METHODS: Participants first underwent oral health examinations to evaluate their plaque scores, bleeding scores, Community Periodontal Index of Treatment Needs (CPITN), and Decayed, Missing, and Filled Teeth (DMFT) index. Additionally, the oral health behaviours and oral health impact profiles of the participants were assessed through a structured questionnaire.
RESULTS: A total of 176 naval personnel participated in the study. Overall, the findings indicate high levels of plaque (30.7%) and bleeding scores (39.6%) while the CPITN results showed a significant proportion of participants (52.1%) requiring advanced periodontal treatment (CPITN 3 or 4). The DMFT index highlighted a substantial burden of dental caries with a mean score of 4.59 ± 4.24, including untreated decay (1.15 ± 1.63). The assessment of oral health-related quality of life using the OHIP-14 revealed low scores among some participants, with a mean of 13.47 and a maximum score of 42. Additionally, oral health behaviours were generally inadequate, with 12% of participants reporting infrequent brushing and 68.2% indicating limited use of interdental aids.
CONCLUSIONS: Oral diseases were highly prevalent among the selected population, with notable deficiencies in oral health behaviours such as toothbrushing frequency, the use of interdental cleaning aids, and tongue cleaning. Oral health issues also significantly impacted daily life, as evidenced by the OHIP-14 scores. These findings highlight the need for tailored oral health interventions within the naval setting to enhance deployment readiness, improve oral health outcomes, and elevate the quality of life for naval personnel.
CLINICAL TRIAL NUMBER: Not applicable.
METHODS: Using data from a multicenter, cluster-randomized controlled trial, this secondary analysis involved patients with baseline circulatory shock as defined by a cardiovascular Sequential Organ Failure Assessment score of two or more. Patients were dichotomized into transient or persistent circulatory shock depending on the duration, while transient circulatory shock was defined by the resolution of shock within the first day of enrollment. Early enteral nutrition was defined as the initiation of enteral nutrition within 48 h after intensive care unit admission. The association between early enteral nutrition and a composite outcome (presence of any organ failure on study day 10 or 28-day mortality) was investigated by multivariable and propensity-score-weighted multivariable logistic regression analyses.
RESULTS: Seven hundred and eighty-five patients were included in the analysis, and early enteral nutrition was administered to 385 patients (49.0 %) in the whole study cohort. In patients with transient circulatory shock (n = 527), 221 patients (41.9 %) received early enteral nutrition, and in those with persistent circulatory shock (n = 258), 164 patients (63.6 %) did so. For the overall cohort, there was no difference in the incidence of primary composite outcome between early enteral nutrition and 'no early enteral nutrition ' groups (adjusted odd ratio 0.84, 95 % confidence interval 0.60-1.18) after adjustment for potential confounders. In patients with transient circulatory shock, receipt of early enteral nutrition, compared to no early enteral nutrition, was significantly associated with reduced incidence of the composite outcome (adjusted odd ratio 0.63, 95 % confidence interval 0.41-0.95, p = 0.027). On the contrary, there is no association between early enteral nutrition and the incidence of the composite outcome in patients with persistent circulatory shock (adjusted odd ratio 1.28, 95 % confidence interval 0.64-2.58, p = 0.485). The results of propensity-weighted multivariable analysis conform to the primary analysis.
CONCLUSION: Early enteral nutrition was associated with improved clinical outcomes among patients with circulatory shock that resolved within the first day. RESEARCH REGISTRATION UNIQUE IDENTIFYING NUMBER (UIN) OF THE ORIGINAL NEED TRIAL: ISRCTN Registry, Registry number: ISRCTN12233792.
METHODS: A comprehensive literature review was conducted, followed by in-depth interviews with key informants. Content analysis was performed to summarize the role of health equity in HTA in 13 health systems in Asia, including Brunei Darussalam, Cambodia, China, Indonesia, Japan, Malaysia, Myanmar, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam.
RESULTS: Health equity was reported to be considered in most health systems' HTA processes, except for Cambodia and Myanmar, which do not have an established HTA process. Interviews revealed that health equity has been more frequently considered to address the unmet medical needs of specific diseases (eg, high disease burden or severity, rare diseases, cancer, and diseases affecting children and the elderly) in Brunei Darussalam, China, Japan, Malaysia, Singapore, South Korea, Taiwan, Thailand, and Vietnam or inequities in socially disadvantaged groups (eg, socioeconomic status and geographical location) in Indonesia and the Philippines. Equity-informative economic evaluation was still in the early stages, with only 3 health systems reporting their use.
CONCLUSIONS: Health equity is considered in the HTA process in most Asian health systems. However, quantitative evaluation of health equity impact is still in its infancy because few health systems have just begun to perform equity-informative economic evaluations.
PURPOSE: This systematic review and meta-analysis assesses the survival of computer-aided design and computer-aided manufacturing (CAD-CAM) resin nanoceramics and polymer interpenetrating ceramic network material restorations on endodontically treated teeth and to describe the incidence of complications.
MATERIAL AND METHODS: The study was registered in the international prospective register of systematic reviews (PROSPERO) database and adhered to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A comprehensive search across 6 online databases was performed. Clinical studies which involved CAD-CAM manufactured resin nanoceramics and polymer interpenetrating ceramic network material restorations on endodontically treated teeth were included. Several investigators independently conducted the study selection, data extraction, and quality assessment processes. Risk of bias was assessed by using the Cochrane Risk of Bias 2 tool and Newcastle-Ottawa Scale. Failure rates were analyzed using Poisson regression models to obtain summary estimates of 3- and 5-year survival proportions, which were pooled using a random-effects model. Subgroup analysis was performed for material type and restoration design (α=.05).
RESULTS: The search resulted in 250 studies after duplicate removal, and 11 articles were included in the final analysis. The meta-analysis of 289 restorations revealed an overall estimated failure rate of 3.44 (95% confidence interval [95% CI]: 2.67-4.21) per 100 restoration years, equivalent to a survival rate of 90.2% (95% CI: 88.1-92.3%) after 3 years and 84.2% (95% CI: 81.0-87.5%) after 5 years. A significantly lower (P
MAIN BODY: A total of 48 studies were included, revealing 30 loci that were confirmed to be associated with skin ageing by multiple studies (e.g., AFG3L1P: odds ratio 1.133 95% confidence interval [1.044, 1.222]; BPIFA3: 1.859 [1.567, 2.151]; CLPTML1: 1.164 [1.0.99, 1.229]; CPNE7: 0.905 [0.852-0.958]; DEF8: 1.186 [1.042, 1.331]; IRF4: 1.260 [1.025, 1.495]; MYO16: 2.303 [1.697, 2.908]; PRDM16: 1.105 [1.084, 1.127]; RORA: 1.391 [1.206, 1.577]; SPG7: 0.922 [0.897, 0.947]; SPON1: 2.214 [1.204, 3.225]; SPTLC1: 1.464 [1.432, 1.495]; TYR: 1.175 [1.007, 1.343]). The lack of significance for many loci may be due to studies analysing different SNPs within the same locus, weakening the overall associations. Several loci were associated with specific phenotypic categories (e.g., skin colour related, skin cancer related, wrinkling and sagging related), suggesting shared biological pathways are involved in the pathogenesis of different skin ageing phenotypes. This pattern was also observed in several of the loci that do not have a significant overall association with skin ageing.
CONCLUSION: Despite significant heterogeneity among the included studies and the use of subjective visual methods for phenotype assessment, our review highlights the critical role of fundamental biological processes, such as development and cellular organisation, in skin ageing. Future research that targets the same SNP across multiple populations could strengthen the association of additional loci with skin ageing. Further investigation into these underlying biological processes would significantly advance our understanding of the pathogenesis of skin ageing phenotypes.
METHODS: In this cross-sectional study, we performed a broad assessment of forty-one signs of skin ageing and characterised the phenotypes that constituted key components of skin ageing. We also explored the interrelationship among forty-one skin ageing phenotypes using Spearman's Correlation and Principal Component Analysis.
RESULTS: We analysed our study population, which is composed of 3281 ethnic Chinese participants from the Singapore/Malaysia Cross-sectional Genetics Epidemiology Study (SMCGES). The first ten principal components cumulatively explain 46.88% of the variance of skin ageing phenotypes in our study population. We discovered that the commonly discussed forms of skin ageing (i.e., wrinkles, pigmentation, and photo-ageing) only accounted for a small portion (24.39%) of the variance of all skin ageing phenotypes in our study population. Telangiectasia, a poor lip fullness, a lighter skin colour, xerosis, ephelides (freckles), ptosis of eyelids (droopy eyelids), eyebags, and a low eyebrow positioning were other key components of skin ageing, accounting for a further 22.49% of the variance of skin ageing phenotypes in our study population. We found that each of these ten skin ageing phenotypes characterises a key and important aspect of skin ageing. In this broad assessment of skin ageing, we first described the prevalence of forty-one signs of skin ageing and then characterised in detail both the prevalence and severity distribution of ten key skin ageing phenotypes.
CONCLUSIONS: We presented clear evidence that skin ageing is much more than just wrinkles, pigmentation and photo-ageing. The addition of telangiectasia, poor lip fullness, a lighter skin colour, xerosis, ephelides, ptosis of eyelids, eyebags, and a low eyebrow positioning added more dimensions to skin ageing phenotype presentations.
METHODS: The mathematical model for the adjusted LSB LIV tilt angle (α) measured preoperatively, was expressed as the sum of preoperative LSB LIV tilt angle (x) and LIV displacement angle (y) (α = x + y). This model was validated through inter-rater and intra-rater analysis in Part I of the study. The α angle derived was applied to estimate the intraoperative LIV tilt angle. In part II of the study, clinical and radiological outcomes of 50 Lenke type 1 and 2 (non-AR curves) AIS patients operated using the α angle were reviewed. The difference between the intraoperative LIV tilt angle achieved (β) and the preoperative α angle was determined (∆LIV tilt angle = β-α).
RESULTS: The α angle had excellent inter-rater and intra-rater intraclass correlation coefficients (0.982; 0.907). 42 patients had positive ∆LIV tilt angles whereas 8 patients had negative ∆LIV tilt angles. The overall incidence of distal adding-on (AO) was 10.0% (n = 5/50). Patients with negative ∆LIV tilt angles had a higher incidence of distal AO (n = 4/8, 50.0%) than patients with positive ∆LIV tilt angles (n = 1/42, 2.4%) (p = 0.001).
CONCLUSION: Achieving an intraoperative LIV tilt angle (β) greater than or equal to the preoperative α angle derived (β ≥ α) may help avoid the distal AO phenomenon.
METHODS: Twenty children including 10 with ASD and 10 normally developing children aged 6-12 years were recruited for this study. One accessible ear was exposed to transient-evoked OAE, whereas the other was exposed to suppressor tones. Contralateral suppressors included white noise, Quranic recitations, environmental noise, and natural sound. The magnitude of OAE suppression was determined from the difference between the OAE amplitude with and without the masker (in dB sound pressure levels) for all sound types. The sound with the highest suppression effect was determined using effect size calculation and repeated-measures analysis of variance at a 95% confidence level. A high suppression effect may suggest a high sensory gating performance, whereas low suppression may indicate low sensory gating performance.
RESULTS: Based on the analysis, the sound with the highest suppression effect was that of the waterfall. The suppression results were supported by descriptive analysis findings and effect-size calculations.
CONCLUSIONS: This study provides a better understanding of the alternative sound stimuli, besides the standard white noise tone, for the assessment of sensory gating deficits among children with ASD. Sounds with a high suppression effect have the potential to be used as sound therapy interventions for children with ASD as part of rehabilitation and therapy.
METHODS: We searched CINAHL, Medline, Global Health, Embase, and WHO COVID-19 in October 2023 for studies reporting the SARS-CoV-2 reinfection incidence during the Omicron period. The quality of the included studies was assessed using the Joanna Briggs Institute checklists. Random effects meta-analyses were conducted to estimate the incidence, and requirement of hospitalisation of SARS-CoV-2 reinfections. Symptomatic severity of reinfections and case fatality rates were analysed narratively.
RESULTS: Thirty-six studies were included. The reinfection cumulative incidence during the Omicron period was 3.35% (95% CI = 1.95-5.72%) based on data from 28 studies. The cumulative incidence was higher in 18-59-year-old adults (6.62% (95% CI = 3.22-13.12%)) compared to other age groups and in health care workers (9.88% (95% CI = 5.18-18.03%)) compared to the general population (2.48% (95% CI = 1.34-4.54%)). We estimated about 1.81% (95% CI = 0.18-15.87%) of the reinfected cases required hospitalisation based on limited and highly variable data.
CONCLUSIONS: There was an increased risk of reinfections during the Omicron period compared to the pre-Omicron period. The incidence was higher in 18-59-year-old adults and health care workers and generally less severe during the Omicron period. However, data were limited on disease severity and long-term outcomes.
REGISTRATION: PROSPERO: CRD42023482598.