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Medical Image Analysis Aug 2023Following unprecedented success on the natural language tasks, Transformers have been successfully applied to several computer vision problems, achieving... (Review)
Review
Following unprecedented success on the natural language tasks, Transformers have been successfully applied to several computer vision problems, achieving state-of-the-art results and prompting researchers to reconsider the supremacy of convolutional neural networks (CNNs) as de facto operators. Capitalizing on these advances in computer vision, the medical imaging field has also witnessed growing interest for Transformers that can capture global context compared to CNNs with local receptive fields. Inspired from this transition, in this survey, we attempt to provide a comprehensive review of the applications of Transformers in medical imaging covering various aspects, ranging from recently proposed architectural designs to unsolved issues. Specifically, we survey the use of Transformers in medical image segmentation, detection, classification, restoration, synthesis, registration, clinical report generation, and other tasks. In particular, for each of these applications, we develop taxonomy, identify application-specific challenges as well as provide insights to solve them, and highlight recent trends. Further, we provide a critical discussion of the field's current state as a whole, including the identification of key challenges, open problems, and outlining promising future directions. We hope this survey will ignite further interest in the community and provide researchers with an up-to-date reference regarding applications of Transformer models in medical imaging. Finally, to cope with the rapid development in this field, we intend to regularly update the relevant latest papers and their open-source implementations at https://github.com/fahadshamshad/awesome-transformers-in-medical-imaging.
Topics: Humans; Chlorhexidine; Language; Neural Networks, Computer
PubMed: 37315483
DOI: 10.1016/j.media.2023.102802 -
The Japanese Dental Science Review Dec 2023To evaluate the effectiveness of antiseptic mouthwashes in reducing SARS-CoV-2 load clinically and in vitro. A systematic electronic search (MEDLINE/Scopus/Cochrane) was... (Review)
Review
To evaluate the effectiveness of antiseptic mouthwashes in reducing SARS-CoV-2 load clinically and in vitro. A systematic electronic search (MEDLINE/Scopus/Cochrane) was conducted to identify prospective clinical and in vitro studies published between 2019 included and 16 June 2023 assessing the effectiveness of mouthwashes in reducing SARS-CoV-2 load in saliva or surrogates. Data were summarized in tables and a network meta-analysis was performed for clinical trials. Thirty-five studies (14 RCTs, 21 in vitro) fulfilled the inclusion criteria. The risk of bias was judged to be high for 2 clinical and 7 in vitro studies. The most commonly test product was chlorhexidine alone or in combination with other active ingredients, followed by povidone-iodine, hydrogen peroxide and cetylpyridinium chloride. Overall, the descriptive analysis revealed the effectiveness of the mouthwashes in decreasing the salivary viral load both clinically and in vitro. Network meta-analysis demonstrated a high degree of heterogeneity. Among these studies, only chlorhexidine 0.20% was associated to a significant Ct increase in the saliva 5 min after rinsing compared to non-active control (p = 0.027). Data from clinical and in vitro studies suggested the antiviral efficacy of commonly used mouthwashes. Large well-balanced trials are needed to identify the best rinsing protocols.
PubMed: 37854066
DOI: 10.1016/j.jdsr.2023.09.003 -
BMC Oral Health Oct 2023Recurrent Aphthous Stomatitis (RAS) is painful oral ulceration frequently treated with topical steroids. There is limited published evidence for the efficacy of any... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Recurrent Aphthous Stomatitis (RAS) is painful oral ulceration frequently treated with topical steroids. There is limited published evidence for the efficacy of any treatment for RAS and there remains a need for longitudinal randomised clinical trials to evaluate and compare the effectiveness of different therapies in the management of RAS. The aim of the current project was to assess the efficacy of betamethasone mouthwash and colchicine tablets, individually and combined, for the treatment of RAS, and to establish the optimum treatment period necessary for a significant reduction in the disease severity.
METHODOLOGY
A randomised, prospective, parallel-group clinical trial was conducted over one year, to compare the efficacy of three therapies in RAS. One hundred and six patients were randomized into three groups; 35 received betamethasone mouthwash, 35 had colchicine tablets and 36 received both therapies. The response was evaluated quantitatively every 3 months for 1 year, using the Ulcer Severity Score (USS).
RESULTS
For all three treatment regimes, the mean USS decreased by about 30% in the first 3 months (p < 0.001). Further improvement was noted for up to 9 months. At the end of the study, the mean USS had improved by 50% from 34.9 ± 7.2 before treatment to 17.5 ± 8.9 after treatment (p < 0.001). Of included participants, 86% showed significant clinical improvement by the end of the study. There were no significant differences in outcomes between the three regimes (p < 0.05).
CONCLUSIONS
This clinical trial has provided evidence for the efficacy of betamethasone mouthwash and for colchicine tablets in the treatment of RAS and has shown that at least six months of treatment may be required for optimum effect.
CLINICAL TRIAL REGISTRATION NUMBER
ISRCTN3267716. Date of clinical trial registration: 15/04/2018.
Topics: Humans; Stomatitis, Aphthous; Colchicine; Mouthwashes; Prospective Studies; Betamethasone
PubMed: 37789351
DOI: 10.1186/s12903-023-03335-x -
International Journal of Group... Oct 2023Utilizing the work of Wilfred Bion, Harry Stack Sullivan, and other theorists and practitioners, as well as philosophers and students of race in America, this article...
Utilizing the work of Wilfred Bion, Harry Stack Sullivan, and other theorists and practitioners, as well as philosophers and students of race in America, this article argues that racism/white supremacy sabotages our work, and yet is fundamental to our way of doing, being, and thinking in our society. As a result of the centrality of racism/white supremacy, the author lays out four challenges which, if met, will aid in overcoming racism/white supremacy: (a) the first challenge of denial, (b) the second challenge of impaired empathy (and the failure to think), (c) the experience of shame, and (d) the denial of death. The article discusses each of these and concludes with a word on the possibility of passion-if we are able to overcome racism/white supremacy.
Topics: Humans; Racism; White; Chlorhexidine; Emotions; Empathy
PubMed: 38446610
DOI: 10.1080/00207284.2023.2290610 -
American Journal of Infection Control Nov 2023Staphylococcus aureus colonization is a key risk factor for S. aureus infections in surgical patients and in hospitalized patients. Many studies have assessed various... (Review)
Review
BACKGROUND
Staphylococcus aureus colonization is a key risk factor for S. aureus infections in surgical patients and in hospitalized patients. Many studies have assessed various decolonization agents, protocols, and settings. This review summarizes key findings about nasal decolonization for 2 different patient populations: patients undergoing surgery and patients hospitalized in intensive care units.
METHODS
We reviewed major studies related to decolonization of patients colonized with S. aureus and who were either undergoing surgical procedures or were hospitalized in intensive care units. We focused on recent studies, particularly randomized controlled trials and robust quasi-experimental trials. We also reviewed select non-randomized trials when more rigorous trials were limited.
DISCUSSION/CONCLUSIONS
Mupirocin is the best-studied agent for decolonization. Its use reduces the risk of surgical site infection following orthopedic surgery (strongest data) and cardiac surgery. Mupirocin decolonization also reduces the incidence of S. aureus clinical cultures in the intensive care unit. Povidone-iodine is less well-studied. Current data suggest that it decreases the risk of surgical site infections after orthopedic surgical procedures. In contrast, povidone-iodine is less effective than mupirocin for reducing the incidence of S aureus clinical cultures in the intensive care unit. Both mupirocin and povidone-iodine have important limitations, highlighting the need for future decolonization research.
Topics: Humans; Anti-Infective Agents, Local; Mupirocin; Povidone-Iodine; Anti-Bacterial Agents; Staphylococcus aureus; Staphylococcal Infections; Surgical Wound Infection; Intensive Care Units; Chlorhexidine; Carrier State
PubMed: 37890955
DOI: 10.1016/j.ajic.2023.02.004 -
BMC Infectious Diseases Oct 2023COVID-19 has been a public health emergency of international concern (PHEIC) for a lengthy period of time. The novel coronavirus is primarily spread via aerosols at a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
COVID-19 has been a public health emergency of international concern (PHEIC) for a lengthy period of time. The novel coronavirus is primarily spread via aerosols at a short distance, with infected individuals releasing large amounts of aerosols when speaking and coughing. However, there is an open question regarding whether mouthwash could effectively reduce virus transmission during the COVID-19 pandemic and support the prevention of infection among medical workers.
METHODS
Cochrane Library, PubMed, Web of Science, and Embase databases were systematically searched from the inception of each database to January 12, 2023 for currently available randomized clinical trials (RCTs) on the effect of mouthwash on novel coronavirus load in the oral cavity in COVID-19 patients. The treatment group received mouthwash for rinsing the mouth, while the control group received a placebo or distilled water for COVID-19 patients. The primary outcomes were CT value and viral load. Odds ratios (ORs) were estimated using a random-effects model. Subgroup and sensitivity analyses were performed to minimize the bias and the impact of heterogeneity.
RESULTS
Thirteen RCTs were included. Seven studies reported the intervention effect of mouthwash on the CT value of novel coronavirus. The analysis results showed that the mouthwash group had a positive impact on the CT value of novel coronavirus [ SMD = 0.35, 95% CI (0.21, 0.50)] compared with the control group. In addition, subgroup analysis showed a significant positive effect of mouthwash on CT values in the treatment group compared with the control group, with chlorhexidine (CHX) [SMD = 0.33, 95% CI (0.10, 0.56)], povidone-iodine (PVP-I) [SMD = 0.61, 95% CI (0.23, 0.99)], or hydrogen peroxide (HP) [SMD = 1.04, 95% CI (0.30, 1.78)] as an ingredient of the mouthwash. Six studies reported the intervention effect of mouthwash on the viral load, 263 cases in the treatment group and 164 cases in the control group. The analysis results showed that there was no statistical difference between the mouthwash group and the control group in the viral load of novel coronavirus [SMD = -0.06, 95% CI (-0.18, 0.05)]. In the subgroup analysis by measurement time, there were statistically significant differences between the mouthwash and control groups for CT values [SMD = 0.52, 95% CI (0.31, 0.72)] and viral load [SMD = - 0.32, 95% CI (- 0.56, - 0.07)] within 30 min of gargling.
CONCLUSIONS
In summary, mouthwash has some efficacy in reducing the viral load of novel coronavirus, especially within 30 min after rinsing the mouth. Mouthwash containing CHX, PVP-I and HP all had significant positive effects on CT values, and PVP-I-containing mouthwash may be a promising option to control novel coronavirus infections and relieve virus-related symptoms. However, studies on the dose and frequency of use of mouthwash for infection control are still lacking, which may limit the clinical application of mouthwash.
TRIAL REGISTRATION
Protocol registration: The protocol was registered at PROSPERO (CRD42023401961).
Topics: Humans; Mouthwashes; SARS-CoV-2; COVID-19; Povidone-Iodine; Viral Load; Respiratory Aerosols and Droplets; Chlorhexidine; Hydrogen Peroxide
PubMed: 37821800
DOI: 10.1186/s12879-023-08669-z -
BMC Oral Health Sep 2023The effects of a low concentration of hypochlorous acid (HOCl) mouthwash on salivary bacteria remained unclear. We aimed to evaluate the antibacterial effects of... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The effects of a low concentration of hypochlorous acid (HOCl) mouthwash on salivary bacteria remained unclear. We aimed to evaluate the antibacterial effects of 100 ppm HOCl mouthwash on salivary bacteria, including Staphylococcus aureus (S. aureus), in patients with periodontal disease (PD).
METHODS
Patients with PD were randomized into mouthwash-only (MW, n = 26) and mouthwash with periodontal flosser (MWPF, n = 27) groups. Patients without PD were selected for the control group (n = 30). S. aureus culture and saliva samples (before and after the intervention) were collected for bacterial DNA extraction. A real-time polymerase chain reaction assay and serial dilutions of S. aureus culture and saliva samples were used to measure the salivary bacteria total count (SBTC) and confirm the antibacterial effects of the mouthwash using S. aureus.
RESULTS
No significant difference in demographic data was observed among the three groups. Before the intervention, the baseline SBTC of the MW and MWPF groups was significantly higher than that of the control group. After the mouthwash rinses, the SBTC data significantly changed in the MW and MWPF groups only (by 62.4% and 77.4%, respectively). After the base-2 log-transformation of the SBTC data, a similar trend was observed. Linear regression revealed that baseline SBTC and the MWPF intervention significantly affected SBTC reduction percentage by volume. After incubation with 10% (v/v) of mouthwash, the survival rates of 10 and 10 colony-forming units/mL of S. aureus were 0.51% ± 0.06% and 1.42% ± 0.37%, respectively.
CONCLUSIONS
These study results indicated that 100 ppm HOCl mouthwash treatment could effectively reduce SBTC in patients with PD and the abundance of S. aureus. It provides that the HOCl mouthwash can be an option for individuals to help control SBTC, especially in patients with PD.
TRIAL REGISTRATION
The study protocol was approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUHIRB-F(I)-20200042) on 20/03/2020 and retrospectively registered at ClinicalTrial.gov (NCT05372835) on 13/05/2022.
Topics: Humans; Mouthwashes; Staphylococcus aureus; Hypochlorous Acid; Saliva; Bacteria; Periodontal Diseases; Anti-Bacterial Agents
PubMed: 37770865
DOI: 10.1186/s12903-023-03358-4 -
Journal of Oral Biology and... 2024Numerous studies on Triphala and Curcumin mouthwashes were analyzed individually and no study has compared the efficacy of Triphala mouthwash to Curcumin mouthwash in...
BACKGROUND
Numerous studies on Triphala and Curcumin mouthwashes were analyzed individually and no study has compared the efficacy of Triphala mouthwash to Curcumin mouthwash in the management of gingivitis. Although various mouthwashes have shown reduction of plaque and gingivitis the search is still on for an ideal mouthwash with minimum side effects and better patient acceptance.
OBJECTIVES
To access the efficacy of all the mouthwashes in the management of gingivitis.
METHODS
By purposive sampling, 81 patients of both sexes with gingivitis were randomized by lottery method into 3 groups - A, B and C. Group A received scaling and Triphala mouthwash, Group B received scaling and Curcumin mouthwash and Group C underwent scaling and received Chlorhexidine mouthwash. Oral hygiene was assessed using Plaque, Gingival and Bleeding indices at baseline,7th day and 14th day. The inter-group comparisons were analysed using One-way analysis of variance (ANOVA) and multiple comparisons using Tukey's Honest significant difference test (α = 0.05) and the intra-group comparisons for the indices across various time periods within each group were analysed using Repeated-measures ANOVA and Bonferroni-adjusted pairwise comparisons post hoc test (α = 0.05). The statistical significance was set at p ≤ 0.05.
RESULTS
The study has shown that herbal mouthwashes are as effective as chlorhexidine in treating gingivitis although curcumin mouthwash showed a greater potential in reducing gingival inflammation.
CONCLUSION
Both Triphala and Curcumin mouthwashes were proven to be equally effective in reducing plaque, gingival and bleeding scores, although curcumin was better in reducing gingival inflammation. Hence herbal mouthwashes such as Triphala and Curcumin with no side effects can be considered as an alternative mouthwash to chlorhexidine.
PubMed: 38832298
DOI: 10.1016/j.jobcr.2024.05.002 -
Aquatic Toxicology (Amsterdam,... Nov 2023The wide application of Avermectin (AVM) has caused pollution of surface water and damage to non-target organisms. A growing body of evidence supports the most prominent... (Review)
Review
The wide application of Avermectin (AVM) has caused pollution of surface water and damage to non-target organisms. A growing body of evidence supports the most prominent role of Eucalyptol (EUC) is antioxidation. To the purpose of explore the injury mechanism of Avermectin on grass carp hepatocytes and the antagonistic effect of Eucalyptol, 5.7 μM AVM and/or 20 μM EUC were used to treat grass carp hepatocytes for 24 h to establish hepatocyte exposure model. The results showed that Avermectin exposure significantly increased the contents of reactive oxygen species (ROS) and malondialdehyde (MDA) in cells, reduced the activities of superoxide dismutase (SOD), catalase (CAT), and total antioxidant capacity (T-AOC). Also, the expressions of NLRP3 inflammasome-related genes including NLRP3, ASC, and Caspase-1, the necroptosis-related genes including RIPK1, RIPK3, and MLKL and apoptotic genes including Bax, Caspase-3, and Caspase-9 were all up-regulated. Meanwhile, the expressions of Caspase-8 and Bcl-2 were significantly decreased upon exposure to Avermectin. However, the toxicity was significantly alleviated with the treatment of EUC or N-acetyl-l-cysteine (NAC). The above results indicated that eucalyptol alleviated AVM exposure-induced apoptosis and necroptosis of grass carp hepatocytes by regulating the ROS/NLRP3 signaling pathway.
Topics: Animals; Reactive Oxygen Species; NLR Family, Pyrin Domain-Containing 3 Protein; Eucalyptol; Carps; Necroptosis; Water Pollutants, Chemical; Apoptosis; Antioxidants; Hepatocytes
PubMed: 37918148
DOI: 10.1016/j.aquatox.2023.106739 -
International Dental Journal Nov 2023Antimicrobial mouthwashes are considered to reduce dental plaque biofilm and thus the potential to prevent plaque-induced oral diseases, particularly periodontal...
Antimicrobial mouthwashes are considered to reduce dental plaque biofilm and thus the potential to prevent plaque-induced oral diseases, particularly periodontal diseases. The effectiveness of mouthwashes relates to this antiplaque role, as well as, their tooth-whitening potential and ability to mask/mange malodour (halitosis). There is also a growing interest in the use of mouthwashes as an adjunctive measure in post surgical and post-dental care, while the COVID-19 pandemic has given a new lease of life to mouthwashes as an oral antispetic that may be useful in reducing the oral viral load. The mode of action of mouthwashes varies, depending on their active ingredients, concentrations, and mode and frequency of use, as does their potential effectiveness. This article aims to provide a narrative overview of the evidence of the effectiveness of the most widely used mouthwashes in managing oral diseases, oral conditions, and adjunctive care roles.
Topics: Humans; Mouthwashes; Chlorhexidine; Pandemics; Dental Plaque; Gingivitis; Anti-Infective Agents, Local
PubMed: 37867064
DOI: 10.1016/j.identj.2023.08.014