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Dynamic navigation has emerged as an innovative technology in endodontics, offering enhanced precision and efficiency compared to traditional and static navigation techniques. By integrating real-time imaging and computer-guided navigation, dynamic navigation systems (DNSs) are transforming the way endodontic procedures are performed. DNSs have demonstrated superior accuracy and efficiency in endodontic treatments, leading to improved procedural outcomes and patient satisfaction. These systems facilitate minimally invasive procedures, reduce treatment time, and enhance the overall precision of root canal treatments, apical surgeries, and retreatment cases. However, challenges such as cost, accessibility, and the learning curve for practitioners remain. Dynamic navigation represents a significant advancement in endodontics, with the potential to revolutionize clinical practice. As technology continues to evolve, further research and innovation are expected to address the current limitations and expand the applications of dynamic navigation in dental care. This review underscores the importance of adopting DNSs to improve the treatment outcomes and patient care in endodontics. [ABSTRACT FROM AUTHOR]

As the use of virtual reality exposure training in treating various anxiety disorders including music performance anxiety increases, it is becoming more important to understand what components of virtual reality programs affect the effectiveness of the training. Thus, this study examines how various attributes of an exposure training program in a computer-assisted virtual environment affect vocalists' music performance anxiety. This study also explores how different attributes of virtual reality programs affect five experiential dimensions of vocalists' music performance anxiety. A quasi-experimental (pre- and post-exposure) design study exposes eighteen adult professional vocalists and those training to become professional vocalists with previous public performance experience to virtual performance situations with varying attributes. The results demonstrate that exposure training in the virtual environment significantly reduces the participants' music performance anxiety. The results also demonstrate that different attributes of the programs affect the sensory, affective, cognitive, behavioral, and relational dimensions of the participants' music performance anxiety differently. The insights the findings provide for the development of virtual reality exposure training programs and digital therapeutic applications for music performance anxiety and other types of anxiety and disorders are discussed. [ABSTRACT FROM AUTHOR]

Abstract Background The acquisition of knowledge and use of skills from digital mental health interventions (DMHIs) are considered important for effectiveness. However, our understanding of user experiences implementing skills learned from these interventions is limited, particularly outside of research trials. This qualitative study aimed to investigate how community users learn and apply knowledge and skills from DMHIs based on cognitive behavioural therapy (CBT) in daily life. The study also examined factors influencing the selection and use of skills and explored perceived changes in mental health resulting from the intervention. Methods Thirteen adults aged 26 to 66 years (10 females) were recruited using social media advertising and participated in semi-structured interviews by telephone or videoconference. All participants were living in Australia and had used a digital CBT program within the past 3 months. Interviews lasted on average 45 min. Transcripts were analysed using theoretical thematic analysis. Results Participants demonstrated high levels of program engagement. Findings were organised into three topics with six major themes. Participants reported that their chosen intervention reinforced existing knowledge and fostered new skills and insights (Topic 1, Theme 1: knowledge consolidation). Most described actively applying skills (Topic 1, Theme 2: active approach to skill enactment), although the extent of learning and range of skills enacted varied across participants. Influences on skill selection included the perceived relevance of intervention strategies to the user’s needs and personal characteristics (Topic 2, Theme 1: relevance of intervention strategies), as well as the perceived or experienced effectiveness of those strategies (Topic 2, Theme 2: perceived and experienced benefit). Challenges to ongoing skill enactment included time scarcity, prioritisation difficulties, and lack of motivation (Topic 2, Theme 3: navigating time constraints and low motivation). Improvements in mental health were generally modest and attributed mainly to participants’ proactive efforts (Topic 3, Theme 1: perceived changes). Conclusions DMHIs may reinforce existing understanding of psychotherapeutic strategies, offer new knowledge, and encourage the application of skills in everyday life among community users who actively engage with these interventions. Future research should prioritise personalising DMHIs and investigating methods to optimise the acquisition, retention, and sustained application of knowledge and skills.

Background: The acquisition of knowledge and use of skills from digital mental health interventions (DMHIs) are considered important for effectiveness. However, our understanding of user experiences implementing skills learned from these interventions is limited, particularly outside of research trials. This qualitative study aimed to investigate how community users learn and apply knowledge and skills from DMHIs based on cognitive behavioural therapy (CBT) in daily life. The study also examined factors influencing the selection and use of skills and explored perceived changes in mental health resulting from the intervention. Methods: Thirteen adults aged 26 to 66 years (10 females) were recruited using social media advertising and participated in semi-structured interviews by telephone or videoconference. All participants were living in Australia and had used a digital CBT program within the past 3 months. Interviews lasted on average 45 min. Transcripts were analysed using theoretical thematic analysis. Results: Participants demonstrated high levels of program engagement. Findings were organised into three topics with six major themes. Participants reported that their chosen intervention reinforced existing knowledge and fostered new skills and insights (Topic 1, Theme 1: knowledge consolidation). Most described actively applying skills (Topic 1, Theme 2: active approach to skill enactment), although the extent of learning and range of skills enacted varied across participants. Influences on skill selection included the perceived relevance of intervention strategies to the user's needs and personal characteristics (Topic 2, Theme 1: relevance of intervention strategies), as well as the perceived or experienced effectiveness of those strategies (Topic 2, Theme 2: perceived and experienced benefit). Challenges to ongoing skill enactment included time scarcity, prioritisation difficulties, and lack of motivation (Topic 2, Theme 3: navigating time constraints and low motivation). Improvements in mental health were generally modest and attributed mainly to participants' proactive efforts (Topic 3, Theme 1: perceived changes). Conclusions: DMHIs may reinforce existing understanding of psychotherapeutic strategies, offer new knowledge, and encourage the application of skills in everyday life among community users who actively engage with these interventions. Future research should prioritise personalising DMHIs and investigating methods to optimise the acquisition, retention, and sustained application of knowledge and skills. [ABSTRACT FROM AUTHOR]

Accurate delineation of the clinical target volume (CTV) is a crucial prerequisite for safe and effective radiotherapy characterized. This study addresses the integration of magnetic resonance (MR) images to aid in target delineation on computed tomography (CT) images. However, obtaining MR images directly can be challenging. Therefore, we employ AI-based image generation techniques to "intelligentially generate" MR images from CT images to improve CTV delineation based on CT images. To generate high-quality MR images, we propose an attention-guided single-loop image generation model. The model can yield higher-quality images by introducing an attention mechanism in feature extraction and enhancing the loss function. Based on the generated MR images, we propose a CTV segmentation model fusing multi-scale features through image fusion and a hollow space pyramid module to enhance segmentation accuracy. The image generation model used in this study improves the peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM) from 14.87 and 0.58 to 16.72 and 0.67, respectively, and improves the feature distribution distance and learning-perception image similarity from 180.86 and 0.28 to 110.98 and 0.22, achieving higher quality image generation. The proposed segmentation method demonstrates high accuracy, compared with the FCN method, the intersection over union ratio and the Dice coefficient are improved from 0.8360 and 0.8998 to 0.9043 and 0.9473, respectively. Hausdorff distance and mean surface distance decreased from 5.5573 mm and 2.3269 mm to 4.7204 mm and 0.9397 mm, respectively, achieving clinically acceptable segmentation accuracy. Our method might reduce physicians' manual workload and accelerate the diagnosis and treatment process while decreasing inter-observer variability in identifying anatomical structures. [ABSTRACT FROM AUTHOR]

Introduction: Augmented Reality (AR) in dentistry has evolved from computer-generated images overlaying the real world, stemming from advancements in software-based Virtual Reality (VR) for anatomic exploration. AR applications in dentistry range from simulations aiding in training to enhancing precision in dental procedures. By overlaying digital information onto the physical environment, AR facilitates better visualisation of dental anatomy and treatment planning. Its integration has shown promise in reducing errors, improving patient outcomes, and augmenting dental education through immersive experiences. Aim: To evaluate AR’s application in dentistry, with a particular emphasis on dental implants. Materials and Methods: A systematic review, using the Problem/patient Intervention Control or comparison Outcome (PICO) framework, selected six articles focusing on challenges in dentistry, specifically in training, practicing complex procedures accurately in implants, and maintaining patient confidentiality. The intervention compared AR with traditional methods. Results: The AR was mostly used in precision dentistry operations. Notably, it was discovered that three-dimensional (3D) AR outperformed two-dimensional (2D) image navigation techniques, resulting in fewer implant location errors. The highest absolute effect was 24.3%, with the angle of implant errors showing a reduction of 9.5% using AR. Conclusion: The findings support AR’s role in enhancing accuracy and efficiency while maintaining patient confidentiality.

Background: Mental health problems are common among university students, yet many students do not seek professional help. Digital mental health interventions can increase students' access to support and have been shown to be effective in preventing and treating mental health problems. However, little is known about the extent to which students implement therapeutic skills from these programs in everyday life (ie, skill enactment) or about the impact of skill enactment on outcomes. Objective: This study aims to assess the effects of a low-intensity video-based intervention, Uni Virtual Clinic Lite (UVC-Lite), in improving skill enactment relative to an attention-control program (primary aim) and examine whether skill enactment influences symptoms of depression and anxiety (secondary aim). The study also qualitatively explored participants' experiences of, and motivations for, engaging with the therapeutic techniques. Methods: We analyzed data from a randomized controlled trial testing the effectiveness of UVC-Lite for symptoms of depression and anxiety among university students with mild to moderate levels of psychological distress. Participants were recruited from universities across Australia and randomly assigned to 6 weeks of self-guided use of UVC-Lite (243/487, 49.9%) or an attention-control program (244/487, 50.1%). Quantitative data on skill enactment, depression, and anxiety were collected through baseline, postintervention, and 3- and 6-month follow-up surveys. Qualitative data were obtained from 29 intervention-group participants through open-ended questions during postintervention surveys (n=17, 59%) and semistructured interviews (n=12, 41%) after the intervention period concluded. Results: Mixed model repeated measures ANOVA demonstrated that the intervention did not significantly improve skill enactment (F3,215.36=0.50; P=.68). Skill enactment was also not found to influence change in symptoms of depression (F3,241.10=1.69; P=.17) or anxiety (F3,233.71=1.11; P=.35). However, higher levels of skill enactment were associated with lower symptom levels among both intervention and control group participants across time points (depression: F1,541.87=134.61; P<.001; anxiety: F1,535.11=73.08; P<.001). Inductive content analysis confirmed low levels of skill enactment among intervention group participants. Participants were motivated to use techniques and skills that were perceived to be personally relevant, easily integrated into daily life, and that were novel or had worked for them in the past. Conclusions: The intervention did not improve skill enactment or mental health among students with mild to moderate psychological distress. Low adherence impacted our ability to draw robust conclusions regarding the intervention's impact on outcomes. Factors influencing skill enactment differed across individuals, suggesting that it may be necessary to tailor therapeutic skills and engagement strategies to the individual user. Theoretically informed research involving collaboration with end users is needed to understand the processes underlying skill enactment in digital mental health interventions. [ABSTRACT FROM AUTHOR]

Abstract Background Breaking Free Online (BFO), a computer-assisted therapy (CAT) program for substance use disorders (SUD), has been available across UK treatment services for the past decade and has demonstrated efficacy. The Covid-19 pandemic has contributed to digital and ‘telehealth’ approaches to healthcare delivery becoming more common and accepted, and has in parallel, increased numbers of referrals to SUD services because of the impact pandemic-related stress has had on substance using habits in the general population. Digital and telehealth approaches, such as BFO, have the potential to support the treatment system to meet this increased demand for SUD services. Methods Parallel-group randomized controlled trial of eight-week BFO as an adjunct to standard treatment for SUD, in comparison to standard treatment only, at a National Health Service (NHS) Mental Health Trust in North-West England. Participants will be service users aged 18 years and over with demonstrable SUD for at least 12-months. Interventional and control groups will be compared on multiple measures from baseline to post-treatment assessment at eight-weeks, and then three and six-months follow-up. Primary outcome will be self-reported substance use, with secondary outcomes being standardized assessments of substance dependence, mental health, biopsychosocial functioning and quality of life. Discussion This study will examine whether BFO and telehealth support, when delivered as an adjunct to standard SUD interventions, improves outcomes for services users receiving NHS SUD treatment. Findings from the study will be used to inform both developments to the BFO program and guidance around augmenting the delivery of CAT programs via telehealth. Trial registration registered with ISRCTN on 25th May 2021—registration number: 13694016. Protocol version: 3.0 05th April 2022. Trial status: This trial is currently open to recruitment—estimated to be completed in May 2023.

Background: Breaking Free Online (BFO), a computer-assisted therapy (CAT) program for substance use disorders (SUD), has been available across UK treatment services for the past decade and has demonstrated efficacy. The Covid-19 pandemic has contributed to digital and 'telehealth' approaches to healthcare delivery becoming more common and accepted, and has in parallel, increased numbers of referrals to SUD services because of the impact pandemic-related stress has had on substance using habits in the general population. Digital and telehealth approaches, such as BFO, have the potential to support the treatment system to meet this increased demand for SUD services. Methods: Parallel-group randomized controlled trial of eight-week BFO as an adjunct to standard treatment for SUD, in comparison to standard treatment only, at a National Health Service (NHS) Mental Health Trust in North-West England. Participants will be service users aged 18 years and over with demonstrable SUD for at least 12-months. Interventional and control groups will be compared on multiple measures from baseline to post-treatment assessment at eight-weeks, and then three and six-months follow-up. Primary outcome will be self-reported substance use, with secondary outcomes being standardized assessments of substance dependence, mental health, biopsychosocial functioning and quality of life. Discussion: This study will examine whether BFO and telehealth support, when delivered as an adjunct to standard SUD interventions, improves outcomes for services users receiving NHS SUD treatment. Findings from the study will be used to inform both developments to the BFO program and guidance around augmenting the delivery of CAT programs via telehealth. Trial registration registered with ISRCTN on 25th May 2021—registration number: 13694016. Protocol version: 3.0 05th April 2022. Trial status: This trial is currently open to recruitment—estimated to be completed in May 2023. [ABSTRACT FROM AUTHOR]

Background: In order to conduct research that is meaningful to speech and language therapy services and their patients, it is often desirable to conduct the research within routine clinical services. This can require considerable time and commitment from speech and language therapists (SLTs). It is therefore important to understand the impact that such participation in research can have. Aims: To explore the impact of research participation in the Big CACTUS study of self‐managed computerized aphasia therapy conducted in 21 UK NHS speech and language therapy departments. Methods & Procedures: An online survey was sent to SLTs who took the lead role for the study at their NHS Trust to evaluate the impact of study participation in three domains: capacity‐building, research development and health services. The questionnaire, based on the VICTOR framework for evaluating research impact, included Likert scale statements and closed and open‐ended questions. The results from open‐ended questions were coded and analysed using framework analysis in NVivo 12 and the data from closed questions were analysed descriptively. Outcomes & Results: A total of 12 SLTs returned the survey. Nine codes were identified from open‐ended questions and 20 predefined from the literature. Analysis of the responses demonstrated the perceived impact including improvements in practices and access to therapy, investments in infrastructure, increased SLT profile, and impact on research culture among SLTs. The usefulness of the intervention during the COVID‐19 pandemic was also highlighted. Conclusions & Implications: The results suggest participation in Big CACTUS has resulted in improvements in patient care and SLT research capacity and culture in speech and language therapy departments. What This Paper Adds: What is already known on the subject: Practice‐based research is encouraged to assist with the clinical relevance of the research findings. Participation in research can be seen as an activity that is additional to the core business of patient care and it can be difficult to secure time to participate or conduct research in clinical settings. Impact evaluation initiatives of individual trials facilitate early identification of benefits beyond the trial. What this paper adds to existing knowledge: This study describes specific examples of the impact on services, staff and patients from SLT participation and leadership in the Big CACTUS speech and language therapy trial in clinical settings. What are the potential or actual clinical implications of this study?: Clinical services participating in research may benefit from improved clinical care for patients both during and after the study, an improved professional reputation, and increased research capacity and culture within the clinical settings. [ABSTRACT FROM AUTHOR]

Difficulty in emotion expression and recognition is typical of the personality trait known as alexithymia, which is often observed in persons with neurodevelopmental disorders (NDD). Past research has investigated various forms of conversational technology for people with NDD, but only a few studies have explored the use of conversational agents to reduce alexithymia. This paper presents Emoty, a speech-based conversational agent designed for people with NDD to train emotional communication skills. An original characteristic of this agent is that it exploits the emotional expression power of the voice. Emoty engages users in small conversations during which they are asked to repeat sentences and express specific emotions using the appropriate vocal tone. We ran an empirical study to evaluate the usability and effectiveness of our conversational agent. The study involved 19 Italian individuals with NDD and alexithymia aged from 29 to 45 (10 women and 9 men). They used Emoty in five individual sessions over two and a half months. The results showed that two subjects encountered problems using the system because they had difficulty verbalizing the sentences and were not understood by Emoty. The others performed the assigned tasks with the agent. Their capability to express emotions with the voice consistently improved, and other benefits were observed in other social and communication skills. [ABSTRACT FROM AUTHOR]

A special challenge in the neuropsychological rehabilitation of adult patients with acquired brain injury is therapy in disorders of the executive (or supervisory) system. This is mainly due to the broad meaning of this term, including functions from the highest, prefrontal level of hierarchical cerebral regulation, and the lack of professionally-prepared therapeutic programs for this diverse group of patients. In the article, the authors present ExeSystem - the first Polish computer program containing tasks to be used in the rehabilitation of patients with executive dysfunctions. These tasks are primarily functional, involving the executive aspects of attention, working memory, the ability to plan complex actions, learning to remember effectively and the social aspects of behaviour. Apart from therapeutic applications, the program may facilitate scientific research on the effectiveness of neuropsychological rehabilitation and the development of its standards. The authors also present preliminary data on the usefulness of the ExeSystem in rehabilitation based on the opinions of neuropsychologists implementing the program and patients undergoing therapy.

Background: Studies on guided internet-delivered treatment have demonstrated promising results for patients with depressive disorder. Objective: The aim of this study was to provide an overview of this research area and identify potential gaps in the research. Methods: In this scoping review, web-based databases were used to identify research papers published between 2010 and 2022 where guided internet-delivered treatment was administered to participants with depressive disorders, a standardized rating scale of depressive symptoms was used as the primary outcome measure, and the treatment was compared with a control condition. Results: A total of 111 studies were included, and an overview of the studies was provided. Several gaps in the research were identified regarding the design of the studies, treatments delivered, participant representation, and treatment completion. Conclusions: This review provides a comprehensive overview of the research area, and several research gaps were identified. The use of other designs and active control conditions is recommended. Future studies should provide access to treatment manuals, and more replications should be conducted. Researchers should aim to include underrepresented populations and provide reports of comorbidities. Definitions of adequate dosage, reports of completion rates, and reasons for treatment dropout are recommended for future studies. [ABSTRACT FROM AUTHOR]

Abstract Background Conventional static computer-assisted implant surgery (s-CAIS) requires special equipment, such as 3D printers or computer numerical control (CNC) lathes. We present a low-cost workflow for manufacturing dental implant guides based on tetrahedron positioning technology (TPT). The aim of this case report was to use a surgical guide technique for dental implant placement using tetrahedron positioning technology. Case presentation A 28-year-old man consulted for the treatment of a missing right first mandibular molar by implant placement. The cone-beam computed tomography (CBCT) data were imported into medical image processing software for analysis, and the implant design was simulated. The implant design on CBCT was transferred to the mandibular model using TPT, and the implant surgical guide was made to guide the dental implant operation. CBCT was performed postoperatively and compared with the preoperative design to check the accuracy. The central deviation of the implant head was 0.31 mm, the central deviation of the implant apex was 0.93 mm, and the implant angular deviation was 2.45°. Conclusion The use of tetrahedral positioning technology based on CBCT data is a new method for making implant guides. It is a promising technique offering a highly predictable outcome and lower risk of iatrogenic damage. However, these results should be interpreted with care since they are based on limited evidence from a case report. Larger population studies with longer follow-up periods and standardized experimental studies are required.

To explore the effect of complexity and feedback on script training outcomes in aphasia Randomized balanced single-blind 2 × 2 factorial design. Freestanding urban rehabilitation hospital. Adults with fluent and nonfluent aphasia (at least 6 months post onset). Experimental treatment was AphasiaScripts, a computer-based script training program. Scripts were 10-turns long and developed at different complexity levels to allow for comparison of high vs low complexity. The program was modified to contrast high vs low feedback conditions during sentence practice. Participants were instructed to practice three 30-minute sessions per day, 6 days per week for 3 weeks. Gains achieved from baseline in accuracy and rate of production of trained and untrained script sentences at post treatment and at 3-, 6-, and 12-weeks after the end of treatment. Sixteen participants completed the intervention. On the trained script, gains were statistically significant for both accuracy and words per minute at post treatment and 3-, 6-, and 12-week maintenance. Gains on the untrained script were smaller than on the trained script; they were statistically significant only for accuracy at post treatment and 3-week maintenance. Complexity had an influence on accuracy at post-treatment (F 1 =4.8391, P =.0501) and at maintenance (F 1 =5.3391, P =.0413). Practicing scripts with high complexity increased accuracy by 11.33% at post treatment and by 9.90% at maintenance compared with scripts with low complexity. Participants with nonfluent aphasia made greater gains than those with fluent aphasia. There was no significant effect of feedback. This study reinforces script training as a treatment option for aphasia. Results highlight the use of more complex scripts to better promote acquisition and maintenance of script production skills. There is a need for further investigation of these variables with larger samples and with other types of aphasia treatments. [ABSTRACT FROM AUTHOR]

The most contemporary approach when dealing with extensive head and neck defects post oncological resections is based on virtual computer planning, surgical resection/reconstruction simulation and three dimensional modeling and printing. It is of great benefit, particularly when the maxillo-mandibular area is involved, because of its complex three dimensional form and active functional load, both these features presenting a long-standing reconstructive challenge to the head and neck surgeons. Developing such complex surgical techniques is a very resource dependent undertaking and relies substantially on a strategic support from the given National Health Service system. An overview of the first 3 consecutive cases of entirely digitally planned and lab-to-theatre transferred mandibular resections and simultaneous microvascular fibula flap reconstructions performed in Sofia between August – October 2017 is presented.

Background: The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. Objective: To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions. Methods: We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. Results: Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence. Conclusions: Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions. [ABSTRACT FROM AUTHOR]

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Background: DIALOG+ is a patient-centred, solution-focused intervention, which aims to make routine patient-clinician meetings therapeutically effective. Existing evidence suggests that it is effective for patients with psychotic disorders in high-income countries. We tested the effectiveness of DIALOG ​+ ​for patients with depressive and anxiety disorders in Bosnia and Herzegovina, a middle-income country. Methods: We conducted a parallel-group, cluster randomised controlled trial of DIALOG+ in an outpatient clinic in Sarajevo. Patients inclusion criteria were: 18 years and older, a diagnosis of depressive or anxiety disorders, and low quality of life. Clinicians and their patients were randomly allocated to either the DIALOG ​+ ​intervention or routine care in a 1:1 ratio. The primary outcome, quality of life, and secondary outcomes, psychiatric symptoms and objective social outcomes, were measured at 6- and 12-months by blinded assessors. Results: Fifteen clinicians and 72 patients were randomised. Loss to follow-up was 12% at 6-months and 19% at 12-months. Quality of life did not significantly differ between intervention and control group after six months, but patients receiving DIALOG ​+ ​had significantly better quality of life after 12 months, with a medium effect size (Cohen's d ​= ​0.632, p ​= ​0.007). General symptoms as well as specifically anxiety and depression symptoms were significantly lower after six and 12 months, and the objective social situation showed a statistical trend after 12 months, all in favour of the intervention group. No adverse events were reported. Limitations: Delivery of the intervention was variable and COVID-19 affected 12-month follow-up assessments in both groups. Conclusion: The findings suggest DIALOG ​+ ​could be an effective treatment option for improving quality of life and reducing psychiatric symptoms in patients with depressive and anxiety disorders in a low-resource setting.

Background: Digital interventions can be tailored to the individual and allow automated collection of data. Computer-assisted therapy program 'Breaking Free Online' (BFO) is delivered within 'Change Grow Live' (CGL) services to support people in recovery from substance misuse. This paper reports baseline data from 5792 participants engaging with BFO at CGL, and post-treatment outcomes from 1489 (26%), and describes how baseline characteristics and BFO engagement were associated with outcomes. Methods: Participants completed a baseline assessment, engaged with BFO and completed a post-treatment assessment. Wilcoxon tests examined changes from baseline to post-treatment and linear regression examined associations between baseline service user characteristics, BFO engagement and outcomes. Results: Participants who did not provide post-treatment data had more severe mental health and biopsychosocial impairment at baseline. Outcomes were associated with baseline characteristics including substance use and dependence, biopsychosocial impairment, age and BFO engagement. Outcomes were significantly positively associated with the number of techniques in BFO completed, indicating a 'dose-response'. Conclusions: Findings indicate positive outcomes for CGL service users who engaged with BFO through to post-treatment outcomes assessment stage. Stratifying BFO to those most likely to engage may improve treatment outcomes. Some groups may benefit from receiving BFO as 'computer-assisted therapy' with Practitioner support. [ABSTRACT FROM AUTHOR]

Momentary intervention has been proposed as a cost-effective, generalizable, and ecologically valid method to increase the efficiency of face-to-face cognitive-behavioral therapy (CBT). The purpose of the current pilot study was to evaluate the efficacy of a six-session palmtop computer-assisted Group CBT for generalized anxiety disorder (GAD) (CAGT6) in comparison with a six-session Group CBT for GAD without the computer (CBGT6) and typical (12 session) Group CBT for GAD (CBGT12) in a randomized controlled trial. Thirty-four individuals with a primary diagnosis of GAD were randomized to one of the three conditions and completed measures of GAD and anxiety before therapy, after therapy, and at 6-, and 12-month follow-ups. Results indicated that CAGT6 was superior to CBGT6 at posttreatment, but not significantly different from CBGT12. At 6- and 12-month follow-ups, CAGT6 was neither significantly different from CBGT6, nor from CBGT12. Percentages of individuals achieving reliable change on two of the three GAD measures favored CAGT6 over CBGT6 at posttreatment, suggesting promise for the added value of the mobile technology.

Background: Conventional static computer-assisted implant surgery (s-CAIS) requires special equipment, such as 3D printers or computer numerical control (CNC) lathes. We present a low-cost workflow for manufacturing dental implant guides based on tetrahedron positioning technology (TPT). The aim of this case report was to use a surgical guide technique for dental implant placement using tetrahedron positioning technology. Case presentation: A 28-year-old man consulted for the treatment of a missing right first mandibular molar by implant placement. The cone-beam computed tomography (CBCT) data were imported into medical image processing software for analysis, and the implant design was simulated. The implant design on CBCT was transferred to the mandibular model using TPT, and the implant surgical guide was made to guide the dental implant operation. CBCT was performed postoperatively and compared with the preoperative design to check the accuracy. The central deviation of the implant head was 0.31 mm, the central deviation of the implant apex was 0.93 mm, and the implant angular deviation was 2.45°. Conclusion: The use of tetrahedral positioning technology based on CBCT data is a new method for making implant guides. It is a promising technique offering a highly predictable outcome and lower risk of iatrogenic damage. However, these results should be interpreted with care since they are based on limited evidence from a case report. Larger population studies with longer follow-up periods and standardized experimental studies are required. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the effectiveness of a Computer-based Cognitive Behavioral Therapy (CCBT) and identify the characteristics of depressed adolescents that participated in the CCBT program.Methods: Screening tests for depression and help-seeking variables were conducted in school-aged Korean adolescents (n= 376, mean age=15.71 years, 53.7% female). The number of adolescents that scored above the threshold for mild depression (PHQ-9, CES-D) was 139. Fifty adolescents agreed to participate in the randomized controlled trial (RCT) of CCBT program. Twenty-five adolescents were randomly assigned to the treatment group, and the other 25 to the waitlist control group. The treatment group engaged in CCBT with therapeutic support. To identify variables affecting the outcomes, the quality of their homework compliance also was assessed.Results: Participants (n=50) who agreed to participate in the CCBT program demonstrated different help-seeking attitudes - a greater recognition of the need for help and lower interpersonal openness - compared to the adolescents (n=87) who did not participate (t = -2.93, p < .01; t = 3.50, p < .001). The treatment group showed significant improvements in depression, self-esteem, and quality of life compared to the waitlist group. Adolescents with high homework compliance showed a significant decrease in the depression scores compared to adolescents with low homework compliance.Limitations: Small sample size, no follow-up assessments.Conclusion: CCBT could be an effective alternative for depressed adolescents, especially those who tend to have low interpersonal openness. To improve the effects of CCBT, therapeutic support needs to be provided. [ABSTRACT FROM AUTHOR]

Abstract Background Substance misuse, including problematic drug and alcohol use, are significant issues in society that can have multiple detrimental effects. Many people access support for their substance misuse during prison sentences, due to the associations between substance misuse and offending, and the high proportion of the prison population who have drug and alcohol issues. Breaking Free Online Health and Justice is a computer-assisted therapy program that has been developed to support substance-involved offenders to address their substance misuse and associated offending within prison settings. Methods This will be a parallel-group randomized controlled trial of 4-week Breaking Free Online Health and Justice program as an adjunct to standard treatment for substance misuse, in comparison to standard treatment only, in a male Category D open prison. Interventional and control groups will be compared in terms of the changes in their scores on multiple measures from baseline to post-treatment assessment at 4-weeks, and then 3- and 6-months follow-up. Participants will be adult male offenders serving sentences in prison in England who have demonstrable difficulties with drugs and/or alcohol for at least the past 12-months. The primary outcome measure will be self-reported substance misuse, with secondary outcomes being standardized psychometric assessments of substance dependence, mental health, biopsychosocial functioning, quality of life and post-release offending. Other secondary measures will include frequency of completion of specific intervention strategies in the program. Discussion This study will examine whether Breaking Free Online Health and Justice as an adjunct to standard substance misuse interventions in prisons, improves outcomes for substance-involved offenders receiving interventions in custodial settings. Findings from the study will be used to inform further developments of the program and potential improvements to custodial treatment. Trials registration ISRCTN09846981.