Degree of Risk of Bias in Randomized Controlled Trials: Does It Have an Impact on Root Coverage Outcomes?

OBJECTIVE: Improvement over time in mean (MRC) and complete root coverage (CRC) reported in randomized controlled trials (RCTs) has been documented. Our objective was to assess the effect that the ROB has on relevant outcomes reported in RCTs evaluating the efficacy of a commonly performed root coverage procedure. METHODS: RCTs that involved the use of a bilaminar technique of coronally advanced flap with connective tissue graft were selected. The following data were extracted: MRC, CRC, whether conflict of interest was addressed (yes/no), adequacy of random sequence generation, allocation concealment, and blinding of outcome assessment. Trials were categorized into four groups as per different time periods: before Consolidated Standards of Reporting Trials (CONSORT) (before 1996), CONSORT (1997 to 2001), CONSORT 2001 (2002 to 2010), and CONSORT 2010 (2011 to 2019). Differences between group means were assessed using statistical analyses. RESULTS: The search yielded a total of 47 RCTs published between 1993 and 2019 that met the inclusion criteria. A trend toward lower ROB over time in the selected RCTs was observed. However, differences in MRC and CRC with respect to the degree ROB of included trials were not significant. CONCLUSIONS: Degree of ROB did not influence MRC and CRC reported in the RCTs included in this investigation. This finding suggests that the observed improvement of clinical outcomes over time should be attributed to other factors, such as refinement of surgical techniques.

Renal Arteries Revisited: Anatomy, Pathologic Entities, and Implications for Endovascular Management.

The renal arteries (RAs) are important vessels that usually arise from the abdominal aorta and supply the kidneys; thus, these arteries play a vital role in physiologic functions such as hemofiltration and blood pressure regulation. An understanding of the basis for embryologic development and the frequently variable anatomy of the RAs is necessary to fully appreciate the range of diseases and the implications for procedural planning. Hemorrhage from an RA is relatively common and is typically traumatic or spontaneous, with the latter form often seen in association with underlying tumors or arteriopathy. Accurate diagnostic evaluation of RA disease due to conditions such as atherosclerosis, fibromuscular dysplasia, vasculitis, aneurysm, arteriovenous shunt, embolic disease, and dissection is dependent on the use of multimodality imaging and is essential for selecting appropriate clinical management, with endovascular therapy having a key role in treatment. Surgical considerations include extra-anatomic renal bypass, which remains an important treatment option even in this era of endovascular therapy, and RA embolization as an adjunct to tumor surgery. A novel area of research interest is the potential role of RA denervation in the management of refractory hypertension. ©RSNA, 2021.

Using Rapid Serial Visual Presentation to Measure Set-Specific Capture, a Consequence of Distraction While Multitasking.

This method uses a rapid serial visual presentation (RSVP) paradigm to measure the cost of distraction when participants maintain multiple search goals. The protocol identifies two types of distraction within a single task - contingent attentional capture and set-specific capture - that represent different types of limitations of cognitive processing. Participants search for letters in two or more "target" ink colors (e.g., green and orange) within a continuous RSVP stream of heterogeneously colored letters, while ignoring two peripheral RSVPs of letters. Upon detecting a target, participants are to identify the letter. On some trials, target-colored distractors appear in the periphery just prior to the presentation of a target, causing a drop in target identification performance. Contingent attentional capture is observed by examining performance on trials in which the peripheral distractor is the same color as the target on that trial (e.g., both orange). Set-specific capture is represented by performance on trials in which the peripheral distractor is target-colored (e.g., orange), but not the same color as the target on that trial (e.g., green.) By varying the amount of time (i.e., the number of stimuli appearing) between the presentation of the distractor and the target, researchers can observe how participants recover from these distraction costs over time. As compared to static displays that are often used to measure contingent attentional capture, the dynamic display produces much larger effects, allowing the researcher to identify subtle effects of smaller manipulations. An unusual aspect of our design is that it employs a continuous display; "filler" stimuli connect one trial to the next seamlessly, and participants respond during this interval whenever they detect a target. The continuous display reduces chance performance to near-zero levels (rather than 50%) and provides researchers with a more sensitive measure of performance differences across trial types.

Determinants of physiological uptake of 18F-fluorodeoxyglucose in palatine tonsils.

To determine the extent of physiological variation of uptake of F-flurodeoxyglucose (FDG) within palatine tonsils. To define normal limits for side-to-side variation and characterize factors affecting tonsillar uptake of FDG.Over a period of 16 weeks 299 adult patients at low risk for head and neck pathology, attending our center for FDG positron emission tomography/computed tomography (PET/CT) scans were identified. The maximum standardized uptake value (SUVmax) was recorded for each palatine tonsil. For each patient age, gender, smoking status, scan indication and prior tonsillectomy status as well as weather conditions were noted.There was a wide variation in palatine tonsil FDG uptake with SUVmax values between 1.3 and 11.4 recorded. There was a strong left to right correlation for tonsillar FDG uptake within each patient (P < .01). The right palatine tonsil showed increased FDG uptake (4.63) compared to the left (4.47) (P < .01). In multivariate analysis, gender, scan indication, and prevailing weather had no significant impact of tonsillar FDG uptake. Lower tonsillar uptake was seen in patients with a prior history of tonsillectomy (4.13) than those without this history (4.64) (P < .01). Decreasing tonsillar FDG uptake was seen with advancing age (P < .01). Significantly lower uptake was seen in current smokers (SUVmax 4.2) than nonsmokers (SUV 4.9) (P = .03).Uptake of FDG in palatine tonsils is variable but shows a strong side-to-side correlation. We suggest the left/ right SUVmax ratio as a guide to normality with a first to 99th percentiles of (0.70-1.36) for use in patients not suspected to have tonsillar pathology.

Response to Comment on "Estimating the reproducibility of psychological science".

Gilbert et al. conclude that evidence from the Open Science Collaboration's Reproducibility Project: Psychology indicates high reproducibility, given the study methodology. Their very optimistic assessment is limited by statistical misconceptions and by causal inferences from selectively interpreted, correlational data. Using the Reproducibility Project: Psychology data, both optimistic and pessimistic conclusions about reproducibility are possible, and neither are yet warranted.

The effect of attention on repetition suppression and multivoxel pattern similarity.

Fundamental to our understanding of learning is the role of attention. We investigated how attention affects two fMRI measures of stimulus-specific memory: repetition suppression (RS) and pattern similarity (PS). RS refers to the decreased fMRI signal when a stimulus is repeated, and it is sensitive to manipulations of attention and task demands. In PS, region-wide voxel-level patterns of responses are evaluated for their similarity across repeated presentations of a stimulus. More similarity across presentations is related to better learning, but the role of attention on PS is not known. Here, we directly compared these measures during the visual repetition of scenes while manipulating attention. Consistent with previous findings, we observed RS in the scene-sensitive parahippocampal place area only when a scene was attended both at initial presentation and upon repetition in subsequent trials, indicating that attention is important for RS. Likewise, we observed greater PS in response to repeated pairs of scenes when both instances of the scene were attended than when either or both were ignored. However, RS and PS did not correlate on either a scene-by-scene or subject-by-subject basis, and PS measures revealed above-chance similarity even when stimuli were ignored. Thus, attention has different effects on RS and PS measures of perceptual repetition.