Aim
To explore the impacts of the COVID‐19 pandemic first wave in Quebec, Canada on practices in early intervention services (EIS) for first‐episode psychosis, including reorganization of clinical ...and administrative practices and teleconsultation use.
Methods
Adopting a cross‐sectional descriptive study design, a 41 questions online survey was sent to the team leaders of all the 33 Quebec EIS, of which 100% responded. Data were collected from 18 May to 4 June 2020 and analysed using descriptive statistics and content analysis. Programmes were categorized as urban/non‐urban and results were compared between these.
Results
All 33 existing Quebec EIS (16 urban and 17 non‐urban) completed the survey. Among them, 85% did not experience redeployment of EIS team staff and 58% reported stable frequency of patient interactions, either in‐person or through telemedicine. During the studied period, 64% of programmes reported that all professionals used teleconsultation at least occasionally. However, 73% of programmes, mostly in non‐urban areas, reported some limitations regarding clinicians' degree of ease with teleconferencing platforms and half of EIS could not access technical support to use them. The majority of EIS (94%) expressed interest to participate in a training program about the use of technologies for teleconsultations. Many smaller clinics reported interest in offering multiregional/multiclinics group teletherapy, therefore merging their pool of patients and clinical staff workforce.
Conclusions
Further studies are warranted to improve access to and use of technology‐mediated treatment, which seems to be a promising alternative to provide high‐quality mental healthcare during the COVID‐19 pandemic and beyond.
Forest plantations are globally important for the economy and are significant for carbon sequestration. Properly managing plantations requires accurate information about stand timber stocks. In this ...study, we used the area (ABA) and individual tree (ITD) based approaches for estimating stem volume in fast-growing Eucalyptus spp forest plantations. Herein, we propose a new method to improve individual tree detection (ITD) in dense canopy homogeneous forests and assess the effects of stand age, slope and scan angle on ITD accuracy. Field and Light Detection and Ranging (LiDAR) data were collected in Eucalyptus urophylla x Eucalyptus grandis even-aged forest stands located in the mountainous region of the Rio Doce Valley, southeastern Brazil. We tested five methods to estimate volume from LiDAR-derived metrics using ABA: Artificial Neural Network (ANN), Random Forest (RF), Support Vector Machine (SVM), and linear and Gompertz models. LiDAR-derived canopy metrics were selected using the Recursive Feature Elimination algorithm and Spearman’s correlation, for nonparametric and parametric methods, respectively. For the ITD, we tested three ITD methods: two local maxima filters and the watershed method. All methods were tested adding our proposed procedure of Tree Buffer Exclusion (TBE), resulting in 35 possibilities for treetop detection. Stem volume for this approach was estimated using the Schumacher and Hall model. Estimated volumes in both ABA and ITD approaches were compared to the field observed values using the F-test. Overall, the ABA with ANN was found to be better for stand volume estimation ( r y y ^ = 0.95 and RMSE = 14.4%). Although the ITD results showed similar precision ( r y y ^ = 0.94 and RMSE = 16.4%) to the ABA, the results underestimated stem volume in younger stands and in gently sloping terrain (<25%). Stem volume maps also differed between the approaches; ITD represented the stand variability better. In addition, we discuss the importance of LiDAR metrics as input variables for stem volume estimation methods and the possible issues related to the ABA and ITD performance.
Abstract
Background
A central challenge of DNA gut content analysis is to identify prey in a highly degraded DNA community. In this study, we evaluated prey detection using metabarcoding and a method ...of mapping unassembled shotgun reads (Lazaro).
Results
In a mock prey community, metabarcoding did not detect any prey, probably owing to primer choice and/or preferential predator DNA amplification, while Lazaro detected prey with accuracy 43–71%. Gut content analysis of field-collected arthropod epigeal predators (3 ants, 1 dermapteran, and 1 carabid) from agricultural habitats in Brazil (27 samples, 46–273 individuals per sample) revealed that 64% of the prey species detections by either method were not confirmed by melting curve analysis and 87% of the true prey were detected in common. We hypothesized that Lazaro would detect fewer true- and false-positive and more false-negative prey with greater taxonomic resolution than metabarcoding but found that the methods were similar in sensitivity, specificity, false discovery rate, false omission rate, and accuracy. There was a positive correlation between the relative prey DNA concentration in the samples and the number of prey reads detected by Lazaro, while this was inconsistent for metabarcoding.
Conclusions
Metabarcoding and Lazaro had similar, but partially complementary, detection of prey in arthropod predator guts. However, while Lazaro was almost 2× more expensive, the number of reads was related to the amount of prey DNA, suggesting that Lazaro may provide quantitative prey information while metabarcoding did not.
To evaluate the effects of systemic antibiotics in combination with scaling and root planing (SRP) on periodontal parameters, tooth loss and oral health-related quality of life in diabetes patients.
...Two independent reviewers screened for controlled clinical trials with at least 6-month follow-up in six electronic databases, registers of clinical trials, meeting abstracts and four major dental journals. After duplicates removal, electronic and hand searches yielded 1,878 records; 18 full-text articles were independently read by two reviewers. To evaluate the additional effect of antibiotic usage, pooled weighted mean differences and 95% confidence intervals were calculated using a fixed effects model.
Five studies met the inclusion criteria, four of which were included in meta-analyses. The meta-analyses showed a significant effect favouring SRP plus antibiotic for reductions in mean probing depth (PD) (-0.22 mm -0.34, -0.11) and mean percentage of bleeding on probing (BoP) (4% -7, -1). There was no significant effect for clinical attachment level gain and plaque index reduction. No study reported on tooth loss and oral health-related quality of life.
Adjunctive systemic antibiotic use in diabetic patients provides a small additional benefit in terms of reductions in mean PD and mean percentage of BoP.
CRD42013006389.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•Amlodipine and valsartan are determined simultaneously by voltammetry.•A cathodically pretreated diamond electrode was used to develop the novel method.•It can be applied in all the different ...dosages available in the market.•The obtained results agree with those of comparative chromatography method.•The new method was applied in synthetic urine sample with adequate recovery results.
A new voltammetric method was developed for simultaneous determination of amlodipine (AML) and valsartan (VAL) in synthetic urine and combined pharmaceutical formulations. The anodic peak potentials of AML and VAL oxidation at a cathodically pretreated boron-doped diamond electrode were found to be 0.791V and 1.37V (vs. Ag/AgCl (3.0molL−1 KCl)), respectively, by cyclic voltammetry, in Britton–Robinson buffer solution (pH 5.0). Using square-wave voltammetry, the obtained analytical curves were linear in the AML and VAL concentration range from 0.497–28.0μmolL−1 and 19.8–280μmolL−1 with detection limits of 0.0764μmolL−1 and 0.193μmolL−1, respectively. The proposed method was successfully applied in the simultaneous determination of AML and VAL in various combined dosage forms available in the market, with results similar to those obtained using a comparative chromatography method. Additionally, adequate recovery results were obtained for the simultaneous determination of AML and VAL in synthetic urine sample. Due to its adequate linearity, the proposed method could be a good alternative for simultaneous determination of AML and VAL in all the different dosages available in the market, even in synthetic urine sample.
Abstract Physicians and dentists usually make clinical decisions and recommendations without a clear understanding of the meaning of the numbers regarding the accuracy of diagnostic tests and the ...efficacy of treatments. This critical review aimed to identify problems in the communication of diagnostic test accuracy and treatment benefits and to suggest strategies to improve risk communication in these contexts. Most clinical decisions are taken under uncertainty. Health professionals cannot predict the outcome in one individual patient. This uncertainty invites these professionals to make decisions based on heuristics, which gives rise to several cognitive biases. Cognitive biases are automatic and unconscious, so how is it possible to mitigate their undesirable effects on risk interpretation in the context of clinical practice? Some forms of risk communication reinforce cognitive bias, while others weaken them. Maybe one of the most difficult obstacles to overcome is the difficulty to think with numbers. This difficulty probably arises from a mismatch of ancestral adaptations of the brain having to deal with modern environments, which are quite different from the ancestral ones. There are two quite common, but bad, forms of risk communication: the conditional probability and the relative risk reduction or efficacy. People, including physicians and dentists, are confused with this kind of information. The main methods discovered so far to facilitate a clearer understanding are to emphasize the base rates of the events and to use absolute numbers, that is to use natural frequencies, instead of percentages and conditional probabilities.
Objectives
Evaluate the ability of current ion-releasing materials to remineralise bacteria-driven artificial caries lesions.
Materials and methods
Standardised class I cavities were obtained in 60 ...extracted human molars. Specimens underwent a microbiological cariogenic protocol (28 days) to generate artificial caries lesions and then were randomly divided into four restorative groups: adhesive + composite (negative control); glass ionomer cement (GIC); calcium silicate cement (MTA); and resin-modified calcium silicate cement (RMTA). Microhardness analysis (ΔKHN) was performed on 40 specimens (10/group,
t
= 30 days, 45 days, 60 days in artificial saliva, AS). Micro-CT scans were acquired (3/group,
t
= 0 days, 30 days, and 90 days in AS). Confocal microscopy was employed for interfacial ultra-morphology analysis (2/group,
t
= 0 days and 60 days in AS). Additional specimens were prepared and processed for scanning electron microscopy (SEM) and FTIR (
n
= 3/group + control) to analyse the ability of the tested materials to induce apatite formation on totally demineralised dentine discs (60 days in AS). Statistical analyses were performed with a significance level of 5%.
Results
Adhesive + composite specimens showed the lowest ΔKHN values and the presence of gaps at the interface when assessed through micro-CT even after storage in AS. Conversely, all the tested ion-releasing materials presented an increase in ΔKHN after storage (
p
< 0.05), while MTA best reduced the demineralised artificial carious lesions gap at the interface. MTA and RMTA also showed apatite deposition on totally demineralised dentine surfaces (SEM and FTIR).
Conclusions
All tested ion-releasing materials expressed mineral precipitation in demineralised dentine. Additionally, calcium silicate-based materials induced apatite precipitation and hardness recovery of artificial carious dentine lesions over time.
Clinical relevance
Current ion-releasing materials can induce remineralisation of carious dentine. MTA shows enhanced ability of nucleation/precipitation of hydroxyapatite compared to RMTA and GIC, which may be more appropriate to recover severe mineral-depleted dentine.
This study aimed at evaluating the mineral variation induced by polyalkenoate cements in residual dentine after different caries removal methods. Ten extracted sound molars were selected, and five ...cavities were prepared on the occlusal surface of each specimen. Carious lesions were generated using a microbial protocol, while the caries removal was performed using bur, hand excavator, or two papain-based chemo-mechanical agents. One cavity was left unexcavated in each tooth. Cavities were restored using a zinc polycarboxylate cement (ZPC; n = 25), or a glass ionomer cement (GIC) was used (n = 25). Subsequently, the specimens were stored under simulated pulpal pressure for 45 days. Micro-CT scanning was performed after caries formation, removal, and restoration. Cavity volumes (mm 3 ) and mineral density (MD) changes were calculated. Remineralisation ability was investigated by scanning electron microscopy (SEM) and Fourier-transformed infrared spectroscopy (FTIR). Statistical analysis was performed (5% significance level). Baseline caries, cavity volume, and MD increase after caries removal were similar to all excavation groups (p > 0.05). MD was higher in ZPC compared to GIC (p < 0.05). SEM revealed that the chemo-mechanical techniques produced a smoother dentine surface compared to mechanical methods. FTIR showed silicon-based minerals in GIC-treated dentine, while ZPC-treated presented mineral deposits characterised by amorphous calcium phosphate. In both cases, the presence of carbonates was detected on dentine surfaces. All caries removal techniques performed similarly in terms of carious dentine excavation. ZPC can be used as dentine replacement material after caries removal as it may induce higher MD increase in residual dentine via deposition of calcium phosphates, compared to GIC.
Pregnancy in chronic kidney disease (CKD) women is relatively rare, and the less risky choice of hemodialysis is unknown. The objective of this systematic review was to identify, systematically ...evaluate and summarize the available evidence on the efficacy and safety of hemodialysis strategies for pregnant CKD women. Sensitive search strategies were applied to six databases without data or language restrictions. Comparative (randomized and non‐randomized) studies were prioritized. Two reviewers independently selected, extracted, and critically evaluated data from studies. The risk of bias assessment was performed using the ROBINS‐I tool, considering the study design (non‐randomized comparative observational studies). The certainty of the evidence was assessed using the GRADE approach. From 7210 references identified, six retrospective cohort studies were included (576 women). The effects of intensive hemodialysis (over 20 h/week) are uncertain for maternal and neonatal mortality (Peto odds ratio OR 0.85; 95% confidence interval 95% CI 0.26–2.80), miscarriage (Peto OR 0, 38; 95% CI 0.12–1.23), stillbirths (Peto OR 0, 56; 95% CI 0.13–2.31), preterm birth (Peto OR 0.87; 95% CI 0.33–2.28), low birth weight (Peto OR 0.71; 95% CI 0.20–2.50) and congenital anomalies rates. The certainty of the evidence was very low due to studies methodological limitations and effect estimates imprecision. The uncertainty about intensive versus conventional hemodialysis effects for pregnant women with CKD and the imprecision in the estimated effects precludes any recommendation. The strategy choice must consider treatment availability, costs, and maternal social aspects until future studies provide more reliable evidence. PROSPERO CRD42021259237.
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