Faculty Bibliography

BACKGROUND:The rapid adoption of robotic surgical systems globally has created a critical gap in training, assessment and certification for visceral and gastrointestinal (GI) surgical trainees. This study, led by the European Association for Endoscopic Surgery (EAES), aimed to achieve an international consensus on a structured, platform-agnostic robotic training curriculum for GI surgical trainees. METHODS:A 106-item Delphi questionnaire was developed with an international committee of surgical experts, trainees, methodologists and patient representatives. It was disseminated to a multidisciplinary panel of 83 GI robotic surgeons, trainees, human factors experts, robotic theatre team members and industry providers. Two Delphi survey rounds were conducted, with a priori consensus standard set at 70% or higher for agreement. A consensus meeting was subsequently held to discuss and finalise the items needed for a robotic training curriculum for GI surgical trainees. RESULTS:Seventy-one (86%) participants from 15 countries completed round 1. A total of 82 items (77%) reached consensus and 32 new items were generated from free-text comments. Seventy of these participants (99%) completed the 56-item round 2 questionnaire, with 36 items (64%) reaching consensus and 5 new items generated. All 143 statements were discussed in the meeting and consensus was reached in the following areas: (i) key knowledge requirements of the bedside assistant and a console surgeon; (ii) training components; (iii) performance assessment and (iv) certification and supervision. CONCLUSION/CONCLUSIONS:International surgical experts, trainees and other key stakeholders reached consensus on the critical components of a platform-agnostic robotic training curriculum for GI surgical trainees. This will help shape the future of robotic surgical education and certification, promote standardised training practices and ultimately benefit patient safety and outcomes.

The inherently slow acquisition speed of MRI makes abdominal imaging highly sensitive to respiratory motion artifacts. Since the early days of MRI, the development of respiratory motion compensation techniques has been an active research topic, and this field has seen substantial progress. Despite these advances, the majority of these techniques are not used in daily clinical practice, and motion management methods used in clinical abdominal MRI today have changed little over the past decades. This observation points to a significant gap between technical innovation and clinical translation in this area. This review is motivated by this question: why have so many motion management techniques not been adopted into routine clinical workflows? Unlike conventional survey-style reviews that focus on summarizing emerging methods, this article takes a different, and perhaps opposite, perspective to investigate why those technologically sophisticated innovations are misaligned with practical clinical needs. Specifically, we discuss the barriers behind the gap between research advances and clinical practice, clarify the clinical requirements for effective respiratory motion management in abdominal MRI, and highlight research directions with stronger relevance to routine workflows. The review begins with an overview of the clinical impact of respiratory motion in abdominal MRI, followed by a discussion of standard abdominal MRI sequences and their motion sensitivity. We then summarize current clinical strategies and advanced approaches, along with the barriers that hinder their clinical adoption. The article concludes with future directions and broader lessons learned from this translational gap, with the goal of guiding future developments toward improved clinical integration.

BACKGROUND:Early detection of oral potentially malignant disorders (OPMDs) and oral cavity cancer can improve patient prognosis. In this guideline, the authors address the use of vital staining, specifically toluidine blue, as an adjunct to screen adults without mucosal abnormalities and to determine the need for biopsy among adults with mucosal abnormalities in the oral cavity. TYPES OF STUDIES REVIEWED/METHODS:The authors conducted systematic searches to identify evidence on the benefits and harms of using vital staining as an adjunct as well as patient and clinician values and preferences regarding the use of this adjunct. The guideline panel used the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework to formulate recommendations. As part of the framework, the panel also considered the resources required, equity, acceptability, and feasibility when formulating recommendations. RESULTS:The panel formulated 2 recommendations and 2 good practice statements. For adults with and without mucosal abnormalities, the panel recommend against the use of vital staining as an adjunct (conditional recommendation, very low certainty). The good practice statements encourage clinicians to perform a clinical oral examination in all adult patients. CONCLUSIONS AND PRACTICAL IMPLICATIONS/CONCLUSIONS:Biopsy remains the first choice for obtaining a definitive diagnosis of an OPMD and oral squamous cell carcinoma. Clinical oral examination should be performed in all asymptomatic adults with no clinically evident mucosal abnormality. When implementing or adapting these recommendations, local contexts should be taken into account to ensure equitable access to early detection.

PURPOSE/OBJECTIVE:Evidence-based dentistry has progressed from case reports and series to best evidence consensus statements; to non-randomized and randomized controlled studies; to systematic reviews (SRs), which analyze individual studies; and to umbrella reviews (URs), which now evaluate SRs. The purpose of this article is to review and summarize the findings of recent dental URs selected by the authors because they analyzed the quality of SRs, identified their strengths and weaknesses, and represented multiple disciplines of dentistry and diverse journals. MATERIALS AND METHODS/METHODS:A PubMed search was completed using the keywords "umbrella review, dentistry" and the filters "meta-analysis" and "systematic review" along with the years 2022-2024. There were 93 URs listed, with 56 being dental-related. The 56 URs were reviewed, and 15 were collectively selected by the authors to be summarized as examples of multiple dental disciplines and dental-related treatments published in a diverse group of dental journals. RESULTS:The 15 selected URs exhibited similar formats with findings based on the included SRs. The results of the 15 URs are summarized and presented along with the strengths and weaknesses noted in the SRs. CONCLUSIONS:The URs included in this article assessed the quality of SRs based on AMSTAR 2 (AMSTAR 2 is a critical appraisal tool used to assess the methodological quality of systematic reviews, particularly those focusing on healthcare interventions), ROBIS (ROBIS is the first rigorously developed tool designed specifically to assess the risk of bias in systematic reviews), and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Deficiencies were reported relative to the following items: failure to register the protocol before starting the review; incomplete literature search; absence of a list of excluded studies and lack of justification for the exclusions; inadequate review methods; lack of reporting the sources of funding; failing to assess risk of bias (ROB) or an unsatisfactory technique to assess ROB; not listing potential sources of conflict of interest; and lack of homogeneity in the study design, which prevented performing a meta-analysis. These findings indicate the need for careful study of SR and UR guidelines related to design and review, assessment of bias risk, and review reporting before applying the conclusion to clinical practice. Clinicians need to be aware of the deficiencies present in SRs and URs. Also, it is important to recognize that reviews are based on only those studies that met the inclusion criteria of the authors, and the exclusion of studies is fraught with potential bias.

OBJECTIVES/OBJECTIVE:This study aimed to develop and validate the Knowledge Related to Oral Health Literacy Spanish (KROHL- S) instrument to assess oral health knowledge among Spanish-speaking adults in the United States, a population facing significant oral health disparities. DESIGN/METHODS:A cross-sectional study was conducted at NYU College of Dentistry. A convenience sample of 175 self-identified Spanish-speaking adults (70% female, mean age 49. 79 years) completed the orally administered KROHL- S questionnaire. Participants, mainly born outside the US (91. 9%), also completed the Comprehensive Measure of Oral Health Knowledge (CMOHK) and a single-item literacy screening tool in Spanish (SILS). Psychometric properties of the KROHL- S, including internal consistency (Cronbach's alpha), discriminant validity (correlation with CMOHK), and known-group validity (comparison across education levels), were evaluated. Confirmatory factor analysis was used to test the original factor structure. RESULTS:The mean KROHL- S score was 8.34 (SD = 5.82), indicating a low level of oral health knowledge in the sample. Internal consistency for the overall KROHL- S was good (Cronbach's alpha = 0.75), and interrater agreement was high. A moderate positive correlation was found between KROHL- S and CMOHK scores (r = 0.49, p < .0001). Participants with higher education levels showed significantly greater oral health knowledge on the KROHL- S. Confirmatory factor analysis suggested an average fit to the data (RMSEA = 0.064, CFI = 0.86, TLI = 0.83). CONCLUSION/CONCLUSIONS:The KROHL- S could be used to assess oral health knowledge among Spanish-speaking adults and incorporates cultural and linguistic aspects, making it suitable for a wider range of individuals. KROHL-S offers a valuable tool for healthcare providers by not only helping identify individuals' knowledge gaps to guide customized educational interventions but also helping enhance patient-provider communications.

PURPOSE/OBJECTIVE:This narrative review summarizes an artificial intelligence (AI)-integrated digital workflow that enables a seamless, multidisciplinary approach to dental diagnosis and treatment planning, aiming to improve diagnostic coordination, efficiency, and interdisciplinary communication. STUDY SELECTION/METHODS:All studies selected for this narrative review were extracted from the PubMed database. Forty studies were selected, of which 24 were used for general information and 16 were used for the statistical analysis of accuracy of AI software within data acquisition, treatment planning, and clinical implementation. RESULTS:The digital workflow was divided into three phases: data acquisition, treatment planning, and AI data analysis for decision support. Six articles reported the accuracy outcomes for AI-integrated data acquisition tools, such as intraoral scanners (IOS), cone-beam computed tomography (CBCT), facial scanners (FS), and jaw motion trackers (JMT); seven reported AI performance in assisting treatment planning; and three assessed the clinician acceptance rate of AI-supported decisions. IOS, CBCT, FS, and JMT achieved 88-97% overall accuracies. The integrated convolutional neural network and recurrent neural network models obtained 87-98% overall accuracy for treatment planning. Finally, the AI-generated treatment plan obtained 75-95% clinician acceptance rate. CONCLUSIONS:By integrating the IOS, CBCT, FS, and JMT, a comprehensive virtual patient can be created to facilitate seamless communication and effective treatment planning. This AI-integrated workflow may enhance interdisciplinary coordination and treatment planning. However, prospective clinical studies are required to validate their effects on patient outcomes and satisfaction.

Meckel's cartilage is a central structure in mandibular morphogenesis, but how developing muscles establish their attachment to the mandible in relation to Meckel's cartilage remains unclear. In this study, we investigated the fetal development of the mouse mylohyoid attachment site using histological analysis, immunohistochemistry, in situ hybridization, and three-dimensional reconstruction, with particular attention to SOX9 and Scleraxis (Scx), markers associated with cartilage and tendon development. At E13.5, the mylohyoid attachment site was located close to the inferior aspect of Meckel's cartilage, and SOX9-positive mesenchymal cells were observed between the mylohyoid muscle bundle and Meckel's cartilage. During subsequent development, the intramembranous mandibular bone extended into the space between Meckel's cartilage and the mylohyoid attachment site. By E17.5, the mylohyoid attachment site was closely associated with the mandibular bone. SOX9 expression was detected at the developing attachment site from E13.5 to E17.5, whereas Scx mRNA expression was detected transiently and became progressively reduced during this period. Three-dimensional reconstruction further supported the developmental shift in the spatial relationship among Meckel's cartilage, the mandibular bone, and the mylohyoid attachment site. These findings suggest that Meckel's cartilage may serve as a transient anatomical framework associated with early organization of the mylohyoid attachment site before definitive attachment to the mandibular bone is established.

BACKGROUND:Identifying oral potentially malignant disorders and oral cavity cancer early can lead to better patient outcomes. The guideline panel evaluated the usefulness of light-based adjuncts for screening adults without mucosal abnormalities and for determining the need for biopsy among adults with mucosal abnormalities in the oral cavity or on the lip. TYPES OF STUDIES REVIEWED/METHODS:The authors conducted a living systematic review to evaluate evidence on the benefits and harms of light-based adjuncts and a scoping review to assess people and clinician values and preferences regarding the use of light-based adjuncts and biopsy of mucosal abnormalities. The guideline panel used this evidence to formulate recommendations according to the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework. The framework also guided the panel's consideration of required resources, equity, acceptability, and feasibility in shaping the final recommendations. RESULTS:The guideline panel formulated 2 recommendations and 2 good practice statements. For adults with and without mucosal abnormalities, they formulated conditional recommendations against the use of light-based adjuncts on the basis of very low certainty evidence. The good practice statements urge clinicians to perform a clinical oral examination in all adult patients. CONCLUSIONS AND PRACTICAL IMPLICATIONS/CONCLUSIONS:Biopsy remains the reference standard for establishing a definitive diagnosis of an oral potentially malignant disorder and oral squamous cell carcinoma. All adults should undergo a clinical oral examination in primary care settings. When implementing or adapting these recommendations, local contexts should be considered to promote equitable access to early detection.

BACKGROUND:Taxes on sugar-sweetened beverages can improve public health. We aimed to characterise the extent and types of sugar-sweetened beverage taxes implemented worldwide and the national characteristics predicting implementation, such as sugar-sweetened beverage intake amounts, disease rates, or economic development. METHODS:This longitudinal analysis aggregated serial global datasets (including the Global Dietary Database, Non-Communicable Diseases Risk Factor Collaboration, Global Burden of Disease study, and World Bank data) from 1990 to 2024 in 183 countries to assess sugar-sweetened beverage tax characteristics and national predictors of policy adoption. Sugar-sweetened beverage taxes for public health purposes were identified and characterised, including amounts, fiscal instruments, structures, and covered beverages. Sugar-sweetened beverage consumption, obesity and diabetes prevalence, gross domestic product (GDP), and sociodemographic index (SDI) were assessed as predictors of tax implementation using Cox proportional hazards models with time-varying covariates. FINDINGS/RESULTS:From 1990 to 2024, 64 countries implemented sugar-sweetened beverage taxes, accelerating over time and covering 3·5 billion people globally. South Asia led in adoption (50% of countries; median tax rate 7·5%), followed by southeast and east Asia (47·8%; 5·0%), the Middle East and North Africa (30·0%; 17·0%), and Latin America and the Caribbean (31·3%; 7·0%). Taxes were ad valorem (ie, based on price; 45%), volume-based (44%), sugar-content-based (5%), or mixed (6%), and 13% of countries earmarked revenue for public health. Multivariable-adjusted predictors of tax implementation included diabetes prevalence (hazard ratio [HR]=1·22 [95% CI 1·05-1·43]), obesity prevalence (1·14 [1·00-1·29]), GDP per capita (HR per $10 000: 1·19 [1·06-1·34]), and SDI (0·70 [0·57-0·86]), but not sugar-sweetened beverage intake (0·77 [0·42-1·39]). INTERPRETATION/CONCLUSIONS:Global adoption of sugar-sweetened beverage taxes has rapidly accelerated since 1990; however, there is important heterogeneity by region and tax structure, and the taxes are shaped by a country's economic capacity, social development, and health conditions. FUNDING/BACKGROUND:This work was supported by the National Institutes of Health (R01HL115189).