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There is extensive literature emerging in the field of dentistry with the aim to optimize clinical practice. Evidence-based guidelines (EBGs) are designed to collate diagnostic criteria and clinical treatment for a range of conditions based on high-quality evidence. Recently, advancements in Artificial Intelligence (AI) have instigated further queries into its applicability and integration into dentistry. Hence, the aim of this study was to develop a model that can be used to assess the accuracy of treatment recommendations for dental conditions generated by individual clinicians and the outcomes of AI outputs. For this pilot study, a Delphi panel of six experts led by CoTreat AI provided the definition and developed evidence-based recommendations for subgingival and supragingival calculus. For the rapid review—a pragmatic approach that aims to rapidly assess the evidence base using a systematic methodology—the Ovid Medline database was searched for subgingival and supragingival calculus. Studies were selected and reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and this study complied with the minimum requirements for completing a restricted systematic review. Treatment recommendations were also searched for these same conditions in ChatGPT (version 3.5 and 4) and Bard (now Gemini). Adherence to the recommendations of the standard was assessed using qualitative content analysis and agreement scores for interrater reliability. Treatment recommendations by AI programs generally aligned with the current literature, with an agreement of up to 75%, although data sources were not provided by these tools, except for Bard. The clinician’s rapid review results suggested several procedures that may increase the likelihood of overtreatment, as did GPT4. In terms of overall accuracy, GPT4 outperformed all other tools, including rapid review (Cohen’s kappa 0.42 vs. 0.28). In summary, this study provides preliminary observations for the suitability of different evidence-generating methods to inform clinical dental practice.

Abstract Background Asylum seekers and refugees (AS&Rs) experience impaired mental health and wellbeing, related to stresses in their country of origin, experiences in transit and reception on arrival, including significant barriers to accessing mainstream services. Their contact with health care is often crisis-driven and mediated through non-governmental organisations (NGOs). Problem Management Plus (PM+) is a psychosocial intervention recommended by the World Health Organisation to address distress experienced by adults affected by humanitarian crises. We are investigating its application for the first time in a high-income country. Methods In a pilot randomised controlled trial (RCT), PM+ will be delivered to AS&Rs in contact with NGOs in Liverpool City Region, UK by lay therapists who have lived experience of forced migration. Following systematic review and stakeholder engagement, PM+ has been adapted to the local context, and lay therapists have been trained in its delivery. We will assess the feasibility of conducting a three-arm RCT of five 90-min sessions of PM+, delivered individually or in groups by lay therapists to AS&Rs experiencing emotional distress and functional impairment, compared with each other and with usual support offered by local NGOs. Distress and impairment at baseline will be measured by the Hospital Anxiety and Depression Scale (HADS) and the WHO Disability Assessment Schedule (WHO-DAS). We aim to recruit 105 participants, 35 per arm. Primary health outcomes are anxiety and depressive symptoms at 3 months, measured by HADS. Secondary outcomes include subjective wellbeing, functional status, progress on identified problems, presence of post-traumatic stress disorder and depressive disorder and service usage. Longer-term impact will be assessed at 6 months post baseline, on the same parameters. We will assess the feasibility of conducting a full RCT in relation to the following elements: recruitment and retention of lay therapists and study participants; fidelity of delivery of PM+; and suitability of the study measures, including any linguistic or cultural barriers. Discussion We will use these findings to specify the parameters for a full RCT to test the effectiveness and cost-effectiveness of PM+ in reducing emotional distress and health inequalities, and improving functional ability and wellbeing, amongst asylum seekers and refugees. Trial registration ISRCTN, ID: ISRCTN15214107 . Registered on 10 September 2019.

Amaç: Diyare çocuklarda Malawi"yide içeren gelir düzeyi düşük ülkelerde sık görülen problemlerden biridir. Diyare, Cryptosporidium parvum and Isospora belli gibi pek çok intestinal parazitlere bağlı olarak ortaya çıkar. Her iki enfeksiyon Her iki enfeksiyon immune direnci düşük olgularda yaşamı tehdit eden diyareye neden olabilir. Çalışmanın temel amacı QECH başvuran diyaresi olan çocuklar arasında enfeksiyonların bu enfeksiyonların sıklığını araştırmaktır Ayrıca Cryptosporidium parvum ve Isospora belliile enfekte olan insane immuneksikliği virusu (HIV) seropozitif ve HIV seronegatif diyareli çocuklarda hastalığın sıklığı yanı sıra tanı yöntemlerinin değerlendirilmesi amaçlanmıştır. Yöntem: Gaita örnekleri akut diyare (3 günden az) ve diyare olmayan cocuklar hariç kliniğimize kabul edilen ve yatmakta olan diyareli çocuklardan alınmıştır. Her bir örnekten dört yayma hazırlanmıştır: İki tanesi Ziehl,Neelsen boyaması diğer ikisi ise Auramine-Fenol boyaması ile incelenmiştir. Elde edilen veriller Microsoft Excel programına kaydedilip, Epi-Info programı kullanılarak analiz edilmiştir. Bulgular: Beş yaşın altında diyareli 25 çocuk çalışmaya dahil edildi. Bunlardan 10 tanesi HIV seropozitif, 7 tanesi HIV seronegatif 8 tanesinin ise durumu bilinmiyordu. 4 çocukta (16%) cryptosporidium parvum güven aralıkları %4.5 ve %36.1 arası ve hiçbir çocukta Isospora belli tespit edilemedi %0.0 ve %86.3 güven aralıklarında. Cryptosporidium parvum tespit edilen 4 çocuğun 3 tanesi HIV-seropozitif frekansı %30, 1 tanesi ise HIV-seronegatifti frekansı ise %14.3 idi. HIV durumu bilinmeyen çocukların hiç birinde enfeksiyon tespit edilmedi. Sonuç: Modifiye edilmiş Ziehl-Neelsen tekniği ve Auramine-Fenol boyaması QECH"e gelen gaita örneklerinin C.parvum and I.belli tespitinde kullanılabilir. Her nekadar, I.belli bizim bölgemizde yaygın olsada çocuklarda tespit edilmemiştir. Ayrıca bu organizmaların endemik patojen olarak evrimleşmedikleri ve halen yetişkinlerde fırsatçı endemik patojenler olarak hayatlarını sürdürdükleri tespit edilmiştir. Bu çalışmanın özellikle altın standart olarak kabul edilen metodlarla yağmurlu sezonda tekrarlanması gerektiği düşünülmektedir. Anahtar Kelimeler:

Purpose: Diarrhoea in children is a common problem in low resourced countries including Malawi. It is caused by many intestinal parasites including Cryptosporidium parvum and Isospora belli. Both infections are prevalent in severely immunocompromised individuals and may cause severe life-threatening diarrhoea. The main aim of the study was to assess the prevalence of Cryptosporidium parvum and Isospora belli infections among children presenting with diarrhoea admitted to QECH - paediatrics wards and methods used for diagnosis. Some specific objectives were to determine the prevalence of Cryptosporidium parvum and Isospora belli infections among human immunodeficiency virus (HIV) seropositive and HIV seronegative children with diarrhoea, to evaluate diagnostic methods used at QECH to identify intestinal parasites and to determine diagnostic methods that can be recommended for implementation. Methods: Faecal samples were collected from all children presenting with diarrhoea upon admission or already hospitalised were recruited excluding all children without or with acute diarrhoea (less than three days). Four smears were prepared from each sample: 2 for Ziehl Neelsen staining and the other 2 for Auramine-phenol staining. The data was entered into Microsoft Excel and analysed using Epi-Info. Results: A total of 25 children with diarrhoea under the age of five years; 10 were human immunodeficiency virus -seropositive, 7 were HIV-seronegative and 8 of them their status was unknown. Cryptosporidium parvum was detected in 4 children (16%) at 4.5% and 36.1% confidence intervals and none had Isospora belli at 0.0% and 86.3% confidence intervals. Out of those 4 who had Cryptosporidium parvum, 3 children were HIV-seropositive and 1 child was HIV-seronegative at a frequency of 30% and 14.3% respectively. No infection was seen in children whose HIV-serostatus was unknown. Conclusion: Modified Ziehl Neelsen technique and auramine-phenol staining can be used to examine stool at QECH for C.parvum and I.belli identification. Although I.belli is prevalent in our environment, it has not yet been detected in children and or evolved as an endemic pathogen and so far remains as an opportunistic pathogen in adults only. There is need to repeat the study in rainy season and include gold standard method. [Cukurova Med J 2012; 37(3.000): 133-138]