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Survival analysis of posterior composite restorations in National Dental PBRN general dentistry practices
(Elsevier, 2024) Thyvalikakath, Thankam; Siddiqui, Zasim Azhar; Eckert, George; LaPradd, Michelle; Duncan, William D.; Gordan, Valeria V.; Rindal, D. Brad; Jurkovich, Mark; Gilbert, Gregg H.; National Dental PBRN Collaborative Group; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
Objective: Quantify the survival of posterior composite restorations (PCR) placed during the study period in permanent teeth in United States (US) general dental community practices and factors predictive of that survival.
Methods: A retrospective cohort study was conducted utilizing de-identified electronic dental record (EDR) data of patients who received a PCR in 99 general dentistry practices in the National Dental Practice-Based Research Network (Network). The final analyzed data set included 700,885 PCRs from 200,988 patients. Descriptive statistics and Kaplan Meier (product limit) estimator were performed to estimate the survival rate (defined as the PCR not receiving any subsequent treatment) after the first PCR was observed in the EDR during the study time. The Cox proportional hazards model was done to account for patient- and tooth-specific covariates.
Results: The overall median survival time was 13.3 years. The annual failure rates were 4.5-5.8 % for years 1-5; 5.3-5.7 %, 4.9-5.5 %, and 3.3-5.2 % for years 6-10, 11-15, and 16-20, respectively. The failure descriptions recorded for < 7 % failures were mostly caries (54 %) and broken or fractured tooth/restorations (23 %). The following variables significantly predicted PCR survival: number of surfaces that comprised the PCR; having at least one interproximal surface; tooth type; type of prior treatment received on the tooth; Network region; patient age and sex. Based on the magnitude of the multivariable estimates, no single factor predominated.
Conclusions: This study of Network practices geographically distributed across the US observed PCR survival rates and predictive factors comparable to studies done in academic settings and outside the US.
Diverse Patient Experiences of Internet-Based Cognitive Behavioral Therapy with Guided Peer Support for Generalized Anxiety Disorders
(Sage, 2025-02-02) Connors, Jill Nault; Magalhaes, Ernani; Prather, Kevin; Khan, Nida; Draucker, Claire; Eliacin, Johanne; Montgomery, Chet; Hayden, Julie; Millard, Michael; Kroenke, Kurt; Musey, Paul; Surgery, School of Medicine
Opportunities exist to improve patient experience in the emergency department for low-risk (ie, non-cardiac) chest pain patients with anxiety and panic as the underlying cause of symptoms. Referral to internet-based cognitive behavioral therapy (iCBT) with guided support is a scalable, evidence-based option that is underused, particularly among non-white patients. In collaboration with a diverse group of patient and community partners, we co-developed and tested an existing iCBT course for generalized anxiety disorder with delivery of guided support by a peer recovery specialist with concordant lived experience. We analyzed patient partner feedback from debriefing sessions during the testing phase using conventional content analysis. Results revealed overall positive experiences with both iCBT lessons and peer support calls. Key points derived from qualitative findings include: (1) iCBT lesson content resonated reasonably well with the diverse group of patient partners, (2) the peer relationship was key to individualizing application of content to various lived experiences, and (3) the guided discussion should be participant-driven and based on content that resonates most with the participant. In conclusion, iCBT with guided peer support was acceptable to patient partners involved in co-development and testing who were representative of a diverse patient population.
Chaotic fun! Promoting active recall of anatomical structures and relationships using the Catch‐Phrase game
(Wiley, 2025) Cale, Andrew S.; McNulty, Margaret A.; Anatomy, Cell Biology and Physiology, School of Medicine
Active recall, the act of recalling knowledge from memory, and games-based learning, the use of games and game elements for learning, are well-established as effective strategies for learning gross anatomy. An activity that applies both principles is Catch-Phrase, a fast-paced word guessing game. In Anatomy Catch-Phrase, players must get their teammates to identify an anatomical term by describing its features, functions, or relationships without saying the term itself. Once a teammate guesses the term, players switch roles and continue play with the next term(s) until time runs out. Meanwhile, the instructor notes common errors and reviews knowledge gaps with the team at the end of the round. Prior to the first exam, a seven-question evaluation was distributed to the health professional students. A total of 18 dissection lab groups (86%) played one round of Anatomy Catch-Phrase, with many groups playing multiple times. After the first exam, 73 students (61%) completed the evaluation. On a five-point scale, most students indicated they enjoyed Anatomy Catch-Phrase (4.3 ± 0.9), highly recommended it (4.2 ± 0.9), and wanted to play it in the future (4.3 ± 1.0). Most students also found the game relevant to the course material (4.5 ± 0.8), useful for reviewing (3.9 ± 0.9), and helped reinforce their knowledge (3.9 ± 0.9). Anatomy Catch-Phrase was highly rated, with a score of 4.3 ± 0.9. Multiple students also provided enthusiastic unsolicited comments, such as 'LOVED IT! A fun way to study anatomy!:)'. Overall, Anatomy Catch-Phrase was well-received as a fun activity for reviewing the anatomy relevant to the course.
An IL-23-STAT4 pathway is required for the proinflammatory function of classical dendritic cells during CNS inflammation
(National Academy of Sciences, 2024) Alakhras, Nada S.; Zhang, Wenwu; Barros, Nicolas; Sharma, Anchal; Ropa, James; Priya, Raj; Yang, X. Frank; Kaplan, Mark H.; Biochemistry and Molecular Biology, School of Medicine
Although many cytokine pathways are important for dendritic cell (DC) development, it is less clear what cytokine signals promote the function of mature dendritic cells. The signal transducer and activator of transcription 4 (STAT4) promotes protective immunity and autoimmunity downstream of proinflammatory cytokines including IL-12 and IL-23. In experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS), Stat4-/- mice are resistant to the development of inflammation and paralysis. To define whether STAT4 is required for intrinsic signaling in mature DC function, we used conditional mutant mice in the EAE model. Deficiency of STAT4 in CD11c-expressing cells resulted in decreased T cell priming and inflammation in the central nervous system. EAE susceptibility was recovered following adoptive transfer of wild-type bone marrow-derived DCs to mice with STAT4-deficient DCs, but not adoptive transfer of STAT4- or IL-23R-deficient DCs. Single-cell RNA-sequencing (RNA-seq) identified STAT4-dependent genes in DC subsets that paralleled a signature in MS patient DCs. Together, these data define an IL-23-STAT4 pathway in DCs that is key to DC function during inflammatory disease.
In vivo Assessment of Bone Quality without X-rays
(Springer, 2024) Surowiec, Rachel K.; Does, Mark D.; Nyman, Jeffry S.; Radiology and Imaging Sciences, School of Medicine
Purpose of Review:
This review summarizes recent advances in the assessment of bone quality using non-X-ray techniques.
Recent Findings:
Quantitative ultrasound (QUS) provides multiple measurements of bone characteristics based on the propagation of sound through bone, the attenuation of that sound, and different processing techniques. QUS parameters and model predictions based on backscattered signals can discriminate non-fracture from fracture cases with accuracy comparable to standard bone mineral density (BMD). With advances in magnetic resonance imaging (MRI), bound water and pore water, or a porosity index, can be quantified in several long bones in vivo. Since such imaging-derived measurements correlate with the fracture resistance of bone, they potentially provide new BMD-independent predictors of fracture risk. While numerous measurements of mineral, organic matrix, and bound water by Raman spectroscopy correlate with the strength and toughness of cortical bone, the clinical assessment of person’s bone quality using spatially offset Raman spectroscopy (SORS) requires advanced spectral processing techniques that minimize contaminating signals from fat, skin, and blood.
Summary:
Limiting exposure of patients to ionizing radiation, QUS, MRI, and SORS have the potential to improve the assessment of fracture risk and track changes of new therapies that target bone matrix and micro-structure.