Human morphology is a critical component of dental and medical graduate training. Innovations in basic science teaching methods are needed to keep up with an ever-changing landscape of technology. The purpose of this study was to investigate whether students in a medical and dental histology course would have better grades if they used gaming software Kahoot® and whether gamification effects on learning and enjoyment. In an effort to both evoke students’ interest and expand their skill retention, an online competition using Kahoot® was implemented for first-year students in 2018 (n = 215) at the University of Eastern Finland. Additionally, closed (160/215) or open-ended (41/215) feedback questions were collected and analyzed. The Kahoot® gamification program was successful and resulted in learning gains. The overall participant satisfaction using Kahoot® was high, with students (124/160) indicating that gamification increased their motivation to learn. The gaming approach seemed to enable the students to overcome individual difficulties (139/160) and to set up collaboration (107/160); furthermore, gamification promoted interest (109/160), and the respondents found the immediate feedback from senior professionals to be positive (146/160). In the open-ended survey, the students (23/41) viewed collaborative team- and gamification-based learning positively. This study lends support to the use of gamification in the teaching of histology and may provide a foundation for designing a gamification-integrated curriculum across healthcare disciplines.

Age-related macular degeneration (AMD) is a mounting cause of loss of sight in the elderly in the developed countries, a trend enhanced by the continual ageing of the population. AMD is a multifactorial and only partly understood, malady. Unfortunately, there is no effective treatment for most AMD patients. It is known that oxidative stress (OS) damages the retinal pigment epithelium (RPE) and contributes to the progression of AMD. We review here the potential importance of two OS-related cellular systems in relation to AMD. First, the nuclear factor erythroid 2-related factor 2 (NFE2L2; NRF2)-mediated OS response signalling pathway is important in the prevention of oxidative damage and a failure of this system could be critical in the development of AMD. Second, epithelial-to-mesenchymal transition (EMT) represents a change in the cellular phenotype, which ultimately leads to the fibrosis encountered in RPE, a characteristic of AMD. Many of the pathways triggering EMT are promoted by OS. The possible interconnections between these two signalling routes are discussed here. From a broader perspective, the control of NFE2L2 and EMT as ways of preventing OS-derived cellular damage could be potentially valuable in the therapy of AMD.

Background: Haptics‐enhanced virtual reality (VR‐haptic) simulation in dental education has evolved considerably during the past decade, representing a promising resource of simulation‐based training opportunities to support conventional practice. We aim to summarize current literature on the applications of VR‐haptics in learning, practicing, and teaching dental education.Methods: A literature search was performed using PubMed, focusing on research articles published between January 2010 and January 2024. Out of the 667 articles that matched the search terms (dentistry, education, haptic, teaching, training, virtual reality), 105 were screened, and 42 were eligible for full‐text reading and utilization. Findings from an ongoing educator survey on the use of VR‐haptics in dental education have also been provided.Results: VR‐haptic simulation has been shown to have a supportive role in dental simulation practice. Despite training within a digital world, hand skill transfer to the real world has been demonstrated, which affords educators more flexibility in how to train their students before and during traditional preclinical and clinical practical education. The individualized VR‐haptic training and feedback help students in mastering essential working techniques, while also increasing engagement and motivation.Conclusions: VR‐haptics‐supported dental education can help students effectively address challenges during their preclinical and clinical training, as well as in their subsequent careers, and it may help mitigate some weaknesses of the current educational system. Validation is a key factor for the acceptance of VR‐haptic simulators; thus, further research and verification are needed before VR‐haptics could be considered a primary hand skill development method of learning in dental education. VR‐haptic simulation may in the future be used as an assessment tool for the students’ and clinicians’ credentialing process.

Increased oxidative stress and mitochondrial damage are observed in protein aggregation diseases, such as age-related macular degeneration (AMD). We have recently reported elevated levels of oxidative stress markers, damaged mitochondria, accumulating lysosomal lipofuscin and extracellular drusen-like structures in the retinal pigment epithelial cells (RPE) of the dry AMD-resembling NFE2L2/PGC1α double knockout (dKO) mouse model. Here, we provide evidence of a disturbance in the autolysosomal machinery handling mitochondrial clearance in the RPE cells of one-year-old NFE2L2/PGC1α-deficient mice. Confocal immunohistochemical analysis revealed an upregulation of autophagosome marker microtubule-associated proteins 1A/1B light chain 3B (LC3B) as well as numerous mitophagy markers, such as PTE-induced putative kinase 1 (PINK1) and E3 ubiquitin ligase (PARKIN) together with damaged mitochondria. However, we detected no evidence of increased autolysosome formation in transmission electron micrographs or of colocalization of lysosomal marker LAMP2 (lysosome-associated membrane protein 2) and the mitochondrial marker ATP synthase β in confocal micrographs. Interestingly, we observed an upregulation of late autolysosomal fusion Ras-related protein (Rab7) in the perinuclear space of RPE cells together with autofluorescence aggregates. Our results reveal that there is at least a relative decrease of mitophagy in the RPE cells of NFE2L2/PGC1α dKO mice. This further supports the hypothesis that mitophagy is a putative therapy target in AMD-like pathology.

Aim: This study aimed to evaluate the influence of virtual reality (VR) haptic simulators on manual dexterity, self‐confidence and stress levels of 3rd‐semester dental students during preclinical endodontic training, as well as to determine the optimal timing for their introduction into the curriculum—before or after training with artificial teeth. Methodology: Forty volunteered dental students enrolled in preclinical endodontic training were randomly divided into two groups. Group 1 (VR Haptic Simulator group, n = 20) completed four sessions with VR haptic simulators, including three training sessions followed by an evaluation session, before practicing on artificial teeth, whilst Group 2 (Control group, n = 20) performed a single attempt on artificial teeth first followed by the identical VR haptic simulator training period as Group 1. Prior to the training sessions, both groups received standardized lectures and demonstrations on access cavity preparation. Pre‐ and post‐training evaluations included stress levels measured via a visual analog scale (VAS) at different phases, assessment of manual dexterity through preclinical training with artificial teeth performance scores, and self‐confidence surveys. Statistical analyses were conducted with significance set at p < .05. Results: Group 1 demonstrated significantly higher manual dexterity scores and self‐assessed proficiency compared to Group 2 ( p < .05). Stress levels, measured via VAS, were notably reduced following simulator practice in both groups, with Group 1 reporting lower anxiety levels during preclinical training with artificial teeth sessions ( p < .05). Simulator‐based performance metrics were comparable between the groups ( p > .05). Self‐confidence surveys indicated that Group 1 felt better prepared and more confident in performing access cavity preparations and managing procedural challenges. Conclusion: The integration of VR haptic simulators before preclinical training with artificial teeth has a positive effect on students' manual dexterity along with reduced stress and increased self‐confidence in clinical skills. Further research is needed to explore long‐term effects and optimal integration strategies for VR simulators in dental curricula.

Age-related macular degeneration (AMD) is the most prevalent form of irreversible blindness worldwide in the elderly population. In our previous studies, we found that deficiencies in the nuclear factor, erythroid 2 like 2 (NFE2L2) and peroxisome proliferator-activated receptor gamma coactivator 1-α (PGC-1α) genes caused AMD-like pathological phenotypes in mice. In the present work, we show hijacked epithelial-mesenchymal transition (EMT) due to the common loss of PGC-1α and NFE2L2 (double knock-out, dKO) genes in aged animals. The implanted area was assessed by histology, immunohistochemistry and transmission electron microscopy. Confocal microscopy revealed altered regions in the filamentous actin ring. This contrasted with hexagonal RPE morphology in wild-type mice. The ultrastructural RPE features here illustrated loss of apical microvilli, alteration of cell-cell contact, loss of basal in-folding with deposits on Bruch’s membrane, and excessive lipofuscin deposition in dKO samples. We also found the expression of epithelial-mesenchymal transition transcription factors, such as Snail, Slug, collagen 1, vimentin and OB-cadherin, to be significantly different in dKO RPEs. An increased immunoreactivity of senescence markers p16, DEC1 and HMGB1 was also noted. These findings suggest that EMT and senescence pathways may intersect in the retinas of dKO mice. Both processes can be activated by damage to the RPE, which may be caused by increased oxidative stress resulting from the absence of NFE2L2 and PGC-1α genes, important for antioxidant defense. This dKO model may provide useful tools for studying AMD pathogenesis and evaluating novel therapies for this disease.