Compounding Effects of Domain-General Cognitive Weaknesses and Word Reading Difficulties on Anxiety Symptoms in Youth.

This study examined whether domain-general cognitive weaknesses in processing speed (PS) or executive functioning (EF) moderate the relation between word reading scores and anxiety such that lower word reading scores in combination with lower cognitive scores are associated with higher anxiety symptoms. The sample consisted of 755 youth ages 8-16 who were recruited as part of the Colorado Learning Disabilities Research Center twins study. Lower scores on PS (R2 = .007, p = .014), EF (R2 = .009, p = .006), and word reading (R2 = .006-.008, p = .010-.032) were associated with higher anxiety scores. In addition, the word reading × cognitive interactions were significant such that lower scores on PS (R2 = .010, p = .005) or EF (R2 = .013, p = .010) combined with lower word reading were associated with higher-than-expected anxiety symptoms. Results suggest that weaknesses in PS, EF, and word reading are modestly associated with higher anxiety symptoms, and these anxiety symptoms may be compounded in youth with both PS or EF weaknesses and word reading difficulties. These findings can guide assessment approaches for identifying youth with word reading challenges who may be at increased risk for anxiety.

Comparison of Contributing Risk Factors for Primary Tooth Caries in Down Syndrome and Non-Special Health Needs Children.

Purpose: To evaluate decayed, missing, and filled surfaces in primary teeth (dmfs) in Down syndrome subjects (DS) compared to typically developed (TD) controls using analysis. Methods: A retrospective study of 440 matched subjects (220 DS and 220 TD) was conducted. Categorical variables were evaluated for association with dental caries, with mean dmfs as the main outcome measure. Pearson's chi-square and independent sample t-tests for unequal variances for means were employed. Results: Overall, the TD control group was found to have significantly higher mean dmfs scores than the DS group: TD Equals 17.65 (mean dmfs), 95% confidence interval (CI) equals 15.48 to 19.90; DS equals 10.30 (mean dmfs), at 95% CI equals 7.96 to 12.78, (P<0.001). However, when controlled for the variable factors African American status (P=0.11), Hispanic status (P=0.07) and income level at or below 200 percent of poverty level (P=0.24) there was no significant difference in mean dmfs. Conclusions: In the study population DS and TD exhibited dissimilar dmfs scores, while when taking into consideration social and economic factors dmfs was equivalent. Caries risk factors modulate disease experience and should be considered in all population-specific studies. Patients with multiple high-risk factors should be treated as such, regardless of DS status.

The relationship between diabetes and carotid artery calcifications detected via dental cone-beam computed tomography in patients undergoing implant treatment planning.

BACKGROUND: The authors investigated the association between carotid artery calcifications (CACs) detected incidentally on dental cone-beam computed tomographic scans and positive diabetes status. METHODS: Two patient groups were identified retrospectively from a patient database: positive for CACs based on cone-beam computed tomographic scans and positive diabetes status. In addition to demographic characteristics, data including diabetes status and presence, type, and absence of CACs were obtained. A χ2 statistical analysis was completed by means of dividing the data into sets of known CAC and known history of diabetes; significance level was P < .05. RESULTS: To satisfy the a priori power analysis, records from 2010 through 2021 were used. For the positive CAC group, data were obtained from 288 patients (171 men, 117 women) and 68 patients (24%) had a positive diabetes status at the time of cone-beam computed tomography (P < .001). There were significantly more male patients (n = 47) than female patients (n = 21) with diabetes (χ2 = 9.9; P = .002). For the positive diabetes group, data were obtained from 225 patients (149 men, 76 women), and 100 patients (44%) had an identifiable CAC. There were significantly more male patients (n = 73) than female patients (n = 27) with CAC (χ2 = 21.2; P < .001). CONCLUSIONS: There was a significant relationship to diabetes for patients with CACs, indicating potential undiagnosed diabetes. Male patients with diabetes are significantly more at risk of developing CACs. PRACTICAL IMPLICATIONS: People with CAC may be at risk of having undiagnosed diabetes and require heightened awareness during implant treatment planning.

Metal artifact reduction using common dental materials.

OBJECTIVES: To determine the effect of different dental lab materials on cone beam computed tomography (CBCT) metal artifact at different resolutions. METHODS: A total of seven common dental lab materials were molded to a dental sextant of four extracted, restored teeth. In addition to base alone (control), each material was scanned using the Carestream 9600 CBCT unit at three resolutions - 0.3 mm, 0.15 mm, and 0.075 mm - at manufacturer established exposure parameters. A single, representative axial view of each trial was evaluated for metal artifact both quantitatively by histogram analysis and qualitatively by profile plot analysis in ImageJ. RESULTS: No statistically significant differences between the control and the dental materials were found; however, post-hoc tests showed significance between Blu-mousse® and polyvinyl siloxane with dental materials and control, predominantly in lower resolutions. CONCLUSIONS: The current study provides initial evidence on the influence of dental materials have on CBCT metal artifact as described by beam hardening, photon starvation, scatter, and noise, especially at lower resolutions. Blu-Mousse® and polyvinyl siloxane reduced the perceived beam hardening and photon starvation artifact the greatest, relative to other materials, at all three resolutions and lower resolutions, respectively.

Recovery from chronic fatigue syndrome: a systematic review-heterogeneity of definition limits study comparison.

BACKGROUND: Paediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a common illness with a major impact on quality of life. Recovery is poorly understood. Our aim was to describe definitions of recovery in paediatric CFS/ME, the rate of recovery and the time to recovery. METHODS: This systematic review included a detailed search of MEDLINE, EMBASE, PsycInfo and Cochrane Library between 1994 and July 2018. Inclusion criteria were (1) clinical trials and observational studies, (2) participants aged <19 years with CFS/ME, (3) conducted in Western Healthcare systems and (4) studies including a measure of recovery and time taken to recover. RESULTS: Twelve papers (10 studies) were identified, involving 826 patients (range 23-135). Recovery rates were highly varied, ranging between 4.5% and 83%.Eleven distinct definitions of recovery were used; six were composite outcomes while five used unidimensional outcomes. Outcome measures used to define recovery were highly heterogeneous. School attendance (n=8), fatigue (n=6) and physical functioning (n=4) were the most common outcomes included in definition of recovery. Only five definitions included a personal measure of recovery. IMPLICATIONS: Definitions of recovery are highly variable, likely secondary to differences in study design, outcomes used, follow-up and study populations. Heterogeneous definitions of recovery limit meaningful comparison between studies, highlighting the need for a consensus definition going forward. Recovery is probably best defined from the child's own perspective with a single self-reported measure. If composite measures are used for research, there should be agreement on the core outcome set used.

Linking Quality and Quantity of Parental Linguistic Input to Child Language Skills: A Meta-Analysis.

This meta-analysis examined associations between the quantity and quality of parental linguistic input and children's language. Pooled effect size for quality (i.e., vocabulary diversity and syntactic complexity; k = 35; N = 1,958; r = .33) was more robust than for quantity (i.e., number of words/tokens/utterances; k = 33; N = 1,411; r = .20) of linguistic input. For quality and quantity of parental linguistic input, effect sizes were stronger when input was observed in naturalistic contexts compared to free play tasks. For quality of parental linguistic input, effect sizes also increased as child age and observation length increased. Effect sizes were not moderated by socioeconomic status or child gender. Findings highlight parental linguistic input as a key environmental factor in children's language skills.

Insomnia symptoms during pregnancy: A meta-analysis.

Reports of sleep disturbances are common during pregnancy, yet estimates of prevalence of insomnia symptoms during pregnancy vary widely. The goals of the current review were to summarize the existing data on prevalence of insomnia symptoms during pregnancy and to explore potential moderators, including trimester, gestational age, maternal age, symptoms of anxiety and symptoms of depression. A systematic search of PubMed, PsycInfo and Web of Science was conducted for articles published from inception up to June 2020. In total, 24 studies with a total of 15,564 participants were included in the analysis. The overall prevalence of insomnia symptoms during pregnancy was 38.2%. Trimester was a significant moderator, such that prevalence of insomnia symptoms was higher in the third trimester (39.7%) compared to first (25.3%) and second (27.2%) trimesters. No other variables significantly moderated the prevalence of insomnia symptoms. The results of the current meta-analysis suggest that the prevalence of insomnia symptoms is higher during pregnancy, particularly in the third trimester. Future research should examine the efficacy and safety of insomnia treatments with this population.

Eleven-Month-Olds Link Sound Properties With Animal Categories.

We examined 11-month-olds' tendency to generalize properties to category members, an ability that may contribute to the inductive reasoning abilities observed in later developmental periods. Across three experiments, we tested 11-month-olds' (N = 113) generalization of properties within the cat and dog categories. In each experiment, infants were familiarized to animal-sound pairings (i.e., dog barking; cat meowing) and tested on this association and the generalization of the sound property to new members of the familiarized categories. After familiarization with a single exemplar, 11-month-olds generalized the sound to new category members that were both highly similar and less similar to the familiarized animal (Experiment 1). When familiarized with mismatched animal-sound pairings (Experiment 2; i.e., dog meowing; cat barking), 11-month-olds did not learn or generalize the sound properties, suggesting that infants have pre-existing expectations about the links between the characteristic sound properties and the animal categories. When familiarized with unfamiliar sound-animal pairings (Experiment 3; i.e., dog-unfamiliar sound), 11-month-olds linked the animals with the novel sounds but did not generalize to new category members. Taken together, these findings highlight the conditions under which young infants generalize properties from one exemplar to other category members.

A definition of global oral health: An expert consensus approach by the Consortium of Universities for Global Health's Global Oral Health Interest Group.

Definitions can generate actionable consensus for a given subject matter by resolving important differences in philosophy and best practices and by streamlining activities for a stronger strategic direction. Interest in the global dimensions of oral health, a generally neglected area of global health, is growing; yet, no previously published research has defined the term 'global oral health.' As such, the Global Oral Health Interest Group of the Consortium of Universities for Global Health determined a need for an introductory definition of 'global oral health' to guide program planning, implementation, and evaluation. With the oversight of an expert senior Task Force for the Definition of Global Oral Health, we employed a mixed-methods approach using the more common expert consensus-building Delphi technique combined with the lesser utilized Q methodology. This approach allowed us to identify the interconnectedness of global oral health themes and integrate multiple, seemingly disparate, topics into a single streamlined concept. Our resulting definition is as follows: Global Oral Health aims for optimal oral health for all people and elimination of global health inequities through health promotion, disease prevention, and appropriate oral care approaches that consider common determinants and solutions and acknowledge oral health as part of overall health. The purpose of this short communication is to generate a narrative around our proposed definition of global oral health to support establishing guidelines and developing best practices for academic global oral health programs, policies, and practices that aim to achieve a goal of oral health globally.

Impact of fashion braces on oral health related quality of life: a web-based cross-sectional study.

BACKGROUND: Orthodontic braces have become symbols of wealth and fashion accessories in some parts of the world. However, there is a scarcity of information about the effects of fashion braces on various aspects of quality of life. Therefore, our aim was to investigate the effects of fashion braces on oral health related quality of life (OHRQoL). METHODS: A cross-sectional study was carried out with data collection from a Google form questionnaire distributed in Saudi Arabia via various forms of social media over a period of 4 months. OHRQoL was assessed using the validated Arabic version of the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The fashion braces group included respondents who had braces installed for fashion purposes only. Therapeutic braces group included subjects who were wearing braces to treat any malocclusion problems. Control group included subjects who did not have any kind of braces. People who had previously completed orthodontic treatments were excluded from the study. The negative impacts were divided into seven domains and a total OHIP score was calculated. Statistical analyses and data illustration were performed with SPSS v25 (IBM, NY). RESULTS: A total of 1141 people voluntarily participated in the study. More than 60% of the participants were in the control group while 33.7% had conventional braces for therapeutic reasons and 3.4% had fashion braces. Sociodemographic distributions varied among the groups, with the majority of the fashion braces group having education below the university level and family incomes less than average. There were significant group differences in OHIP domains. Physical pain was the most frequently reported complaint by all subjects and was the highest in the therapeutic braces group. People with therapeutic braces reported significantly higher functional limitation and physical disability than the controls. Fashion braces group reported significantly lower psychological discomfort and disability, social disability and handicap compared to control groups. CONCLUSIONS: The illustrated effects of fashion braces on OHRQoL suggest the need to study the role of social media and educate the public on the use of braces to minimize the negative effects experienced by individuals.

The Prevalence of Sexting Behaviors Among Emerging Adults: A Meta-Analysis.

Sexting is the sharing of sexually explicit images, videos, and/or messages via electronic devices. Prevalence estimates of sexting have varied substantially, potentially due to broad age ranges being examined. The current study sought to synthesize relevant findings examining the prevalence of consensual and non-consensual sexting in a specific developmental period, emerging adulthood (≥ 18-< 29), to try to explain discrepancies in the literature. Searches were conducted in electronic databases for articles published up to April 2018. Relevant data from 50 studies with 18,122 emerging adults were extracted. The prevalence of sexting behaviors were: sending 38.3% (k = 41; CI 32.0-44.6), receiving 41.5% (k = 19; CI 31.9-51.2), and reciprocal sexting 47.7% (k = 16; CI 37.6-57.8). Thus, sexting is a common behavior among emerging adults. The prevalence of non-consensual forwarding of sexts was also frequent in emerging adults at 15.0% (k = 7; CI 6.9-23.2). Educational awareness initiatives on digital citizenship and psychological consequences of the non-consensual forwarding of sexts should be targeted to youth and emerging adults with the hopes of mitigating this potentially damaging and illegal behavior.

Development of a conceptual framework to underpin a health-related quality of life outcome measure in paediatric chronic fatigue syndrome/myalgic encephalopathy (CFS/ME): prioritisation through card ranking.

PURPOSE: Chronic fatigue syndrome (CFS)/myalgic encephalopathy (ME) is relatively common in children and is disabling at an important time in their development. This study aimed to develop a conceptual framework of paediatric CFS/ME using the patient-perspective to ensure that the content of a new outcome measure includes the outcomes most important to young people. METHODS: We developed a child-centred interactive card ranking exercise that included health-related quality of life (HRQoL) outcomes identified from a previous review of the literature as well as qualitative work. Adolescents and their parents selected and ranked the outcomes most important to them and discussed each outcome in further detail. Adolescents were purposively sampled from a single specialist paediatric CFS/ME service in England. Interviews were audio recorded and transcribed verbatim, and thematic framework analysis was used to develop the final conceptual framework. RESULTS: We interviewed 43 participants in which there are 21 adolescents, 12-17 years of age with mild-moderate CFS/ME and their parents (20 mothers and 2 fathers). 'Symptoms', 'tiredness', 'payback and crashing' and 'activities and hobbies' were ranked most important to improve by both children and parents. Children ranked 'school' higher than parents and parents ranked 'mood' higher than children. A youth- specific CFS/ME conceptual framework of HRQoL was produced that included 4 outcome domains and 11 subdomains: sleep, tiredness, problems concentrating, individual symptoms, fluctuation and payback, daily and general activities, participation in school, leisure and social life, mood, anxiety and self-esteem. CONCLUSIONS: An interactive card ranking exercise worked well for adolescents aged 12-17 to elicit the most important outcomes to them and explore each domain in further detail. We developed a final conceptual framework of HRQoL that forms the basis of a new paediatric patient-reported outcome measure (PROM) in CFS/ME.

Parenting Behavior and Child Language: A Meta-analysis.

CONTEXT: Early language development supports cognitive, academic, and behavioral success. Identifying modifiable predictors of child language may inform policies and practices aiming to promote language development. OBJECTIVE: To synthesize results of observational studies examining parenting behavior and early childhood language in typically developing samples. DATA SOURCES: Searches were conducted in Medline, Embase, PsycINFO, Web of Science, and Dissertation Abstracts (1967 to 2017). STUDY SELECTION: Studies had 1 of 2 observational measures of parenting behavior (i.e., sensitive responsiveness or warmth) and a measure of child language. DATA EXTRACTION: Data from 37 studies were extracted by independent coders. Estimates were examined by using random-effects meta-analysis. RESULTS: Two meta-analyses were conducted, which examined (1) the association between sensitive-responsive parenting and child language (k = 36; r = 0.27; 95% confidence interval: 0.21 to 0.33); and (2) the association between parental warmth and child language (k = 13; r = 0.16; 95% confidence interval: 0.09 to 21). The pooled effect size for the association between sensitive responsiveness and child language was statistically higher than that of warmth and child language. The association between sensitive responsiveness and child language was moderated by family socioeconomic status (SES): effect sizes were stronger in low and diverse SES groups compared with middle to upper SES groups. Effect sizes were also stronger in longitudinal versus cross-sectional studies. LIMITATIONS: Results are limited to typically developing samples and mother-child dyads. Findings cannot speak to causal processes. CONCLUSIONS: Findings support theories describing how sensitive parenting may facilitate language and learning.

Paediatric chronic fatigue syndrome patients' and parents' perceptions of recovery.

OBJECTIVES: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is common in children and adolescents; however, little is known about how we should define recovery. This study aims to explore perceptions of recovery held by paediatric patients with CFS/ME and their parents. METHODS: Children with CFS/ME and their parents were recruited through a single specialist paediatric CFS/ME service. Data were collected through semistructured interviews with children and parents. The interview questions explored how participants would know if they/their child had recovered from CFS/ME. Thematic analysis was used to identify patterns within the data. RESULTS: Twenty-one children with CFS/ME, twenty mothers and two fathers were interviewed. Some children found it hard to define recovery as the illness had become a 'new normal'. Others thought recovery would indicate returning to pre-morbid levels of activity or achieving the same activity level as peers (socialising, education and leisure activities). Increased flexibility in routines and the absence of payback after activities were important. The interviews highlighted the concept of recovery as highly individual with wide variation in symptoms experienced, type and level of activity that would signify recovery. Parents describe how changes in mood and motivation would signify their child's recovery, but children did not reflect on this. CONCLUSION: Some parents and children struggle to define what would constitute complete recovery. However, signs of recovery were more easily identifiable. Definitions of recovery went far beyond symptom reduction and were focused towards rebuilding lives.

A Retrospective Study of Patient Outcomes After Temporomandibular Joint Replacement With Alloplastic Total Joint Prosthesis at Massachusetts General Hospital.

PURPOSE: Disorders of the temporomandibular joint (TMJ) occur frequently, with a prevalence of 15 to 18%. Total joint replacement (TJR) surgery is indicated for severe joint damage associated with impaired function, pain, or occlusal change for which other treatments have been unsuccessful. The aim of this study was to assess changes in pain and range of motion (ROM), as well as postoperative complications and comorbidities, in patients receiving TJR surgery at Massachusetts General Hospital (MGH). PATIENTS AND METHODS: This study is a retrospective review that describes the clinical variables in patients after alloplastic TMJ reconstruction performed at MGH from 2000 to 2015. Clinical variables included primary diagnosis; number of previous surgical procedures; comorbidities; preoperative and postoperative pain; preoperative, intraoperative, and postoperative ROM; and complications. RESULTS: Data were obtained from 95 patients undergoing a total of 108 surgical procedures, with an average follow-up period of 4.48 ± 3.38 years. The most common primary indications for TJR were ankylosis (44%) and inflammatory disease (23%). The maximum interincisal opening improved by a mean of 7.7 ± 10.27 mm, and pain decreased by a mean of 1.5 ± 3.29 points on a visual analog scale. Transient facial nerve palsy (25%) was the most common postoperative complication; however, long-term complications were rare. The most frequent comorbidities were psychiatric disorders (56%) and gastrointestinal disease (46%). Psychiatric patients had similar preoperative pain scores (6.0 ± 2.90) but significantly higher postoperative pain scores (4.7 ± 2.58) compared with nonpsychiatric patients. Twenty-eight percent of patients had prior failed TMJ implant materials, specifically Proplast-Teflon (Vitek, Houston, TX). These patients were significantly older (50.4 ± 8.26 years) and had smaller preoperative ROM (21.7 ± 8.85 mm) and smaller postoperative ROM (28.3 ± 9.59 mm). CONCLUSIONS: Patients showed a statistically significant (P < .01) increase in ROM and reduction in pain. TJR is an effective treatment option in patients with limited mouth opening or severe pain.

Animacy cues facilitate 10-month-olds' categorization of novel objects with similar insides.

In this experiment, we examined whether sensitivity to the relevance of object insides for the categorization of animate objects is in place around 10 months of age. Using an object examining paradigm, 10-month-old infants' (N = 58) were familiarized to novel objects with varying outward appearances but shared insides in one of three groups: No cues, Eyes, and Cue control. During test trials, infants were presented with a novel in-category test object followed by an out-of-category test object. When objects were presented with animacy cues (i.e., Eyes), infants categorized the objects together. In contrast, when objects were presented without any added cues or when they were presented with a shared perceptual marker (Cue control, i.e., plastic spoons placed on top of the objects), infants showed no evidence of categorization. These results indicate that by 10 months of age, eyes signal to infants that objects share some kind of uniting commonality that may not be obvious or readily perceptually available.

Adolescent's descriptions of fatigue, fluctuation and payback in chronic fatigue syndrome/myalgic encephalopathy (CFS/ME): interviews with adolescents and parents.

OBJECTIVE: As part of a larger qualitative study to explore outcomes important in paediatric chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) and what improvements in fatigue and disability are key, interviews were undertaken with adolescents and their parents. This paper focuses on their descriptions of fatigue, fluctuation of symptoms and payback. DESIGN AND SETTING: Semistructured qualitative interviews were undertaken between December 2014 and February 2015. Adolescents and parents were interviewed separately. Participants were recruited from a single specialist paediatric chronic fatigue service. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis. PARTICIPANTS: We interviewed 21 adolescents and their parents (20 mothers and 2 fathers). The adolescents were aged between 12 and 17 years of age (mean age 14.4 years), mild to moderately affected by CFS/ME (not housebound) and the majority were female (16/21). RESULTS: All adolescents with CFS/ME reported fatigue, a natural fluctuation of the condition, with good days and bad days as well as an increase in symptoms after activity (payback). However, adolescent's descriptions of fatigue, symptoms and the associated impact on their daily lives differed. The variations included: fatigue versus a collection of symptoms, constant versus variable symptoms and variable symptom severity. There were differences between participants in the amount of activity taken to cause payback. The impact of fatigue and symptoms on function ranged from: limiting the duration and amount of leisure activities, struggling with daily activities (eg, self-care) to no activity (sedentary). CONCLUSIONS: Fatigue, fluctuation of the condition and payback after activity are described by all adolescents with CFS/ME in this study. However, the individual experience in terms of how they describe it and the degree and impact varies.

A Vibration Device to Control Injection Discomfort.

Pain from local anesthesia injections can be reduced by distraction and counter-stimulation techniques. This study investigated the DentalVibe® Injection Comfort System (third-generation, DV3), developed to lessen anesthesia pain through pulsed vibration, a form of counter-stimulation. The aim of the study was to evaluate both the efficacy of DV3 in reducing pain and discomfort from intraoral long buccal (LB) and inferior alveolar nerve (IAN) injections and the time needed to achieve complete anesthesia during an IAN block. The study enrolled 60 subjects, 30 men and 30 women, aged 21 to 32 years, who rated both injection pain on a visual analog scale and discomfort, unpleasantness, and difficulty in enduring the injection on a modified symptom severity index. Each subject received bilateral LB injections and an IAN block. Using block design, the third-generation DV (DV3) was randomly assigned to either the first or second LB injection and to 30 subjects on their third injection, the IAN block. No topical anesthesia was applied. Subjects receiving DV3 reported significantly less pain, discomfort, unpleasantness, and difficulty in enduring LB and IAN injections (P < .05), regardless of whether DV3 was used on the first or second LB injection. Time to complete anesthesia was not significantly different (P > .05) when DV3 was used on IAN block injections. The DV3 significantly (P < .02) reduced pain/discomfort from anesthetic injections in this pilot study, in which many subjects were either dental or medical students familiar with performing and enduring injections. More studies are warranted on layperson populations.