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The dental pulp is a highly innervated tissue transmitting pain‐related sensations in the tooth. Consequently, understanding the intricacies of its innervation mechanism in odontogenesis is crucial for gaining insights into dental pain and developing dental pain‐modulating agents. This study examined neuroregulatory molecules such as neurotrophic factors (nerve growth factor [NGF], brain‐derived neurotrophic factor [BDNF], neurotrophin‐4 [NTF‐4], and neurturin [NRTN]) and neuroinhibitory factors (slit2, ephrin isoforms and netrin‐1) in developing rat teeth with follicles. NGF, BDNF and NRTN transcriptions showed time‐dependent upregulation, particularly during the root formation stage. In contrast, NTF‐4 mRNA was highly expressed at the cap stage, but became downregulated over time. Slit2 and ephrin‐B2 expression was distinct at the cap stage and then downregulated in a time‐dependent manner. Ephrin‐A5 and netrin‐1 expression did not significantly change. Immunofluorescence analysis revealed a robust expression of both ephrin‐B2 and slit2 in the outer and inner dental epithelia of the enamel organ, a non‐neurogenic tissue, during the cap stage of 3rd molar germs. In contrast, BDNF was predominantly localized in dental papilla cells and odontoblasts during the root formation stage. These results suggest that neuroregulatory molecules, such as BDNF, slit2 and ephrin‐B2, may be important in identifying therapeutic targets for modulating dental pulp pain. [ABSTRACT FROM AUTHOR]

Accurate location information is crucial for ensuring the reliability of service robots, such as field vehicles and agricultural robots. These practical robots often encounter fluctuating or inclined terrains in dynamic conditions during operation. Additionally, the performance of mobile robots depends on the physical size and weight of the localization system–physically heavy systems may degrade performance. In this paper, we present a compact, lightweight RTK‐GNSS device weighing under 40 g, which achieves centimeter‐level accuracy across different attitudes and dynamic situations. To enhance signal reception and positioning performance, we lessen noise levels in the power circuit and radio‐frequency signal conditioning using a low‐dropout regulator and low‐noise amplifier. Utilizing the configured device, we verified centimeter‐level accuracy through experiments of tracking an unmanned ground vehicle. The potential of the device is substantiated via three application scenarios—a localization of a moving human for a wearable device, a heading estimation of a mobile robot in stationary conditions, and practical field tests in various signal‐reception environments. Attributable to its compact dimensions and lightweight features, the proposed device can yield a low system strain while maintaining high accuracy and reliable performance, rendering it highly adaptable for various robotic applications. [ABSTRACT FROM AUTHOR]

Aim: To study the role of sclerostin in periodontal ligament (PDL) as a homeostatic regulator in biophysical‐force‐induced tooth movement (BFTM). Materials and Methods: BFTM was performed in rats, followed by microarray, immunofluorescence, in situ hybridization, and real‐time polymerase chain reaction for the detection and identification of the molecules. The periodontal space was analysed via micro‐computed tomography. Effects on osteoclastogenesis and bone resorption were evaluated in the bone‐marrow‐derived cells in mice. In vitro human PDL cells were subjected to biophysical forces. Results: In the absence of BFTM, sclerostin was hardly detected in the periodontium except in the PDL and alveolar bone in the furcation region and apex of the molar roots. However, sclerostin was up‐regulated in the PDL in vivo by adaptable force, which induced typical transfiguration without changes in periodontal space as well as in vitro PDL cells under compression and tension. In contrast, the sclerostin level was unaffected by heavy force, which caused severe degeneration of the PDL and narrowed periodontal space. Sclerostin inhibited osteoclastogenesis and bone resorption, which corroborates the accelerated tooth movement by the heavy force. Conclusions: Sclerostin in PDL may be a key homeostatic molecule in the periodontium and a biological target for the therapeutic modulation of BFTM. [ABSTRACT FROM AUTHOR]

Background: The association between diabetes mellitus (DM) and bone diseases is acknowledged. However, the mechanistic pathways leading to the alveolar bone (AB) destruction remain unclear. This study aims to elucidate the mechanical forces (MF)-induced AB destruction in DM and its underlying mechanism.Methods: In vivo periodontal tissue responses to MF were evaluated in rats with diabetes. In vitro human periodontal ligament (PDL) cells were either treated with advanced glycation end products (AGEs) alone or with AGEs and MF.Results: In vivo, the transcription of VEGF-A, colony stimulating factor-1 (CSF-1), and Ager was upregulated in diabetes, whereas changes in DDOST and Glo1 mRNAs were negligible. DM induced VEGF-A protein in the vascular cells of the PDL and subsequent angiogenesis, but DM itself did not induce osteoclastogenesis. MF-induced AB resorption was augmented in DM, and such augmentation was morphologically substantiated by the occasional undermining resorption as well as the frontal resorption of the AB by osteoclasts. The mRNA levels of CSF-1 and vascular endothelial growth factor (VEGF) during MF application were highly elevated in diabetes, compared with those of the normal counterparts. In vitro, AGEs treatment elevated Glut-1 and CSF-1 mRNA levels via the p38 and JNK pathways, whereas OGT and VEGF levels remained unchanged. Compressive MF especially caused upregulation of VEGF, CSF-1, and Glut-1 levels, and such upregulation was further enhanced by AGEs treatment.Conclusions: Overloaded MF and AGEs metabolites may synergistically aggravate AB destruction by upregulating CSF-1 and VEGF. Therefore, regulating the compressive overloading of teeth, as well as the levels of diabetic AGEs, may prove to be an effective therapeutic modality for managing DM-induced AB destruction. [ABSTRACT FROM AUTHOR]

Aim: We aimed to identify a key molecule that maintains periodontal tissue homeostasis during biophysical force‐induced tooth movement (BTM) by orchestrating alveolar bone (AB) remodelling. Materials and Methods: Differential display‐PCR was performed to identify key molecules for BTM in rats. To investigate the localization and expression of the identified molecules, immunofluorescence, real‐time RT‐PCR and Western blotting were performed in rats and human periodontal ligament (PDL) cells. Functional test and micro‐CT analysis were performed to examine the in vivo effects of the identified molecules on BTM. Results: Secretory leucocyte peptidase inhibitor (SLPI) in the PDL was revealed as a key molecule for BTM‐induced AB remodelling. SLPI was enhanced in the PDL under both compression and tension, and downregulated by an adenyl cyclases inhibitor. SLPI induced osteoblastogenic genes including runt‐related transcription factor 2 (Runx2) and synergistically augmented tension‐induced Runx2 expression. SLPI augmented mineralization in PDL cells. SLPI induced osteoclastogenic genes including receptor activator of nuclear factor kappa‐Β ligand (RANKL) and synergistically augmented the compression‐induced RANKL and macrophage colony‐stimulating factor (MCSF) expression. Finally, the in vivo SLPI application into the AB significantly augmented BTM. Conclusions: SLPI or its inhibitors might serve as a biological target molecule for therapeutic interventions to modulate BTM. [ABSTRACT FROM AUTHOR]

Background: Limited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes.Methods/design: SPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate. The multifaceted SPEC intervention, a geriatric care model guided by the chronic care model, consists of five components: comprehensive geriatric assessment for need/risk profiling, individual need-based care planning, interdisciplinary case conferences, person-centered care coordination, and a cloud-based information and communications technology (ICT) tool supporting the intervention process. The primary outcome is quality of care for older residents using a composite measure of quality indicators from the interRAI LTCF assessment system. Outcome assessors and data analysts will be blinded to group assignment. Secondary outcomes include quality of life, healthcare utilization, and cost. Process evaluation will be also conducted.Discussion: This study is expected to provide important new evidence on the effectiveness, cost-effectiveness, and implementation process of an ICT-supported chronic care model for older persons with multiple chronic illnesses. The SPEC intervention is also unique as the first registered trial implementing an integrated care model using technology to promote person-centered care for frail older nursing home residents in South Korea, where formal LTC was recently introduced.Trial Registration: ISRCTN11972147. [ABSTRACT FROM AUTHOR]

Objective To determine the diameter of the crown, total crown area, individual cusp area, and occlusal table area in Korean maxillary permanent molars, as well as dental characteristics relevant to the hypocone reduction trait. Materials and methods Subjects included 121 dental school students in Korea (81 men and 40 women). A digital image analysis system was used for measurements and we relied on visual scoring to assign categories of hypocone expression. Results The mean crown dimension was larger in the first molar (M1) than in the second molar (M2). Regarding differences according to gender, the crown diameter, total crown area, and individual cusp area were significantly larger in the men than in the women. The mean occlusal table area ratios were 61% for M1 and 57% for M2, and these ratios increased in proportion to the total crown area. With respect to the hypocone and other features of the maxillary molars, differences between the men and women were more prominent for M1 than for M2. The M2 hypocone tended to be smaller than the M1 hypocone, and hypocone reduction was inversely related to the cusp area of the protocone. The protocone area may be considered a reliable parameter for comparing race and/or gender differences in maxillary molars. Conclusion This study concerning characteristics of the maxillary molar occlusal surface in Koreans provides useful information for comparative studies among human races. [ABSTRACT FROM AUTHOR]

Background: Community pharmacists confronted dual burdens in response to the COVID-19 pandemic by expanding the scope of pharmaceutical practices., Objective: This study aimed to assess the perceived roles and functions of community pharmacies during the pandemic and to explore their updated roles after the pandemic began., Methods: We conducted a self-reported web-based survey in October 2022. Based on Korean census data, we recruited the study participants (n=1000) through quota sampling stratified by age, sex, and region, yielding a 7.45% (1000/13,423) response rate. The questionnaires were composed of 3 sections: demographics, the roles and functions of community pharmacies during the pandemic, and the updated roles of community pharmacies during disasters. Each question in the second and third sections was rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree), and each item's mean scores and SDs were reported. The study participants were categorized into 2 groups: individuals who had a family pharmacy and those who did not. A chi-square test and ordered logistic regression analyses were conducted., Results: Out of 1000 respondents, 418 (41.8%) had a history of COVID-19, and 639 (63.9%) had a family pharmacy. Assigning specific roles and functions to community pharmacies during the pandemic contributed to positive assessments. Respondents gave higher scores to community pharmacies that had responded appropriately (a mean Likert score of 3.66, SD .077 out of 5) and provided continuous pharmaceutical services (mean 3.67, SD 0.87) during the pandemic. The pandemic served as an opportunity to positively recognize the role of community pharmacies (mean 3.59, SD 0.83). In the ordered logistic model, having a family pharmacy was consistently associated with positive perceptions. Respondents perceived that community pharmacies collaborated with general practitioners and health authorities. However, community pharmacies need to function appropriately in terms of knowledge. The mean score of the 4 domains of community pharmacy functions was the highest for collaboration (mean 3.66, SD 0.83), followed by communication (mean 3.57, SD 0.87), responsiveness (mean 3.54, SD 0.87), and knowledge (mean 3.41, SD 0.91)., Conclusions: The pandemic resulted in interprofessional collaboration between community pharmacists and general practitioners. Family pharmacies could be a valuable asset to the comprehensive case management of patients. However, community pharmacists should have the expertise to build solid interprofessional collaborations and fulfill their expanded and updated roles., (©Dong-Wook Yang, Kyung-Bok Son. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 13.07.2023.)

Direct reprogramming, also known as a trans-differentiation, is a technique to allow mature cells to be converted into other types of cells without inducing a pluripotent stage. It has been suggested as a major strategy to acquire the desired type of cells in cell-based therapies to repair damaged tissues. Studies related to switching the fate of cells through epigenetic modification have been progressing and they can bypass safety issues raised by the virus-based transfection methods. In this study, a protocol was established to directly convert fully differentiated fibroblasts into diverse mesenchymal-lineage cells, such as osteoblasts, adipocytes, chondrocytes, and ectodermal cells, including neurons, by means of DNA demethylation, immediately followed by culturing in various differentiating media. First, 24 h exposure of 5-azacytidine (5-aza-CN), a well-characterized DNA methyl transferase inhibitor, to NIH-3T3 murine fibroblast cells induced the expression of stem-cell markers, that is, increasing cell plasticity. Next, 5-aza-CN treated fibroblasts were cultured in osteogenic, adipogenic, chondrogenic, and neurogenic media with or without bone morphogenetic protein 2 for a designated period. Differentiation of each desired type of cell was verified by quantitative reverse transcriptase-polymerase chain reaction/ western blot assays for appropriate marker expression and by various staining methods, such as alkaline phosphatase/alizarin red S/oil red O/alcian blue. These proposed procedures allowed easier acquisition of the desired cells without any transgenic modification, using direct reprogramming technology, and thus may help make it more available in the clinical fields of regenerative medicine.

Background/aims: Many chronic obstructive pulmonary disease (COPD) patients have physical limitations. We investigated EuroQol five-dimensions five-level (EQ-5D-5L) of COPD patients to assess quality of life, and assessed indirect burden including time expenditure to visit doctor, home care rate, and caregiver related burden., Methods: We recruited 355 COPD patients according to severity of airflow limitation that severity was set at 10% mild, 40% moderate, 30% severe, and 20% very severe in two primary and 11 secondary/tertiary hospitals. Eligible patients were aged ≥ 40 years, who have been diagnosed with COPD for more than 1 year. Patients were recruited between June 2015 and October 2016., Results: The quality of life tended to decline with age, from mild to very severe impairment, as revealed by the EQ-5D-5L scores and the EQ visual analog scale. Family caregivers accompanied 22.6% of patients who visited outpatient clinics, and 25% of stage IV COPD patients. During emergency visits and hospitalization, this figure increased to > 60%. The home care rates were 28.5% for stage I patients, and 34.4, 31.8, and 52% for stage II to IV patients, respectively. The percentage of caregivers who stopped working was 13.6%. The EQ-5D index was strongly associated with the dyspnea scale (r = -0.64, p < 0.001). The average required time to see a doctor and visit the pharmacy was 154 minutes., Conclusion: In patients with COPD, the EQ-5D index decreased and disease-related home caregiving increased with airflow limitation. We considered the caregiver- related burden when making a strategy for COPD management.

Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea., Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report., Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs., Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD., Competing Interests: This study was supported by a grant of GlaxoSmithKline., (Copyright©2019. The Korean Academy of Tuberculosis and Respiratory Diseases.)

Background: Limited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes., Methods/design: SPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate. The multifaceted SPEC intervention, a geriatric care model guided by the chronic care model, consists of five components: comprehensive geriatric assessment for need/risk profiling, individual need-based care planning, interdisciplinary case conferences, person-centered care coordination, and a cloud-based information and communications technology (ICT) tool supporting the intervention process. The primary outcome is quality of care for older residents using a composite measure of quality indicators from the interRAI LTCF assessment system. Outcome assessors and data analysts will be blinded to group assignment. Secondary outcomes include quality of life, healthcare utilization, and cost. Process evaluation will be also conducted., Discussion: This study is expected to provide important new evidence on the effectiveness, cost-effectiveness, and implementation process of an ICT-supported chronic care model for older persons with multiple chronic illnesses. The SPEC intervention is also unique as the first registered trial implementing an integrated care model using technology to promote person-centered care for frail older nursing home residents in South Korea, where formal LTC was recently introduced., Trial Registration: ISRCTN11972147.