Clinical evaluation of marketed and non-marketed orthodontic products: are researchers now ahead of the times? A meta-epidemiological study.

BACKGROUND The advertisement and adoption of untested orthodontic products is common. This study aimed to provide an update regarding the prevalence of clinical trials in orthodontics evaluating commercially marketed products. Associations between marketed/non-marketed products and study characteristics such as direction of effect, declaration of conflict of interest and industry sponsorship were evaluated. In addition, within the marketed products associations between direction of effect and study characteristics were explored. MATERIAL AND METHODS Electronic searching of a single database (Medline via PubMed) was undertaken to identify Randomized controlled trials (RCTs) published over a 5-year period (1st January 2017 to 31st December 2021). Descriptive statistics and associations between trial characteristics were explored. RESULTS 196 RCTs were analysed. RCTs were frequently published in Angle Orthodontist (18.4%), American Journal of Orthodontics and Dentofacial Orthopedics (14.8%) and European Journal of Orthodontics (13.3%). 65.3% (128/196) of trials assessed marketed products after their introduction. The majority of trials assessed interventions to improve treatment efficiency (33.7%). Growth modification appliances were typically analysed in non-marketed compared to marketed products. An association between the type of product (marketed vs non-marketed) and both the declaration of conflict of interest and industry sponsorship was detected. For individual RCTs assessing marketed products either a positive effect (45.3%) or equivalence between interventions or between intervention and untreated control (47.7%) was evident. In 27% of these trials either no conflict of interest or industry funding was not clearly declared. Within the marketed products, no association between the direction of the effect and conflict of interest or funding was detected. CONCLUSIONS The analysis of marketed orthodontic products after their introduction is still common practice. To reduce research waste, collaboration prior to the licensing and marketing of orthodontic products between researchers, industry and manufacturers is recommended

Conceivable security risks and authentication techniques for smart devices

With the rapidly escalating use of smart devices and fraudulent transaction of users’ data from their devices, efficient and reliable techniques for authentication of the smart devices have become an obligatory issue. This paper reviews the security risks for mobile devices and studies several authentication techniques available for smart devices. The results from field studies enable a comparative evaluation of user-preferred authentication mechanisms and their opinions about reliability, biometric authentication and visual authentication techniques

International Guideline on Dose Prioritization and Acceptance Criteria in Radiation Therapy Planning for Nasopharyngeal Carcinoma

Purpose: The treatment of nasopharyngeal carcinoma requires high radiation doses. The balance of the risks of local recurrence owing to inadequate tumor coverage versus the potential damage to the adjacent organs at risk (OARs) is of critical importance. With advancements in technology, high target conformality is possible. Nonetheless, to achieve the best possible dose distribution, optimal setting of dose targets and dose prioritization for tumor volumes and various OARs is fundamental. Radiation doses should always be guided by the As Low As Reasonably Practicable principle. There are marked variations in practice. This study aimed to develop a guideline to serve as a global practical reference. Methods and Materials: A literature search on dose tolerances and normal-tissue complications after treatment for nasopharyngeal carcinoma was conducted. In addition, published guidelines and protocols on dose prioritization and constraints were reviewed. A text document and preliminary set of variants was circulated to a panel of international experts with publications or extensive experience in the field. An anonymized voting process was conducted to rank the proposed variants. A summary of the initial voting and different opinions expressed by members were then recirculated to the whole panel for review and reconsideration. Based on the comments of the panel, a refined second proposal was recirculated to the same panel. The current guideline was based on majority voting after repeated iteration for final agreement. Results: Variation in opinion among international experts was repeatedly iterated to develop a guideline describing appropriate dose prioritization and constraints. The percentage of final agreement on the recommended parameters and alternative views is shown. The rationale for the recommendations and the limitations of current evidence are discussed. Conclusions: Through this comprehensive review of available evidence and interactive exchange of vast experience by international experts, a guideline was developed to provide a practical reference for setting dose prioritization and acceptance criteria for tumor volumes and OARs. The final decision on the treatment prescription should be based on the individual clinical situation and the patient's acceptance of optimal balance of risk. (C) 2019 Elsevier Inc. All rights reserved

International Recommendations on Reirradiation by Intensity Modulated Radiation Therapy for Locally Recurrent Nasopharyngeal Carcinoma

Purpose: Reirradiation for locally recurrent nasopharyngeal carcinoma (NPC) is challenging because prior radiation dose delivered in the first course is often close to the tolerance limit of surrounding normal structures. A delicate balance between achieving local salvage and minimizing treatment toxicities is needed. However, high-level evidence is lacking because available reports are mostly retrospective studies on small series of patients. Pragmatic consensus guidelines, based on an extensive literature search and the pooling of opinions by leading specialists, will provide a useful reference to assist decision-making for these difficult decisions. Methods and Materials: A thorough review of available literature on recurrent NPC was conducted. A set of questions and preliminary draft guideline was circulated to a panel of international specialists with extensive experience in this field for voting on controversial areas and comments. A refined second proposal, based on a summary of the initial voting and different opinions expressed, was recirculated to the whole panel for review and reconsideration. The current guideline was based on majority voting after repeated iteration for final agreement. Results: The initial round of questions showed variations in clinical practice even among the specialists, reflecting the lack of high-quality supporting data and the difficulties in formulating clinical decisions. Through exchange of comments and iterative revisions, recommendations with high-to-moderate agreement were formulated on general treatment strategies and details of reirradiation (including patient selection, targets contouring, dose prescription, and constraints). Conclusion: This paper provides useful reference on radical salvage treatment strategies for recurrent NPC and optimization of reirradiation through review of published evidence and consensus building. However, the final decision by the attending clinician must include full consideration of an individual patient's condition, understanding of the delicate balance between risk and benefits, and acceptance of risk of complications. (C) 2021 Elsevier Inc. All rights reserved

Profiling estrogen, progesterone, and androgen receptors in colorectal cancer in relation to gender, menopausal status, clinical stage, and tumour sidedness

BackgroundAlthough estrogen (ERα/ERβ), progesterone (PGR), and androgen (AR) receptors are pathologically altered in colorectal cancer (CRC), their simultaneous expression within the same cohort of patients was not previously measured.MethodsERα/ERβ/PGR/AR proteins were measured in archived paired normal and malignant colon specimens (n =120 patients) by immunohistochemistry, and results were analyzed by gender, age (≤50 vs. ≥60 years), clinical stages (early-stage I/II vs. late-stage III/IV), and anatomical location (right; RSCs vs. left; LSCs). Effects of 17β-estradiol (E2), progesterone (P4), and testosterone alone or combined with the specific blockers of ERα (MPP dihydrochloride), ERβ (PHTPP), PGR (mifepristone), and AR (bicalutamide) on cell cycle and apoptosis were also measured in the SW480 male and HT29 female CRC cell lines. ResultsERα and AR proteins increased, whilst ERβ and PGR declined markedly in malignant specimens. Moreover, male neoplastic tissues showed highest AR expression, whilst ERβ and PGR weakest alongside ERα strongest expression was seen in cancerous tissues from women aged ≥60 years. Late-stage neoplasms also revealed maximal alterations in the expression of sex steroid receptors. By tumor location, LSCs disclosed significant elevations in ERα with marked declines in PGR compared with RSCs, and ERα strongest alongside PGR weakest expression was detected in advanced LSCs from women aged ≥60 years. Late-stage LSCs from females aged ≥60 years also showed weakest ERβ and strongest AR expression. In contrast, male RSC and LSC tissues exhibited equal ERβ and AR expression in all clinical stages. ERα and AR proteins also correlated positively, whereas ERβ and PGR inversely, with tumor characteristics. Concomitantly, E2 and P4 monotherapies triggered cell cycle arrest and apoptosis in the SW480 and HT29 cells, and while pre-treatment with ERα-blocker enhanced the effects of E2, ERβ-blocker and PGR-blocker suppressed the E2 and P4 anti-cancer actions, respectively. In contrast, treatment with the AR-blocker induced apoptosis, whilst co-treatment with testosterone hindered the effects. ConclusionsThis study advocates that protein expression of sex steroid receptors in malignant tissues could represent prognostic markers, as well as hormonal therapy could provide an alternative strategy against CRC, and their efficacies could be dependent on gender, clinical stage, and tumor location

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Localizing pedestrians in indoor environments using magnetic field data with term frequency paradigm and deep neural networks

Indoor environments are challenging for global navigation satellite systems and cripple its performance. Magnetic field data-based positioning and localization has emerged as a potential solution for ubiquitous indoor positioning and localization. The availability of embedded magnetic sensors in the smartphone simplifies the positioning without the additional cost of infrastructure. However, the data divergence due to smartphone heterogeneity circumscribes the wide applicability of magnetic field-based positioning approaches. This research proposes the use of term frequency (TF) extracted from the magnetic field data to alleviate the impact of smartphone heterogeneity. For this purpose, the magnetic field data are transformed into terms (words) and documents. Extracted TF vectors are used to train long short term memory and gated recurrent unit networks. A voting scheme is contrived to incorporate the predictions from these networks. Experiment results with three different smartphones like LG G6, Galaxy S8, and LG Q6 demonstrate that the use of TF mitigates the impact of the smartphones’ variability. Performance comparison with state-of-the-art approaches reveals that the proposed approach performs better than those of other approaches in alleviating the influence of using various smartphones for magnetic field-based indoor localization. Furthermore, the localization performance of the proposed is better than those of other approaches, even using a smaller amount of magnetic field data

Prevalance of overweight, obesity and diabetes in undergraduate medical students at Qassim University

Background: Obesity is a public health issue and a worldwide epidemic linked to several major ailments, including diabetes, cancer, and cardiovascular disease. Saudi Arabia has one of the highest rates of overweight and obesity globally, posing a severe threat to the country’s public health.Objectives:  To assess the prevalence of overweight, obesity, and high blood sugar among  Qassim University medical students. Methods: This cross-sectional study involved medical students at Qassim University, in Saudi Arabia. Results: the prevalence of overweight (27.1%), obesity (14%), sedentary lifestyle (78.8%), poor diet (68.7%),  increased weight associated with genetics stood (11.1%), and hyperglycemia among obese medical students (12.1%). Family history of obesity (adjOR = 5.95, 95% CI: 2.94-12.06; p < 0.001), and diet (adjOR = 2.60, 95% CI: 1.27-5.33; p = 0.009), were significantly associated with obesity. Conclusions: A change in sedentary lifestyle and healthy dietary intake is recommended among medical students as a significant association between obesity and diet has been established.Antecedentes: la obesidad es un problema de salud pública y una epidemia mundial vinculada a varias dolencias importantes, como la diabetes, el cáncer y las enfermedades cardiovasculares. Arabia Saudita tiene una de las tasas más altas de sobrepeso y obesidad a nivel mundial, lo que representa una grave amenaza para la salud pública del país. Objetivos: Evaluar la prevalencia del sobrepeso, la obesidad y el nivel alto de azúcar en la sangre entre los estudiantes de medicina de la Universidad de Qassim. Métodos: Este estudio transversal involucró a estudiantes de medicina de la Universidad de Qassim, en Arabia Saudita. Resultados: se mantuvo la prevalencia de sobrepeso (27,1%), obesidad (14%), sedentarismo (78,8%), mala alimentación (68,7%), aumento de peso asociado a la genética (11,1%) e hiperglucemia entre estudiantes de medicina obesos (12,1%). %). Los antecedentes familiares de obesidad (adjOR = 5,95, IC del 95 %: 2,94-12,06; p < 0,001) y la dieta (adjOR = 2,60, IC del 95 %: 1,27-5,33; p = 0,009), se asociaron significativamente con la obesidad. Conclusiones: Se recomienda un cambio en el sedentarismo y la ingesta dietética saludable entre los estudiantes de medicina, ya que se ha establecido una asociación significativa entre la obesidad y la dieta

Le Néolithique de Syrie est bien vivant. Quatorze thèses en témoignent

International audienc