Chronic insomnia affects 10%–15% of the population, with one-third of Western adults struggling with sleep initiation or maintenance. Binaural beats, which involve two audio frequencies, have shown the potential for enhancing sleep and mood. This study examined the efficacy of customized binaural audio tracks generated using facial analysis software to treat chronic insomnia. Methods: A 45-minute personalized binaural beat audio session was delivered using the Spatial app and headband (SoundHealth) to 20 participants with moderate-to-severe insomnia, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and Insomnia Severity Index (ISI) criteria, over four weeks in California. Statistical analysis (paired t-test and linear mixed modeling) was used to compare baseline ISI scores to posttreatment scores, with p<0.05 indicating significance. The study assumed 80% power and aimed to achieve a 7-point ISI reduction. Results: All participants completed the study with no adverse events or full protocol adherence. The cohort was 60% White, with a 3:1 female-to-male ratio and an average age of 51.9 years. The baseline ISI was 19.8, dropping to 8.5 after four weeks, showing an 11.3-point reduction (95% confidence interval [CI]: -15 to -7.6, p<0.001). Mixed modeling indicated a similar ISI decrease of 11.28 points (95% CI: -14.98 to -7.57, p<0.001). The treatment response rate was 70%. Conclusions: Customized binaural beats show promise for insomnia treatment, with no adverse effects and high adherence. Most participants improved to no insomnia or subthreshold insomnia. Further research is needed to validate these results using larger samples and to assess long-term effects.

Depression is a common mental health problem that is associated with significant disability and mortality. Electroconvulsive therapy (ECT) has been demonstrated to be effective at resolving expression of suicidal intent in patients with depression. In less acute situations, patients are usually referred for ECT after several medication trials. Neuromuscular blocking agents (NMBAs) are used to block tonic-clonic motor activity and associated physical harm during the delivery of ECT. Succinylcholine (Sch), with its rapid onset of muscle relaxation, short self-terminating duration of action, and rapid subsequent return of spontaneous ventilation, is the NMBA of choice for ECT. However, the use of Sch is problematic or contraindicated is some situations. Although non-depolarizing NMBAs can be used, the variable time to onset of adequate muscle relaxation and prolonged duration of action have limited their widespread acceptance as alternatives to Sch. Recently, however, with the widespread availability of sugammadex, a chemically modified γ-cyclodextrin that rapidly and predictably reverses the effect of non-depolarizing NMBAs, the muscle relaxation achieved by rocuronium can predictably and effectively be reversed. In situations where Sch is contraindicated or otherwise problematic, rocuronium, followed by pharmacological antagonism with sugammadex, can provide a safe and effective muscle relaxation approach comparable to that of Sch in terms of duration of action. This review provides a summary of the current state of evidence for the use of sugammadex during ECT, which should lend support to further acceptance and future studies of sugammadex in the context of ECT.

Objectives: The integration of large language models (LLMs), particularly those based on the generative pre-trained transformer (GPT) architecture, has begun to revolutionize various fields, including dentistry. Despite these promising applications, the use of GPT in dentistry presents several challenges. Ongoing research and the development of robust ethical frameworks are essential to mitigate these issues and enhance the responsible deployment of GPT technologies in clinical settings. Hence, this systematic review aims to explore the trends, applications, strengths, and challenges associated with the use of GPT in dentistry. Methods: Articles were selected if they contained detailed information on the application of GPT in dentistry. The search strategy used in systematic reviews follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our search of databases and other sources yielded a total of 704 studies. After removing duplicates and conducting a full-text screening, 16 articles were included in the review. The methodological quality of the research was evaluated using the Critical Appraisal Skills Programme (CASP) checklist. Results: Out of a total of 91 articles published on GPT in dentistry, 20 were editorials and 11 were narrative reviews; these were excluded, leaving 60 original research articles for further analysis. The articles were assessed based on the type of results they provided. Ultimately, 16 articles that reported positive findings with robust methodology were included in this review Conclusions The results highlight mixed responses; therefore, further research on integration into clinical workflows must be conducted with extensive methodological rigor.

Objective: The COVID-19 pandemic disrupted disease surveillance systems globally, leading to reduced notifications of other infectious diseases. This study aims to estimate the impact of the COVID-19 pandemic on the infectious disease surveillance system in Klang district, Selangor state, Malaysia. Methods: Data on notifiable diseases from 2014 to 2022 were sourced from the Klang District Health Office. The 11 diseases with more than 100 notifications each were included in the study. For these 11 diseases, a negative binomial regression model was used to explore the effect of the pandemic on case notifications and registrations by year, and a quasi-Poisson regression model was used to explore the changes by week. Results: The results showed a reduction in the number of notifications and registrations for all 11 diseases combined during the pandemic compared with previous years. Changes between expected and observed notifications by week were heterogeneous across the diseases. Discussion: These findings suggest that restrictive public health and social measures in Klang district may have impacted the transmission of other infectious diseases during the COVID-19 pandemic. The differential impact of the pandemic on disease notifications and reporting highlights the large ancillary effects of restrictive public health and social measures and the importance of building resilience into infectious disease surveillance systems.

Depression is a common mental health problem that is associated with significant disability and mortality. Electroconvulsive therapy (ECT) has been demonstrated to be effective at resolving expression of suicidal intent in patients with depression. In less acute situations, patients are usually referred for ECT after several medication trials. Neuromuscular blocking agents (NMBAs) are used to block tonic-clonic motor activity and associated physical harm during the delivery of ECT. Succinylcholine (Sch), with its rapid onset of muscle relaxation, short self-terminating duration of action, and rapid subsequent return of spontaneous ventilation, is the NMBA of choice for ECT. However, the use of Sch is problematic or contraindicated is some situations. Although non-depolarizing NMBAs can be used, the variable time to onset of adequate muscle relaxation and prolonged duration of action have limited their widespread acceptance as alternatives to Sch. Recently, however, with the widespread availability of sugammadex, a chemically modified γ-cyclodextrin that rapidly and predictably reverses the effect of non-depolarizing NMBAs, the muscle relaxation achieved by rocuronium can predictably and effectively be reversed. In situations where Sch is contraindicated or otherwise problematic, rocuronium, followed by pharmacological antagonism with sugammadex, can provide a safe and effective muscle relaxation approach comparable to that of Sch in terms of duration of action. This review provides a summary of the current state of evidence for the use of sugammadex during ECT, which should lend support to further acceptance and future studies of sugammadex in the context of ECT.

Arthroscopic rotator cuff repair is the gold standard for treatment, but current techniques have shortcomings, especially for larger tears. Single-row repairs often fail to fully restore the footprint, leading to high retear rates. Although triple-row and double-row repairs show promise, concerns regarding retear persist. Biomechanical studies favor triple-row repair for better coverage and pressure distribution. Techniques such as linked double-row and double-pulley methods enhance strength. Secondary cuff failures near the musculotendinous junction are commonly caused by stress concentration. To address these challenges, novel methods have employed linked, knotless, and bridging constructs. Our approach, the double pulley-triple row, aims to minimize retears, especially at the musculotendinous junction, and provides uniform pressure distribution, which is particularly beneficial for large tears. The surgical steps involve standard arthroscopic procedures with specific instruments. Despite these challenges, our method combines proven techniques for optimized outcomes and promising improved results in rotator cuff repair.

Rotator cuff tears are common shoulder injuries that often necessitate surgical intervention, particularly when nonoperative treatments fail. Arthroscopic rotator cuff repair is the current gold standard; however, challenges, such as high retear rates, especially in large tears, persist. Traditional techniques, such as single-row and double-row repairs, have limitations in fully restoring the anatomical footprint and ensuring optimal healing. This review examines the novel double pulley-triple row technique, which aims to overcome these limitations by enhancing the footprint contact area, load distribution, and tendon healing. By evaluating the double pulley-triple row method in comparison to established techniques, this study explores the potential advantages, limitations, and future directions of rotator cuff repair.

Arthroscopic rotator cuff repair is the gold standard for treatment, but current techniques have shortcomings, especially for larger tears. Single-row repairs often fail to fully restore the footprint, leading to high retear rates. Although triple-row and double-row repairs show promise, concerns regarding retear persist. Biomechanical studies favor triple-row repair for better coverage and pressure distribution. Techniques such as linked double-row and double-pulley methods enhance strength. Secondary cuff failures near the musculotendinous junction are commonly caused by stress concentration. To address these challenges, novel methods have employed linked, knotless, and bridging constructs. Our approach, the double pulley-triple row, aims to minimize retears, especially at the musculotendinous junction, and provides uniform pressure distribution, which is particularly beneficial for large tears. The surgical steps involve standard arthroscopic procedures with specific instruments. Despite these challenges, our method combines proven techniques for optimized outcomes and promising improved results in rotator cuff repair.

Rotator cuff tears are common shoulder injuries that often necessitate surgical intervention, particularly when nonoperative treatments fail. Arthroscopic rotator cuff repair is the current gold standard; however, challenges, such as high retear rates, especially in large tears, persist. Traditional techniques, such as single-row and double-row repairs, have limitations in fully restoring the anatomical footprint and ensuring optimal healing. This review examines the novel double pulley-triple row technique, which aims to overcome these limitations by enhancing the footprint contact area, load distribution, and tendon healing. By evaluating the double pulley-triple row method in comparison to established techniques, this study explores the potential advantages, limitations, and future directions of rotator cuff repair.