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An Assessment of Deep Learning’s Impact on General Dentists’ Ability to Detect Alveolar Bone Loss in 2D Intraoral Radiographs
Get PDFBackground/Objective: Deep learning (DL) technology has shown potential in enhancing diagnostic accuracy in dentomaxillofacial radiology, particularly for detecting carious lesions, apical lesions, and periodontal bone loss. However, its effect on general dentists’ ability to detect radiographic bone loss (RBL) in clinical practice remains unclear. This study investigates the impact of the Denti.AI DL technology on general dentists’ ability to identify bone loss in intraoral radiographs, addressing this gap in the literature. Methods: Ten dentists from the university’s dental clinics independently assessed 26 intraoral radiographs (periapical and bitewing) for bone loss using a Likert scale probability index with and without DL assistance. The participants viewed images on identical monitors with controlled lighting. This study generated 3940 data points for analysis. The statistical analyses included receiver operating characteristic (ROC) curves, area under the curve (AUC), and ANOVA tests. Results: Most dentists showed minor improvement in detecting bone loss on periapical radiographs when using DL. For bitewing radiographs, only a few dentists showed minor improvement. Overall, the difference in diagnostic accuracy between evaluations with and without DL was minimal (0.008). The differences in AUC for periapical and bitewing radiographs were 0.031 and −0.009, respectively, and were not statistically significant. Conclusions: This study found no statistically significant improvement in experienced dentists’ diagnostic accuracy for detecting bone loss in intraoral radiographs when using Denti.AI deep learning technology
School Safety Concerns and Solutions: A Qualitative Analysis of U.S. School Psychologists’ Perspectives
Get PDFIn the present study, we analyzed qualitative survey data from 538 school psychologists across schools in the United States regarding their perceptions of school safety issues and potential strategies to address school safety. There are only a few studies exploring the experiences and perspectives of school psychologists that have been based on large-scale qualitative data. Using inductive coding, three themes for safety concerns emerged: (a) aggressive behaviors from students, (b) mental and behavioral needs, and (c) limited staffing. Three themes also emerged for potential solutions: (a) professional development/training, (b) school–family–community relationships, and (c) threat assessments. These findings from school psychologists have implications for addressing structural issues to prevent school violence in research and practice. Policy recommendations to inform resource allocation and improve school safety are discussed
Ensitrelvir for the Treatment of Nonhospitalized Adults with COVID-19: Results from the SCORPIO-HR, Phase 3, Randomized, Double-blind, Placebo-Controlled Trial
Get PDFBACKGROUND: Ensitrelvir, a severe acute respiratory syndrome coronavirus-2 main protease inhibitor, has demonstrated clinical and virologic efficacy in previous studies. METHODS: In this global phase 3 trial, nonhospitalized adults with mild-to-moderate coronavirus disease 2019 (COVID-19) and symptom onset within 5 days were randomized (1:1) to receive once-daily ensitrelvir (375 mg day 1, 125 mg days 2-5) or blinded matching placebo. The primary endpoint was the restricted mean time to sustained (≥2 days) resolution of 15 COVID-19 symptoms, recorded in participant daily diaries, through day 29 in participants starting treatment within 3 days after symptom onset. Virologic efficacy and safety were assessed. RESULTS: Of 2093 participants, 1888 started treatment within 3 days after symptom onset. Mean time to symptom resolution was 12.5 and 13.1 days with ensitrelvir and placebo, respectively (difference, -0.6 days; 95% confidence interval, -1.38 to 0.19; P = .14). On day 4, ensitrelvir reduced least-squares mean RNA by 0.72 log10 copies/mL more than placebo (95% confidence interval, 0.55-0.90). Among those with positive viral cultures at enrollment, 274/287 (95.5%) ensitrelvir-treated versus 210/280 (75.0%) placebo-treated participants had negative cultures on day 4. RNA rebound was similar (<1.5%) between groups. The proportion of participants with ≥1 adverse event was similar with ensitrelvir (61.5%) and placebo (60.6%). No treatment-related serious adverse events or deaths occurred. Three (0.3%) ensitrelvir-treated and 1 (0.1%) placebo-treated participants had COVID-19-related hospitalizations by day 29. CONCLUSIONS: Despite the evidence of antiviral activity with ensitrelvir, this trial did not demonstrate a significant difference in time to sustained symptom resolution
Adherence to a digital therapeutic mediates the relationship between momentary self-regulation and health risk behaviors
Get PDFSmoking, obesity, and insufficient physical activity are modifiable health risk behaviors. Self-regulation is one fundamental behavior change mechanism often incorporated within digital therapeutics as it varies momentarily across time and contexts and may play a causal role in improving these health behaviors. However, the role of momentary self-regulation in achieving behavior change has been infrequently examined. Using a novel momentary self-regulation scale, this study examined how targeting self-regulation through a digital therapeutic impacts adherence to the therapeutic and two different health risk behavioral outcomes. This prospective interventional study included momentary data for 28 days from 50 participants with obesity and binge eating disorder and 50 participants who smoked regularly. An evidence-based digital therapeutic, called Laddr™, provided self-regulation behavior change tools. Participants reported on their momentary self-regulation via ecological momentary assessments and health risk behaviors were measured as steps taken from a physical activity tracker and breathalyzed carbon monoxide. Medical regimen adherence was assessed as daily Laddr usage. Bayesian dynamic mediation models were used to examine moment-to-moment mediation effects between momentary self-regulation subscales, medical regimen adherence, and behavioral outcomes. In the binge eating disorder sample, the perseverance [β1 = 0.17, 95% CI = (0.06, 0.45)] and emotion regulation [β1 = 0.12, 95% CI = (0.03, 0.27)] targets of momentary self-regulation positively predicted Laddr adherence on the following day, and higher Laddr adherence was subsequently a positive predictor of steps taken the same day for both perseverance [β2 = 0.335, 95% CI = (0.030, 0.717)] and emotion regulation [β2 = 0.389, 95% CI = (0.080, 0.738)]. In the smoking sample, the perseverance target of momentary self-regulation positively predicted Laddr adherence on the following day [β = 0.91, 95% CI = (0.60, 1.24)]. However, higher Laddr adherence was not a predictor of CO values on the same day [β2 = −0.09, 95% CI = (−0.24, 0.09)]. This study provides evidence that a digital therapeutic targeting self-regulation can modify the relationships between momentary self-regulation, medical regimen adherence, and behavioral health outcomes. Together, this work demonstrated the ability to digitally assess the transdiagnostic mediating effect of momentary self-regulation on medical regimen adherence and pro-health behavioral outcomes. ClinicalTrials.gov, identifier (NCT03774433)
Strengthening Education Through Equitable and Inclusive Evidence-Based Teaching Practices: A Scoping Review
Get PDFThis scoping review provides clarity on the landscape of evidence-based and High-Leverage Practices that have been shown to be effective with students with disabilities and have the potential to meet the needs of marginalized students across lines of difference. Of 672 articles screened, 85 met eligibility criteria, including 46 studies, 11 systematic reviews, and 28 conceptual papers. Among included articles, instruction practices were the most frequently reported High-Leverage Practice category (89.4%), followed by social, emotional, and behavioral practices (37.6%), and assessment practices (25.8%). A wide variety of specific evidence-based practices were identified in the literature. Marginalized student identities represented included English language learners, students with disabilities, neurodivergent students, racially or ethnically marginalized students, students with health disabilities, and students with behavioral or emotional difficulties. Future research should consider further examining the effectiveness of different practices to inform data-driven decision-making to improve educational outcomes for marginalized students
Characterizing long-acting injectable antiretroviral therapy eligibility and initiation at a safety net academic medical center in the southeastern United States
Get PDFBackground: Long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) extends dosing intervals from daily to every 8 weeks. Equitable implementation requires anticipating and addressing barriers to use. We described LAI-CAB/RPV eligibility and initiation among persons with HIV (PWH) receiving care at a Southeastern US academic medical center. Methods: We included PWH ≥18 years, in care 01/01/2020-12/31/2021, and participating in the UNC CFAR HIV Clinical Cohort. We characterized LAI-CAB/RPV eligibility, compared those with and without recent detectable viral load (VL), and described clinical outcomes on LAI-CAB/RPV. Results: Among 1672 PWH, 425 (25.4%) had LAI-CAB/RPV drug-resistance. Among 1238 LAI-eligible PWH, 8.9% had detectable VL. Median age was 53 (interquartile range 40, 61), 54.6% were non-Hispanic Black, and 73.6% male. Over one-third lived >50 miles from clinic, one-fifth were uninsured, and 7.4% reported hazardous alcohol use. Gaps in care (prior 12-month) were more common among PWH with detectable VL versus suppressed (23.1% vs 13.9%, p = 0.03). 6/47 initiated LAI-CAB/RPV had detectable VL prior to injection; >95% sustained suppression and those with detectable VL had a rapid decline in viremia. Conclusions: Three-quarters of PWH were eligible for LAI-CAB/RPV, but equitable implementation may require addressing challenges such as distance to care, inconsistent care engagement, and other comorbid conditions, particularly for PWH with viremia
Correction: FHIR PIT: a geospatial and spatiotemporal data integration pipeline to support subject-level clinical research
Get PDFCorrection to: "FHIR PIT: a geospatial and spatiotemporal data integration pipeline to support subject-level clinical research
Coding of Global Fishing Watch Research Articles (2016-2020)
No full textNew data technologies are taking center stage in environmental governance for their potential to illuminate environmental challenges and inform policy and management directions. They hold particular promise in the oceans where ecological and human activities have long been difficult to see and know. In this piece, we turn attention to an ocean data science initiative (ODSI) that produces new data technologies with an aim of enhancing understanding of the role of such bodies in defining and experimenting with the relationship among problem framings, data mobilization, and policy and management recommendations in an era of data-driven environmental governance. The work archived here is the dataset that emerged from our analysis of the first phase research program of Global Fishing Watch (GFW), a high profile organization innovating new data technologies related to the movement of industrial fishing vessels. We review research publications GFW researchers and affiliates published between 2016-2020 and examine what concerns GFW researchers seek to address, how they develop and mobilize GFW data analysis techniques to illuminate or better understand those concerns, and the policy and management possibilities that they suggest based on findings. This dataset comprises the results of coding of GFW papers. Coding results were used for analysis that contributes to understanding organizations that work with data with a goal of improving conditions in the oceans as oceans governance actions
