Therapeutic effect of long-acting muscarinic antagonist for treating uncontrolled asthma assessed using impulse oscillometry.

BACKGROUND: In recent years, the incorporation of LAMAs into asthma therapy has been expected to enhance symptom control. However, a significant number of patients with asthma continue to experience poorly managed symptoms. There have been limited investigations on LAMA-induced airway alterations in asthma treatment employing IOS. In this study, we administered a LAMA to patients with poorly controlled asthma, evaluated clinical responses and respiratory function, and investigated airway changes facilitated by LAMA treatments using the IOS. METHODS: Of a total of 1282 consecutive patients with asthma, 118 exhibited uncontrolled symptoms. Among them, 42 switched their treatment to high-dose fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) (ICS/LABA/LAMA). The patients were then assessed using AHQ-33 or LCQ and ACT. Spirometry parameters (such as FEV1 or MMEF) and IOS parameters (such as R20 or AX) were measured and compared before and after exacerbations and the addition of LAMA. RESULTS: Of the 42 patients, 17 who switched to FF/UMEC/VI caused by dyspnea exhibited decreased pulmonary function between period 1 and baseline, followed by an increase in pulmonary function between baseline and period 2. Significant differences were observed in IOS parameters such as R20, R5-R20, Fres, or AX between period 1 and baseline as well as between baseline and period 2. Among the patients who switched to inhaler due to cough, 25 were classified as responders (n = 17) and nonresponders (n = 8) based on treatment outcomes. Among nonresponders, there were no significant differences in spirometry parameters such as FEV1 or PEF and IOS parameters such as R20 or AX between period 1 and baseline. However, among responders, significant differences were observed in all IOS parameters, though not in most spirometry parameters, between period 1 and baseline. Furthermore, significant differences were noted between baseline and period 2 in terms of FEV1, %MMEF, %PEF, and all IOS parameters. CONCLUSION: ICS/LABA/LAMA demonstrates superiority over ICS/LABA in improving symptoms and lung function, which is primarily attributed to the addition of LAMA. Additionally, IOS revealed the effectiveness of LAMA across all airway segments, particularly in the periphery. Hence, LAMA can be effective against various asthma phenotypes characterized by airway inflammation, even in real-world cases.

Depth of reading within the gingival sulcus of seven intraoral scanners: an in vitro study.

AIM: The present in vitro study aimed to evaluate the depth of reading of intraoral scanners (IOSs) within the gingival sulcus. MATERIALS AND METHODS: A knife-edge preparation for a full crown was performed on a Frasaco model. The gingival sulcus of the scanned model was modified using a dedicated software program (Model Creator, exocad DentalCAD 2.4 Plovdiv) by setting the apical width (AW), coronal width (CW), and gingival sulcus depth (D). Two dental models with different gingival sulcus depths (1 or 2 mm) were printed using the digital light processing (DLP) technique. Each model was scanned 10 times. Seven different IOSs were used: Emerald, Trios 3, Carestream 3600, Dental Wings DWIO, CondorScan, True Definition Scanner (TDS), and Cerec Omnicam. Measurements of D values were performed using 3Shape 3D viewer software. The normality of the data distribution was evaluated using the Shapiro-Wilk test (P < 0.05). The nonparametric Levene's test was used to check for homoscedasticity. The data were statistically analyzed using the Kruskal-Wallis test (α = 0.05) and the Nemenyi test. RESULTS: All IOSs were able to read within the 1-mm-deep gingival sulcus, albeit with some statistically significant differences (P < 0.001). TDS and Trios 3 were able to read within the 2-mm-deep gingival sulcus (P < 0.001). CONCLUSIONS: The depth of reading of different IOSs can vary significantly. In the model with a 2-mm gingival sulcus, even in the absence of oral fluids, the depth of reading was incomplete, suggesting that deep preparations into the gingival sulcus are difficult to detect with IOSs.

Usefulness of simultaneous impulse oscillometry and spirometry with airway response to bronchodilator in the diagnosis of asthmatic cough.

Objective: Some of the most common causes of chronic cough include cough variant asthma (CVA), bronchial asthma (BA), and asthma-COPD overlap (ACO). Although there is some overlap in the etiology of these diseases, it is clinically important to attempt an early differential diagnosis due to treatment strategies and prognoses.Methods: Spirometry and impulse oscillometry (IOS) before and after bronchodilator inhalation were analyzed for clinically diagnosed CVA (cCVA, n = 203), BA (cBA, n = 222), and ACO (cACO, n = 61).Results: A significant difference in ΔFEV1 was observed between cBA and cCVA (ΔFEV1 improvement of 122.5 mL/5.4% and 65.7 mL/2.2%, respectively), but no difference was observed in ΔPEF, ΔV50, or ΔV25. Except for R20 (resistance at 20 Hz), significant differences between the three groups were observed in IOS. In IOS, cCVA and cBA showed comparable peripheral airway response to bronchodilator which was thought to be commensurate with changes in V50 and V25. cACO improved ΔFEV1 improvement of 81.0 mL/6.2% and was distinguished by a downward respiratory system reactance (Xrs) waveform with a limited bronchodilator response. FEV1/FVC, %FEV1, and %V25 had relatively strong correlations with the three IOS parameters, X5 (reactance at 5 Hz), resonant frequency (Fres), and low-frequency reactance area (ALX), in the correlation between IOS and spirometers.Conclusion: Changes in IOS parameters were more sensitive in this study than changes in FEV1 or the flow-volume curve. Considering the benefits and relevance of the two different tests, simultaneous IOS and spirometry testing were useful in the diagnosis of asthmatic cough.

Beyond forced exhalation: impulse oscillometry as a promising tool for bronchial hyperresponsiveness evaluation.

Introduction: The multiple forced expiratory maneuvers that must be performed during methacholine test require a high degree of collaboration and can lead to fatigue. However, impulse oscillometry (IOS) is a noninvasive test, quick and easy to perform, that does not require effort-dependent maneuvers.Objectives: The primary endpoint was to evaluate the relationship between IOS and spirometry during the methacholine test. The secondary endpoint was to study the predictive value of baseline IOS in the development of bronchial hyperreactivity.Methods: Observational, prospective, cross-sectional study, with recruitment of consecutive patients from the pulmonology department with clinical suspicion of bronchial asthma with negative bronchodilator test and normal FeNO.Results: Twenty-five patients were included, with a mean age of 49 ± 18 years. Thirteen patients (52%) had a positive methacholine test. The correlation between IOS indices and FEV1 was significant (p < 0.05) in all cases. The indices with the highest predictive power were R5-20 and AX. The optimal cutoff points were an increase of greater than 32.96% in R5, greater than 120.83% for X5, an increase of 30.30 [kPa l-1s-1] in R5-20, and an increase of 1.01 [kPa l-1] for AX. Baseline oscillometry demonstrated a strong predictive value in the development of bronchial hyperreactivity, with a sensitivity of 61.5% and a specificity of 91.7%, using the cut-off point of 160.0% for R5.Conclusions: IOS may be a valuable alternative to forced spirometry in detecting bronchial hyperreactivity during the methacholine test, showing a good correlation between both tests.

Short-term effect of particulate matter on lung function and impulse oscillometry system (IOS) parameters of chronic obstructive pulmonary disease (COPD) in Beijing, China.

OBJECTIVE: This study aimed to evaluate the associations between particulate matter (PM), lung function and Impulse Oscillometry System (IOS) parameters in chronic obstructive pulmonary disease (COPD) patients and identity effects between different regions in Beijing, China. METHODS: In this retrospective study, we recruited 1348 outpatients who visited hospitals between January 2016 and December 2019. Ambient air pollutant data were obtained from the central monitoring stations nearest the participants' residential addresses. We analyzed the effect of particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) exposure on lung function and IOS parameters using a multiple linear regression model, adjusting for sex, smoking history, education level, age, body mass index (BMI), mean temperature, and relative humidity . RESULTS: The results showed a relationship between PM2.5, lung function and IOS parameters. An increase of 10 µg/m3 in PM2.5 was associated with a decline of 2.083% (95% CI: -3.047 to - 1.103) in forced expiratory volume in one second /predict (FEV1%pred), a decline of 193 ml/s (95% CI: -258 to - 43) in peak expiratory flow (PEF), a decline of 0.932% (95% CI: -1.518 to - 0.342) in maximal mid-expiratory flow (MMEF); an increase of 0.732 Hz (95% CI: 0.313 to 1.148) in resonant frequency (Fres), an increase of 36 kpa/(ml/s) (95% CI: 14 to 57) in impedance at 5 Hz (Z5) and an increase of 31 kpa/(ml/s) (95% CI: 2 to 54) in respiratory impedance at 5 Hz (R5). Compared to patients in the central district, those in the southern district had lower FEV1/FVC, FEV1%pred, PEF, FEF75%, MMEF, X5, and higher Fres, Z5 and R5 (p < 0.05). CONCLUSION: Short-term exposure to PM2.5 was associated with reductions in lung function indices and an increase in IOS results in patients with COPD. The heavier the PM2.5, the more severe of COPD.

Technology Trends for Massive MIMO towards 6G.

At the dawn of the next-generation wireless systems and networks, massive multiple-input multiple-output (MIMO) in combination with leading-edge technologies, methodologies, and architectures are poised to be a cornerstone technology. Capitalizing on its successful integration and scalability within 5G and beyond, massive MIMO has proven its merits and adaptability. Notably, a series of evolutionary advancements and revolutionary trends have begun to materialize in recent years, envisioned to redefine the landscape of future 6G wireless systems and networks. In particular, the capabilities and performance of future massive MIMO systems will be amplified through the incorporation of cutting-edge technologies, structures, and strategies. These include intelligent omni-surfaces (IOSs)/intelligent reflecting surfaces (IRSs), artificial intelligence (AI), Terahertz (THz) communications, and cell-free architectures. In addition, an array of diverse applications built on the foundation of massive MIMO will continue to proliferate and thrive. These encompass wireless localization and sensing, vehicular communications, non-terrestrial communications, remote sensing, and inter-planetary communications, among others.

Non-Invasive Disease Specific Biomarker Detection Using Infrared Spectroscopy: A Review.

Many life-threatening diseases remain obscure in their early disease stages. Symptoms appear only at the advanced stage when the survival rate is poor. A non-invasive diagnostic tool may be able to identify disease even at the asymptotic stage and save lives. Volatile metabolites-based diagnostics hold a lot of promise to fulfil this demand. Many experimental techniques are being developed to establish a reliable non-invasive diagnostic tool; however, none of them are yet able to fulfil clinicians' demands. Infrared spectroscopy-based gaseous biofluid analysis demonstrated promising results to fulfil clinicians' expectations. The recent development of the standard operating procedure (SOP), sample measurement, and data analysis techniques for infrared spectroscopy are summarized in this review article. It has also outlined the applicability of infrared spectroscopy to identify the specific biomarkers for diseases such as diabetes, acute gastritis caused by bacterial infection, cerebral palsy, and prostate cancer.

ESMira: A decentralized open-source application for collecting experience sampling data.

This paper introduces ESMira, a server and mobile app (Android, iOS) developed for research projects using experience sampling method (ESM) designs. ESMira offers a very simple setup process and ease of use, while being free, decentralized, and open-source (source code is available on GitHub). The ongoing development of ESMira started in early 2019, with a focus on scientific requirements (e.g., informed consent, ethical considerations), data security (e.g., encryption), and data anonymity (e.g., completely anonymous data workflow). ESMira sets itself apart from other platforms by both being free of charge and providing study administrators with full control over study data without the need for specific technological skills (e.g., programming). This means that study administrators can have ESMira running on their own webspace without needing much technical knowledge, allowing them to remain independent from any third-party service. Furthermore, ESMira offers an extensive list of features (e.g., an anonymous built-in chat to contact participants; a reward system that allows participant incentivization without breaching anonymity; live graphical feedback for participants) and can deal with complex study designs (e.g., nested time-based sampling). In this paper, we illustrate the basic structure of ESMira, explain how to set up a new server and create studies, and introduce the platform's basic functionalities.

Performance of the caries diagnosis feature of intraoral scanners and near-infrared imaging technology-A narrative review.

PURPOSE: To describe and discuss the benefits and drawbacks of various dental caries diagnostic techniques, including the use of intraoral scanners for caries diagnosis based on near-infrared imaging (NIR) technology. MATERIAL AND METHODS: A MEDLINE search from 1980-2023 focused on dental caries diagnostic techniques, emphasizing intraoral scanners using NIR technology. Alternative caries detection methods were also evaluated for their advantages and limitations, enabling a comparison with NIR. The review included traditional caries tools, the latest detection methods, and NIR's role in intraoral scanners, drawing from case reports and both in vivo and in vitro studies. Keywords like "caries detection," "intraoral scanners," and "Near Infrared Imaging (NIRI)" guided the search. After screening titles and abstracts for relevance, full texts with valuable insights were thoroughly analyzed. The data was grouped into three: traditional diagnostics, advanced digital methods, and intraoral scanner-based detection. RESULTS: This comprehensive narrative review described and discussed the current state of dental caries diagnostic methods, given the insufficient number of clinical investigations suitable for a systematic review. Traditional caries diagnosis techniques have shown variable accuracy dependent on a dentist's experience and the potential over-removal of healthy tooth structures. Intraoral scanners have emerged as a novel caries detection method, because of their integration of NIR technology. Various studies have confirmed the efficacy of NIR in detecting interproximal caries and in the early diagnosis of non-cavitated caries. Specifically, intraoral scanners have demonstrated promising results, proving comparable to established diagnostic methods like bitewing radiography. Nevertheless, while the integration of NIR into intraoral scanners seems promising, the technology still faces challenges, notably its accuracy in detecting secondary and subgingival cavities. However, with anticipated integrations of AI, NIR in intraoral scanners could revolutionize early caries detection. CONCLUSIONS: Intraoral scanners with NIR technology offer non-destructive imaging, real-time lesion visuals, and enhanced patient communication. Although comparable to bitewing radiography in some studies, a universally accepted diagnostic tool is lacking. Future research should compare them with existing methods, focusing on clinical outcomes, cost-effectiveness, and patient acceptance.

Long-term variability of impulse oscillometry and spirometry in stable COPD and asthma.

BACKGROUND: While optimizing spirometry is a challenge for lung function labs, long-term variability if any between IOS (impulse oscillometry) parameters and spirometry is not clearly known in stable COPD (chronic obstructive pulmonary disease) and chronic asthma. The forced oscillation technique is increasingly employed in routine lung function testing. Our aim in this study was to determine the variability in oscillometric parameters between clinic visits over weeks or months in two patient groups during a period of clinical stability. Moreover, the research assessed relationships between IOS parameters long-term variability and COPD severity. METHODS: We used data from 73 patients with stable COPD and 119 patients with stable asthma at the Shanghai Pulmonary Hospital Affiliated to Tongji University. Patients were included if they had three or more clinic visits where spirometry and IOS were performed during a clinically stable period. Data recorded from the first three visits were used. The standard deviation (SDbv), the coefficient of variation (COV), intraclass correlation coefficient (ICC) and the coefficient of repeatability (COR) were calculated, Wilcoxon Mann-Whitney test was used for data that did not conform to normality of distributions, Kruskal Wallis test was used to compare with multiple groups, post hoc comparison was analyzed by Bonferroni, Spearman correlation coefficients for non-parametric data, the multiple regression analyses to determine the relationship between long-term variability and airflow obstruction. RESULTS: (1) The repeatability of IOS resistance parameters with ICC values > 0.8 was high in COPD and asthma. ICC values of IOS resistance parameters were higher than IOS reactance parameters; (2) the repeatability of spirometry parameters with ICC values < 0.8 was lower than IOS resistance parameters in different GOLD (the Global Initiative for Chronic Obstructive Lung Disease) stages, the higher the stage the worse the repeatability; (3) the severity of airflow obstruction was correlated with long-term variability of R5 (R at 5 Hz) (P < 0.05) in GOLD4, not with long-term variability of R20 (R at 20 Hz) (P > 0.05) and R5-R20 (P > 0.05). CONCLUSION: IOS resistance parameters have good long-term repeatability in asthma and COPD. Additionally, repeatability of spirometry parameters is lower than IOS resistance parameters in different GOLD stages.

Validation of a Market-Approved Artificial Intelligence Mobile Health App for Skin Cancer Screening: A Prospective Multicenter Diagnostic Accuracy Study.

BACKGROUND: Mobile health (mHealth) consumer applications (apps) have been integrated with deep learning for skin cancer risk assessments. However, prospective validation of these apps is lacking. OBJECTIVES: To identify the diagnostic accuracy of an app integrated with a convolutional neural network for the detection of premalignant and malignant skin lesions. METHODS: We performed a prospective multicenter diagnostic accuracy study of a CE-marked mHealth app from January 1 until August 31, 2020, among adult patients with at least one suspicious skin lesion. Skin lesions were assessed by the app on an iOS or Android device after clinical diagnosis and before obtaining histopathology. The app outcome was compared to the histopathological diagnosis, or if not available, the clinical diagnosis by a dermatologist. The primary outcome was the sensitivity and specificity of the app to detect premalignant and malignant skin lesions. Subgroup analyses were conducted for different smartphone types, the lesion's origin, indication for dermatological consultation, and lesion location. RESULTS: In total, 785 lesions, including 418 suspicious and 367 benign control lesions, among 372 patients (50.8% women) with a median age of 71 years were included. The app performed at an overall 86.9% (95% CI 82.3-90.7) sensitivity and 70.4% (95% CI 66.2-74.3) specificity. The sensitivity was significantly higher on the iOS device compared to the Android device (91.0 vs. 83.0%; p = 0.02). Specificity calculated on benign control lesions was significantly higher than suspicious skin lesions (80.1 vs. 45.5%; p < 0.001). Sensitivity was higher in skin fold areas compared to smooth skin areas (92.9 vs. 84.2%; p = 0.01), while the specificity was higher for lesions in smooth skin areas (72.0 vs. 56.6%; p = 0.02). CONCLUSION: The diagnostic accuracy of the mHealth app is far from perfect, but is potentially promising to empower patients to self-assess skin lesions before consulting a health care professional. An additional prospective validation study, particularly for suspicious pigmented skin lesions, is warranted. Furthermore, studies investigating mHealth implementation in the lay population are needed to demonstrate the impact on health care systems.

Do the Right Thing: A Privacy Policy Adherence Analysis of over Two Million Apps in Apple iOS App Store.

Mobile app developers are often obliged by regulatory frameworks to provide a privacy policy in natural comprehensible language to describe their apps' privacy practices. However, prior research has revealed that: (1) not all app developers offer links to their privacy policies; and (2) even if they do offer such access, it is difficult to determine if it is a valid link to a (valid) policy. While many prior studies looked at this issue in Google Play Store, Apple App Store, and particularly the iOS store, is much less clear. In this paper, we conduct the first and the largest study to investigate the previous issues in the iOS app store ecosystem. First, we introduce an App Privacy Policy Extractor (APPE), a system that embraces and analyses the metadata of over two million apps to give insightful information about the distribution of the supposed privacy policies, and the content of the provided privacy policy links, store-wide. The result shows that only 58.5% of apps provide links to purported privacy policies, while 39.3% do not provide policy links at all. Our investigation of the provided links shows that only 38.4% of those links were directed to actual privacy policies, while 61.6% failed to lead to a privacy policy. Further, for research purposes we introduce the App Privacy Policy Corpus (APPC-451K); the largest app privacy policy corpus consisting of data relating to more than 451K verified privacy policies.

Potential of intraoral optical scanning to evaluate motor skills' improvement for tooth preparation: A prospective cohort study.

INTRODUCTION: This prospective cohort study investigated the potential of digital assessment using intraoral scanning (IOS) combined with software analysis (prepCheck) to evaluate the outcome of repetitive tooth preparation and its influence on the acquisition of motor skills in dental students. MATERIALS AND METHODS: Twenty-six students completed 177 full-crown preparations of the same tooth in six practice sessions followed by a final examination. Preparations were assessed digitally using prepCheck and conventionally by calibrated faculty instructors. In addition, students assessed their own performance and this was compared with the instructors' assessments. RESULTS: Conventional assessment showed that students preparations improved over time, with 43.5% of students receiving score 2 (highest grade) at the fifth practice session. With the prepCheck assessment, statistically significant improvements indicated by an enlarged area within the tolerance range set at 0.2 mm were found between the first and the second practice session (7.5% improvement; 95% CI: 2.2%, 12.7%, p = 0.006), and between the first run and the final exam preparation (6.7%; 95% CI: 1.7%, 12.5%, p = 0.011). Agreement between instructor/student assessments was best immediately after students received visual feedback using prepCheck (76% agreement; Spearman's rho 0.78). CONCLUSION: These data indicate that IOS technology was useful for student's self-evaluation by visual feedback.

Small airway dysfunction and poor asthma control: a dangerous liaison.

Asthma is a common chronic condition, affecting approximately 339 million people worldwide. The main goal of the current asthma treatment guidelines is to achieve clinical control, encompassing both the patient symptoms and limitations and the future risk of adverse asthma outcomes. Despite randomized controlled trials showing that asthma control is an achievable target, a substantial proportion of asthmatics remain poorly controlled in real life. The involvement of peripheral small airways has recently gained greater recognition in asthma, and many studies suggest that the persistent inflammation at these sites leads to small airway dysfunction (SAD), strongly contributing to a worse asthma control. Overall, the impulse oscillometry (IOS), introduced in the recent years, seems to be able to sensitively assess small airways, while conventional spirometry does not. Therefore, IOS may be of great help in characterizing SAD and guiding therapy choice. The aim of this article is to review the literature on SAD and its influence on asthma control, emphasizing the most recent evidence.

Trueness and Precision Achieved With Conventional and Digital Implant Impressions: A Comparative Investigation of Stone Versus 3-D Printed Master Casts.

OBJECTIVE: To analyze implant casts obtained from intraoral optical scanning and conventional impressions. MATERIALS AND METHODS: Ten optical scans (test) and ten conventional polyether impressions (control) were obtained from a two-implant reference model. Ten casts each were manufactured additively or from stone. All casts were digitized and virtually superimposed to the digital reference (trueness) applying a best-fit algorithm, and secondary analysis for intra-group comparisons (precision). The signed nearest neighbor distance of each surface point (FDI:24/26) was computed and deviations of the three-dimensional vectors (X,Y,Z) analyzed. The groups were compared with the Wilcoxon's rank sum test. RESULTS: The printed casts had mean deviations of 106.0µm and the stone casts 187.9µm compared to the reference. Controls had significantly higher deviations and dispersion (p⟨0.001). The printed casts showed mean intra-group deviations of 149.8µm and the stone casts 181.2µm without significant differences (p=0.162). There was no statistically significant difference in any of the vector analyses (X:p=0.105, Y:p=0.089, Z:p=0.123). CONCLUSION: Optical scanning seems to be an alternative to conventional impressions in terms of trueness and precision of implant master casts, simulating the scenario of a three-unit implant-supported fixed dental prosthesis. Digitally manufactured master casts might serve as reliable reference for the final restorations.

What are we saving? Tracing governing knowledge and truth discourse in global COVID-19 policy responses.

As the world went suddenly into lockdown due to the COVID-19 pandemic, sending individuals to their homes and shutting businesses and institutions, the closing of schools posed big problems. The majority of the world's children were out of school, leading to the longest sustained period of school closures in history. We saw educators turning towards responses not aimed at collegial and community-engaged strategies for education in an emergency but at online learning cast as education/business as usual. This study explores the logic driving this global response through analyses of the documents released by three key global education actors: (1) the OECD and its paper A Framework to Guide Education Response to the COVID-19 Pandemic of 2020; (2) UNESCO's Global Education Coalition #LearningNeverStops; and (3) the World Bank's Guidance Note on Education Systems' Response to COVID-19; and Guidance Note: Remote Learning and COVID-19. The authors of this article draw on Carol Bacchi's approach to poststructural policy analysis to make visible the key concepts and binaries used within policy texts and to understand the "technologies of saving" that were invoked in each policy response, locating the education programmes, activities and actors within knowledge practices in educational reform. This article explores the World Bank, OECD and UNESCO responses using an analysis of knowledge harmonisation and difference among these institutions as well as their location as key norm-setters and governing actors in the field of education. The authors argue that all three responses privilege private-sector providers of digital technology. The consequence of these responses is that technologies of saving have centred on privatised, corporate edu-business and edu-tech aimed at online education delivery, bringing significant risks for the erasure of local knowledges. The authors' study suggests that local policymakers, including community-based and national actors, must be invited into the discussion to envision other possibilities and to name the potential destructiveness embedded in the international organisations' actions.

Que sauvons-nous ? Sur la piste du savoir dominant et du discours de vérité dans les réponses politiques mondiales à la COVID-19 ­ Quand le monde s'est brusquement confiné à cause de la COVID-19, renvoyant les gens chez eux et fermant entreprises et institutions, la fermeture des écoles a posé de gros problèmes. La majeure partie des enfants dans le monde se sont retrouvés hors des établissements scolaires, ce qui s'est traduit par la plus longue période de fermeture des écoles de toute l'histoire. Nous avons vu des pédagogues se tourner vers des réponses qui ne visaient pas à trouver des stratégies éducatives collégiale et axées sur la communauté dans une situation d'urgence mais à simplement adopter une forme d'apprentissage en ligne pour continuer d'enseigner comme d'habitude. Cette étude se penche sur la logique qui sous-tend cette réponse globale en analysant les documents publiés par trois acteurs clés de l'éducation : (1) Un cadre pour guider une réponse éducative à la Covid-19 en cas de pandémie de 2020 de l'OCDE; (2) la Coalition mondiale pour l'éducation #ContinuitePedagogique de l'UNESCO et (3) deux notes d'orientation de la Banque mondiale : Note d'orientation sur la riposte des systèmes éducatifs au COVID19 et Note d'orientation mise à jour:Apprentissage à distance et COVID-19. Les auteures de cet article s'inspirent de l'approche analytique de la politique poststructurelle de Carol Bacchi pour mettre en relief les concepts clés et les binaires utilisés dans les textes politiques, et pour comprendre les « technologies de l'économie ¼ invoquées dans toutes les réponses politiques, situant les programmes, les activités et les acteurs de l'éducation dans des pratiques du savoir en réforme éducative. Cet article examine les réponses de la Banque mondiale, de l'OCDE et de l'UNESCO en recourant à une analyse de l'harmonisation du savoir et des différences au sein de ces organismes ainsi que leur position en tant que décideurs clés qui imposent des normes et acteurs déterminants dans le secteur de l'éducation. Les auteures affirment que les trois réponses privilégient les fournisseurs de technologie numérique du secteur privé. En conséquence, les technologies de l'économie se sont focalisées sur un entrepreneuriat et une technologie privatisés en vue de proposer des services éducatifs en ligne, ce qui met considérablement en danger les savoirs locaux risquant ainsi d'être effacés. L'étude des auteures indique que les politiques locaux, y compris les acteurs communautaires et nationaux, doivent être invités à prendre part au débat afin d'envisager d'autres possibilités et dénoncer le pouvoir destructeur potentiel que recèlent les actions des organisations internationales.

Internet/smartphone-based applications for the treatment of tinnitus: a systematic review.

INTRODUCTION: Most of the individuals suffering from tinnitus report of negative effects on their lives to the extent that clinical intervention is necessary. Although traditional tinnitus management has proven to be effective in treating tinnitus, there are a few drawbacks. The major drawback is the lack of professionals for the treatment of tinnitus, especially in remote areas. Considering the growing usage of the internet as a platform for availing treatment, there is a requirement for the development of applications in the health care sector. Recent search related to tinnitus treatment revealed that more than 200 applications are available online in the most popular platforms like Android and iOS. However, most of the applications for the treatment of tinnitus lack validation, and thus, there is a need for research on this ground. METHOD: Five studies evaluating the efficacy of Internet/app delivered tinnitus treatments were identified. The treatment forms included were Tinnitus E-program, Mobile serious game, Tinnitus web-based sound therapy, and Tailor-made notch music therapy delivered through a smart phone. RESULTS: Each study used a variety of standardized and validated questionnaires to measure the outcome of the treatment. The outcome measures were diverse, but both Internet/app-based and traditional methods like Tinnitus Retraining Therapy, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy had similar improvements in terms of tinnitus distress and quality of life. CONCLUSION: It can be construed that the development of tinnitus treatment applications and web-based platforms will have a significant impact on the normal life of individuals with tinnitus.

Influence of intraoral scanning on the quality of preparations for all-ceramic single crowns.

OBJECTIVES: To evaluate the influence of intraoral scanning on the quality of preparations for all-ceramic single crowns. MATERIAL AND METHODS: A total of 690 randomly selected and anonymized in vivo single crown preparations were examined. Three hundred twenty-three preparations were directly recorded with an intraoral scanner (group IS). Data from plaster casts digitized by a laboratory scanner (group ID; N = 367) served as control. Comparisons included convergence angle, marginal design, marginal substance reduction, homogeneity of the finish line, and undercuts. Evaluation was performed using fully automated specialized software. Data were analyzed applying Kolmogorov-Smirnov, Mann-Whitney U test, and Fisher's exact test. Level of significance was set at p < 0.05. RESULTS: Convergence angle was above optimum in both groups, but significantly larger for group IS (p < 0.001). Marginal design was more ideal in group IS concerning the absence of featheredge design (p < 0.001) and reverse bevel (p = 0.211). Marginal substance reduction was closer to prerequisites for all-ceramic restorations in group IS (p < 0.001). Finish lines were more homogeneous in group IS regarding the uniformity of their course (p < 0.001). Undercuts were more frequently found in group ID than in group IS (p < 0.001). CONCLUSIONS: Intraoral scanning of prepared teeth has positive impact on the quality of preparations for all-ceramic single crowns regarding marginal substance reduction, marginal design, homogeneity of the finish line, and undercuts. CLINICAL RELEVANCE: Accurate preparation design represents a fundamental condition for success of ceramic crowns. Since there is potential for optimization, intraoral scanning might enhance preparation quality providing instant visual feedback.

Mobile MIM: a Portable Solution in Imaging.

Clinicians experience various situations, such as peer consultation or tumor boards, in which they need to access and view radiologic studies without a full radiologic workstation. Mobile MIM is a diagnostic medical imaging device on the Apple App Store that is FDA-approved and can meet the portable needs of clinicians. The goal of the app is to give physicians the opportunity to visualize scans from multiple modalities on a single iOS mobile device. The intended uses include reviewing complex aspects of radiation treatment plans and analyzing medical images from a wide array of modalities. The key limitation is incompatibility for mammography. The free app allows users to manipulate image sets from ten sample patients before an organization can commit to extensive systems integration with MIMcloud 2.0 to store, encrypt, and route image sets for real-time patients. This review explores the app's strengths and weaknesses through discussion of its features and usability.

So You Want to Develop an App for Radiology Education? What You Need to Know to Be Successful.

Apple changed the communications landscape with its 2007 introduction of the iPhone. In little more than a decade, most Americans have become smartphone owners. With more than 200,000 applications (apps) for education available in the Apple App Store, we can infer that many smartphone owners use their devices to learn. Several surveys of medical students reveal that apps do indeed enhance clinical knowledge and provide comparable training with textbooks. We launched our first iOS app, the CTisus iQuiz, in 2010 in response to the growing number of portable devices, and with an intention to grow alongside technology. We now have 17 apps available for free on the App Store, and present tips here on how to successfully develop apps for radiology education. Furthermore, we detail the steps necessary to advertise a new app and use analytics to assess how the app is performing. Generating apps for radiology can play an important role in continuing education. As the medical and education fields are integrating increasingly with technology, it is essential that we use technology to reach and interact with its users. Creating iOS applications and using analytics to understand how they meet the goals of the developer can expand the reach of the medical and education communities and render information more accessible on mobile devices on a large scale.