Greater Confidence Research Articles

Oncology and Primary Care Involvement in Breast Cancer Survivorship Care More Than 5 Years After Initial Treatment.

Very little is known about primary care involvement in the care of cancer survivors beyond the initial 5 years post-treatment when transitioning to primary care is guideline-recommended for many survivors. The ICanCare study is a longitudinal survey of women diagnosed with breast cancer in 2014-2015 identified in the Georgia and Los Angeles SEER registries. Women were surveyed during initial treatment and again approximately 6 years later in survivorship (2021-2022; n = 1,412, 60% response rate). Respondents were asked which provider led their survivorship care (oncology, shared care, primary care provider [PCP]) and PCP management of eight common survivorship issues (range, 0-32). Multivariable-adjusted associations of participant characteristics with survivorship care delivery and PCP management of survivorship issues were evaluated using logistic and linear regression models, respectively. Over half of the women (57.2%) reported oncologist-led survivorship care delivery, 20.5% shared care, and 22.4% PCP-led. PCP management of survivorship issues was moderate (mean, 11.4, 95% CI, 11.0 to 11.8) and was highest (often/always discussed) for medication management (50.1%), improving physical activity (49.1%), and chronic disease management (43.6%). Greater confidence in PCP's ability to manage survivorship care (v no or little confidence) was associated with PCP-led delivery (P = .01) and more PCP management of survivorship issues (P < .0001). In this diverse cohort of breast cancer survivors, primary care involvement in survivorship care delivery and management of common survivorship issues remains low even more than 5 years after completing treatment and little variation was seen across survivor sociodemographic or clinical characteristics. Confidence in PCP ability to manage survivorship care was found to be important and may represent an opportunity to foster transition to primary care-led survivorship care delivery.

Addressing code response challenges: Development of a pharmacist‐focused training program at an Academic Medical Center

AbstractIntroductionPharmacists are essential to the multidisciplinary team during code response. Commercially available basic and advanced‐life support training programs are not tailored for the depth of medication‐specific content essential for pharmacists to competently respond to codes. Opportunities exist to provide additional training to improve pharmacists' code response.ObjectiveTo develop pharmacist‐specific didactic education and hands‐on assessments for adult code response.MethodsAt our institution, acute care clinical staff pharmacists attend all adult codes. A mandatory pharmacist training program was designed to meet minimum institutional expectations for code response and address knowledge gaps. The program included three components: (1) online training module, (2) knowledge‐based assessment, and (3) hands‐on assessment. Pharmacists were surveyed pre‐ and post‐completion of the training program. The surveys consisted of 15 Likert scale questions and open‐ended questions. Chi‐square tests were used to compare a “positive” response to pre‐ and post‐survey questions. A “positive” response was defined as “Strongly Agree” or “Agree” on the Likert questions.ResultsSeventy‐three pharmacists completed the training program with 71 passing the hands‐on skills training on the first attempt. The pre‐ and post‐intervention survey was completed by 43/74 (58.1%) and 33/82 (40.2%) of pharmacists, respectively. A statistically significant increase in the number of “positive” survey responses was noted in 7 of the 15 Likert scale questions post‐intervention, with nominal improvements in the remaining 8. There were notable improvements in pharmacist perceived familiarity and comfort with medication locations (9% vs. 64%) and preparation (44% vs. 76%), and greater confidence in using available resources.ConclusionThe pharmacist‐specific code response training resulted in notable improvements in disclosed familiarity and comfort with code responsibilities. This training was transitioned into an annual competency module that may be used as a framework for other institutions implementing a similar process to maintain a standard level of competence in code response for pharmacists.

Implementation of a Urologic Surgery Skills Fair for Medical Students

To increase the proportion of applicants to urology residencies, we created a surgical skills fair to introduced urology early in undergraduate medical education. Funded by the Department of Urology, the fair was designed to have student rotations through 12 hands-on practice stations supervised by faculty and an advanced care practitioner or resident physicians. At conclusion, medical students completed a voluntary survey about their experience. Surgical skills fairs were organized at Yale School of Medicine (New Haven, CT) in 2022 and 2023. The fair was designed to encourage interaction between medical students, urology residents, and urology faculty by highlighting common urologic procedures and skills. The fair was well received by medical students at all levels of training. Over 2 years, 155 medical students attended, including 67 (43%) first-year and 60 (39%) second-year medical students. Eighty-two medical students completed the survey. An average of 19 attendings, advanced care practitioners and residents attended each event. Of the survey respondents, 42.7% reported prior interest in a surgical specialty but had not considered urology. Students reported increased interest in urology and greater confidence in urologic skills after the event (p < 0.001). We demonstrate that creating a surgical fair in urology is feasible and enhances early exposure and interest in urology. For students who do not pursue urology, the fair provides knowledge of urological pathologies and valuable skills for all physicians.

Understanding Gender Dynamics in Teacher Educators' Computer Self-Efficacy

This study examines computer self-efficacy among teacher educators, defined as the confidence in one's ability to effectively utilize computer technology for educational purposes. The main aim is to investigate gender differences in self-efficacy across three competency levels: basic, intermediate, and advanced. Utilizing a quantitative research approach, a self-constructed questionnaire containing 35 items was distributed to a purposive sample of 100 teacher educators, which included 61 female and 39 male participants. T-tests were employed to analyze the differences in self-efficacy scores between genders. The findings indicate no significant difference in self-efficacy at the basic competency level (t = 0.8391). In contrast, female educators displayed significantly higher self-efficacy scores in intermediate (t = 4.1417) and advanced competencies (t = 4.2159). Furthermore, female educators achieved an average score of 142.62 on the overall computer self-efficacy scale, notably exceeding the average score of 117.28 for male educators (t = 5.0717). Thus, the study reveals important gender dynamics in computer self-efficacy among teacher educators. It indicates that female educators tend to have greater confidence in their computer skills as they advance in competency levels. This highlights the need to address gender disparities in professional development initiatives and suggests that further research should explore the underlying factors that influence self-efficacy in technology use among educators.

The behavioural intentions for integrating artificial intelligence in science teaching among pre-service science teachers in South Africa and Thailand

Developing countries in the Global South exhibit diverse trends in the integration of digital technologies, such as Artificial Intelligence in teaching. Complex context-specific factors, including teacher preparedness, influence these trends. Using the Theory of Planned behavior as a theoretical framework, this study explores the behavioral intentions of pre-service science teachers in South Africa and Thailand towards integrating AI into their teaching to inform teacher training, support, and resource allocation policies. The main research question is: "What are the behavioral intentions of pre-service science teachers in South Africa and Thailand towards integrating AI into their teaching practices?" The study followed a non-experimental comparative descriptive survey involving 97 South African and 95 Thai final-year BEd students. Data were collected using a structured online questionnaire and analyzed using several statistical tools to compare the TPB constructs between the two samples. South African and Thai pre-service teachers exhibited favorable attitudes and behavioral intentions toward AI integration in teaching. However, Thai students showed significantly higher control and normative beliefs, indicating greater confidence and perceived social support for AI integration than South African students. The findings suggest that targeted teacher training programs and supportive educational policies are essential for enhancing AI readiness, particularly in resource-constrained settings.

Why trust is crucial – The moderating role of trust in the relationship between motivation and intention to buy healthy, sustainable and novel foods

Within an increasingly resource-challenged food system, consumers need greater confidence in their ability to make better and more informed food choices. We investigated the role of trust as a moderator of the relationship between the motivation to make healthy, sustainable and novel food choices and the intention to actually do so, based on the reasoning that novel healthy and sustainable food products are marketed by credence attributes, where consumers must rely on information that is provided by food chain actors. In an online survey conducted in 13 European countries over two years with a sample of 25,610 respondents, we explored how social trust, beliefs in trustworthiness and overall trust moderate the motivation-intention relationship. Results show that while trust cannot compensate for a lack of motivation to engage in healthy or sustainable behaviours, the relationship between motivation and intention was strengthened by higher levels of trust for sustainable and innovative food choices, but not for healthy food choices, and this finding was largely consistent across both years. For sustainable choices, the motivation-intention relationship was moderated by trust in farmers and retailers but not in manufacturers or authorities. All types of trust moderated the motivation-intention relationship for adoption of novel foods. This has implications for investment in trust initiatives on the part of policymakers, food businesses and food system actors.

How should I know? Lack of confidence biases stock market expectations toward zero

Consumers’ expectations of stock market movements are important for understanding individual decisions about consequential financial outcomes and forming economic policy. Across three studies, we posit a new relationship underlying reported stock market expectations: that respondents lack confidence about their ability to forecast stock market movements and this lack of confidence biases reported probabilities toward 0 %. In Study 1, using 10 years of nationally representative survey data, we show that stock market expectations are more pessimistic than warranted when compared to actual stock market movements. In Study 2, we measure stock market expectations in several nationally representative survey experiments over 12 monthly waves (n = 4,613 participants providing 21,670 survey responses) where participants are randomly assigned to report the chances that the stock market will be “lower” or “higher” over the next month and year. Reported probabilities are biased toward 0 % in each question frame, yielding a “framing effect” gap of >10 percentage points each wave. In Study 3, we find that confidence moderates this framing effect: when we manipulate confidence regarding one's ability to forecast the stock market, there is a smaller gap between “lower” and “higher” frames for those participants who have greater confidence. To our knowledge, this is the first research showing that a lack of confidence biases reported stock market probabilities toward 0 %. It also uncovers a framing effect that is counter to psychological theory on “valence framing” and helps explain prior research showing that people are pessimistic about the stock market.

Outlier Detection in Bayesian Neural Networks

Describing uncertainty is one of the major issues in modern deep learning. Artificial Intelligence models could be used with greater confidence by having solid methods for identifying and quantifying uncertainty. This article proposes two alternative methods for outlier detection in Bayesian Neural Networks used for classification tasks. This is done by looking for unusual pre-activation neuron values in the last layer of a Bayesian Neural Network. The proposed methods are compared to a baseline method for outlier detection, Predictive Entropy, on three datasets: a simulated dataset, the MNIST dataset, and the Breast Cancer Wisconsin dataset. In addition, we introduce a method for separating In-Between and Out-Of-Distribution outliers. The results indicate that the proposed methods' performance depends on the dataset type. In the case of a simple simulated dataset, we see that the proposed methods outperform the baseline method. The proposed method also outperforms the baseline method on the Breast Cancer Wisconsin dataset. However, when tested on the MNIST image dataset, we observed that the baseline is better than the proposed method. As expected, for all three datasets, an OR-combination of the two methods gives slightly better POWER score than the two methods separately, but this comes at the price of also obtaining a higher FDR score.

Measuring Self-Efficacy for Concussion Recovery: Psychometric Characteristics of the Progressive Activities of Controlled Exertion-Self-Efficacy Scale.

Control over symptoms postconcussion is central to an active self-directed recovery process. Therefore, assessing a patient's confidence in controlling their symptoms and facilitating their concussion recovery is an important component of treatment. Previously, no measures existed to assess symptom-specific self-efficacy (SE) in pediatric concussion recovery. SE is an individual's belief or confidence in their capabilities to execute action plans necessary to perform certain behaviors. Based on this definition, we developed the Progressive Activities of Controlled Exertion-Self-Efficacy (PACE-SE) scale to measure a patient's SE related to pediatric concussion recovery-specific activities. The aim of this article is to present the psychometric characteristics (evidence of reliability, validity) of the PACE-SE scale. The 17-item PACE-SE was administered to children and adolescents, 10-18 years of age, recovering from a diagnosed concussion as part of a standard clinical evaluation. Results revealed a four-factor structure producing the following scales: Managing My Stress, Managing My Activity, Seeking Adult Assistance, and Maintaining Positive Outlook. The PACE-SE scores indicated excellent internal consistency reliability with reasonable test-retest reliability over time. Evidence for the association between recovery status and greater confidence and control over recovery-related activities as measured by the PACE-SE was supported by: (1) an inverse association with symptom status reflecting lower confidence for managing recovery with higher symptom load, (2) greater reported problems with school performance associated with lower SE, (3) positive change in SE ratings across two clinic visits associated with symptom improvement, and (4) a significant difference in SE ratings evident between recovered and nonrecovered patients. The psychometric evidence supporting the PACE-SE scale provides the clinician with a measure to understand the child/adolescent patient's self-confidence in facilitating their concussion recovery.

Visual Upward/Downward Motion Elicits Fast and Fluent High-/Low-Pitched Speech Production

Abstract Participants tend to produce a higher or lower vocal pitch in response to upward or downward visual motion, suggesting a pitch–motion correspondence between the visual and speech production processes. However, previous studies were contaminated by factors such as the meaning of vocalized words and the intrinsic pitch or tongue movements associated with the vowels. To address these issues, we examined the pitch–motion correspondence between simple visual motion and pitched speech production. Participants were required to produce a high- or low-pitched meaningless single vowel [a] in response to the upward or downward direction of a visual motion stimulus. Using a single vowel, we eliminated the artifacts related to the meaning, intrinsic pitch, and tongue movements of multiple vocalized vowels. The results revealed that vocal responses were faster when the pitch corresponded to the visual motion (consistent condition) than when it did not (inconsistent condition). This result indicates that the pitch–motion correspondence in speech production does not depend on the stimulus meaning, intrinsic pitch, or tongue movement of the vocalized words. In other words, the present study suggests that the pitch–motion correspondence can be explained more parsimoniously as an association between simple sensory (visual motion) and motoric (vocal pitch) features. Additionally, acoustic analysis revealed that speech production aligned with visual motion exhibited lower stress, greater confidence, and higher vocal fluency.

Participation in eHealth Communication Interventions Among Patients Undergoing Hemodialysis: Scoping Review.

eHealth communication interventions have been shown to offer individuals with chronic kidney disease the opportunity to embrace dialysis therapies with greater confidence, the potential to obtain better clinical outcomes, and an increased quality of life. eHealth is an emerging field that offers diverse, flexible designs and delivery options. However, existing evidence on eHealth communication among patients undergoing hemodialysis is sparse and scattered and lacks systematization. This scoping review aims to identify and map the current evidence on patient participation in eHealth communication interventions. We aimed to map the associations between interventions and electronic health records, the participative role of individuals living with chronic kidney disease and undergoing hemodialysis, and the barriers to and facilitators of patient involvement in eHealth communication with health care professionals. This study used the Joanna Briggs Institute methodology for conducting a scoping review. Studies eligible for inclusion were those that included adult patients (aged >18 y) undergoing all types of hemodialysis, including prescheduled in-center hemodialysis and conventional home-based hemodialysis. Systematic searches were completed in Ovid MEDLINE, Ovid Embase, EBSCOhost CINAHL with Full Text, Scopus, and ProQuest Dissertations and Theses. Extracted data from the included studies were presented in figures and tables along with descriptions that responded to the research questions. This review was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. In total, 9 peer-reviewed studies were included. The main result was a low participative patient role and a vaguely described link to electronic health records. The key participative facilitators were availability of and access to the intervention; security, trust, and confidence; patient knowledge of their health situation and use of self-care; and patient preparedness for an uncertain future health situation and the ability to relate to family and friends about it. The key participative barriers were lack of availability of and access to information, mistrust and lack of safety, lack of knowledge of health situation and self-care, and relational issues. All barriers and facilitators were related to health literacy. This scoping review summarizes 4 specific and 3 nonspecific eHealth communication interventions developed and evaluated in various studies involving patients receiving hemodialysis. A knowledge gap exists between low levels of patient participation in eHealth communication and patients' limited access to electronic health records. eHealth communication interventions should implement patient participation and focus on the fact that different modalities of eHealth communication can complement face-to-face communication. RR2-10.2196/38615.

Assessing the impact of a leadership development programme on self-reported confidence of Community Pharmacy Neighbourhood Leads in South East London

Abstract Introduction Community Pharmacy (CP) integration is a key NHS England strategy, including for South East London (SEL) Integrated Care Board (ICB). To drive forward this strategy in SEL, the ICB medicines team created and funded community pharmacy neighbourhood lead (CPNL) roles. The CPNLs provide local leadership to strengthen CP-GP relationships and increase uptake of CP services (now badged Pharmacy First). To support implementation, a leadership programme was developed with system partners and delivered by Kaleidoscope,1 building on previous work.2 Core themes were building trust, driving collaboration and embedding innovation. Aim To measure the confidence level of CPNLs in SEL throughout the development programme, and associated outcomes. Methods There were five leadership sessions delivered to invited CPNLs and ICB colleagues between November 2023 and March 2024. The first and last sessions were face-to-face with the others virtual. Sessions covered both theory and implementation. At the end of each session all participants were asked to complete an online Microsoft forms survey compiled by Kaleidoscope, asking about their confidence in the CPNL role (where 1 is not at all confident and 5 is extremely confident), current relationships locally and actions planned and completed to date, using tick box, Likert scale and free text responses. Data was analysed in Microsoft Excel and through content analysis, with analysis completed for all attendees per session and separately for those attending 4 or 5 sessions. This study received ethics approval from Kingston University Ethics Committee (3396). Results A total of 37 individuals attended one or more sessions, with 16 attending 4 or 5 sessions. For all attendees, mean confidence score increased from 3.7 in session one to 4.14 in session five (out of 5) (session two:3.77; session three:4.05; session 4:4.17). Those who attended four or five sessions finished with a mean confidence score of 4.33, starting at 4.00 (session two:3.86; session three:4.19; session four:4.27). Comments showed participants initially reporting that there was room to improve relationships with key stakeholders, such as clinical directors, GPs, ICB and CP colleagues. By session five confidence had increased with comments noting that there was confidence to meet new people, network appropriately, and fulfil the required role. ‘Through the network we have created through this programme, confidence has grown with shared learning and new relationships.’ Comments were also received relating to improved joint working supporting the rollout of community pharmacy initiatives such as the Pharmacy First scheme. ‘Our confidence has grown, and we are arranging training sessions with the clinical directors with the local surgeries for some of the newer services like Pharmacy First.’ Discussion / Conclusion Our programme has increased CPNL confidence and engagement with local stakeholders, with greater confidence seen in those engaging most with the leadership programme. Limitations include not having consistent attendance at sessions. The launch of the national ‘Pharmacy First’ service halfway through the programme had a significant impact on the community pharmacy sector,3 with CPNLs being pivotal in building success in partnership. Further evaluation should assess impact of CPNLs on community pharmacy service provision and referrals by GPs.

Empowering Leadership: A Journey of Growth and Insight Through a Mentoring Program for Nurses in Leadership Positions.

This study explores the experiences of mentors and mentees participating in a mentor program for nurses in leadership positions, aiming to identify areas for program improvement. A qualitative approach was used, with semi-structured interviews conducted with 20 nurses in leadership roles. The participants, 10 mentees and 10 mentors, were involved in the Norwegian Nurses Organization's "Mentor Program for Nurses as Leaders". Thematic analysis was applied to the data. Participants in the mentorship program reported increased leadership awareness, stronger motivation, better stress-coping mechanisms, and greater confidence as leaders. They received valuable feedback and support from their mentors, boosting their motivation to pursue leadership roles. Both mentees and mentors expressed a desire for a longer program and emphasized the importance of networking opportunities, along with the need for predictability and long-term planning to improve program effectiveness. Participants reported that the mentorship program increased their awareness, motivation, coping skills, and confidence as leaders, encouraging them to pursue leadership roles. The results show that the NNO's mentor program positively influences leadership aspirations of new nurse leaders, with potential for further development in networking and program duration.

A Course-Based Undergraduate Research Experience (CURE) in Statistics: Enhancing Educational Outcomes and Promoting Access to Data-Driven Careers

Course-based undergraduate research experiences (CUREs) have been shown to help students gain research skills. Few studies, however, have evaluated the impact of CUREs on long-term educational and employment outcomes. This article examines postgraduation outcomes for students enrolling in introductory statistics delivered as a CURE compared with those taking a traditional mathematics-based introductory statistics course. Participating in the CURE was found to be associated with a higher likelihood of holding a job in which a primary responsibility was working with data, greater confidence in working with data, and a higher likelihood of earning more than $100K annually. This study suggests that CUREs may not only impart technical skills but also boost students’ self-efficacy in applying statistical methods and analyzing data.

Meandering pathways to success: a careers perspective on self-employment

PurposeThe paper aims to provide a career perspective on self-employment (SE) by focusing on how engaging in SE shapes the career experiences of MBA graduates in a distinct cultural and institutional context.Design/methodology/approachWe thematically analyse interviews with 29 Indian MBA graduates (including 10 women) who have engaged in both SE and salaried employment, using the conservation of resources (COR) theory as the theoretical framework.FindingsParticipants took up SE in a challenging institutional and cultural environment. Resources such as financial stability, social networks and family support enabled participants to pursue SE. Participants noted that the SE experience boosted their psychological resources, providing them with greater confidence, perseverance and self-awareness. Participants observed that SE had a negative impact on subjective career success (SCS) dimensions of financial success and positive work relationships but positively impacted other SCS dimensions such as entrepreneurship, learning and development, positive (social) impact and work–life balance (particularly for women).Research limitations/implicationsParticipants were highly educated with strong social networks from past work experience in a developing economy, so the transferability of the findings to other contexts may be limited.Practical implicationsIndividuals could benefit from considering a broader career canvas that includes SE as a career option. Policymakers should work towards removing institutional barriers and changing cultural perceptions towards SE.Originality/valueOur study is distinct in that it comprises participants who had engaged in both SE and salaried employment during their careers. Few studies have looked at the impact of one employment episode on another. We show that SE episodes can contribute to career sustainability by developing psychological resources.

A framework for training graduate students and campus communities in inclusive teaching.

While graduate student teaching assistants (TAs) contribute significantly to university education, many graduate programs across diverse disciplines offer limited formal pedagogical training. In turn, many researchers informally develop teaching and mentoring skills as they advance to faculty positions or related careers. This can perpetuate a lag in the implementation of inclusive educational environments despite the clear benefits demonstrated by recent pedagogical research. For instance, the integration of inclusive teaching strategies like universal design for learning, growth mindset feedback, and the use of relatable role models in curricula may help increase the persistence, success, and self-efficacy of traditionally underrepresented groups in the sciences. Additionally, research indicates that training graduate TAs in evidence-based practices may have benefits beyond teaching efficacy, such as greater confidence in research preparedness and science communication-skills applicable to any scientific field or career path. Here, we developed and implemented an inclusive teaching series for a marine science department that included: (i) campus-wide pedagogical journal article discussions and knowledge-sharing, (ii) expert-led interactive workshops on evidence-based teaching strategies, and (iii) a graduate TA professional development module on inclusive lesson planning with opportunities to teach and receive feedback. Based on our experiences, we share a framework and resources to facilitate a broader adoption of formalized TA training in inclusive teaching practices within graduate programs across a variety of fields.

Market Volatility from a linear Perspective: Trend Forecasting for Business and stock movements Author’s Information

lives. From the simplest transactions such as buying groceries to the complex mechanisms of global markets, finance touches almost every aspect of our economic interactions. The term “finance” emerged at the end of the nineteenth century and became increasingly important as economies developed and expanded. A key element of finance is the technical analysis of stocks, an indispensable practice for financial experts and investors. The method uses historical data and statistical techniques to forecast market trends. By scrutinizing past price movements and trading volumes, technical analysts can uncover patterns and signals that guide strategic decisions, risk management, and portfolio optimization. This analytical approach helps not only in identifying market trends, but also in identifying key support and resistance levels, which are essential for effective trading timing. Therefore, technical analysis is a powerful tool that enables investors to deal with the complexity of financial markets with greater confidence and accuracy.

Spatiotemporal variation in fish mercury contamination: Comparing approaches for crafting consumption advisories and assessing impairment

Mercury in fish is a serious human health concern. Mercury is a widespread contaminant that exceeds health effect thresholds in many fish species and waterbodies. The objectives were to determine the spatiotemporal variation of mercury in fish tissue for several fish species across thousands of lakes and to assess the potential use of fish length standardization and statistical models to improve fish consumption guidelines and impairments determinations in lake-rich areas. The results showed that fish length, species, ecoregion, lake size, latitude, color dissolved organic matter, water clarity, and zebra mussel presence influenced mercury concentrations. Fish mercury concentrations were generally higher from 1967 to 1990, and since 1990 there was no obvious trend. We found that a statistical model provided estimates of mean mercury concentrations by fish total length that were unbiased and with greater confidence than those based solely on sample statistics. The use of fish length standardization and inclusion of predictive models could improve precision and consistency of fish consumption guidelines and impairments determinations.

Computer-guided implant surgery and tooth-mirroring digital workflow to treat an esthetically compromised clinical case

Background: In multidisciplinary dentistry, it is common to observe clinical cases that present multiple complications at the end of orthodontic therapy, such as differences in gingival height, alterations in size and shape of the teeth, and reduced residual spaces for implant therapies. Aim: The aim of the study was to solve an esthetic case with the help of digitally assisted prosthetic and surgical design. Methods: A young patient had been treated orthodontically for the agenesis of tooth 12 and the conoid shape of tooth 22. Previous therapy consisted of opening the space for tooth 12 by positioning a Maryland-type composite bridge, followed by reconstruction with a composite of tooth 22. Various composite reconstructions on teeth 11 and 21 were no longer adequate. Furthermore, both elements had discordant coronal axes, the diastema was observed at the incisal level, and tooth 21 was approximately 1 mm longer than tooth 11. Radiographic analysis revealed that the roots of teeth 11 and 13 converge, providing sufficient space for the insertion of a small-diameter implant. An intraoral scan and cone-beam computed tomography (CBCT) were performed; both data files were merged using surgical design software. A surgical guide was developed for the insertion of an implant in site 12. After insertion, the composite bridge, which was no longer suitable, was removed and a new temporary metal-composite Maryland bridge was positioned. Using an artificial intelligence tool of the design software, tooth 22 was isolated, mirrored, inserted in site 12 to reproduce the gingival profile, and subtracted from the digital impression. A technician then copied this emergence profile to build a zirconia prosthetic crown to be screwed on the implant. Teeth 22, 11, and 21 were restored with a lithium disilicate crown and two veneers, respectively. Results: The initial digital design and the use of a guided surgery procedure allowed for the insertion of a small diameter implant without damaging the roots of the adjacent teeth. The prosthetic design procedure, using the digital tools of the design program, made it possible to standardize and create symmetrical gingival profiles of teeth 12 and 22. The overall composition was completed by the use of minimally invasive adhesive prosthetic techniques on teeth 11, 21, and 22. Conclusion: Digital resources have become essential tools for dental professionals. The knowledge and use of technologies like intraoral scanning and CBCT, combined with various innovations such as artificial intelligence in prosthetic and implant design software, enable dentists to manage even the most complex interdisciplinary clinical cases with greater confidence. Relevance for Patients: Digital techniques are now widely used across all fields of dentistry. This has led to the need for operators of all ages to adjust their decision-making process compared to traditional techniques. These new techniques have also improved communication with patients, allowing the dental team to have a clearer understanding of the clinical path to follow and consequently offer their patients precise dentistry solutions.

Willingness to pay for farmed salmon: Balancing sustainability and safety perceptions

Given pressure on wild fish stocks, aquaculture has worked to develop farmed seafood markets. While farmed seafood should be more sustainable, consumers may lack confidence in its sustainability and may have food safety concerns. Using a sample of 266 seafood consumers in the US state of Maine, the study examined preferences for wild-caught and farmed salmon based on safety perceptions of the latter. Most preferred wild-caught, but this declined with lower food safety concerns. Additionally, willingness to pay for certified sustainably farmed versus non-certified farmed salmon was compared, revealing higher premiums with greater confidence in food safety. The industry should improve food safety perceptions and promote its benefits as a sustainable seafood source.