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Bioaugmentation techniques still show drawbacks in the cleanup of total petroleum hydrocarbons (TPHs) from petroleum-contaminated site soil. Herein, this study explored high-performance immobilized bacterial pellets (IBPs) embed Microbacterium oxydans with a high degrading capacity, and developed a controlled-release oxygen composite (CROC) that allows the efficient, long-term release of oxygen. Tests with four different microcosm incubations were performed to assess the effects of IBPs and CROC on the removal of TPHs from petroleum-contaminated site soil. The results showed that the addition of IBPs and/or CROC could significantly promote the remediation of TPHs in soil. A CROC only played a significant role in the degradation of TPHs in deep soil. The combined application of IBPs and CROC had the best effect on the remediation of deep soil, and the removal rate of TPHs reached 70%, which was much higher than that of nature attenuation (13.2%) and IBPs (43.0%) or CROC (31.9%) alone. In particular, the CROC could better promote the degradation of heavy distillate hydrocarbons (HFAs) in deep soil, and the degradation rates of HFAs increased from 6.6% to 33.2%-21.0% and 67.9%, respectively. In addition, the IBPs and CROC significantly enhanced the activity of dehydrogenase, catalase, and lipase in soil. Results of the enzyme activity were the same as that of TPH degradation. The combined application of IBPs and CROC not only increased the microbial abundance and diversity of soil, but also significantly enhanced the enrichment of potential TPH-biodegrading bacteria. M. oxydans was dominant in AP (bioaugmentation with addition of IBPs) and APO (bioaugmentation with the addition of IBPs and CROC) microcosms that added IBPs. Overall, the IBPs and CROC developed in this study provide a novel option for the combination of bioaugmentation and biostimulation for remediating organic pollutants in soil.

Oil spills cause severe environmental damage that motivates scientists to explore better and sustainable strategies for cleaner and cheaper remediation techniques. Advances in extreme-wetting materials that selectively absorb oil and yet be water repellent have recently brought about promising results. However, the challenge of practical application persists due to the high costs associated with this technology, the limited oil-absorbing capacity, and the instability of oil retention. An innovative design of capsule-type reusable oil collector (CROC) has been developed to address the current shortcomings of conventional oil collection practices. The CROC can be replaced as a self-contained module and consists of a modified melamine sponge (MMS). The CROC system demonstrated high potential for repeated use (up to 10 times) and achieved an oil collection efficiency of up to 89% during testing in a 1000 L custom-built water pool, with a 0.5 L oil collection per unit when tilted. In our work, we focus on four aspects: (1) MMS integration with the innovative concept of CROC design; (2) theoretical correlation and experimental testing of buoyant force, submergence depth, and tilt angle; (3) performance evaluation with oils of different viscosities in a custom 1000 L water pool; and (4) cyclic reusability of MMS under repeated oil absorption. The combination of MMS with the innovative compact design provides a new route for oil spill cleanup. The technical feasibility of creating a modular CROC unit that can efficiently recover oil is proven through experimental findings, and it also demonstrates its potential for application on an industrial scale. These results indicate that CROC may play an important role in environmental protection by offering a practical, reusable, and scalable solution for oil spill cleanup.

To comprehensively evaluate the effectiveness of FDG-PET/MRI multiparametric analysis in predicting myocardial wall motion recovery following revascularization of chronic coronary total occlusions (CTO), incorporating both traditional and machine learning approaches. This retrospective study assessed fluorine-18 fluorodeoxyglucose uptake (FDG), late gadolinium enhanced MR imaging (LGE), and MR wall motion abnormalities (WMA) of the left ventricle walls of a clinical cohort with 21 CTO patients (62&#x202f;&#xb1;&#x202f;9 years, 20 men). All patients were examined using a PET/MRI prior to revascularization and a follow-up cardiac MRI six months later. Prediction models for wall motion recovery after perfusion restoration were developed using linear and nonlinear algorithms as well as multiparametric variables. Performance and prediction explainability were evaluated in a 5x2 cross-validation framework, using ROC AUC and McNemar's test modified for clustered matched-pair data, and Shapley values. Based on 79 CTO-subtended myocardial wall segments with wall motion abnormalities at baseline, the reference logistic regression model LGE&#x202f;+&#x202f;FDG obtained 0.55(SE&#x202f;=&#x202f;0.07) in the clustered ROC AUC (cROC AUC) and 0.17(0.05) in the Global Absolute Shapley value. The reference outperformed FDG standalone in cROC AUC (-35(17) %, p&#x202f;<&#x202f;0.0001), but not LGE standalone (11(12) %, p&#x202f;>&#x202f;0.05). There were no statistically significant differences between the marginal probabilities of success of these three models. Moreover, no significant improvements (differences&#x202f;<&#x202f;10&#x202f;% in cROC AUC, and&#x202f;<&#x202f;20&#x202f;% in Global Absolute Shapley, p&#x202f;>&#x202f;0.05) were found when using mixed effects logistic regression, decision tree, k-nearest neighbor, Naive Bayes, random forest, and support vector machine, with multiparametric combinations of FDG, LGE, and/or WMA. In this clinical cohort, adding more complex interactions between PET/MRI imaging of cardiac function, infarct extension, and/or metabolism did not enhance the prediction of wall motion recovery after perfusion restoration. This finding raises the question whether multiparametric FDG-PET/MRI analysis has demonstrable benefits in risk stratification for CTO revascularization. Further studies with larger cohorts and external validation datasets are crucial to clarify this question and refine the role of multiparametric imaging in this context.

The effectiveness of immunotherapy for hepatocellular carcinoma (HCC) is severely compromised by an immunosuppressive tumor microenvironment (TME) dominated by M2-polarized tumor-associated macrophages (TAMs), coupled with a lack of reliable strategies for real-time treatment monitoring. To address this, we developed a pH-responsive nanoimmunomodulator derived from macrophage exosomes for spatiotemporal TAM reprogramming combined with second near-infrared (NIR-II) theranostics. Our nanoplatform (anti-CD47 conjugated Croc@DMPC/Ag2Te/exosome, termed aCD47-CATE) is functionalized with anti-CD47 antibodies to block the CD47-"don't eat me" signal. For precise theranostics, it co-encapsulates silver telluride quantum dots for high-contrast NIR-II fluorescence imaging and croconaine J-aggregates that serve as efficient photothermal converters (emission >1100&#x202f;nm) and acid-activated photoacoustic probes. The aCD47-CATE platform integrates acid-activated ratiometric photoacoustic imaging with NIR-II fluorescence for accurate tumor targeting and delineation. It effectively blocks CD47 to promote macrophage phagocytosis while exerting mild photothermal effects under NIR-II irradiation to induce immunogenic cell death. This combined action potently remodels the immunosuppressive TME, achieving significant antitumor efficacy. Transcriptomic profiling validated this mechanism, showing enhanced T-cell and macrophage activation alongside suppressed immunosuppressive signals. Collectively, aCD47-CATE represents a robust and multifaceted theranostic platform for image-guided photothermal immunotherapy in HCC.

Despite the potential benefits of implant-supported rehabilitation, data on implant performance and peri-implant health in adults with intellectual disabilities (ID) are limited. To evaluate dental implant outcomes in adults with non-syndromic ID and to identify variables associated with peri-implant health, complications, and implant loss. This multicenter retrospective cohort study included adults with non-syndromic ID who received at least one dental implant and had a minimum follow-up of 36&#x2009;months. Dental implants placed in 137 patients across 7 specialised centers in Spain, France, Italy, and South Korea were analysed. Standardised data were collected on patient characteristics, oral health status, implant design, prosthetic variables, and follow-up care. Clinical outcomes were categorised as peri-implant health, mucositis, peri-implantitis, or implant loss. Of the 453 implants placed, 418 (92.3%) remained functional at a mean follow-up of 75.9&#x2009;&#xb1;&#x2009;42.7&#x2009;months (range: 36-211&#x2009;months). Among the 445 implants evaluated for clinical outcomes, 63.6% were classified as healthy, 23.4% as presenting with mucositis, 4.4% with peri-implantitis, and 7.3% were lost during the follow-up period. Tissue-level implant type, cement-retained fixed prostheses, and the use of general anaesthesia during the impression step were significantly associated with peri-implant clinical outcomes. No variables were identified as statistically significant predictors of implant loss. Dental implant therapy represents a viable long-term treatment option for adults with non-syndromic ID. Despite the clinical challenges of this population, high survival and success rates can be achieved, particularly when appropriate implant selection, prosthetic retention systems, and behavioural management techniques are implemented.

Children with intellectual disabilities often have unmet oral health needs. Challenging behaviours during dental procedures create uncertainty for dentists about the appropriate approach to adopt. Tailored strategies, including cognitive-behavioural approaches, sedation, or physical restraint, are often required. To explore the experiences and perceptions of dentists treating children with intellectual disabilities, including the use of pharmacological or physical restraint and any ethical dilemmas involved. Four focus groups of French dentists (overall n&#x2009;=&#x2009;20) with experience of treating children with intellectual disabilities were assembled and discussions undertaken. Thematic content analysis identified the underlying themes. Participants described the characteristics of their practice, the difficulties and rewards they encountered, and their motivation in working with this population. They described the different strategies used to overcome challenging behaviours. Participants demonstrated a commitment to care, prioritising beneficence over autonomy in difficult situations, but were aware of compromising on ideals in these situations. This study describes the complexity of dental care for children with intellectual disabilities. The ethical tensions surrounding the use of restraint and pharmacological techniques were significant, as these practices conflict with the principle of autonomy. This moral complexity highlights the need for deeper understanding and discussion regarding the ethical implications of dental care in such contexts.

The two-coloured chewing gum test is widely used to quantify oral mixing ability. Lack of consensual normative reference values limits its interpretation and comparability across studies. To present the methodology establishing normative reference cut-offs for masticatory mixing ability in healthy young adults using two-coloured chewing gums. Data from 61 healthy individuals (22.08&#x2009;&#xb1;&#x2009;2.22&#x2009;years) who fulfilled anatomical (&#x2265;&#x2009;7 posterior functional units), psychosocial (GOHAI &#x2265;&#x2009;52) and physiological (carrot D50 <&#x2009;4&#x2009;mm) criteria for good oral health were considered. Mixing ability was measured after 5 cycles, 20 cycles and 1&#x2009;min with two different gum types (Hue-Check Gum and Hollywood gum). Outcomes were SD-Hue and Mix%. Mix% increased significantly from 5 to 20&#x2009;cycles for both gums and approached maximal values after 1&#x2009;min (p&#x2009;<&#x2009;0.001). At 20&#x2009;cycles, mean Mix% was 81.06% (95% CI: 78.46-83.66) for Hollywood and 88.31% (95% CI: 85.44-91.17) for Hue-Check Gum. Corresponding mean SD-Hue values were 0.076 (95% CI: 0.068-0.084) and 0.108 (95% CI: 0.085-0.131), respectively. Normative reference cut-offs at 20&#x2009;cycles were defined using the lower bound of the 95% CI for Mix% (78.46% for Hollywood and 85.44% for Hue-Check Gum) and the upper bound of the 95% CI for SD-Hue (0.084 for Hollywood and 0.131 for Hue-Check Gum). Normative reference cut-offs for the two-coloured chewing gum test are provided for healthy young adults, enabling standardized interpretation of mixing outcomes. However, their applicability across other age groups is needed.

To clinically validate a self-administered Wax Bite Test (WBT) for counting posterior functional units (PFU) by assessing its agreement with the articulating-paper reference method, reliability, feasibility and acceptability. In this cross-sectional study, 44 adults were enrolled. PFU were assessed using the reference method (PFU-reference) and the self-administered WBT (PFU-WBT) with pre-sized modelling wax. Two calibrated evaluators independently interpreted each wax record twice. Agreement with the reference method was assessed using Bland-Altman analysis and method-comparison regression using orthogonal distance regression (ODR). Equivalence was evaluated using TOST with a predefined margin of &#xb1;1 PFU. Intra- and inter-rater reliability were quantified using intraclass correlation coefficients (ICC). Feasibility was assessed by the frequency and determinants of unreadable records. Acceptability was evaluated using visual analogue scales. Participants completed two successive rounds of the WBT, generating 176 wax bites records, read twice by two investigators (704 assessments). Overall, 22.2% of records were unreadable, but this limitation was concentrated mainly among fully edentulous participants (p&#x2009;<&#x2009;0.001) due to insufficient bite force. Bland-Altman analysis showed a bias of 0.20 PFU (95% CI: -0.11 to 0.51) with limits of agreement from -1.66 to 2.06 PFU. ODR indicated a slope near unity and TOST confirmed equivalence within the predefined &#xb1;1 PFU margin. Reliability was good to excellent in fully dentate and partially dentate participants (ICC >&#x2009;0.826). Acceptability was high for all participants. For severe impairment (PFU &#x2264;&#x2009;4), the WBT showed high specificity (97%) and good sensitivity (80%) compared with the reference method. In nutritional research, simple and reliable tools to assess oral functional capacity are essential for understanding dietary choices and nutritional risk. The WBT appears to be a practical, self-administered tool for monitoring PFU in clinical and community settings. However, adaptations are required for fully edentulous individuals wearing complete dentures, in whom unreadable records were frequent because of reduced bite force. IRB00013412, December 19th, 2024 CLINICAL SIGNIFICANCE: WBT provides a low-cost, participant-friendly way to monitor PFU in clinical and community settings.

Interprofessional collaboration (IPC) has the potential of improving quality of dental care by integrating dental, medical and social care professionals to deliver high quality comprehensive and patient centered care. The aim of the study was to review current examples of good practice in IPC in selected countries globally followed by exploring the facilitators and barriers in achieving IPC. Barriers included fragmented health care and working in silos, governance and health system challenges, education, professional resistance and lack of integration and data sharing. A roadmap was developed which included the following domains: Governance and legislation, funding and incentives, education, health system public and community engagement, digital data and integration and multidisciplinary research. The findings will inform future development in policy, practice and research in supporting IPC and oral health for the benefit of populations and communities.

Orthodontic treatment is often sought for aesthetic and psychosocial reasons, while the functional consequences of dental malocclusions remain less frequently integrated into clinical decision-making. To evaluate how the presence, type, and combinations of dental malocclusions affect masticatory performance using Indicator of Anatomical Malocclusion (IAM) with objective physiological measures of mastication. Masticatory performance was assessed using a two-colour chewing gum mixing test (20 chewing cycles; Hue-Check Gum), with colour homogeneity quantified as percentage mixing index (Mix%). Deficient performance was defined as Mix%&#x2009;<&#x2009;85.44%. Malocclusion was characterized using Angle's classification, number of functional dental units, and IAM assessing craniofacial anomalies, dental number anomalies, crowding, anteroposterior, transverse, and vertical discrepancies. Associations between malocclusion and masticatory performance were explored using univariate followed by logistic regression analyses. The study included 345 patients (age 14.6&#x2009;&#xb1;&#x2009;6.9&#x2009;years) seeking orthodontic consultation. 57.1% of participants exhibited deficient masticatory performance. Independent predictors of deficient mastication included IAM items related to dental number anomalies (OR&#x2009;=&#x2009;2.59; 95% CI: 1.16-5.75), transverse discrepancies (OR&#x2009;=&#x2009;1.91; 95% CI: 1.03-3.53), age (OR&#x2009;=&#x2009;0.92; 95% CI: 0.88-0.96), and Angle Class II/III (OR&#x2009;=&#x2009;1.65; 95% CI: 1.02-2.66). Subgroup analyses showed that transverse discrepancies increased deficiency in Class I malocclusion, while Class III participants exhibited high prevalence regardless of anomalies. The combination of transverse discrepancy and infraocclusion was associated with the highest prevalence of deficiency (75%). Using objective masticatory assessment, masticatory performance is associated with dental malocclusions characteristics, and the coexistence of specific traits as captured by the IAM. These findings support the integration of functional evaluation into orthodontic diagnosis. Interventional studies are needed to determine whether orthodontic treatment improves masticatory performance.

In September 2024, a workshop was held, during the EADPH conference in Crete. It aimed to explore what constitutes essential oral healthcare and what are the challenges and solutions in adopting Universal Health Coverage (UHC). It also aimed to raise awareness of the need for oral health to be included in (UHC). The workshop was informed by presentations from five speakers. The attendees then divided into four break-out groups that discussed the topics of,: (1) Which oral health services and which population groups should be publicly funded ? (2) What are the most frequently demanded oral health services at your practice/in your region? (3) What are the most frequently provided services at your practice/in your region? (4) Which of these services are publicly covered and for whom? (5) What are the barriers and enablers for reaching universal health coverage? Each group then considered enablers and challenges to achieving the inclusion of oral health care in UHC and reported their findings and discussions in a plenary session,. during which the implications were discussed. The commentary, which follows, reports the proceedings of the workshop and discusses the implications of its findings.

Self-medication appears to be a common practice for dental pain. However, in France, its prevalence and patterns in dentistry have never been studied. The primary objective was to assess the prevalence and self-medication behaviours in two at-risk populations: patients consulting for acute pulpal or periapical pain and patients with dental anxiety requiring treatment under general anaesthesia. The secondary objective was to examine the influence of socio-behavioural factors on these practices. Between April 2021 and May 2023, the behaviours of two at-risk population regarding self-medication were analysed in a cross-sectional observational study. The first population regrouped patients referred to an endodontic postemergency care unit after visiting the emergency service of a dental hospital. These patients were referred due to acute pulpal or periapical pain (Endodontic Group). The second population regrouped patients referred to a special care unit for dental treatment under general anaesthesia due to dental anxiety (Anxiety Group). Self-medication behaviours of the two at-risk populations were analysed with 5 self-administered questionnaires (self-medication, EPICES, IDAF-4C, Pain Catastrophizing Scale, Socio-demographic data). Comparisons between the two population were done using Pearson's chi-square and Student's t tests. During the study period, 43 patients were included in the endodontic group and 66 in the anxiety group. Socio-demographic and behavioural data differed between the two groups. However, self-medication prevalence was similar (51.2% in the Endodontic Group vs 45.5% in the Anxiety Group), as were self-medication behaviours (types and number of substances used, methods of acquisition, knowledge). No socio-demographic or behavioural factors explained these attitudes. Self-medication in dentistry is often overlooked or poorly managed. Preventive measures and patient education on the proper use of medication are essential. Standardized cooperation protocols should be developed involving dentists and community pharmacists to optimize the management of patients suffering from dental pain.

In 2019, France implemented a large-scale reform aimed at reducing out-of-pocket health care expenditures, with the objective of preventing the forgoing of dental care for financial reasons. The aim of this study was to assess the impacts of this reform on dental care utilization, with a focus on full dentures as prosthetic care, which was the main target of the reform. The study was based on analyses of large-volume administrative data from the French social health insurance funds and comprised >1 billion dental treatments encountered in the years 2014 to 2023. Drawing from a quasi-experimental research design and segmented negative binomial regression, controlled interrupted time series analyses were conducted with a "control outcome" approach. Controlled interrupted time series analyses compared utilization rates for various types of care whose coverage was differentially affected by the reform. Models were adjusted for COVID-19 and seasonality covariates and stratified by socioeconomic status. Following the removal of out-of-pocket payments for resin-based full dentures, their utilization was 58.85% higher (95% CI, 37.18% to 83.95%) as compared with the control scenario. The utilization of other types of dental care, largely unaffected by the reform, remained unchanged. Prophylactic care use increased only slightly during the study period. These findings suggest that the removal of out-of-pocket expenditures through the French 100% sant&#xe9; reform led to higher utilization of full dentures. However, as the reform focuses on specific treatment items and mainly concerns patients with voluntary health insurance, the impacts of the reform should be carefully monitored in the future, particularly its effects on vulnerable populations.

Clinical trials play a critical role in providing patients with access to novel treatments and therapies. However, limitations in clinical trial search engines impede healthcare professionals and patients from accessing the most suitable clinical trials. This study aimed to address this issue by conducting a critical analysis of several prominent clinical trial search websites, including ClinicalTrials.gov, Canadian Cancer Trials, Clinical Trials Ontario, Canadian Cancer Clinical Trials Network, and Q-CROC. To identify areas for improvement, three skilled clinical trials navigators independently curated clinical trial searches for 18 cancer patients over a 2-month period. After verifying patients' eligibility for enrollment in clinical trials, the navigators documented their search outcomes and identified several limitations in the current search engines. Careful curation of clinical trials for 18 patients revealed 247 trials. However, 140 eligible trials out of 247 (57% with 95% binomial confidence interval [50%, 63%]) were found only on alternative websites yet not discoverable on the initial ClinicalTrials.gov searches, even though they were listed on ClinicalTrials.gov. Our study revealed multiple deficiencies in available clinical trials search engines. Lack of reliability was repeatedly identified in all search engines. This study highlights that the current clinical trial search system needs improvement to enhance patient outcomes. It needs to be highlighted that these searches were performed by trained and dedicated clinical trials navigators. The challenges facing patients and health care professionals in navigating would be much greater. The findings from this study can serve as a foundation for the development of enhanced search engines with improved functionality, which will enable healthcare professionals and patients to find and access the most suitable clinical trials with greater ease and accuracy.