Soft tissue lasers: An innovative tool enhancing treatment outcomes in orthodontics - A narrative review.

Lasers have been utilised in the field of dentistry for over 40 years, but their use has been limited in the field of orthodontics. The advent of lasers with accompanying computer interfaces has made them significantly user-friendly, adding to their appeal in the orthodontic profession. Knowledge regarding the laser device's capabilities and limitations is essential to optimise patient care and to make a satisfactory investment return. For the effective and successful integration of lasers in orthodontic practice, adequate training is required, limited not only to the orthodontist but the dental assistants and auxiliaries as well. Orthodontists may safely and readily execute gingivectomy, exposure of teeth, frenectomy, circumferential supracrestal fiberotomy, ankyloglossia release and uvulopalatoplasty. The current narrative review was planned to introduce the benefits and general principles of soft tissue lasers in the field of orthodontics and recent surgical research comparing different laser-assisted surgeries against conventional scalpel surgeries.

Dental, skeletal, and soft-tissue changes in adult orthodontic patients treated with premolar extraction and nonextraction: A cross-sectional study.

INTRODUCTION: Various treatment modalities exist to improve and correct Class I malocclusion. This study evaluated the dental, skeletal, and soft-tissue changes in patients treated by premolar extraction (PME) and nonextraction. METHODS: A cross-sectional study was conducted, including subjects ideally planned for PME. Pretreatment and posttreatment lateral cephalograms were compared among the 2 groups. The American Board of Orthodontics Objective Grading System (ABO-OGS) was used to score the posttreatment casts, and soft-tissue profile silhouettes were judged by a panel of orthodontists to evaluate the improvement among the 2 groups. Comparisons between the 2 groups were performed using the Mann-Whitney U test. Spearman correlation was used to study the correlation between the assessment methodologies. RESULTS: Highly significant differences were observed between the 2 groups for ABO-OGS scores (P ≤0.001) and profile silhouette assessment (P ≤0.001). Compared with posttreatment cephalometric readings, highly significant differences were seen for the dental variables: SN-U1, IMPA, and interincisal angle (P ≤0.001). Statistically significant differences were seen for all soft-tissue cephalometric variables. Highly significant moderate to negative correlation (r = -0.410, P ≤0.001) was seen between profile silhouettes and ABO-OGS alignment scores. Highly significant strong negative correlation (r = -0.642, P ≤0.001) was seen between profile silhouettes and the lower lip. CONCLUSION: Dental and soft-tissue changes were highly significant and were found to be in the ideal range when treated with PME. However, PME and nonextraction treatment modalities did not significantly affect the skeletal parameters as seen on the lateral cephalogram.

Comparison of treatment outcomes as assessed by 3 indexes in subjects with Class I malocclusion treated by 3 different methods: A cross-sectional study.

INTRODUCTION: Various treatment modalities exist to improve and correct Class I malocclusion. This study was conducted to evaluate the outcomes of nonextraction (NE), premolar extraction (PME), and mandibular incisor extraction (MIE) treatment modalities in subjects presenting with Class I malocclusion. METHODS: A cross-sectional study was conducted at a tertiary care hospital using pretreatment and posttreatment dental casts along with intraoral photographs of 90 orthodontic subjects. These subjects were divided equally into NE, PME, and MIE groups and scored using the Index of Orthodontic Treatment Need, Index of Complexity, Outcome, and Need (ICON), and peer assessment rating (PAR) indexes. Nonparametric tests were run to compare pretreatment and posttreatment scores and to evaluate the percentage and categorical changes for the treatment modalities. Pairwise comparisons were performed using the Mann-Whitney U test. RESULTS: Statistically significant differences (P ≤0.001) were seen between the pretreatment and posttreatment scores for all modalities. Statistically significant improvements were seen between the 3 treatment modalities for the PAR (P = 0.010) and ICON (P = 0.003) indexes. Significant categorical improvements were found for the Aesthetic Component (AC) (P = 0.012) among the 3 groups. Pairwise comparison revealed significant differences between the NE and MIE groups (ICON, P = 0.001; AC, P = 0.018) and PME and MIE groups (PAR, P = 0.002; ICON, P = 0.007; AC, P = 0.007). CONCLUSIONS: Posttreatment scores of all indexes were reduced, with significant differences found among the treatment modalities for all except the Dental Health Component index. The pairwise comparison revealed suboptimal occlusal results with the MIE group. Good occlusal and esthetic treatment outcomes were achieved with the PME and NE groups.

A systematic review of comparisons between protocols or registrations and full reports in primary biomedical research.

BACKGROUND: Prospective study protocols and registrations can play a significant role in reducing incomplete or selective reporting of primary biomedical research, because they are pre-specified blueprints which are available for the evaluation of, and comparison with, full reports. However, inconsistencies between protocols or registrations and full reports have been frequently documented. In this systematic review, which forms part of our series on the state of reporting of primary biomedical, we aimed to survey the existing evidence of inconsistencies between protocols or registrations (i.e., what was planned to be done and/or what was actually done) and full reports (i.e., what was reported in the literature); this was based on findings from systematic reviews and surveys in the literature. METHODS: Electronic databases, including CINAHL, MEDLINE, Web of Science, and EMBASE, were searched to identify eligible surveys and systematic reviews. Our primary outcome was the level of inconsistency (expressed as a percentage, with higher percentages indicating greater inconsistency) between protocols or registration and full reports. We summarized the findings from the included systematic reviews and surveys qualitatively. RESULTS: There were 37 studies (33 surveys and 4 systematic reviews) included in our analyses. Most studies (n = 36) compared protocols or registrations with full reports in clinical trials, while a single survey focused on primary studies of clinical trials and observational research. High inconsistency levels were found in outcome reporting (ranging from 14% to 100%), subgroup reporting (from 12% to 100%), statistical analyses (from 9% to 47%), and other measure comparisons. Some factors, such as outcomes with significant results, sponsorship, type of outcome and disease speciality were reported to be significantly related to inconsistent reporting. CONCLUSIONS: We found that inconsistent reporting between protocols or registrations and full reports of primary biomedical research is frequent, prevalent and suboptimal. We also identified methodological issues such as the need for consensus on measuring inconsistency across sources for trial reports, and more studies evaluating transparency and reproducibility in reporting all aspects of study design and analysis. A joint effort involving authors, journals, sponsors, regulators and research ethics committees is required to solve this problem.

A scoping review of comparisons between abstracts and full reports in primary biomedical research.

BACKGROUND: Evidence shows that research abstracts are commonly inconsistent with their corresponding full reports, and may mislead readers. In this scoping review, which is part of our series on the state of reporting of primary biomedical research, we summarized the evidence from systematic reviews and surveys, to investigate the current state of inconsistent abstract reporting, and to evaluate factors associated with improved reporting by comparing abstracts and their full reports. METHODS: We searched EMBASE, Web of Science, MEDLINE, and CINAHL from January 1st 1996 to September 30th 2016 to retrieve eligible systematic reviews and surveys. Our primary outcome was the level of inconsistency between abstracts and corresponding full reports, which was expressed as a percentage (with a lower percentage indicating better reporting) or categorized rating (such as major/minor difference, high/medium/low inconsistency), as reported by the authors. We used medians and interquartile ranges to describe the level of inconsistency across studies. No quantitative syntheses were conducted. Data from the included systematic reviews or surveys was summarized qualitatively. RESULTS: Seventeen studies that addressed this topic were included. The level of inconsistency was reported to have a median of 39% (interquartile range: 14% - 54%), and to range from 4% to 78%. In some studies that separated major from minor inconsistency, the level of major inconsistency ranged from 5% to 45% (median: 19%, interquartile range: 7% - 31%), which included discrepancies in specifying the study design or sample size, designating a primary outcome measure, presenting main results, and drawing a conclusion. A longer time interval between conference abstracts and the publication of full reports was found to be the only factor which was marginally or significantly associated with increased likelihood of reporting inconsistencies. CONCLUSIONS: This scoping review revealed that abstracts are frequently inconsistent with full reports, and efforts are needed to improve the consistency of abstract reporting in the primary biomedical community.

UNETR++: Delving into Efficient and Accurate 3D Medical Image Segmentation.

Owing to the success of transformer models, recent works study their applicability in 3D medical segmentation tasks. Within the transformer models, the self-attention mechanism is one of the main building blocks that strives to capture long-range dependencies, compared to the local convolutional-based design. However, the self-attention operation has quadratic complexity which proves to be a computational bottleneck, especially in volumetric medical imaging, where the inputs are 3D with numerous slices. In this paper, we propose a 3D medical image segmentation approach, named UNETR++, that offers both high-quality segmentation masks as well as efficiency in terms of parameters, compute cost, and inference speed. The core of our design is the introduction of a novel efficient paired attention (EPA) block that efficiently learns spatial and channel-wise discriminative features using a pair of inter-dependent branches based on spatial and channel attention. Our spatial attention formulation is efficient and has linear complexity with respect to the input. To enable communication between spatial and channel-focused branches, we share the weights of query and key mapping functions that provide a complimentary benefit (paired attention), while also reducing the complexity. Our extensive evaluations on five benchmarks, Synapse, BTCV, ACDC, BraTS, and Decathlon-Lung, reveal the effectiveness of our contributions in terms of both efficiency and accuracy. On Synapse, our UNETR++ sets a new state-of-the-art with a Dice Score of 87.2%, while significantly reducing parameters and FLOPs by over 71%, compared to the best method in the literature. Our code and models are available at: https://tinyurl.com/2p87x5xn.

How to optimize the systematic review process using AI tools.

Systematic reviews are a cornerstone for synthesizing the available evidence on a given topic. They simultaneously allow for gaps in the literature to be identified and provide direction for future research. However, due to the ever-increasing volume and complexity of the available literature, traditional methods for conducting systematic reviews are less efficient and more time-consuming. Numerous artificial intelligence (AI) tools are being released with the potential to optimize efficiency in academic writing and assist with various stages of the systematic review process including developing and refining search strategies, screening titles and abstracts for inclusion or exclusion criteria, extracting essential data from studies and summarizing findings. Therefore, in this article we provide an overview of the currently available tools and how they can be incorporated into the systematic review process to improve efficiency and quality of research synthesis. We emphasize that authors must report all AI tools that have been used at each stage to ensure replicability as part of reporting in methods.

Advancements in TiO2-based photocatalysis for environmental remediation: Strategies for enhancing visible-light-driven activity.

Researchers have focused on efficient techniques for degrading hazardous organic pollutants due to their negative impacts on ecological systems, necessitating immediate remediation. Specifically, TiO2-based photocatalysts, a wide-bandgap semiconductor material, have been extensively studied for their application in environmental remediation. However, the extensive band gap energy and speedy reattachment of electron (e-) and hole (h+) pairs in bare TiO2 are considered major disadvantages for photocatalysis. This review extensively focuses on the combination of semiconducting photocatalysts for commercial outcomes to develop efficient heterojunctions with high photocatalytic activity by minimizing the e-/h+ recombination rate. The improved activity of these heterojunctions is due to their greater surface area, rich active sites, narrow band gap, and high light-harvesting tendency. In this context, strategies for increasing visible light activity, including doping with metals and non-metals, surface modifications, morphology control, composite formation, heterojunction formation, bandgap engineering, surface plasmon resonance, and optimizing reaction conditions are discussed. Furthermore, this review critically assesses the latest developments in TiO2 photocatalysts for the efficient decomposition of various organic contaminants from wastewater, such as pharmaceutical waste, dyes, pesticides, aromatic hydrocarbons, and halo compounds. This review implies that doping is an effective, economical, and simple process for TiO2 nanostructures and that a heterogeneous photocatalytic mechanism is an eco-friendly substitute for the removal of various pollutants. This review provides valuable insights for researchers involved in the development of efficient photocatalysts for environmental remediation.

ChatGPT: Transcending Language Limitations in Scientific Research Using Artificial Intelligence.

Health and scientific researchers in non-English speaking countries such as Pakistan, are not proficient in English, which limits their ability to communicate their ideas and findings to the international scientific community. ChatGPT is a large language model that can help non-native English speakers to write high-quality scientific papers much faster by assisting them in conveying their ideas in a clear and understandable manner, as well as avoiding common language errors. In fact, ChatGPT has already been used in publication of research papers, literature reviews, and editorials. However, it is imperative to recognise that ChatGPT is still in its early stages, thus, it is important to recognise its limitations. It is suggested that ChatGPT should be employed to complement writing and reviewing tasks but should not be relied on to generate original content or perform essential analysis, as it cannot replace human expertise, contextual knowledge, experience, and intelligence. Researchers should exercise caution and thoroughly scrutinise the generated text for accuracy and plagiarism before incorporating it into their work. Key Words: Artificial intelligence, ChatGPT, Health research, Scientific research.

Facial flow line and its effect on dental midline deviation on a female subject in an Asian population - A cross-sectional study.

INTRODUCTION: This study aims to understand the relationship between midline deviations and the inherent asymmetry that can be observed in a human face. MATERIALS AND METHODS: A cross-sectional study was conducted using a frontal smile photograph of a female which was altered on Adobe Photoshop software version 23.0 into eight different photographs by deviating the dental midlines by 2 mm, 4 mm, and 6 mm towards and away from the facial flow line (FFL). 4 mm of chin deviation was incorporated in all the pictures except for the first picture in which the midline and chin were kept symmetric. Orthodontic residents evaluated those photographs on an interrupted visual analogue scale (VAS) with 0 being the least attractive and 10 being the most. Simple linear regression was applied to observe factors associated with VAS score. RESULTS: Highest score was observed for picture with midline and chin on (MLCon) with a score of 9.4 ± 0.7, followed by picture with midline on and chin deviated (MLon) 8.7 ± 0.8. The deviations towards green zone received higher scores in comparison to deviations towards red zone. Linear regression revealed highly statistically significant differences between the constant and the rest of the pictures. CONCLUSIONS: The formation of green and red zones by the FFL influences the perception of midline deviation as judged by orthodontic residents. Midline when deviated towards the green zone, was judged to be more aesthetic than when shifted towards the red zones.

Comparison of mesiodistal root angulation of teeth by conventional panoramic and cone beam computed tomography images - A cross-sectional study.

INTRODUCTION: Accurate bracket positioning is required for proper root parallelism and for stable orthodontic treatment outcomes. This study aimed to determine the difference in mesiodistal root angulation of teeth measured on three radiographic images. MATERIAL AND METHODS: A cross-sectional study was conducted using orthopantomogram (OPG), panoramic images of cone beam computed tomography (Pan-CBCT) and cone beam computed tomography (CBCT). An occlusal plane was constructed in OPG and Pan-CBCT for angular measurements. The axial and sagittal views were used for assessing the mesiodistal root angulation on CBCT. Mesiodistal root angulation differences among three radiographs were assessed using the Kruskal-Wallis test. Mann-Whitney U test was applied for pairwise comparison and multinomial logistic regression was used to determine the association of sexual dimorphism with the direction of root angulation. RESULTS: On comparing the mesiodistal root angulation in degrees (DE) among all three groups, upper right (UR2) and left lateral incisors (UL2) were found to be statistically significant with P=0.033 and P=0.050 respectively. On pair-wise comparison, we found a statistically significant difference for upper right lateral incisor (UR2) between OPG and Pan-CBCT (P=0.045). Upper left lateral (UL2) (P=0.024) was significant in OPG and Pan-CBCT while upper left first molar (UL6) (P=0.043) in OPG and CBCT group. On comparing the sexual dimorphism in the direction of root angulation, females showed a greater tendency of mesial root angulation (5.62) times for upper right second premolar (UR5) as compared to males. CONCLUSIONS: There were no significant difference in mesiodistal root angulation between panoramic CBCT and CBCT images. The angulation of the upper lateral incisors was found to be significant between OPG and panoramic CBCT images, whereas the angulation of the upper right lateral incisors and left first molars was significant between OPG and CBCT images. In terms on sexual dimorphism, females showed greater mesial angulation of teeth than males.

Macroalgal biochar synthesis and its implication on membrane fouling mitigation in fluidized bed membrane bioreactor for wastewater treatment.

The intensification of biochar into fluidized bed membrane bioreactor was investigated to mitigate membrane fouling. Different biochars from algal biomass were produced and used as biomaterials for wastewater treatment. In this study, different macroalgal biochar was synthesized at different pyrolysis temperatures and characterized using Scanning Electron Microscopy (SEM), X-ray Diffraction (XRD), Brunauer Emmett-Teller (BET) and Fourier transform infrared spectroscopy (FTIR) techniques to implicate their effect on membrane fouling reduction in fluidized bed membrane bioreactor. The combined effect of macroalgal biochars and biocarriers with gas sparging was evaluated for fouling mitigation. Macroalgal biochar curtailed membrane fouling effectively at low gas sparging rate. Transmembrane pressure (TMP) was reduced to 0.053 bar; under the fluidization of biochar-650 and biocarriers with gas sparging; from 0.27 bar (gas sparging only). Combined effect of gas sparging, biocarriers and biochar-650 instigated 92.1% fouling reduction in comparative to gas sparging alone. Mechanical scouring driven by biocarriers could reduce fouling due to removing surface deposit of foulants from membrane surface effectively and biochar can efficiently adsorb foulants because of its active functional groups resulting in reduction of colloidal fouling. The addition of divalent ions (Ca2+) further enhanced the fouling reduction in fluidized bed membrane bioreactor.

Pharmacotherapy of impulse control disorders: A systematic review.

There are currently no evidence-based treatment recommendations for impulse control disorders, which include intermittent explosive disorder (IED), kleptomania and pyromania. Therefore, this systematic review sought to identify all randomized controlled trials (RCTs) that investigated pharmacological treatments for impulse control disorders, to evaluate their efficacy and tolerability. Searches were conducted within MEDLINE, PsychINFO, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Eight studies were included, six investigated pharmacotherapies for IED, while two investigated management for kleptomania. For the treatment of IED, oxcarbazepine and fluoxetine were the most efficacious. Importantly, divalproex was not superior to placebo in decreasing IED symptoms and was associated with significant adverse effects. In the treatment of kleptomania, only naltrexone was effective. The existing data suggest that the pharmacological treatment for impulse control disorders is an understudied area of psychiatry. Much of the current research on impulse control disorders focuses on management with anticonvulsants and antidepressants. Further studies conducted on these interventions in this population may yield promising results.

A Primer on the Game Theory Behind the National Resident Matching Program for the Medical Educator and Student.

Every year, medical students vie for American graduate training through the National Resident Matching Program (NRMP). Some students yet behave in ways that imply persistent misunderstandings about the matching algorithm. This paper explains the economic and mathematical literature underpinning it for a medical audience. The NRMP implements the Roth-Peranson algorithm, finding a stable match by having students propose to residency programs according to their preference ranking. This configuration favors students while disfavoring hospitals. Game-theoretic analysis shows us that students are unequivocally unable to "game the system" by misstating their preferences. Telling the truth is the optimal strategy.

Correction to: A Primer on the Game Theory Behind the National Resident Matching Program for the Medical Educator and Student.

[This corrects the article DOI: 10.1007/s40670-020-00955-8.].

Anaerobic membrane bioreactors for wastewater treatment: Novel configurations, fouling control and energy considerations.

Water shortage, public health and environmental protection are key motives to treat wastewater. The widespread adoption of wastewater as a resource depends upon development of an energy-efficient technology. Anaerobic membrane bioreactor (AnMBR) technology has gained increasing popularity due to their ability to offset the disadvantages of conventional treatment technologies. However there are several hurdles, yet to climb over, for wider spread and scale-up of the technology. This paper reviews fundamental aspects of anaerobic digestion of wastewater, and identifies the challenges and opportunities to the further development of AnMBRs. Membrane fouling and its implications are discussed, and strategies to control membrane fouling are proposed. Novel AnMBR configurations are discussed as an integrated approach to overcome technology limitations. Energy demand and recovery in AnMBRs is analyzed. Finally key issues that require urgent attention to facilitate global penetration of AnMBR technology are highlighted.

Management of Frailty: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.

OBJECTIVE: To analyze and determine the comparative effectiveness of interventions targeting frailty prevention or treatment on frailty as a primary outcome and quality of life, cognition, depression, and adverse events as secondary outcomes. DESIGN: Systematic review and network meta-analysis (NMA). METHODS: Data sources-Relevant randomized controlled trials (RCTs) were identified by a systematic search of several electronic databases including MEDLINE, EMBASE, CINAHL, and AMED. Duplicate title and abstract and full-text screening, data extraction, and risk of bias assessment were performed. Data extraction-All RCTs examining frailty interventions aimed to decrease frailty were included. Comparators were standard care, placebo, or another intervention. Data synthesis-We performed both standard pairwise meta-analysis and Bayesian NMA. Dichotomous outcome data were pooled using the odds ratio effect size, whereas continuous outcome data were pooled using the standardized mean difference (SMD) effect size. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA) for each outcome. The quality of evidence was evaluated using the GRADE approach. RESULTS: A total of 66 RCTs were included after screening of 7090 citations and 749 full-text articles. NMA of frailty outcome (including 21 RCTs, 5262 participants, and 8 interventions) suggested that the physical activity intervention, when compared to placebo and standard care, was associated with reductions in frailty (SMD -0.92, 95% confidence interval -1.55, -0.29). According to SUCRA, physical activity intervention and physical activity plus nutritional supplementation were probably the most effective intervention (100% and 71% likelihood, respectively) to reduce frailty. Physical activity was probably the most effective or the second most effective interventions for all included outcomes. CONCLUSION AND IMPLICATIONS: Physical activity is one of the most effective frailty interventions. The quality of evidence of the current review is low and very low. More robust RCTs are needed to increase the confidence of our NMA results and the quality of evidence.