Publications

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), has emerged as a significant public health concern, affecting approximately 25% of the global population with its prevalence rising from 22% in 1991 to 37% in 2019.1 While the hepatic consequences of MASLD, such as steatohepatitis, fibrosis, and cirrhosis, are well documented, its systemic implications are increasingly coming to light. While traditionally viewed as a hepatic disorder, growing evidence highlights MASLD as a multisystem disease with profound implications on cardiovascular health. Atherosclerotic cardiovascular disease (ASCVD) has now been recognized as the leading cause of mortality in patients with MASLD, surpassing liver-related complications. MASLD is present in up to 75% of patients with type 2 diabetes mellitus (T2DM). Notably, MASLD is linked to a higher risk of cardiovascular diseases (CVD), including arrhythmia, atherosclerotic heart disease, heart failure, and CVD-related mortality.2 The association between MASLD and ASCVD is particularly alarming, positioning MASLD as a critical gateway for cardiovascular morbidity and mortality.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a complex endocrine-metabolic disorder with significant age-related, anthropometric, and metabolic variations. Understanding the interplay between age, body composition, and micronutrient status can help identify predictors of metabolic dysfunction and long-term complications in women with PCOS. Most studies assess these factors in isolation, resulting in fragmented evidence and inconsistent conclusions.

OBJECTIVES: This study aimed to evaluate the predictive associations of age, anthropometric parameters, and micronutrient levels (vitamin B12 and vitamin D3) with key metabolic, cardiovascular, and nutritional markers in women diagnosed with PCOS.

MATERIALS AND METHODS: A cross-sectional analysis was conducted among women with PCOS, divided into two age-groups: group I (15-30 years) and group II (31-40 years). One-way analysis of variance (ANOVA) and linear regression analyses were performed to investigate age- and obesity-related differences in metabolic parameters. Pearson's correlations and regression models were applied to assess the predictive strength of age, body mass index (BMI), waist circumference (WC), vitamin B12, and vitamin D3 on metabolic outcomes. The Benjamini-Hochberg method was applied to control the false discovery rate (FDR) for multiple comparisons and ensure conclusions account for the increased risk of type I error due to multiple comparisons, thereby supporting the validity of the study's observations.

RESULTS: The PCOS cohort exhibited generalized overweight (BMI 23.0-24.9 kg/m2) and obesity (BMI ≥25.0 kg/m2) in 40 and 54% of subjects, respectively; notably, visceral obesity (WC ≥80 cm) was present in 97% of the cohort, underscoring a marked predominance of central adiposity even among those with lower BMI thresholds. The PCOS cohort demonstrated high metabolic risk, with frequent insulin resistance, dyslipidemia, and hypertension; notably, 25% had nonalcoholic fatty liver disease (NAFLD), predominantly mild steatosis, indicating a substantial risk for future cardiometabolic complications. Advancing age was significantly associated with higher fasting blood sugar (FBS) (p = 0.019) and glycated hemoglobin (HbA1c) (p = 0.048), while fasting insulin declined with age (p = 0.048). BMI and WC were strong predictors of metabolic risk, positively impacting fasting insulin, FBS, HbA1c, and blood pressure (p < 0.05), while showing significant negative associations with high-density lipoprotein cholesterol (HDL-C) (p < 0.001). Vitamin B12 and D3 levels showed no significant impact on metabolic parameters. Vitamin B12 was predicted only by age (p < 0.001) and vitamin D3 (p < 0.001), while vitamin D3 was influenced by age (p < 0.001) and vitamin B12 levels (p = 0.041).

CONCLUSION: Central obesity markers-particularly WC and BMI-are robust predictors of metabolic dysfunction in PCOS, offering greater prognostic value than micronutrient levels such as vitamin B12 or D3, which showed limited association with metabolic disturbances in this population. These findings highlight the primacy of early detection and intervention targeting adiposity and insulin resistance to reduce long-term cardiometabolic risk among women with PCOS. Integrated, multifactorial risk assessment remains essential, as age, nutritional deficits, and obesity-related factors independently and collectively drive adverse metabolic outcomes in PCOS, emphasizing the need for comprehensive preventive and management strategies.

Lateral interactions are pervasive in early visual processing, contributing directly to processes such as object grouping and segregation. This study examines whether saccade preparation - known to affect visual perception - modulates lateral interactions. In a psychophysical task, participants were instructed to detect a Gabor target flanked by two adjacent Gabors, while they either prepared a saccade to the target or maintained central fixation. Flanker gratings could be iso- or orthogonally oriented to the target and were positioned at three different distances (4λ, 8λ, and 16λ). Contrast thresholds for target detection were estimated in each condition using a 3-down/1-up staircase procedure. The results showed that in both presaccadic and fixation conditions, the target was suppressed at the shortest flanker distance (4λ), revealed by markedly higher thresholds in iso-oriented compared to orthogonal flanker configurations. Lateral interaction effects were completely abolished at their largest separation (16λ). Interestingly, at the intermediate flanker distance (8λ), target suppression seemed to increase during the presaccadic period, whereas no such effect was observed during fixation. This result suggests that saccade preparation can modulate lateral interactions, promoting suppressive effects over larger distances. These findings are consistent with the visual remapping phenomenon observed before saccade execution, especially the convergent remapping of receptive fields in oculomotor and visual areas. Finally, this presaccadic expansion of inhibitory lateral interactions could assist target selection by suppressing homogeneous peripheral signals - such as iso-oriented collinear patterns - while prioritizing the processing of more salient visual information.

PURPOSE: To establish a cell origin tracing framework for aqueous humor (AH) exosomal membrane proteins and decipher their pathological implications in retinitis pigmentosa (RP).

METHODS: In this prospective cohort study, comprehensive ophthalmic evaluations were conducted in 14 patients with RP with concurrent cataracts and 7 age-matched senile cataract controls. AH samples from these cohorts underwent exosomal membrane protein profiling via EVArray technology. Integrated bioinformatics analysis incorporated single-cell RNA sequencing data sets from human ocular tissues. Gene Ontology (GO) enrichment analysis with cellular trajectory mapping was performed to elucidate disease-associated pathways.

RESULTS: Patients with RP in this cohort predominantly exhibited characteristic fundus pathology. EVArray profiling of AH exosomes revealed nine differentially expressed membrane proteins, comprising three downregulated and six upregulated proteins. Single-cell deconvolution mapped these proteins to immune (T cells, hyalocytes, monocytes/macrophages) and retinal glial cell lineages. Key findings showed (1) CTLA4 upregulation (1.7-fold, P = 0.021), reflecting T-cell checkpoint activation; (2) CSF-1R suppression (0.36-fold, P < 0.0001), suggesting immune homeostasis disruption; and (3) DKK1 downregulation (0.72-fold, P = 0.015), indicating activation of glia-derived Wnt signaling. GO analysis highlighted cytokine signaling (GO:0019221) and MAPK cascade activation (GO:0043410) as central pathways.

CONCLUSIONS: This study demonstrates that AH exosomal membrane proteins play a role in uncovering immunopathogenic cascades and glial reactivity underpinning disease progression in RP. Furthermore, AH exosomal proteins hold promise as potential biomarkers for monitoring disease activity.

TRANSLATIONAL RELEVANCE: These findings highlight that AH exosomal proteins hold promise as potential biomarkers and propose that immunomodulation and glial protection serve as conservative strategies to delay progression in cases of genetically unresolved RP.

Organizing visual input into coherent percepts requires dynamic grouping and segmentation mechanisms that operate across both spatial and temporal domains. Crowding occurs when nearby elements interfere with target perception, but specific flanker configurations can alleviate this effect through Gestalt-based grouping, a phenomenon known as uncrowding. Here, we examined the temporal dynamics underlying these spatial organization processes using a Vernier discrimination task. In Experiment 1, we varied stimulus duration and found that uncrowding emerged only after 160 ms, suggesting a time-consuming process. In Experiment 2, we manipulated the stimulus onset asynchrony (SOA) between the target and flankers. We found that presenting good-Gestalt flankers briefly before the target (as little as 32 ms) significantly boosted uncrowding, even in the absence of temporal overlap between the two stimuli. This effect was specific to conditions in which flankers preceded the target, ruling out pure temporal integration and masking accounts. These findings suggest that spatial segmentation can be dynamically facilitated when the temporal order of presentation allows grouping mechanisms to engage prior to target processing. Moreover, the observed time course indicates that segmentation is not purely feedforward, particularly for stimuli that are likely to recruit higher level visual areas, pointing instead to the involvement of recurrent or feedback processes.

OBJECTIVE: The public health impact of substance use (SU) is substantial, with tobacco use and excessive drinking leading as causes of death in the USA. To address this growing epidemic, governments have implemented a range of SU-related policies. The NIH's Clinical & Translational Science Awards (CTSA) program, which aims to accelerate translation of research findings into health impact, may advance translation through its impact on the policy literature that informs policymakers, health professionals, and the public. Using innovative bibliometric tools, this study evaluates how CTSA-supported research published from 2006-2023 has influenced SU-related policy literature.

METHOD: The authors identified 135K publications that acknowledged CTSA support. Those publications were queried in the Overton Policy database, which indexes references to research publications in global policy literature.

RESULTS: Thus far, CTSA-supported publications have been cited in 3,451 policy documents identified as SU-related according to Overton's Topics field. SU-related Topics were classified into top categories of: Tobacco, Opioids, Cannabis, Alcohol, and General/Other SU. Policy documents came from 321 organizations across 49 countries- often governments, health agencies, or political think tanks, including the World Health Organization, Guidelines in Pubmed Central, and the RAND Corporation. The authors present case illustrations of individual research publications that have had notable influence on SU policy.

CONCLUSIONS: By elucidating ways that supported publications are applied outside academia, bibliometrics offer a useful avenue for evaluating the translational impact of programs on specific areas of policy. Our findings showcase the impact that CTSA research has had on SU-related policy literature, a critical area of health policy.

AIM: This in vitro study evaluated the microtensile bond strength (µTBS) of two nanohybrid resin composites to caries-affected dentin (CAD) after pretreatment with different hesperidin (HPN) concentrations, before and after thermocycling.

MATERIALS AND METHODS: Eighty extracted human molars were assigned to two groups by composite type (Filtek Z250 XT, Grandio; n = 40 each) and subdivided into four pretreatment protocols (n = 10): control (no treatment), 0.5%, 1%, or 2% HPN. Half of the specimens in each subgroup were subjected to thermocycling. Microtensile bond strength was measured using a universal testing machine. Data were analyzed using two-way and three-way ANOVA followed by post hoc tests (α = 0.05).

RESULTS: Bond strength was significantly affected by HPN concentration and thermocycling. Non-aged Filtek and Grandio showed higher values (up to 39.90 ± 10.67 and 45.87 ± 13.37 MPa, respectively), while aging reduced strength in specific subgroups (Filtek no-treatment: p = 0.016; Grandio 0.5% HPN: p = 0.004; 2% HPN: p = 0.033). Overall, 0.5% HPN maintained better adhesive performance after aging, whereas higher concentrations showed diminished stability. Failure mode analysis supported these trends, with higher bond strength linked to cohesive/mixed failures.

CONCLUSION: Pretreatment with 0.5% HPN significantly improved bond strength and durability to CAD, while higher concentrations reduced performance, especially after thermocycling.

CLINICAL SIGNIFICANCE: Applying 0.5% HPN as a dentin pretreatment may enhance the longevity of composite restorations in cases involving CAD. How to cite this article: Abdel-Salam FD, Sheta N, Eid EG. Effect of Matrix Metalloproteinase Inhibitors on the Bonding Durability of Nanocomposite Resin to Caries-affected Dentin: An In Vitro Study. J Contemp Dent Pract 2025;26(11):1096-1102.

AIM: The study aims to evaluate the effect of fluoridated and non-fluoridated mouthwash on the rate of tooth movement and surface topography changes of nickel-titanium (NiTi) and multistranded stainless steel arch wires.

MATERIALS AND METHODS: Twenty patients aged 18-30 years with moderate mandibular anterior crowding [Little's Irregularity Index (LII): 4-6 mm] were selected and randomly divided into two groups (n = 10) and were assigned by archwire type: Group I (NiTi) and group II (multistranded SS). Each group was subdivided into fluoridated (Colgate MaxFresh Mouthwash; groups IA and IIA) and non-fluoridated (Listerine; groups IB and IIB) mouthwash subgroups (n = 5). The rate of tooth movement was assessed monthly for 3 months using LII, and the surface topography of the retrieved wires was evaluated using scanning electron microscopy (SEM). Data were recorded and statistically analyzed.

RESULTS: Both group I and group II demonstrated a reduction in LII over the 3 months. The non-fluoridated subgroup of group I had the greatest reduction (from 5.58 ± 0.12 mm at T0 to 0.76 ± 0.03 mm at T3) compared to the fluoridated subgroup (from 4.80 ± 0.11 to 0.50 ± 0.07 mm). For group II, the non-fluoridated subgroup reduced from 5.26 ± 0.12 mm to 0.73 ± 0.04 mm, and the fluoridated subgroup reduced from 4.27 ± 0.15 mm to 0.43 ± 0.07 mm. Intragroup comparisons were statistically significant over time (p < 0.001; Friedman test), and intergroup differences at each time point also proved statistically significant (p < 0.05; Kruskal-Wallis test). The SEM showed more significant surface damage (pitting, corrosion, and inclusions) in wires exposed to the fluoridated mouthwash group than the non-fluoridated rinse.

CONCLUSION: Non-fluoridated mouth rinses seem to aid in orthodontic tooth movement rates, especially with NiTi arch wire, while fluoridated mouth rinses can inhibit arch wire efficacy.

CLINICAL SIGNIFICANCE: This study addresses the lack of in vivo evidence regarding the impact of frequently used mouth rinses on orthodontic treatment efficiency. These findings will assist in selecting adjunctive mouth rinses to maintain the integrity of the arch wire and improve the rate of movement during the alignment phase. How to cite this article: Gadde H, Kumar S, Bhattu BK, et al. Effect of Fluoridated and Non-fluoridated Mouthwash on Tooth Movement and Surface Topography Changes of Arch Wires: An In Vivo Study. J Contemp Dent Pract 2025;26(11):1079-1086.

AIM: This study aims to evaluate the effectiveness of hyaluronic acid (HA) and mint-flavored toothpaste in the recovery from persistent sensory loss.

MATERIALS AND METHODS: A pilot study of 16 adult patients suffering from anosmia or severe hypoanosmia in Baghdad was selected purposively from a larger sample of 135, examined using the Modified Connecticut Chemosensory Clinical Research Center ("modified CCCRC") test between October 2023 and January 2024 and then re-examined 3 weeks later after twice-daily use of the toothpaste, using the same repeatable, objective method, the modified CCCRC test.

RESULTS: The majority of participants were within the age-group of >35 years at 75%, and 56% were males. There was a significant difference between the median composite scores of thresholds and identification of the smell beside the taste score before and after using the toothpaste (p < 0.001, 0.023), respectively.

CONCLUSION: Smell and taste scores increase after weeks of daily twice using the hyaluronic toothpaste.

CLINICAL SIGNIFICANCE: The combination of HA and mint odor in the same product was effective in promoting the recovery of the sense of smell and improving the quality of life of the study participants. How to cite this article: Abdulrida FM, Hadartie SF, Hobballah AI. The Effect of Hyaluronic acid Toothpaste in Smell and Taste Recovery: A Pilot Study. J Contemp Dent Pract 2025;26(11):1103-1108.