Independent Examiners Research Articles

A two-stage deep-learning model for determination of the contact of mandibular third molars with the mandibular canal on panoramic radiographs.

This study aimed to assess the accuracy of a two-stage deep learning (DL) model for (1)detecting mandibular third molars (MTMs) and the mandibular canal (MC), and (2)classifying the anatomical relationship between these structures (contact/no contact) on panoramic radiographs. MTMs and MCs were labeled on panoramic radiographs by a calibrated examiner using bounding boxes. Each bounding box contained MTM and MC on one side. The relationship of MTMs with the MC was assessed on CBCT scans by two independent examiners without the knowledge of the condition of MTM and MC on the corresponding panoramic image, and dichotomized as contact/no contact. Data were split into training, validation, and testing sets with a ratio of 80:10:10. Faster R-CNN was used for detecting MTMs and MCs and ResNeXt for classifying their relationship. AP50 and AP75 were used as outcomes for detecting MTMs and MCs, and accuracy, precision, recall, F1-score, and the area-under-the-receiver-operating-characteristics curve (AUROC) were used to assess classification performance. The training and validation of the models were conducted using the Python programming language with the PyTorch framework. Three hundred eighty-seven panoramic radiographs were evaluated. MTMs were present bilaterally on 232 and unilaterally on 155 radiographs. In total, 619 images were collected which included MTMs and MCs. AP50 and AP75 indicating accuracy for detecting MTMs and MCs were 0.99 and 0.90 respectively. Classification accuracy, recall, specificity, F1-score, precision, and AUROC values were 0.85, 0.85, 0.93, 0.84, 0.86, and 0.91, respectively. DL can detect MTMs and MCs and accurately assess their anatomical relationship on panoramic radiographs.

RADT-24. WALLERIAN DEGENERATION OF THE CORTICOSPINAL TRACT IN GLIOMAS: A RETROSPECTIVE ANALYSIS AND A SYSTEMATIC REVIEW OF MOTOR FUNCTION IN ELOQUENT AREAS POST-RADIATION THERAPY. HOW IMPORTANT IS MOTOR FUNCTION FOR PATIENTS WITH GLIOMAS IN RADIATION THERAPY?

Abstract BACKGROUND The quality of life for patients with gliomas is significantly impacted by tumor characteristics, treatment modalities, and radiation dosages. Variability in radiotherapy protocols and differences in tissue tolerance necessitate a detailed risk-benefit assessment, especially in eloquent brain areas responsible for motor functions. METHODS A retrospective analysis of electronic medical records from a Brazilian Radiation Therapy Department (2018-2023) was conducted. Patients with gliomas who underwent surgical resection and adjuvant radiochemotherapy, subsequently developing Wallerian Degeneration of the Corticospinal Tract (WDCT), were included. Additionally, a systematic search was performed in PubMed, Embase, and Cochrane databases, focusing on radiotherapy in eloquent areas and evaluating motor function. Of the 1,064 studies identified, 11 underwent full-text review by two independent examiners. RESULTS Among 192 glioma patients, 13 (6.77%) developed WDCT, all with high-grade gliomas, including 3 post-reirradiation cases. Retrospective dosimetric analysis of the corticospinal tract was performed for two patients who had tractography. Patient 1, with right frontoparietal tumor, had an ipsilateral corticospinal tract volume of 10.6 cm³, a max dose of 62.81 Gy, and 0.5 cc receiving 62.2 Gy; the contralateral tract volume was 18.5 cm³, with 0.5 cc receiving 51 Gy. Patient 2, with right frontal tumor, had an ipsilateral corticospinal tract volume of 31.1 cm³, a max dose of 42.76 Gy, and 0.5 cc receiving 42.37 Gy; the contralateral tract volume was 30.3 cm³, with 0.5 cc receiving 24.19 Gy. The systematic review identified 5 studies reporting pre- and post-radiotherapy motor outcomes in eloquent areas, with 4 focusing exclusively on gliomas. However, heterogeneity in radiotherapy techniques and outcome assessments precluded a meta-analysis. CONCLUSION Motor function in glioma patients undergoing radiation therapy remains an underexplored area. Future studies should focus on standardized assessments of functional outcomes to establish dose constraints and optimize treatment protocols, thus improving the quality of life for glioma patients.

Evaluation of Preclinical Class I Amalgam Cavity Preparation: A Comparison of Two Assessment Methods

Preclinical assessment forms an effective strategy in undergraduate training. It enhances the continuous development of skills, facilitates early intervention, and optimizes training resources. Constructive feedback provided to the student fosters continuous improvement in preparedness for professional practice and has implications for the development of a learning culture characterized by student activity. This indeed ensures that a smooth transition will be made toward clinical application of skills. The aim of the study was to evaluate examiner`s reliabilities while applying two different assessment methods: a Glance and Grade assessment method and a Checklist and Criteria assessment method. A total of 100 class I amalgam cavity preparations were assessed by three independent examiners to evaluate Class I amalgam cavity preparations on artificial first mandibular molar teeth prepared by second-year undergraduate dental students in a preclinical laboratory setting. Statistical analysis for inter-examiner and intra-examiner variability was tested using one-way ANOVA test and a paired t-test, respectively. Results of this study showed that intra-examiner variability was significantly reduced with Checklist and Criteria assessment method. The inter-examiner variability was present in a Glance and Grade assessment method while with the Checklist and Criteria assessment method, there was an extremely high level of agreement among the examiners. The study's findings indicated considerable variability among examiners using the Glance and Grade assessment method. However, the Checklist and Criteria assessment method demonstrated remarkable consistency among examiners, indicating that it may offer a more standardized and reliable approach to evaluation.

Enhancing the diagnostic capacity of [18F]PSMA-1007 PET/MRI in primary prostate cancer staging with artificial intelligence and semi-quantitative DCE: an exploratory study

BackgroundTo investigate the ability of artificial intelligence (AI)-based and semi-quantitative dynamic contrast enhanced (DCE) multiparametric MRI (mpMRI), performed within [18F]-PSMA-1007 PET/MRI, in differentiating benign from malignant prostate tissues in patients with primary prostate cancer (PC).ResultsA total of seven patients underwent whole-body [18F]-PSMA-1007 PET/MRI examinations including a pelvic mpMRI protocol with T2w, diffusion weighted imaging (DWI) and DCE image series. Conventional analysis included visual reading of PET/MRI images and Prostate Imaging Reporting & Data System (PI-RADS) scoring of the prostate. On the prostate level, we performed manual segmentations for time-intensity curve parameter formation and semi-quantitative analysis based on DCE segmentation data of PC-suspicious lesions. Moreover, we applied a recently introduced deep learning (DL) pipeline previously trained on 1010 independent MRI examinations with systematic biopsy-enhanced histopathological targeted biopsy lesion ground truth in order to perform AI-based lesion detection, prostate segmentation and derivation of a deep learning PI-RADS score. DICE coefficients between manual and automatic DL-acquired segmentations were compared. On patient-based analysis, PET/MRI revealed PC-suspicious lesions in the prostate gland in 6/7 patients (Gleason Score-GS ≥ 7b) that were histologically confirmed. Four of these patients also showed lymph node metastases, while two of them had bone metastases. One patient with GS 6 showed no PC-suspicious lesions. Based on DCE segmentations, a distinction between PC-suspicious and normal appearing tissue was feasible with the parameters fitted maximum contrast ratio (FMCR) and wash-in-slope. DICE coefficients (manual vs. deep learning) were comparable with literature values at a mean of 0.44. Further, the DL pipeline could identify the intraprostatic PC-suspicious lesions in all six patients with clinically significant PC.ConclusionFirstly, semi-quantitative DCE analysis based on manual segmentations of time-intensity curves was able to distinguish benign from malignant tissues. Moreover, DL analysis of the MRI data could detect clinically significant PC in all cases, demonstrating the feasibility of AI-supported approaches in increasing diagnostic certainty of PSMA-radioligand PET/MRI.

Segmentation of periapical lesions with automatic deep learning on panoramic radiographs: an artificial intelligence study

Periapical periodontitis may manifest as a radiographic lesion radiographically. Periapical lesions are amongst the most common dental pathologies that present as periapical radiolucencies on panoramic radiographs. The objective of this research is to assess the diagnostic accuracy of an artificial intelligence (AI) model based on U²-Net architecture in the detection of periapical lesions on dental panoramic radiographs and to determine whether they can be useful in aiding clinicians with diagnosis of periapical lesions and improving their clinical workflow. 400 panoramic radiographs that included at least one periapical radiolucency were selected retrospectively. 780 periapical radiolucencies in these anonymized radiographs were manually labeled by two independent examiners. These radiographs were later used to train the AI model based on U²-Net architecture trained using a deep supervision algorithm. An AI model based on the U²-Net architecture was implemented. The model achieved a dice score of 0.8 on the validation set and precision, recall, and F1-score of 0.82, 0.77, and 0.8 respectively on the test set. This study has shown that an AI model based on U²-Net architecture can accurately diagnose periapical lesions on panoramic radiographs. The research provides evidence that AI-based models have promising applications as adjunct tools for dentists in diagnosing periapical radiolucencies and procedure planning. Further studies with larger data sets would be required to improve the diagnostic accuracy of AI-based detection models.

Chloroplast redox state mediates the short-term regulation of leaf isoprene emission.

Isoprene emission from plants not only confers thermoprotection, but also has profound impacts on atmospheric chemistry and the climate. Leaf isoprene emission is dynamically regulated in response to various environmental cues, but the exact mechanism remains unclear. It has been proposed that chloroplast redox/energy state or cytosolic phosphoenolpyruvate carboxylation regulates isoprene biosynthesis and consequently emission, and the latter has been disproven by recent literature. However, the possible covariation of chloroplast redox/energy state and cytosolic PEP carboxylation in previous experiments impedes the independent examination of the former hypothesis. We developed an index of chloroplast redox state and showed its validity by examining the relationships between the index and the rates of certain processes which have been demonstrated to be affected or unaffected by chloroplast redox/energy state. According to the former hypothesis alone, we modelled how isoprene emission rate (IER) responded to different short-term environmental variations, and compared theoretical predictions with experimental data. We predicted that no matter which environmental factor was varied, IER would respond to the index of chloroplast redox state with similar velocities. We found that IER showed comparable increasing rates in response to the increase in the index of chloroplast redox state caused by different environmental variations (0.0479, 0.0439 or 0.0319 when ambient CO2 concentration, photosynthetic photon flux density or leaf temperature was varied, respectively). These results support that chloroplast redox/energy state regulates isoprene biosynthesis, leading to dynamic isoprene emission in nature.

Inter-rater and Intra-rater Reliability of Het’s MMT in Pelvic Floor Assessment

Abstract Objective: Pelvic floor dysfunctions (pfds) such as urinary incontinence, pelvic organ prolapse, and vaginismus are very common and are affecting the quality of life of the female suffering through it. The pelvic floor muscles can be in spasm, thus resulting in the inability to relax or the pelvic floor muscles can be extremely weak or loose, resulting in the inability to contract strongly and completely. The spasmodic pelvic floor can result in vaginismus, dyspareunia, chronic pelvic pain, constipation, etc., Moreover, a weak pelvic floor can lead to issues such as urinary incontinence, pelvic organ prolapse, and sexual dysfunction. There is a scarcity of a valid and reliable scale that assesses both the components of pfd. Subjects and Methods: The present study was conducted on 1349 participants which were divided into three groups on the basis of their symptoms. Group A – No symptoms (n = 439), Group B – Hypotonus pfd (n = 658), and Group C – Hypertonus pfd (n = 252). Examination: Vaginal examination to assess the pelvic floor muscles relaxation and contraction was done by Het’s Manual Muscle Testing (MMT). Inter rater reliability was assessed by comparing the data of two independent examiners on the same day. The intra rater reliability was assessed by comparing the data of test and retest at an interval of 1 week. Results: The intra rater reliability at 95% confidence interval (CI) was 0.92 – Normal pelvic floor function, 0.96 – Hypotonus pfd, and 0.97 – Hypertonus pfd. Moreover, inter rater reliability at 95% CI was 0.93 – normal pelvic floor function, 0.95 for hypotonus pfd, and 0.98 – hypertonus pfd. Conclusions: This study concludes Het’s MMT is a highly reliable manual muscle testing tool to assess the pelvic floor muscles.

Prospective Study of Contamination Spread Produced During Open Surgical vs Conventional Percutaneous vs Novel Percutaneous Tracheostomy During COVID-19 Era in a Pig Model.

Because of concerns about provider contamination during tracheostomy procedures in a pandemic such as COVID-19, it is essential to objectively evaluate aerosol generation in all tracheostomy approaches, including newly developed tracheostomy procedures. We performed open surgical tracheostomy (OST), conventional percutaneous tracheostomy (CPT), and novel percutaneous tracheostomy (NPT), a modification of CPT designed to reduce contamination spread, in pig models and then compared the degree of contamination to providers using Glo Germ (Glo Germ, Moab, UT, USA). Six Yorkshire pigs were used for data collection. Either OST, CPT or NPT was performed on the pigs by the same team including a surgeon, anesthesiologist, and respiratory therapist. A mixture of Glo Germ and water was administered via atomizer into the oral cavity to the tracheal bifurcation before each procedure, and additionally dispersed via an aersolizer in the trachea and lungs through the endotracheal tube before and throughout the procedure. Before and immediately after each procedure, pre-specified body parts of the providers were photographed and two independent examiners blindly evaluated the photographs to determine degree of Glo Germ contamination using a 3-point Likert scale. Total contamination among provider team average score (min. 0, max. 2), was significantly lower for OST than CPT (0.29 ± 0.59 vs 0.63 ± 0.65; P<0.01) or NPT (0.29 ± 0.59 vs 0.59 ± 0.66; p <0.01). No significant difference was seen in overall contamination of any provider between CPT and NPT (0.63 ± 0.65 vs 0.59 ± 0.66; p =0.92). Our results suggest that OST causes significantly less aerosol contamination to providers than either CPT or NPT.

The reliability of a modified three-stage cervical vertebrae maturation method for estimating skeletal growth in males and females.

Reliability of the six-stage cervical vertebrae maturation method to evaluate skeletal growth was evaluated on the combined male and female samples and revealed diverse results. The current study aimed to determine the reliability of the modified three-stage cervical vertebrae maturation method for estimating the skeletal growth of males and females. Pretreatment lateral cephalometric radiographs of 137 orthodontic patients were utilized to evaluate the intra- and inter-observer reliability of a modified cervical vertebrae maturation method. Four independent examiners categorized each radiograph into one of the three skeletal growth stages according to the cervical vertebrae morphology: (1) a pre-peak group (combining the CS1 and CS2 stages), (2) a peak group (combining the CS3 and CS4 stages), and (3) a post-peak group (combining the CS5 and CS6 stages). The Kappa index and the Fleiss multirater Kappa test were carried out to determine the reproducibility of this method. The studied sample included cephalometric radiographs of 68 males (49.6%) and 69 females (50.4%) aged between 7 and 58 years; no significant age difference was found between the sexes (p = 0.189). The overall inter-observer reliability was 0.689 (p < 0.001), and the inter-observer reliability for the post-peak stage showed only Kappa = 0.896 (p < 0.001). The Kappa values were significantly greater in males than in females during the peak stage (0.626 and 0.488, respectively). A modified three-stage cervical vertebrae maturation method showed substantial overall inter-examiner agreement; however, differential reliability for diverse skeletal maturation stages and sexes was found.

Evaluating AI Excellence: A Comparative Analysis of Generative Models in Library and Information Science

ABSTRACT This study compares the performance of GPT-3.5, GPT-4, Bard, and Gemini in answering Library and Information Science (LIS) questions. Sixteen questions were used for assessment, with two independent examiners scoring the initial and two successive responses from each AI system. Statistical analyses, including one-way Analysis of Variance (ANOVA), independent sample t-test, and one-sample t-test, were employed to identify performance differences. The results revealed consistency in responses generated across iterations for all AI systems. Significant differences were observed among the AI models, with Bard consistently underperforming compared to GPT-3.5, GPT-4, and Gemini. The study uncovered variability in the examiners’ scoring and emphasized the need for multiple evaluators in AI assessment.

Shedding light on the DICER1 mutational spectrum of uncertain significance in malignant neoplasms.

The Dicer protein is an indispensable player in such fundamental cell pathways as miRNA biogenesis and regulation of protein expression in a cell. Most recently, both germline and somatic mutations in DICER1 have been identified in diverse types of cancers, which suggests Dicer mutations can lead to cancer progression. In addition to well-known hotspot mutations in RNAase III domains, DICER1 is characterized by a wide spectrum of variants in all the functional domains; most are of uncertain significance and unstated clinical effects. Moreover, various new somatic DICER1 mutations continuously appear in cancer genome sequencing. The latest contemporary methods of variant effect prediction utilize machine learning algorithms on bulk data, yielding suboptimal correlation with biological data. Consequently, such analysis should be conducted based on the functional and structural characteristics of each protein, using a well-grounded targeted dataset rather than relying on large amounts of unsupervised data. Domains are the functional and evolutionary units of a protein; the analysis of the whole protein should be based on separate and independent examinations of each domain by their evolutionary reconstruction. Dicer represents a hallmark example of a multidomain protein, and we confirmed the phylogenetic multidomain approach being beneficial for the clinical effect prediction of Dicer variants. Because Dicer was suggested to have a putative role in hematological malignancies, we examined variants of DICER1 occurring outside the well-known hotspots of the RNase III domain in this type of cancer using phylogenetic reconstruction of individual domain history. Examined substitutions might disrupt the Dicer function, which was demonstrated by molecular dynamic simulation, where distinct structural alterations were observed for each mutation. Our approach can be utilized to study other multidomain proteins and to improve clinical effect evaluation.

YouTube videos on gingival grafting procedures: Content and quality analysis

BackgroundPeriodontal surgery for gingival defects is widely recognized by dental care professionals and researchers for its effectiveness in treating gingival recession and improving oral health outcomes. YouTube (Google LLC) is 1 of the health information sources patients and clinicians use, and assessing its content quality is crucial. The authors aimed to examine the content and quality of YouTube videos on gingival graft procedures. MethodsThe online video streaming platform YouTube was searched using the key word gingival graft. Two independent examiners analyzed a total of 120 videos; a third examiner assessed interrater reliability. Fifty videos that met the inclusion criteria were included in the study. The assessed content topics for these YouTube videos consisted of 13 different categories, and their overall quality was evaluated using the Video Information and Quality Index (VIQI). Statistical analyses were performed using SAS software, Version 9.4 (SAS Institute). ResultsThere were 23 videos in the high-quality content groups and 27 videos in the low-quality content group. Hospitals and universities uploaded most of the included videos. The most commonly discussed topics in the included videos were the patient’s condition (36 [72%]) and area of tissue graft (34 [68%]). The total VIQI score and flow had a significant impact on the overall content score (P < .05). ConclusionsThere was a direct correlation between total VIQI scores and total content scores and an inverse relationship between viewing rate and total content scores. Practical ImplicationsTo ensure patients receive accurate and up-to-date information about treatment, the authors recommend guiding them toward reliable resources by means of providing direct links to trustworthy websites, creating and sharing playlists of reliable educational videos, and offering printed materials with quick-response codes linking to verified sources. These actions will help patients easily access and trust the information they need for their treatment decisions.

Functional classification systems in Brazilian children with cerebral palsy: Reliability and associations between functional levels

ABSTRACT Children with Cerebral palsy (CP) present movement and posture disorders. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), Eating and Drinking Ability Classification System (EDACS), and Visual Function Classification System (VFCS) enhance the understanding of their performance. We verified inter-rater reliability and associations between the classification levels. Physical therapists classified 100 Brazilian children with CP (3–17 years) according to GMFCS, MACS, CFCS, EDACS, and VFCS. To evaluate inter-rater reliability (Intraclass Correlation Coefficient-ICC) two independent examiners concurrently assessed a subset of 60 participants. According to Spearman’s correlation coefficients, there were associations between GMFCS/MACS (r = 0.81), GMFCS/CFCS (r = 0.70), MACS/CFCS (r = 0.73), GMFCS/VFCS (r = 0.61), MACS/VFCS (r = 0.61), CFCS/EDACS (r = 0.58), CFCS/VFCS (r = 0.50), and EDACS/VFCS (r = 0.45) (p < .05). The inter-rater reliability ranged from excellent (ICC = 0.93-0.99) to good (ICC = 0.89), p < .05. The classification systems are reliable, and the levels associated with each other in Brazilian children, especially the GMFCS, MACS, and CFCS.

Patient safety in the pandemic: Experiences of charge nurses.

The aim of this study was to identify charge nurses' experiences ensuring patient safety during the coronavirus disease 2019 (COVID-19) pandemic. The research was conducted with charge nurses between July 2021 and February 2022. Research data were collected using a semi-structured interview with two main questions, six sub-questions and an audio recording. Interviews were conducted with 12 charge nurses and lasted ≈30 min. The content analysis method was used to transfer the collected data to written documents and define them to analyse the individual interview data. Content analyses were conducted independently by three different researchers. Inclusion and exclusion criteria for content were established to ensure consistency among all researchers. Researchers independently developed a coding scheme for content analysis based on the research objectives and applied it to the content. Intercoder reliability was assessed with Cohen's kappa coefficient to measure the consistency of coding among researchers. Three main themes were identified as a result of the content analysis. The themes identified after independent examination by the three researchers were 'ensuring safety and protection', 'sustaining motivation and resilience' and 'organizational restructuring and challenges'. This study highlights the challenges faced by charge nurses during the COVID-19 pandemic and their critical role in maintaining patient safety. The findings emphasize the importance of organizational adaptability, continuous motivation and comprehensive risk management strategies. Charge nurses played a key role in enhancing safety measures and fostering a culture of resilience among healthcare staff. Moving forward, these insights should guide health policies and practices to better prepare for future public health crises, ensuring the safety of both patients and staff.

Handling of Corruption Crimes at the Tanggahan Peken Village Credit Institution, Susut District, Bangli Regency Handled by the Bali Police

Lembaga Perkreditan Desa (LPD) is a vital financial institution for traditional villages in Bali, whose role is to save funds, provide credit, and support village development. However, some LPDs, such as Tanggahan Peken LPD in Bangli Regency, have experienced legal problems related to alleged corruption crimes committed by their administrators. The purpose of this study is to determine and analyze the handling of criminal acts at the Tanggahan Peken Village Credit Institution, Susut District, Bangli Regency handled by the Bali Police. The natural method of this research uses empirical legal research. The results showed that the occurrence of criminal acts of corruption committed by the Tanggahan Peken LPD management was caused by internal factors from the individual aspect of the LPD management to gain profit, enrich themselves and perpetuate their positions and external factors from the organizational aspect, namely the lack of regular guidance, supervision and audits carried out by LPD internal supervisors and LPLPD as technical supervisors and audits. The handling of corruption crimes by the Bali Police at the Tanggahan Peken Village Credit Institution (LPD) uses Standard Operating Procedures (SOP) from the process of receiving public complaints, investigating and investigating. Creating effective investigation and investigation plans. Investigators also conduct independent audits and examinations by involving experts in the field of accounting and auditing, experts in the field of economics and experts in criminal law.

Insights into dental age estimation: introducing multiple regression data from a Black South African population on modified gustafson's criteria.

Dental Age Estimation (DAE) is an effective instrument of the rule of law for verifying dubious age claims in living individuals. Once tooth development is complete, only degenerative dental characteristics can be used for this purpose. The influence of ethnicity on these degenerative dental characteristics has not been clarified.Degenerative changes were examined using modified Gustafson's criteria including secondary dentin formation, cementum apposition, periodontal recession and attrition using the Olze et al. (2012) staging scales. Orthopantomograms of 1882 black South Africans, consisting of 934 females and 948 males, from 12.00 to 40.96 years of chronological age were utilized. Two independent examiners performed the evaluations, with one of the two evaluating all radiographs twice.The relationship between individual characteristics and chronological age was analyzed using multiple regression analysis with chronological age as the dependent variable. The resulting R2 values ranged from 0.22 to 0.35, and the standard error of estimate were between 6.6 and 7.3 years. The correlation with age was consistently lower for females compared to males. The characteristic of cementum apposition emerged as critical in this population, due to a particularly low correlation with age and observer agreements partly in the "slight" range. The formula's values for the correlation with age were in general below the literature values for other populations. Overall, the limited precision of the age estimation by the formulae presented, especially for females, must be emphasized. The question of whether ethnicity per se exerts an influence on the characteristics in question, or whether the different socio-economic status, which encompasses factors such as nutrition and healthcare, is the determining factor, needs to be assessed in future studies.

Clinical audit of an artificial intelligence (AI) empowered smile simulation system: a prospective clinical trial

Smile aesthetics is an important factor to consider during orthodontic treatment planning. The aim of the present study is to assess the predictability of Invisalign SmileView for digital AI smile simulation in comparison to actual smile treatment outcomes, using various smile assessment parameters. A total of 24 adult subjects (12 females and 12 males; mean age 22 ± 5.2 years) who chose to be treated using Invisalign were prospectively recruited to have their pretreatment smiles captured using the Invisalign SmileView to simulate their new smiles before treatment was started. Patients were then treated using upper and lower Invisalign aligners with average treatment time of 18 ± 6 months. Full post-treatment records were obtained and full smile frame images of simulated smile and actual final smile of each subject were evaluated by an independent examiner using an objective assessment sheet. Ten smile variants were used to assess the characteristics of the full smile images. Significance level was set at P < 0.05. The ICC for the quantitative parameters showed that there was an overall excellent & good internal consistency (alpha value > 0.7 & > 0.9). The Independent t test was performed amongst the quantitative variables. The P value was not significant for all except maxillary inter canine width (P = 0.05), stating that for the five variables namely; philtrum height, commissure height, smile width, buccal corridor and smile index, actual mean values were similar to the simulation mean values. For the qualitative variables, the Kappa value ranged between 0.66 and − 0.75 which showed a substantial level of agreement between the examiners. Additionally, the Chi square test for the qualitative variables, revealed that the P value was found to be significant in all except lip line. This implies that only the lip line values are comparable. More optimal lip lines, straighter smile arcs and more ideal tooth display were achieved in actual post treatment results in comparison to the initially predicted smiles. Five quantitative smile assessment parameters i.e., philtrum height, commissure height, smile width, buccal corridor, and smile index, could be used as reliable predictors of smile simulation. Maxillary inter canine width cannot be considered to be a reliable parameter for smile simulation prediction. A single qualitative parameter, namely the lip line, can be used as a reliable predictor for smile simulation. Three qualitative parameters i.e., most posterior tooth display, smile arc, and amount of lower incisor exposure cannot be considered as reliable parameters for smile prediction.Trial Registration number and date: NCT06123585, (09/11/2023)

What Happened to Intellectual Curiosity?

Anthropogenic Climate Change (ACC) is a contentious subject with two camps: the warmists and the skeptics. The warmists claim a 97% consensus among the world’s scientists. Climatologist, Dr. Roy Spencer postulated that the so-called 97% consensus was not comprised of scientists who did an independent examination of the data but were merely not disputing the hypothesis. This paper examined the extent to which there was acceptance of the ACC hypothesis in the academic community and whether the skeptic position was acknowledged. The study found that the ACC hypothesis was overwhelmingly accepted with very little acknowledgement of the skeptic position.

Assessment of treatment needs, barriers, and self-perception regarding oral health among female university students: a cross-sectional study

BackgroundThe study aimed to compare the self-perceived oral health status measured through a self-administered questionnaire with clinically determined oral health status measured by decayed-missing-filled teeth (DMFT) and community periodontal index of treatment need (CPITN) indices in university going females. In addition, access barriers to treatment related to oral healthcare were also determined.MethodsA 3-month analytical cross-sectional study was designed for consenting university going females (aged 18–22 years) in Islamabad, Pakistan. The self-perceived oral health was recorded through a questionnaire requesting information regarding socio-demographics, self-perception of oral health, frequency of dental visits and barriers to seeking oral health. Seven independent examiners performed intraoral clinical examination and assessed the oral health status using globally standardized oral health assessment indices (DMFT and CPITN).ResultsA total of 400 students were included in the final sample. The study revealed a significant disparity between self-perceived oral health and clinical assessment. Although perceived oral health was considered “good” by 80.0% of the respondents, clinical examination revealed moderate DMFT scores (mean 2.95 ± 1.41) and periodontal disease requiring treatment in 89.5% of the individuals. The most common barriers in seeking dental care were lack of knowledge, dental phobia, affordability issue and false self-perception.ConclusionThe present study demonstrated a notable discrepancy between self-perception of oral health and clinically assessed oral health. These results emphasize the importance of focused educational programs and community outreach programs, especially directed towards this demographic. Prioritizing such initiatives will help individuals to recognize their actual oral health condition thus encouraging positive oral health behaviors and outcomes.

Berry Fruits and Their Improving Potential on Skeletal Muscle Health and Performance: A Systematic Review of the Evidence in Animal and in Human Studies.

The well-established anti-inflammatory and antioxidant properties of red fruits leave room for a biological pathway of improved muscle health promoted by berries in the diet. Our objective was to systematically review the number of trials conducted on human and animal species around the relationship between a berry diet and muscle health outcomes. Two independent examiners conducted a search for studies that utilized keywords associated with muscle health outcomes and a berry-based diet in both human and animal trials, in accordance with the PRISMA statement guidelines. The literature was searched through six electronic databases until December 2023. Screening of 152 retrieved articles resulted in a final selection of 16 reports investigating the effect of exposure to a berry-based diet and skeletal muscle health outcomes. The study protocol was registered on PROSPERO (CRD42023479682). Among the selected studies, nine involved humans and seven animal models (rats and mice). Overall, most of the studies reported positive effects on performance or muscle health. Specifically, five studies investigated the possible effects of blackcurrant on active human subjects or athletes; three studies focused on blueberry and presented results on running performance (human sample) and muscle health (rat models). The rest of the studies involved raspberries (two studies, rat models), aronia (one study, rat models), elderberry (one study, rat models), and a mixed compound (one study, rat models). In conclusion, there is some early evidence that a berry-rich diet may increase performance or muscle health, but more research is needed to fully understand the underlying biological trajectories, and thus, no firm conclusions can yet be drawn.