State of the art and prospects for artificial intelligence in orthognathic surgery: A systematic review with meta-analysis.

OBJECTIVE: To present a systematic review of the state of the art regarding clinical applications, main features, and outcomes of artificial intelligence (AI) in orthognathic surgery. METHODS: The PICOS strategy was performed on a systematic review (SR) to answer the following question: "What are the state of the art, characteristics and outcomes of applications with artificial intelligence for orthognathic surgery?" After registering in PROSPERO (CRD42021270789) a systematic search was performed in the databases: PubMed (including MedLine), Scopus, Embase, LILACS, MEDLINE EBSCOHOST and Cochrane Library. 195 studies were selected, after screening titles and abstracts, of which thirteen manuscripts were included in the qualitative analysis and six in the quantitative analysis. The treatment effects were plotted in a Forest-plot. JBI questionnaire for observational studies was used to asses the risk of bias. The quality of the SR evidence was assessed using the GRADE tool. RESULTS: AI studies on 2D cephalometry for orthognathic surgery, the Tau2 = 0.00, Chi2 = 3.78, p = 1.00 and I² of 0 %, indicating low heterogeneity, AI did not differ statistically from control (p = 0.79). AI studies in the diagnosis of the decision of whether or not to perform orthognathic surgery showed heterogeneity, and therefore meta-analysis was not peformed. CONCLUSION: The outcome of AI is similar to the control group, with a low degree of bias, highlighting its potential for use in various applications.

Characterizing Disabilities in Preschool Aged Children with Congenital Zika Virus Syndrome with the ICF Model.

Understanding functioning and disabilities in children with Congenital Zika Syndrome (CZS) is essential for health planning. We describe disabilities present in children with CZS followed in a reference hospital in Rio de Janeiro, Brazil, based on the biopsychosocial model of the International Classification of Functioning, Disability and Health (ICF). This was a cohort study of children >3 years of age with CZS. Disability was characterized through outcomes related to ICF components assessed via clinical and motor development evaluations. Among 50 children, with a median age of 40 months, 47 (94%) presented with severe impairment and 46 (92%) had microcephaly. Damage to the head and neck was found in most children, with abnormal central nervous system imaging universally present. Most children had cognitive impairment (92%), muscle tone problems (90%), and speech deficits (94%). We found movement limitations in all categories but more pervasively (80−94%), in postural transfers and displacements. The main environmental factors identified in the ICF model were the use of products or substances for personal consumption and access to health services. Children with CZS have extremely high rates of disability beyond aged 3 years, particularly regarding motor activity. ICF-based models can contribute to the assessment of health domains.

Complementary and alternative medicine use in an Australian kidney transplant recipient population.

The prevalence of complementary and alternative medicine (CAM) use in kidney transplant recipients in Australia is unknown. Chronic transplant recipients completed a questionnaire, and participants who did not report CAM use also had medical chart audits. Among 127 participants, CAM use was reported by 26.8%, considerably lower than the general population. These findings may reflect underreporting due to misperception about what constitutes CAM (commonly vitamin use was not reported by the group denying CAM use), or perhaps a motivated population who are receptive to education efforts from the transplant team.

Recurrent glomerulonephritis after kidney transplantation: a practical approach.

PURPOSE OF REVIEW: This review will provide a practical approach in the assessment of kidney failure patients with primary glomerulonephritides (GN) being considered for kidney transplantation, focusing on high-risk subtypes of immunoglobulin A nephropathy, focal segmental glomerulosclerosis, idiopathic membranous glomerulonephritis and membranoproliferative glomerulonephritis. RECENT FINDINGS: Recurrent glomerulonephritis remains one of the most common causes of allograft loss in kidney transplant recipients. Although the epidemiology and clinical outcomes of glomerulonephritis recurrence occurring after kidney transplantation are relatively well-described, the natural course and optimal treatment strategies of recurrent disease in kidney allografts remain poorly defined. With a greater understanding of the pathophysiology and treatment responses of patients with glomerulonephritis affecting the native kidneys, these discoveries have laid the framework for the potential to improve the management of patients with high-risk glomerulonephritis subtypes being considered for kidney transplantation. SUMMARY: Advances in the understanding of the underlying immunopathogenesis of primary GN has the potential to offer novel therapeutic options for kidney patients who develop recurrent disease after kidney transplantation. To test the efficacy of novel treatment options in adequately powered clinical trials requires a more detailed understanding of the clinical and histological characteristics of kidney transplant recipients with recurrent glomerulonephritis.

Effect of the Endocannabinoid System in Memory Updating and Forgetting.

Most memories of life experiences will be forgotten or modified over time. Although several studies have investigated the processes underlying memory formation, the mechanisms behind memory updating and forgetting remain unclear. The endocannabinoid system has been shown to be closely involved in various memory processes such as consolidation, destabilization, and extinction. Here, we investigate the role of the endocannabinoid system in memory updating, behavioral flexibility, and forgetting. We found that the hippocampal infusion of CB1 antagonist prevented memory updating in the immediate footshock (context pre-exposure facilitation effect) and reversal learning. Also, CB1 antagonist accelerated forgetting in inhibitory avoidance. Thus, by indicating the important role played by the endocannabinoid system, our results extend current knowledge of the mechanisms underpinning memory updating and forgetting.

Evaluation of root canal morphology of maxillary premolars: a cone-beam computed tomography study.

The aim of this study was to evaluate the root canal configuration of maxillary premolars using cone-beam computed tomography (CBCT). CBCT images of 999 maxillary premolars from a database were analysed to determine the frequency of the number of roots, root canals and Vertucci's classification. The associations among these variables were evaluated by Chi-square test (P < 0.05). In the first premolars, 42.2% of single-rooted teeth had a type II configuration, whereas 98.7% of 2-rooted teeth showed type IV. In the second premolars, type I was the most prevalent (49.9%). The presence of two roots was more prevalent in first premolars, and the presence of one root was more prevalent in second premolars (P < 0.05). Male patients had a higher percentage of two roots compared with female patients (P < 0.05). Type IV and I was more prevalent in first and second premolars respectively (P < 0.05). There was a high frequency of 2-rooted and single-rooted teeth among maxillary first and second premolars respectively.

A Connective Tissue Graft as a Biologic Alternative to Class V Restorations in Miller Class I and II Recession Defects: Case Series.

Although cervical lesions are commonly treated using restorative materials, the esthetics and durability of the restoration can be problematic. Despite improvements in bonding to dentin, the performance of resin-based cervical restorations suffers from a variety of clinical problems. Biologic options using connective tissue grafts to replace the lost soft tissues have proven longevity and esthetic benefits. A collection of case reports is presented to demonstrate a surgical alternative to correct carious and noncarious cervical lesions. Clinicians should consider the biologic option of replacing the missing gingival tissue prior to placement of restorative materials on exposed root surfaces.

12 years of universal access to hepatitis C treatment: Brazil's comprehensive response.

Hepatitis C is considered one of the most neglected diseases in world. Worldwide about 150 million people are chronically infected by hepatitis C virus (HCV), and 60% to 70% of them will develop severe liver disease. This article describes Brazil's response to hepatitis C, from the first steps in 1993 to a national program in 2002. We reviewed the available literature, most of it in Brazilian Portuguese, and compiled them in order to share this experience with those seeking some pragmatic solutions. After 12 years, the national program has achieved universal coverage of treatment, resulting in saved lives and resources for the health system. There is abundant evidence that the HCV epidemic deserves attention. The overall consequence of long-term HCV infection is a negative impact on the health care economy. The Brazilian experience can be adapted to many countries in the world, in compliance with the 2010 World Health Organization World Health Assembly Resolution.

A model of interval timing by neural integration.

We show that simple assumptions about neural processing lead to a model of interval timing as a temporal integration process, in which a noisy firing-rate representation of time rises linearly on average toward a response threshold over the course of an interval. Our assumptions include: that neural spike trains are approximately independent Poisson processes, that correlations among them can be largely cancelled by balancing excitation and inhibition, that neural populations can act as integrators, and that the objective of timed behavior is maximal accuracy and minimal variance. The model accounts for a variety of physiological and behavioral findings in rodents, monkeys, and humans, including ramping firing rates between the onset of reward-predicting cues and the receipt of delayed rewards, and universally scale-invariant response time distributions in interval timing tasks. It furthermore makes specific, well-supported predictions about the skewness of these distributions, a feature of timing data that is usually ignored. The model also incorporates a rapid (potentially one-shot) duration-learning procedure. Human behavioral data support the learning rule's predictions regarding learning speed in sequences of timed responses. These results suggest that simple, integration-based models should play as prominent a role in interval timing theory as they do in theories of perceptual decision making, and that a common neural mechanism may underlie both types of behavior.

A prospective pediatric clinical trial of digital music players: do they interfere with pacemakers?

BACKGROUND: There has been recent concern in the media about iPod interference with pacemakers. We systematically tested two types of digital music players (DMP) on pacemaker or ICD function in children. METHODS/RESULTS: Patients were monitored by a 6-lead ECG and programmer telemetry. The pacemaker was tested in bipolar and unipolar sensing at normal and maximal sensitivities. The order of DMP tested was randomized. Each DMP was placed on top of the pacemaker pocket, put into "play" mode three times (5 seconds each), with and without programmer wand placed one cm adjacent to DMP. Pacemaker interference was defined as: pacing inhibition, inappropriate pacing, oversensing, or detection of high-rate episodes associated with the use of DMP. Of the 67 patients (mean age 12 +/- 5 years), 62 had pacemakers and five had ICDs; 39 endocardial and 28 epicardial systems. Patients were tested with Sansa (67), iPod 30 GB (51), and other DMPs (43). There was no evidence of interference with pacemaker function by any DMP under any of the study conditions (each performed in triplicate). Reproducible programmer telemetry interference was shown in 11 cases (Medtronic 6/47, St. Jude Medical 5/18, Guidant 0/2) related to use of iPod (6), Sansa (1), or others (4). None of these were associated with any evidence of pacemaker malfunction. CONCLUSION: Interference with pacemaker function could not be shown with iPod or MP3 players. No additional precaution beyond standard is necessary for patients with pacemakers when they are using these players.

trans-5,6-Diphenyl-perhydro-pyran-2,4-dione.

In the title compound, C(17)H(14)O(3), the pyran ring adopts a boat conformation and the dihedral angle between the aromatic ring planes is 59.1 (1)°. In the crystal structure inter-molecular C-H⋯O hydrogen bonds and C-H⋯π inter-actions link the mol-ecules.

Hemopressin is an inverse agonist of CB1 cannabinoid receptors.

To date, the endogenous ligands described for cannabinoid receptors have been derived from membrane lipids. To identify a peptide ligand for CB(1) cannabinoid receptors, we used the recently described conformation-state sensitive antibodies and screened a panel of endogenous peptides from rodent brain or adipose tissue. This led to the identification of hemopressin (PVNFKFLSH) as a peptide ligand that selectively binds CB(1) cannabinoid receptors. We find that hemopressin is a CB(1) receptor-selective antagonist, because it is able to efficiently block signaling by CB(1) receptors but not by other members of family A G protein-coupled receptors (including the closely related CB(2) receptors). Hemopressin also behaves as an inverse agonist of CB(1) receptors, because it is able to block the constitutive activity of these receptors to the same extent as its well characterized antagonist, rimonabant. Finally, we examine the activity of hemopressin in vivo using different models of pain and find that it exhibits antinociceptive effects when administered by either intrathecal, intraplantar, or oral routes, underscoring hemopressin's therapeutic potential. These results represent a demonstration of a peptide ligand for CB(1) cannabinoid receptors that also exhibits analgesic properties. These findings are likely to have a profound impact on the development of novel therapeutics targeting CB(1) receptors.

Determination of the free radical scavenging activity of dihydropyran-2,4-diones.

The antioxidant activities of four synthetic dihydropyran-2,4-diones have been established through the determination of their abilities to inhibit free radicals using DPPH(*) as the stable radical. Whilst all of the compounds exhibited high inhibition percentages, the most active member of the group was 6-phenyl-dihydropyran-2,4-dione. The antioxidant activity of the dihydropyran-2,4-diones is reported here for the first time and extends our knowledge of the range of valuable biological activities associated with this group of compounds.

Synthesis and evaluation of the molluscicidal activity of the 5,6-dimethyl-dihydro-pyran-2,4-dione and 6-substituted analogous.

Five dihydro-piran-2,4-diones, including 5,6-dimethyl-dihydro-piran-2,4-dione one of the intermediates of the synthesis of caloverticilic acid, were synthesized and submitted to molluscicidal bioassay. The compound's yields varied from moderate to good (42%- 80%) and were achieved through the preparation of the dianion of ethyl acetoacetate, reaction with and aldehyde followed by hydrolysis of the ester (NaOH, H(2)O, 2 h, T.A.) and lactonization in acidic medium (HCl, 0 degrees C). The 5,6-dimethyl-dihydro-piran-2,4-dione and three analogous dihydro-piran-2,4-diones 6-substituted,-phenyl, (4-methoxy-phenyl), and -propenyl, showed significant activities against the Biomphalaria glabrata egg masses, while the analogous 6-(3,4-dimethoxy-phenyl) was inactive as molluscicide. This activity is reported for the first time, extending the range of biological activities of this group.