Letter to editor: Minimally invasive tubular removal of spinal schwannoma and neurofibroma - a case series of 49 patients and review of literature.

The article on "Minimally invasive tubular removal of spinal schwannoma and neurofibroma - a case series of 49 patients and review of the literature" by Dr Argiti et al. in Neurosurgical Review journal. It is based on brief study of this article and also additional points from other references which elaborate it for further research.

Influence of dental midline deviation with respect to facial flow line on smile esthetics-A cross-sectional study.

BACKGROUND/OBJECTIVE: A contemporary concept states that dental midline deviation towards the direction of facial flow line (FFL) can mask the compromised smile esthetics. This study aimed to identify a range of midline deviations that can be perceived towards or away from the FFL influencing smile esthetics. MATERIALS AND METHODS: A cross-sectional study was conducted using a frontal smile photograph of an adult female. The photograph was altered on Adobe Photoshop software into six different photographs by deviating the dental midlines towards and away from the FFL. A constant deviation of chin towards the left side was incorporated in all the photographs. Forty-three laypersons (LP) and dental professionals (DPs) evaluated those photographs. Independent t-test was used to compare the perception of dental midline deviation between LP and DPs. Simple linear regression was run to identify the factors associated with the scoring. RESULTS: A statistically significant difference was observed for picture two with 4 mm towards FFL in the perception of midline deviation between LP and DPs. LP could not perceive the midline deviations up to 4 mm while DPs were able to perceive deviations above 2 mm. The greater the age the better the scores were and female raters had a greater inclination towards poor scores. CONCLUSIONS: From 2 to 4 mm of midline deviation towards the FFL can be tolerated by LP and DPs. CLINICAL SIGNIFICANCE: These findings underscore the importance of considering facial symmetry in orthodontic and cosmetic dental treatments to optimize smile esthetics.

Evaluation of user experience and satisfaction with workplace-based assessments (WPBAs) in dental postgraduate programmes.

Objectives: To explore the experience of and satisfaction with workplace-based assessment tools among dental postgraduate trainees. METHODS: The cross-sectional study was conducted from March to October 2022 at the Aga Khan University Hospital, Karachi, and comprised all Operative Dentistry, Prosthodontics and Orthodontics postgraduate trainees. A questionnaire with both open-ended and closed-ended questions was used to record the experiences and satisfaction level of the dental residents who had earlier been subjected to workplace-based assessment. Data was analysed using SPSS 20, while thematic analysis was used for open-ended questions. RESULTS: Of the 20 Subjects, 15(75%) were females. Also, 11(55%) participants had received prior training for workplacebased assessment. There were 16(80%) residents who were satisfied with workplace-based assessment tools in the dental residency programme, 15(75%) agreed that the tools improved their clinical skills and helped them identify their weak areas, all the 20(100%) participants said the feedback given to them was constructive, 18(90%) reported that they were allowed to put in their views. However, 7(35%) participants reported that being observed adversely affected their performance. CONCLUSIONS: Dental residents generally gave positive feedback related to workplace-based assessment tools in a clinical setting.

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.

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.

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.

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.