating antibody affinity for FcRIIIa, which can impact secondary T-cell activation. Immune responses toward most common solid tumors are dominated by a humoral immune response rather than the presence of tumor-infiltrating cytotoxic T cells. IgG antibodies directed against numerous tumor-associated proteins are found in the sera of both patients with breast cancer and transgenic mice bearing mammary cancer. We questioned whether 2FF would have antitumor activity in two genetically distinct transgenic models; TgMMTV-neu (luminal B) and C3(1)-Tag (basal) mammary cancer. 2FF treatment significantly improved overall survival. The TgMMTV-neu doubled survival time compared with controls [P < 0.0001; HR, 7.04; 95% confidence interval (CI), 3.31–15.0], and survival was significantly improved in C3(1)-Tag (P = 0.0013; HR, 3.36; 95% CI, 1.58–7.14). 2FF treated mice, not controls, developed delayed-type hypersensitivity and T-cell responses specific for syngeneic tumor lysates (P < 0.0001). Serum IgG from 2FF-treated mice enhanced tumor lysis more efficiently than control sera (P = 0.004). Administration of 2FF for prophylaxis, at two different doses, significantly delayed tumor onset in both TgMMTV-neu; 20 mmol/L (P = 0.0004; HR, 3.55; 95% CI, 1.60–7.88) and 50 mmol/L (P = 0.0002; HR: 3.89; 95% CI, 1.71–8.86) and C3(1)-Tag; 20 mmol/L (P = 0.0020; HR, 2.51; 95% CI, 1.22–5.18), and 50 mmol/L (P = 0.0012; HR, 3.36; 95% CI, 1.57–7.18). Mammary cancer was prevented in 33% of TgMMTV-neu and 26% of C3(1)-Tag. 2FF has potent antitumor effects in mammary cancer models. The agent shows preclinical efficacy for both cancer treatment and prevention. Full Article
io Pharmacologic Inhibitor of DNA-PK, M3814, Potentiates Radiotherapy and Regresses Human Tumors in Mouse Models By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 Physical and chemical DNA-damaging agents are used widely in the treatment of cancer. Double-strand break (DSB) lesions in DNA are the most deleterious form of damage and, if left unrepaired, can effectively kill cancer cells. DNA-dependent protein kinase (DNA-PK) is a critical component of nonhomologous end joining (NHEJ), one of the two major pathways for DSB repair. Although DNA-PK has been considered an attractive target for cancer therapy, the development of pharmacologic DNA-PK inhibitors for clinical use has been lagging. Here, we report the discovery and characterization of a potent, selective, and orally bioavailable DNA-PK inhibitor, M3814 (peposertib), and provide in vivo proof of principle for DNA-PK inhibition as a novel approach to combination radiotherapy. M3814 potently inhibits DNA-PK catalytic activity and sensitizes multiple cancer cell lines to ionizing radiation (IR) and DSB-inducing agents. Inhibition of DNA-PK autophosphorylation in cancer cells or xenograft tumors led to an increased number of persistent DSBs. Oral administration of M3814 to two xenograft models of human cancer, using a clinically established 6-week fractionated radiation schedule, strongly potentiated the antitumor activity of IR and led to complete tumor regression at nontoxic doses. Our results strongly support DNA-PK inhibition as a novel approach for the combination radiotherapy of cancer. M3814 is currently under investigation in combination with radiotherapy in clinical trials. Full Article
io Two previously unrecorded xiphosurid trace fossils, Selenichnites rossendalensis and Crescentichnus tesiltus, from the Middle Jurassic of Yorkshire, UK By pygs.lyellcollection.org Published On :: 2019-11-22T06:43:26-08:00 The invertebrate trace fossils Selenichnites rossendalensis and Crescentichnus tesiltus are recorded and described from the Middle Jurassic Gristhorpe Member of the Cloughton Formation of the Cleveland Basin. This is the first record of these ichnospecies from the basin and now completes the occurrence of these and other traces assumed to have been made by limulids from all three non-marine formations of the Ravenscar Group. Full Article
io Age of the Acadian deformation and Devonian granites in northern England: a review By pygs.lyellcollection.org Published On :: 2019-11-22T06:43:26-08:00 Field evidence shows that emplacement of Devonian granites in northern England overlaps in space and time with the end of the supposed Acadian deformation in their country rocks. The age of this Acadian event in England and Wales is in need of review because of revised Rb-Sr and K-Ar decay constants and recently acquired radiometric ages on the granites. Published K-Ar and Ar-Ar cleavage ages recalculated to the new decay constants range from 404 to 394 Ma (Emsian, Early Devonian). Emplacement of the Skiddaw and Weardale granites at 398.8 ± 0.4 and 399.3 ± 0.7 Ma respectively is indicated by U-Pb zircon ages, and is compatible with the field evidence. However, emplacement of the Shap Granite at a Re-Os molybdenite age of 405.2 ± 1.8 Ma and at the youngest U-Pb zircon age of 403 ± 8 Ma matches the field evidence less well. The apparent paradox in these ages is resolved if the K-Ar ages record only the end of millions of years of cleavage formation. An earlier cluster of K-Ar and Ar-Ar cleavage ages at 426–420 Ma (Ludlow to Přídolí, late Silurian) dates a pre-Acadian resetting event soon after Iapetus closure, an event of uncertain significance. Ion microprobe U-Pb zircon ages for the Shap Granite have a mean of 415.6 ± 1.4 Ma but a range of 428–403 Ma, compatible with a long magmatic history. Thermal considerations suggest that this history was not at the upper crustal emplacement site but in a mid-crustal mush zone, now preserved at about 10 km depth as a component of the Lake District and North Pennine batholiths. Full Article
io Peer Education: Reviews of the Literature (PERLs) By www.jdentaled.org Published On :: 2019-12-01T06:00:19-08:00 Full Article
io 3D Printed Teeth with Enamel and Dentin Layer for Educating Dental Students in Crown Preparation By www.jdentaled.org Published On :: 2019-12-01T06:00:19-08:00 Commonly used model teeth are so far uniform in color and hardness. There is no discrimination between enamel and dentin part of a tooth. This condition makes it difficult to train a preparation technique, which is adapted to real tooth substance. The aim of this study was to design and establish a 3D printed tooth with different layers for enamel and dentin for education in crown preparation. A printable tooth with different layers for enamel and dentin was designed, and all 38 fourth-year dental students in the first clinical course in prosthodontics and 30 experienced dentists were trained during a voluntary hands-on course in 2019. Prior to the study, the students had used standard model teeth and real-teeth models in their preclinical education. They had experience in caries removal and preparation on real patients. The perceived benefits of the 3D printed tooth were evaluated by a questionnaire. All individuals in both groups completed the questionnaire, for a 100% response rate. The results showed that the printed tooth was given an overall mean grade of 2.3 (students) and 2.0 (experts) on a scale from 1=excellent to 5=poor. The difference in hardness between the dentin and enamel layer was given a mean of 2.4 (students and experts) and the difference in color a 1.7 (students) and 1.8 (experts). The tooth model with the prepared tooth illustrating an ideal preparation was graded 1.6 (students and experts). In this study, the students had the opportunity to learn a correct crown preparation on a printed tooth with different material properties for enamel and dentin. The learning effect with this tooth model was rated as good on the questionnaire by both students and expert dentists. Full Article
io Residents Perspectives on and Application of Dental Public Health Competencies Using Case-Based Methods By www.jdentaled.org Published On :: 2019-12-01T06:00:19-08:00 The aims of this study were to qualitatively assess dental public health (DPH) residents’ perspectives on teaching methods for DPH competencies and to develop and implement a case-based simulation to address those competencies, constructed on the basis of the qualitative assessment. Focus group discussions were conducted with 18 DPH residents enrolled in two university-based DPH programs. Topic areas discussed in the two focus groups were perceived value of DPH competencies, ways to acquire new DPH skills/abilities, and additional skills/abilities needed by DPH residents. The focus groups’ responses showed that the residents felt competent in the analytical thinking competencies such as research methodology and critiquing literature. They emphasized the importance of learning leadership skills and reported feeling somewhat uncertain about their mastery of the policy and advocacy and system evaluation competencies. Of the two distinct categories of DPH skills and competencies— analytical/critical thinking and practical competencies—these residents reported that a greater proportion of time needed to be devoted to integrating the practical competencies into their education. Based on the residents’ feedback, the authors developed a structured seminar series taking a case-based approach to simulate real-world DPH problems, using real and semi-hypothetical planning projects to meet the residents’ perceived needs and covering gaps between didactic learning and practice. Full Article
io Perceptions of Dental Hygienists About Thesis Completion in Graduate Education By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 Few studies have been published on thesis completion experiences of master’s degree students. However, for doctoral students, dissertation completion has been found to be dependent on individual, relational, and institutional factors. The aim of this study was to examine dental hygienists’ perceptions of their experiences completing a thesis as a requirement for an advanced degree. A qualitative phenomenological research design was used utilizing virtual focus groups with a national purposive sample of dental hygienists (n=25) who had graduated from a degree program in which a thesis was a requirement for the degree. Data analysis used an inductive approach to identify themes using Liechty et al.’s framework of individual, relational, and institutional factors impacting completion of a dissertation. Liechty et al.’s framework is based on Vygotsky’s sociocultural theory of learning. In the results, individual factors identified included family/work responsibilities, lack of understanding of the thesis process, time management, health issues, and reaching personal and professional goals. Relational factors focused primarily on positive and negative experiences with the thesis advisor/committee and support from expert peers/family. Institutional factors included the thesis structure, financial concerns, and challenges in recruiting research participants. This study found many factors influencing the thesis experience that may help guide the process in graduate degree programs. In addition, the findings suggest a need to provide mentoring and support for thesis advisors and committee members to more effectively guide students through the thesis process. Effective modifications of these may improve retention of students and facilitate timely completion of thesis research. Full Article
io Development of a Dental School Strategic Plan to Inform Interprofessional Education By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 Changes in U.S. health care delivery systems and Commission on Dental Accreditation standards provide impetus for interprofessional education (IPE) and collaborative practice, but roadmaps for engaging dental and dental hygiene faculty to incorporate IPE in a systematic manner are limited. The purpose of this report is to describe the process for creating a strategy and gathering a variety of baseline data to use for determining objectives and metrics and the subsequent development of an IPE strategic plan at the University of North Carolina (UNC) at Chapel Hill Adams School of Dentistry (SOD). SOD IPE committee members included representation from the UNC Schools of Dentistry, Medicine, Pharmacy, and Business. A three-phase framework was developed. Phase 1 (IPE assessment) was an internal environmental scan including a 2017 faculty survey, departmental mapping of IPE activities, comparison of UNC with national results on the IPE component of the American Dental Education Association (ADEA) survey of dental school seniors (2016 graduating class), identification of faculty joint/adjunct appointments at other UNC schools, and a strengths, weaknesses, opportunities, threats (SWOT) analysis. Phase 2 (visioning) consisted of development of IPE mission, vision, and priorities. In Phase 3 (implementation), priorities were developed. Data-gathering led to a strategic plan with three objectives: 1) increase faculty engagement and recognition, 2) develop predoctoral dentistry and dental hygiene IPE curricula, and 3) develop an infrastructure that supports IPE. Specific initiatives and activities, supporting metrics, and estimated costs were developed for each objective. The framework guided a systematic, transparent, and organized process for collecting and monitoring the evidence and directing activities. A three-year strategic plan for IPE was developed in 2017, and implementation is ongoing. Full Article
io Learning and Teaching Together to Advance Evidence-Based Clinical Education: A Faculty Learning Community By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 Clinical teaching is a cornerstone of health sciences education; it is also the most challenging aspect. The University of Pittsburgh Schools of Dental Medicine, Nursing, and Pharmacy developed a new evidence-based interprofessional course framed as a faculty learning community (FLC) around the principles of learning in a clinical environment. The aim of this study was to assess the overall effectiveness of this two-semester FLC at four health professions schools in academic year 2014-15. The assessment included anonymous participant surveys in each session and an anonymous end-of-course survey. Thirty-five faculty members from dental, health and rehabilitation sciences, nursing, and pharmacy enrolled in the FLC, with six to 32 enrollees attending each session. All attendees at each session completed the session evaluation surveys, but the attendance rate at each session ranged from 17.1% to 91.4%. Sixteen participants (46%) completed the end-of-course survey. The results showed overall positive responses to the FLC and changes in the participants’ self-reported knowledge. Session surveys showed that the participants found the FLC topics helpful and appreciated the opportunity to learn from each other and the interprofessional nature of the FLC. Responses to the end-of-course survey were in alignment with the individual session surveys and cited specific benefits as being the content, teaching materials, and structured discussions. In additional feedback, participants reported interest to continue as a cohort and to extend the peer-support system beyond the FLC. This outcomes assessment of the first round of the FLC confirmed that this cohort-based faculty development in an interprofessional setting was well received by its participants. Their feedback provided valuable insights for changes to future offerings. Full Article
io Evaluation of Faculty Mentoring Practices in Seven U.S. Dental Schools By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 The aim of this cross-sectional study was to examine the faculty mentoring practices in seven dental schools in the U.S. A 34-item survey was administered electronically to dental faculty members of all ranks, tracks, and job categories in seven dental schools using faculty listservs. Survey questions addressed current mentoring practices in which the faculty members were involved; their perceptions of those mentoring practices; their perceived characteristics of an ideal mentoring program, mentor, and mentee; perceived best practices; and respondents’ demographics. The survey was conducted from October 2017 to February 2018. A total of 154 surveys were completed (response rate 22%). Over 58% (90/154) of the respondents reported receiving no mentoring; 31.9% (49/154) said they received informal mentoring; and 9.7% (15/154) received formal mentoring. Of the 64 respondents who received mentoring, both formal and informal, 92.2% (59/64) were full-time faculty, and 7.8% (5/64) were part-time faculty (p=0.001). Approximately 39% of the respondents indicated that their mentoring program was not overseen by anyone and that participation was voluntary. The top three perceived benefits of mentoring were increased overall professional development, development of a career plan, and increased professional networks. The three most important characteristics of an ideal mentoring program for the respondents were a program based on the needs of the mentee, a mentor who has the desire to help the mentee, and a mentee who is eager to learn. The results of this study showed a very low level of formal or informal faculty mentoring programs in the dental schools surveyed. Future studies are needed to determine best practices and strategies to expand and enhance mentoring of faculty members. Full Article
io Top-Cited Articles from Dental Education Journals, 2009 to 2018: A Bibliometric Analysis By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 The number of citations an article receives is an important indicator to quantify its influence in its field. The aim of this study was to identify and analyze the characteristics of the 50 top-cited articles addressing dental education published in two journals dedicated to dental education (European Journal of Dental Education and Journal of Dental Education). The Web of Science database was searched to retrieve the 50 most-cited articles from the two journals in December 2018. The top-cited articles were analyzed for journal of publication, number of citations, institution and country of origin, year of publication, study type, keywords, theme and subtheme, and international collaborations. The results showed the 50 top-cited articles were cited between 24 and 146 times each. The majority of these top-cited articles (n=34) were published in the Journal of Dental Education. Half (n=25) of the articles were by authors in the U.S. The most common study types were surveys (n=26) and reviews (n=10). The main themes of these top-cited articles were curriculum and learner characteristics. This bibliometric analysis can serve as a reference for recognizing studies with the most impact in the scholarship of dental education. Full Article
io Entrustable Professional Activities in Oral Health for Primary Care Providers Based on a Scoping Review By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 Despite advances in oral health care, inequalities in oral health outcomes persist due to problems in access. With proper training, primary care providers can mitigate this inequality by providing oral health education, screening, and referral to advanced dental treatment. Diverging sets of oral health competencies and guidelines have been released or endorsed by multiple primary care disciplines. The aim of this study was to transform multiple sets of competencies into Entrustable Professional Activities (EPAs) for oral health integration into primary care training. A scoping review of the literature between January 2000 and December 2016 was conducted according to PRISMA methodology to identify all existing sets of competencies. The following primary care disciplines were included in the search: allopathic/osteopathic medical schools and residency programs in family medicine, internal medicine, and pediatrics; physician assistant programs; and nurse practitioner programs. Competencies were compared using the Health Resources and Services Administration Integration of Oral Health and Primary Care Practice competencies as the foundational set and translated into EPAs. The resulting EPAs were tested with a reactor panel. The scoping review produced 1,466 references, of which 114 were selected for full text review. Fourteen competencies were identified as being central to the integration of oral health into primary care. These were converted to seven EPAs for oral health integration into primary care and were mapped onto Accreditation Council for Graduate Medical Education residency competency domains as well to the Association of American Medical Colleges EPAs for graduating medical students. The resulting EPAs delineate the essential, observable work required of primary care providers to ensure that oral health is treated as a critical determinant of overall health. Full Article
io A Systematic Meta-Analysis of the Effect of Interprofessional Education on Health Professions Students Attitudes By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 Interprofessional education (IPE) is based on collaborative practices that increase the occasions for communication among those in various health professions. However, there is a paucity of literature about the effectiveness of IPE programs in health professions education. The aim of this systematic review and meta-analysis was to objectively assess the literature on the effectiveness of IPE in improving health professions students’ attitudes after training. The major scholarly databases were searched for relevant IPE studies involving predoctoral health professions students. Two independent researchers selected the studies, extracted the data, and assessed the quality of the studies. Meta-analyses of the outcomes were performed using random effects models. Sixteen articles were ultimately selected for detailed review and meta-analysis. The meta-analysis showed that IPE training had a significant influence on students’ understanding of collaboration and resulted in better attitudes about interprofessional teamwork. Subscale analysis showed that one subscale score (roles and responsibilities) did not statistically significantly improve after IPE training (p=0.06), whereas the other four subscale items showed statistically significant improvements (p<0.01). The test for overall effects showed that IPE training had a significantly positive influence on students’ attitudes about IPE (Z=6.85, p<0.01). Subgroup results showed that medical students had more positive attitudes about IPE than did dental students. Regardless of profession, women students responded with significantly more positive feedback than did men students (p=0.02). These results suggest that intervention through IPE training has had positive effects in health professions education. Gender was an important factor impacting the outcomes of IPE. However, further clinical practice interventions may be helpful to enhance the IPE competence of health professions students. Full Article
io Reflections: My Time as JDE Editor By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 Full Article
io State Licensing Board Requirements for Entry into the Dental Hygiene Profession By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Purpose: The purpose of this study was to identify current requirements for initial licensure and entry into the dental hygiene profession across state dental and dental hygiene licensing boards in the United States.Methods: A non-experimental study design was used to study dental and dental hygiene board licensing requirements in the United States, Puerto Rico and the Virgin Islands. Each regulatory board website was searched for requirements for entry-level dental hygiene licensure. Requirements were recorded on an Excel spreadsheet. State dental practice acts were reviewed to gather further information and 20 regulatory bodies were contacted to verify accuracy. Descriptive statistics were used to analyze data.Results: Information from a total of 52 dental boards (n=52) was examined for this study. Nearly all boards (n=51, 98.1%), with the exception of Alabama, required completion of entry-level education from a CODA accredited dental hygiene program and successful completion of the National Board Dental Hygiene Examination. Most states (n=51, 98.1%), except Delaware, also required a live-patient, a clinical board examination. Application fees ranged from $47.70 to $600. States varied considerably in terms of requirements for background checks, age, military status, and infection control training.Conclusion: Although the majority of regulatory bodies require completion of entry-level dental hygiene education from a CODA accredited program and successful completion of national board and a live-patient, clinical examination, there is considerable variation in other additional requirements for initial dental hygiene licensure. Full Article
io Evaluation of an Automated Digital Scoring System of Dental Plaque By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Purpose: Measurement of dental plaque is frequently used as an indicator of overall oral health. The purpose of this study was to compare a manual (visual) plaque scoring system (University of Mississippi Oral Hygiene Index, UM-OHI) with an innovative automated digital scoring system.Methods: Mechanically ventilated, intensive care unit (ICU) patients (n=79) were the study population. Informed consent was given by the subject's legally authorized representative. Digital images of dental plaque were taken using an intraoral camera; and the quantity of dental plaque was scored using the UM-OHI and with a digitized automated scoring system. Distributions of dental plaque scores from both methods were plotted. Pearson correlation coefficients and intra-class coefficients were calculated between the two methods.Results: Participant mean age was 57.3 years; respiratory failure was the most prevalent admission diagnosis (55.7%). The mean percentage of dental plaque calculated by the manual method was found to be remarkably higher (67.3% ± 18.7%) than the percentage of dental plaque calculated by the automated scoring method (23.7% ± 15.2%) (p<0.0001). Despite remarkably different distributions of plaque scores, both the automated and manual scoring systems demostrated relatively high correlation (r=0.62) and good reliability (ICC=0.63).Conclusion: The automated digital scoring system resulted in a significantly lower overall percentage of total dental plaque as compared to the UM-OHI manual scoring system. While the automated digital scoring system may be more precise than a manual (visual) scoring system, its use should be weighed against the added effort, cost, and expertise required for the method. Further study is needed to determine whether an automated digital scoring system can be commercialized and is warranted for use outside of research settings. Full Article
io Oral Health-Related Quality of Life of Children: An Assessment of the Relationship between Child and Caregiver Reporting By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Purpose: Oral and craniofacial conditions or diseases can impact an individual's health and quality of life. The purpose of this study was to assess the perceived oral health related quality of life (OHRQoL) of children, and evaluate the reported level of agreement between caregivers and their children.Methods: Purposive sampling was used to recruit children ages 8-15, and their caregivers from a dental clinic in a pediatric hospital for this descriptive, cross-sectional study. A modified version of a validated measure, Child Oral Health Impact Profile-Short Form (COHIP-SF), was used for a 22-item questionnaire encompassing three subscales: oral health, functional well-being, and social emotional well-being. Two additional items were included to assess child/caregiver's level of agreement. A dental chart review was also conducted to assess the child's overbite, overjet, and decayed surfaces. Data were analyzed through descriptive statistics and examined for assumptions of normality and linearity.Results: Sixty child/caregiver pairs (n=120) participated in this study. Overbite, overjet and decayed surfaces were not found to be related to any OHRQoL variable, including child/caregiver ratings and overall agreement (p>.05). Average OHRQoL scores for caregivers found to be more positive those of their children (p=.02). Agreement between caregivers and the child's gender was shown to be significant (p=.01). Female child scores differed significantly from males with respect to their caregiver responses (p=.02). Caregivers rated a higher OHRQoL for female children, thus overestimating their female child's reported OHRQoL.Conclusions: The moderate level of agreement found between children and caregivers reinforces the importance of including the child, as well as the caregiver, when assessing OHRQoL. Full Article