Delivering oral healthcare to asylum seekers and refugees: A mixed-methods service evaluation of charitable mobile dental clinics in England.

Is laparoscopic treatment of endometriosis better?

To evaluate the effects of a postsurgical rehabilitation program on employment status 2 years after temporal lobe epilepsy surgery in relation to other predictors. Employment outcome 2 years after temporal lobe resection in a group of 232 adult patients with the offer of a 3-week inpatient rehabilitation program immediately after surgery ("Reha group") was compared to a group of 119 patients who had surgery before such a rehabilitation program existed. One hundred thirty-nine (59.9%) of the Reha group patients attended the rehabilitation program. Further predictors for employment outcome were analyzed using multivariate logistic regression analysis. Preoperatively, the groups did not differ significantly in variables relevant for employment, including employment rate. Two years after surgery, the rate of those not being employed had decreased in the Reha group from 38.4% to 27.6% (p < 0.001, McNemar test), and slightly increased in the control group (37.8-42.0%; n.s.), resulting in a difference of 14.4% in favor of the Reha group (p = 0.008). General unemployment rates during the two observation periods were similar. In addition to the offer of rehabilitation support ("Reha group") and preoperative employment, the following other variables were shown as significant predictors of employment post surgery in multivariate regression analysis: seizure outcome, diagnosis of a personality disorder preoperatively, and age at surgery (all, p < 0.01; Nagelkerkes R(2) = 0.59). Independently from other factors, a 3-week inpatient rehabilitation program after temporal lobe epilepsy surgery seems to improve employment status 2 years after surgery.

To assess self-reported oral health perceptions and associated factors in an adult Somali population living in Minnesota, USA. We analysed data from a cross-sectional study of Somali adults aged 18 to 65+ years attending a dental school clinic for care. A comprehensive oral examination was performed by the dental school outreach team on all patients who attended a 2-week designated Somali dental clinic. Adults who consented were given an oral health questionnaire to collect information on sociodemographics, marital status, language preference and self-rated oral and general health. We performed summary statistics and differences between proportions using Fisher's exact test and a comparison of means using one-way anova or a two-sample t-test. The sample consisted of 53 adults, 75% of whom were females. About 49% of subjects reported poor/fair oral health and 38% reported poor/fair general health. Seventy-four percent rated their access to dental care as poor/fair and 83% reported that they did not have a regular source of dental care. Self-rated oral health was significantly associated with marital status (P < 0.05) and self-rated general health (P < 0.01) using Fisher's exact test. A substantial proportion of Somali adults rated their oral health and access to dental care as poor/fair. These findings suggest that this population would benefit from improved access to oral health care and culturally appropriate oral health education and promotion programs.

When analyzing a 2 x 2 table, the two-sided Fisher's exact test and the usual exact confidence interval (CI) for the odds ratio may give conflicting inferences; for example, the test rejects but the associated CI contains an odds ratio of 1. The problem is that the usual exact CI is the inversion of the test that rejects if either of the one-sided Fisher's exact tests rejects at half the nominal significance level. Further, the confidence set that is the inversion of the usual two-sided Fisher's exact test may not be an interval, so following Blaker (2000, Confidence curves and improved exact confidence intervals for discrete distributions. Canadian Journal of Statistics 28, 783-798), we define the "matching" interval as the smallest interval that contains the confidence set. We explore these 2 versions of Fisher's exact test as well as an exact test suggested by Blaker (2000) and provide the R package exact2x2 which automatically assigns the appropriate matching interval to each of the 3 exact tests.

Misuse of methamphetamine types can cause dental and oral health problems such as meth mouth, xerostomia, periodontitis and so on. Meanwhile, based on the 2018 BNN survey, cases of methamphetamine abuse in Indonesia are still relatively high. The high level of dental and oral health problems in shabu addicts can also be caused by a lack of knowledge and behavior in maintaining dental and oral health. Therefore, this study aims to determine the level of knowledge and behavior as well as the relationship between the level of knowledge of dental and oral health with brushing behavior in former users of methamphetamine.&#x0D; This study is an analytical study using a cross-sectional design. Data was collected by distributing questionnaires containing closed-ended questions regarding dental and oral health and by observing tooth brushing behavior in 40 respondents who were undergoing rehabilitation at the Cakra Sehati Foundation, Bandung. The analytical method used is the Fisher Exact test because there are cells with an expected value of less than 5. The results show that 92.3% of respondents have a level of knowledge of oral health and tooth brushing behavior in the poor category. Fisher's Exact statistical test showed that there was a relationship between the level of knowledge of oral health and tooth brushing behavior in former methamphetamine addicts at the Cakra Sehati Foundation, Bandung (p = 0.013 &lt; 0.05).

Systemic reactions during skin tests with β-lactams: A risk factor analysis

Barriers to pre-exposure prophylaxis (PrEP) access have limited its reach to priority populations. Community-based mobile clinics have potential to broaden PrEP engagement. We evaluated reach and persistence for fixed and mobile clinic cohorts in Miami-Dade County, Florida. This observational cohort study analysed data from 1896 clients engaged through our fixed or mobile clinic from August 2018 to March 2023. Services were offered at no cost to clients. The same staff and package of barrier-lowering strategies was deployed across fixed and mobile clinic sites. Chi-square and Fisher's exact test or the Kruskal-Wallis test were used to test for differences in characteristics across sites as well as across services sought. Kaplan-Meier curves were generated to evaluate persistence on PrEP and in care, defined as completion of at least one clinic visit (including PrEP prescribing, for PrEP persistence, or for any reason, for persistence in care) within 24 weeks of the prior visit. Cox proportional hazards models were used to evaluate risk factors for discontinuation of PrEP or clinic care by 48 weeks by gender, race, ethnicity, insurance status and site. The fixed and mobile clinics reached 781 and 1109 clients, respectively, during the study period. The median client age was 35 years; the majority (70.4%) of clients were cisgender men, identified as Hispanic/Latino (62.5%) and were men who have sex with men (54.5%). The mobile clinic extended reach to a higher proportion of cisgender women (32.1% mobile vs. 12.9% for fixed clinic), Black clients (34.5% vs. 13.1%) and older clients (median 37 vs. 33 years) compared with the fixed setting. Uninsured individuals, men and those who initiated services in the mobile clinic were more likely to continue PrEP to 48 weeks (HR: 1.20, p = 0.01; HR: 2.02, p<0.01; HR: 1.68, p<0.01, respectively). Persistence did not differ by race or ethnicity. A mobile clinic strategy for PrEP engagement can increase reach to key populations underrepresented in HIV prevention care including cisgender women and Black clients. Persistence in PrEP was increased for the mobile clinic cohort, suggesting an additional benefit to this modality beyond other barrier-lowering strategies employed in our fixed and mobile clinics.

Increasing the diagnosis of multifocal primary breast cancer by the use of bilateral whole-breast ultrasound

The Endothelin-Converting Enzyme-1/Endothelin-1 Pathway Plays a Critical Role in Inflammation-Associated Premature Delivery in a Mouse Model

Decision letter: Identification of drugs associated with reduced severity of COVID-19 – a case-control study in a large population

This retrospective service evaluation considers the oral health of children with disabilities in post‐Soviet Lithuania. It identifies that they have extensive dental decay and that the predominant course of dental treatment for children with disabilities is tooth extraction under general anesthetic. There is little in the way of specialist service provision, preventative care, or oral health promotion for this group. This study adds to the literature by identifying and emphasizing the impact on oral health of the sweeping economic and political changes, the move toward deinstitutionalization, and new economic trends such as a market economy. In particular, the lack of social welfare support, high levels of child poverty, poor educational outcomes, and the privatization of the oral health‐care system has served to increase oral health inequity for marginalized groups. The outcome is an increase in oral health inequalities for children with disabilities and an urgent need for policy and reform.

Introduction: Mucinous (MBCs) and neuroendocrine breast carcinomas (NBCs) are special histologic types of estrogen receptor (ER)-positive breast cancers. Together, MBCs and NBCs account for approximately 5% of invasive breast cancers. NBCs are defined by the expression of neuroendocrine markers (i. e., chromogranin and/ or synaptophysin), whereas MBCs consist of nests of cancer cells floating in pools of extracellular mucin and can be either hypocellular/type A (MBC-A) or hypercellular/type B (MBC-B). MBC-B may display neuroendocrine differentiation. We compared the repertoire of somatic genetic alterations in MBCs-A and MBCs-B, and in NBCs, and evaluated whether they differ from ER-positive/ HER2-negative invasive ductal carcinomas of no special type (IDC-NSTs). Materials and methods: Reanalysis of the targeted capture or whole exome sequencing data of 22 MBCs (12 MBCs-A and 10 MBCs-B), and of 15 NBCs was performed. The BAM files were retrieved and somatic mutations were detected with MuTect, indels with Strelka, Varscan2, Scalpel and Lancet, and copy number alterations using FACETS. The mutational repertoire of MBCs-A and MCBs-B was compared to that of NBCs, and of ER-positive/ HER2-negative IDC-NSTs from The Cancer Genome Atlas (TCGA) breast cancer study (n=310). Results: The most frequently mutated genes in MBCs-A were SF3B1 and FRG1B (17%, each); in MBCs-B were GATA3 and KMT2C (30%, each), and in NBCs were FOXA1 and TBX3 (20%, each) and KMT2C (20%). No significant differences were observed in single gene comparisons between MBCs-A, MBCs-B and NBCs (Fisher's exact tests, p&amp;gt;0.05). When compared with ER-positive/HER2-negative IDC-NSTs from TCGA, NBCs harbored a higher frequency of mutations targeting FOXA1 (20% vs 2.9%, Fisher's exact test, p&amp;lt;0.05) and TBX3 (20% vs 2.9%, Fisher's exact test, p&amp;lt;0.05), and a lower frequency of TP53 mutations (0% vs 23.9%; Fisher's exact test, p&amp;lt;0.05). We observed a lower frequency of PIK3CA mutations in both MBCs-A (8.3% vs 40%, Fisher's exact test, p&amp;lt;0.05) and MBCs-B (0% vs 40%; Fisher's exact test, p&amp;lt;0.01) compared to ER-positive/HER2-negative IDC-NSTs. Although not statistically significant, PIK3CA mutations were numerically less frequent in NBCs than in ER+/HER2- IDC-NSTs (13.3% vs 40%; Fisher's exact test, p&amp;gt;0.05). Concurrent 1q gains and 16q losses, the hallmark copy number alterations of ER-positive/HER2-negative breast cancer were found in 47% of the ER-positive/HER2-negative IDC-NSTs from TCGA, but only present in 20% of NBCs and in none of the MBCs-A or MBCs-B. Conclusion: Type A MBCs, type B MBCs and NBCs harbor similar patterns of genetic alterations, including a low frequency of PIK3CA mutations and of concurrent 1q gains/ 16q deletions. Taken together, our data suggest that both MBCs and the vast majority of NBCs constitute a spectrum of histologically and genomically related subtypes, distinct from ER-positive/HER2-negative IDC-NSTs. Citation Format: Pareja F, Da Cruz Paula A, Selenica P, Lee JY, Marchio C, Brown D, Geyer FC, Brogi E, Vincent-Salomon A, Weigelt B, Reis-Filho JS. Mucinous and neuroendocrine breast cancers: A spectrum of genetically-related lesions distinct from common forms of estrogen receptor-positive breast cancers [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-06-08.

Drug-resistant genotyping in HIV-1 therapy

To assess and compare the effectiveness of different bone grafting techniques, including unmasked meshes and graft-masked meshes approaches, for augmenting alveolar bone defects using 3D-printed titanium mesh (3D-TM). This retrospective study included 34 patients (69 teeth with alveolar bone defects) who underwent guided bone regeneration (GBR) using 3D-printed titanium mesh (3D-TM). Patients were assigned to two groups: the unmasked meshes group (n = 17, 34 treatment sites) and the graft-masked meshes group (n = 17, 35 treatment sites). Cone beam computed tomography (CBCT) data of pre- and post-operative 3D-TM implantation were digitally reconstructed, with a minimum 6-month follow-up period. Clinical outcomes included titanium mesh exposure rates, pseudo-periosteum rates, and osteogenic efficiency metrics such as bone volume, vertical bone height/width, and bone contour. Bone volume was analyzed using samples t-tests, vertical bone height/width was analyzed using a generalized estimating equations (GEE) model, and bone contour was analyzed using the Mann-Whitney U test. Categorical outcomes were evaluated via Fisher's exact probability test. Clinical complications analysis revealed distinct outcomes between the two groups. Titanium mesh exposure occurred in 7 cases overall, with no statistically significant difference between the unmasked meshes group (5/17, 29.4%) and the graft-masked meshes group (2/17, 11.8%) (Fisher's exact test, p = 0.398). In contrast, pseudo-periosteum demonstrated a significant discrepancy, observed in 14/17 cases (82.4%) in the unmasked meshes group compared to 4/17 cases (23.5%) in the graft-masked meshes group (Fisher's exact test, p = 0.002). Notably, no infections occurred in either group. Analysis of osteogenic efficacy revealed significant intergroup differences in bone volume ratio (Independent samples t-test, df = 32, p < 0.05), vertical bone height ratio, and width ratio (GEE, df = 1, p < 0.05), and bone contour accuracy at the minimum and 25% percentiles (Mann-Whitney U test, p < 0.05). No significant differences were observed at the 50%, 75% percentile, or maximum value. The graft-masked meshes technique in 3D-TM guided bone regeneration surgery is a reliable and effective method for augmenting alveolar bone defects. This method effectively reduces procedure-related complications, including titanium mesh exposure and pseudo-periosteum, thereby improving osteogenic efficacy.

Highly Skewed X-Chromosome Inactivation Is Associated with Idiopathic Recurrent Spontaneous Abortion