Search

Botulinum toxin (BTX) is becoming widely used as an adjunct to conservative management of myalgia-predominant temporomandibular disorders (TMDs) with reports of improved quality of life. There is, however, no consensus on the optimal dosage. Based on previous studies, dose regimens vary between clinicians, and we know of no standard dose protocol for the administration of BTX for the purpose of TMD management. A survey was sent to members of the British Association of Oral and Maxillofacial Surgeons (BAOMS) Temporomandibular Joint Sub-Specialty Interest Group (TMJ SSIG) and an international mailing list of high-volume TMJ surgeons (the TMJ Internetwork) to ascertain variations in dose regimens between different clinicians. The survey found that 41 respondents offered BTX to patients. The masseter muscle group was the most commonly injected site, and the majority of respondents (34/41) used Botox® (Allergan). Brands less commonly used included Dysport® (Ipsen), and Xeomin® (Merz Pharma). Botox® doses varied between 30 and 100 units, whilst Dysport® doses ranged from 50 - 300 units/muscle. The number of injection sites/muscle also varied. This survey demonstrates the wide variation in practice amongst clinicians with respect to BTX administration. To ensure optimal dose and response titration, further studies and evidence-based research are needed to standardise its use for the treatment of TMDs. [ABSTRACT FROM AUTHOR]

It is a common belief that the incorporation of computer technology into mathematics teaching and learning motivates and engages students. However, research into the use of ICTs (Information and Communication Technologies) in mathematics classrooms has revealed some issues that could negatively impact on student engagement as a result of how they integrate with existing practices. There is a danger of the technology driving pedagogy, rather than pedagogy driving the technology. In other words, technology sometimes becomes the focus of the mathematics lessons instead of the mathematics itself. Research by Samuelsson (2007) revealed some teachers who regularly incorporate computers into their lessons tend to use them in a way that resonates with a didactical, teacher-centred approach. In this situation such an approach restricts the potential of ICTs to act as an agent of change in terms of supporting students' engagement with the subject. When good pedagogy drives the incorporation of technology into mathematics teaching and learning, ICTs have immense potential to enhance students' experiences with mathematics. In this article, the authors explore the use of the iPod Touch and iPad and provide a brief overview of how these can be used in the primary mathematics classroom. (Contains 3 figures.)

New technologies continue to change every aspect of home, life and work: the way people communicate, calculate, analyse, shop, make presentations and socialise. "The Australian Curriculum" acknowledges the importance of teaching and learning with technology by including the use of information and communication technology (ICT) as one of the skills, behaviours and attributes, identified as general capabilities, that students need to "succeed in life and work in the twenty-first century." With ICT embedded within the content descriptions and elaborations across each of the three strands in the Australian Curriculum comes a responsibility for teachers to incorporate a repertoire of ICTs that serve to enhance student learning and engagement with mathematics. As with any teaching and learning resources, ICTs have the potential to succeed or fail depending on how they are implemented. This is the first of a series of articles that explores the use of ICT in the classroom. Here, the author highlights the use of the Web as a tool for teaching mathematics.

Shared e-scooters (SES) have recently gained popularity, but their environmental sustainability remains debatable. This study develops a data-driven and scalable method based on big data and data fusion from multiple sources to comprehensively analyze substitutions and the environmental impacts of SES from trip to city level analysis. Field trip transaction data in three major Swedish cities (Stockholm, Gothenburg, and Malmö) are leveraged for empirical analysis considering mode choice behavior. The results reveal that most SES trips (86.7% in Stockholm, 85.6% in Gothenburg, and 85.3% in Malmö) replace walking or public transport, while the proportion substituting private car and taxis is less than 12%. On average, each SES trip increases in CO 2 − e q emissions (34.58 g in Stockholm, 21.18 g in Gothenburg, and 24.07 g in Malmö). Only a limited percentage of SES trips (19.20% in Stockholm, 24.22% in Gothenburg, and 23.94% in Malmö) and a small percentage of urban areas with SES (8.3% in Stockholm, 7.48% in Gothenburg, and 2.02% in Malmö) demonstrate positive environmental effects from SES. The substitution and environment impacts of SES vary significantly across different trips spatially and temporally, emphasizing the importance of conducting trip-level analyses. The analysis provides quantitative insights into the sustainability of SES in Nordic contexts, offering potential support for sustainable management in a variety of urban contexts. • A data-driven and scalable analysis method for environmental sustainability. • Substitution of shared e-scooters to other transport modes in different trips. • Quantitative estimation about environmental impacts of shared e-scooters. • Spatial variation in the environmental impacts in different Swedish cities. [ABSTRACT FROM AUTHOR]

This case-control study sought to investigate whether thyroid autoimmunity is significantly associated with identifiable and potentially modifiable environmental factors. A total of 324 individuals were recruited: 164 cases (with positive thyroid peroxidase antibodies [TPO-Ab] and/or thyroid-stimulating hormone receptor antibodies [TSH-R Ab]) and 160 controls (negative antibodies) who had been screened for thyroid autoimmunity within the previous 12 months. A questionnaire sought information on drug, social, and reproductive history, stress, and iodine intake, while blood specimens were collected to measure glycosylated hemoglobin, thyroid function, TPO-Ab/TSH-R Ab status, 25-hydroxyvitamin D level, and hepatitis C antibody status. Both TPO-Ab–positive and TSH-R Ab–positive individuals were exposed to a higher amount of smoking pack-years (P = 0.038 and 0.037, respectively). No significant predictors of TSH-R Ab positivity were identified on multivariate regression analysis. The odds for TPO-Ab positivity was increased by female gender (odds ratio [OR] 2.815, 95% confidence interval [CI], 1.387, 5.714; P = 0.004) and discontinuation of smoking (OR 2.367, 95% CI, 1.213, 4.621; P = 0.012), while birth in winter (OR 0.470, 95% CI, 0.253, 0.871; P = 0.017) and higher intake of iodine-rich foods (OR 0.864, 95% CI, 0.761, 0.981; P = 0.024) decreased the odds for TPO-Ab development. Therefore, avoidance of ever starting smoking and correction of iodine deficiency may help protect against TPO-Ab development. [ABSTRACT FROM AUTHOR]

Objectives: Familial adenomatous polyposis (FAP) is a hereditable disorder characterized by early and unremitting development of intestinal polyps and extraintestinal manifestations requiring multidisciplinary surveillance. Herein we describe a multicenter cross-sectional analysis of the dento-osseous radiographic findings of patients with FAP from North and South America.Study Design: Groups I and II included individuals with FAP diagnosed by standard clinical criteria. Patients were paired with age- and sex-matched participants without FAP. Panoramic radiograph of both cohorts, including children and adults, were analyzed.Results: Of 114 panoramic radiographs, 38 were from patients with FAP, composed of group I (n = 22) and group II (n = 16), and 76 were from matched control participants. Evaluators had excellent agreement on key findings (intraclass correlation coefficient = 0.89). The prevalence of osseous anomalies was higher in adults (75%) than in children (65.4%). Dental anomalies were also higher in children with FAP with a prevalence of 15.4%.Conclusions: We describe important and significant differences in the prevalence of dento-osseous anomalies in children compared with adult patients with FAP. These findings warrant careful consideration and may influence multidisciplinary management of the condition. Conversely, the presence of these abnormalities in pediatric dental patients even if not diagnosed with FAP should be borne in mind as possibly indicating de novo or unrecognized disease. [ABSTRACT FROM AUTHOR]

Recombinant activated factor VIIa (rVIIa) is used off-label for refractory bleeding after cardiac surgery. This study reviewed the indications, usage rates, and complications of rVIIa. A retrospective case-control observational study. A single quaternary pediatric hospital. All children undergoing cardiac surgery with cardiopulmonary bypass over a three-year period. Administration of rVIIa as rescue therapy for refractory bleeding after weaning from cardiopulmonary bypass. Onethousand, five hundred fifteen cardiopulmonary bypass procedures were reviewed. Patients receiving rVIIa were each matched to two control patients by age, procedure type, and bypass time. Data collected included weight, crossclamp time, anticoagulant and antifibrinolytic dose, return to the operating room for bleeding, thrombotic events, and extracorporeal membrane oxygenation (ECMO) circuit interventions. Forty-two patients received rVIIa (2.8%). Major systemic thrombotic complications were observed in 19% (controls 12.5%) of patients; 80% of recombinant factor VIIa patients requiring postoperative ECMO had interventions for circuit thrombosis (controls 31.25%); 4.76% of rVIIa recipients required reexploration for intractable bleeding (controls 1.39%). This study added to understanding regarding the use of recombinant factor VIIa in pediatric cardiac surgery and reported increased thrombotic complications, especially for children who progress to ECMO. Prospective studies to better understand the pathophysiology of coagulopathy and hemorrhage in pediatric cardiac surgery and the role of hemostatic agents, such as rVIIa, are required. [ABSTRACT FROM AUTHOR]

The digital waxing of single crowns can be affected by the quality of intraoral scans and use of computer-aided design (CAD) software programs. However, clinical outcomes of the resulting crowns are also affected by computer-aided manufacturing (CAM) methodologies. Studies on the effect of different levels of expertise on digital waxing are lacking. The purpose of this in vitro study was to assess the impact of different levels of expertise on the reliability and reproducibility of margin outlining during digital waxing. Thirty analogs of implant stock abutments (Ø4.8×4 mm) were embedded into resin blocks. To simulate different clinical situations, abutments were divided into 3 groups: 10 abutments (group GOS) received artificial gingiva and were scanned with an open system intraoral scanner, while 10 abutments with (group GIS) and 10 abutments without artificial gingiva (group IS) were scanned with an intraoral scanner within an integrated CAD-CAM system. All resulting standard tessellation language (STL) files were used by 2 different observers (an experienced CAD professional and a clinician with basic CAD knowledge) to digitally design a left mandibular central incisor in the same software program. All resulting digital crown designs were exported to STL files to assess crown margin accuracy at the coupling interface by superimposition with the control STL file of the scan body designed for the same abutment by the manufacturer. For this purpose, a CAD software program was used to automatically calculate median, minimum, and maximum deviations of margins in millimeters. Statistically significant pairwise differences among groups and between observers were assessed with the Wilcoxon signed-rank test (α=.05). For the CAD professional, median deviations between designed crown STL files and the control STL of the scan body were 0.08 mm (range: 0.04 to 0.15) for group GOS; 0.10 mm (range: 0.06 to 0.18) for group GIS; and 0.05 mm (range: 0.03 to 0.08) for group IS. For the clinician, median deviations were 0.08 mm (range: 0.04 to 0.12) for group GOS; 0.11 mm (range: 0.07 to 0.17) for group GIS; and 0.05 mm (range: 0.04 to 0.11) for group IS. There were no significant differences between observers (P >.05). However, statistically significant differences were found between group IS and the other 2 groups (P =.001) but not between groups GOS and GIS (P >.05). The present findings suggest that a digital wax pattern made with a dental CAD software program is not affected by varying levels of expertise but might be affected by subgingival margins. [ABSTRACT FROM AUTHOR]