Chromatographic capture of cells to achieve single stage clarification in recombinant protein purification

Recent advancements in cell culture engineering have allowed drug manufacturers to achieve higher productivity by driving higher product titers through cell line engineering and high‐cell densities. However, these advancements have shifted the burden to clarification and downstream processing where the difficulties now revolve around removing higher levels of process‐ and product‐related impurities. As a result, a lot of research efforts have turned to developing new approaches and technologies or process optimization to still deliver high quality biological products while controlling cost of goods. Here, we explored the impact of a novel single use technology employing chromatographic principle‐based clarification for a process‐intensified cell line technology. In this study, a 16% economic benefit ($/g) was observed using a single‐use chromatographic clarification compared to traditional single‐use clarification technology by improving the overall product cost through decreased operational complexity, higher loading capacity, increased product recovery, and higher impurity clearance. In the end, the described novel chromatographic approach significantly simplified and enhanced the cell culture fluid harvest unit operation by combining the reduction of insoluble and key soluble contaminants of the harvest fluid into a single stage.

Gagging and cooperation in 4-12-year-old children over a series of dental appointments

PURPOSE

The purposes were to evaluate if gagging can affect children's cooperation with treatment, investigate possible changes in gagging and study factors that can predict children's behaviour over dental treatment.

METHODS

255 children aged 4-12 years, needing at least three consecutive dental appointments, completed the Children's Fear Survey Schedule-Dental Subscale before examination. The Gagging Problem Assessment was performed before the initial examination and after the third/final appointment. Frankl's Behaviour Rating Scale (FBRS) was used to rate children's behaviour. Multivariate Mixed Linear and Logistic Regression Models were used.

RESULTS

Children with definitely positive behaviour were significantly older, less fearful and less likely to gag before treatment. Girls and older children had lower odds of gagging over time, while fearful children had higher odds. There were no statistically significant associations between gagging over time, FBRS and the type of dental treatment at the third appointment. The percentage of children who gagged after the third appointment (27.05%) was significantly lower as compared to the percentage found at the initial appointment (32.54%; p = 0.004).

CONCLUSION

Among the variables studied, age, dental fear, initial GPA and type of treatment were good predictors of children's behaviour during dental treatment.

Factors associated with gagging during radiographic and intraoral photographic examinations in 4-12-year-old children

AIMS

No studies are available in paediatric samples evaluating gagging during toothbrushing, radiographic and/or intraoral photographic examinations. The aims were to collectively examine potential factors associated with gagging during radiographs and intraoral photographs in 4-12-year-old children.

METHODS

Parents/guardians of 395 children (aged 4-12 years old) completed questionnaires asking about their children's toothbrushing habits. Children completed Greek versions of the Gagging Assessment Scale (GAS) and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), while the dentist used the shorter version of the Gagging Problem Assessment (GPA-de-c/SF) to objectively assess gagging. X-ray and Photo Rating Scales were created to evaluate gagging during X-rays and photographs, respectively. Multivariate logistic regression was used to examine the relationship between the potential factors and gagging.

RESULTS

59 of 275 patients (21%) and 56 of 276 patients (20%) who needed X-rays and intraoral photographs, respectively, gagged. Children who gagged during X-rays had significantly higher GAS scores (p = 0.007). Boys, younger children, and those who gagged on GPA-de-c/SF were more likely to gag during X-rays, and children who gagged on GPA-de-c/SF were more likely to gag during photographs. Brushing habits were not related to dental fear or gagging.

CONCLUSION

Of the variables which we studied, GPA-de-c/SF most strongly affected the odds of gagging during taking radiographs and/or intraoral photographs.

Child dental fear and past dental experience: comparison of parents' and children's ratings

PURPOSE

To compare the parental and child versions of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and the parental and child evaluations of the Child's Past Dental Experience (CPDE) in 4- to 12-year-old children in a sample from Greece.

METHODS

537 families (652 children) with 4- to 12-year-old children seeking dental care either at a University paediatric dental clinic (UC) (50.8%) or a paediatric private practice (PP) participated. Parents completed a sociodemographic questionnaire and the parental Greek version of the CFSS-DS, and children independently completed the child's Greek version. All family members answered questions about CPDE. Statistical analyses were based on multilevel models (p < 0.05).

RESULTS

Mothers' and fathers' mean CFSS-DS total scores were not significantly different from each other (p = 0.655), but were significantly higher than the scores of their sons and daughters (p < 0.001), regardless of the child's age. There was a negative association between mother's age and CFSS-DS agreement, but not for fathers. There was poor agreement for CPDE ratings between children and both parents, regardless of gender. Parents' ratings of CPDE were not related to their assessment of their children's dental fear, whilst the children's ratings of their CPDE were significantly related to their current dental fear. Location (UC or PP) had no significant influence on CFSS-DS or CPDE parental-child differences.

CONCLUSIONS

Both parents overestimated their sons' and daughters' dental fear. There was poor agreement on CPDE evaluation between parents and children. Parental CFSS-DS and CPDE evaluations are poor indicators of children's dental fear and prior dental experience.

Psychometric properties of the Greek version of the Toronto Composite Empathy Scale in Greek dental students

INTRODUCTION

Empathy levels of health practitioners are related to patient satisfaction and treatment outcomes. The Toronto Composite Empathy Scale (TCES) was recently developed to assess cognitive and emotional empathy levels in both professional and personal spheres, and tested in an English-speaking sample of dental students. The aim of this study was to examine the psychometrics of the Greek version of the TCES.

MATERIALS AND METHODS

The TCES was translated into Greek and administered to all of the dental students at Aristotle University of Thessaloniki. A random subset of students completed the questionnaire twice for test-retest analysis.

RESULTS

Nearly all (96.5%) of the students completed the questionnaire. The internal consistencies of each of the four subscales were generally acceptable (Cronbach's alphas: 0.676-0.805), and the scale showed good discriminant and convergent validities (r's for discriminant validity: 0.217 and 0.103; r's for convergent validity: 0.595 and 0.700). Test-retest reliabilities ranged from 0.478 to 0.779. After eliminating items that fell on both cognitive and emotional factors, a rotated factor analysis indicated that the items loaded on two cognitive and three emotional factors.

DISCUSSION

Our results indicate that the Greek version of the TCES has good psychometric properties. The factor analysis indicates that the emotional and cognitive aspects of empathy are distinct, supporting the need to address both aspects in studies of empathy.

CONCLUSIONS

The Greek version of the TCES is a reliable and valid tool for the measurement of cognitive and emotional empathy, in both professional and personal life, in Greek dental students.

Recruiting rural dentally-avoidant adolescents into an intervention study

AIM

To carry out a study designed to test an intervention to increase dental attendance in rural dentally-avoidant adolescents, to identify and recruit eligible adolescents.

STUDY DESIGN AND METHODS

This study used a cross-sectional design to identify eligible adolescents. A total of 2,762 adolescents (60% of the enrolled students) from junior high and senior high schools in a rural county in Washington State (USA) were given a dental examination with a light and mirror by calibrated dental examiners using WHO criteria. Parents of children with serious dental needs were urged to seek dental care for their adolescent children. They were offered the chance to enroll their child in a study comparing two programs designed to help the adolescent decide whether to seek out dental care. A second group of emancipated adolescents and young adults (aged < 26 years) receiving services at the local college and health department was also screened, and eligible individuals were also offered the chance to enroll.

RESULTS AND STATISTICS

Only 23 (6%) of 357 eligible junior and senior high school adolescents enrolled, compared with 24 (67%) of the 36 eligible emancipated adolescents and young adults. A second follow-up letter was sent to the 85 parents of un-enrolled adolescents with the most severe caries, offering direct assistance in obtaining dental care for their children; only 3 families responded.

CONCLUSIONS

This study illustrates the difficulty in engaging adolescents in their oral health and utilization of oral health interventions. The results also suggest that slightly older rural individuals are more interested in and/or able to overcome barriers to seeking out dental care. Alternative strategies are suggested for recruiting avoidant adolescents.

Parental presence versus absence in the dental operatory: a technique to manage the uncooperative child dental patient

AIM

Societal changes have led to an increased parental presence in paediatric dental surgeries. The aim of this study was to assess the deliberate use of a parental presence/absence (PPA) intervention as a behavioural technique to manage very uncooperative children.

STUDY DESIGN

This is a retrospective study of the PPA technique in a Greek paediatric dental practice.

METHODS

Practice patient records were examined over a six year period, during which time Frankl behaviour ratings were made for each patient. At the initial dental visit, 85 otherwise normal healthy children were found to be very uncooperative (Frankl score of definitely negative); 46 female and 39 male, mean age 4.6+/-1.5 yrs (range 2.7-8.8). Their parents stepped out of the operatory and returned after the child became cooperative. These children were compared with 85 randomly selected cooperative children, matched for age and gender.

STATISTICS

A one sample binomial test was used to assess the technique's success, while chi(2) and t-tests were used for between group comparisons of proportions and means, respectively.

RESULTS

Seventy-four out of the 85 initially uncooperative children displayed Frankl positive behaviour as the initial appointment progressed, while 6 children remained uncooperative during the first appointment but were cooperative at following visits. The total technique success was 80/85 (94%, p<0.001). The two groups differed significantly with regards to control in caries scores (frequency 77.6% with 12.2 +/- 11.8 dmfs as opposed to 54.1% with 6.7 +/- 5.7 dmfs), and in parent's awareness of patient dental needs or symptoms (76 vs 52). There was no significant difference between groups with regards to completing the treatment planned (63/80 vs 75/85). There was no significant difference in the proportion of returning children who displayed uncooperative behaviour in subsequent visits.

CONCLUSIONS

The PPA technique can be successful in gaining the cooperation of children displaying very negative behaviour, thus minimising the need for other more aversive techniques.

The Child Dental Control Assessment (CDCA) in youth: reliability, validity and cross-cultural differences

AIM

The Child Dental Control Assessment (CDCA) measures children's preferred control strategies in the dental situation. Three studies are reported, assessing aspects of this instrument in youths from the USA, Japan and Australia. In particular, measurements were made as to the reliability and validity of this instrument in this age group in the three cultures, as well as comparing some results across cultures.

STUDY DESIGN

These studies used a questionnaire design.

METHODS

Questionnaires (including the CDCA and other measures) were given to youths aged 11-15 in the three cultures. In one culture, youths received the questionnaire twice, to compute test-retest reliability.

RESULTS

The measure's reliability and validity were similar to those of other measures. The CDCA behaves similarly to the Revised Iowa Dental Control Index (R-IDCI). Youths in all three cultures showed similar responses, although the Japanese were less likely to endorse items.

STATISTICS

Internal reliability of the scale ranged from 0.74 to 0.85. Test- retest reliability was 0.74. Participants in the High Desire/Low Predicted classification on the R-IDCI scored higher on the CDCA (t (73) = 2.9, p < .01). In the Japanese and Australian samples the correlation between CDCA and dental fear was 0.29-0.33 (p < .001). The Australian and USA samples scored significantly higher than the Japanese sample (overall F(2,1544) = 383.98, p < .001, followed by Tukey's HSD, p < .001).

CONCLUSIONS

These results provide evidence for the reliability and validity of the CDCA in youth. It appears to measure the discrepancy between Desired and Predicted Control identified in the Revised Iowa Dental Control Index (R-IDCI). Responses of the youth in all three cultures were similar, indicating common dental control preferences for individuals of this age. However, consistent with cultural values, Japanese youth were less likely to endorse the control strategies. These results underline the need to develop culturally-specific, as well as situationally-specific control measures.