Caries risk assessment using different Cariogram models. A comparative study about concordance in different populations-Adults and children.

This methodological survey aimed to verify whether there is concordance among several Cariogram different risk models at different thresholds, comparing both children and adult populations and how each risk/protective factor weight on the overall caries risk profile. Three groups' data (two in children and one in adults) were obtained from previous studies, while a fourth, in young adults, was ad hoc enrolled. Different caries risk levels were assessed: a) three risk categories with two different thresholds as: "low risk"  =  61-100% or 81-100% chance to avoid caries, "moderate risk"  =  41-60% or 21-80% and "high risk"  =  0-40% or 0-20%, named model 1 and 2; b) four risk categories with two different thresholds as: "low risk"  =  61-100% or 76-100%, "moderate/low risk" = 41-60% or 51-75%; "moderate/high risk" = 21-40% or 26-50% and "high risk" = 0-20% or 0-25%, model 3 and 4; c) five risk categories as: "very low risk"  =  81-100%; "low risk"  =  61-80% "moderate risk" = 41-60%; "high risk" = 21-40% and "very high risk" = 0-20%, model 5. Concordance of the different Cariogram risk categories among the four groups was calculated using Cohen's kappa. The weight of the association between all Cariogram models toward the Cariogram risk variables was evaluated by ordinal logistic regression models. Considering Cariogram model 1 and 2, Cohen's Kappa values ranged from 0.40 (SE = 0.07) for the young adult group to 0.71 (SE = 0.05) for the adult one. Cohen's Kappa values ranged from 0.14 (SE = 0.03 p<0.01) for the adult group to 0.62 (SE = 0.02) for the two groups of children in models 3 and 4. Statistically significant associations were found for all Cariogram risk variables excepting Fluoride program in models 4 and 5 and the overall risk on children's samples. Caries experience showed a quite variable weight in the different models in both adult groups. In the regression analyses, adult groups' convergence was not always achievable since variations in associations between caries risk and different risk variables were narrower compared to other samples. Significant differences in caries risk stratification using different thresholds stands out from data analysis; consequently, risk assessments need to be carefully considered due to the risk of misleadingly choosing preventive and research actions

Feasibility of discriminating UAV propellers noise from distress signals to locate people in enclosed environments using MEMS microphone arrays

Producción CientíficaDetecting and finding people are complex tasks when visibility is reduced. This happens, for example, if a fire occurs. In these situations, heat sources and large amounts of smoke are generated. Under these circumstances, locating survivors using thermal or conventional cameras is not possible and it is necessary to use alternative techniques. The challenge of this work was to analyze if it is feasible the integration of an acoustic camera, developed at the University of Valladolid, on an unmanned aerial vehicle (UAV) to locate, by sound, people who are calling for help, in enclosed environments with reduced visibility. The acoustic array, based on MEMS (micro-electro-mechanical system) microphones, locates acoustic sources in space, and the UAV navigates autonomously by closed enclosures. This paper presents the first experimental results locating the angles of arrival of multiple sound sources, including the cries for help of a person, in an enclosed environment. The results are promising, as the system proves able to discriminate the noise generated by the propellers of the UAV, at the same time it identifies the angles of arrival of the direct sound signal and its first echoes reflected on the reflective surfaces.Junta de Castilla y León (project VA082G18

A Virtual 3D Dynamic Model of Caries Lesion Progression as a Learning Object for Caries Detection Training and Teaching: Video Development Study

BACKGROUND: In the last decade, 3D virtual models have been used for educational purposes in the health sciences, specifically for teaching human anatomy and pathology. These models provide an opportunity to didactically visualize key spatial relations that can be poorly understood when taught by traditional educational approaches. Caries lesion detection is a crucial process in dentistry that has been reported to be difficult to learn. One especially difficult aspect is linking clinical characteristics of the different severity stages with their histological features, which is fundamental for treatment decision-making. OBJECTIVE: This project was designed to develop a virtual 3D digital model of caries lesion formation and progression to aid the detection of lesions at different severity stages as a potential complement to traditional lectures. METHODS: Pedagogical planning, including identification of objectives, exploration of the degree of difficulty of caries diagnosis-associated topics perceived by dental students and lecturers, review of the literature regarding key concepts, and consultation of experts, was performed prior to constructing the model. An educational script strategy was created based on the topics to be addressed (dental tissues, biofilm stagnation areas, the demineralization process, caries lesion progression on occlusal surfaces, clinical characteristics related to different stages of caries progression, and histological correlations). Virtual 3D models were developed using the Virtual Man Project and refined using multiple 3D software applications. In the next phase, computer graphic modelling and previsualization were executed. After that, the video was revised and edited based on suggestions. Finally, explanatory subtitles were generated, the models were textured and rendered, and voiceovers in 3 languages were implemented. RESULTS: We developed a 6-minute virtual 3D dynamic video in 3 languages (English, Spanish, and Brazilian Portuguese) intended for dentists and dental students to support teaching and learning of caries lesion detection. The videos were made available on YouTube; to date, they have received more than 100,000 views. CONCLUSIONS: Complementary pedagogical tools are valuable to support cariology education. This tool will be further tested in terms of utility and usability as well as user satisfaction in achieving the proposed objectives in specific contexts

A Política Nacional de Educação Superior na Saúde e a Reorientação Curricular da FOUSP: Análise Comparativa do Desempenho e Percepção dos Estudantes

This paper presents a report of the national policy for higher education and health, as the context in which the undergraduate course of the Faculdade de Odontologia da USP has conducted its curricular restructuring. The reference documents for the restructuring curriculum were the National Education Plan (2014-2024), the National Curriculum Guidelines, the Pro-Saúde and PET Health Programs. It is also reported the application of curricular restructuring to the Pediatric Dentistry Discipline, as well as the result of the performance evaluation and the perception of students, comparing the curricula before and after the restructuring.Este artigo apresenta um histórico recente da política nacional de educação superior e da política nacional de saúde, como contexto no qual o curso de graduação em Odontologia da Faculdade de Odontologia da USP conduziu sua reestruturação curricular. São destacados como referência o Plano Nacional de Educação (2014- 2024), as Diretrizes Curriculares Nacionais para o curso de graduação em Odontologia, o Programa Nacional de Reorientação da Formação Profissional em Saúde (Pró-Saúde) e o Programa de Educação pelo Trabalho em Saúde (PET Saúde), como contexto a partir do qual a reestruturação foi conduzida. Relatam-se ainda a aplicação da reestruturação curricular às mudanças formuladas e implementadas na Disciplina de Odontopediatria, e o resultado da avaliação de desempenho e de percepção dos estudantes, comparando-se os currículos antes e depois da reestruturação

Assessment of Glass Ionomer Cements (GIC) restorations after acidic erosive challenges: an in vitro study

Objective: To analyze the marginal adaptation of two different Glass Ionomer Cements (GIC) after erosive challenges. Material and Methods: Sixty sound extracted primary canines were selected and class V cavities were made. Teeth were allocated into 6 groups according to restorative material: 1) high-viscosity GIC (Ketac™Molar Easymix) and 2) resin-modified GIC with nanoparticles (Ketac™N100), low pH beverage erosive challenge (Orange juice and Coca-Cola) or distilled water as control. Thereafter the sample was restored and subjecting to thermocycling. The sample was immersed for a 10-days period for the erosive simulation and then embedded in methylene blue solution during 4 hours. Finally teeth were sectioned for further analysis. Marginal adaptation test was performed by two trained examiners using the Salama et al. criteria. Descriptive and Kruskal-Wallis test (α=5%) were used to analyze the data. Results: The groups treated with Ketac™Molar EasyMix were similar in terms of marginal sealing ability when submitted to Orange juice and Coca-Cola but significantly worse than water. For samples restored with the Ketac™N100 the worst results were found in the Coca-Cola group. Conclusion: Erosive challenges with acidic drinks affected the marginal adaptation of the tested GIC

Children’s self-reported discomfort of restorative treatments for deep caries lesions in primary teeth: results from a randomized clinical trial

The aim of this study was to evaluate the impact of different restorative techniques to treat deep caries lesions of primary molars on children’s self-reported discomfort. A randomized clinical trial with two parallel arms (1:1) was conducted in São Paulo, Brazil. 4-8 years-old children with at least one occlusal or occlusoproximal deep caries lesion in primary molars were selected. Molars were randomly allocated into two groups: (1) restoration performed with calcium hydroxide cement followed by high-viscosity Glass Ionomer Cement (CHC+HVGIC), and (2) HVGIC restoration. Immediately after the intervention, children reported the experienced discomfort during restoration to an external examiner using a Wong-Baker face-scale. Children’s self-reported discomfort was analyzed using Poisson regression comparing both groups and assessing other variables’ influence (α=5%). One hundred and eight children fulfilled the eligibility criteria and were randomized in the two groups (n=54). Most of the children who received CHC+HVGIC restorations reported none or minimal discomfort (83.3%). Similar scores (92.6%) were reported for those treated with HVGIC (p=0.758). The mean reported discomfort in children with CHC+HVGIC restorations was 0.37(1.01), and 0.41(1.01) for those with HVGIC restorations. Children’s self-reported discomfort was associated with age, sex, children’s cooperation, and intervention duration. We can conclude that CHC+HVGIC or HVGIC restorations result in none or minimal discomfort in the management of deep caries lesions, being considered a reliable option

Impact of the radiographic examination on diagnosis and treatment decision of caries lesions in primary teeth – the Caries Detection in Children (CARDEC-01) trial: study protocol for a randomized controlled trial

Abstract\ud \ud Background\ud Although most clinical guidelines throughout the world indicate that clinicians take two bitewings for detecting caries lesions in primary molars of all children, evidence for this recommendation is essentially based on cross-sectional studies performed in laboratory settings or using convenience samples. The benefits and impact of performing radiographs on diagnosis and treatment decision of caries lesions in primary teeth, mainly considering relevant outcomes for patients, have not been evaluated yet. Thus, the aim of this randomized clinical trial will be to evaluate the impact of performing radiographic examination adjunct to the visual inspection for detecting and making treatment decision regarding caries lesions in primary teeth compared with visual inspection performed alone. We will consider different outcomes related to children's health and welfare.\ud \ud \ud Methods/Design\ud To reach this objective, 250 children ages 3 to 6 years who sought dental treatment in our dental school will be randomly allocated in two groups according to the diagnostic strategy used for caries detection: visual inspection performed alone or visual inspection associated to radiographic examination. Two trained and calibrated examiners will carry out the examinations and elaborate the treatment decision plan. Then, children will be treated and followed up for 2 years, with evaluations after 12 and 24 months after the inclusion of children in the study. Children will also return after 6 and 18 months to reinforce the preventive orientations. Primary outcome will be the number of dental surfaces in need of dental treatment at the follow-up. Secondary outcomes will be the components of the primary outcome separately, as well as, proportion of false-positive results, the oral health-related quality of life, cost-efficacy, cost-adjusted life years, and number of new lesions in the first permanent molars.\ud \ud \ud Discussion\ud Our working hypothesis is that radiographic examination would actually exert little influence on patient-centered outcomes, and visual inspection would be enough as diagnostic strategy for caries detection in primary teeth.\ud \ud \ud Trial registration\ud \ud \ud NCT02078453\ud \ud . Registered 4 March 2015.This trial is funded by the Fundação de Amparo à Pesquisa do Estado de\ud São Paulo – FAPESP (Grant # 2012/24243-7), CNPQ (Grants # 471817/2012-0\ud and 471817/2012-0) and CAPES, Brazilian funding agencies. The authors\ud wish to thank the participants of the Post-Graduation in Pediatric Dentistry\ud Seminar of FOUSP for the critical comments

Negligible therapeutic impact, false-positives, overdiagnosis and lead-time are the reasons why radiographs bring more harm than benefits in the caries diagnosis of preschool children

Background: To evaluate the clinical course and interventions required during two years of follow-up of dental surfaces of deciduous molars diagnosed, and consequently treated, by two different strategies: diagnosis made by clinical examination alone or associated with radiographs. Methods: This is a secondary analysis of a two-arm randomized clinical trial with parallel groups related to the diagnostic strategy for caries detection in preschool children. 216 children (3-6 years old) were followed-up for two years. All dental surfaces were diagnosed by visual inspection and later, through radiographic assessment. Baseline treatment was made in accordance with the results obtained by visual inspection performed alone or combined with radiographic method, considering the allocated group. Dental surfaces with no restoration needs, or those restored at the beginning of the study were followed-up for two years. The treatment decision was made according to the allocated group. The outcome was the occurrence of failure (a new caries lesion or a restoration replacement) during the follow-up. Results: 4383 proximal and occlusal surfaces of deciduous molars in 216 preschool children were diagnosed and treated according to the abovementioned diagnostic strategies and followed-up for 24 months. The assessment of radiographs made change the initial decision reached by visual inspection in about 30% of the surfaces when all types of interventions were considered. However, most disagreements occurred for initial lesions, where radiographs tended to underestimate them. Discordances between methods occurred in less than 5% of all surfaces when considered lesions requiring operative treatment. For discrepancy cases, the placed interventions guided by following the radiographic results did not present less failures against those made following only visual inspection. As a matter of fact, the use of radiographs in the diagnostic strategy for caries detection in children brought more harms than benefits due to the occurrence of false-positives, overdiagnosis and lead-time bias. Conclusions: Simultaneous association of visual inspection and radiographic assessment for caries detection in preschool children causes more harms than benefits, and therefore, visual inspection should be conducted alone in the regular clinical practice. Trial registration Clinicaltrials.gov platform: NCT02078453, registered on 5th March 2014

Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn’s Disease Patients on Ustekinumab

Ustekinumab has shown efficacy in Crohn's Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients' data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index <= 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission

Reinterpretation of LHC Results for New Physics: Status and recommendations after Run 2

We report on the status of efforts to improve the reinterpretation of searches and measurements at the LHC in terms of models for new physics, in the context of the LHC Reinterpretation Forum. We detail current experimental offerings in direct searches for new particles, measurements, technical implementations and Open Data, and provide a set of recommendations for further improving the presentation of LHC results in order to better enable reinterpretation in the future. We also provide a brief description of existing software reinterpretation frameworks and recent global analyses of new physics that make use of the current data