American Association Research Articles

Incidence of urethral stricture in patients with urethral trauma: a 10-year experience in an Indonesian tertiary hospital

BACKGROUND Urethral injuries are rarely life-threatening but can cause significant morbidity if left untreated. Until now, data on urethral trauma incidence are still limited in Indonesia. This study aimed to report the incidence of traumatic urethral stricture within 10 years of experience in treating urethral trauma. METHODS This retrospective study used a total sampling method for all patients with urethral trauma who came to the emergency department and agreed to undergo radiological evaluation. Patient data were collected from January 2012 to December 2021. All patients were followed up for 3 months after trauma, and the incidence of urethral stricture was analyzed using the chi-square or Fisher's exact tests as an alternative. RESULTS The overall incidence of urethral stricture was 48.4%. Of 122 patients, 82.0% had anterior urethral trauma. Grade III American Association for the Surgery of Trauma (43.4%) was the most common urethral trauma. The cause of urethral trauma was iatrogenic, pelvic fracture urethral injury (PFUI), straddle injury, and penile fracture, contributing in 64.8%, 18.0%, 16.4%, and 0.8% of the cases, respectively. Most patients (70.5%) underwent a cystostomy catheterization procedure as initial treatment. Straddle injury, PFUI, and a higher degree of urethral trauma were significantly associated with urethral stricture formation (p<0.05). CONCLUSIONS Straddle injury, PFUI, and a higher degree of urethral trauma were significantly related to a higher incidence of urethral stricture. Most low-grade and anterior urethral traumas can resolve spontaneously.

Perceptions and utilization of tele-orthodontics: a survey of the members of the American Association of Orthodontists

ObjectiveThis study aimed to investigate orthodontists’ utilization and perceptions of tele-orthodontics.Materials and methodsA 30-item online survey was distributed to members of the American Association of Orthodontists (AAO). The questionnaire encompassed topics concerning the orthodontists’ utilization, perceptions, clinical applications, limitations, and concerns regarding tele-orthodontics. Descriptive statistics were employed, and comparisons between responses from users and non-users were conducted using Wilcoxon rank-sum tests and Fisher’s exact tests.Results152 members completed the survey, (response rate: 2.4%). More than two third of respondents (69.74%) were users of tele-orthodontics. Users were more aligned with the belief that tele-orthodontics facilitates effective communication (mean ± standard deviation (SD) 4.06 ± 0.83 vs. 3.33 ± 0.94, p < 0.001). Both groups agreed on the requirement of patient fees for tele-orthodontic visits (mean ± SD: 3.62 ± 1.11 users vs. 3.74 ± 1.02 non-users, p = 0.659), and on the capability of the system to reduce unwarranted referrals (p = 0.20). The majority of participants acknowledged the utility of the system in monitoring aligners’ patients (89% in users vs. 61% in non-users, p < 0.001). Non-users expressed greater concerns regarding privacy risks (mean ± SD: 3.06 ± 0.97 users vs. 3.57 ± 0.86 non-users, p = 0.002). Both groups stressed the significance of obtaining informed consent before utilizing tele-orthodontics.ConclusionsThe widespread acceptance of tele-orthodontics among AAO members was apparent, as demonstrated by their recognition of its effectiveness. There was notable variation in how users and non-users perceived tele-orthodontics. The study's results offer valuable insights into both the potential benefits and drawbacks of incorporating this technology into clinical practice from the clincians' perspective.

KRAS Allelic Variants in Biliary Tract Cancers

Biliary tract cancers (BTCs) contain several actionable molecular alterations, including FGFR2, IDH1, ERBB2 (formerly HER2), and KRAS. KRAS allelic variants are found in 20% to 30% of BTCs, and multiple KRAS inhibitors are currently under clinical investigation. To describe the genomic landscape, co-sequence variations, immunophenotype, genomic ancestry, and survival outcomes of KRAS-mutated BTCs and to calculate the median overall survival (mOS) for the most common allelic variants. This retrospective, multicenter, pooled cohort study obtained clinical and next-generation sequencing data from multiple databases between January 1, 2017, and December 31, 2022. These databases included Princess Margaret Cancer Centre, MD Anderson Cancer Center, Foundation Medicine, American Association for Cancer Research Project GENIE, and cBioPortal for Cancer Genomics. The cohort comprised patients with BTCs who underwent genomic testing. The main outcome was mOS, defined as date of diagnosis to date of death, which was measured in months. A total of 7457 patients (n = 3773 males [50.6%]; mean [SD] age, 63 [5] years) with BTCs and genomic testing were included. Of these patients, 5813 had clinical outcome data available, in whom 1000 KRAS-mutated BTCs were identified. KRAS allelic variants were highly prevalent in perihilar cholangiocarcinoma (28.6%) and extrahepatic cholangiocarcinoma (36.1%). Thirty-six KRAS allelic variants were identified, and the prevalence rates in descending order were G12D (41%), G12V (23%), and Q61H (8%). The variant G12D had the highest mOS of 25.1 (95% CI, 22.0-33.0) months compared with 22.8 (95% CI, 19.6-31.4) months for Q61H and 17.8 (95% CI, 16.3-23.1) months for G12V variants. The majority of KRAS-mutated BTCs (98.9%) were not microsatellite instability-high and had low tumor mutational burden (ranging from a median [IQR] of 1.2 (1.2-2.5) to a mean [SD] of 3.3 [1.3]). Immune profiling through RNA sequencing of KRAS and NRAS-mutated samples showed a pattern toward a more immune-inflamed microenvironment with higher M1 macrophage activation (0.16 vs 0.12; P = .047) and interferon-γ expression compared with wild-type tumors. The G12D variant remained the most common KRAS allelic variant in all patient ancestries. Patients with admixed American ancestry had the highest proportion of G12D variant (45.0%). This cohort study found that KRAS allelic variants were relatively common and may be potentially actionable genomic alterations in patients with BTCs, especially perihilar cholangiocarcinoma and extrahepatic cholangiocarcinoma. The findings add to the growing data on genomic and immune landscapes of KRAS allelic variants in BTCs and are potentially of value to the planning of specific therapies for this heterogeneous patient group.

Low back pain: justification of treatment standards (literature review)

Low back pain: justification of treatment standards (literature review)

Implementation of a countywide adult suicide review commission: Development, lessons learned, and recommendations.

Fatality review is a public health approach designed to inform efforts to prevent fatalities of a certain kind (e.g., suicide, homicide) or in a specific setting or population (e.g., hospitals, youth). Despite extensive literature on fatality review generally, the literature on suicide review teams specifically is scant. The aim of this paper is to: describe the implementation of a local adult suicide review commission, detail examples of initial outcomes and recommendations developed by the commission, and provide recommendations and/or best practices for how to develop and implement an adult suicide review team. We utilize framing questions from the American Association of Suicidology's psychological autopsy framework. By using these guiding questions in the discussion, members are invited to explore not only the stressors that may have more immediately preceded the suicide event itself, but to situate those stressors in the context of the individual's life course. Several recommendations proposed by our commission have resulted in tangible outcomes and are detailed using Haddon's Matrix as a guiding prevention planning tool. We have highlighted the need to move beyond looking at individual-level help-seeking to focus on structural/systemic issues that result in stress or create unsafe environments for at-risk individuals.

Roadmap for integrating the AACN essentials with perioperative nursing

Faculty members teaching in pre-licensure nursing programs are entrusted with revising nursing education to meet the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education. Colleges of nursing faculty experience difficulty establishing enough clinical sites as healthcare facilities continue to overcome staffing challenges since the start of the COVID-19 pandemic. Perioperative nursing is an underutilized area despite the potential for students to attain valuable nursing competencies and experiences in perioperative areas. An opportunity exists for faculty, regardless of having perioperative nursing experience or not, to use perioperative environments for clinical experiences in didactic and simulation courses. Our aim is to provide a roadmap for nursing faculty to include perioperative nursing in the pre-licensure nursing curriculum. Perioperative education exemplars aligned with the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education domains are included for adoption in any college of nursing.

Comparative analysis of diagnostic accuracy in endodontic assessments: dental students vs. artificial intelligence.

This study evaluates the comparative diagnostic accuracy of dental students and artificial intelligence (AI), specifically a modified ChatGPT 4, in endodontic assessments related to pulpal and apical conditions. The findings are intended to offer insights into the potential role of AI in augmenting dental education. Involving 109 dental students divided into junior (54) and senior (55) groups, the study compared their diagnostic accuracy against ChatGPT's across seven clinical scenarios. Juniors had the American Association of Endodontists (AEE) terminology assistance, while seniors relied on prior knowledge. Accuracy was measured against a gold standard by experienced endodontists, using statistical analysis including Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. ChatGPT achieved significantly higher accuracy (99.0 %) compared to seniors (79.7 %) and juniors (77.0 %). Median accuracy was 100.0 % for ChatGPT, 85.7 % for seniors, and 82.1 % for juniors. Statistical tests indicated significant differences between ChatGPT and both student groups (p<0.001), with no notable difference between the student cohorts. The study reveals AI's capability to outperform dental students in diagnostic accuracy regarding endodontic assessments. This underscores AIs potential as areference tool that students could utilize to enhance theirunderstanding and diagnostic skills. Nevertheless, the potential for overreliance on AI, which may affect the development of critical analytical and decision-making abilities, necessitates a balanced integration of AI with human expertise and clinical judgement in dental education. Future research is essential to navigate the ethical and legal frameworks for incorporating AI tools such as ChatGPT into dental education and clinical practices effectively.

The Effectiveness Of Virtual Reality Along With Task Specific Training On Quality Of Life Of C6-C7 Level- Incomplete Spinal Cord Injury Patients

Background- Spinal cord injury is a devastating condition. In recent years, traumatic spinal cord injury has become one of the major disabling conditions in young males. These chronic complications negatively impact patients’ functional independence and thus affect the quality of life. Methods-Thirty-seven spinal cord injury patientsC6-C7 with American Spinal Cord Injury Association (C, D) who full-filled the inclusion criteria were recruited, out of which 7 discontinued the therapy program, 15 spinal cord injury patients in Group I (Virtual Reality with Task Specific Training) and 15 spinal cord injury patients in the Group II (only task specific) completed the study.Virtual Reality training was given as an intervention using NIRVANA which is a semi-immersive Virtual Reality training. Results-Group I, which received only Task Specific Training, revealed a statistically significantly positive change in Quality of life (Z = -2.671, p = 0.008) with a medium effect size of (r = 0.48). For Group II, which received Virtual Reality along with Task Specific Training,revealed a statistically significantly positive change in Quality of life (Z = -3.415 p = 0.001) with a large effect size of (r = 0.62) Conclusion-Both the groups showed significant positive improvements in quality of life inspinal cord injury patients, indicating that both task-oriented training and the use of Virtual Reality as treatment modalities have a direct impact on QoL. However, more significant improvement was seen in Group 2 where Virtual Reality was combined with Task Specific Training.

The Pathway to Developing a Competency-based Tool for Entry-level Nursing Simulation: A Delphi Study

BackgroundSimulation-based learning experiences allow undergraduate nursing students to develop competence and confidence through deliberate practice with immediate feedback on the learner's performance through debriefing. With the transition to competency-based nursing education, nursing faculty need more guidance in implementing competency-based evaluations in the simulation setting. PurposeThis Delphi study aims to inform the future development of a competency-based tool – SimComp – based on the American Association of Colleges of Nursing (AACN) Essentials. MethodsA Delphi framework was used to recruit expert nursing faculty to complete the surveys via an online platform. Data analysis occurred through open-ended questions and quantitative methods to ensure that the responses from expert panelists were used to form the results. ResultsAfter four rounds of this Delphi study, a consensus was achieved on 111 appropriate items for assessing competence in the simulation-based learning environment. ConclusionWhile further research is warranted, this study provides insight for nursing institutions considering implementing or increasing the use of simulation within their program for competency-based evaluations.

Talking Fieldwork with Rebekka King

In The Interview, we chat with movers and shakers whose contributions help us think about the field. Bulletin Editor, Richard Newton, and Editorial Assistant, Stephen Heaton sat down with Rebekka King. King is Professor of Religious Studies at Middle Tennessee State University and faculty resident at MTSU’s Honors College. We learned about Rebekka’s work in the anthropology of Christianity, her recent book, The New Heretics: Skepticism, Secularism, and Progressive Christianity (NYU Press, 2023), and her tenure as president of the North American Association for the Study of Religion (2021–2023).

Celebrating 20 Years of Excellence: Latin American Pediatric Neurosurgery Course LACPN (2004-2024)

Two decades ago, a visionary initiative was launched in Latin America with the aim of advancing pediatric neurosurgery education and expertise across the region. Today, as we mark the 20th anniversary of the Latin American Pediatric Neurosurgery Course (LACPN), it is an opportune moment to reflect on its journey, celebrate its achievements, and chart a course for its continued success. The LACPN was established with a clear mission: to provide a platform for knowledge exchange, skill development, and collaboration among neurosurgeons dedicated to caring for children with neurological conditions. Designed to cover the major fields in Pediatric Neurosurgery, the scientific program is divided into annual courses over a 3-year cycle, with each biannual course is based on a four-day program divided in the morning sessions; lectures and case discussion an afternoon session; lectures, video session, "hand-on", and "solve a case". Following the ESPN post-graduate course and Asian-Australasian Course in Pediatric Neurosurgery program. At the heart of the LACPN's success lies its unwavering commitment to education and training, a culture of continuous learning and mentorship, the LACPN has not only raised the standard of care but also inspired a new generation of neurosurgeons dedicated to pediatric neurosurgery in the past 20 years. Over the past 18 years of LACPC more than 350 different trainees (from Brazil, Argentina, Chile, Colombia, Uruguay, Mexico, Venezuela, Bolivia, Cuba, Paraguay, and others) and 73 faculty invitees (from Brazil, Argentina, Chile, Mexico, USA, France, Italy, Costa Rica, Colombia, Turkish, Singapore, Spain, UK, and Australia, South Africa) have attended the course. In 2024, the LACPN become an official course of the Latin American Association for Pediatric Neurosurgery (ASOLANPED). This year the course was held in Pilar, Buenos Aires, Argentina, with the brilliant direction of Dr. Ramiro delRio and Dr. Sebastian G. Jaimovich. As we reflect on the past 20 years, it is evident that the LAPNC has made a profound impact on the field of pediatric neurosurgery in Latin America. Its legacy extends far beyond the confines of the operating room, encompassing a legacy of excellence, collaboration, and compassion that will continue to shape the future of pediatric neurosurgery for generations to come. As we celebrate this significant milestone, we are reminded that our work is far from complete. Challenges remain, ranging from disparities in access to care to the need for continued innovation and research. As we look ahead to the next 20 years and beyond, let us recommit ourselves to the pursuit of excellence, the advancement of knowledge, and the relentless pursuit of better outcomes for the children and families we serve.LACPN is a unique course! Friendship, collaboration and opportunities for everyone are the pillars of this course. In closing, we extend our heartfelt gratitude to all those who have contributed to the success of the Latin American Pediatric Neurosurgery Course over the past two decades – the organizers, faculty, participants, sponsors, and supporters. Your dedication, passion, and commitment have made this journey possible, and we look forward to continuing our shared mission of advancing pediatric neurosurgery in Latin America and beyond. Here's to 20 years of excellence, and to many more years of innovation, collaboration, and impact. See you in Rio de Janeiro 2024!!

Use of jejunal serosal patch and pyloric exclusion in the management of complex duodenal injury.

Duodenal injuries are relatively rare but remain a management challenge with a high incidence of postoperative complications. Guidelines from the World Society of Emergency Surgery and American Association for the Surgery of Trauma favour a primary repair for less-complex injuries, but the management of more complex duodenal trauma remains controversial with varying techniques supported, including pyloric exclusion, omental or jejunal patch closure, gastrojejunostomy and pancreatoduodenectomy. We describe the techniques used in one case of complex duodenal trauma. The duodenum is approached via a standard laparotomy with Kocherisation. Primary repair of the duodenal perforations is performed using a 3/0 polydioxanone suture (PDS), followed by mobilisation of a loop of mid-jejunum against the area of duodenal trauma over the primary repair as a jejunal serosal patch. The antimesenteric jejunal serosal border is sutured to the serosa of the duodenum (serosa only) using a 3/0 PDS. Pyloric exclusion is then performed through an anterior gastrostomy, to control the volume of gastric juice entering the duodenum. The pylorus is sutured closed using an absorbable suture followed by closure of the anterior gastrostomy using a GIA stapling device.

Relevance of Positive Surgical Margins in Localized Renal Cell Carcinoma After Surgical Resection: Predictive Factors and Survival Implications

IntroductionThe implications of positive surgical margins (PSM) after surgery for renal cell carcinoma (RCC) remain subject of discussion. This study aimed to identify risk factors for PSM, assess its effect on overall survival (OS), and determine predictors of OS. Patients and MethodsData from RCC surgeries at Mannheim University Medical Center between 2010 and 2023 was analyzed. Propensity score matching balanced PSM and control groups using age, surgical approach, tumor stage, histological subtype, and American Association of Anesthesiologists (ASA) score. Logistic and cox regression models predict PSM and OS, respectively. Kaplan–Meier analysis compared OS of PSM patients and controls. ResultsA total of 1066 RCC patients were included. Propensity score matching yielded 32 PSM patients and 96 controls. Multivariable logistic regression identified tumor stage ≥ T3a (odds ratio [OR] = 2.74, 95% confidence interval [CI] = 1.0-6.8, P = .04) and chromophobe, compared to clear cell, RCC (OR = 3.19, 95% CI = 1.0-8.7, P = .03) as independent predictors of PSM. Multivariable cox regression found age > 65 years (hazard ratio [HR] = 2.65, 95% CI = 1.7-4.2, P < .01) and tumor stage ≥ T3a (HR = 2.25, 95% CI = 1.4-3.7, P < .01) to predict shorter OS. Partial vs. radical nephrectomy was associated with improved OS (HR = 0.49, 95% CI = 0.3-0.9, P = .02). Kaplan–Meier analysis revealed no OS difference between PSM patients and controls (P = .49) over a 45-month median follow-up. ConclusionPSM is not a primary determinant of inferior survival, while age and tumor stage play a more prominent role. A well-calibrated follow-up protocol for PSM patients, combining PSM with coinciding factors such as tumor stage, grade, size, or PSM extent, is crucial for adequate surveillance while preventing excessive interventions.

Publication patterns of posters and oral presentations at the Annual Meeting of the Joint AANS/CNS Cerebrovascular Section.

The American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) Joint Cerebrovascular (CV) Section serves as a centralized entity for the dissemination of information related to CV neurosurgery. The quality of scientific conferences, such as the CV Section's Society of NeuroInterventional Surgery Annual Meeting, can be gauged by the number of poster and oral presentations that are published in peer-reviewed journals. However, publication rates from the CV Section's meetings are unknown. The objective of this study was to assess the rate at which abstracts presented at the AANS/CNS CV Section Annual Meeting from 2014 to 2018 were subsequently published in peer-reviewed journals. The abstract titles for all accepted poster and oral podium presentation abstracts from the 2014-2018 Annual Joint AANS/CNS CV Section Meetings were searched using PubMed. A match was defined as sufficient similarity between the abstract and its corresponding journal publication with regard to title, authors, methods, and results. Five-year impact factors (IFs) from Journal Citation Reports (JCR), the country of the corresponding author, and the number of citations in the Scopus database were obtained using the articles' digital object identifier when available, or the exact article title, journal, and year of publication. Of the 607 total poster and oral presentations from the 2014-2018 Annual Meetings of the AANS/CNS Joint CV Section, 46.29% (n = 281) have been published. Published articles received 3233 total citations for an average number of citations per article (± SD) of 10.89 ± 16.37. The average 5-year JCR IF of published studies was 4.64 ± 3.13. Additionally, 98.22% of published abstracts were in publication within 4 years from the time the abstract was presented. The most common peer-reviewed neurosurgical journals featuring these publications were the Journal of Neurosurgery, World Neurosurgery, the Journal of NeuroInterventional Surgery, Neurosurgery, and the Journal of Clinical Neuroscience. Nearly half of all poster and oral presentations at the annual meetings of the AANS/CNS Joint CV Section from 2014 to 2018 have been published in PubMed-indexed, peer-reviewed journals. The average number of citations per publication (10.89 ± 16.37) reflects the high quality of abstracts accepted for presentation. It is important to continuously assess the quality of research presented at national conferences to ensure that standards are being maintained for the advancement of clinical practice in a given area of medicine. Conference abstract publication rates in peer-reviewed journals represent a way in which research quality can be gauged, and the authors encourage others to conduct similar investigations in their subspecialty area of interest and/or practice.

Preoperative Counseling and Surgical Practice: Gynecologic Surgeons' Approach to Ovary-Sparing Hysterectomy [ID 2683432

INTRODUCTION: Since the early 20th century, surgical practices on prophylactic oophorectomy at the time of hysterectomy have fluctuated. This study aims to assess how current gynecologic surgeons are counseling patients on ovary-sparing benign hysterectomies and assess any gaps in provider knowledge. METHODS: Institutional review board exception was obtained. A survey was piloted and underwent several rounds of editing before being sent to members of American Association of Gynecologic Laparoscopists (AAGL) in April 2023. The questionnaire evaluated preoperative counseling on risks and benefits of ovary-sparing hysterectomy for benign indications and surgical practices for when to perform bilateral salpingectomy and oophorectomy. Descriptive statistics and regression analyses were performed. RESULTS: The survey was sent out by email to 6,622 AAGL members, 3,576 opened the email, and 520 completed surveys (14% response rate). Approximately one-half (58%) completed subspeciality training. Most counsel patients on the benefits of ovarian conservation including the prevention of osteoporosis (88%), early onset menopause (87%), cardiovascular disease (84%), and dementia (52%). Fifty percent recommend routine bilateral salpingo-oophorectomy at time of hysterectomy starting at age 61, whereas 38% recommend this be performed at age 51–55 years. CONCLUSION: Gynecologic surgeons are counseling patients on the risks and benefits of ovarian conservation. How frequently ovary-sparing hysterectomies are offered and the age at which bilateral salpingo-oophorectomy is recommended vary by provider. Additional high-quality studies are needed to further understand the optimal timing of oophorectomy at time of benign hysterectomy, and there is also a need for provider education to minimize discrepancy in practice patterns.

Analysis of neurosurgery resident research activity in the United States.

Evaluation of the demographic and academic characteristics of current neurosurgery residents may provide prospective students with insight into factors that affect research output. Therefore, this study aimed to evaluate the research output among neurosurgery residents. US neurosurgery residency programs were abstracted from the American Association of Neurological Surgeons website. Demographic data on 1690 current residents across 119 programs were collected using publicly available institutional websites, Doximity, and LinkedIn. The h-index of each resident was recorded using Scopus and exported into the NIH iCite tool to determine the weighted relative citation ratio (w-RCR) and mean relative citation ratio (m-RCR). The total number of publications, h-index, and w-RCR were used as a proxy for research output, while m-RCR was used to measure research impact. One-way ANOVA and Kruskal-Wallis H-tests were used to assess the statistical significance of relationships between demographic data and measures of research activity. A total of 1690 residents (25.4% female), representing 119 programs, were evaluated. Neurosurgery residents had an average of 17 publications, h-index of 5.5, m-RCR of 1.4, and w-RCR of 16.9, with an upward trend of research activity by postgraduate year (PGY) class. Male residents on average had a greater total number of publications (p < 0.001), higher h-index (p < 0.001), and higher w-RCR (p = 0.002) compared with their female peers. Significant differences in research activity were also observed by degree (Doctor of Medicine [MD], Doctor of Osteopathy [DO], or other), where those with MD and other degrees had higher metrics than those with DO degrees. International medical graduates (IMGs) also had higher research output than American medical graduates (AMGs) (p < 0.001). Differences in all measures of research activity except impact were also observed in research activity when pre-residency medical school ranks were compared. The authors observed overall high research activity among neurosurgery residents. Factors such as gender, degree, PGY, IMG/AMG status, and medical school rank may therefore be related to the success of matching within neurological surgery. Although large disparities in gender representation have been identified in neurosurgery, newer classes are trending toward shrinking the gap. These data may be used by prospective residents to gauge changes and progress occurring in the neurosurgery match.

What constitutes quality in endocrine surgery? Statement from the American Association of Endocrine Surgeons

What constitutes quality in endocrine surgery? Statement from the American Association of Endocrine Surgeons

Pulp regeneration treatment using different bioactive materials in permanent teeth of pediatric subjects

Background and Objectives: The present systematic review aims to assess the success rate of the pulp regeneration treatment, according to the American Association of Endodontists (AAE) criteria, using different bioactive materials in permanent teeth of pediatric subjects (6–17 years of age). Materials and Methods: The study protocol was registered on PROSPERO and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The question formulation was accomplished using the PICO model, and an electronic search was carried out on Scopus, MEDLINE/PubMed, Web of Science, and Cochrane databases till April 1, 2023. A total of 30 studies were established to fulfill the inclusion criteria of this systematic review. Results: A total of 273 teeth have been treated with pulp regeneration treatment. By comparing different biomaterials and the success criteria defined by the AAE, the material associated with a higher success rate was found to be the white mineral trioxide aggregate. However, the overall success rate of pulp regeneration treatment was reported for 248 out of 273 teeth (91.20%). Conclusions: Data obtained support the potential that regenerative endodontics aids in continuing root development in permanent immature teeth. Further studies are needed for a more extensive evaluation of the use of different biomaterials and the success rate in regenerative endodontics.

Defining “Ethical Mathematical Practice” Through Engagement with Discipline-Adjacent Practice Standards and the Mathematical Community

This project explored what constitutes “ethical practice of mathematics”. Thematic analysis of ethical practice standards from mathematics-adjacent disciplines (statistics and computing), were combined with two organizational codes of conduct and community input resulting in over 100 items. These analyses identified 29 of the 52 items in the 2018 American Statistical Association Ethical Guidelines for Statistical Practice, and 15 of the 24 additional (unique) items from the 2018 Association of Computing Machinery Code of Ethics for inclusion. Three of the 29 items synthesized from the 2019 American Mathematical Society Code of Ethics, and zero of the Mathematical Association of America Code of Ethics, were identified as reflective of “ethical mathematical practice” beyond items already identified from the other two codes. The community contributed six unique items. Item stems were standardized to, “The ethical mathematics practitioner…”. Invitations to complete the 30-min online survey were shared nationally (US) via Mathematics organization listservs and other widespread emails and announcements. We received 142 individual responses to the national survey, 75% of whom endorsed 41/52 items, with 90–100% endorsing 20/52 items on the survey. Items from different sources were endorsed at both high and low rates. A final thematic analysis yielded 44 items, grouped into “General” (12 items), “Profession” (10 items) and “Scholarship” (11 items). Moreover, for the practitioner in a leader/mentor/supervisor/instructor role, there are an additional 11 items (4 General/7 Professional). These results suggest that the community perceives a much wider range of behaviors by mathematicians to be subject to ethical practice standards than had been previously included in professional organization codes. The results provide evidence against the argument that mathematics practitioners engaged in “pure” or “theoretical” work have minimal, small, or no ethical obligations.

PULMONARY REHABILITATION IN ROMANIA: FROM THE BEGINNINGS TO THE PRESENT

Pulmonary rehabilitation is the standard of care for patients with chronic lung disease. Material and method: Starting from the systematic review of specialized literature and practical expertise obtained both internationally and nationally, the exposition emphasizes the aspects related to pulmonary rehabilitation in patients with chronic lung diseases. Results: The cornerstone of pulmonary rehabilitation is the American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation published in 2006 and developed based on the documents of the American College of Chest Physicians (ACCP) and American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) published in 1997 and 2004. The document was subsequently updated in 2007, 2013, 2015, 2021 and 2023, with the concept of pulmonary rehabilitation constantly evolving over the years. In Romania, pulmonary rehabilitation is carried out according to these guidelines and international standards, Iasi being a reference center in this field. Conclusions: Pulmonary rehabilitation is one of the most powerful evidence-based therapies for patients with chronic lung disease. Keywords: COPD, exercise capacity, training, quality of life.