Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

Introduction: A prosthesis is an artificial assistive device designed to replace a missing body part (e.g., limb), secondary to a disease, injury or congenital deformities. Prostheses are often used to restore functional capacity while improving the quality of life (QoL). Methods: An analytical cross-sectional study was conducted among adults aged 19 to 64 years who were permanent residents in Luzon who had undergone unilateral lower leg amputation. This epidemiologic study employed the Modified Barthel Index for activities of daily living (ADLs), the Frenchay Activities Index for instrumental activities of daily living (IADLs), and the WHOQOL-BREF for QoL. Descriptive and analytical statistics of the responses of the Lower Limb Amputees (LLA) were done. Prevalence odds ratio (POR) was calculated, and statistical significance was determined. Results: Among 165 LLA respondents, only 47.88% used prostheses. Unilateral LLA who exhibited greater independence in ADLs (POR=19.22), more actively performed IADLs (POR=5.51), and had good QoL (POR=3.83) were more likely to have been using prosthesis. All these findings were statistically significant. Conclusion This study revealed a statistically significant association between prosthesis use to the physical functioning and QoL among adult unilateral LLAs. It showed that prosthetic use was likely linked with improved performance in ADLs and IADLs, and better QoL compared to those without.
Quality of Life

Purpose: This study was performed to introduce, evaluate, and compare various novel assessment protocols designed for straightforward, reliable, and reproducible measurement of alveolar bone levels. These protocols are intended for standardized periodontal assessment and follow-up, utilizing cone-beam computed tomography (CBCT) images and manipulation of Digital Imaging and Communications in Medicine (DICOM) viewer software. Materials and Methods: Two experienced oral and maxillofacial radiologists developed 5 distinct radiographic measurement protocols. These techniques were established to assess the alveolar bone level of a periodontally affected upper central incisor using a method that is consistently repeatable across observers. Two additional assessors, blindedto the details of the study, independently applied the protocols to retrieved DICOM files that met the eligibility criteria.A scoring system with 3 subscores was created and used to compare the protocols. Results: Statistically excellent inter-observer reliability was observed for all protocols, other than protocol 1, which demonstrated moderate reliability. The average discrepancy between measurements taken by the 2 observers was 1.2 mm for protocol 1, 0.81 mm for protocol 2, and less than 0.5 mm for the remaining 3 protocols. All approaches except protocol 4 were straightforward to apply. Conclusion This study introduces multiple reliable protocols for the evaluation of periodontal bone levels that ensureconsistency across observers. Based on the findings, the double axial lines and incisocrestal distance protocols are recommended. These new assessment approaches, along with any future modifications, may be useful in periodontal assessment, dental implant follow-up, orthodontic evaluation, research, and artificial intelligence model generation.

Purpose: This study was performed to introduce, evaluate, and compare various novel assessment protocols designed for straightforward, reliable, and reproducible measurement of alveolar bone levels. These protocols are intended for standardized periodontal assessment and follow-up, utilizing cone-beam computed tomography (CBCT) images and manipulation of Digital Imaging and Communications in Medicine (DICOM) viewer software. Materials and Methods: Two experienced oral and maxillofacial radiologists developed 5 distinct radiographic measurement protocols. These techniques were established to assess the alveolar bone level of a periodontally affected upper central incisor using a method that is consistently repeatable across observers. Two additional assessors, blindedto the details of the study, independently applied the protocols to retrieved DICOM files that met the eligibility criteria.A scoring system with 3 subscores was created and used to compare the protocols. Results: Statistically excellent inter-observer reliability was observed for all protocols, other than protocol 1, which demonstrated moderate reliability. The average discrepancy between measurements taken by the 2 observers was 1.2 mm for protocol 1, 0.81 mm for protocol 2, and less than 0.5 mm for the remaining 3 protocols. All approaches except protocol 4 were straightforward to apply. Conclusion This study introduces multiple reliable protocols for the evaluation of periodontal bone levels that ensureconsistency across observers. Based on the findings, the double axial lines and incisocrestal distance protocols are recommended. These new assessment approaches, along with any future modifications, may be useful in periodontal assessment, dental implant follow-up, orthodontic evaluation, research, and artificial intelligence model generation.

Purpose: This study was performed to introduce, evaluate, and compare various novel assessment protocols designed for straightforward, reliable, and reproducible measurement of alveolar bone levels. These protocols are intended for standardized periodontal assessment and follow-up, utilizing cone-beam computed tomography (CBCT) images and manipulation of Digital Imaging and Communications in Medicine (DICOM) viewer software. Materials and Methods: Two experienced oral and maxillofacial radiologists developed 5 distinct radiographic measurement protocols. These techniques were established to assess the alveolar bone level of a periodontally affected upper central incisor using a method that is consistently repeatable across observers. Two additional assessors, blindedto the details of the study, independently applied the protocols to retrieved DICOM files that met the eligibility criteria.A scoring system with 3 subscores was created and used to compare the protocols. Results: Statistically excellent inter-observer reliability was observed for all protocols, other than protocol 1, which demonstrated moderate reliability. The average discrepancy between measurements taken by the 2 observers was 1.2 mm for protocol 1, 0.81 mm for protocol 2, and less than 0.5 mm for the remaining 3 protocols. All approaches except protocol 4 were straightforward to apply. Conclusion This study introduces multiple reliable protocols for the evaluation of periodontal bone levels that ensureconsistency across observers. Based on the findings, the double axial lines and incisocrestal distance protocols are recommended. These new assessment approaches, along with any future modifications, may be useful in periodontal assessment, dental implant follow-up, orthodontic evaluation, research, and artificial intelligence model generation.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has led to an association between COVID-19 and pediatric diabetes. Studies have indicated the increased likelihood of children with COVID-19 infection developing diabetes. Our objective was to assess not only the increase in pediatric diabetes at our hospital and identify possible risk factors, but also to correlate the psychosocial changes resulting from the pandemic with new-onset diabetes. Methods: We analyzed data from 58 children aged 1 to 18 years admitted to our hospital with new-onset diabetes between March 2020 and December 2021. The data included inflammatory biomarkers and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies (Abs), as well as the results of a lifestyle questionnaire. Results: The average number of hospital admissions per month for new-onset diabetes increased from 10 to 18 with the start of the pandemic. Of the 58 children in our analysis, 33% had positive SARS-CoV-2 IgG Ab, 31% had type 1 diabetes mellitus, and 62% had type 2 diabetes mellitus (T2DM). More than half (54%) were experiencing diabetic ketoacidosis. Those with T2DM were older, majority African American, had higher median body mass index (BMI) percentiles, and lower vitamin D levels. There were no significant correlations between any psychosocial risk factors and either diabetes type or SARS-CoV2 Ab status. Conclusion Despite the increased incidence of new-onset diabetes among children in Mississippi during the pandemic, this study was unable to demonstrate a significant correlation between COVID-19 infection and new-onset diabetes. The findings of this study highlighted the correlation between increased BMI and type 2 diabetes, underscoring the significant problems of obesity and diabetes in our study region. Further research is warranted.

Background: and Purpose Randomized trials proved the benefits of mechanical thrombectomy (MT) for select patients with large vessel occlusion (LVO) within 24 hours of last-known-well (LKW). Recent data suggest that LVO patients may benefit from MT beyond 24 hours. This study reports the safety and outcomes of MT beyond 24 hours of LKW compared to standard medical therapy (SMT). Methods: This is a retrospective analysis of LVO patients presented to 11 comprehensive stroke centers in the United States beyond 24 hours from LKW between January 2015 and December 2021. We assessed 90-day outcomes using the modified Rankin Scale (mRS). Results: Of 334 patients presented with LVO beyond 24 hours, 64% received MT and 36% received SMT only. Patients who received MT were older (67±15 vs. 64±15 years, P=0.047) and had a higher baseline National Institutes of Health Stroke Scale (NIHSS; 16±7 vs.10±9, P<0.001). Successful recanalization (modified thrombolysis in cerebral infarction score 2b-3) was achieved in 83%, and 5.6% had symptomatic intracranial hemorrhage compared to 2.5% in the SMT group (P=0.19). MT was associated with mRS 0–2 at 90 days (adjusted odds ratio [aOR] 5.73, P=0.026), less mortality (34% vs. 63%, P<0.001), and better discharge NIHSS (P<0.001) compared to SMT in patients with baseline NIHSS ≥6. This treatment benefit remained after matching both groups. Age (aOR 0.94, P<0.001), baseline NIHSS (aOR 0.91, P=0.017), Alberta Stroke Program Early Computed Tomography (ASPECTS) score ≥8 (aOR 3.06, P=0.041), and collaterals scores (aOR 1.41, P=0.027) were associated with 90-day functional independence. Conclusion In patients with salvageable brain tissue, MT for LVO beyond 24 hours appears to improve outcomes compared to SMT, especially in patients with severe strokes. Patients’ age, ASPECTS, collaterals, and baseline NIHSS score should be considered before discounting MT merely based on LKW.

Objective: The Commonwealth of the Northern Mariana Islands (CNMI) is a remote Pacific island territory with a population of 47 329 that successfully prevented the significant introduction of coronavirus disease (COVID-19) until late 2021. This study documents how the response to the introduction of COVID-19 in CNMI in 2021 was conducted with limited resources without overwhelming local clinical capacity or compromising health service delivery for the population. Methods: Data from COVID-19 case investigations, contact tracing, the Commonwealth’s immunization registry and whole genome sequencing were collated and analysed as part of this study. Results: Between 26 March 2020 and 31 December 2021, 3281 cases and 14 deaths due to COVID-19 were reported in CNMI (case fatality rate, 0.4%). While notification rates were highest among younger age groups, hospitalization and mortality rates were disproportionately greater among those aged >50 years and among the unvaccinated. The first widespread community transmission in CNMI was detected in October 2021, with genomic epidemiology and contact tracing data indicating a single introduction event involving the AY.25 lineage and subsequent rapid community spread. Vaccination coverage was high before widespread transmission occurred in October 2021 and increased further over the study period. Discussion: Robust preparedness and strong leadership generated resilience within the public health sector such that COVID-19 did not overwhelm CNMI’s health system as it did in other jurisdictions and countries around the world. At no point was hospital capacity exceeded, and all patients received adequate care without the need for health-care rationing.