Publications

PURPOSE: To determine the prevalence, factors, temporal trends, and projections of glaucoma over 15 years among multiethnic older Asian adults aged 60 to 100 years.

METHODS: We included 2380 participants (mean [SD] age, 73.6 [8.5] years; 55.2% female) from the baseline phase of the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER; 2017-2022) study. Comprehensive eye examinations and standardized questionnaires assessed sociodemographic, clinical, and lifestyle factors. Glaucoma and subtypes were defined using International Society of Geographical and Epidemiological Ophthalmology guidelines, with age-standardized prevalence rates based on the 2020 Singapore census. Logistic regression using generalized estimating equations identified risk factors, temporal trends were analyzed using population-based data, and projections utilized United Nations population data.

RESULTS: The census-adjusted glaucoma prevalence was 5.1%, comprising 3.4% primary open-angle glaucoma, 0.7% primary angle-closure glaucoma, and 1% secondary glaucoma. Prevalence was higher among Malays (6.5%) and Indians (6.2%) compared to Chinese (4.9%). Significant factors included older age (odds ratio [OR], 1.07), Malay ethnicity (OR, 2.07), higher intraocular pressure (OR, 1.14), longer axial length (OR, 1.20), cataract surgery (OR, 1.81), and polypharmacy (OR, 2.04). Over two decades, age-adjusted glaucoma prevalence in Singapore remained stable (5%-7%) but increased among Indians (3.65% in 2013 to 6.70% in 2022), likely due to the high rates of systemic diseases. Currently, ∼57,800 Singaporeans aged ≥60 years have glaucoma, projected to rise by 43%, reaching 85,800 by 2040.

CONCLUSIONS: Glaucoma is common among older Singaporeans, with notable sociodemographic and modifiable clinical factors. Rising prevalence among Indians and the projected increase in cases underscore the need for targeted screening and early interventions.

Editor's note: This is the 28th article in a series on clinical research by nurses coordinated by the Heilbrunn Family Center for Research Nursing at Rockefeller University. The series is designed to be used as a resource for nurses to understand the concepts and principles essential to research. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation-and most can be read without knowledge of the preceding articles. To see all the articles in the series, go to https://links.lww.com/AJN/A204.

Health is determined by the quality of and access to the healthcare system, but more importantly by the characteristics of the social and physical environment in which individuals live. Actions to promote health can be integrated into public policies, especially at the local level. In Switzerland, local authorities do not always have their own competencies in the field of health, but they can act to improve living conditions and promote access to healthcare. In this sense, healthcare professionals have an important role to play in health promotion by initiating, supporting, and participating in collaborations with municipalities, as demonstrated by the creation of health centers. This article provides an overview of the general framework for health promotion at the municipality level and some examples of collaborations.

In 2021, noncommunicable diseases caused 43 million deaths worldwide, with one-third attributable to four major industries: tobacco, alcohol, ultraprocessed foods, and fossil fuels. In this context, can poor health still be explained solely by individual choices? The concept of commercial determinants of health, increasingly discussed in public health, examines the structural causes of these « industrial epidemics » and highlights the influence of economic actors on population health. It urges healthcare professionals, policymakers, and organizations to assess the impact of industrial strategies on consumption behaviors, while advocating for the implementation of appropriate regulations.

This research was intended to unravel the effects of exosomal microRNA-22-3p (miR-22-3p) secreted from bone marrow mesenchymal stem cells (BMSCs) on oxidative stress damage and neuronal apoptosis in Alzheimer's disease (AD) via KDM6B. BMSCs and BMSCs-derived exosomes (BMSCs-Exos) were obtained and identified. An in vitro AD model was established. The levels of miR-22-3p and KDM6B were tested. Cell viability, ROS levels, MDA content and SOD levels, as well as apoptosis levels, were evaluated. The targeting relationship between miR-22-3p and KDM6B was validated. BMSC-Exos, miR-22-3p mimic and KDM6B siRNA advanced the cell viability, attenuated cell apoptosis, and ameliorated the oxidative stress injury of Aβ1-42-induced HT22 cells, including the decrease in the content of ROS and MDA and the increase in SOD activity. miR-22-3p inhibitor and KDM6B overexpression lentivirus advanced the decrease of cell viability, aggravated cell apoptosis, and promoted oxidative stress injury in Aβ1-42-induced HT22 cells, including the increase of ROS and MDA content and the decrease of SOD activity. miR-22-3p mimic combined with oe-KDM6B reversed the effects caused by miR-22-3p mimic alone. miR-22-3p targeted KDM6B. BMSC-Exos-derived miR-22-3p suppresses KDM6B expression to alleviate oxidative stress damage and apoptosis in AD neurons.

AIM: To evaluate the influence of spatulas on resin composite color stability, and characterize the surface of both the spatulas and the resin composites before and after manipulation.

MATERIALS AND METHOD: Discs (ø6 mm x 2 mm) of suprananofilled resin composite (Palfique LX5/Tokuyama) and nanohybrid resin (Empress Direct/Ivoclar Vivadent) were fabricated. They were divided into groups (n=10), and manipulated with different spatulas: non-manipulated (control), metal spatulas (Almore Millennium/ Golgran, Almore #3/ Quinelato, LM Arte Modella/ Quinelato), or plastic spatulas (Jon). Manipulation involved lightly pressing the spatula 50 times against the resin composite on waterproof paper. Color was analyzed at three time points: immediately, after finishing and polishing, and after 24-hour immersion in distilled water, with CIELab* parameters, ΔEab, ΔE00, and ΔWID. Spatulas and resins were submitted to micromorphological and energy-dispersive X-ray spectroscopic (EDS) analysis. Generalized linear models or Kruskal-Wallis and Dunn tests (α=5%) were applied.

RESULTS: Resin color changed after manipulation with a metal spatula, but there was no significant difference in ΔEab and ΔE00 for the resin composites according to the spatula (p>0.05). The suprananofilled resin varied more than the nanohybrid resin over time (p<0.05). Abrasive wear was observed on the spatulas after manipulating the resin composites, with greater wear for the spatulas used with suprananofilled resin. EDS showed different spatula and resin composite compositions.

CONCLUSIONS: Metal spatulas influenced resin composite color stability, with greater color change for suprananofilled resin. The spatulas exhibited abrasive wear, attributable to the difference in hardness between the spatulas and the resin composites.

UNLABELLED: Rehabilitating teeth after root canal treatment often requires the use of glass fiber posts (GFPs) to retain the final restorations, so the choice of resin cement is critical for bond strength (BS) and treatment success.

AIM: The aim of this study was to evaluate the effect of different GFP systems on BS to intraradicular dentin using two dual-curing resin cement types.

MATERIALS AND METHOD: Thirty bovine incisors with wide canals were filled endodontically with gutta-percha and epoxy resin sealer. Initially, the canal filling was removed, and 4 mm of the apical seal was left intact. The teeth were divided into three groups according to the GFPs used: AP (anatomical posts - prefabricated GFP (Reforpost #2, Angelus®) relined with composite resin (Filtek Z350, 3M ESPE); SPLENDOR (Splendor SAP, Angelus®), and milled CAD/CAM (FiberCAD, Angelus®). Posts were fixed with conventional (RelyX Ultimate, 3M ESPE) or self-adhesive resin cement (RC) (RelyX U200, 3M ESPE), following the manufacturer's instructions. After 48 h, the roots were sectioned into thirds and subjected to pushout BS testing using a universal testing machine. BS data were analyzed using Wilcoxon and Mann- Whitney U tests. Failure modes were assessed with Fisher's Exact test (α=0.05).

RESULTS: In the apical and middle root sections, BS was similar in the AP and Splendor groups, both of which performed better than the milled CAD/CAM group (p≤0.05). In the cervical section, BS was significantly higher for the anatomical posts than for Splendor and milled CAD/CAM posts. Self-adhesive RC promoted statistically lower BS compared to conventional RC for the milled CAD/CAM post in the cervical and middle thirds (p≤0.05). Self-adhesive RC provided statistically higher bond strength than conventional RC for the anatomical post in the apical third (p≤0.05). No significant difference in failure modes was observed between resin cements and different root sections (p>0.05).

CONCLUSION: The BS of the GFP system was affected by resin cement type and root section, with composite resin-relined anatomically shaped posts generally performing better.

UNLABELLED: Endodontic failures are usually the result of technical errors compromising the proper endodontic procedures required to control and prevent periradicular infections. Among these errors, the extrusion of materials through the apical foramen has been associated with periapical inflammation, postoperative pain, tissue necrosis, delayed periapical healing and long-term failure.

AIM: To compare the debris extruded through the apical foramen when different glide path files are used prior to endodontic instrumentation with the WaveOne Gold Primary file.

MATERIALS AND METHOD: Twenty-four mesial roots of extracted human mandibular first molars were divided into three groups (n=8): C-Pilot hand file (CPH) #15/.02; R-Pilot (RPL); WaveOne Gold Glider (WGG). The roots were placed in Eppendorf tubes containing 1.5% agar gel and weighed before and after instrumentation to calculate the weight of debris and irrigant solution extruded. Apical extrusion of debris was compared using one-way analysis of variance. The Games-Howell test was used for multiple comparisons due to heteroscedasticity, with a significance level of 5%.

RESULTS: Debris extrusion was significantly lower with the WaveOne Gold Glider file than with the R-Pilot file, which in turn produced less extrusion than the C-Pilot file.

CONCLUSION: All glide path files caused apical extrusion, with the WaveOne Gold Glider causing the least.

UNLABELLED: Facial asymmetries, often subtle, can indicate imbalances that go beyond aesthetic concerns.

AIM: This cross-sectional study analyzed molar bite force, occlusal contact distribution, and masseter and temporal muscle thickness in adult women with facial symmetry and slight non-pathological facial asymmetry, which generally goes unnoticed and is often considered a variation of normality.

MATERIALS AND METHOD: Forty-two women aged 18 to 30 were evaluated for slight non-pathological facial asymmetry using the VECTRA M3. Two groups were established: facial symmetry (n=21) and slight non-pathological facial asymmetry (n=21). Molar bite force was measured with a dynamometer. T-Scan was used to evaluate occlusal contact distribution. Masseter and temporal muscles thickness was assessed using ultrasound. Analyses used a 5% significance level (Student's t-test).

RESULTS: No significant difference was found in maximum molar bite force between the groups, though the slight asymmetry group showed lower force in clinical observation. No significant difference was observed in masseter and temporal muscle thickness during rest and maximum voluntary contraction, but clinically, the masseter was thicker than the temporal in both groups, being thicker in the slight non-pathological facial asymmetry group than in the facial symmetry group. Occlusal contact distribution did not differ significantly between groups, but clinically, the slight non-pathological facial asymmetry group showed less distribution in the occlusal contacts of the first permanent molars and more pronounced distribution in the left hemiarch compared to facial symmetry group.

CONCLUSION: Although no significant difference was observed between groups in this study, the numerical analysis of the results highlights the importance of evaluating the stomatognathic system in dental procedures, particularly with regard to non-pathological facial asymmetry.