Impact of air pollutants on climate change and prediction of air quality index using machine learning models.

The impact of air pollution in Chennai metropolitan city, a southern Indian coastal city was examined to predict the Air Quality Index (AQI). Regular monitoring and prediction of the Air Quality Index (AQI) are critical for combating air pollution. The current study created machine learning models such as XGBoost, Random Forest, BaggingRegressor, and LGBMRegressor for the prediction of the AQI using the historical data available from 2017 to 2022. According to historical data, the AQI is highest in January, with a mean value of 104.6 g/gm, and the lowest in August, with a mean AQI value of 63.87 g/gm. Particulate matter, gaseous pollutants, and meteorological parameters were used to predict AQI, and the heat map generated showed that of all the parameters, PM2.5 has the greatest impact on AQI, with a value of 0.91. The log transformation method is used to normalize datasets and determine skewness and kurtosis. The XGBoost model demonstrated strong performance, achieving an R2 (correlation coefficient) of 0.9935, a mean absolute error (MAE) of 0.02, a mean square error (MSE) of 0.001, and a root mean square error (RMSE) of 0.04. In comparison, the LightGBM model's prediction was less effective, as it attained an R2 of 0.9748. According to the study, the AQI in Chennai has been increasing over the last two years, and if the same conditions persist, the city's air pollution will worsen in the future. Furthermore, accurate future air quality level predictions can be made using historical data and advanced machine learning algorithms.

Wearable Orofacial Technology and Orthodontics.

Wearable technology to augment traditional approaches are increasingly being added to the arsenals of treatment providers. Wearable technology generally refers to electronic systems, devices, or sensors that are usually worn on or are in close proximity to the human body. Wearables may be stand-alone or integrated into materials that are worn on the body. What sets medical wearables apart from other systems is their ability to collect, store, and relay information regarding an individual's current body status to other devices operating on compatible networks in naturalistic settings. The last decade has witnessed a steady increase in the use of wearables specific to the orofacial region. Applications range from supplementing diagnosis, tracking treatment progress, monitoring patient compliance, and better understanding the jaw's functional and parafunctional activities. Orofacial wearable devices may be unimodal or incorporate multiple sensing modalities. The objective data collected continuously, in real time, in naturalistic settings using these orofacial wearables provide opportunities to formulate accurate and personalized treatment strategies. In the not-too-distant future, it is anticipated that information about an individual's current oral health status may provide patient-centric personalized care to prevent, diagnose, and treat oral diseases, with wearables playing a key role. In this review, we examine the progress achieved, summarize applications of orthodontic relevance and examine the future potential of orofacial wearables.

Does the use of platelet-rich plasma in sinus augmentation improve the survival of dental implants? A systematic review and meta-analysis.

Background: Platelet-rich plasma is considered an effective modality to promote bone regeneration, improve hard and soft tissue healing in surgical procedures including sinus augmentation. However, the survival of dental implants in sinus augmented sites with platelet-rich plasma has shown equivocal results in recent studies. Purpose: In this systematic review, data on dental implants' survival in sinus augmentation sites with platelet-rich plasma were examined. Materials and methods: Randomized controlled trials on the topic with a minimum mean follow-up of 6 months with no language restriction were considered. Other study designs on the topic were excluded. Accordingly, relevant articles were searched in Clinicaltrials.gov, Cochrane databases, PubMed/Medline, and Scopus up to April 2021. Using the Cochrane risk of bias assessment tool, the listed studies' risk of bias was evaluated. From the included studies, the pertinent information was taken and pooled for qualitative and quantitative analysis using R software 4.1.1. Results: Six randomized controlled trials involving 188 patients who underwent sinus augmentation with and without platelet-rich plasma, and 781 implants were included for qualitative and quantitative analysis. Four hundred and eleven implants were placed in the intervention group (with platelet-rich plasma) and 370 implants were placed in the control group (without platelet-rich plasma). The pooled estimate (OR 0.84, 95% CI 0.37 to 1.91; I2 = 0%) indicated that there was no statistically significant difference observed between the groups. The test for subgroup differences showed no statistically significant differences between the subgroups (p = 0.45) with no heterogeneity (I2 = 0%). Conclusion: The bias associated with selective reporting of outcome data was considered as some concern for bias. This systematic review revealed that the effect of platelet-rich plasma is uncertain on the survival of dental implants.

Entrustable professional activities in undergraduate dental education: A practical model for development and validation.

OBJECTIVE: Entrustable professional activities (EPAs) are tasks that a person who is qualified or is in the process to be credentialed are allowed to engage. There are several levels of entrustment based on degrees of supervision assigned to each EPA. This paper aims to describe the process and outcome of creating EPAs; validate EPAs relevant to undergraduate dental training. METHODS: A draft set of EPA statements was developed based on the consensus of an expert panel. These were then mapped to the nationally determined minimum experience thresholds (clinical and procedural experiences/competencies) and aligned to task-based instructional strategy. The EPAs were validated to improve the relevance by using a criterion-based rubric. RESULTS: An end-to-end process workflow led to the development of an EPA-based educational framework to bridge the gaps in the curriculum. The process identified a total of 41 EPAs and out of which, 10 EPAs were notated as core EPAs and will be subjected to structured workplace-based assessment complying to the national standards. The validation exercise rated core EPAs with an overall score matching close to the cut-off of 4.07 (Equal rubric). CONCLUSION: The end-to-end process workflow provided the opportunity to elaborate a structured process for the development of EPAs for undergraduate dental education. As validation is a continuous process, feedback from implementation will inform the next steps.

Clinical audit of orthodontic chart documentation by dental undergraduates.

INTRODUCTION: Clinical audit is a quality improvement process that seeks to improve patient care and outcomes through the systematic review of care against explicit criteria and the implementation of change. The objective of this audit was to evaluate the quality of orthodontic chart documentation by dental undergraduates against established guidelines. MATERIALS AND METHODS: An audit checklist with 13 criteria for good documentation was adapted from guidelines proposed by the American Association of Orthodontists and British Orthodontic Society. Orthodontic chart documentation in 103 removable appliance therapy patients under 4th and 5th year dental undergraduates' care was retrieved from the electronic record of the University dental clinic and audited. The audit exercise explored in detail the thirteen criteria for good documentation and eight assessment attributes of the first criterion, namely, basic orthodontic examination. The level of compliance was measured as the percentage records meeting the criteria. The data were statistically analysed using SPSS 26.0 (SPSS, Inc., Chicago, IL, USA). RESULTS: There was no complete compliance for any of the criteria. Thirty-five (33.9%) patient charts reported basic orthodontic examination documentation adequately. Compliance was the highest for documentation of treatment modality (77.6%), appliance delivery encounters (77.6%), and appliance adjustment appointments (83.5%). About 51.4% of the 68 patient charts (treatment of 35 patients of the total 103 were in the progress stage) stated adequately the outcome of treatment. Only 22% of the 68 patient charts had the details for retention protocol. There was statistically significant difference in chart documentation between male and female students for basic orthodontic assessment and appliance delivery and patient instructions attributes. CONCLUSION: The clinical audit demonstrated poor compliance with the criteria for orthodontic chart documentation. The audit should be repeated after the provision of learning opportunities and self-critical analysis.

Does arch length preservation in mixed dentition children affect mandibular second permanent molar eruption? A systematic review and meta-analysis.

BACKGROUND: Arch length preservation strategies utilize leeway space or E-space in the mixed dentition to resolve mild to moderate mandibular incisor crowding. The purpose of this systematic review of the literature was to analyze the effects of arch length preservation strategies in on mandibular second permanent molar eruption. METHODS: A search for relevant articles published from inception until May 2020 was performed using PubMed/Medline, Cochrane databases, Clinicaltrials.gov, Google scholar and journal databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adopted for the conduct of the systematic review. Using RevMan 5.3 software, the most pertinent data were extracted and pooled for quantitative analysis with 95% confidence intervals. Heterogeneity was analyzed by using Cochran Q test and I squared statistics. RESULTS: A total of 5 studies involving 855 mixed dentition patients with arch length preservation therapy were included in the qualitative analysis. Pooled estimate of the data from two studies revealed 3.14 times higher odds of developing mandibular second molar eruption difficulty due to arch length preservation strategies using lingual holding arch (95% CI; OR 1.10-8.92). There was no heterogeneity found in the analysis. The certainty levels were graded as very low. CONCLUSIONS: This systematic review demonstrates that arch length preservation strategies pose a risk for development of mandibular second molar eruption disturbances, but the evidence was of very low quality. Registration number: CRD42019116643.

Does HIV infection affect the survival of dental implants? A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Immunosuppression and coinfections associated with human immunodeficiency virus (HIV) infection pose a relative contraindication for dental implant therapy. However, although implants have been placed in patients with HIV with reasonable success, how HIV infection affects their survival is unclear. PURPOSE: The purpose of this systematic review of the literature and meta-analysis was to analyze the data on the survival of dental implants in patients with HIV. MATERIAL AND METHODS: A search for relevant articles published up to November 2019 was performed in PubMed/Medline and Cochrane databases, Clinicaltrials.gov, and Google Scholar. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted for the conduct of the systematic review. The most pertinent data were extracted and pooled for qualitative and quantitative analyses with 95% confidence intervals. Heterogeneity was analyzed by using I-squared statistics. RESULTS: A total of 8 studies involving 411 individuals with HIV and 1109 implants were included in the meta-analysis. The mean follow-up period was 2.8 years. A pooled estimate of 95% of implant survival rate with 95% confidence interval(92% to 96%) was noted. Heterogeneity across the 8 studies was found to be 41% with moderate true variability. CONCLUSIONS: This systematic review demonstrated that HIV infection does not pose a serious threat to implant survival on short-term evaluation, but the evidence is of low quality.

Do Highly Active Antiretroviral Therapy Drugs in the Management of HIV Patients Influence Success of Dental Implants?

HIV infection is a global pandemic that affects CD4 cells in the immune system and leads to lethal opportunistic infections. The advent of highly active antiretroviral therapy (HAART) has induced a marked reduction in the viral load and an increase in the CD4 cell count, thereby changing the course of the disease from an acute life-threatening condition to chronic disease. Accordingly, need and demand for oral rehabilitation in HIV positive population have increased in recent years. However, few drugs used in the HAART regimen have also known to be associated with osteopenia and osteoporosis. Although HAART reduces the morbidity in HIV patients, it remains unknown to what extent the therapy influences the implant healing. Few scientific literatures have identified osteoporosis and HIV infection as an unconducive milieu for dental implant placement and survival but demonstrated favorable outcomes in short-term assessments. The long-term impact of bone metabolic effects of HAART on implant success remains a conundrum.

COVID-19-Orthodontic Care During and After the Pandemic: A Narrative Review.

OBJECTIVES: To provide comprehensive information regarding the implications of the coronavirus disease 2019 (COVID-19), mode of transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and its effects on orthodontic care during the pandemic and post-pandemic outbreak of the disease, based on currently available literature and information. MATERIALS AND METHODS: A comprehensive research for studies that focused on the COVID-19 pandemic and orthodontic care up to August 18, 2020, with no language restriction. The databases included PubMed, MEDLINE, Scopus, Google Scholar, and COVID-19 Open Research Dataset (CORD-19) 2020. The research was focused on presenting symptoms, disease transmission, infection control, orthodontic care, and financial implications affecting the delivery of orthodontic treatment. The research also included reports from major health policy regulatory bodies such as World Health Organization, Centers for Disease Control and Prevention, European Centre for Disease Control and Prevention, and major international dental and orthodontic societies and associations. The peer-reviewed publications and guidelines from the health regulatory authorities were given priority. RESULTS: The latest information on the SARS-CoV-2 virus effects and orthodontic implications were arranged sequentially. The SARS-CoV-2 virus mode of transmission and its prevention were emphasized to keep the orthodontic and dental operatory safe for continuing practice. CONCLUSION: The COVID-19 outbreak has changed the way orthodontics is practiced. Strict infection control, near-zero aerosol production, and minimal touch dentistry are the keys to prevent contamination of orthodontic operatory. During the pandemic, only emergency orthodontic procedures could be extended to the orthodontic patient while adhering to all the regulatory guidelines. Fortunately, to date, there is no reported case of cross-transmission of the SARS-CoV-2 virus at the dental setup.

COVID-19 Reflections and Team-Based Entrustable Professional Activities for Bioevent Preparedness.

This article was migrated. The article was marked as recommended. The coronavirus disease 2019 (COVID-19) outbreak has shaken the entire human race with its unprecedented health and economic outcomes. Researchers and clinicians are trying to get an insight into various aspects of the COVID-19 disease and related aspects, and to some extent, they have succeeded too, but a lot more is yet to be discovered and disclosed. However, it appears that the pandemic is going to stay for a longer duration with varied expressions. In these testing and challenging times when the entire world is battling the massive public health crises, the healthcare workers remain the most vulnerable targets. The current situation unleashes adoption of new structures and processes, but often gloomed with ethical dilemmas. The COVID-19 is not going to be the last major pandemic in the history of human civilization. Henceforth, the million-dollar questions we face now and forever are: How are we planning to prepare the workforce for an health crisis of this cataclysmic proportions? Can we reimagine a curricular framework that could address public health crises arising from epidemics and pandemics? What model could facilitate for advancement in crisis preparedness and management? Do we need an orchestrated team approach in managing and containing any public health crisis of global concern like the COVID-19? What about the entrustable professional activities for a team task? These pertinent questions do not have straight forward answers. It requires a great effort at various levels, but such a change in curricular framework appears to be the need of the hour.