Agent-based modeling of the COVID-19 pandemic in Florida.

The onset of the COVID-19 pandemic drove a widespread, often uncoordinated effort by research groups to develop mathematical models of SARS-CoV-2 to study its spread and inform control efforts. The urgent demand for insight at the outset of the pandemic meant early models were typically either simple or repurposed from existing research agendas. Our group predominantly uses agent-based models (ABMs) to study fine-scale intervention scenarios. These high-resolution models are large, complex, require extensive empirical data, and are often more detailed than strictly necessary for answering qualitative questions like "Should we lockdown?" During the early stages of an extraordinary infectious disease crisis, particularly before clear empirical evidence is available, simpler models are more appropriate. As more detailed empirical evidence becomes available, however, and policy decisions become more nuanced and complex, fine-scale approaches like ours become more useful. In this manuscript, we discuss how our group navigated this transition as we modeled the pandemic. The role of modelers often included nearly real-time analysis, and the massive undertaking of adapting our tools quickly. We were often playing catch up with a firehose of evidence, while simultaneously struggling to do both academic research and real-time decision support, under conditions conducive to neither. By reflecting on our experiences of responding to the pandemic and what we learned from these challenges, we can better prepare for future demands.

Multiple models for outbreak decision support in the face of uncertainty.

Policymakers must make management decisions despite incomplete knowledge and conflicting model projections. Little guidance exists for the rapid, representative, and unbiased collection of policy-relevant scientific input from independent modeling teams. Integrating approaches from decision analysis, expert judgment, and model aggregation, we convened multiple modeling teams to evaluate COVID-19 reopening strategies for a mid-sized United States county early in the pandemic. Projections from seventeen distinct models were inconsistent in magnitude but highly consistent in ranking interventions. The 6-mo-ahead aggregate projections were well in line with observed outbreaks in mid-sized US counties. The aggregate results showed that up to half the population could be infected with full workplace reopening, while workplace restrictions reduced median cumulative infections by 82%. Rankings of interventions were consistent across public health objectives, but there was a strong trade-off between public health outcomes and duration of workplace closures, and no win-win intermediate reopening strategies were identified. Between-model variation was high; the aggregate results thus provide valuable risk quantification for decision making. This approach can be applied to the evaluation of management interventions in any setting where models are used to inform decision making. This case study demonstrated the utility of our approach and was one of several multimodel efforts that laid the groundwork for the COVID-19 Scenario Modeling Hub, which has provided multiple rounds of real-time scenario projections for situational awareness and decision making to the Centers for Disease Control and Prevention since December 2020.

Comparative Evaluation of Microleakage in Hall's with SDF, Hall's, and Conventional Technique Using Different Luting Cements.

The most common pathological condition, dental caries when remain untreated which shows pulpal involvement and may lead to invasive treatment, such as crown placement followed by pulp therapy. Larger carious lesions on primary molars stainless steel crowns (SSCs) placement by means of conventional tooth preparation. The modern approach to managing carious lesions concentrates on using less invasive treatment techniques, with the focus being on biofilm change. One among such alternative method of managing the primary molars is the Hall's technique. Another most important factor for the survival of a crown is its sealing ability, in which luting cements, such as adhesive cements, have a crucial role as they help in providing a suitable marginal seal and thereby cause a reduction in the microleakage. Silver diamine fluoride (SDF) has proven anticariogenic activity in arresting carious lesions. Hence the aim was to evaluate and compare the microleakage of SSCs placed by Hall's technique, Hall's technique with SDF, and the conventional crown technique using different luting cements. A total of 60 primary first and second molars with occlusoproximal caries, which were initial and moderate in nature. The blocks were randomly divided into three groups, in which precontoured SSCs were applied by using either the Hall's technique or the conventional technique. After subjecting tothermocycling, the samples were examined under stereomicroscopic for microleakage evaluation. A few samples were randomly selected from each subgroup, and a scanning electron microscopic (SEM) examination was done. Highest values of microleakage were noted with Hall's technique resin-modified glass ionomer cements (RMGIC) luting cement group. It can be concluded from the present study that the conventional technique was found to be superior over the Hall's technique with SDF and then by the Hall's group alone. SDF application beneath the Hall's crown appears to be promising approach for the reduction of microleakage. How to cite this article: Thakur NS, Tyagi P, Tiwari S, et al. Comparative Evaluation of Microleakage in Hall's with SDF, Hall's, and Conventional Technique Using Different Luting Cements. Int J Clin Pediatr Dent 2023;16(1):16-21.

Clinical Outcome of Direct Pulp Therapy in Primary Teeth: A Systematic Review and Meta-analysis.

Background: Direct pulp treatment is carried out when a healthy pulp gets mechanically/accidentally exposed during the operative procedures or trauma. Aim: To determine the effects of various direct pulp capping materials as measured by the clinical and radiographic analysis. Design: Two reviewers performed a database search of the studies published between January 2005 and November 2020. The inclusion criteria were papers published in the English language; children aged 3-12 years having deep carious lesions in primary teeth. All potential studies were acknowledged by their title and abstract. The full-text analysis of potentially relevant studies, the selected studies were included in the systematic review. A meta-analysis calculation was performed for the overall data and the subgroup data. Results: The database searching led to 57 articles, which were of direct pulp treatment in primary teeth, after the removal of duplicates, 55 records remained but did not meet all inclusion criteria. A high variability was observed among the papers. Further filtering with criteria led to nine articles, which met all inclusion criteria. Meta-analysis demonstrated the success rates of DPT in primary teeth (95% confidence interval -0.799-0.898); P < 0.001. Clinical assessments of various direct pulp capping materials suggested 84.9% of success irrespective of the material used. The nine studies were heterogeneous according to the random effect model (P < 0.001, I2 = 84.08%). Conclusions: Direct pulp treatment has the advantage of being a conservative vital pulp therapy reducing the need for a more invasive treatment.

Knowledge, Attitude, and Practice of Pediatric Dentists Regarding Oral Health Management of Visually Impaired Children.

Aim: The aim of this study is to investigate the knowledge, attitude, and practices of pediatric dentists regarding oral health management of visually impaired children. Material and methods: A combination of convenience sampling and snowball sampling was used to send an online Google form survey questionnaire to pediatric dentists all around the world. Four sections made up the questionnaire-the first asked for personal information, while the second, third, and fourth examined the knowledge, attitudes, and practices of pediatric dentists, respectively. The IBM Statistical Package for the Social Sciences (SPSS) for Windows, version 21.0, was used to analyze the data. Result: The total responses (511) were broken up according to the different continents. The Asian continent produced the most pediatric dentists (206, 40.3%). Most of the participants in the study were females (365, 71.4%), and the maximum was postgraduate students (203, 39.7%). Moreover, the participants were practicing in the private sector (445, 87.1%) and had an experience of 2-5 years (118, 23.1%). Good knowledge scores were significantly associated with work profile (p = 0.014*) years of practice, and associated countries had shown significant differences (p ≤ 0.001). Conclusion: According to this study, the majority of the pediatric dentists included have just rudimentary knowledge of children who are visually impaired. Pediatric dentists are prevented from treating and properly managing visually impaired children as a result of deficient practices in the field of visually impaired children. How to cite this article: Tiwari S, Bhargava S, Tyagi P, et al. Knowledge, Attitude, and Practice of Pediatric Dentists Regarding Oral Health Management of Visually Impaired Children. Int J Clin Pediatr Dent 2022;15(6):764-769.

COVID-19 reopening strategies at the county level in the face of uncertainty: Multiple Models for Outbreak Decision Support.

Policymakers make decisions about COVID-19 management in the face of considerable uncertainty. We convened multiple modeling teams to evaluate reopening strategies for a mid-sized county in the United States, in a novel process designed to fully express scientific uncertainty while reducing linguistic uncertainty and cognitive biases. For the scenarios considered, the consensus from 17 distinct models was that a second outbreak will occur within 6 months of reopening, unless schools and non-essential workplaces remain closed. Up to half the population could be infected with full workplace reopening; non-essential business closures reduced median cumulative infections by 82%. Intermediate reopening interventions identified no win-win situations; there was a trade-off between public health outcomes and duration of workplace closures. Aggregate results captured twice the uncertainty of individual models, providing a more complete expression of risk for decision-making purposes.