Exploring Oral Health Care Awareness among Intensive Care Units Nurses at KAUH

The relationship between oral health status and systemic diseases is well established, however, literature shows that there is still lack of awareness among individuals taking care of ICU patients. This work aims to explore if ICU nurses are aware of the relationship between oral health status and systemic diseases, whether they practice oral health care on their patients and if they do, what methods they use. A pre-validated questionnaire was used and distributed to all nurses practicing at KAUH Medical and Surgical ICU. All surveys were voluntary and anonymous. A total of 45 of questionnaires were distributed to ICU nurses with a response rate of 95.6% (Tn = 43). Mean responses indicated that nurses recognize that micro-aspiration of contaminated oropharyngeal secretions is the most likely mechanism of transmission of bacteria into the lung of ventilated patients (mean = 5.6). Accordingly, our results also showed that oral care was perceived as a very high priority for mechanically ventilated patients by 95% of nurses. Mouthwash was the primary material used for oral care by the majority of nurses (n = 32;74.4%), and chlorhexidine the most used one (n = 42;98%). The use of manual toothbrushes was very low (n = 8;23.5%) and not surprisingly, none of the nurses used electric toothbrushes to provide oral care for their ventilated patients. Finally, 86% of the respondents agreed on the need of better supplies and equipment to be provided by the hospital in order to perform better oral care in the ICU. Oral care provided in the ICU is not concordant with the global oral care protocols. Thus, the need for translation of oral care guidelines into clinical practice is of serious importance to improve the quality of care.

Bone Mineral “Quality”: Differing Characteristics of Calcified Microsphere Populations at the Osteoporotic and Osteoarthritic Femoral Articulation Front

The mineral front consists of large populations of organically enshrouded calcified microspheres (filamentous clusters) about 1 micron in diameter and associated smaller numbers of variably dense nanospheres, 30 - 40 nm in diameter. The discrete objects persist and modulate in maturity, and may constitute a variable “qualitative” factor in the skeletal inorganic phase, exemplified by the biomechanically contrasting pathologies of osteoporosis (OP;fracture, low stress condition) and osteoarthritis (OA;non fracture, high stress condition). The aim was to compare the articulation front material for morphological and trace element diversity using fresh female femoral head discards (from Dewsbury District Hospital NHS Mid-Yorkshire Trust). These were prepared for histology of the cartilage/bone interface region by immersion in hydrazine hydrate to expose the anorganic mineral topography for microscopy and FEGSEM microanalysis. 1) Mineral microsphere morphology (compared to animals as arbitrary controls) suggested that calcified microspheres from OP (n = 19) tended to be small (0.5 - 0.7 microns), smooth and compacted;those from OA (n = 19) were large (0.5 - 4.0 microns), uneven and irregularly dispersed. Respective calcified nanospheres from OP were similarly smaller (30 - 50 nm) than those from OA (>100 nm). In subchondral bone a proportion of the filamentous microspheres had fused into a fine-textured phase in OP and a coarse-textured phase in OA. 2) Trace element analysis (compared to positive porcine Si and Mg and other peaks) suggested a diminution with mineral maturity, and also with age effecting OP and OA similarly, with minor differences detected between them. It was concluded that calcified objects constituting the inorganic phase vary regionally with age and in fracture and nonfracture, being diminished in size (not number) in weak OP and enlarged (compared to porcine control) in stronger OA, with Si or Mg “doping” diminishing with time, perhaps influencing their individual bioactivity and matrix dynamics.

Adaptive Dynamic Dipper Throated Optimization for Feature Selection in Medical Data

The rapid population growth results in a crucial problem in the early detection of diseases inmedical research.Among all the cancers unveiled,breast cancer is considered the second most severe cancer.Consequently,an exponential rising in death cases incurred by breast cancer is expected due to the rapid population growth and the lack of resources required for performing medical diagnoses.Utilizing recent advances in machine learning could help medical staff in diagnosing diseases as they offer effective,reliable,and rapid responses,which could help in decreasing the death risk.In this paper,we propose a new algorithm for feature selection based on a hybrid between powerful and recently emerged optimizers,namely,guided whale and dipper throated optimizers.The proposed algorithm is evaluated using four publicly available breast cancer datasets.The evaluation results show the effectiveness of the proposed approach from the accuracy and speed perspectives.To prove the superiority of the proposed algorithm,a set of competing feature selection algorithms were incorporated into the conducted experiments.In addition,a group of statistical analysis experiments was conducted to emphasize the superiority and stability of the proposed algorithm.The best-achieved breast cancer prediction average accuracy based on the proposed algorithm is 99.453%.This result is achieved in an average time of 3.6725 s,the best result among all the competing approaches utilized in the experiments.

Exercise-induced irisin in bone and systemic irisin administration reveal new regulatory mechanisms of bone metabolism

Irisin is a polypeptide hormone derived from the proteolytic cleavage of fibronectin-type III domain- containing 5 （FNDC5） protein. Once released to circulation upon exercise or cold exposure, irisin stimulates browning of white adipose tissue （WAT） and uncoupling protein I （UCP1） expression, leading to an increase in total body energy expenditure by augmented UCPl-mediated thermogenesis. It is currently unknown whether irisin is secreted by bone upon exercise or whether it regulates bone metabolism in vivo. In this study, we found that 2 weeks of voluntary wheel-running exercise induced high levels of FNDC5 messenger RNA as well as FNDC5/irisin protein expression in murine bone tissues. Increased immunoreactivity due to exercise-induced FNDC5/irisin expression was detected in different regions of exercised femoral bones, including growth plate, trabecular bone, cortical bone, articular cartilage, and bone-tendon interface. Exercise also increased expression of osteogenic markers in bone and that of UCP1 in WAT, and led to bodyweight loss. Irisin intraperitoneal （IP） administration resulted in increased trabecular and cortical bone thickness and osteoblasts numbers, and concurrently induced UCP1 expression in subcutaneous WAT. Lentiviral FNDC5 IP administration increased cortical bone thickness. In vitro studies in bone cells revealed irisin increases osteoblastogenesis and mineralization, and inhibits receptor activator of nuclear factor-kB ligand （RANKL）- induced osteoclastogenesis. Taken together, our findings show that voluntary exercise increases irisin production in bone, and that an increase in circulating irisin levels enhances osteogenesis in mice.