Publications by authors named "Keith D"

479 Publications

Focus group study of factors relevant to treatment decisions and experiences among patients with symptomatic peripheral artery disease.

J Vasc Surg 2022 Jul 18. Epub 2022 Jul 18.

Division of Public Health Sciences.

Background: Clinical guidelines recommend shared decision-making for treatment of peripheral artery disease (PAD), which requires understanding of patient perspectives and preferences. We conducted a focus group study of patients with symptomatic PAD to identify factors important and relevant to treatment choices, and to characterize aspects of the healthcare process that contribute to positive versus negative experiences apart from the specific treatment(s) received.

Methods: Participants were recruited from an academic medical center over two years using a purposeful sampling approach based on a clinical diagnosis of symptomatic PAD (either claudication or chronic limb threatening ischemia [CLTI]) confirmed by abnormal ankle or toe brachial index. Focus groups were led by a non-physician moderator, consisted of 5-12 participants, and were conducted separately for patients with CLTI and claudication. Audio recordings converted to verbatim transcripts were used for qualitative analysis.

Results: 51 patients (26 with CLTI and 25 with claudication) were enrolled and participated in focus groups. Major themes related to the process of care included: decision-making input, provider communication and trust, the timeline from diagnosis to definitive treatment, and compartmentalized care (including different venues of care). Major themes related to the process of care included: decision-making input, provider communication and trust, the timeline from diagnosis to definitive treatment, and compartmentalized care (including different venues of care).

Conclusions: The results provide insights into patient preferences, perspectives, and experiences related to PAD treatment. These observations can be used to inform patient-centered approaches to shared decision making, communication, and assessment of PAD treatment outcomes.
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http://dx.doi.org/10.1016/j.jvs.2022.06.023DOI Listing
July 2022

The LED loupe magnifier: a cost-effective method of dermoscopic examination and photography of skin lesions in primary care and beyond.

J Eur Acad Dermatol Venereol 2022 Jul 20. Epub 2022 Jul 20.

Department of Dermatology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.

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http://dx.doi.org/10.1111/jdv.18448DOI Listing
July 2022

Are There Identifiable Risk Factors Associated With Heterotopic Ossification of the Temporomandibular Joint?

J Oral Maxillofac Surg 2022 Aug 2;80(8):1318-1330. Epub 2022 May 2.

Visiting Oral and Maxillofacial Surgeon, Division of Oral and Maxillofacial Surgery, Department of Surgery, Massachusetts General Hospital, Professor Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA. Electronic address:

Purpose: Heterotopic ossification (HO) is defined as bone where it does not belong and as the abnormal presence of calcifications within soft tissues or joints. The purpose of this study was to answer the following clinical question: Are there identifiable risk factors associated with HO in and around the temporomandibular joint (TMJ)?

Methods: We designed a retrospective review of patients seen at the Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, between January 1985 and December 2019 and diagnosed with HO involving the TMJ. Variables studied included demographic factors, medical history including hereditary conditions, and specific TMJ history including past interventions. The primary outcome variable was the diagnosis of HO based on radiographic findings using the classification system described by Turlington and Durr. Inclusion criterion was clinical or radiographic evidence of TMJ HO.

Results: A total of 67 patients met the inclusion criteria. There were 48 females and 19 males (2.5:1) with an average age of 44.1 ± 16.7 years (range, 5-76 years). Risk factors associated with TMJ HO included musculoskeletal disease, psychiatric illness, history of trauma or previous TMJ surgeries, and congenital conditions. Of these, a history of nonsurgical TMJ therapy (odds ratio [OR], 3.5; P < .00) was most closely associated with HO. This was followed by male sex (OR, 3.1; P = .001), other craniofacial or musculoskeletal surgeries (OR, 2.4; P = .004), TMJ surgeries (OR, 1.9; P = .012), and neurogenic injury (OR, 1.8; P = .018). The results also demonstrated that patients diagnosed with TMJ HO were medically complex, with 86.6% presenting with other systemic conditions.

Conclusion: This study identifies several risk factors which differ from those reported in the orthopedic literature. The Turlington and Durr classification is only partially helpful in clinical decision-making and needs to include HO associated with TMJ alloplasts and autogenous bone grafts (eg, costochondral grafts).
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http://dx.doi.org/10.1016/j.joms.2022.04.020DOI Listing
August 2022

Measuring plant biomass remotely using drones in arid landscapes.

Ecol Evol 2022 May 13;12(5):e8891. Epub 2022 May 13.

Centre for Ecosystem Science School of Biological, Earth and Environmental Sciences UNSW Sydney New South Wales Australia.

Measurement of variation in plant biomass is essential for answering many ecological and evolutionary questions. Quantitative estimates require plant destruction for laboratory analyses, while field studies use allometric approaches based on simple measurement of plant dimensions.We estimated the biomass of individual shrub-sized plants, using a low-cost unmanned aerial system (drone), enabling rapid data collection and non-destructive sampling. We compared volume measurement (a surrogate for biomass) and sampling time, from the simple dimension measurements and drone, to accurate laboratory-derived biomass weights. We focused on three Australian plant species which are ecologically important to their terrestrial and floodplain ecosystems: porcupine grass , Queensland bluebush , and lignum .Estimated volume from the drone was more accurate than simple dimension measurements for porcupine grass and Queensland bluebush, compared to estimates from laboratory analyses but, not for lignum. The latter had a sparse canopy, with thin branches, few vestigial leaves and a similar color to the ground. Data collection and analysis consistently required more time for the drone method than the simple dimension measurements, but this would improve with automation.The drone method promises considerable potential for some plant species, allowing data to be collected over large spatial scales and, in time series, increasing opportunities to answer complex ecological and evolutionary questions and monitor the state of ecosystems and plant populations.
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http://dx.doi.org/10.1002/ece3.8891DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106562PMC
May 2022

The influence of caffeinated and non-caffeinated multi-ingredient pre-workout supplements on resistance exercise performance and subjective outcomes.

J Int Soc Sports Nutr 2022 4;19(1):126-149. Epub 2022 Apr 4.

Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA.

Background: There is substantial consumer and practitioner interest in an emerging supplement class known as multi-ingredient pre-workout supplements (MIPS), largely due to their prevalence in resistance training communities as well as research findings demonstrating the ergogenic impact of caffeine on muscular performance. However, limited research has examined the potential efficacy of non-caffeinated MIPS, despite their growing popularity among those who are caffeine-sensitive or who train later in the day.

Methods: Twenty-four resistance-trained college-aged males (n = 12) and females (n = 12) completed three visits in which they ingested either a caffeinated MIPS (C), an otherwise identical non-caffeinated MIPS (NC), or placebo in a double-blind, counterbalanced, crossover fashion. Squat isometric peak force (PF), rate of force development (RFD), and isokinetic performance were assessed. Upper and lower body maximal muscular strength and endurance were evaluated using the bench press and leg press, respectively. Visual analog scales for energy, focus, and fatigue were completed five times throughout the testing protocol. The effects of supplementation and biological sex on all variables were examined using linear mixed effects models.

Results: Significantly greater PF was observed in both C (: 0.36 transformed units [0.09, 0.62]) and NC (: 0.32 transformed units [95% CI: 0.05, 0.58]) conditions, relative to placebo. Early RFD (RFD) may have been higher with supplementation, particularly in females, with no effects for late RFD (RFD) or peak RFD. In addition, increases in subjective energy after supplement ingestion were noted for C, but not NC. No effects of supplementation on traditional resistance exercise performance or isokinetic squat performance were observed, other than a lower leg press one-repetition maximum for males in the NC condition.

Conclusions: These data indicate that acute ingestion of either a caffeinated or non-caffeinated pre-workout formulation improved maximal force production during an isometric squat test but did not provide additional benefit to leg press, bench press, or isokinetic squat performance over placebo, within the context of a laboratory environment. The consumption of a caffeinated, but not non-caffeinated, MIPS increased subjective ratings of energy over placebo when assessed as part of a testing battery.
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http://dx.doi.org/10.1080/15502783.2022.2060048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116396PMC
May 2022

The phenotype of recovery VIII: Association among delay discounting, recovery capital, and length of abstinence among individuals in recovery from substance use disorders.

J Subst Abuse Treat 2022 Aug 30;139:108783. Epub 2022 Apr 30.

Addiction Recovery Research Center, Fralin Biomedical Research Institute at Virginia Tech Carilion, United States of America. Electronic address:

Introduction: Research defines recovery capital as the amount of tangible and intangible resources (e.g., human/personal, physical, social, and cultural) available to initiate and sustain recovery from substance use disorders (SUDs). An individual's amount of recovery capital is dynamic over time and influenced by a number of factors such as baseline amount at initiation of recovery/treatment, length of abstinence, access/availability of resources, and individual factors such as the decision to utilize available resources. Research has been proposed delay discounting (DD), which reflects an individual's relative preference for immediate versus delayed rewards, as a candidate behavioral marker for SUDs but has not yet examined it in the context of recovery capital, and DD may be an important aspect of human capital. Thus, the aim of the current study was to examine associations among recovery capital, DD, and length of abstinence.

Methods: The study included in its analysis data from 111 individuals in recovery from SUDs from the International Quit and Recovery Registry, an ongoing data collection program used to further scientific understanding of recovery. The study assessed recovery capital using the Assessment of Recovery Capital (ARC) and assessed discounting rates using an adjusting-delay task. The study team performed univariate linear regression to examine the relationship between total ARC score and demographic variables, length of abstinence, and DD. The research team performed a mediation analysis to understand the role of length of abstinence in mediating the relationship between DD and ARC score.

Results: Total ARC score was significantly negatively associated with DD and positively associated with length of abstinence, even after adjusting for covariates. Mediation analysis indicated that length of abstinence significantly partially mediated the relationship between DD and ARC score.

Conclusion: These findings support the characterization of DD as an important aspect of human capital and a candidate behavioral marker for SUDs. Future research may wish to investigate whether interventions designed to increase the value of future rewards also increase recovery capital.
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http://dx.doi.org/10.1016/j.jsat.2022.108783DOI Listing
August 2022

The utility of telemedicine in orofacial pain: Guidelines for examination and a retrospective review at a hospital-based practice.

J Oral Rehabil 2022 Aug 16;49(8):778-787. Epub 2022 May 16.

Orofacial Pain Division, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.

Background: Following the onset of the COVID-19 pandemic, telemedicine has become rapidly implemented into both medical and dental practices. While guidelines for examination through telemedicine have been described in similar fields of oral medicine and neurology, the framework for a comprehensive telemedicine examination for a patient with symptoms of orofacial pain has not yet been described.

Objective: The objective of this study is to introduce the format of a telemedicine examination for a new patient with orofacial pain as well as describe the success and utility of a telemedicine consultation in a hospital-based orofacial pain practice.

Methods: A retrospective review was performed of all new telemedicine consults from April 2, 2020, to March 29, 2021. Medical records were reviewed for patient demographics as well as details of the initial telemedicine consult and in-office follow up.

Results: Two hundred seventy new patients were seen. The most common diagnoses were myofascial pain of the masticatory muscles (37%), an articular disc disorder of the TMJ (21%), and TMJ arthralgia (16%), followed by obstructive sleep apnea (9%) and neuropathic orofacial pain (6%). 146 patients returned to the clinic for an in-office follow up, 78.8% of which had an accurate telemedicine diagnosis. Difficulty discerning between masticatory myofascial pain and TMJ arthralgia was the most common reason for inaccuracy during the telemedicine diagnosis.

Conclusions: Telemedicine consultation for patients with orofacial pain can help facilitate an accurate diagnosis and expedite treatment for patients who face challenges presenting for an in-office consultation.
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http://dx.doi.org/10.1111/joor.13335DOI Listing
August 2022

Recovery from opioid use disorder: A 4-year post-clinical trial outcomes study.

Drug Alcohol Depend 2022 05 9;234:109389. Epub 2022 Mar 9.

Fralin Biomedical Research Institute at Virginia Tech Carilion, 2 Riverside Circle, Roanoke, VA 24016, United States. Electronic address:

Background: Opioid use disorder (OUD) seriously impacts public health in the United States. However, few investigations of long-term outcomes following treatment with medication for OUD exist. Additionally, these studies have prioritized opioid use and treatment utilization outcomes, and a gap in knowledge regarding long-term, multidimensional trajectories of OUD recovery exists. This study investigated a diverse array of outcomes for individuals with OUD at an average of 4.2 years post clinical trial participation.

Methods: Individuals who previously participated in long-acting buprenorphine subcutaneous injection clinical trials (NCT023579011; NCT025100142; NCT02896296) and enrolled in The Remission from Chronic Opioid Use-Studying Environmental and SocioEconomic Factors on Recovery (RECOVER; NCT03604861) Study participated in a follow up assessment (n = 216). Substance use, psychosocial, opioid dependence, and delay discounting outcomes were assessed. Regression analyses were conducted to determine significant associations between psychosocial/opioid dependence variables and both recent opioid use and delay discounting.

Results: The majority of participants reported abstinence from opioids since the last RECOVER study assessment (mean 2.26 years; 55%) and in the past 30 days (69%). Participants reported low levels of depression and psychological distress. Positive associations between depression and opioid craving with past 30-day opioid misuse and delay discounting, and negative associations between quality of life and treatment effectiveness with these outcomes were observed.

Conclusions: This study examined longer term OUD recovery outcomes. Participants reported high levels of abstinence from opioids and psychosocial functioning. These encouraging results highlight the multidimensional nature of recovery from OUD, and further support the effectiveness of buprenorphine as an OUD treatment.
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http://dx.doi.org/10.1016/j.drugalcdep.2022.109389DOI Listing
May 2022

Neoadjuvant Therapy Is Associated with Improved Chemotherapy Delivery and Overall Survival Compared to Upfront Resection in Pancreatic Cancer without Increasing Perioperative Complications.

Cancers (Basel) 2022 Jan 26;14(3). Epub 2022 Jan 26.

Department of Radiation Medicine, Oregon Health & Science University, Portland, OR 97239, USA.

The role of neoadjuvant chemoradiotherapy and/or chemotherapy (neoCHT) in patients with pancreatic ductal adenocarcinoma (PDAC) is poorly defined. We hypothesized that patients who underwent neoadjuvant therapy (NAT) would have improved systemic therapy delivery, as well as comparable perioperative complications, compared to patients undergoing upfront resection. This is an IRB-approved retrospective study of potentially resectable PDAC patients treated within an academic quaternary referral center between 2011 and 2018. Data were abstracted from the electronic medical record using an institutional cancer registry and the National Surgical Quality Improvement Program. Three hundred and fourteen patients were eligible for analysis and eighty-one patients received NAT. The median overall survival (OS) was significantly improved in patients who received NAT (28.6 vs. 20.1 months, = 0.014). Patients receiving neoCHT had an overall increased mean duration of systemic therapy ( < 0.001), and the median OS improved with each month of chemotherapy delivered (HR = 0.81 per month CHT, 95% CI (0.76-0.86), < 0.001). NAT was not associated with increases in early severe post-operative complications ( = 0.47), late leaks ( = 0.23), or 30-90 day readmissions ( = 0.084). Our results show improved OS in patients who received NAT, driven largely by improved chemotherapy delivery, without an apparent increase in early or late perioperative complications compared to patients undergoing upfront resection.
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http://dx.doi.org/10.3390/cancers14030609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833799PMC
January 2022

Hairy mouths: a simple solution to a hairy problem.

Lasers Med Sci 2022 08 8;37(6):2773-2774. Epub 2022 Feb 8.

Dermatology Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.

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http://dx.doi.org/10.1007/s10103-022-03521-3DOI Listing
August 2022

The phenotype of recovery VI: The association between life-history strategies, delay discounting, and maladaptive health and financial behaviors among individuals in recovery from alcohol use disorders.

Alcohol Clin Exp Res 2022 01 24;46(1):129-140. Epub 2022 Jan 24.

Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA.

Background: The life-history theory is a well-established framework that predicts behaviors and explains how and why organisms allocate effort and resources to different life goals. Delay discounting (DD) is associated with risky behaviors and has been suggested as a candidate behavioral marker of addiction. Thus, we investigated the relationship between DD, life-history strategies, and engagement in risky behaviors among individuals in recovery from alcohol use disorder (AUD).

Methods: Data from 110 individuals in recovery from addiction from The International Quit & Recovery Registry, an ongoing online registry designed to understand recovery phenotype, were included in the analysis. The association between life-history strategies, DD, engagement in risky behaviors, and remission status were assessed.

Results: Life-history strategy scores were significantly associated with DD rates and finance, health, and personal development behaviors after controlling for age, sex, race, ethnicity, years of education, marital status, smoking status, and history of other substance use. Remission status was significantly associated with life-history strategy, DD, drug use, fitness, health, and safe driving after controlling for age, sex, race, years of education, marital status, and smoking status. In addition, a mediation analysis using Hayes' methods revealed that the discounting rates partially mediated the association between remission status and life-history strategy scores.

Conclusions: Life-history strategies and remission status are both significantly associated with DD and various health and finance behaviors among individuals in recovery from AUD. This finding supports the characterizations of DD as a candidate behavioral marker of addiction that could help differentiate subgroups needing special attention or specific interventions to improve the outcomes of their recovery. Future longitudinal studies are warranted to understand the relationships between changes in life-history strategies, DD, maladaptive health behaviors, and remission status over time.
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http://dx.doi.org/10.1111/acer.14747DOI Listing
January 2022

Do rural oral and maxillofacial surgeons prescribe more postoperative opioids?

Oral Maxillofac Surg 2022 Jan 20. Epub 2022 Jan 20.

Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA.

Purpose: This study assesses rural-urban differences in opioid prescription practices among oral and maxillofacial surgeons (OMSs) who treated Medicare beneficiaries in 2017.

Methods: This cross-sectional study examines the 2017 Medicare Provider Utilization and Payment Dataset. The primary predictor variable was provider Rural-Urban Commuting Area code (rural versus urban). The primary outcome variable was mean opioid claims per Medicare beneficiary. Additional outcomes include total opioid claims volume, average Medicare beneficiaries and opioid cost per provider, mean days' supply of opioids per opioid claim, and average percentage of Medicare Part D claims represented by opioid claims. Mann-Whitney U tests compared continuous variables. A least-squares regression identified correlates of opioid claims volume.

Results: Rural OMSs demonstrated a higher mean opioid claims per OMS and opioid cost per provider compared to urban surgeons. Urban OMSs prescribed a greater mean days' supply of opioids per opioid claim. A larger percentage of Medicare Part D claims were represented by opioid claims for rural OMSs compared to urban OMSs. There were no differences in mean opioid claims per Medicare beneficiary. Male provider gender, female Medicare beneficiary gender, total number of beneficiaries, and a higher hierarchical condition category score were correlated with increased opioid claims per Medicare beneficiary for urban providers only.

Conclusion: Urban and rural OMSs prescribe a similar volume of opioids per Medicare beneficiary, with rural providers prescribing higher total volumes of opioids due to larger patient panels. This work indicates that rural and urban OMSs have similar opioid prescribing practices.
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http://dx.doi.org/10.1007/s10006-021-01033-yDOI Listing
January 2022

Fire Seasonality, Seasonal Temperature Cues, Dormancy Cycling, and Moisture Availability Mediate Post-fire Germination of Species With Physiological Dormancy.

Front Plant Sci 2021 3;12:795711. Epub 2021 Dec 3.

Centre for Ecosystem Science, School of Biological, Earth and Environmental Sciences, University of New South Wales, Kensington, NSW, Australia.

Fire seasonality (the time of year of fire occurrence) has important implications for a wide range of demographic processes in plants, including seedling recruitment. However, the underlying mechanisms of fire-driven recruitment of species with physiological seed dormancy remain poorly understood, limiting effective fire and conservation management, with insights hampered by common methodological practices and complex dormancy and germination requirements. We sought to identify the mechanisms that regulate germination of physiologically dormant species in nature and assess their sensitivity to changes in fire seasonality. We employed a combination of laboratory-based germination trials and burial-retrieval trials in natural populations of seven species of (Rutaceae) to characterize seasonal patterns in dormancy and fire-stimulated germination over a 2-year period and synthesized the observed patterns into a conceptual model of fire seasonality effects on germination. The timing and magnitude of seedling emergence was mediated by seasonal dormancy cycling and seasonal temperature cues, and their interactions with fire seasonality, the degree of soil heating expected during a fire, and the duration of imbibition. Primary dormancy was overcome within 4-10 months' burial and cycled seasonally. Fire-associated heat and smoke stimulated germination once dormancy was alleviated, with both cues required in combination by some species. For some species, germination was restricted to summer temperatures (a strict seasonal requirement), while others germinated over a broader seasonal range of temperatures but exhibited seasonal preferences through greater responses at warmer or cooler temperatures. The impacts of fires in different seasons on germination can vary in strength and direction, even between sympatric congeners, and are strongly influenced by moisture availability (both the timing of post-fire rainfall and the duration soils stay moist enough for germination). Thus, fire seasonality and fire severity (via its effect on soil heating) are expected to significantly influence post-fire emergence patterns in these species and others with physiological dormancy, often leading to "germination interval squeeze." Integration of these concepts into current fire management frameworks is urgently required to ensure best-practice conservation. This is especially pertinent given major, ongoing shifts in fire seasonality and rainfall patterns across the globe due to climate change and increasing anthropogenic ignitions.
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http://dx.doi.org/10.3389/fpls.2021.795711DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8678276PMC
December 2021

Oromandibular dystonia and temporomandibular disorders.

J Am Dent Assoc 2021 Dec 1. Epub 2021 Dec 1.

Background: The aim of this study was to characterize clinical features of patients with oromandibular dystonia (OMD) who had temporomandibular disorder (TMD) symptoms.

Methods: A retrospective chart review of patients seeking treatment at a tertiary-level orofacial pain clinic from January 2015 through December 2020 was undertaken. The inclusionary criteria consisted of a diagnosis of OMD (International Classification of Diseases, Revision 10 code G24.4), which had been confirmed by a neurologist.

Results: Eleven patients met the inclusion criteria. Focal dystonia and jaw deviation OMD were the most frequent diagnoses. A dental procedure was a triggering or aggravating factor in 36.4% of patients. All but 2 patients had a sensory trick, or tactile stimulus to a particular body part, and approximately one-half of the patients used an oral appliance as a sensory trick device. All but 1 patient had received a diagnosis of TMD, with myofascial pain of the masticatory muscles being the most prevalent diagnosis. Four patients had received a recommendation for orthodontic treatment. About one-half of the patients had undergone 1 or more invasive dental or maxillofacial surgical interventions to address their dystonia. Anxiety was the most common psychological comorbidity.

Conclusions: Because patients with OMD commonly experience TMD symptoms, they can receive a misdiagnosis of TMD while the OMD is overlooked.

Practical Implications: Owing to concomitant TMD symptoms, patients most often seek dental consultations and undergo treatments such as orthodontic interventions and temporomandibular joint surgeries. A dentist's competency in recognizing these patients can prevent unnecessary procedures and facilitate appropriate patient care.
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http://dx.doi.org/10.1016/j.adaj.2021.07.026DOI Listing
December 2021

First Bite Syndrome - An Underrecognized and Underdiagnosed Pain Complication After Temporomandibular Joint Surgery.

J Oral Maxillofac Surg 2022 Mar 29;80(3):437-442. Epub 2021 Oct 29.

Visiting Oral and Maxillofacial Surgeon, Division of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA.

Purpose: First bite syndrome (FBS) can develop after head and neck surgical procedures. The aim of this study is to identify patients diagnosed with FSB after temporomandibular joint (TMJ) surgery, including their pain characteristics and risk factors for FBS.

Methods: Using a retrospective study design, a cohort of 24 patients with confirmed diagnosis of FBS were identified from the oral and maxillofacial surgery and orofacial pain (OFP) practices at Massachusetts General Hospital and Research Patient Data Registry (RPDR) between 1975 and 2019. The inclusion criteria were facial pain that was triggered by taste stimulus only and followed by a refractory period until the next gustatory stimulus.

Results: Of the 24 patients identified, 19 had undergone TMJ surgery, 3 patients had idiopathic FBS, 1 had a parapharyngeal space tumor and 1 developed FBS after facial burns. In the surgical patients, the median duration of onset was 2.75 months post-surgery. Most patients reported pain in the parotid region. Pain was only triggered by a taste stimulus and subsided with subsequent bites of food. 2 patients underwent spontaneous resolution of their symptoms and 1 reported complete resolution with onabotulinum toxin A (BTX) injections. Anxiety and depression were the most common comorbid conditions.

Conclusion: FBS is an underrecognized pain complication in TMJ surgery patients. A precise history and accurate description of the pain is necessary for correct diagnosis which is important for improved treatment outcomes.
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http://dx.doi.org/10.1016/j.joms.2021.10.012DOI Listing
March 2022

Is there an association between otologic symptoms and temporomandibular disorders?: An evidence-based review.

J Am Dent Assoc 2021 Nov 16. Epub 2021 Nov 16.

Background: The aim of this article is to discuss the scientific evidence available on the the pathophysiology and management of otologic complaints in patients with temporomandibular disorders (TMDs).

Types Of Studies Reviewed: The authors conducted an electronic search in MEDLINE, Web of Science and ScienceDirect and retrieved all the relevant peer-reviewed journal articles available in English on the topic. No time restriction was applied.

Results: No consensus exists on the management of otologic symptoms in patients with concomitant TMD. The scientific evidence suggests that conservative or reversible TMD therapy might provide relief. However, this evidence is scarce and low, thus further studies with larger sample sizes and better designed methodological frameworks are needed. Until such evidence is available, dentists and orofacial pain specialists should treat TMD patients using current guidelines and refer those with otologic symptoms to an otolaryngologist.

Practical Implications: Given the wide range of potential pathophysiologies and treatments for each otologic symptom described in the TMD patient, close collaboration with otolaryngologists is essential to achieve the best patient care.
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http://dx.doi.org/10.1016/j.adaj.2021.07.029DOI Listing
November 2021

Toward constructive disagreement about geoengineering.

Authors:
David W Keith

Science 2021 Nov 11;374(6569):812-815. Epub 2021 Nov 11.

John F. Kennedy School of Government, Harvard University, Cambridge, MA, USA.

A shared taxonomy of concerns may help.
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http://dx.doi.org/10.1126/science.abj1587DOI Listing
November 2021

Current thinking in lower third molar surgery.

Br J Oral Maxillofac Surg 2022 04 30;60(3):257-265. Epub 2021 Jul 30.

Oral and Maxillofacial Surgery, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK.

The removal of lower third molar teeth is one of the most common surgical procedures performed worldwide, but many concepts in this surgery have been unclear and have engendered different opinions. This paper aims to review current thinking in certain pertinent aspects of this surgery to update the reader on the most current research and synthesise it to make clinical recommendations. Topics covered include preoperative imaging, timing of removal, flap design, lingual retraction, coronectomy, lingual split, closure techniques, and use of antibiotics, steroids, and drains.
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http://dx.doi.org/10.1016/j.bjoms.2021.06.016DOI Listing
April 2022

Pulsed dye laser to treat reactive angioendotheliomatosis.

Lasers Med Sci 2022 04 20;37(3):2097-2098. Epub 2021 Oct 20.

Department of Dermatology and Bristol Laser Centre, Southmead Hospital, Bristol, UK.

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http://dx.doi.org/10.1007/s10103-021-03444-5DOI Listing
April 2022

Transcending the disaster paradigm: Understanding persistence of animal populations in fire-prone environments.

Authors:
David A Keith

Glob Chang Biol 2022 01 31;28(2):341-342. Epub 2021 Oct 31.

Centre for Ecosystem Science, University of NSW, Sydney, New South Wales, Australia.

An extensive high severity fire was a disaster for this swamp wallaby, but not its population, as many others detected the approaching fire and evaded its lethal heat.
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http://dx.doi.org/10.1111/gcb.15925DOI Listing
January 2022

Persistent Pain Following Proplast-Teflon Implants of the Temporomandibular Joint: A Case Report and 35-Year Management Perspective.

J Pain Res 2021 27;14:3033-3046. Epub 2021 Sep 27.

Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA.

Over three decades ago, hundreds of predominantly young women with temporomandibular joint pain and other symptoms were implanted with a prosthetic device composed of Proplast-Teflon that subsequently caused considerable harm, with patients developing chronic pain, dysfunction, and disability. This perspective review presents such a patient who suffered for decades with severe pain despite extensive pharmacotherapy, injection therapy, multiple surgeries, and behavioral health interventions. The details of the origin and subsequent events regarding the use of Proplast-Teflon interpositional implants in the temporomandibular joint are described with resources from several different perspectives. The lessons learned demonstrate failures at the federal, professional, and individual level.
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http://dx.doi.org/10.2147/JPR.S329123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486010PMC
September 2021

Cross-sectional and longitudinal associations between subcutaneous adipose tissue thickness and dual-energy X-ray absorptiometry fat mass.

Clin Physiol Funct Imaging 2021 Nov 22;41(6):514-522. Epub 2021 Sep 22.

Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA.

The present study examined cross-sectional and longitudinal relationships between total and segmental subcutaneous tissue thicknesses from ultrasonography (US) and total and segmental fat mass (FM) estimates from dual-energy X-ray absorptiometry (DXA). Traditional US FM estimates were also examined. Twenty resistance-trained males (mean ± SD; age: 22.0 ± 2.6 years; body mass: 74.8 ± 11.5 kg; DXA fat: 17.5 ± 4.5%) completed a 6-week supervised resistance training programme while consuming a hypercaloric diet. Pre- and post-intervention body composition was assessed by DXA and B-mode US. Data were analysed using Pearson's correlation (r), Lin's correlation coefficient (CCC), paired t-tests, Wilcoxon signed-rank tests and Bland-Altman analysis, as appropriate. Cross-sectionally, correlations were observed between total DXA FM and total subcutaneous tissue thickness (r = 0.88). Longitudinally, a correlation was observed between total DXA FM changes and total subcutaneous tissue changes (r = 0.49, CCC = 0.38). Correlations of similar magnitudes were observed for the upper body and trunk estimates, but DXA FM changes were unrelated to subcutaneous tissue changes for the lower body and arms. Cross-sectionally, US 2-compartment FM and DXA FM were correlated (r = 0.91, CCC = 0.83). Longitudinally, a weaker correlation was observed (r = 0.47, CCC = 0.33). In summary, longitudinal associations between US and DXA are weaker than cross-sectional relationships; additionally, correlations between US subcutaneous tissue and whole-body DXA FM appear to be driven by the trunk region rather than appendages. Reporting raw skinfold thicknesses rather than FM estimates alone may improve the utility of techniques based on subcutaneous tissue thickness, such as US and skinfolds.
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http://dx.doi.org/10.1111/cpf.12727DOI Listing
November 2021

Neuropathic orofacial pain: Characterization of different patient groups using the ICOP first edition, in a tertiary level Orofacial Pain Clinic.

Oral Surg Oral Med Oral Pathol Oral Radiol 2021 12 31;132(6):653-661. Epub 2021 Jul 31.

Professor, Department of Clinical Dentistry, University of Bergen, Bergen, Norway; Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway.

Objective: To characterize patients with chronic neuropathic orofacial pain in accordance with the International Classification of Orofacial Pain (ICOP first edition) criteria.

Study Design: A retrospective chart review of 108 patients was conducted. The most common categories observed were trigeminal neuralgia (TN) (25.9%), burning mouth syndrome (BMS) (11.1%), persistent idiopathic facial pain (PIFP) (26.9%), and posttraumatic trigeminal neuropathic pain (PTTNP) (26.9%); 9.3% of patients could not be categorized.

Results: TN and BMS was more prevalent in the sixth decade, and PIFP and PTTN were more prevalent in the fifth decade. All categories showed female predilection. The pain in TN was predominantly episodic, described as "sharp shooting" and like an "electric shock," unilateral and affecting the V2 division, and with trigger zones in 50% of patients. Pain in BMS was predominantly constant and described as "burning," with the tongue being the most common site. Pain in PIFP and PTTNP was as follows: varied from constant to episodic; described as "burning," "sharp shooting," "throbbing," or "dull aching"; intraoral or extraoral; and mostly involving the V2 or V3 division.

Conclusion: This study is the first to characterize patients with neuropathic orofacial pain using the new ICOP criteria. PIFP and PTTNP were most commonly misdiagnosed categories. Using diagnostic criteria will increase the understanding of this patient group.
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http://dx.doi.org/10.1016/j.oooo.2021.07.021DOI Listing
December 2021

Scientific foundations for an ecosystem goal, milestones and indicators for the post-2020 global biodiversity framework.

Nat Ecol Evol 2021 10 16;5(10):1338-1349. Epub 2021 Aug 16.

Centre for Biodiversity and Conservation Science, School of Earth and Environmental Sciences, University of Queensland, Brisbane, Queensland, Australia.

Despite substantial conservation efforts, the loss of ecosystems continues globally, along with related declines in species and nature's contributions to people. An effective ecosystem goal, supported by clear milestones, targets and indicators, is urgently needed for the post-2020 global biodiversity framework and beyond to support biodiversity conservation, the UN Sustainable Development Goals and efforts to abate climate change. Here, we describe the scientific foundations for an ecosystem goal and milestones, founded on a theory of change, and review available indicators to measure progress. An ecosystem goal should include three core components: area, integrity and risk of collapse. Targets-the actions that are necessary for the goals to be met-should address the pathways to ecosystem loss and recovery, including safeguarding remnants of threatened ecosystems, restoring their area and integrity to reduce risk of collapse and retaining intact areas. Multiple indicators are needed to capture the different dimensions of ecosystem area, integrity and risk of collapse across all ecosystem types, and should be selected for their fitness for purpose and relevance to goal components. Science-based goals, supported by well-formulated action targets and fit-for-purpose indicators, will provide the best foundation for reversing biodiversity loss and sustaining human well-being.
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http://dx.doi.org/10.1038/s41559-021-01538-5DOI Listing
October 2021

Estimating the Impact of Tobacco Parity and Harm Reduction Tax Proposals Using the Experimental Tobacco Marketplace.

Int J Environ Res Public Health 2021 07 23;18(15). Epub 2021 Jul 23.

Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA 24016, USA.

Taxes are a demonstrably effective method to suppress tobacco use. This study examined the effects of the tobacco parity (i.e., imposing taxes equally on all tobacco products) and the harm reduction (i.e., applying taxes in proportion to the products' levels of harm) tax proposals on demand and substitution across products. A crowdsourced sample of cigarette smokers ( = 35) completed purchasing trials with increasing tax magnitudes across different tax tiers in the Experimental Tobacco Marketplace in a repeated-measures design. Products were placed in three tax tiers (high, medium, and no tax) according to each proposal's goal. The results indicated that total nicotine (mg) purchased was not significantly different between the proposals, with higher taxes yielding lower demand. However, as taxes increased, the tobacco parity proposal decreased the purchasing of all tobacco products and increased the purchasing of medicinal nicotine (i.e., the no tax tier). Conversely, the harm reduction proposal resulted in greater purchases of electronic nicotine delivery systems and smokeless tobacco (i.e., the medium tax tier). These findings support tobacco taxation as a robust tool for suppressing purchasing and suggest that differential taxation in proportion to product risk would be an effective way to incentivize smokers to switch from smoked to unsmoked products. Further studies should investigate the unintended consequences of their implementation.
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http://dx.doi.org/10.3390/ijerph18157835DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345477PMC
July 2021

Temporal discounting as a candidate behavioral marker of obesity.

Neurosci Biobehav Rev 2021 10 3;129:307-329. Epub 2021 Aug 3.

Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

Although obesity is a result of processes operating at multiple levels, most forms result from decision-making behavior. The aim of this review was to examine the candidacy of temporal discounting (TD) (i.e. the reduction in the value of a reinforcer as a function of the delay to its receipt) as a behavioral marker of obesity. For this purpose, we assessed whether TD has the ability to: identify risk for obesity development, diagnose obesity, track obesity progression, predict treatment prognosis/outcomes, and measure treatment effectiveness. Three databases (Pubmed, PsycINFO, and Web of Science) were searched using a combination of terms related to TD and obesity. A total of 153 papers were reviewed. Several areas show strong evidence of TD's predictive utility as a behavioral marker of obesity (e.g., distinguishing obese from non obese). However, other areas have limited and/or mixed evidence (e.g., predicting weight change). Given the positive relationship for TD in the majority of domains examined, further consideration for TD as a behavioral marker of obesity is warranted.
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http://dx.doi.org/10.1016/j.neubiorev.2021.07.035DOI Listing
October 2021

Testing a global standard for quantifying species recovery and assessing conservation impact.

Conserv Biol 2021 12 21;35(6):1833-1849. Epub 2021 Jul 21.

Wildlife Institute of India, Dehradun, India.

Recognizing the imperative to evaluate species recovery and conservation impact, in 2012 the International Union for Conservation of Nature (IUCN) called for development of a "Green List of Species" (now the IUCN Green Status of Species). A draft Green Status framework for assessing species' progress toward recovery, published in 2018, proposed 2 separate but interlinked components: a standardized method (i.e., measurement against benchmarks of species' viability, functionality, and preimpact distribution) to determine current species recovery status (herein species recovery score) and application of that method to estimate past and potential future impacts of conservation based on 4 metrics (conservation legacy, conservation dependence, conservation gain, and recovery potential). We tested the framework with 181 species representing diverse taxa, life histories, biomes, and IUCN Red List categories (extinction risk). Based on the observed distribution of species' recovery scores, we propose the following species recovery categories: fully recovered, slightly depleted, moderately depleted, largely depleted, critically depleted, extinct in the wild, and indeterminate. Fifty-nine percent of tested species were considered largely or critically depleted. Although there was a negative relationship between extinction risk and species recovery score, variation was considerable. Some species in lower risk categories were assessed as farther from recovery than those at higher risk. This emphasizes that species recovery is conceptually different from extinction risk and reinforces the utility of the IUCN Green Status of Species to more fully understand species conservation status. Although extinction risk did not predict conservation legacy, conservation dependence, or conservation gain, it was positively correlated with recovery potential. Only 1.7% of tested species were categorized as zero across all 4 of these conservation impact metrics, indicating that conservation has, or will, play a role in improving or maintaining species status for the vast majority of these species. Based on our results, we devised an updated assessment framework that introduces the option of using a dynamic baseline to assess future impacts of conservation over the short term to avoid misleading results which were generated in a small number of cases, and redefines short term as 10 years to better align with conservation planning. These changes are reflected in the IUCN Green Status of Species Standard.
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http://dx.doi.org/10.1111/cobi.13756DOI Listing
December 2021

Assessment of Polymer Atmospheric Correction Algorithm for Hyperspectral Remote Sensing Imagery over Coastal Waters.

Sensors (Basel) 2021 Jun 16;21(12). Epub 2021 Jun 16.

Alfred Wegener Institute, Klußmannstr. 3d, D-27570 Bremerhaven, Germany.

Spaceborne imaging spectroscopy, also called hyperspectral remote sensing, has shown huge potential to improve current water colour retrievals and, thereby, the monitoring of inland and coastal water ecosystems. However, the quality of water colour retrievals strongly depends on successful removal of the atmospheric/surface contributions to the radiance measured by satellite sensors. Atmospheric correction (AC) algorithms are specially designed to handle these effects, but are challenged by the hundreds of narrow spectral bands obtained by hyperspectral sensors. In this paper, we investigate the performance of Polymer AC for hyperspectral remote sensing over coastal waters. Polymer is, in nature, a hyperspectral algorithm that has been mostly applied to multispectral satellite data to date. Polymer was applied to data from the Hyperspectral Imager for the Coastal Ocean (HICO), validated against in situ multispectral (AERONET-OC) and hyperspectral radiometric measurements, and its performance was compared against that of the hyperspectral version of NASA's standard AC algorithm, L2gen. The match-up analysis demonstrated very good performance of Polymer in the green spectral region. The mean absolute percentage difference across all the visible bands varied between 16% (green spectral region) and 66% (red spectral region). Compared with L2gen, Polymer remote sensing reflectances presented lower uncertainties, greater data coverage, and higher spectral similarity to in situ measurements. These results demonstrate the potential of Polymer to perform AC on hyperspectral satellite data over coastal waters, thus supporting its application in current and future hyperspectral satellite missions.
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http://dx.doi.org/10.3390/s21124125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234994PMC
June 2021

Pain Management for Dental Medicine in 2021: Opioids, Coronavirus and Beyond.

J Pain Res 2021 24;14:1371-1387. Epub 2021 May 24.

Department of Diagnostic Sciences, Craniofacial Pain and Headache Center, Tufts University School of Dental Medicine, Boston, MA, USA.

Over the past year our attention has inevitably been on the coronavirus pandemic, the health and welfare of our families, patients, and office staffs as well as the re-opening of our dental practices. In addition, the opioid crisis continues, is very likely to worsen as a result of the pandemic and continues to be a challenge to Dentistry. National public health issues and healthcare disparities continue and have created a global concern for providing evidence-based, adequate pain management in the dental setting. We have brought together a group of national thought leaders and experts in this field who will share their insights on the current state of opioid prescribing in Dentistry and describe some of the exciting work being done in advancing pain management. The learning objectives for this conference proceedings were: Describing the implications of current public health concerns for safe and effective pain management in dental medicine.Identifying risk factors and understanding the current guidelines for the use of opioid and non-opioid medications in dental medicine.Analyzing the interprofessional collaborations necessary for effective pain management in dental medicine.Recognizing the challenges and opportunities brought about by the COVID-19 pandemic for the dental profession.Applying evidence-based strategies for managing the complex pain patient in the dental setting.Appraising new and future modalities for the assessment and management of orofacial pain.
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http://dx.doi.org/10.2147/JPR.S319373DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164473PMC
May 2021
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