Sequential Treatment Application Robot (STAR) for high-replication marine experimentation

Marine organisms are often subject to numerous anthropogenic stressors, resulting in widespread ecosystem degradation. Physiological responses to these stressors, however, are complicated by high biological variability, species-specific sensitivities, nonlinear relationships, and countless permutations of stressor combinations. Nevertheless, quantification of these relationships is paramount for parameterizing predictive tools and ultimately for effective management of marine resources. Multi-level, multi-stressor experimentation is therefore key, yet the high replication required has remained a logistical challenge and a financial barrier. To overcome these issues, we created an automated system for experimentation on marine organisms, the Sequential Treatment Application Robot (STAR). The system consists of a track-mounted robotic arm that sequentially applies precision treatments to independent aquaria via syringe and peristaltic pumps. The accuracy and precision were validated with dye and spectrophotometry, and stability was demonstrated by maintaining corals under treatment conditions for more than a month. The system is open source and scalable in that additional treatments and replicates may be added without incurring multiplicative costs. While STAR was designed for investigating the combined impacts of nutrients, warming, and disease on reef-building corals, it is highly customizable and may be used for experimentation involving a diverse array of treatments and species.

Editorial: The WHO Global Oral Health Action Plan 2023-2030

Oral health is finally on the global agenda. The World Health Organisation Global Oral Health Action Plan (OHAP) 2023-2030 (WHO, 2022a) has been completed following a public consultation which took place during August and September 2022. As oral diseases are the most prevalent non-communicable diseases; it is good to see that the OHAP will co-exist alongside the Global Action Plan for the Prevention and Control of Non-communicable Diseases 2013-2030. This editorial summarises the OHAP and highlights the opportunities and challenges discussed during the September 2022 EADPH congress, held co-jointly with the Council of the European Chief Dental Officers (CECDO).

The WHO Action Plan for Oral Health - How Can the EADPH Contribute - Opportunities and Challenges

This paper summarises the proceedings of a workshop organised by the European Association of Dental Public Health, held in Montpellier in September 2022. The full proceedings were transcribed and are available on the Community Dental Health website (https://www.cdhjournal.org/article/973). The WHO Action Plan for Oral Health provides a golden opportunity to help raise the profile of oral health, to put oral health on the global public health agenda and ultimately improve oral health. It is to be applauded. However, delivery will present a challenge. Those challenges and opportunities are detailed in this paper.

A new framework for host-pathogen interaction research

COVID-19 often manifests with different outcomes in different patients, highlighting the complexity of the host-pathogen interactions involved in manifestations of the disease at the molecular and cellular levels. In this paper, we propose a set of postulates and a framework for systematically understanding complex molecular host-pathogen interaction networks. Specifically, we first propose four host-pathogen interaction (HPI) postulates as the basis for understanding molecular and cellular host-pathogen interactions and their relations to disease outcomes. These four postulates cover the evolutionary dispositions involved in HPIs, the dynamic nature of HPI outcomes, roles that HPI components may occupy leading to such outcomes, and HPI checkpoints that are critical for specific disease outcomes. Based on these postulates, an HPI Postulate and Ontology (HPIPO) framework is proposed to apply interoperable ontologies to systematically model and represent various granular details and knowledge within the scope of the HPI postulates, in a way that will support AI-ready data standardization, sharing, integration, and analysis. As a demonstration, the HPI postulates and the HPIPO framework were applied to study COVID-19 with the Coronavirus Infectious Disease Ontology (CIDO), leading to a novel approach to rational design of drug/vaccine cocktails aimed at interrupting processes occurring at critical host-coronavirus interaction checkpoints. Furthermore, the host-coronavirus protein-protein interactions (PPIs) relevant to COVID-19 were predicted and evaluated based on prior knowledge of curated PPIs and domain-domain interactions, and how such studies can be further explored with the HPI postulates and the HPIPO framework is discussed.

Is Zirconia a Viable Alternative to Titanium for Dental Implantology?

AIM

To review the literature using a systematic approach to answer the question: 'Are zirconia dental implants an alternative to titanium dental implants?' This was evaluated by assessing the evidence for survival rate, success rate and marginal bone loss of the two implant materials.

METHODS

Relevant studies were identified after searching PUBMED, EMBASE and the Cochrane library. Two reviewers assessed the papers using the specified inclusion criteria, title and abstracts. Studies that were not related to the outcomes of: survival rate, success rate or marginal bone loss of zirconia dental implants were excluded.

RESULTS

From a total of 1617 titles and abstracts, 33 potentially relevant full text papers were identified. Of these, 18 met the criteria for inclusion in the review. The review revealed heterogeneity between the studies in terms of surgical characteristics, implant characteristics, defining success and measuring marginal bone loss therefore making comparisons between studies difficult. However, in the three randomised control studies included in this review, which compared zirconia implants to titanium implants, the survival rate was lower for zirconia implants, but the success rate and marginal bone loss were found to be similar.

CONCLUSION

Overall, initial studies indicate that zirconia dental implants could be a viable alternative to titanium implants but need further well-designed studies need to be carried out to assess their long-term survival rate, success rate and marginal bone loss. At present, zirconia implants should be used with caution but can be an alternative option if a patient has an absolute contraindication to titanium.

Cost Benefit Analysis of Two Oral health Improvement Programmes

INTRODUCTION

Oral health is frequently given a low priority when healthcare funds are allocated to new initiatives. One method to highlight the health and social benefits of new oral health initiatives is to use cost benefit analysis to show their value.

AIM

To demonstrate how Cost Benefit Analysis (CBA) has been applied to two recent oral health initiatives to evaluate their ability to reduce costs and improve the quality of life.

METHODS

CBA was applied to the Mouth Care Matters project in Kent, Surrey and Sussex, and the Senior Smiles project - improving oral health in residential homes in Australia.

RESULTS

Over a five-year period, the Mouth Care Matters project would generate £2.66 in cost savings, within the healthcare system, for every £1 spent. Over a three year period the Senior Smiles project would generate a cost saving for the healthcare system of $3.14 for every $1 spent. These evaluations were instrumental to enable a national rollout for Mouth Care Matters and a public endorsement of the programme for Senior Smiles.

CONCLUSIONS

Health economics can be a useful tool in aiding care organisations to assess the implications of decisions to spend limited resources in particular areas of healthcare over others.

AB0820 COMPARATIVE EFFICACY OF GUSELKUMAB IN PATIENTS WITH PSORIATIC ARTHRITIS: RESULTS FROM SYSTEMATIC LITERATURE REVIEW AND NETWORK META-ANALYSIS

Background:

The efficacy of the interleukin (IL)-23 subunit p19 inhibitor guselkumab (GUS) for psoriatic arthritis (PsA) has recently been demonstrated in two Phase 3 trials (DISCOVER-1 & -2) but has not been evaluated versus existing targeted therapies for PsA.

Objectives:

To compare GUS to targeted therapies for PsA through network meta-analysis (NMA).

Methods:

A systematic literature review was performed to identify PsA randomized controlled trials from 2000 to 2018. Bayesian NMAs were performed to compare treatments on American College of Rheumatology (ACR) 20/50/70 response, Psoriasis Area Severity Index (PASI) 75/90/100 response, Health Assessment Questionnaire Disability Index (HAQ-DI) score, resolution of enthesitis (RoE), resolution of dactylitis (RoD), adverse events (AEs) and serious adverse events (SAEs). Analyses used random effects models that adjusted for placebo response via meta-regression on baseline risk when feasible. Results are summarized by ranking treatments according to median absolute probabilities of response derived from NMAs.

Results:

Twenty-six Phase 3 studies were included in the quantitative synthesis. Studies were placebo-controlled up to 24 weeks and evaluated 13 targeted therapies for PsA. Absolute probabilities are reported for PASI 90 & ACR 20 responses according toFigure 1,and a forest plot of relative risks versus placebo for AEs is reported according toFigure 2. For ACR 20 response, GUS 100 mg every 4 weeks (Q4W) and every 8 weeks (Q8W) ranked 5th and 8th out of 20 interventions and were comparable to IL-17A inhibitor (IL-17Ai) and most tumor necrosis factor inhibitor (TNFi) agents. Similar findings were observed for ACR 50 and 70 responses. For PASI 90 response, GUS Q4W and Q8W ranked 1st and 2nd out of 15 interventions and were highly likely to provide a greater benefit than most other agents. Similar findings were observed for PASI 75 and 100 responses. For HAQ-DI score, GUS Q4W and Q8W ranked 6th and 10th out of 20 interventions and were comparable to IL-17Ai and most TNFi agents. For RoE, GUS Q4W and Q8W ranked 8th and 6th out of 13 interventions and were comparable to IL-17Ai and TNFi agents. For RoD, GUS Q4W and Q8W ranked 8th and 9th out of 13 interventions and were comparable to most IL-17Ai and TNFi agents. For AEs, GUS Q4W and Q8W ranked 3rd and 2nd out of 19 interventions and were comparable to IL-17Ai and TNFi agents. Likewise, for SAEs, GUS Q4W and Q8W ranked 4th and 5th out of 20 interventions and were comparable to IL-17Ai and TNFi agents. Analyses that controlled for previous exposure to biologics or assessed outcomes at alternative timepoints were broadly consistent with primary analysis results.

Conclusion:

NMA results indicate that GUS is comparable to most targeted PsA treatments for improvement in arthritis, soft tissue damage, physical function, and safety outcomes. For PASI outcomes, GUS is highly likely to provide a greater benefit than other targeted PsA treatments.

Disclosure of Interests:

Iain McInnes Grant/research support from: Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Janssen, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, Novartis, Pfizer, and UCB, Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau, Kiefer Eaton Shareholder of: Test Pharma, Consultant of: Janssen, Agata Schubert Employee of: Janssen-Cilag, Steve Peterson Employee of: Janssen Research & Development, LLC, Tim Disher Consultant of: Janssen, Wim Noel Employee of: Janssen Pharmaceuticals NV, Hassan Fareen Employee of: Janssen, Chetan Karyekar Shareholder of: Johnson & Johnson, Consultant of: Janssen, Employee of: Janssen Global Services, LLC. Previously, Novartis, Bristol-Myers Squibb, and Abbott Labs., Suzy Van Sanden Employee of: Janssen, Christopher T. Ritchlin Grant/research support from: UCB Pharma, AbbVie, Amgen, Consultant of: UCB Pharma, Amgen, AbbVie, Lilly, Pfizer, Novartis, Gilead, Janssen, Wolf-Henning Boehncke Grant/research support from: Janssen Research & Development, LLC, Consultant of: Janssen

Aim2-mediated/IFN-β-independent regulation of gastric metaplastic lesions via CD8+ T cells

Development of gastric cancer is often preceded by chronic inflammation, but the immune cellular mechanisms underlying this process are unclear. Here we demonstrated that an inflammasome molecule, absent in melanoma 2 (Aim2), was upregulated in patients with gastric cancer and in spasmolytic polypeptide-expressing metaplasia of chronically Helicobacter felis-infected stomachs in mice. However, we found that Aim2 was not necessary for inflammasome function during gastritis. In contrast, Aim2 deficiency led to an increase in gastric CD8+ T cell frequency, which exacerbated metaplasia. These gastric CD8+ T cells from Aim2-/- mice were found to have lost their homing receptor expression (sphingosine-1-phosphate receptor 1 [S1PR1] and CD62L), a feature of tissue-resident memory T cells. The process was not mediated by Aim2-dependent regulation of IFN-β or by dendritic cell-intrinsic Aim2. Rather, Aim2 deficiency contributed to an increased production of CXCL16 by B cells, which could suppress S1PR1 and CD62L in CD8+ T cells. This study describes a potentially novel function of Aim2 that regulates CD8+ T cell infiltration and retention within chronically inflamed solid organ tissue. This function operates independent of the inflammasome, IFN-β, or dendritic cells. We provide evidence that B cells can contribute to this mechanism via CXCL16.

Replication Study: Intestinal inflammation targets cancer-inducing activity of the microbiota

As part of the Reproducibility Project: Cancer Biology we published a Registered Report (Eaton et al., 2015) that described how we intended to replicate selected experiments from the paper "Intestinal Inflammation Targets Cancer-Inducing Activity of the Microbiota" (Arthur et al., 2012). Here we report the results. We observed no impact on bacterial growth or colonization capacity when the polyketide synthase (pks) genotoxic island was deleted from E. coli NC101, similar to the original study (Supplementary Figure 7; Arthur et al., 2012). However, for the experiment that compared inflammation, invasion, and neoplasia in azoxymethane (AOM)-treated interleukin-10-deficient mice mono-associated with NC101 or NC101[Formula: see text] pks the experimental timing of the replication attempt was longer than that of the original study. This difference was because in the original study the methodology was not clearly stated and likely led to the increased mortality and severity of inflammation observed in this replication attempt. Additionally, early death occurred during AOM treatment with higher mortality observed in NC101[Formula: see text] pks mono-associated mice compared to NC101, which was in the same direction, but more severe than the original study (Suppleme1ntal Figure 10; Arthur et al., 2012). A meta-analysis suggests that mice mono-associated with NC101[Formula: see text] pks have higher mortality compared to NC101. While these data were unable to address whether, under the conditions of the original study, NC101 and NC101[Formula: see text] pks differ in inflammation, invasion, and neoplasia this replication attempt demonstrates that clear description of experimental methods is essential to ensure accurate reproduction of experimental studies.

Toward More Patient-Centered and Prevention-Oriented Oral Health Care: The ADVOCATE Project

ADVOCATE (Added Value for Oral Care) is a project funded by the European Commission's Horizon 2020 program, which aims to develop strategies for a system transition toward more patient-centered and prevention-oriented oral health care delivery within health care systems. This system should balance the restorative and preventive approaches in dental and oral health care. ADVOCATE is a partnership among 6 European Union member states, which involves collaboration among universities, state-funded health care providers, and private insurance companies in Denmark, Germany, Hungary, Ireland, the Netherlands, the United Kingdom, and Aridhia, a biomedical informatics company based in Scotland. There are 6 interrelated work packages, which aim to address the following objectives: 1) in-depth evaluation of oral health care systems in European Union member states to identify best system designs for oral disease prevention, 2) development of a set of measures to provide information on oral care delivery and oral health outcomes, 3) evaluation of a feedback approach in dental practice that aims to facilitate a change toward preventive oral health care delivery, and 4) economic evaluation of strategies to promote preventive oral health care and development of policy recommendations for oral health care systems. The project is novel in its use of data that are routinely collected by health insurance organizations, as well as the engagement of key stakeholders from dental teams, insurers, patients, and policy makers in guiding the development and progress of the project. This article outlines in detail the objectives and research methodology of the ADVOCATE project and its anticipated impact. Knowledge Transfer Statement: This commentary describes the development of policy options to promote a greater focus on disease prevention in general dental practice. The approach builds on identifying the comparative effectiveness of alternative incentive schemes, as well as methods to monitor clinical and patient-derived measures of success in creating health for patients. The article describes the development and application of the measures and the evaluation of their success in orienting clinical practice more toward disease prevention.

NLRP6 function in inflammatory monocytes reduces susceptibility to colitis in mice

NLRP6 is a member of the Nod-like receptor (NLR) family, whose members are involved in the recognition of microbes and/or tissue injury. NLRP6 was previously shown to regulate IL-18 secretion and is important for protecting mice against chemically-induced colitis and colitis-associated colon cancer. However, the cellular mechanisms by which NLRP6 reduces susceptibility to colonic inflammation remain unclear. Here, we determined that NLRP6 expression is specifically upregulated in Ly6Chi inflammatory monocytes that infiltrate into the colon during dextran sulfate sodium (DSS)-induced inflammation. Adoptive transfer of WT Ly6Chi inflammatory monocytes into Nlrp6−/− mice was sufficient to protect them from mortality, significantly reducing intestinal permeability and damage. NLRP6-deficient inflammatory monocytes were specifically defective in TNFα production, which was important for reducing DSS-induced mortality and dependent on autocrine IL-18 signaling by inflammatory monocytes. Our data reveal a previously unappreciated role for NLRP6 in inflammatory monocytes, which are recruited during colitis to promote barrier function and limit bacteria-driven inflammation. This study also highlights the importance of early cytokine responses, particularly NLRP6-dependent and IL-18-dependent TNFα production, in preventing chronic dysregulated inflammation that occurs in patients with inflammatory bowel disease.

Nlrp6 limits inflamation in mouse colon by regulating microbiota

Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that involves chronic inflammation involving the colon. We have previously shown that NLRP6 protects against the development of chemically-induced colitis. Here, we demonstrate that NLRP6 is important for suppressing the development of spontaneous colitis in the IL-10−/− mice model of IBD. IL10−/−Nlrp6−/− mice have significantly increased inflammation based on histologic scoring, spleen weight, fecal lipocalin levels, intestinal permeability, infiltration of immune cells, and upregulation of proinflammatory mediators. To determine whether NLRP6 protects against colitis by modulating the microbiome, we generated and recolonized germ-free (GF) Nlrp6−/− mice with the microbiota from WT donors and compared the composition of the microbiome to that of recolonized GF WT mice. We determined that GF WT and Nlrp6−/− mice acquire distinct microbiota upon re-colonization. Importantly, Nlrp6−/− mice have reduced a-diversity and dramatically increased colonization of Akkermansia muciniphila, which was also observed in IL10−/−Nlrp6−/− mice. To determine whether Akkermansia contributes to increased inflammation in IL-10−/− mice, we monocolonized GF IL-10−/− mice with Akkermansia muciniphila and found that these mice developed increased colitis compared to GF IL-10−/− mice gavaged with a control non-colitogenic Bacteroides strain. Altogether these results demonstrate that NLRP6 regulates the colonization of Akkermansia, which in turn, can precipitate colitis in a genetically susceptible host. Our work furthered the insight into the pathogenesis of UC and will be instrumental in the development of therapeutics that reduce pathobionts colonization to treat IBD.

Shoulder rotational properties of throwing athletes

Throwing arm injuries are common and often related to the shoulder external and internal rotation. Quantitative assessment may provide new insights to physical assessment and options for treatment. After having signed IRB approved consents and filled out injury questionnaires, 96 baseball pitchers were examined on both shoulders using a custom-made wireless device. The resistance onset angle (ROA), end-point angle (EPA), shoulder rotational flexibility (SRF) in both external and internal rotation, and rotational ranges of motion (ROM) of both shoulders were determined. About 34% of subjects had surgeries on their throwing arm. Another 15% of subjects had throwing arm injuries that did not require surgical treatments. The throwing arm had significantly lower internal ROA, EPA and SRF, but significantly higher external ROA, EPA and SRF than the non-throwing arm. There were significant differences in shoulder rotational properties among groups with different surgery locations. Subjects with shoulder surgeries had greater internal rotation flexibility of their throwing arm than those with surgeries on the elbow. Throwers with injury and surgery history had significantly different shoulder rotational properties. Abnormal shoulder rotational properties may be related to throwing arm injuries. A better understanding of their relationship may lead us to effective preventive measures of throwing arm injuries.

Atorvastatin induces apoptosis in vitro and slows growth of tumor xenografts but not polyp formation in MIN mice

BACKGROUND

Despite the availability of effective surveillance for colorectal cancer with colonoscopy, relatively few at-risk individuals utilize this option. Colon cancer chemoprevention might be a more acceptable alternative. Some epidemiologic studies have suggested that statins may have chemopreventive effects without the risks of nonsteroidal anti-inflammatory drugs, but other epidemiologic studies have found no effect of statins.

METHODS

We aimed to evaluate the efficacy of atorvastatin in inducing apoptosis in vitro, in preventing polyp formation in the min mouse, and in preventing tumor growth in nude mice.

RESULTS

Atorvastatin rapidly induces apoptosis in the HCT116 colon cancer cell line in vitro, and this effect is reversible with mevalonate and geranylgeranyl pyrophosphate, but less so by farnesyl pyrophosphate. Atorvastatin chow was ineffective in reducing polyp formation in the min mouse model, with no significant effect on polyp number. Atorvastatin was effective in significantly slowing the growth of HCT116 colon cancer cell xenografts in nude mice (p = 0.008). Further, this reduction is due to increased levels of apoptosis.

CONCLUSIONS

Atorvastatin can induce apoptosis in vitro, through mevalonate and prenylation pathways. Atorvastatin, while not effective in preventing polyp formation in the min mouse model, was very effective in slowing tumor growth in a nude mouse model. Consistent with in vitro findings, increased apoptosis accounted for decreased tumor growth. Statins may have benefit in cancer by slowing tumor growth, rather than preventing tumor initiation.