Search

Background: Lack of professional integrity among dental students can greatly impact the safety of future patients. Currently, there are no established learning outcomes for dental professionalism. Aim: The aim of the study is to assess the perceptions of Indian educators (DE) and residents (DR) towards the attributes and methods to learn/teach dental professionalism. Materials and Methods: A cross-sectional descriptive study was conducted among Indian DE and DR from April 1, 2022, to July 31, 2022. A 31-item questionnaire was developed to evaluate the demographic data, perceptions of learning/teaching methods, and attributes of professionalism. The sample size was calculated to 446 subjects. Descriptive statistics were carried out. Results: Of the 428 participants, 287 were DE and 141 were DR. Most participants are aware of the attributes and have a positive attitude toward professionalism. Role modeling and mentoring were the most effective ways to learn professionalism. About 97.9% of DE and 97.9% of DR felt it was important to teach dental students about professionalism. About 85.7% of DE and 73% of DR felt the need for an additional program in the current BDS curriculum. Most participants selected contact with role model teachers, clinical experience with patients, and discussion with peers as methods by which they learned dental professionalism. Conclusion: The majority of the participants are aware and have a positive attitude toward dental professionalism.

Background: Vernal keratoconjunctivitis (VKC), a chronic and bilateral allergic eye condition, predominantly affects young males and is more prevalent in hot, humid regions with high allergen exposure. It manifests with itching, light sensitivity, burning sensations, and tearing. The three main clinical forms include limbal or bulbar, palpebral or tarsal, and mixed presentations. Aims and Objectives: This study aimed to describe the clinical patterns of VKC in children at a tertiary care hospital in Andhra Pradesh. Materials and Methods: This cross-sectional observational study was conducted in a hospital setting at the Department of Ophthalmology, SV Medical College in Tirupati, Andhra Pradesh, between January 2021 and January 2022. Ninety children aged 5–12 years with symptoms of allergic conjunctivitis were enrolled in the study. The Bonini grading system was used to grade the severity of the disease based on clinical manifestations at the time of initial presentation. Results: Mean age of disease onset was 8.6±2.3 years, with a male-to-female ratio (M: F) of 2.1:1. The majority of the subjects experienced seasonal occurrence 69 (77.0%), whereas 21 (23%) had perennial occurrence. The commonly reported symptoms included itching (83%), redness (73%), watering (73%), and discharge (47%). A significant number of patients (60, 69%) had a mixed type of disease that affected both the tarsal and bulbar conjunctiva. Conclusion: VKC predominantly affects young males, displaying a seasonal distribution and showing less allergic association, consistent with patterns observed in other tropical regions. Most patients had mild VKC at presentation, and a mixed-form pattern was most frequently observed.

OBJECTIVE: This study assessed contributing factors associated with dental adverse events (AEs). METHODS: Seven electronic health record-based triggers were deployed identifying potential AEs at 2 dental institutions. From 4106 flagged charts, 2 reviewers examined 439 charts selected randomly to identify and classify AEs using our dental AE type and severity classification systems. Based on information captured in the electronic health record, we analyzed harmful AEs to assess potential contributing factors; harmful AEs were defined as those that resulted in temporary moderate to severe harm, required hospitalization, or resulted in permanent moderate to severe harm. We classified potential contributing factors according to (1) who was involved (person), (2) what were they doing (tasks), (3) what tools/technologies were they using (tools/technologies), (4) where did the event take place (environment), (5) what organizational conditions contributed to the event? (organization), (6) patient (including parents), and (7) professional-professional collaboration. A blinded panel of dental experts conducted a second review to confirm the presence of an AE. RESULTS: Fifty-nine cases had 1 or more harmful AEs. Pain occurred most frequently (27.1%), followed by nerve injury (16.9%), hard tissue injury (15.2%), and soft tissue injury (15.2%). Forty percent of the cases were classified as temporary not moderate to severe harm. Person (training, supervision, and fatigue) was the most common contributing factor (31.5%), followed by patient (noncompliance, unsafe practices at home, low health literacy, 17.1%), and professional-professional collaboration (15.3%). CONCLUSIONS: Pain was the most common harmful AE identified. Person, patient, and professional-professional collaboration were the most frequently assessed factors associated with harmful AEs.

The stated goal of the research is to investigate the surface water quality of the Baitarani River in Odisha to ascertain its compatibility for various uses. Large, complex datasets generated during the one-year (2021-2022) monitoring program were collected from 13 locations and encompassed 22 parameters. To examine temporal and spatial fluctuations in and to interpret these datasets, MCDMs like TOPSIS and the Entropy-based Water Quality Index (EWQI) were utilized. The physical and chemical outcomes of the current experiment were compared to WHO standards. According to the analysis’s results, turbidity and total coliform (TC) are indicators that have a greater impact on water quality in all locations during both seasons and are directly linked to home and agricultural non-point source pollution. As per EWQI interpretation, 30.77 % of the observations in PRM and POM fall under the poor category. The findings showed how anthropogenic activities have harmed St. 8, 11, 12, and 13 and require effective management. A quantifiable approach was also carried out to decide the efficacy of TOPSIS. Farming attributes, including SAR, % Na, RSC, MR, KI, and PI, were estimated to delineate the agriculturally practicable zones. This work can offer a reference database for the betterment of water quality.

BackgroundA learning health system (LHS) is a health system in which patients and clinicians work together to choose care on the basis of best evidence and to drive discovery as a natural outgrowth of every clinical encounter to ensure the right care at the right time. An LHS for dentistry is now feasible, as an increased number of oral health care encounters are captured in electronic health records (EHRs).MethodsThe authors used EHRs data to track periodontal health outcomes at 3 large dental institutions. The 2 outcomes of interest were a new periodontitis case (for patients who had not received a diagnosis of periodontitis previously) and tooth loss due to progression of periodontal disease.ResultsThe authors assessed a total of 494,272 examinations (new periodontitis outcome: n = 168,442; new tooth loss outcome: n = 325,830), representing a total of 194,984 patients. Dynamic dashboards displaying performance on both measures over time allow users to compare demographic and risk factors for patients. The incidence of new periodontitis and tooth loss was 4.3% and 1.2%, respectively.ConclusionsPeriodontal disease, diagnosis, prevention, and treatment are particularly well suited for an LHS model. The results showed the feasibility of automated extraction and interpretation of critical data elements from the EHRs. The 2 outcome measures are being implemented as part of a dental LHS. The authors are using this knowledge to target the main drivers of poorer periodontal outcomes in a specific patient population, and they continue to use clinical health data for the purpose of learning and improvement.Practical implicationsDental institutions of any size can conduct contemporaneous self-evaluation and immediately implement targeted strategies to improve oral health outcomes.

Formalin fixation is the most essential step of routine histopathology practice. During the last few years, various fixatives have been developed for use in histopathology practice as an alternative to formalin, to overcome its side effects on health. Here we have demonstrated an interesting and novel idea of using sirka or sugar cane vinegar as an alternative to the formalin with the adequate result.

Abstract Reissner’s fiber (RF) is an extracellular polymer comprising the large monomeric protein SCO-spondin (SSPO) secreted by the subcommissural organ (SCO) that extends through cerebrospinal fluid (CSF)-filled ventricles into the central canal of the spinal cord. In zebrafish, RF and CSF-contacting neurons (CSF-cNs) form an axial sensory system that detects spinal curvature, instructs morphogenesis of the body axis, and enables proper alignment of the spine. In mammalian models, RF has been implicated in CSF circulation. However, challenges in manipulating Sspo, an exceptionally large gene of 15,719 nucleotides, with traditional approaches has limited progress. Here, we generated a Sspo knockout mouse model using CRISPR/Cas9-mediated genome-editing. Sspo knockout mice lacked RF-positive material in the SCO and fibrillar condensates in the brain ventricles. Remarkably, Sspo knockout brain ventricle sizes were reduced compared to littermate controls. Minor defects in thoracic spine curvature were detected in Sspo knockouts, which did not alter basic motor behaviors tested. Altogether, our work in mouse demonstrates that SSPO and RF regulate ventricle size during development but only moderately impact spine geometry.

In recent years, remarkable strides have been made in the management of gastrointestinal disorders, transforming the landscape of patient care and outcomes. This article explores the latest breakthroughs in the field, encompassing innovative diagnostic techniques, personalized treatment approaches, and novel therapeutic interventions. Additionally, this article emphasizes the use of precision medicine tailored to individual genetic and microbiome profiles, and the application of artificial intelligence in disease prediction and monitoring. This review highlights the dynamic progress in managing conditions such as inflammatory bowel disease, gastroesophageal reflux disease, irritable bowel syndrome, and gastrointestinal cancers. By delving into these advancements, we offer a glimpse into the promising future of gastroenterology, where multidisciplinary collaborations and cutting-edge technologies converge to provide more effective, patient-centric solutions for individuals grappling with gastrointestinal disorders.

BackgroundRapid screening tools such as the WHO well-being Index (WWBI), Six-item screener (SIS), and the CLOX-1 test can be used to assess overall mental health and cognition, respectively. We sought to evaluate mental health with cognition in individuals with chronic diseases and stable vital signs presenting to the Emergency Department (ED).MethodsAn observational study in the ED with 279 participants was conducted.ResultsChronic diseases were more prevalent among 51–70 years (43.4%) and diabetes was most common (58.8%). Fever (22.6%) and GI bleeding (32.6%) presentation were high. Participants with low WWBI had low SIS compared to the ones with higher scores (83.3% vs. 17.7%, p

BACKGROUND: Longitudinal patient level data available in the electronic health record (EHR) allows for the development, implementation, and validations of dental quality measures (eMeasures). OBJECTIVE: We report the feasibility and validity of implementing two eMeasures. The eMeasures determined the proportion of patients receiving a caries risk assessment (eCRA) and corresponding appropriate risk-based preventative treatments for patients at elevated risk of caries (appropriateness of care [eAoC]) in two academic institutions and one accountable care organization, in the 2019 reporting year. METHODS: Both eMeasures define the numerator and denominator beginning at the patient level, populations specifications, and validated the automated queries. For eCRA, patients who completed a comprehensive or periodic oral evaluation formed the denominator, and patients of any age who received a CRA formed the numerator. The eAoC evaluated the proportion of patients at elevated caries risk who received the corresponding appropriate risk-based preventative treatments. RESULTS: EHR automated queries identified in three sites 269,536 patients who met the inclusion criteria for receiving a CRA. The overall proportion of patients who received a CRA was 94.4% (eCRA). In eAoC, patients at elevated caries risk levels (moderate, high, or extreme) received fluoride preventive treatment ranging from 56 to 93.8%. For patients at high and extreme risk, antimicrobials were prescribed more frequently site 3 (80.6%) than sites 2 (16.7%) and 1 (2.9%). CONCLUSION: Patient-level data available in the EHRs can be used to implement process-of-care dental eCRA and AoC, eAoC measures identify gaps in clinical practice. EHR-based measures can be useful in improving delivery of evidence-based preventative treatments to reduce risk, prevent tooth decay, and improve oral health.

Abstract Transmission and secretion of signals via the choroid plexus (ChP) brain barrier can modulate brain states via regulation of cerebrospinal fluid (CSF) composition. Here, we developed a platform to analyze diurnal variations in male mouse ChP and CSF. Ribosome profiling of ChP epithelial cells revealed diurnal translatome differences in metabolic machinery, secreted proteins, and barrier components. Using ChP and CSF metabolomics and blood-CSF barrier analyses, we observed diurnal changes in metabolites and cellular junctions. We then focused on transthyretin (TTR), a diurnally regulated thyroid hormone chaperone secreted by the ChP. Diurnal variation in ChP TTR depended on Bmal1 clock gene expression. We achieved real-time tracking of CSF-TTR in awake Ttr mNeonGreen mice via multi-day intracerebroventricular fiber photometry. Diurnal changes in ChP and CSF TTR levels correlated with CSF thyroid hormone levels. These datasets highlight an integrated platform for investigating diurnal control of brain states by the ChP and CSF.

Abstract Systems-level assessments of protein-protein interaction (PPI) network dysfunctions are currently out-of-reach because approaches enabling proteome-wide identification, analysis, and modulation of context-specific PPI changes in native (unengineered) cells and tissues are lacking. Herein, we take advantage of chemical binders of maladaptive scaffolding structures termed epichaperomes and develop an epichaperome-based ‘omics platform, epichaperomics, to identify PPI alterations in disease. We provide multiple lines of evidence, at both biochemical and functional levels, demonstrating the importance of these probes to identify and study PPI network dysfunctions and provide mechanistically and therapeutically relevant proteome-wide insights. As proof-of-principle, we derive systems-level insight into PPI dysfunctions of cancer cells which enabled the discovery of a context-dependent mechanism by which cancer cells enhance the fitness of mitotic protein networks. Importantly, our systems levels analyses support the use of epichaperome chemical binders as therapeutic strategies aimed at normalizing PPI networks.

Abstract Tissue homeostasis is maintained after stress by engaging and activating the hematopoietic stem and progenitor compartments in the blood. Hematopoietic stem cells (HSCs) are essential for long-term repopulation after secondary transplantation. Here, using a conditional knockout mouse model, we revealed that the RNA-binding protein SYNCRIP is required for maintenance of blood homeostasis especially after regenerative stress due to defects in HSCs and progenitors. Mechanistically, we find that SYNCRIP loss results in a failure to maintain proteome homeostasis that is essential for HSC maintenance. SYNCRIP depletion results in increased protein synthesis, a dysregulated epichaperome, an accumulation of misfolded proteins and induces endoplasmic reticulum stress. Additionally, we find that SYNCRIP is required for translation of CDC42 RHO-GTPase, and loss of SYNCRIP results in defects in polarity, asymmetric segregation, and dilution of unfolded proteins. Forced expression of CDC42 recovers polarity and in vitro replating activities of HSCs. Taken together, we uncovered a post-transcriptional regulatory program that safeguards HSC self-renewal capacity and blood homeostasis.

Efficient degradation of organic pollutants is a pressing environmental concern. In our current study, we propose a novel photocatalytic solution to address this challenge, harnessing the potential of advanced nanomaterials to enhance pollutant removal rates. The present work reports the synthesis of Magnesium Oxide (MgO) nanoparticles via a green technique using an aqueous extract of Syzygium samarangense leaves. The role of reducing and capping agents in the process was owned by Syzygium samarangense leaf extract. The green synthesized MgO nanoparticles (MgO NPs) were characterized for their structural, morphology, and optical details using various analytical techniques. The formation of metal oxide in the sample was evident from a strong absorbance peak at 264 nm, and the calculated Eg value of 5.5 eV. The high crystallinity of the prepared NPs was authenticated by PXRD analysis with a cubic structure of calculated average crystalline size of 18 nm. Both leaf extract and the prepared MgO NPs were subjected to FTIR analysis, and the action of phytochemicals was affirmed by the absence of major band in MgO NPs spectrum. Precursor and agglomerated morphology were confirmed on SEM analysis. The prepared sample were utilized to perform degradation of Methylene blue (MB) and congo red (CR) dyes through photocatalysis under UV irradiation. The results affirm the decrement in absorbance with the increment of irradiation time. The affirmed decrement was put forth to study the kinetics of the degradation reaction, and the results was best aligned with 1st kinetic equation with R2 value of 0.9850 and 0.976 for MB and CR dye, respectively. The same results were utilized to study the effect of dye dosage, catalyst concentration, pH level, and presence of different scavengers. All the results found compelling and suggest the prepared MgO NPs as a potent candidate for photocatalytic dye degradation of MB and CR.

BACKGROUND: Our objective was to measure the proportion of patients for which comprehensive periodontal charting, periodontal disease risk factors (diabetes status, tobacco use, and oral home care compliance), and periodontal diagnoses were documented in the electronic health record (EHR). We developed an EHR-based quality measure to assess how well four dental institutions documented periodontal disease-related information. An automated database script was developed and implemented in the EHR at each institution. The measure was validated by comparing the findings from the measure with a manual review of charts. RESULTS: The overall measure scores varied significantly across the four institutions (institution 1 = 20.47%, institution 2 = 0.97%, institution 3 = 22.27% institution 4 = 99.49%, p-value  80%). CONCLUSION: Our results demonstrate the feasibility of developing automated data extraction scripts using structured data from EHRs, and successfully implementing these to identify and measure the periodontal documentation completeness within and across different dental institutions.

Darier disease is an autosomal dominant inherited skin disorder with complete penetrance and variable expressivity due to mutation in the ATP 2A2 gene. It usually develops from childhood and persists through adolescence. Late onset of this genodermatosis has been infrequently reported and found to have minimal findings compared to the classical cases. Classical disease presents with greasy keratotic yellowish-brown papules over the seborrheic areas with palmar pits and nail changes. We hereby report a case of late onset comedonal darier disease with extensive hypopigmented lesions, involvement of palms and nails which is rarely reported in this setting. A thorough review of literature was done and a compendium prepared of late onset darier and no other case report was found to have such extensive involvement as the case reported. It will be interesting to compare more such late onset cases to see if they have a common pattern which can suggest them to be a separate entity from the classical darier.

BACKGROUND: Although sealants are an established and recommended caries-preventive treatment, many children still fail to receive them. In addition, research has shown that existing measures underestimate care by overlooking the sealable potential of teeth before evaluating care. To address this, the authors designed and evaluated 3 novel dental electronic health record-based clinical quality measures that evaluate sealant care only after assessing the sealable potential of teeth. METHODS: Measure I recorded the proportion of patients with sealable teeth who received sealants. Measure II recorded the proportion of patients who had at least 1 of their sealable teeth sealed. Measure III recorded the proportion of patients who received sealant on all of their sealable teeth. RESULTS: On average, 48.1% of 6- through 9-year-old children received 1 or more sealants compared with 32.4% of 10- through 14-year-olds (measure I). The average measure score decreased for patients who received sealants for at least 1 of their sealable teeth (measure II) (43.2% for 6- through 9-year-olds and 28.4% for 10- through 14-year-olds). Fewer children received sealants on all eligible teeth (measure III) (35.5% of 6- through 9-year-olds and 21% of 10- through 14-year-olds received sealant on all eligible teeth). Among the 48.5% who were at elevated caries risk, the sealant rates were higher across all 3 measures. CONCLUSIONS: A valid and actionable practice-based sealant electronic measure that evaluates sealant treatment among the eligible population, both at the patient level and the tooth level, has been developed. PRACTICAL IMPLICATIONS: The measure developed in this work provides practices with patient-centered and actionable sealant quality measures that aim to improve oral health outcomes.

The present study focuses on developing a thermochromic device with a flexible substrate through the coating of cotton fabric with ZnO (Zinc oxide) by solvothermal synthesis technique. Here, ZnO is used as the thermochromic layer for the fabrication work, and it is suitable for textile and wearable applications as it is non-toxic to human skin. This device is designed and fabricated in order to gain better insight into the role of ZnO in thermochromic applications. Here, 3D nanostructures of ZnO are grown on the surface of cotton fabric using a simple and cost-effective solvothermal synthesis approach. The coated fabrics are investigated to determine their structure, morphology, composition, electrical, optical and emissivity properties using an X-ray diffraction (XRD), field-emission scanning electron microscope (FE-SEM), current-voltage (I-V) characteristics, ultraviolet protection factor (UPF) etc. From the morphology study, uniformly packed ZnO nanorods with growth in the c -axis direction are observed. The ZnO nanostructures are known to have excellent UPF when exposed to solar radiation and showed UPF value of 112.48. It is found that coated fabrics have increased electrical conductivity under optical excitations and also enhanced the reflectance. Moreover, based on the emissivity analysis coated ZnO cotton fabric showed the emissivity of 0.95, which is higher and has greater radiation protection than that of bare cotton fabric. Hence, the developed thermochromic device has potential for use in the future in textile and wearable based thermochromic application.

Patients who require blood from rare blood group donors present great challenges even to the most advanced healthcare delivery system. It is most challenging to supply blood for a patient with an antibody to an antigen of high prevalence. The blood donor lacking the corresponding antigen would have an occurrence rate of less than one in 1,000. The International Rare Donor Panel was established in 1965, but since then there has been gross underrepresentation of South Asian countries, including India. There are several challenges to starting a rare blood group donor program in India that include technical, logistical, and administrative limitations. But the main limiting factors are poor availability of trained resources, lack of awareness, absence of antibody screening, inadequate number of laboratories with blood group genotyping facilities, and the decentralized nature of blood transfusion services. Despite that, there were several rare blood groups identified by Indian immunohematologists in the recent past. Recently, a transfusion genomic group has been established in collaboration with the clinical transfusion medicine specialists in India under the GUaRDIAN (Genomics for Understanding Rare Disease in India Alliance Network) initiative to address the domain of rare blood group genomics. Similarly, the National Institute of Immunohematology, Mumbai under the directive of the ICMR (Indian Council of Medical Research) has taken a step to start the RDRI (Rare Donor Registry of India). In this context, we explore the current challenges of setting-up a rare blood group registry in India and future goals from a developing nation’s perspective.

Process-of-care quality measure research can be used to identify gaps in the delivery of dental services to pregnant patients. The aim of this study was to evaluate the types of dental services that pregnant patients received in four dental clinics over five years as documented in the electronic health record (EHR). To accomplish this objective, the authors modified and validated a previously published claims-based dental quality measure for EHR use. After the electronic dental quality measure specifications were defined, the number of pregnant patients was calculated at three academic dental institutions and one large accountable care organization, and the types of dental care services they received over a five-year period (2013-17) were determined. Calibrated reviewers at each institution independently reviewed a sub-sample of patient charts to validate the information obtained from EHR queries, and the concordance between manual chart reviews and EHR query reports was analyzed. Of the 335,078 women aged 15-44 years who received care at the four clinics for the five reporting years, 3.9% (n=13,026) were pregnant. Among these pregnant patients, 48.9% (n=6,366) received a periodic dental examination; 30.0% (n=3,909) received a comprehensive dental exam; and 21.5% (n=2,799) received additional dental services, irrespective of comprehensive or periodic oral evaluations. Overall, the mean proportion of pregnant patients seeking care in these academic dental and group practice clinics was low, but 78.9% of them received either a periodic or comprehensive oral evaluation. Given the importance of oral health care during pregnancy, these findings suggest a need for curriculum development to incorporate prenatal oral health education in the training of dental students.

Huntington’s disease (HD) is a progressive neurodegenerative disorder characterized by abnormal progressive involuntary movements, cognitive deficits, sleep disturbances, and psychiatric symptoms. The onset and progression of the clinical symptoms have been linked to impaired adult neurogenesis in the brains of subjects with HD, due to the reduced neurogenic potential of neural stem cells (NSCs). Among various pathogenic determinants, an altered clock pathway appears to induce the dysregulation of neurogenesis in neurodegenerative disorders. Notably, gamma-aminobutyric acid (GABA)-ergic neurons that express the vasoactive intestinal peptide (VIP) in the brain play a key role in the regulation of circadian rhythm and neuroplasticity. While an abnormal clock gene pathway has been associated with the inactivation of GABAergic VIP neurons, recent studies suggest the activation of this neuronal population in the brain positively contributes to neuroplasticity. Thus, the activation of GABAergic VIP neurons in the brain might help rectify the irregular circadian rhythm in HD. Chemogenetics refers to the incorporation of genetically engineered receptors or ion channels into a specific cell population followed by its activation using desired chemical ligands. The recent advancement of chemogenetic-based approaches represents a potential scientific tool to rectify the aberrant circadian clock pathways. Considering the facts, the defects in the circadian rhythm can be rectified by the activation of VIP-expressing GABAergic neurons using chemogenetics approaches. Thus, the chemogenetic-based rectification of an abnormal circadian rhythm may facilitate the neurogenic potentials of NSCs to restore the neuroregenerative plasticity in HD. Eventually, the increased neurogenesis in the brain can be expected to mitigate neuronal loss and functional deficits.

Abstract Medical records management had always been a challenging in healthcare sector. Traditionally, medical records are handled either manually or electronically that are under the stewardship of hospitals/healthcare institutions. A patient centric approach is the new paradigm where patient is an inherent part of the healthcare ecosystem controlling the access and sharing of his/her personal medical care information. Medical care information requires robust security and privacy. Also there are other issues like confidentiality, interoperability, scalability, cost efficiency and timeliness that need to be addressed. To achieve these objectives, this paper proposes a novel-scalable patient centric yet privacy preserving framework for efficient and secure electronic medical records management. In addition, proposed system generates a unified trusted record and authentication role mapping for enforcing secure access control for medical records using complex encryption algorithms. This paper identifies 13 key performance factors for performance comparison of proposed framework with traditional models. Ethereum and Binance Smart Chain acted as a benchmark platform for performance evaluation of MRBSChain on the basis of three metrics (transaction cost, average block time and deployment cost).At last, a comparative analysis of MRBSChain with other state of art blockchain systems on the basis of execution time is presented in the paper.

There is a great demand to replace non-renewable materials with eco-friendly renewable materials for many applications in recent times. In the present study, such an attempt was made to substitute synthetic polymer-based films used for food packaging applications with films prepared out of renewable materials derived from waste. The pectin/polyvinyl alcohol (PP) and pectin-MgO/polyvinyl alcohol (PMP) films were prepared and characterized to ascertain their suitability for packaging applications. To improve the mechanical strength and thermal stability of films, MgO nanoparticles were incorporated in situ into the polymer matrix. The pectin used in the study was extracted from citrus fruit peel. The prepared nanocomposite films were evaluated for physico-mechanical properties, water contact angle, thermal stability, crystallinity, morphology, compositional purity and biodegradability. The elongation at break for PP film was 42.24% and for PMP film it was 39.18%. Also, the ultimate modulus in terms of MPa for PP film was 6.8 and for PMP it was 7.9. So, it was found that PMP films have better ductility and modulus than PP films due to the presence of MgO nanoparticles. The spectral studies confirmed the compositional purity of the prepared films. The biodegradation studies revealed that both films could be degraded at ambient conditions at appreciable time span, suggesting them to be a better choice as an environmentally friendly food packaging material.

OBJECTIVES:The purpose of this study was to adapt, test, and evaluate the implementation of a primary care "Preventive care and Screening" meaningful use quality measure for tobacco use, in dental institutions. We determined the percentage of dental patients screened for tobacco use, and the percentage of tobacco users who received cessation counseling. METHODS:We implemented the dental quality measure (DQM), in three dental schools and a large dental accountable care organization. An automated electronic health record (EHR) query identified patients 18 years and older who were screened for tobacco use one or more times within 24 months, and who received cessation counseling intervention if identified as a tobacco user. We evaluated EHR query performance with a manual review of a subsample of charts. RESULTS:Across all four sites, in the reporting calendar year of 2015, a total of 143,675 patients met the inclusion criteria for the study. Within 24 months, including 2014 and 2015 calendar years, percentages of tobacco screening ranged from 79.7 to 99.9 percent, while cessation intervention percentages varied from 1 to 81 percent among sites. By employing DQM research methodology, we identified intervention gaps in clinical practice. CONCLUSIONS:We demonstrated the successful implementation of a DQM to evaluate screening rates for tobacco use and cessation intervention. There is substantial variation in the cessation intervention rates across sites, and these results are a call for action for the dental profession to employ tobacco evidence-based cessation strategies to improve oral health and general health outcomes.