Christopher A. Wiesen’s research while affiliated with University of North Carolina at Chapel Hill and other places

Introduction: First-order Markov models assume future tobacco use behavior is dependent on current tobacco use and are often used to characterize patterns of tobacco use over time. Higher-order Markov models that assume future behavior is dependent on current and prior tobacco use may better estimate patterns of tobacco use. This study compared Markov models of different orders to examine whether incorporating information about tobacco use history improves model estimation of tobacco use and estimated tobacco use transition probabilities. Methods: We used data from four waves of the Population Assessment of Tobacco and Health Study. In each wave a participant was categorized into one of the following tobacco use states: never smoker, former smoker, menthol cigarette smoker, non-menthol cigarette smoker, or e-cigarette/dual user. We compared 1 st, 2 nd and 3 rd order Markov models using multinomial logistic regression and estimated transition probabilities between tobacco use states. Results: The 3 rd order model was the best fit to the data. The percentage of former smokers, menthol cigarette smokers, non-menthol cigarette smokers, and e-cigarette/dual users in Wave 3 that remained in their same tobacco use state in Wave 4 ranged from 63.4%-97.2%, 29.2%-89.8%, 34.8%-89.7%, and 20.5%-80.0%, respectively, dependent on tobacco use history. Individuals who were current tobacco users, but former smokers in the prior two years, were most likely to quit. Conclusions: Transition probabilities between tobacco use states varied widely dependent on tobacco use history. Higher-order Markov models improve estimation of tobacco use over time and can inform understanding of trajectories of tobacco use behavior. Implications: Findings from this study suggest that transition probabilities between tobacco use states vary widely dependent on tobacco use history. Tobacco product users (cigarette or e-cigarette/dual users) who were in their same tobacco use state in the prior two years were least likely to quit. Individuals who were current tobacco users, but former smokers in the prior two years, were most likely to quit. Quitting smoking for at least two years is an important milestone in the process of cessation.

Purpose/objectives: Multimedia presentations and online platforms are used in dental education. Though studies indicate the benefits of video-based lectures (VBLs), data regarding user reception and optimal video features in dental education are limited, particularly on Web 2.0 platforms like YouTube. Given increasing technology integration and remote learning, dental educators need evidence to guide implementation of YouTube videos as a freely available resource. The purpose of this study is to determine video metrics, viewership and format efficacy for dental education videos. Methods: First, a cross-sectional survey was conducted of viewers (N = 683) of the Mental Dental educational videos on YouTube. Analytics were evaluated for 677 200 viewers to assess audience demographics, retention and optimal video length. Second, a randomized crossover study was conducted of dental students (N = 101) who watched VBLs in either slideshow or pencast formats and were tested on content learning to compare format efficacy. Results: Most viewers of Mental Dental videos were dental students (44.2%) and professionals (37.8%) who would likely recommend the platform to a friend or colleague (Net Promoter Score = 82.1). Audience retention declined steadily at 1.34% per minute, independent of video length. Quiz performance did not differ between slideshow and pencast videos, with students having a slight preference for slideshows (P = 0.049). Conclusions: Dental students and professionals use VBLs and are likely to recommend them to friends and colleagues. There is no optimal video length to maximize audience retention and lecture format (slideshow vs. pencast) does not significantly impact content learning. Results can guide implementation of VBLs in dental curricula.

Unlabelled: Orthodontists often encounter significant clinical challenges in the finishing stages of treatment due to a disproportion in interarch tooth size relationships. Despite the increasing presence of digital technology and concomitant focus on customized treatment approaches, there is a gap in the knowledge of how generating tooth size data using digital versus traditional methods may impact our treatment regime. Objective: This study aimed to compare the prevalence of tooth size discrepancies using digital models and a digitally based cast analysis in our cohort based on (i) Angle's Classification; (ii) gender and (iii) race. Materials and methods: The mesiodistal widths of teeth in 101 digital models were assessed using computerized odontometric software. A Chi-square test was used to determine the prevalence of tooth size disproportions among the study groups. The differences between all three groups of the cohort were analysed using a three-way analysis of variance (ANOVA). Results: An overall Bolton tooth size discrepancy (TSD) prevalence of 36.6% was observed in our study cohort; 26.7% had an anterior Bolton TSD. No differences existed in the prevalence of tooth size discrepancies between male and female subjects as well as between the different malocclusion groups (P > .05). Caucasian subjects had a statistically significant smaller prevalence of TSD compared to Black and Hispanic patients (P < .05). Conclusion: The prevalence results in this study illuminate how relatively common TSD is and underscores the importance of proper diagnosis. Our findings also suggest that racial background may be an influential factor in the presence of TSD.

Background: COVID-19-related olfactory dysfunction (OD) can persist long after patients recover from acute infection, yet few studies have investigated the long-term progression of this complication. Moreover, existing studies are focused on hyposmia/anosmia but parosmia is becoming an increasingly recognized long-term symptom. Methods: We completed a longitudinal study about OD in individuals with mild cases of COVID-19. Participants completed a questionnaire and Brief Smell Identification Test (BSIT) one week, one month and one year after diagnosis. At one-year, participants completed an additional survey about parosmia. Results: We obtained questionnaires and psychophysical olfactory testing information from participants at one week (n=45), one month (n=38), and one year (n=33) post COVID-19 diagnosis. At one-year, 15.2% of participants had persistent OD and 66.7% of participants reported experiencing parosmia at some point following COVID-19 diagnosis. The mean onset of parosmia was 1.3 weeks (SD: 1.9 weeks) after diagnosis, although two patients reported delayed onset (>4 weeks after diagnosis). Eight patients (24.2%) reported ongoing parosmia one year after diagnosis. Of the patients whose parosmia resolved, the mean duration of symptoms was 7.2 weeks (SD: 7.3 weeks). Conclusion: Decreased sense of smell associated with COVID-19 infection has received significant recognition in both the media and in the medical literature. Symptoms of OD and parosmia were common in our patients with COVID-19. Hyposmia, anosmia, and parosmia, all decrease quality of life, necessitating continued research to understand the pathogenesis, course of symptoms, and possible treatment for these complications.

A central assumption in population coverage error estimation is that non-residential units are not counted (i.e., no erroneous enumerations) and, thus, the only remaining errors are omissions. This assumption is violated in many situations, notably in the US Census 2000, where undetected erroneous enumerations were a primary reason that the post-enumeration survey (PES) results could not be used in census undercount adjustments. This paper develops a latent class modeling approach that allows for varying levels of undetected erroneous enumerations in one of the population lists. Our approach requires three population lists which may be the Census, the PES, and a list derived from merging records from administrative systems. The resulting data take the form of an incomplete contingency table which can be represented by a latent class model where the latent variable is an individual’s true status (i.e., resident or nonresident of the population). Latent class analysis is used to estimate the expected values of the observed cells of this table and then to project these estimates onto the unobserved cells in order to estimate the total number of population members. Using artificial populations, the improvement in mean squared error using this approach is evaluated and compared to other modeling approaches from the capture-recapture literature.KeywordsCapture-recaptureDual system estimator (DSE)Administrative records listStatistical administrative records system (StARS)Correct enumeration probabilityOmissionIdentifiableidentifiabilityEqual catchabilitySchabel’s modelTrap response modelTrap happy behaviorBehavior correlationNon-stationary behavior1988 Dress RehearsalLog-linear modelsLatent class modelArtificial dataMisspecificationCensus undercountConditional multinomial modelFinite mixture modelModel bias

Purpose: The purpose of this retrospective pilot study was to examine the short-term effect of simultaneous Ahmed Glaucoma Valve implantation and cyclophotocoagulation on postoperative outcomes in patients with neovascular glaucoma. Methods and materials: Patient charts were selected for inclusion in this study if they carried a diagnosis of neovascular glaucoma and underwent Ahmed glaucoma valve implantation only, Ahmed glaucoma valve implantation with cyclophotocoagulation, or cyclophotocoagulation only. A total of 55 eyes of 54 patients were selected for data collection and analysis. Main outcome measures included 1-, 3-, and 6-month intraocular pressure and occurrence of the hypertensive phase. Other outcomes included visual acuity, surgical complication rate, and a number of 6-month postoperative ophthalmic medications. Results: A significantly lower intraocular pressure was seen in the group that received Ahmed glaucoma valve implantation + cyclophotocoagulation compared to the Ahmed glaucoma valve-only group at 3 and 6 months (p = 0.03 and <0.001, respectively). The difference in the occurrence of the hypertensive phase between the Ahmed glaucoma valve-only group and the Ahmed glaucoma valve + cyclophotocoagulation group approached but did not reach significance (p = 0.052). A significantly lower intraocular pressure was also seen in the cyclophotocoagulation-only group compared to the Ahmed glaucoma valve-only group at 3 months (p = 0.006). Conclusion: Simultaneous Ahmed glaucoma valve implantation and cyclophotocoagulation significantly lowered intraocular pressure at 3 and 6 months compared to Ahmed glaucoma valve implantation alone in patients with neovascular glaucoma. Clinical significance: Neovascular glaucoma is difficult to manage medically and surgically. When surgery is performed, intraocular pressure often remains elevated postoperatively despite aggressive medical management. This study examines a novel method to lower intraocular pressure after Ahmed glaucoma valve implantation in patients with neovascular glaucoma. How to cite this article: Ford RL, Knight ORJ, Klifto MR, et al. A Pilot Study Assessing Treatment Outcomes in Neovascular Glaucoma Using Ahmed Glaucoma Valve with and without Cyclophotocoagulation. J Curr Glaucoma Pract 2022;16(1):4-10.

Objective: To evaluate the effect of HIV coinfection on nontreponemal titers during pregnancy in women with syphilis. Methods: This is a secondary analysis of pregnant women with syphilis in the prospective, observational Zambian Preterm Birth Prevention Study (ZAPPS). Treponemal (TPPA) and nontreponemal (RPR) testing were performed on serum biospecimens, resulting in 47 participants with serologically-confirmed syphilis (27 HIV-positive, 20 HIV-negative). The primary outcome, achievement of RPR titer seroreduction during pregnancy, was analyzed by logistic regression. Secondary outcomes included overall titer reduction, seroreduction rate, serologic cure, and adverse pregnancy outcomes. Results: Seroreduction of RPR titer occurred in 78% (21/27) of women with HIV versus 45% (9/20) of women without (aOR 4.66; 95%CI 1.14-19.08). Overall RPR titer reduction, rates of seroreduction per week, and the proportion achieving serologic cure each trended higher among women with HIV compared to those without HIV. There was a trend toward decreased stillbirth incidence in participants achieving seroreduction (OR 0.15, 95%CI 0.01-1.58). Conclusion: HIV coinfection in this cohort of Zambian women with syphilis was associated with greater odds of RPR titer seroreduction during pregnancy. Pregnant women with syphilis and HIV may not be at increased risk for delayed syphilis treatment response compared to women without HIV.

Introduction Studies find differences in tobacco retailer density according to neighborhood sociodemographic characteristics, raising issues of social justice, but not all research is consistent. This study examined associations between tobacco retailer density and neighborhood sociodemographic characteristics in the United States (US) at four timepoints (2000, 2007, 2012, 2017) and investigated if associations remained stable over time. Methods Data on tobacco retailers came from the National Establishment Time-Series Database. Adjusted log-linear models examined the relationship between retailer density and census tract sociodemographic characteristics (% non-Hispanic Black [Black], % Hispanic, % vacant housing units, median household income), controlling for percentage of youth, urbanicity and US region. To examine whether the relationship between density and sociodemographic characteristics changed over time, additional models were estimated with interaction terms between each sociodemographic characteristic and year. Results Tobacco retailer density ranged from 1.22-1.44 retailers/1,000 persons from 2000 to 2017. There were significant, positive relationships between tobacco retailer density and the percentage of Black (standardized exp(b)=1.05 (95% CI: 1.04, 1.07) and Hispanic (standardized exp(b)=1.06 (95% CI: 1.05, 1.08) residents and the percentage of vacant housing units (standardized exp(b)=1.08 (95% CI: 1.07, 1.10) in a census tract. Retailer density was negatively associated with income (standardized exp(b)=0.84 (95% CI: 0.82, 0.86). From 2000 to 2017, the relationship between retailer density and income and vacant housing units became weaker. Conclusions Despite the weakening of some associations, there are sociodemographic disparities in tobacco retailer density from 2000 to 2017, which research has shown may contribute to inequities in smoking. Implications This study examines associations between tobacco retailer density and neighborhood sociodemographic characteristics in the United States at four time points from 2000 to 2017. Although some associations weakened, there are sociodemographic disparities in tobacco retailer density over the study period. Research suggests that sociodemographic disparities in retailer density may contribute to inequities in smoking. Findings from this study may help identify which communities should be prioritized for policy intervention and regulation.

Background The COVID-19 pandemic has impacted the U.S. economy and workforce, with marked effects on small businesses. Studies have evaluated workers’ views of financial confidence and advancement, but there has been limited focus on the dental industry. Methods To extend investigations to dentistry, published scales and pretested questions were used to determine workforce confidence and workflow changes among dentists. Data were evaluated using descriptive and bivariate statistics. In the wake of the pandemic, surveys were distributed to the American Dental Association (ADA) and American Association of Orthodontics (AAO) membership (N=656). Results Dentists’ top concern is increased cost of providing treatment (57.4% [Confidence Interval (CI): 53.5, 61.3]), associated with widely adopted workflow changes including reduced patient volumes (66.0% [CI: 62.4, 69.6]) and increased safety protocols and equipment (health screening, 75.5% [CI: 72.2, 78.8]), KN/N95 masks, 76.7% [CI: 73.5, 80.0]). However, the majority of respondents do not expect their personal or practice finances to be negatively affected after the pandemic, as only 18.5% ([CI: 15.4, 21.7]) predict their practice’s gross revenue to decrease. Conclusions Dentists are optimistic in the wake of vaccinations and lifting restrictions. Most expect their finances and practice performance to remain the same or grow in the short-term and expect long-term improvements post-pandemic. Practical Implications Results suggest that despite shutdowns and workflow changes, dentists have financially rebounded and anticipate future growth.