Text mining analysis of scientific literature on digital intraoral scanners in dentistry: Bibliometric analysis.

Objective: This study aimed to provide valuable insights into the current research status and gaps in digital intraoral scanner literature in dentistry. Methodology: Scopus Search Query TITLE-ABS-KEY (intraoral AND scanners AND (dentistry OR digital AND dentistry)). The search query used in Scopus for the bibliometric analysis was "TITLE-ABS-KEY (intraoral AND scanners AND (dentistry OR digital AND dentistry))." This query indicates that the analysis focused on documents in which the title, abstract, or keywords contained the terms "intraoral," "scanners," and either "dentistry" or "digital dentistry." Results: The analysis covers a timespan from 1998 to 2023 and includes 331 documents sourced from 136 publications. The annual growth rate of research in this field is reported to be 15.9%, indicating a steady increase over time. Among the top sources, the "Journal of Esthetic and Restorative Dentistry" and the "Journal of Prosthetic Dentistry" have the highest number of articles, indicating their significance in the field. Some notable authors and their corresponding statistics include WÖSTMANN B, with 15 articles and a fractionalized value of 3.16, and SCHLENZ MA, with 14 articles and a fractionalized value of 2.91. The United States has the highest number of articles, indicating a significant presence in research publications. Germany closely follows this, demonstrating a notable contribution to the scientific community. Conclusions: This bibliometric analysis of intraoral scanners used in dentistry provided valuable insights into the current state of research and scholarly publications in this field. This analysis sheds light on the trends, patterns, and advancements in the use of these scanners in dental practice.

In silico assessment of biocompatibility and toxicity: molecular docking and dynamics simulation of PMMA-based dental materials for interim prosthetic restorations.

AIM: This study aimed to comprehensively assess the biocompatibility and toxicity profiles of poly(methyl methacrylate) (PMMA) and its monomeric unit, methyl methacrylate (MMA), crucial components in dental materials for interim prosthetic restorations. METHODOLOGY: Molecular docking was employed to predict the binding affinities, energetics, and steric features of MMA and PMMA with selected receptors involved in bone metabolism and tissue development, including RANKL, Fibronectin, BMP9, NOTCH2, and other related receptors. The HADDOCK standalone version was utilized for docking calculations, employing a Lamarckian genetic algorithm to explore the conformational space of ligand-receptor interactions. Furthermore, molecular dynamics (MD) simulations over 100 nanoseconds were conducted using the GROMACS package to evaluate dynamic actions and structural stability. The LigandScout was utilized for pharmacophore modeling, which employs a shape-based screening approach to identify potential ligand binding sites on protein targets. RESULTS: The molecular docking studies elucidated promising interactions between PMMA and MMA with key biomolecular targets relevant to dental applications. MD simulation results provided strong evidence supporting the structural stability of PMMA complexes over time. Pharmacophore modeling highlighted the significance of carbonyl and hydroxyl groups as pharmacophoric features, indicating compounds with favorable biocompatibility profiles. CONCLUSION: This study underscores the potential of PMMA in dental applications, emphasizing its structural stability, molecular interactions, and safety considerations. These findings lay a foundation for future advancements in dental biomaterials, guiding the design and optimization of materials for enhanced biocompatibility. Future directions include experimental validation of computational findings and the development of PMMA-based dental materials with improved biocompatibility and clinical performance.

Belief Updating, Childhood Maltreatment, and Paranoia in Schizophrenia-Spectrum Disorders.

BACKGROUND AND HYPOTHESIS: Exposure to childhood maltreatment-a risk factor for psychosis is associated with paranoia-may impact one's beliefs about the world and how beliefs are updated. We hypothesized that increased exposure to childhood maltreatment is related to volatility-related belief updating, specifically higher expectations of volatility, and that these relationships are strongest for threat-related maltreatment. Additionally, we tested whether belief updating mediates the relationship between maltreatment and paranoia. STUDY DESIGN: Belief updating was measured in 75 patients with schizophrenia-spectrum disorders and 76 nonpsychiatric controls using a 3-option probabilistic reversal learning (3PRL) task. A Hierarchical Gaussian Filter (HGF) was used to estimate computational parameters of belief updating, including prior expectations of volatility (µ03). The Childhood Trauma Questionnaire (CTQ) was used to assess cumulative maltreatment, threat, and deprivation exposure. Paranoia was measured using the Positive and Negative Syndrome Scale (PANSS) and the revised Green et al. Paranoid Thoughts Scale (R-GPTS). RESULTS: Greater exposure to childhood maltreatment is associated with higher prior expectations of volatility in the whole sample and in individuals with schizophrenia-spectrum disorders. This was specific to threat-related maltreatment, rather than deprivation, in schizophrenia-spectrum disorders. Paranoia was associated with both exposure to childhood maltreatment and volatility priors, but we did not observe a significant indirect effect of volatility priors on the relationship between maltreatment and paranoia. CONCLUSIONS: Our study suggests that individuals with schizophrenia-spectrum disorders who were exposed to threatening experiences during childhood expect their environment to be more volatile, potentially facilitating aberrant belief updating and conferring risk for paranoia.

Dental biomaterials redefined: molecular docking and dynamics-driven dental resin composite optimization.

BACKGROUND: Dental resin-based composites are widely recognized for their aesthetic appeal and adhesive properties, which make them integral to modern restorative dentistry. Despite their advantages, adhesion and biomechanical performance challenges persist, necessitating innovative strategies for improvement. This study addressed the challenges associated with adhesion and biomechanical properties in dental resin-based composites by employing molecular docking and dynamics simulation. METHODS: Molecular docking assesses the binding energies and provides valuable insights into the interactions between monomers, fillers, and coupling agents. This investigation prioritizes SiO2 and TRIS, considering their consistent influence. Molecular dynamics simulations, executed with the Forcite module and COMPASS II force field, extend the analysis to the mechanical properties of dental composite complexes. The simulations encompassed energy minimization, controlled NVT and NPT ensemble simulations, and equilibration stages. Notably, the molecular dynamics simulations spanned a duration of 50 ns. RESULTS: SiO2 and TRIS consistently emerged as influential components, showcasing their versatility in promoting solid interactions. A correlation matrix underscores the significant roles of van der Waals and desolvation energies in determining the overall binding energy. Molecular dynamics simulations provide in-depth insights into the mechanical properties of dental composite complexes. HEMA-SiO2-TRIS excelled in stiffness, BisGMA-SiO2-TRIS prevailed in terms of flexural strength, and EBPADMA-SiO2-TRIS offered a balanced combination of mechanical properties. CONCLUSION: These findings provide valuable insights into optimizing dental composites tailored to diverse clinical requirements. While EBPADMA-SiO2-TRIS demonstrates distinct strengths, this study emphasizes the need for further research. Future investigations should validate the computational findings experimentally and assess the material's response to dynamic environmental factors.

Quantum mechanical analysis of yttrium-stabilized zirconia and alumina: implications for mechanical performance of esthetic crowns.

BACKGROUND: Yttrium-stabilized zirconia (YSZ) and alumina are the most commonly used dental esthetic crown materials. This study aimed to provide detailed information on the comparison between yttrium-stabilized zirconia (YSZ) and alumina, the two materials most often used for esthetic crowns in dentistry. METHODOLOGY: The ground-state energy of the materials was calculated using the Cambridge Serial Total Energy Package (CASTEP) code, which employs a first-principles method based on density functional theory (DFT). The electronic exchange-correlation energy was evaluated using the generalized gradient approximation (GGA) within the Perdew (Burke) Ernzerhof scheme. RESULTS: Optimization of the geometries and investigation of the optical properties, dynamic stability, band structures, refractive indices, and mechanical properties of these materials contribute to a holistic understanding of these materials. Geometric optimization of YSZ provides important insights into its dynamic stability based on observations of its crystal structure and polyhedral geometry, which show stable configurations. Alumina exhibits a distinctive charge, kinetic, and potential (CKP) geometry, which contributes to its interesting structural framework and molecular-level stability. The optical properties of alumina were evaluated using pseudo-atomic computations, demonstrating its responsiveness to external stimuli. The refractive indices, reflectance, and dielectric functions indicate that the transmission of light by alumina depends on numerous factors that are essential for the optical performance of alumina as a material for esthetic crowns. The band structures of both the materials were explored, and the band gap of alumina was determined to be 5.853 eV. In addition, the band structure describes electronic transitions that influence the conductivity and optical properties of a material. The stability of alumina can be deduced from its bandgap, an essential property that determines its use as a dental material. Refractive indices are vital optical properties of esthetic crown materials. Therefore, the ability to understand their refractive-index graphs explains their transparency and color distortion through how the material responds to light..The regulated absorption characteristics exhibited by YSZ render it a highly attractive option for the development of esthetic crowns, as it guarantees minimal color distortion. CONCLUSION: The acceptability of materials for esthetic crowns is strongly determined by mechanical properties such as elastic stiffness constants, Young's modulus, and shear modulus. YSZ is a highly durable material for dental applications, owing to its superior mechanical strength.

Measurement of the major ignored burden of multiple myeloma, pernicious anaemia and of other haematological conditions on partners and family members: A cross-sectional study.

BACKGROUND: Having a haematological condition can adversely affect the quality of life (QoL) of family members/partners of patients. It is important to measure this often ignored burden in order to implement appropriate supportive interventions. OBJECTIVE: To measure current impact of haematological conditions on the QoL of family members/partners of patients, using the Family Reported Outcome Measure-16 (FROM-16). METHODS: A cross-sectional study, recruited online through patient support groups, involved UK family members/partners of people with haematological conditions completing the FROM-16. RESULTS: 183 family members/partners (mean age = 60.5 years, SD = 13.2; females = 62.8%) of patients (mean age = 64.1, SD = 12.8; females = 46.4%) with 12 haematological conditions completed the FROM-16. The FROM-16 mean total score was 14.0 (SD = 7.2), meaning 'a moderate effect on QoL'. The mean FROM-16 scores of family members of people with multiple myeloma (mean = 15.8, SD = 6.3, n = 99) and other haematological malignancies (mean = 13.9, SD = 7.8, n = 29) were higher than of people with pernicious anaemia (mean = 10.7, SD = 7.5, n = 47) and other non-malignant conditions (mean = 11, SD = 7.4, n = 56, p < .01). Over one third (36.1%, n = 183) of family members experienced a 'very large effect' (FROM-16 score>16) on their quality of life. CONCLUSIONS: Haematological conditions, in particular those of malignant type, impact the QoL of family members/partners of patients. Healthcare professionals can now, using FROM-16, identify those most affected and should consider how to provide appropriate holistic support within routine practice.

Modeling the influence of bacteria concentration on the mechanical properties of self-healing concrete (SHC) for sustainable bio-concrete structures.

In this research paper, the intelligent learning abilities of the gray wolf optimization (GWO), multi-verse optimization (MVO), moth fly optimization, particle swarm optimization (PSO), and whale optimization algorithm (WOA) metaheuristic techniques and the response surface methodology (RSM) has been studied in the prediction of the mechanical properties of self-healing concrete. Bio-concrete technology stimulated by the concentration of bacteria has been utilized as a sustainable structural concrete for the future of the built environment. This is due to the recovery tendency of the concrete structures after noticeable structural failures. However, it requires a somewhat expensive exercise and technology to create the medium for the growth of the bacteria needed for this self-healing ability. The method of data gathering, analysis and intelligent prediction has been adopted to propose parametric relationships between the bacteria usage and the concrete performance in terms of strength and durability. This makes is cheaper to design self-healing concrete structures based on the optimized mathematical relationships and models proposed from this exercise. The performance of the models was tested by using the coefficient of determination (R2), root mean squared errors, mean absolute errors, mean squared errors, variance accounted for and the coefficient of error. At the end of the prediction protocol and model performance evaluation, it was found that the classified metaheuristic techniques outclassed the RSM due their ability to mimic human and animal genetics of mutation. Furthermore, it can be finally remarked that the GWO outclassed the other methods in predicting the concrete slump (Sl) with R2 of 0.998 and 0.989 for the train and test, respectively, the PSO outclassed the rest in predicting the flexural strength with R2 of 0.989 and 0.937 for train and test, respectively and the MVO outclassed the others in predicting the compressive strength with R2 of 0.998 and 0.958 for train and test, respectively.

Evaluation of the effect of chemical disinfection and ultraviolet disinfection on the dimensional stability of polyether impression material: an in-vitro study.

BACKGROUND: Various methods, chemical and physical, disinfect dental impressions. Common chemicals include 1% Sodium Hypochlorite and 2% glutaraldehyde, while UV radiation is a prevalent physical method. Few studies compare their effects on dimensional stability in polyether impressions. This study aims to assess such stability using different disinfection methods. Therefore, this study was planned to evaluate the dimensional stability of polyether impression material using different disinfection methods. METHODS: This in vitro study compared the effects of chemical disinfectants (1% Sodium Hypochlorite and 2% glutaraldehyde) and UV irradiation on the dimensional stability of polyether impression material. Groups A, B, C, and D, each with ten samples (N = 10), were studied. Group A was untreated (control). Group B was treated with 2% glutaraldehyde for 20 min, Group C with 1% Sodium Hypochlorite for 20 min, and Group D with UV rays for 20 min. A pilot milling machine drill was used to make four parallel holes labeled A, B, C, and D in the anterior and premolar regions from right to left. After sequential drilling, four implant analogs were positioned using a surveyor for accuracy. Ten open-tray polyether impressions were made and treated as described in the groups, followed by pouring the corresponding casts. Distortion values for each disinfection method were measured using a coordinate measuring machine capable of recording on the X- and Y-axes. RESULTS: A comprehensive analysis was conducted using the one-way ANOVA test for distinct groups labeled A, B, C, and D, revealing significant differences in the mean distances for X1, X2, X4, X5, and X6 among the groups, with p-values ranging from 0.001 to 0.000. However, no significant differences were observed in X3. Notably, mean distances for the Y variables exhibited substantial differences among the groups, emphasizing parameter variations, with p-values ranging from 0.000 to 0.033. The results compared the four groups using the one-way ANOVA test, revealing statistically significant distance differences for most X and Y variables, except for X3 and Y4. Similarly, post-hoc Tukey's tests provided specific pairwise comparisons, underlining the distinctions between group C and the others in the mean and deviation distances for various variables on both the X- and Y-axes. CONCLUSIONS: This study found that disinfection with 1% sodium hypochlorite or UV rays for 20 min maintained dimensional stability in polyether impressions.

Handling 'carbon footprint' in orthopaedics.

INTRODUCTION: The National Health Service contributes 4%-5% of England and Wales' greenhouse gases and a quarter of all public sector waste. Between 20% and 33% of healthcare waste originates from a hospital's operating room, and up to 90% of waste is sent for costly and unneeded hazardous waste processing. The goal of this study was to quantify the amount and type of waste produced during a selection of common trauma and elective orthopaedic operations, and to calculate the carbon footprint of processing the waste. METHODS: Waste generated for both elective and trauma procedures was separated primarily into clean and contaminated, paper or plastic, and then weighed. The annual carbon footprint for each operation at each site was subsequently calculated. RESULTS: Elective procedures can generate up to 16.5kg of plastic waste per procedure. Practices such as double-draping the patient contribute to increasing the quantity of waste. Over the procedures analysed, the mean total plastic waste at the hospital sites varied from 6 to 12kg. One hospital site undertook a pilot of switching disposable gowns for reusable ones with a subsequent reduction of 66% in the carbon footprint and a cost saving of £13,483.89. CONCLUSIONS: This study sheds new light on the environmental impact of waste produced during trauma and elective orthopaedic procedures. Mitigating the environmental impact of the operating room requires a collective drive for a culture change to sustainability and social responsibility. Each clinician can have an impact upon the carbon footprint of their operating theatre.

Vegetation-edaphic correlation and importance value index in himalayan 'ecotone' temperate conifer forest using the multivariate technique.

Himalayan 'Ecotone' temperate conifer forest is the cradle of life for human survival and wildlife existence. In spite of the importance of these areas, they have not been studied in depth. This study aimed to quantify the floristic structure, important value index (IVI), topographic and edaphic variables between 2019 and 2020 utilizing circular quadrant method (10 m x 10 m). The upper-storey layer consisted of 17 tree species belongs to 12 families and 9 orders. Middle-storey shrubs comprised of 23 species representing 14 families and 12 orders. A total of 43 species of herbs, grasses, and ferns were identified from the ground-storey layer, representing 25 families and 21 orders. Upper-storey vegetation structure was dominated by Pinus roxburghii (22.45 %) and middle-storey by Dodonaea viscosa (7.69 %). However, the ground layer vegetation was diverse in species composition (43 species) and distribution. The floral vegetation structure was encompassing of three floral communities which were diverse in IVI, such as, in Piro-Aial (Group 2), Pinus roxburghii (54.46 x 15.94) had the highest IVI value, followed by Pinus wallichiana (45.21 x 14.85) in Piwa-Quin (Group 3) and Ailanthus altissima (22.84 x 19.25) in Aial-Qugal (Group 1). However, the IVI values for Aesculus indica, Celtis australis, and Quercus incana in Aial-Qugal (Group 1) were not determined due to low detection rate. Nevertheless, eleven of these species showed 0 IVI values in Piro-Aial (Group 2) and Piwa-Quin (Group 3). CCA ordination biplot illustrated the significant differences among floral communities and its distribution, which impacted by temperature, rainfall, soil pH, altitude, and topographic features. Ward's agglomerative clustering finding reflected 'Ecotone' temperate conifer forest is rich and diverse floristic structure.

Ketamine-based Sedation Use in Mechanically Ventilated Critically Ill Patients with COVID-19: A Multicenter Cohort Study.

Backgrounds: Ketamine possesses analgesia, anti-inflammation, anticonvulsant, and neuroprotection properties. However, the evidence that supports its use in mechanically ventilated critically ill patients with COVID-19 is insufficient. The study's goal was to assess ketamine's effectiveness and safety in critically ill, mechanically ventilated (MV) patients with COVID-19. Methods: Adult critically ill patients with COVID-19 were included in a multicenter retrospective-prospective cohort study. Patients admitted between March 1, 2020, and July 31, 2021, to five ICUs in Saudi Arabia were included. Eligible patients who required MV within 24 hours of ICU admission were divided into two sub-cohort groups based on their use of ketamine (Control vs. Ketamine). The primary outcome was the length of stay (LOS) in the hospital. P/F ratio differences, lactic acid normalization, MV duration, and mortality were considered secondary outcomes. Propensity score (PS) matching was used (1:2 ratio) based on the selected criteria. Results: In total, 1,130 patients met the eligibility criteria. Among these, 1036 patients (91.7 %) were in the control group, whereas 94 patients (8.3 %) received ketamine. The total number of patients after PS matching, was 264 patients, including 88 patients (33.3 %) who received ketamine. The ketamine group's LOS was significantly lower (beta coefficient (95 % CI): -0.26 (-0.45, -0.07), P = 0.008). Furthermore, the PaO2/FiO2 ratio significantly improved 24 hours after the start of ketamine treatment compared to the pre-treatment period (6 hours) (124.9 (92.1, 184.5) vs. 106 (73.1, 129.3; P = 0.002). Additionally, the ketamine group had a substantially shorter mean time for lactic acid normalization (beta coefficient (95 % CI): -1.55 (-2.42, -0.69), P 0.01). However, there were no significant differences in the duration of MV or mortality. Conclusions: Ketamine-based sedation was associated with lower hospital LOS and faster lactic acid normalization but no mortality benefits in critically ill patients with COVID-19. Thus, larger prospective studies are recommended to assess the safety and effectiveness of ketamine as a sedative in critically ill adult patients.

Why selective screening for asymptomatic carotid stenosis is currently appropriate: a special report.

INTRODUCTION: Two of the main reasons recent guidelines do not recommend routine population-wide screening programs for asymptomatic carotid artery stenosis (AsxCS) is that screening could lead to an increase of carotid revascularization procedures and that such mass screening programs may not be cost-effective. Nevertheless, selective screening for AsxCS could have several benefits. This article presents the rationale for such a program. AREAS COVERED: The benefits of selective screening for AsxCS include early recognition of AsxCS allowing timely initiation of preventive measures to reduce future myocardial infarction (MI), stroke, cardiac death and cardiovascular (CV) event rates. EXPERT OPINION: Mass screening programs for AsxCS are neither clinically effective nor cost-effective. Nevertheless, targeted screening of populations at high risk for AsxCS provides an opportunity to identify these individuals earlier rather than later and to initiate a number of lifestyle measures, risk factor modifications, and intensive medical therapy in order to prevent future strokes and CV events. For patients at 'higher risk of stroke' on best medical treatment, a prophylactic carotid intervention may be considered.

Implications of the Centers for Medicare and Medicaid Services (CMS) decision to expand indications for carotid artery stenting.

OBJECTIVE: On October 11, 2023, the Centers for Medicare and Medicaid Services (CMS) expanded the indications for carotid artery stenting (CAS) to include patients with ≥50% symptomatic or ≥70% asymptomatic carotid stenosis. The aim of this article was to investigate the implications of this decision. METHODS: The reasons behind the increased coverage for CAS are analyzed and discussed, as well as the various Societies supporting or opposing the expansion of indications for CAS. RESULTS: The benefits associated with expanding CAS indications include providing an additional therapeutic option to patients and enabling individualization of treatment according to patient-specific characteristics. The drawbacks of expanding CAS indications include a possible bias in decision-making and an increase in inappropriate CAS procedures. CONCLUSIONS: The purpose of the CMS recommendation to expand indications for CAS is to improve the available therapeutic options for patients. Hopefully this decision will not be misinterpreted and will be used to improve patient options and patient outcomes.

Distinct Time-resolved Brain-wide Coactivations in Oxygenated and Deoxygenated Hemoglobin.

OBJECTIVE: Human resting-state networks (RSNs) estimated from oxygenated (HbO) and deoxygenated hemoglobin (HbR) data exhibit strong similarities, while task-based studies show different dynamics in HbR and HbO responses. Such a discrepancy might be explained due to time-averaged estimations of RSNs. Our study investigated differences between HbO and HbR on time-resolved brain-wide coactivation patterns (CAPs). APPROACH: Diffuse optical tomography was reconstructed from resting-state whole-head functional near-infrared spectroscopy data of HbR and HbO in individual healthy participants. Timeaveraged RSNs were obtained using the group-level independent component analysis. Time-resolved CAPs were estimated using a clustering approach on the time courses of all obtained RSNs. Characteristics of the RSNs and CAPs from HbR and HbO were compared. MAIN RESULTS: Spatial patterns of HbR and HbO RSNs exhibited significant similarities. Meanwhile, HbR CAPs revealed much more organized spatial and dynamic characteristics than HbO CAPs. The entire set of HbR CAPs suggests a superstructure resulted from brain-wide neuronal dynamics, which is less evident in the set of HbO CAPs. These differences between HbO and HbR CAPs were consistently replicated in individual session data. CONCLUSION: Our results suggest that human resting brain-wide neuronal activations are preserved better in time-resolved brainwide patterns, i.e., CAPs, from HbR than those from HbO, while such a difference is lost between time-averaged HbR and HbO RSNs. SIGNIFICANCE: Our results reveal, for the first time, HbR concentration fluctuations are more directly coupled with resting dynamics of brain-wide neuronal activations in human brains.

A population-based study of 15,000 people on Knowledge and awareness of lung cancer symptoms and risk factors in Saudi Arabia.

Background: Lung cancer is currently the most fatal form of cancer worldwide, ranking as the fourth most prevalent type in Saudi Arabia, particularly among males. This trend is expected to increase with growing population, lifestyle changes, and aging population. Understanding the awareness of the Saudi population regarding the risk factors and symptoms of lung cancer is necessary to attenuate the predicted increase in cases. Method: A cross-sectional, population-based survey was performed using a previously validated questionnaire (Lung CAM). Multiple linear regression analysis was used to assess variables associated with deficiency in knowledge and awareness of risk factors and symptoms of lung cancer. Results: Majority of the 15,099 respondents were male (65%), aged between 18 and 30 years (53%), 50% of which were educated up to a bachelor's degree level. Overall awareness of lung cancer signs and symptoms was 53%, with painful cough and coughing up blood being the best-known symptoms. Conversely, persistent shoulder pain (44%) and clubbing fingers (47%) were the least known lung cancer symptoms. Also, 60% of the respondents showed low confidence in identifying the signs and symptoms of lung cancer. The overall awareness of the risk factors for lung cancer development was 74%, with first-hand (74%) and second-hand (68%) smoking being the most known risk factors. However, only ≤ 62% know the other non-smoking risk factors. Awareness of the risk factors and symptoms of lung cancer depended on age, gender, education, marital and employment status (p < 0.001). Conclusion: Public awareness of the risk factors and symptoms of lung cancer in Saudi Arabia is inadequate and heavily dependent on education and socio-economic status. Awareness can be improved through campaigns to raise awareness about other lesser-known lung cancer risk factors and symptoms.

Post-pandemic paradigm shift toward telemedicine and tele-education; an updated survey of the impact of Covid-19 pandemic on neurosurgery residents in United States.

Background: Several strategies were implemented during the Covid-19 pandemic to enhance residency training and patient care. Objective: This study aims to assess the post-pandemic landscape of neurosurgical training and practice. Method: A survey consisting of 28 questions examining the challenges faced in neurosurgery and the adaptive measures was conducted among US neurosurgery residents from May 2022 to May 2023. Results: This study encompassed 59 neurosurgical residents, predominantly male (72.9%) and in later years of training (66.1%) and were distributed across 25 states. Telemedicine and tele-education were pivotal during the pandemic, with virtual lecture series, standalone lectures, and virtual discussions highly favored. Remote didactic learning increased for nearly half of the residents, while 54.2% resumed in-person instruction. Telemedicine was deemed effective by 86.4% for evaluating neurosurgical patients. Access to teaching environments was restricted for 61.0% of residents, impacting their training. The pandemic significantly influenced elective surgeries, with complete cancellations reported by 42.4%. Reduced faculty engagement was noted by 35.6% of residents, while 47.5% reported a negative impact on the overall resident experience. The majority (76.3%) considered changes to their training reasonable given the global health situation. Conclusions: Strategies implemented during the peak of the pandemic remain crucial in shaping neurosurgery training. Telemedicine has become indispensable, with widespread adoption. Tele-education has also expanded, providing additional learning opportunities. However, traditional didactic courses and hands-on experiences remain essential for comprehensive training. Balancing technology-driven methods with established approaches is crucial for optimizing neurosurgical education and maintaining high-quality patient care.

Responsiveness and minimal important change of the Family Reported Outcome Measure (FROM-16).

BACKGROUND: The FROM-16 is a generic family quality of life (QoL) instrument that measures the QoL impact of patients' disease on their family members/partners. The study aimed to assess the responsiveness of FROM-16 to change and determine Minimal Important Change (MIC). METHODS: Responsiveness and MIC for FROM-16 were assessed prospectively with patients and their family members recruited from outpatient departments of the University Hospital Wales and University Hospital Llandough, Cardiff, United Kingdom. Patients completed the EQ-5D-3L and a global severity question (GSQ) online at baseline and at 3-month follow-up. Family members completed FROM-16 at baseline and a Global Rating of Change (GRC) in addition to FROM-16 at follow-up. Responsiveness was assessed using the distribution-based (effect size-ES, standardized response mean -SRM) and anchor-based (area under the receiver operating characteristics curve ROC-AUC) approaches and by testing hypotheses on expected correlation strength between FROM-16 change score and patient assessment tools (GSQ and EQ-5D). Cohen's criteria were used for assessing ES. The AUC ≥ 0.7 was considered a good measure of responsiveness. MIC was calculated using anchor-based (ROC analysis and adjusted predictive modelling) and distribution methods based on standard deviation (SD) and standard error of the measurement (SEM). RESULTS: Eighty-three patients with 15 different health conditions and their relatives completed baseline and follow-up questionnaires and were included in the responsiveness analysis. The mean FROM-16 change over 3 months = 1.43 (SD = 4.98). The mean patient EQ-5D change over 3 months = -0.059 (SD = 0.14). The responsiveness analysis showed that the FROM-16 was responsive to change (ES = 0.2, SRM = 0.3; p < 0.01). The ES and SRM of FROM-16 change score ranged from small (ES = 0.2; SRM = 0.3) for the distribution-based method to large (ES = 0.8, SRM = 0.85) for anchor-based methods. The AUC value was above 0.7, indicating good responsiveness. There was a significant positive correlation between the FROM-16 change scores and the patient's disease severity change scores (p < 0.001). The MIC analysis was based on data from 100 family members of 100 patients. The MIC value of 4 was suggested for FROM-16. CONCLUSIONS: The results of this study confirm the longitudinal validity of FROM-16 which refers to the degree to which an instrument is able to measure change in the construct to be measured. The results yield a MIC value of 4 for FROM-16. These psychometric attributes of the FROM-16 instrument are useful in both clinical research as well as clinical practice.

Thyroidectomy Effects on the Body Mass Index and Thyroid-Stimulating Hormone: A Systematic Review and Meta-Analysis.

Thyroidectomy is common and is performed for malignancy, goiters with pressure symptoms, and certain types of Grave's disease. Weight and body mass index (BMI) following thyroidectomy were discussed controversially. This meta-analysis aimed to assess weight and BMI following thyroidectomy. A systematic literature search was conducted in PubMed, Medline, and Google Scholar with interest in articles that assessed body weight and BMI following total or subtotal thyroidectomy. The search engine was limited to the period from inception up to January 2024. Keywords "total thyroidectomy", "subtotal thyroidectomy", "Graves' disease", "multinodular goiter", "differentiated thyroid carcinoma", and "toxic nodules" were used. Out of the 634 articles retrieved, 89 full texts were screened, and only six studies (five retrospective and one prospective cohort) fulfilled the inclusion and exclusion criteria. No differences were evident regarding weight and BMI before and after thyroidectomy (odds ratio: -0.63, 95%CI: -1.50 to -0.24, P-value for the overall effect: 0.15; and odds ratio: -0.12, 95% CI: -0.41 to -0.16, P-value for the overall effect: 0.40 respectively). No heterogeneity was observed (I2 for heterogeneity: 0.0%). No association between thyroidectomy (when performed for differentiated thyroid carcinoma and hyperthyroidism), weight, and BMI was found. Further studies assessing thyroid-stimulating hormone (TSH) levels, radioactive iodine therapy, and thyroxine dose are needed.

A Comprehensive Review of Various Therapeutic Strategies for the Management of Skin Cancer.

Skin cancer (SC) poses a global threat to the healthcare system and is expected to increase significantly over the next two decades if not diagnosed at an early stage. Early diagnosis is crucial for successful treatment, as the disease becomes more challenging to cure as it progresses. However, identifying new drugs, achieving clinical success, and overcoming drug resistance remain significant challenges. To overcome these obstacles and provide effective treatment, it is crucial to understand the causes of skin cancer, how cells grow and divide, factors that affect cell growth, and how drug resistance occurs. In this review, we have explained various therapeutic approaches for SC treatment via ligands, targeted photosensitizers, natural and synthetic drugs for the treatment of SC, an epigenetic approach for management of melanoma, photodynamic therapy, and targeted therapy for BRAF-mutated melanoma. This article also provides a detailed summary of the various natural drugs that are effective in managing melanoma and reducing the occurrence of skin cancer at early stages and focuses on the current status and future prospects of various therapies available for the management of skin cancer.

Relationships between perception of black triangles appearance, personality factors and level of education.

This analytical cross-sectional study evaluated the perception of black triangles (BT) and examined the relationships between the perception of BT, personality factors, different educational backgrounds and demographic factors. 435 participants were included and divided into four groups: dentists, clinical (4th and 5th year) dental students, pre-clinical (3rd year) dental students, and laypeople. Participants' perception of the attractiveness of smile profiles of maxillary and mandibular anterior dentition with BT was rated using a ten-point VAS scale with 0 being the least, and 10 being the most attractive smile profile. The personality was assessed using the NEO-FFI personality questionnaire. The smile profile with multiple large BT was rated the least attractive for the maxillary (mean = 3.6) and mandibular (mean = 3.9) tested profiles. The smile profile without BT was rated the most attractive for the maxillary (mean = 9.1) and mandibular (mean = 8.8) tested profiles. The dental professionals perceived the maxillary smile profile with multiple large BT as less attractive than the non-dental participants (t = - 2.715, P = 0.007). Being a male, having dental education, having lower Neuroticism scores, as well as having higher Openness, Agreeableness, Conscientiousness, and Extraversion scores predicted and contributed more towards perceiving various tested smile profiles as more attractive. These findings show that black triangles negatively impacts the perception of smile attractiveness, and that personality traits and having dental education impact the perception of smile attractiveness for smiles with black triangles.