Test Group Research Articles

Home-use agents in the treatment of dentin hypersensitivity: clinical effectiveness evaluation with different measurement methods

ObjectivesThis study aimed to evaluate the effectiveness of home-use desensitizing agents over an 8-week period by comparing them using different measurement methods.MethodsA randomized, controlled clinical trial was conducted with 180 individuals aged between 18 and 70 who clinically diagnosed dentin hypersensitivity (DH) in two or more non-adjacent teeth. Subjects who met the inclusion criteria (n = 164) were randomly allocated into five test groups—using Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), Arginine, Novamin, Propolis, and Potassium nitrate—and a control group using standard fluoride toothpaste. The status of DH was assessed at week 4 and week 8 by the same independent examiner. Changes from baseline in Dentine Hypersensitivity Experience Questionnaire-15 (DHEQ-15), Schiff Sensitivity Scale (SSS) and Visual Analog Scale (VAS) were analysed using ANOVA and Kruskall-Wallis tests.ResultsAll test groups showed statistically significant improvements in DH at weeks 4 and 8 compared to baseline in the DHEQ-15, VAS, and SSS assessments (p < 0.005). In the control group, significant improvements were observed only in the VAS and SSS measurements from baseline to weeks 8 (p < 0.005). The CPP-ACP group demonstrated the greatest reduction in scores by the end of week 8 compared to baseline, with DHEQ-15 (56.68 ± 17.87), VAS (6.52 ± 1.48), and SSS (2.32 ± 0.56).ConclusionsAmong the tested agents, the CPP-ACP group demonstrated the most notable reduction in DH symptoms by week 8, highlighting its potential as an effective method for alleviating DH symptoms in a home-use agents.Clinical relevanceHome-use desensitizing agents are effective in the treatment of DH, improving the daily activities of patients who cannot access clinical care and ensuring the relief of DH before clinical invasive procedures.Trial registrationClinicalTrials.gov Identifier: NCT06216262.

Development of a multi-laboratory integrated predictive model for silicosis utilizing machine learning: a retrospective case-control study

ObjectiveDue to the high global prevalence of silicosis and the ongoing challenges in its diagnosis, this pilot study aims to screen biomarkers from routine blood parameters and develop a multi-biomarker model for its early detection.MethodsA case-control study was conducted to screen biomarkers for the diagnosis of silicosis using LASSO regression, SVM and RF. A sample of 612 subjects (half cases and half controls) were randomly divided into training and test groups in a 2:1 ratio. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to construct a multiple biomarker-based model for the diagnosis of silicosis, which was applied to both the training and the testing datasets.ResultsThe training cohort revealed significant statistical differences (P &amp;lt; 0.05) in multiple hematologic parameters between silicosis patients and healthy individuals. Based on machine learning, eight silicosis biomarkers were screened and identified from routine blood cell, biochemical and coagulation parameters. D-dimer (DD), Albumin/Globulin (A/G), lactate dehydrogenase (LDH) and white blood cells (WBC) were selected for constructing the logistic regression model for silicosis diagnostics. This model had a satisfactory performance in the training cohort with an area under the ROC curve (AUC) of 0.982, a diagnostic sensitivity of 95.4%, and a specificity of 92.2%. In addition, the model had a prediction accuracy of 0.936 with an AUC of 0.979 in the independent test cohort. Moreover, the diagnostic accuracies of the logistic model in silicosis stages 1, 2, and 3 were 88.0, 95.4, and 94.3% with an AUC of 0.968, 0.983, and 0.990 for silicosis, respectively.ConclusionA diagnostic model based on DD, A/G, LDH and WBC is successfully proposed for silicosis diagnostics. It is cheap, sensitive, specific, and preliminarily offers a potential strategy for the large-scale screening of silicosis.

Multiple Sessions of Antimicrobial Photodynamic Therapy Improve Periodontal Outcomes in Patients with Down Syndrome: A 12-Month Randomized Clinical Trial

Background/Objectives: Individuals with Down syndrome (DS) often present with severe periodontal disease at a young age. Adjuvant treatments to scaling and root planing (SRP), such as antimicrobial photodynamic therapy (aPDT), may benefit this population. This study evaluated the effectiveness of aPDT as an adjunct to SRP in individuals with DS. A randomized, double-blind, parallel trial was conducted with 37 individuals with DS. Methods: The test group (aPDT; n = 18) received SRP + aPDT, while the control group (C group; n = 19) received SRP only. For aPDT, a red laser (658 nm; 0.1 W; 2229 J/cm2; 40 s sweeping with optical fiber) combined with methylene blue (MB) (100 µg/mL) was applied across repeated sessions (on days 3, 7, and 14). Clinical parameters, such as plaque index (PI), clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP), were recorded at baseline and after 3, 6, and 12 months of treatment. Statistical analyses were performed using parametric and non-parametric tests (p &lt; 0.05). Results: Both treatments promoted improvements in all clinical periodontal parameters (p &lt; 0.05). The aPDT group showed a statistically significant reduction in CAL at 3 months (aPDT = 4.58 mm vs. C = 4.72 mm; p &lt; 0.05) and 12 months (aPDT = 4.59 mm vs. C = 4.84 mm; p &lt; 0.05). Conclusions: aPDT improved periodontal health in the long term through a stable gain in attachment.

A Novel Treatment for Scabies with Herbal Formulation: A Clinical Safety Assessment Study

Introduction: Scabies, known as Jarb in Unani medicine, is a parasitic infection caused by the mite Sarcoptes scabiei var. Hominis. It is characterized by intense itching, particularly noted by patients at night. In India, this disease affects over three million people, manifesting as papular or vesicular eruptions accompanied by pruritus. Unani physicians have developed comprehensive treatments for scabies, considering its causative factors and various types. Methods: This study was conducted as an open-label, single-arm clinical trial involving 75 patients diagnosed with scabies with male female ration of 1:2.7. The primary objective was to assess the efficacy and safety of a compound Unani formulation. The test group received a Compound Unani formulation Irtifal Shahtra (Fumaria indica Pugsley) at a dose of 5 grams twice daily, Marham Kharish Jadeed (Lawsonia inermis) for topical application twice daily, and Aab-e-Barg-e-Neem (a decoction of Neem leaves) for washing the affected areas before applying Marham twice daily, for a duration of 15 days. Both subjective and objective parameters were evaluated before and after the treatment period. Results: In this study, 94% patients reported a significant reduction in itching after using unani formulation for Scabies. Only 5% patients had mild itching at the end of the study. Regarding cure of the lesions, the reduction in mean values from before to after treatment indicates an improvement in skin lesions. P-value less than 0.05 indicate that the results are statistically significant. Objective parameters such as the skin scraping test, demonstrated a significant reduction (p&lt;0.001). Importantly, no adverse effects were observed with the treatment regimen, further highlighting its effectiveness in alleviating scabies symptoms. Conclusion: This study highlights the safe and effective utilization of Unani formulations in treating one of the most distressing skin disease scabies, without any adverse effects. Keywords: Scabies, Jarb, Itrifal shahtra, Barg neem, Marham Kharish Jadeed, Classical Pharmacopoeial formulations.

Effect of a chemically-modified-curcumin on dental resin biodegradation

IntroductionPrevious studies have shown Streptococcus mutans (S. mutans) esterase is a key mediator of dental composite biodegradation, which can contribute to recurrent caries. This study is to investigate the inhibitory effects of a novel Chemically-Modified-Curcumin (CMC 2.24) on esterase activities and related dental material biodegradation.MethodsDental adhesive materials and composite resins were incubated in S. mutans suspension with CMC 2.24 and other compounds, including doxycycline, Chemically-Modified-Tetracycline (CMT-3), and curcumin for 4 weeks. The pre- and post-incubation surface roughness were evaluated by either laser diffraction pattern and/or a 3D laser scanning microscope. Esterase enzyme inhibition assays were performed with the same test groups and activities were determined spectrophotometrically.ResultsAmong all experimental groups, CMC 2.24 significantly reduced surface roughness of dental composite (p &amp;lt; 0.01) and adhesive (p &amp;lt; 0.01) materials compared to bacteria-only group. Additionally, CMC 2.24 reduced porcine esterase activity by 46.5%, while other compounds showed minimal inhibition. In the S. mutans esterase assay, CMC 2.24 showed inhibition of 70.0%, while other compounds showed inhibition ranging from 19% to 36%.ConclusionOur study demonstrated that CMC 2.24 inhibited biodegradation of dental composite material more effectively than its mother compound, curcumin. Moreover, the mechanism of this biodegradation was likely mediated through bacterial esterase activity. Doxycycline achieved similar inhibition by completely eradicating S. mutans with its antibiotic action; hence, it is not recommended for long-term use.

Plasma Lipid Lowering Potential of Carrot (Daucus carota) Extract in Male Wistar Rats

Carrots (Daucus carota) are widely consumed for their nutritional and medicinal benefits. The aim of the present study was to investigate the effects of Daucus carota on lipid profile. The study involved 28 male wistar rats separated into 4 groups of 7 rats each. Group 1 served as control and was given distilled water, whilst groups 2, 3 and 4 served as test groups and were given aqueous extract of Daucus carota at daily doses of 200mg/kg, 400mg/kg and 600mg/kg respectively. The experiment lasted for 28 days and thereafter, blood samples collected for determination of lipid profile [total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL)] using standard laboratory techniques. Results showed that oral administration of all three doses of carrot extracts significantly reduced the plasma concentrations of both TC and TG but caused no significant changes in the LDL levels. However, the higher doses; 400mg/kg and 600mg/kg significantly increased the HDL levels in wistar rats. The lipid lowering potential of Daucus carota could be based on its fibre content as well as its antioxidant content which possibly enhanced fecal excretion of lipids. Conclusively, moderate consumption of Daucus carota decreased the plasma levels of TC and TG, increased HDL but had no significant effect on the LDL.

Can preoperative urodynamic studies predict de novo stress urinary incontinence following advanced pelvic organ prolapse surgery?

Introduction: We aimed to assess the predictivity of preoperative urodynamics (UDS) on de novo stress urinary incontinence (SUI) in patients having advanced pelvic organ prolapse (POP). Methods: Between January 2016 and June 2019, 133 patients with symptomatic POP at stage 3 or higher were included in the study. The presence of postoperative SUI symptoms after a minimum of six months of followup was considered the primary outcome. The results of all patients' preoperative UDS were compared to their postoperative SUI symptoms. In addition, patients were divided into two groups based on whether SUI was detected during preoperative UDS testing (Group 1) or not (Group 2). Results: Although preoperative measurements, such as bladder capacity and residual urine volume, were not different between groups, group 1 had lower maximal urethral closure pressures (p=0.001). Preoperative SUI symptoms had a sensitivity of 32.1% and a specificity of 91.4% for predicting de novo SUI. In patients with advanced POP, preoperative UDS had a sensitivity of 60.7% and a specificity of 87.6% for predicting de novo SUI. Conclusions: Urodynamic examination with a pessary can significantly predict the development of de novo SUI.

Expression and prognosis of cellular senescence genes in head and neck squamous cell carcinoma

BackgroundCellular senescence refers to cells entering a relatively stable state of cell cycle arrest, which is a barrier that tumor cells must cross to achieve immortalization and plays an extremely important role in preventing the occurrence and development of tumors. In recent years, numerous studies have shown that inducing tumor cells to enter a senescent state has become a feasible tumor control strategy. At present, cellular senescence has become a research hotspot in tumor prevention and treatment, as well as in cell biology. However, the expression and prognostic values of cellular senescence genes in head and neck squamous cell carcinoma (HNSC) remain unclear.Material/MethodsWe analyzed the expression patterns and prognostic values of cellular senescence genes in HNSC from TCGA and GEO. The TCGA-HNSC data were used as the training group and were divided into high- and low-risk groups, and the GEO database was used as the test group. Analyses included survival analysis, ROC curve analysis, risk curve analysis, independent prognostic analysis and model validation for clinical grouping. We used the HPA database for protein-level validation of the genes.ResultsWe identified 5 cellular senescence genes associated with HNSC, namely, BTG3, EHF, EZH2, TACC3 and TXN. These cellular senescence genes were analyzed in the training and test groups and were found to be significantly associated with the prognosis of HNSC patients.ConclusionsThe tumor immune microenvironment of HNSC appears to have correlations with certain cellular senescence-related features. Genes associated with cellular senescence, such as BTG3, EHF, EZH2, TACC3, and TXN, show promise as potential diagnostic and prognostic biomarkers for HNSC.

Cost-effectiveness analysis of PD-L1 testing associated with pembrolizumab for first-line treatment of advanced non-small cell lung cancer in China.

Lung cancer is the leading cause of cancer-related deaths in China, and pembrolizumab shows differential efficacy in advanced non-small cell lung cancer (NSCLC) with different PD-L1 expression levels. To assess the cost-effectiveness of PD-L1 testing associated with pembrolizumab for first-line treatment of NSCLC from the perspective of Chinese healthcare system. Over a lifetime horizon, a three-state partitioned survival model was developed to assess the cost-effectiveness of PD-L1 testing and no PD-L1 testing. In the PD-L1 testing group, patients were stratified by PD-L1 tumor proportion score ≥ 50%, 1-49%, or < 1% and received pembrolizumab monotherapy, pembrolizumab plus chemotherapy, or chemotherapy alone, respectively. In the non-PD-L1 testing group, all patients received pembrolizumab plus chemotherapy. Model inputs were obtained from published literature and a healthcare price database, and clinical outcomes from two randomized clinical trials were used. The net monetary benefit (NMB) was estimated for the PD-L1 testing group versus the non-PD-L1 testing group. Deterministic and probabilistic sensitivity analyses, and scenario analyses were conducted to assess robustness of results. Using PD-L1 testing to guide treatment led to cost savings of $49,392.7 and a reduction in quality-adjusted life years (QALYs) of 0.234, resulting in a positive NMB of $46,421.7 at a willingness-to-pay (WTP) threshold of $12,680.8/QALY (GDP per capita in China, 2023). Findings were robust across sensitivity and scenario analyses. Using PD-L1 testing to guide first-line pembrolizumab treatment in patients with advanced NSCLC is a cost-effective strategy at a WTP threshold of $12,680.8/QALY for China.

Investigating Cell Wall Diffusion in Wood Modified with Phenol Urea Formaldehyde Resin in Different Length Scales.

Wood modification using low molecular weight thermosetting resins improves the biological durability and dimensional stability of wood while avoiding increasingly regulated biocides. During the modification process, resin monomers diffuse from the cell lumen to the cell wall, occupying micropore spaces before in situ curing at 150 °C. This study investigated the mechanism of cell wall diffusion at multiple scales, comparing two test groups where diffusion was either facilitated or restricted. Antiswelling efficiency tests demonstrated improved dimensional stability when diffusion was facilitated. Differential scanning calorimetry showed that bound water was excluded more effectively from the cell wall if cell wall diffusion was enabled. Solid-state NMR spectroscopy (1H MAS and 13C MAS) with relaxation time analysis indicated that resin migrated to distinct locations within the cell wall, influenced by diffusion and drying conditions. These findings highlight how optimizing cell wall diffusion can significantly improve the performance of wood modification processes using thermosetting resins.

Deep Learning and Automatic Detection of Pleomorphic Esophageal Lesions—A Necessary Step for Minimally Invasive Panendoscopy

Background: Capsule endoscopy (CE) improved the digestive tract assessment; yet, its reading burden is substantial. Deep-learning (DL) algorithms were developed for the detection of enteric and gastric lesions. Nonetheless, their application in the esophagus lacks evidence. The study aim was to develop a DL model for esophageal pleomorphic lesion (PL) detection. Methods: A bicentric retrospective study was conducted using 598 CE exams. Three different CE devices provided 7982 esophageal frames, including 2942 PL lesions. The data were divided into the training/validation and test groups, in a patient-split design. Three runs were conducted, each with unique patient sets. The sensitivity, specificity, accuracy, positive and negative predictive value (PPV and NPV), area under the conventional receiver operating characteristic curve (AUC-ROC), and precision–recall curve (AUC-PR) were calculated per run. The model’s diagnostic performance was assessed using the median and range values. Results: The median sensitivity, specificity, PPV, and NPV were 75.8% (63.6–82.1%), 95.8% (93.7–97.9%), 71.9% (50.0–90.1%), and 96.4% (94.2–97.6%), respectively. The median accuracy was 93.5% (91.8–93.8%). The median AUC-ROC and AUC-PR were 0.82 and 0.93. Conclusions: This study focused on the automatic detection of pleomorphic esophageal lesions, potentially enhancing the diagnostic yield of this type of lesion, compared to conventional methods. Specific esophageal DL algorithms may provide a significant contribution and bridge the gap for the implementation of minimally invasive CE-enhanced panendoscopy.

High-risk habitat radiomics model based on ultrasound images for predicting lateral neck lymph node metastasis in differentiated thyroid cancer

BackgroundThis study aims to evaluate the predictive usefulness of a habitat radiomics model based on ultrasound images for anticipating lateral neck lymph node metastasis (LLNM) in differentiated thyroid cancer (DTC), and for pinpointing high-risk habitat regions and significant radiomics traits.MethodsA group of 214 patients diagnosed with differentiated thyroid carcinoma (DTC) between August 2021 and August 2023 were included, consisting of 107 patients with confirmed postoperative lateral lymph node metastasis (LLNM) and 107 patients without metastasis or lateral cervical lymph node involvement. An additional cohort of 43 patients was recruited to serve as an independent external testing group for this study. Patients were randomly divided into training and internal testing group at an 8:2 ratio. Region of interest (ROI) was manually outlined, and habitat analysis subregions were defined using the K-means method. The ideal number of subregions (n = 5) was determined using the Calinski-Harabasz score, leading to the creation of a habitat radiomics model with 5 subregions and the identification of the high-risk habitat model. Area under the curve (AUC) values were calculated for all models to assess their validity, and predictive model nomograms were created by integrating clinical features. The internal and external testing dataset is employed to assess the predictive performance and stability of the model.ResultsIn internal testing group, Habitat 3 was identified as the high-risk habitat model in the study, showing the best diagnostic efficacy among all models (AUC(CRM) vs. AUC(Habitat 3) vs. AUC(CRM + Habitat 3) = 0.84(95%CI:0.71–0.97) vs. 0.90(95%CI:0.80-1.00) vs. 0.79(95%CI:0.65–0.93)). Moreover, integrating the Habitat 3 model with clinical features and constructing nomograms enhanced the predictive capability of the combined model (AUC = 0.95(95%CI:0.88-1.00)). In this study, an independent external testing cohort was utilized to assess the model’s accuracy, yielding an AUC of 0.88 (95%CI: 0.78–0.98).ConclusionThe integration of the High-Risk Habitats (Habitat 3) radiomics model with clinical characteristics demonstrated a high predictive accuracy in identifying LLNM. This model has the potential to offer valuable guidance to surgeons in deciding the necessity of LLNM dissection for DTC.Clinical trial numberNot applicable.

Impact of diagnostic testing on outcomes of children with rumination syndrome.

Rumination syndrome (RS) is diagnosed based on clinical criteria with or without diagnostic testing showing characteristic findings on antroduodenal manometry (ADM), high-resolution esophageal manometry (HREM), and multichannel intraluminal impedance-pH testing (MII-pH). The objective of this study was to evaluate the correlation between diagnostic testing and clinical outcomes. We conducted a retrospective review of children with RS evaluated at our institution. Patients were divided into two groups: those with confirmatory diagnostic testing for rumination based on ADM, HREM, and/or MII-pH, and those without. We compared response to treatment based on the proportion no longer having vomiting at follow-up and no longer needing supplemental nutrition. We included 152 children (60% female, median age of diagnosis 13 years, interquartile range 8-15 years) with RS. 22 patients (14%) had diagnostic testing that confirmed RS. At baseline, there was no statistical difference in the percentage of patients who had overt vomiting (p = 0.311), however, the confirmatory testing group was more likely to need supplemental nutrition (p ≤ 0.001) and to receive intensive treatment (p < 0.001). After treatment, the proportion of patients without vomiting increased in both groups without a statistically significant difference between the two groups. There were also no significant differences in likelihood of reporting improvement in symptoms or needing supplemental nutrition. Children with RS who had confirmatory diagnostic testing were equally likely to no longer have vomiting after treatment when compared to those without confirmatory testing. Future studies are needed to account for potential differences in baseline severity between groups.

Crosslinked Versus Non-Crosslinked Resorbable Collagen Membranes for Periodontal Regeneration: A Multicenter, Randomized, Double-Blind, Non-Inferiority Clinical Trial.

This study aimed to evaluate and compare the results of combination therapy involving bone grafting and two different resorbable collagen membranes in 1-, 2- and 3-wall infrabony defects. A total of 174 patients with infrabony defects (≥ 7 mm periodontal probing depth) were randomized to receive deproteinized bovine bone mineral (DBBM) with either a native porcine non-crosslinked collagen membrane (N-CM, control, n = 87) or a novel porcine crosslinked collagen membrane (C-CM, test, n = 87). Clinical parameters, including periodontal probing depth (PPD), clinical attachment level (CAL), and gingival recession (GR), were recorded at baseline, 12 weeks, and 24 weeks. Radiographic evaluations measured linear bone gain (LBG) and percentage of bone fill (%BF) at baseline and 24 weeks. Generalized Estimating Equations (GEE) were used to identify predictors of clinical outcomes. The primary outcome was the total effectiveness rate based on a composite outcome score integrating clinical and radiographic parameters at 24 weeks. One hundred seventy three patients completed the study. At 24 weeks, mean improvements in PPD were 4.17 ± 1.48 mm and 4.16 ± 0.97 mm for the control and test groups, respectively, while CAL gains were 3.69 ± 1.32 mm and 3.60 ± 1.81 mm. Radiographic linear bone gain was 3.12 ± 2.19 mm in the control group and 3.00 ± 1.92 mm in the test group. Subgroup analysis showed trends favoring the test group for PPD (p = 0.046) and CAL (p = 0.042) improvements in 1-wall defects. The total effectiveness rate was 96.55% in the control group and 95.35% in the test group, with a difference of -1.2% (95% CI: -5.88% to 3.47%). Among those with effective results, the test group had a higher proportion achieving significantly effective outcomes compared to the control group (96.5% vs. 86.2%, p = 0.032). Regression analysis identified treatment group, defect morphology, and baseline defect depth as significant predictors of PPD and CAL outcomes. The novel porcine crosslinked collagen membrane demonstrated non-inferiority to the native non-crosslinked membrane in periodontal regeneration. Regression analysis highlighted defect morphology and baseline defect depth as key predictors of outcomes, while subgroup analysis suggested potential advantages of the C-CM in challenging defect morphologies, such as 1-wall defects. These findings provide valuable insights into clinical decision-making. However, the findings are limited by the short-term nature of the study (24 weeks), and further long-term investigations are needed to confirm these preliminary results and assess their clinical relevance. ClinicalTrials.gov identifier: NCT04851847.

Real-time human–computer interface based on eye gaze estimation from low-quality webcam images: integration of convolutional neural networks, calibration, and transfer learning

Abstract Eye gaze estimation represents a well-established research domain within computer vision. It has a wide range of practical applications in numerous fields, including human–computer interaction (HCI) for cursor control, health care, and virtual reality, enhancing its suitability for adoption throughout the scientific community. Different methods have been used for eye gaze estimation, such as model based, feature based, and appearance based. The appearance-based method is mainly used because it directly estimates an individual’s gaze direction from images/videos rather than depending on specific features or geometric models. This article developed an appearance-based, real-time generic eye gaze system for HCI to control the cursor through the eye using the convolutional neural network (CNN), calibration, and transfer learning. The study employed low-quality eye images captured from a conventional desktop webcam, enabling the proposed methodology to be implemented on any computer system equipped with a similar web camera without the need for supplementary hardware. Initially, the labeled dataset of both eyes is collected using the webcam. Then, a CNN model is trained by inputting left and right eye images to predict the gaze coordinate as output. We applied the calibration and transfer learning approach to the trained models to make a generic model for new users. In real-time use, the first step is calibration, where the user’s eye images are captured for various screen coordinates, and transfer learning is employed to fine-tune the pre-trained model according to the user’s eyes. Then, the fine-tuned model is used for eye gaze prediction to control the cursor. The system’s performance is evaluated using a test group of multiple users, and it demonstrated an average visual angle accuracy of 2.08 degrees before calibration, which notably improved to 1.81 degrees after the calibration process.

Predicting Age and Visual-Motor Integration Using Origami Photographs: Deep Learning Study.

Origami is a popular activity among preschool children and can be used by therapists as an evaluation tool to assess children's development in clinical settings. It is easy to implement, appealing to children, and time-efficient, requiring only simple materials-pieces of paper. Furthermore, the products of origami may reflect children's ages and their visual-motor integration (VMI) development. However, therapists typically evaluate children's origami creations based primarily on their personal background knowledge and clinical experience, leading to subjective and descriptive feedback. Consequently, the effectiveness of using origami products to determine children's age and VMI development lacks empirical support. This study had two main aims. First, we sought to apply artificial intelligence (AI) techniques to origami products to predict children's ages and VMI development, including VMI level (standardized scores) and VMI developmental status (typical, borderline, or delayed). Second, we explored the performance of the AI models using all combinations of photographs taken from different angles. A total of 515 children aged 2-6 years were recruited and divided into training and testing groups at a 4:1 ratio. Children created origami dogs, which were photographed from 8 different angles. The Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition, was used to assess the children's VMI levels and developmental status. Three AI models-ResNet-50, XGBoost, and a multilayer perceptron-were combined sequentially to predict age z scores and VMI z scores using the training group. The trained models were then tested using the testing group, and the accuracy of the predicted VMI developmental status was also calculated. The R2 of the age and the VMI trained models ranged from 0.50 to 0.73 and from 0.50 to 0.66, respectively. The AI models that obtained an R2>0.70 for the age model and an R2>0.60 for the VMI model were selected for model testing. Those models were further examined for the accuracy of the VMI developmental status, the correlations, and the mean absolute error (MAE) of both the age and the VMI models. The accuracy of the VMI developmental status was about 71%-76%. The correlations between the final predicted age z score and the real age z score ranged from 0.84 to 0.85, and the correlations of the final predicted VMI z scores to the real z scores ranged from 0.77 to 0.81. The MAE of the age models ranged from 0.42 to 0.46 and those of the VMI models ranged from 0.43 to 0.48. Our findings indicate that AI techniques have a significant potential for predicting children's development. The insights provided by AI may assist therapists in better interpreting children's performance in activities.

Use of a Non-Endoscopic Capsule-Sponge Triage Test for Reflux Symptoms: Results From the NHS England Prospective Real-World Evaluation.

Acid reflux is a common presentation in primary care leading to a high volume of referrals to endoscopy that are often normal. To determine whether a non-endoscopic capsule sponge biomarker test could triage patients with low-risk reflux symptoms, reduce endoscopy waiting lists and identify Barrett's oesophagus in a real-world setting. Patients with reflux symptoms on NHS endoscopy waiting lists who were offered a capsule sponge (test group) between February 2021 and August 2022 were included in this national multicentre prospective cohort study and compared with eligible patients on the standard endoscopy pathway (counterfactual group). Two thousand one hundred seventy patients from 23 hospitals undertook a capsule sponge triage test and submitted follow-up data, of whom 1694 (78%) were discharged without endoscopy and 476 (22%) were referred for endoscopy. In a detailed subgroup analysis 1411/1549 (92%) attended and successfully swallowed the capsule of whom 307/1411 (21.8%) required endoscopy. Of 111 patients with positive capsule sponge biomarker results who had endoscopy, 19.8% had Barrett's oesophagus. In comparison, in patients with negative sponge biomarkers who were referred for endoscopy due to ongoing symptoms, none had Barrett's oesophagus (p = 0.0002). Eighty-two percent surveyed (267/357) were satisfied with the alternative pathway. Capsule sponge triage is feasible, safe and acceptable. It substantially reduces the endoscopy burden for routine reflux referrals with a favourable diagnostic yield for Barrett's oesophagus. Longer term follow-up will help to confidently assess the impact of the programme and place of capsule sponge in the diagnostic pathway.

Is ADDM graft practical? A comparative study to evaluate ADDM graft in third molar surgery.

It has been outlined that LTM (Lower third molar) extracted from patients in which grinding, cleaning, sterilization & demineralization prove to be highly effective as graft material for filling the alveolar socket of the very same patient. These investigations aim to assess the efficiency of ADDM (Autogenous Demineralized Dentin Matrix) graft in third molar extraction sockets. To check the effectiveness of ADDM as graft material in extraction socket by evaluating pain, swelling, trismus, PD (Probing Depth) and bone density. A prospective, randomized control trial was conducted at our institute. The patients were haphazardly, non-blindly alienated into two groups. Group A (45 patients) on the test side after LTM impaction surgery will receive ADDM graft material with bio-collagen membrane and Group B (45 patients) on the control side underwent LTM removal, with the alveolus left to heal conventionally by forming a blood clot. Swelling showed significant difference between CG (Control Group) and TG (Test Group), the intergroup comparison of change in the swelling scores at seventh post-operative day (from pre-op level) was significantly higher in the TG (117.35) as compared to the CGs (115.92) (p = 0.001). A statistically significant difference in probing depth was also noted between the two groups, CG 4.46 ± 1.252 & TG 2.52 ± 0.641 in the post-operative examination at three months. In our study radiographical evaluation revealed progressive increase in bone density in TG (135.81 ± 8.73) when compared to CG (121.59 ± 13.83) over a period of three months. Pain and trismus evaluation did not reveal any significant difference between TG & CG. The clinical results of the ADDM graft procedure demonstrate satisfactory outcomes in extraction sockets. The findings of this study highlight the importance of preservation methods in maintaining the periodontal pocket depth distal to the second molar and the remaining alveolar ridge following extraction.

Implementation of a program to strengthen oral hygiene in patient with cleft deformities: a prospective randomized controlled clinical trial

BackgroundCleft lip and/or palate is the most common congenital orofacial deformity, affecting 1/800 births. A thorough review of the literature has shown that children with cleft have poorer oral hygiene and dental health than other children, with higher levels of caries in both temporary and permanent teeth and poorer periodontal health. Cleft patients are treated by a multidisciplinary team that aims to provide comprehensive care from pre- or post-natal diagnosis to early adulthood and the end of growth. We aim to assess, through a single-center, prospective, randomized and controlled clinical trial conducted at the Nantes Cleft Centre, the impact of an enhanced dental program on oral hygiene and dental health in cleft patients.MethodsPatients aged 3 to 15 years with unilateral or bilateral cleft lip and/or palate will be offered to participate in this study. After acceptance, patients will be randomly assigned to 2 groups: test group or control group. For the control group, there will be no change in the patient’s care, and they will continue to see their surgeon on an annual basis.For the test group, a 30–45-min consultation will be added to the annual check-up. During this visit, patients and their parents will receive oral and written oral hygiene instructions to improve oral hygiene knowledge and brushing technique. If necessary, dental treatment will be provided at the same appointment or at a later date. In addition, patients will be contacted via telemedicine every 2 months to increase motivation, and an additional dental appointment will be scheduled at 6 months.DiscussionThis is a single-center study which, if conclusive, could lead to a paradigm shift in the dental care pathway for cleft patients.Trial registrationNCT05867862 submitted 2023–07-05 https://clinicaltrials.gov/study/NCT05867862?locStr=Nantes,%20France&country=France&state=Pays%20de%20la%20Loire&city=Nantes&distance=50&cond=CLEFT%20LIP&rank=1--Trial Sponsor Nantes University Hospital.Trial status: 8th Version date 2023 May 05; recruitment began in June 2023 and will be completed in June 2024.

The plaque reducing efficacy of oil pulling with sesame oil: a randomized-controlled clinical study

ObjectivesTo compare the plaque reducing efficacy of oil pulling with sesame oil compared to distilled water in a randomized, controlled, examiner-blinded parallel group study.Materials and methodsForty probands without advanced periodontal disease of the University Hospital for Restorative Dentistry and Periodontology, Medical University of Innsbruck (Austria) were randomized allocated to test- (sesame oil) or control group (distilled water) and asked to pull daily in the morning for eight weeks with their allotted fluid for 15 min. Rustogi Modified Navy Plaque Index (RMNPI) and gingival bleeding index were assessed at baseline and after four and eight weeks. Plaque samples underwent microbiological analysis.ResultsPulling with sesame oil was significantly more effective in reducing full mouth RMNPI compared to distilled water after eight weeks (median reduction 18.98% versus 10.49%; p = 0.023), and was most pronounced in anterior, buccal, and lingual subscales. On approximal surfaces, significantly higher plaque reduction was found in the test group after four (24.07% versus 14.29%) and eight weeks (16.00% versus 5.36%) of intervention (p < 0.05). No significant changes in gingival index and mirobiological analysis could be detected.ConclusionPlaque reduction was statistically significantly higher with oil pulling than with distilled water, however, a study bias cannot be ruled out. Further high-quality trials are needed to understand the mechanisms and effectiveness of oil pulling, to finally clarify the evidence.Clinical relevanceOil pulling may be recommended as an adjuvant to mechanical dental cleaning. Individuals with keratosis may experience adverse effects.Trial registrationClinicalTrials.gov NCT06327841.