A Comparison of Statistical Methods for Studying Interactions of Chemical Mixtures.

Properly assessing the effects of environmental chemical exposures on disease risk remains a challenging problem in environmental epidemiology. Various analytic approaches have been proposed, but there are few papers that have compared the performance of different statistical methods on a single dataset. In this paper, we compare different regression-based approaches for estimating interactions between chemical mixture components using data from a case-control study on non-Hodgkin's lymphoma. An analytic challenge is the high percentage of exposures that are below the limit of detection (LOD). Using imputation for LOD, we compare different Bayesian shrinkage prior approaches including an approach that incorporates the hierarchical principle where interactions are only included when main effects exist. Further, we develop an approach where main and interactive effects are represented by a series of distinct latent functions. We also fit the Bayesian kernel machine regression to these data. All of these approaches show little evidence of an interaction among the chemical mixtures when measurements below the LOD were imputed. The imputation approach makes very strong assumptions about the relationship between exposure and disease risk for measurements below the LOD. As an alternative, we show the results of an analysis where we model the exposure relationship with two parameters per mixture component; one characterizing the effect of being below the LOD and the other being a linear effect above the LOD. In this later analysis, we identify numerous strong interactions that were not identified in the analyses with imputation. This case study demonstrated the importance of developing new approaches for mixtures when the proportions of exposure measurements below the LOD are high.

Novel application of latent class analysis to outcome assessment in traumatic brain injury with multiple injury subtypes or poly-TBI.

OBJECTIVE: The aim of this study was to stratify poly-traumatic brain injury (poly-TBI) patterns into discrete classes and to determine the association of these classes with mortality and withdrawal of life-sustaining treatment (WLST). METHODS: The authors performed a single-center retrospective review of their institutional trauma registry from 2018 to 2020 to identify patients with traumatic brain injury (TBI). Patients were included if they had moderate to severe TBI, defined as Glasgow Coma Scale score ≤ 12 and Abbreviated Injury Scale (AIS) head score ≥ 3, and the presence of more than one TBI subtype. TBI subtypes were defined as subdural hemorrhage (SDH), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and epidural hemorrhage (EDH). Latent class analysis was used to identify patient classes based on TBI subtypes and Rotterdam CT (RCT) scores. The authors then evaluated class membership in relation to categorical outcomes of in-hospital mortality and WLST by using Lanza et al.'s method. RESULTS: A total of 125 patients met inclusion criteria for poly-TBI. Latent class analysis yielded 3 poly-TBI classes: class 1-mixed; class 2-SDH/SAH; and class 3-EDH/SAH. Class 1-mixed had a higher likelihood of SDH, SAH, and ICH, and a lower likelihood of EDH. Class 2-SDH/SAH had a higher likelihood of only SDH and SAH. Class 3-EDH/SAH had a higher likelihood of EDH and SAH, and a lower likelihood of SDH and ICH. Class 1-mixed was relatively more likely to have an RCT score of 2. Class 2-SDH/SAH was relatively more likely to have an RCT score of 2, 3, and 4. Class 3-EDH/SAH had a higher likelihood of an RCT score of 3, 4, and 5. Class 1-mixed had significantly lower mortality (χ2 = 7.968; p = 0.005) and less WLST (χ2 = 4.618; p = 0.032) than Class 2-SDH/SAH. Class 2-SDH/SAH had the highest probability of death (0.612), followed by class 3-EDH/SAH (0.385) and class 1-mixed (0.277). Similarly, class 2-SDH/SAH had the highest WLST probability (0.498), followed by class 3-EDH/SAH (0.615) and class 1-mixed (0.238). CONCLUSIONS: Distinct poly-TBI classes were associated with increased in-hospital mortality and WLST. Further research with larger datasets will allow for more comprehensive poly-TBI class definitions and outcomes analysis.

Clear aligner treatment of an adult open bite with bilateral missing mandibular first molars through molar protraction with Albert cantilever arms.

Premature loss of first permanent molars is a common occurrence in clinical practice, leading to abnormal occlusion and inefficient mastication for patients. This case report presented the orthodontic retreatment of a 32-year-old female patient who suffered from premature loss of mandibular bilateral first molars. The mesial tipping of the mandibular second molars led to an occlusal interference, resulting in a clockwise rotation of the lower jaw and an anterior open bite (AOB). We achieved long-distance molar mesialization using clear aligners with Albert cantilever arms. After 42 months of treatment, the patient's occlusion and facial profile significantly improved. The cantilever combined with the cleat aligner treatment has been clinically effective for the protraction of mandibular posterior teeth, extending the field of application of clear aligners.

A class-incremental learning approach for learning feature-compatible embeddings.

Humans have the ability to constantly learn new knowledge. However, for artificial intelligence, trying to continuously learn new knowledge usually results in catastrophic forgetting, the existing regularization-based and dynamic structure-based approaches have shown great potential for alleviating. Nevertheless, these approaches have certain limitations. They usually do not fully consider the problem of incompatible feature embeddings. Instead, they tend to focus only on the features of new or previous classes and fail to comprehensively consider the entire model. Therefore, we propose a two-stage learning paradigm to solve feature embedding incompatibility problems. Specifically, we retain the previous model and freeze all its parameters in the first stage while dynamically expanding a new module to alleviate feature embedding incompatibility questions. In the second stage, a fusion knowledge distillation approach is used to compress the redundant feature dimensions. Moreover, we propose weight pruning and consolidation approaches to improve the efficiency of the model. Our experimental results obtained on the CIFAR-100, ImageNet-100 and ImageNet-1000 benchmark datasets show that the proposed approaches achieve the best performance among all the compared approaches. For example, on the ImageNet-100 dataset, the maximal accuracy improvement is 5.08%. Code is available at https://github.com/ybyangjing/CIL-FCE.

The Challenges of Measuring Socioeconomic Inequality in Pharmacoepidemiology Studies.

Social conditions like socioeconomic status (SES) are critical sources of health disparities. In pharmacoepidemiology research, our ability to measure SES in retrospective, real world clinical data remains challenged by a lack of patient-reported data. Some broadly accepted concepts can be measured at the individual level, such as income, poverty, and education. Community-level measures such as the Centers for Disease Control and Prevention's Social Vulnerability Index (SVI) also exist. After reflecting on these existing measures and discussing the challenges for leveraging them with real world data, we offer three recommendations that we believe could improve the ability of pharmacoepidemiologists to better measure and interrogate the effect of SES in their own research. These recommendations include a greater collection of patient-reported metrics, reduced reliance on ZIP Codes and ZIP Code Tabulation Areas for creating community-level measures of deprivation, and the inclusion of GIS and demography specialists within pharmacoepidemiology teams.

Safety and efficacy of sleeve gastrectomy in non-diabetic individuals with class I vs. class II obesity: a matched controlled experiment from Tehran Obesity Treatment Study (TOTS).

BACKGROUND: This study aimed to evaluate the 3-year outcomes of sleeve gastrectomy in non-diabetic individuals with class I obesity. METHODS: A total of 78 participants with class I obesity and 78 participants with class II obesity, matched in terms of age, sex (93.6% female), and the rates of dyslipidemia and hypertension, were included in this prospective cohort study. Follow-up data, including metabolic features, body composition, nutritional characteristics, and surgery complications, were gathered at the baseline and 6, 12, 24, and 36 months post-bariatric surgery. Micronutrient deficiencies and comorbidities (hypertension and dyslipidemia) were evaluated in both groups using conditional logistic regression analysis, and Clavien-Dindo classification was used to compare surgical complications. RESULTS: Baseline characteristics of the participants in both groups were similar (n = 78, mean age: 36.4 ± 8.5). The two groups were also comparable in terms of weight loss, cardiovascular risk factors, and remission of obesity-related comorbidities 3 years following sleeve gastrectomy. Overall values of Δ total weight loss (TWL)%, Δ excess weight loss (EWL)%, and ß (95% CI) were - 1.86 (1.19), and - 2.56 (4.5) with a P value of 0.118 and 0.568, respectively. The occurrence of surgical complications and undesirable outcomes were also similar between the two study groups. CONCLUSION: Bariatric surgery is an effective and safe method to achieve weight loss and alleviate cardiovascular risk factors and obesity-related comorbidities in non-diabetic individuals with class I and class II obesity.

Self-Efficacy in Nursing Competencies during Students' Clinical Practicum: The Development of a Self-Assessment Scale.

The evaluation of the competencies corresponding to the different professional profiles of future nursing graduates is fundamental to their training. In this regard, students' self-evaluation must be part of their training. This study aimed to develop and psychometrically test the Perceived Self-Efficacy in Nursing Competencies (PSENC) Scale. This study was conducted in two phases: selecting and adjusting items and assessing the instrument's psychometric properties. A sample of 1416 students completed the scale online. Exploratory factor and confirmatory factor analyses were conducted. Inferential analysis was carried out. The exploratory factor analysis of the PSENC scale with 20 items resulted in five factors (76.3% of variance). All factors showed Cronbach's alpha coefficients > 0.70. The confirmatory factor analysis measurement model showed satisfactory and adequate goodness-of-fit indices. The developed scale showed the psychometric adequacy and usefulness to the self-assessment of nursing students regarding their self-efficacy expectations in competencies during their clinical practicum. This study was not registered.

Evaluation of the diagnostic ability of the Fränkel manoeuvre to detect the contributing jaw in angle class II division 1 malocclusion.

BACKGROUND: A correct diagnosis of patients with an Angle Class II malocclusion is needed to guide treatment decisions toward the contributing jaw and to achieve better treatment outcomes. The aim of the study is to evaluate the diagnostic potential of the Fränkel manoeuvre (FM) for detecting the components determining sagittal discrepancy in Angle Class II division 1. MATERIALS AND METHODS: Anonymous questionnaires containing photographs were distributed totwo groups: general practitioner (GP) dentists and orthodontists. The level of the patient's profile aesthetics before (T0) and after (T1) the manoeuvre was determined using a 100 mm visual analog scale, and the 'profile improvement' score was defined as T1 minus T0. The diagnostic ability of the FM was calculated by comparison with lateral cephalometry as a reference standard using receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 102 respondents participated in the survey; 40 were orthodontists, and 62 were GP dentists. According to the post-FM images, the "profile improvement" score (T1-T0) was significantly greater in patients with mandibular retrusion than in those with maxillary protrusion (p < 0.05). The predictive power of FM, coinciding with the area under the ROC curve, was 0.62 for GPs and 0.78 for orthodontists. CONCLUSIONS: The FM method is a useful and accurate tool for diagnosing skeletal Angle Class II malocclusion etiology (mandibular retrusion or maxillary protrusion), especially when used by orthodontists.

Retrospective analysis of the upper airway anatomy and Sella turcica morphology across different skeletal malocclusions: a computerized technique.

OBJECTIVE: This study aimed to investigate the normal volumetric space and variations in the measurements of different landmarks in adults with different skeletal relations of the maxilla and the mandible based on CBCT data. The study also analyses these landmarks to locate any correlations. BACKGROUND: Numerous studies in orthodontics have found a relationship between orthodontic treatment and changes in the anatomy and function of the airway. Severe changes in airway morphology can cause breathing difficulties, lower quality of life, and even result in life-threatening conditions such as obstructive sleep apnoea. Consequently, orthodontic diagnosis and treatment planning require a thorough understanding of the airway space and its function. METHODS: The present retrospective study was conducted using CBCT records of 120 adult patients, containing 40 samples of each skeletal class (20 males and 20 females). The boundaries were defined for the 3 major regions: the nasopharynx, the oropharynx, and the hypopharynx. Various measurements were recorded across these regions, as well as selective cephalometric landmarks. The obtained data was used to calculate average and standard deviation, while regression analysis was used to evaluate correlations and t-test was used to test statistical significance of gender differences. RESULTS: The results demonstrate that skeletal Class III individuals exhibit a reduced airway volume in the nasopharynx compared to other groups, whereas skeletal Class II individuals displayed a diminished airway volume in the hypopharynx. A strong correlation was observed for Sella turcica parameters. There were no significant differences in skeletal parameters across genders. Nasopharynx cavity volume demonstrated significant differences between skeletal Class I-Class III as well as between skeletal Class II-Class III. Hypopharynx cavity volume also demonstrated significant differences between skeletal Class I-Class II and between skeletal Class II-Class III. CONCLUSION: The major findings are the presence of a reduced nasopharyngeal volume in skeletal Class III malocclusions while skeletal Class II individuals displayed a diminished hypopharyngeal volume, making these critical areas to consider during the diagnostic and orthodontic treatment planning stages. This study also revealed a consistent correlation between Sella turcica parameters across various facial skeletal profiles, with skeletal Class II patients exhibiting a distinct pattern and skeletal Class I and Class III demonstrating an average relationship.

Using latent variable modelling to identify etiological heterogeneity in preterm delivery.

AIMS: To identify a subgroup of mothers at high risk of preterm delivery, defined by empirical classes of multimorbidity and recurrence across three consecutive births. METHODS: The data were extracted from the perinatal data collection (PDC) of all inpatient live births (n = 435 912) occurring in the Australian state of Queensland between January 2009 and December 2015. Within this data, a total of 7714 primiparous mothers delivered three consecutive singleton live births (total births = 23 142), and comprise the sample for all analyses. RESULTS: The LCA indicated a four-class solution fit the data best at each time point, including (i) a 'normative' or healthy class with little morbidity (including >80% of the sample at each birth); (ii) a preterm, high morbidity class (<2% of the sample); (ii) a delivery morbidity class (4-8% of the sample); and (iii) preterm, low morbidity class (5-6% of the sample). Each group exhibited unique and consistent associations with maternal and pregnancy-related factors across births. After accounting for these factors, the high morbidity class and preterm, low morbidity class strongly predicted these same classes across consecutive births, and from birth 1 to birth 3 (second-order transition). CONCLUSIONS: A small but highly morbid class of neonatal deliveries emerged, exhibiting strong continuity across consecutive births (odds ratios >10), independent of a range of maternal and pregnancy-related factors. This group of women, if subject to further investigation, could provide valuable insight into the aetiology of prematurity and associated morbidity, perhaps providing information to improve birth outcomes among all women.

The genetic architecture of substance use and its diverse correlations with mental health traits.

Although harmful substance use is common and represented by shared symptom features and high genetic correlations, the underlying genetic relationships between substance use traits have not been fully explored. We have investigated the genetic architecture of substance use traits through exploratory and confirmatory factor analyses using genomic structural equation modeling (Genomic SEM), and explored genetic correlations between different aspects of substance use and mental health-related traits. Genomic SEM was used to identify latent factors representing the relationships between 14 substance use traits (alcohol, nicotine, cannabis and opioid use), and to confirm or modify existing latent factors for 38 mental health-related traits. A bi-factor model best explained the genetic overlap between substance use traits, including a general substance use factor and two sub-factors representing genetic liability specific to alcohol use or smoking. The SNP-based heritability of these factors ranged from 2 to 7 % and each factor had 10 or more independent significant SNPs identified. Bivariate correlations revealed patterns of genetic overlap with other mental health-related factors unique to each substance use factor. Variations in the genetic overlap between psychiatric traits and different aspects of substance use can be used to further investigate the pleiotropy present between these traits, and explore commonalities in etiology.

Evaluation of alveolar bone loss among diabetic patients with class II amalgam restorations.

The relationship between Class II amalgam restorations and alveolar bone loss among diabetic and non-diabetic patients is evaluated at the Faculty of Dentistry, Najran University, KSA. Hence, we compared type 2 diabetic (n = 32) and non-diabetic patients (n=32) using clinical assessments and imaging techniques. Parameters such as bone loss rate, extent, age, and periodontal condition (plaque index and Gingival Index) were analyzed. Analysis of data shows that diabetic patients on average have higher bone loss.

Factors associated with receiving an obesity diagnosis and obesity-related treatment for patients with obesity class II and III within a single integrated health system.

Objectives: The prevalence and associated adverse effects of obesity on health and healthcare cost make it a primary public health concern. However, individuals with the physiological features of obesity may be underdiagnosed and undertreated. We aimed to determine the prevalence of obesity diagnoses and obesity-related treatments in an integrated health system and determine the factors associated with receiving an obesity diagnosis and treatment for this indication. Methods: This retrospective cross-sectional study of data from the Henry Ford Health electronic health record included adult patients with a body mass index (BMI) indicating clinical evidence of class II and III (severe) obesity in 2017 and who received treatment through 2019. The primary outcome was prevalence of obesity diagnosis and obesity-related treatment. Logistic regression evaluated the patient-level factors associated with odds of having obesity diagnosis and treatment. Results: Among 64,741 patients meeting the clinical definition of definition of severe obesity, only 40.7 % were clinically diagnosed with obesity, and 23.5 % received an obesity-related intervention. Patients with BMI≥40 kg/m2 (class III) were more likely to be diagnosed with obesity than those with BMI 35-39.9 kg/m2 (class II) (odds ratio [OR] 5.84; 95 % CI, 5.62-6.07). Patients with a diagnosis of obesity (OR 2.92; 95 % CI, 2.80-3.05), Black patients (OR 1.46; 95 % CI, 1.40-1.53), and female patients (OR 1.47; 95 % CI, 1.41-1.54) were more likely to be offered obesity-related treatment. Conclusions: Severe obesity may be underdiagnosed in patients who have BMI 35-39.9 kg/m2 and 1 comorbidity.

Subgroup Behaviors and Factors Influencing Compliance With COVID-19 Preventive Measures Among Undergraduate Students in Southern Thailand.

Objective: To investigate clusters of students' COVID-19 preventive behaviors and their associated factors. Methods: We surveyed undergraduate students using an online questionnaire at a regional university in southern Thailand, between April and June 2022. Statistical analyses included latent class analysis and multinomial regression analysis. Results: Three latent classes were identified: moderately consistent practitioner (7.5%), high compliance overall (48.9%), and good compliance with routine safeguards (43.6%). Females tended to have high compliance overall (RRR 2.46 95% CI 1.23-4.94), and higher academic performance was associated with high compliance overall and good routine safeguards. Perceived threats from COVID-19 were associated with good compliance with routine safeguards (RRR 4.21 95% CI 1.70-10.45). Benefits of actions and clear cues to action were associated with high overall compliance (RRR 5.24 95% CI 2.13-12.90). Students who perceived feasibility were more likely to be moderately consistent practitioners. Conclusion: The common clusters of the students' preventive behaviors were high compliance overall and good compliance with routine preventions. Female, academic performance, perceived threats, and perceived benefits and cues to action were associated with compliance.

Optimization of Glyburide-Loaded Nanosuspensions via Ball Milling and Homogenization Techniques: A Central Composite Design Approach for Enhanced Solubility.

INTRODUCTION: Glyburide is a drug for the treatment of diabetes mellitus and has a potential effect on Alzheimer's disease. It is also a BCS Class 2 drug with low solubility and low permeability. Developing a nanosuspension formulation and increasing the solubility and dissolution rate of glyburide is required to overcome this challenge. METHODS: Thus, the goal of this work was to create glyburide nanosuspensions by ball milling and homogenizing glyburide to increase its solubility and rate of dissolution. To achieve this, the nanosuspension formulation was optimized using a central composite design. Zeta potential, particle size distribution and solubility were selected by way of dependent variables, and ball milling time, homogenization cycles, and Pluronic F-127/glyburide ratio were chosen as independent variables. Glyburide nanosuspensions were obtained with a particle size of 244.6 ± 2.685 nm. In vitro release and solubility studies were conducted following optimization. RESULTS: The saturation solubility of glyburide was nearly doubled as a result of the nanocrystal formation. Xray diffraction (XRD), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and Fourier-transform infrared spectroscopy (FT-IR) were used to assess the nanosuspension. SEM images confirmed that the nanocrystal formation process was successful. Glyburide and the excipients have no incompatibilities, their physical states have not changed, and the preparation method has not affected the stability of glyburide, according to DCS, XRD, and FT-IR analyses. CONCLUSION: These studies indicated that a combination of ball milling and homogenization techniques significantly enhanced the solubility of glyburide and its release from the formulation. Consequently, this approach can be applied to formulations characterized by low absorption and limited bioavailability.

Comparison between clear aligners and twin-block in treating class II malocclusion in children: a retrospective study.

The study herein evaluated and compared the efficacy of Clear Aligners (CA) and Twin-Block (TB) appliances as the early orthodontic treatments of developing class II division 1 malocclusion. Twenty-four patients each for CA (11.73 ± 0.33 y) and TB (11.87 ± 0.34 y) groups were selected according to the inclusion and exclusion criteria. The cephalometric X-rays and intraoral photos were taken for the patients after nearly 12 months of treatment. Treatment impacts were evaluated by the molar correction and overjet reduction. The vertical and sagittal changes were analyzed through cephalometric measurements. Sella-nasion-point B angle (SNB), point A-nasion-point B angle (ANB), Wits Appraisal (AO-BO) and overjet were statistically significant regarding the sagittal changes analyzed before and after the treatments in both groups, respectively. So, no significant difference was noted in the sagittal changes between CA and TB groups. However, for the vertical changes, OP (occlusal plane) angle of CA group and OP angle, AFH (anterior facial height) and PFH (posterior facial height) of TB group were statistically significant. Moreover, the Z angle and cranial facial difficulty (C.F. difficulty) were also statistically significant in both groups. Class II children with retrognathic mandible are effectively treated by employing the CA, which has almost the same impact as of TB in sagittal and vertical changes. Resultantly, the patient profile is improved. The CA and TB treatments thus minimize the subsequent treatment difficulty by reducing the C.F. difficulty.

Difference in trajectories according to early amyloid accumulation in cognitively unimpaired elderly.

BACKGROUND AND PURPOSE: Amyloid ß (Aß), a major biomarker of Alzheimer's disease, leads to tau accumulation, neurodegeneration and cognitive decline. Modelling the trajectory of Aß accumulation in cognitively unimpaired (CU) individuals is crucial, as treatments targeting Aß are anticipated. The evolution of Aß levels was investigated to determine whether it could lead to classification into different groups by studying longitudinal Aß changes in older CU individuals, and differences between the groups were compared. METHODS: A total of 297 CU participants were included from the Alzheimer's Disease Neuroimaging Initiative database, and these participants underwent apolipoprotein E (APOE) genotyping, neuropsychological testing, brain magnetic resonance imaging, and an average of 3.03 follow-up 18F-florbetapir positron emission tomography scans. Distinct Aß trajectory patterns were classified using latent class growth analysis, and longitudinal cognitive performances across these patterns were assessed with a linear mixed effects model. RESULTS: The optimal model consisted of three classes, with a high entropy value of 0.947. The classes were designated as follows: class 1, non-accumulation group (n = 197); class 2, late accumulation group (n = 70); and class 3, early accumulation group (n = 30). The late accumulation and early accumulation groups had more APOE ε4 carriers than the non-accumulation group. The longitudinal analysis of cognitive performance revealed that the early accumulation group showed the steepest decline (modified Preclinical Alzheimer's Cognitive Composite with digit symbol substitution [mPACCdigit], p < 0.001; modified Preclinical Alzheimer's Cognitive Composite with trails B [mPACCtrailsB], p < 0.001) and the late accumulation group showed a steeper decline (mPACCdigit, p = 0.014; mPACCtrailsB, p = 0.007) compared to the non-accumulation group. CONCLUSIONS: Our study showed the heterogeneity of Aß accumulation trajectories in CU older individuals. The prognoses for cognitive decline differ according to the Aß trajectory patterns.

Effect of various active reminders via mobile phone on cooperation of orthodontic teenage patients regarding oral hygiene and Class II elastics use : A three-month follow-up prospective cohort study.

INTRODUCTION: The purpose of this prospective cohort study was to assess the impact of reminders via mobile phone, such as text messages or video/multimedia images, on orthodontic patients' cooperation with regard to oral hygiene and the use of Class II intermaxillary elastics. METHODS: The study included 124 orthodontic patients aged 12-20 years (mean age 14.06 ± 2.0 years, 63 females and 61 males). The patients were divided into two groups: group 1 (n = 56) was evaluated for oral hygiene, while group 2 (n = 68) was evaluated for the use of Class II intermaxillary elastics. Each main group was divided into three subgroups: text message group, video message group, and control group. Specific messages were sent to the participants in the study groups twice a week for 12 weeks. Data were collected at the beginning of the study (T0), after 6 weeks (T1), and 12 weeks (T2) and compared to determine the impact of the reminders. Oral hygiene was evaluated using plaque and gingival index scores, and the use of Class II elastics was evaluated using digital model measurements. Between-subject comparisons were performed using Kruskal-Wallis or one-way analysis of variance (ANOVA). For within-subject comparisons (T0-T1, T1-T2, and T0-T2 time intervals), one-way repeated measures ANOVA or Friedman test was performed. RESULTS: There was no significant difference between the control group (1.49 ± 0.22) and the message groups (video: 1.58 ± 0.34 and text: 1.51 ± 0.28) in terms of plaque index scores and gingival index (control: 1.56 ± 0.26, text: 1.51 ± 0.36, video: 1.52 ± 0.26) scores. However, in the intragroup comparison, it was observed that both plaque index scores and gingival index scores at T0, T1, and T2 increased for both the study and control groups. While there was no difference between the subgroups in overjet measurement at T0 (control: 3.46 ± 1.20, video: 3.34 ± 1.20, text: 2.73 ± 1.03; p = 0.51), there was a significant difference at T2 (control: 2.62 ± 0.85, video: 2.32 ± 1.41, text: 1.48 ± 0.72, p < 0.01). CONCLUSION: Mobile active reminders had no effect on improving oral hygiene. Despite repeated reminders, hygiene worsened over time. The use of Class II elastics seemed to have increased as a result of the mobile reminders.

The association between poverty and longitudinal patterns of adverse childhood experiences across childhood and adolescence: Findings from a prospective population-based cohort study in the UK.

BACKGROUND: Adverse childhood experiences (ACEs) affect up to half the general population, they are known to co-occur, and are particularly common among those experiencing poverty. Yet, there are limited studies examining specific patterns of ACE co-occurrence considering their developmental timing. OBJECTIVE: To examine the longitudinal co-occurrence patterns of ACEs across childhood and adolescence, and to examine the role of poverty in predicting these. PARTICIPANTS AND SETTING: The sample was 8859 children from the Avon Longitudinal Study of Parents and Children, a longitudinal prospective population-based UK birth cohort. METHODS: Repeated measures of ten ACEs were available, occurring in early childhood (birth-5 years), mid-childhood (6-10 years), and adolescence (11-16 years). Latent class analysis was used to identify groups of children with similar developmental patterns of ACEs. Multinomial regression was used to examine the association between poverty during pregnancy and ACE classes. RESULTS: Sixteen percent of parents experienced poverty. A five-class latent model was selected: "Low ACEs" (72·0 %), "Early and mid-childhood household disharmony" (10·6 %), "Persistent parental mental health problems" (9·7 %), "Early childhood abuse and parental mental health problems" (5·0 %), and "Mid-childhood and adolescence ACEs" (2·6 %). Poverty was associated with a higher likelihood of being in each of the ACE classes compared to the low ACEs reference class. The largest effect size was seen for the "Early and mid-childhood household disharmony" class (OR 4·70, 95 % CI 3·68-6·00). CONCLUSIONS: A multifactorial approach to preventing ACEs is needed - including support for parents facing financial and material hardship, at-risk families, and timely interventions for those experiencing ACEs.

IL-10 and TGF-ß, but Not IL-17A or IFN-γ, Potentiate the IL-15-Induced Proliferation of Human T Cells: Association with a Decrease in the Expression of ß2m-Free HLA Class I Molecules Induced by IL-15.

IL-15 is a homeostatic cytokine for human T and NK cells. However, whether other cytokines influence the effect of IL-15 is not known. We studied the impact that IL-10, TGF-ß, IL-17A, and IFN-γ have on the IL-15-induced proliferation of human T cells and the expression of HLA class I (HLA-I) molecules. Peripheral blood lymphocytes (PBLs) were labeled with CFSE and stimulated for 12 days with IL-15 in the absence or presence of the other cytokines. The proportion of proliferating T cells and the expression of cell surface HLA-I molecules were analyzed using flow cytometry. The IL-15-induced proliferation of T cells was paralleled by an increase in the expression of HC-10-reactive HLA-I molecules, namely on T cells that underwent ≥5-6 cycles of cell division. It is noteworthy that the IL-15-induced proliferation of T cells was potentiated by IL-10 and TGF-ß but not by IL-17 or IFN-γ and was associated with a decrease in the expression of HC-10-reactive molecules. The cytokines IL-10 and TGF-ß potentiate the proliferative capacity that IL-15 has on human T cells in vitro, an effect that is associated with a reduction in the amount of HC-10 reactive HLA class I molecules induced by IL-15.