Reimagining the pipeline: Saturday Academy at New York University College of Dentistry goes virtual

PURPOSE/OBJECTIVES

This study describes and evaluates efforts to transition an established pre-dental pipeline program to a remote platform, in response to the coronavirus disease 2019 pandemic.

METHODS

The semester-long pipeline program, Saturday Academy at New York University College of Dentistry, was conducted remotely through Zoom, and materials for hands-on, pre-clinical activities, were mailed to participants. Saturday Academy aims to educate underrepresented minority and low-income high school students about the college application process and the dental profession. After the program's completion, program applications and engagement data were analyzed. An anonymous online survey was administered to the high school student participants. The survey questions included topics about their interest in the profession of dentistry, satisfaction with the Saturday Academy programming, and program engagement.

RESULTS

In its remote format, Saturday Academy had an average attendance of 87.8% at each session. All (60/60, 100%) of the high school student participants responded to the anonymous program satisfaction survey. Sixty-seven percent reported an interest in the profession of dentistry before participating in the program and 82% after participating in the program. Ninety-eight percent agreed with the statement "I enjoyed my experience participating in Saturday Academy." Additionally, 97% agreed with the statement "Saturday Academy's virtual programming was effective." There were no statistically significant differences in program satisfaction when data from the virtual program were compared to 2 years of in-person program satisfaction data.

CONCLUSION

Challenges to fulfilling the missions of dental institutions in response to the coronavirus pandemic impact service and recruitment efforts, in addition to formal dental education. Transitioning pipeline programming efforts, with hands-on components, to a remote format is possible and was met with favorable engagement and responses from program participants.

A systematic review on incidental findings in cone beam computed tomography (CBCT) scans

OBJECTIVES

Cone beam CT's use (CBCT) in dentistry is increasing. Incidental findings (IFs: discoveries unrelated to the original purpose of the scan), are frequently found as a result of a large field of view. The aim of the systematic review is to analyze present literature on IFs using CBCT.

METHODS AND MATERIALS

The authors searched online databases of studies and assessed the prevalence of IFs among patients undergoing head and neck CBCT scans. STROBE criteria was used to evaluate the quality of the studies.

RESULTS

The original search retrieved 509 abstracts of which only 10 articles met the inclusion criteria. The sample size varied between 90 and 1000 participants. The frequency of IFs of the selected articles were 24.6-94.3%. The most common non-threatening IFs were found in the airway, such as mucous retention cyst (55.1%) and sinusitis (41.7%). Other non-threatening IFs were soft tissue calcifications such as calcified stylohyloid ligament (26.7%), calcified pineal gland (19.2%), and tonsillolith (14.3%). Threatening IFs were rare findings (1.4%). Three articles reported incidental carotid artery calcifications with a prevalence of 5.7-11.6%. Pathological findings were not common between the articles, but still relevant (2.6%). The studies had a risk of bias varying from moderate to low.

CONCLUSIONS

There is a high frequency of IFs, yet not all of them require immediate medical attention. The low prevalence of threatening IFs emphasizes that CBCT should not be considered a substitution for conventional radiographs, but when used, the scans should be evaluated by a maxillofacial radiologist.

Technical and Biological Conditions Influencing the Functional APC Resitance Test

Poor anticoagulant response to APC is conveniently screened by a commercially available functional test (Coatest® APC Resistance) allowing identification of APC-resistant patients. These patients may then be genotyped with respect to factor V, the Arg - > Gin mutation being the principle cause of APC resistance. However, determination of phenotype generally precedes that of genotype, and the need for an “abnormality threshold” prompted a study of inter-batch variations and the clinical conditions associated with an altered APC response. The response to APC was assessed twice in plasma from 111 patients using two of four successive kit batches. A modest but significant inter-batch variability was observed. At the same time, we also tested 130 patients with retinal venous occlusion (RVO), 28 patients with glaucoma and 24 normal volunteers. The APCaPTT/aPTT ratio was found to be lower in the presence of elevated thrombin-antithrombin complexes (r = 0.167, p <0.02) and low blood viscosity (at high shear rate: r = 0.305, p <0.0001) independently of any alteration in genotype.

Technical and biological conditions influencing the functional APC resistance test

Poor anticoagulant response to APC is conveniently screened by a commercially available functional test (Coatest APC Resistance) allowing identification of APC-resistant patients. These patients may then be genotyped with respect to factor V, the Arg -> Gln mutation being the principle cause of APC resistance. However, determination of phenotype generally precedes that of genotype, and the need for an "abnormality threshold" prompted a study of inter-batch variations and the clinical conditions associated with an altered APC response. The response to APC was assessed twice in plasma from 111 patients using two of four successive kit batches. A modest but significant inter-batch variability was observed. At the same time, we also tested 130 patients with retinal venous occlusion (RVO), 28 patients with glaucoma and 24 normal volunteers. The APCaPTT/aPTT ratio was found to be lower in the presence of elevated thrombin-antithrombin complexes (r = 0.167, p < 0.02) and low blood viscosity (at high shear rate: r = 0.305, p < 0.0001) independently of any alteration in genotype.

Fibrinolytic and hemorheologic alterations during and after elective aortic graft surgery: implications for postoperative management

The hemorheologic and fibrinolytic variables of 15 patients undergoing elective aortic graft surgery were investigated before, during, and after surgery. During the operation, a relative hemodilution was induced intentionally by an infusion of crystalloids and albumin. This led to a decrease in hematocrit (35.5 +/- 6.3-->31.8 +/- 5.6%, P < 0.01), fibrinogen, and platelets, as well as a decrease in fibrinolysis (Euglobulin Clot Lysis Time increases 246 +/- 52-->300 +/- 46 min and fast-acting plasminogen activator inhibitor 1 [PAI-1] activity increases 10.5 +/- 6.9-->15.1 +/- 9 IU/mL, P < 0.01). There was also specific rheologic impairment with a dissociation of erythro-aggregates (primary aggregation time 3.37 +/- 2.63-->7.18 +/- 7.2 s). Tissue-type plasminogen activator (t-PA) antigen was only increased just after surgery (8.3-->14.5 ng/mL, P < 0.01). During the first postoperative week, the acute-phase response subsided. This was accompanied by an increase in fibrinogen, von Willebrand factor antigen, and plasma viscosity (1.33 +/- 0.13-->1.49 +/- 0.13 mPa x s, P < 0.01). Hematocrit and the extrinsic fibrinolytic system (t-PA/PAI) returned to baseline values, whereas intrinsic fibrinolysis remained altered (the Euglobulin Clot Lysis Time, reflecting total activity of plasminogen activators, was still increased). Postoperative management may benefit from a recognition of these two distinct phases induced by surgery. The acute-phase reaction of the first postoperative week is an added vascular risk factor and requires a specific therapeutic approach.