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"Sensitivity"
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Comparative Assessment of Two Global Sensitivity Approaches Considering Model and Parameter Uncertainty
Global Sensitivity Analysis (GSA) is key to assisting appraisal of the behavior of hydrological systems through model diagnosis considering multiple sources of uncertainty. Uncertainty sources typically comprise incomplete knowledge in (a) conceptual and mathematical formulation of models and (b) parameters embedded in the models. In this context, there is the need for detailed investigations aimed at a robust quantification of the importance of model and parameter uncertainties in a rigorous multi‐model context. This study aims at evaluating and comparing two modern multi‐model GSA methodologies. These are the first GSA approaches embedding both model and parameter uncertainty sources and encompass the variance‐based framework based on Sobol indices (as derived by Dai & Ye, 2015, https://doi.org/10.1016/j.jhydrol.2015.06.034) and the moment‐based approach upon which the formulation of the multi‐model AMA indices (as derived by Dell'Oca et al., 2020, https://doi.org/10.1029/2019wr025754) is based. We provide an assessment of various aspects of sensitivity upon considering a joint analysis of these two approaches in a multi‐model context. Our work relies on well‐established scenarios that comprise (a) a synthetic setting related to reactive transport across a groundwater system and (b) an experimentally‐based study considering heavy metal sorption onto a soil. Our study documents that the joint use of these GSA approaches can provide different while complementary information to assess mutual consistency of approaches and to enrich the information content provided by GSA under model and parameter uncertainty. While being related to groundwater settings, our results can be considered as reference for future GSA studies coping with model and parameter uncertainty. Key Points Two modern multi‐model Global Sensitivity Analysis (GSA) approaches are evaluated and compared upon considering two groundwater‐related scenarios The results of the two multi‐model GSA methods can be markedly different due to their differing theoretical bases Joint use of the two GSA methods enhances one's ability for model diagnosis and assessment of system behaviors
Journal Article
Microbiological Diagnostic Performance of Metagenomic Next-generation Sequencing When Applied to Clinical Practice
Abstract
Background
Metagenomic next-generation sequencing (mNGS) was suggested to potentially replace traditional microbiological methodology because of its comprehensiveness. However, clinical experience with application of the test is relatively limited.
Methods
From April 2017 to December 2017, 511 specimens were collected, and their retrospective diagnoses were classified into infectious disease (347 [67.9%]), noninfectious disease (119 [23.3%]), and unknown cases (45 [8.8%]). The diagnostic performance of pathogens was compared between mNGS and culture. The effect of antibiotic exposure on detection rate was also assessed.
Results
The sensitivity and specificity of mNGS for diagnosing infectious disease were 50.7% and 85.7%, respectively, and these values outperformed those of culture, especially for Mycobacterium tuberculosis (odds ratio [OR], 4 [95% confidence interval {CI}, 1.7-10.8]; P < .01), viruses (mNGS only; P < .01), anaerobes (OR, ∞ [95% CI, 1.71-∞]; P < .01) and fungi (OR, 4.0 [95% CI, 1.6-10.3]; P < .01). Importantly, for mNGS-positive cases where the conventional method was inconclusive, 43 (61%) cases led to diagnosis modification, and 41 (58%) cases were not covered by empirical antibiotics. For cases where viruses were identified, broad-spectrum antibiotics were commonly administered (14/27), and 10 of 27 of these cases were suspected to be inappropriate. Interestingly, the sensitivity of mNGS was superior to that of culture (52.5% vs 34.2%; P < .01) in cases with, but not without, antibiotic exposure.
Conclusions
mNGS could yield a higher sensitivity for pathogen identification and is less affected by prior antibiotic exposure, thereby emerging as a promising technology for detecting infectious diseases.
Journal Article
Bleaching efficacy of in-office dental bleaching with different application protocols: a single-blind randomized controlled trial
Objective
This randomized controlled trial aimed to evaluate the equivalence in the color change, adverse effects, self-perception (AS) and the impact on oral condition (IO) of participants submitted to different application protocols of in-office dental bleaching.
Materials and methods
165 participants were bleached with a 35% hydrogen peroxide gel (Total Blanc Office One-Step, DFL), according to the following protocols: (1) 2 applications of 20-min each (2 × 20 min); (2) 1 × 40-min and; (3) 1 × 30-min. The color change was evaluated with the Vita Easyshade spectrophotometer, Vita Classical and Vita Bleachedguide scales. The intensity and risk of tooth sensitivity (TS) and gingival irritation (GI) were recorded using a 0–10 visual analogue scale (VAS). AS and IO was assessed before and after the bleaching procedure using the Orofacial Aesthetic Scale and Oral Health Impact Profile-14, respectively.
Results
Equivalent color change were observed (
p
< 0.001), with no significant difference between groups. The group 2 × 20 min presented the highest risk of TS (76%, 95% CI 63 to 85), compared to the 1 × 30 min (
p
< 0.04). The intensity of TS and GI and the risk of GI was similar between groups (
p
> 0.31). Irrespectively of the group (
p
= 0.32), significant improvements were observed for all items of AS and IO after bleaching (
p
< 0.02).
Conclusions
The 1 × 30 min protocol produced equivalent color change to the other bleaching protocols with reduced risk of TS and shorter application time.
Clinical relevance
A more simplified application regimen of a single application of 30 min yields effective bleaching and patient satisfaction while minimizing undesirable side effects and improving patient satisfaction.
Journal Article
Self-care for empaths : 100 activities to help you relax, recharge, and rebalance your life
\"If you are an empath, you understand that your unique sensitivity-unusually high awareness of surrounding emotions and energies-can sometimes feel like a challenge. You may find yourself overwhelmed by large groups, worn out by other people's emotions, or inexplicably uncomfortable in certain places. Finding the time and space-and having the empath-specific tools-to rest, recharge, and reconnect with your own emotions and energy is vital for your self-care. Finally, there's a book that helps you do just that! In Self-Care for Empaths, you'll find 100 exercises, quizzes, and rituals that you can incorporate in your daily life to keep you feeling centered, grounded, and energized, including: techniques to help you avoid becoming overwhelmed and drained, like building in healthy retreat and recovery time; tools for setting stronger boundaries, like learning how to tune in or more mindfully tune out of other people's energies and emotions; tricks for remembering that you're not responsible for other people's emotions so you can avoid people-pleasing, rescuing, and codependency; and tips for honoring your personal gifts and skills, like exercises to connect to the deeper meaning and purpose of your empath nature\"-- Provided by publisher.
Book
Effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) on dental hypersensitivity: A randomized controlled clinical trial
This randomized controlled clinical trial aimed to evaluate the effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) in the treatment of dentin hypersensitivity (DH), and the impact of this on the health-related quality of life (HRQL).
Eighty teeth with DH were randomized into four groups and received three treatment sessions: PLACEBO = placebo + LASER application mimicking; CPP-ACPF = CPP-ACPF + LASER application mimicking; PBM = placebo + LASER active application; CPP-ACPF+PBM = CPP-ACPF + LASER active application. Tactile (exploratory probe) and evaporative (triple syringe) stimuli were used to measure DH and were recorded with the aid of a visual analogue scale (VAS) after the 1st, 2nd and 3rd treatment sessions and one-month follow-up. The HRQL was recorded in the DH experience questionnaire (DHEQ).
The intragroup comparison showed a significant reduction in DH (p < 0.05) with both stimuli after one-month follow-up. The intergroup comparison with the evaporative stimulus showed that CPP-ACPF+PBM significantly reduced DH when compared to the rest of treatments, after one-month follow-up. CPP-ACPF+PBM group statistically differed from the other treatment groups in the DHEQ evaluation after one-month follow-up.
After one-month follow-up, the association of CPP-ACPF with PBM was effective in the reduction of DH and promoted a positive impact on the HRQL of the participants of this study.
Journal Article
Tough guys (have feelings too)
Explains through simple text and colorful illustrations that tough guys have the same feelings as you and I.
Book
Effect of gingival barrier brands on operator perception, cervical adaptation, and patient comfort during in-office tooth bleaching: a randomized clinical trial
Background
Light-cured resins are widely used as gingival barriers to protect the gums from highly concentrated peroxides used in tooth bleaching. The impact of barrier brand on clinical outcomes is typically considered negligible. However, there is limited evidence on the effects of different brands on operator experience, barrier adaptation, and patient comfort.
Objective
This clinical trial assessed the impact of four commercial gingival barrier brands (Opaldam, Topdam, Lysadam, and Maxdam) on operator perception, adaptation quality, and patient comfort.
Methods
Twenty-one undergraduate students placed gingival barriers in a randomized sequence using blinded syringes. Photographs of the barriers were taken from frontal and incisal perspectives. After bleaching procedures, operators rated handling features and safety using Likert scale forms. Two experienced evaluators independently assessed barrier adaptation quality on a scale from 1 (perfect) to 5 (unacceptable). The absolute risk of barrier-induced discomfort was recorded. Data were analyzed using Friedman and Chi-square tests (α = 0.05).
Results
Opaldam and Topdam received the highest scores in most handling features, except for removal, which was similar among all brands. No significant difference was observed in barrier adaptation quality between the evaluated brands. Discomforts were mainly reported in the upper dental arch, with Maxdam having the highest absolute risk (35% for this arch and 24% overall).
Conclusions
This study suggests that gingival barrier brands can influence operator perception and patient comfort. Opaldam and Topdam were preferred by operators, but all brands demonstrated comparable adaptation quality.
Clinical trial registration
The study was nested in a randomized clinical trial registered in the Brazilian Clinical Trials Registry under identification number RBR-9gtr9sc.
Journal Article