Alfordchappell5205

all significant differences between the intervention and control groups were not observed, high adherence rates to health promotion interventions may improve effectiveness and outcomes in children. Reintervention strategies may be required at multiple stages to induce sustained health promotion effects (Salud Integral Colombia [SI! Colombia II]; NCT03119792). BACKGROUND Given the shortage of cardiac rehabilitation (CR) programs in India and poor uptake worldwide, there is an urgent need to find alternative models of CR that are inexpensive and may offer choice to subgroups with poor uptake (e.g., women and elderly). OBJECTIVES This study sought to evaluate the effects of yoga-based CR (Yoga-CaRe) on major cardiovascular events and self-rated health in a multicenter randomized controlled trial. METHODS The trial was conducted in 24 medical centers across India. This study recruited 3,959 patients with acute myocardial infarction with a median and minimum follow-up of 22 and 6 months. Patients were individually randomized to receive either a Yoga-CaRe program (n = 1,970) or enhanced standard care involving educational advice (n = 1,989). The co-primary outcomes were 1) first occurrence of major adverse cardiovascular events (MACE) (composite of all-cause mortality, myocardial infarction, stroke, or emergency cardiovascular hospitalization); and 2) self-rated health amme in India and United Kingdom; CTRI/2012/02/002408). BACKGROUND An inverse association between cardiorespiratory fitness and mortality was robustly demonstrated 3 decades ago. OBJECTIVES The purpose of this study was to determine whether significant advances in disease prevention, detection, and treatment since that time have modified this association. METHODS A total of 47,862 men completed baseline examinations, including a maximal treadmill test. Cohort 1 (n = 24,475) was examined during 1971 to 1991 and followed for mortality through 1992. Cohort 2 (n = 23,387) was examined during 1992 to 2013 with follow-up through 2014. Men were categorized as low fit, moderate fit, or high fit using Cooper Clinic normative data. Hazard ratios (HRs) for all-cause, cardiovascular disease, and cancer mortality were determined across fitness categories in the 2 cohorts. RESULTS A significant inverse trend between fitness categories and all-cause (HR 1.0, 0.60, and 0.53 in cohort 1 and HR 1.0, 0.76, and 0.52 in cohort 2) and cardiovascular disease mortality (HR 1.0, 0.55, and 0.43 in cohort 1 and HR 1.0, 0.84, and 0.52 in cohort 2) was observed (p trend  less then 0.001 for all). The trend across fitness categories and cancer mortality was significant for cohort 1 (HR 1.0, 0.62, and 0.48; p  less then  0.001), but not for cohort 2 (HR 1.0, 1.08, and 0.74; p = 0.19). HRs for all-cause mortality were 0.86 (95% confidence interval 0.82 to 0.90) and 0.87 (95% confidence interval 0.83 to 0.91) per 1-MET increment in fitness for cohorts 1 and 2, respectively (p  less then  0.001 for both). Similar values were seen for cardiovascular disease and cancer mortality. CONCLUSIONS Despite significant advances in disease prevention, detection, and treatment since fitness was first shown to be associated with mortality, the inverse association between fitness and mortality remains consistent in a contemporary cohort of men. BACKGROUND Current management of patients with atrial fibrillation (AF) is limited by low detection of AF, non-adherence to guidelines, and lack of consideration of patients' preferences, thus highlighting the need for a more holistic and integrated approach to AF management. OBJECTIVE The objective of this study was to determine whether a mobile health (mHealth) technology-supported AF integrated management strategy would reduce AF-related adverse events, compared with usual care. METHODS This is a cluster randomized trial of patients with AF older than 18 years of age who were enrolled in 40 cities in China. Recruitment began on June 1, 2018 and follow-up ended on August 16, 2019. Patients with AF were randomized to receive usual care, or integrated care based on a mobile AF Application (mAFA) incorporating the ABC (Atrial Fibrillation Better Care) Pathway A, Avoid stroke; B, Better symptom management; and C, Cardiovascular and other comorbidity risk reduction. The primary composite outcome was a composite or patients receiving the mAFA intervention compared with usual care (all p  less then  0.05). CONCLUSIONS An integrated care approach to holistic AF care, supported by mHealth technology, reduces the risks of rehospitalization and clinical adverse events. (Mobile Health [mHealth] technology integrating atrial fibrillation screening and ABC management approach trial; ChiCTR-OOC-17014138). Many treatment options are available to address the problem of missing second premolars. Extraction of retained deciduous second molars and subsequent space closure are often appropriate because this option alleviates the need for implants or other restorations. This article describes the conventional orthodontic closure of unilateral and bilateral congenitally missing second premolar spaces after the extraction of retained deciduous second molars. This case report illustrates the successful nonsurgical treatment of an adult with a skeletal Class III malocclusion exacerbated by a functional anterior shift that resulted in a severe overclosure of the mandible and a reverse smile line. To maximize the soft tissue and smile esthetics while idealizing the occlusion, active clockwise rotation of the mandible was induced along with mandibular molar uprighting and sequential leveling. In the maxilla, full arch distalization was achieved after second molar extraction. The treatment provided a satisfying esthetic and functional outcome and has remained stable. This case report describes the successful orthodontic treatment for a healthy woman with maxillary canine-premolar transposition associated with rare hypodontia of the contralateral canine. The treatment included extraction of the transposed maxillary right and deciduous maxillary left canines and 2 mandibular second premolars. The objectives of the treatment were to (1) correct the upper midline deviation and the occlusal plane cant, (2) move the maxillary first premolars into the canine position, (3) retract the mandibular incisors to improve the facial profile, and (4) reduce the labial protrusion. Orthodontic treatment was carried out with the lingual technique in the maxillary arch and esthetic ceramic brackets in the mandibular arch. The segmented mechanics were effective, fast, and consistently promoted the necessary movement without side effects. The smile line was improved, resulting in an ideal and esthetic gingival exposition, with the borders of the maxillary teeth following the lower lip smile curvature. The patient achieved ideal dentofacial esthetics, achieved better dental and functional occlusion, was pleased with her improved facial contour, and as a result, showed an improved self-image. INTRODUCTION This study aimed to evaluate whether viewing digital treatment simulations influenced orthodontic treatment planning decisions or practitioners' confidence in their selected plans. METHODS Records of 6 patients representing different case types (eg, missing teeth, crowding, sagittal discrepancies) were collected. A total of 22 orthodontists and 7 orthodontic residents viewed these records and formulated treatment plans for each case, indicating their most recommended plan and up to 2 alternative plans. After treatment planning each case, digital setups of each treatment plan indicated by the practitioner were shown. The practitioners were then asked if they still recommended their original plan, or if they would now recommend a different plan. Their confidence levels in the success of their plans were recorded before and after viewing the setups. RESULTS After viewing the digital setups, there was a significant change in the treatment plan for 9.2% of the cases. These included modifications like changing the extraction pattern or proposing space closure rather than opening space for an implant. In an additional 14.4% of the cases, treatment plans underwent partial changes, like adding interproximal reduction or temporary anchorage devices. Practitioner confidence levels increased after viewing the setups. In cases where the treatment plan changed, the practitioner's confidence level in the plan increased the most, and the final confidence level was uniformly high among all practitioners. Practitioners reported the most helpful features of digital setups were the ability to superimpose the setup with the original model, determine the amount of tooth movement needed, check the final incisal relationship (overjet and overbite), and establish the amount of interproximal reduction required. CONCLUSIONS Viewing digital setups resulted in changes to the treatment plans in about 24% of the cases. The use of digital setups was associated with higher levels of confidence in the selected plans. INTRODUCTION The purpose of this study was to evaluate the occlusal contact area and cast-radiograph evaluation (CRE) score changes in patients with 3 different retention protocols after a 1-year retention period. METHODS A total of 90 patients with acceptable final occlusion according to American Board of Orthodontics CRE were equally divided into 3 groups according to the retention protocol upper bonded retainer and lower Essix or bonded retainer (Essix group); upper bonded retainer and Hawley or lower bonded retainer (Hawley group); and upper bonded retainer and lower bonded retainer (bonded retainer group). Digital models were used to assess occlusal contact area changes after a 1-year retention period. The follow-up occlusion models were assessed with the American Board of Orthodontics CRE. RESULTS Occlusal contact areas increased significantly in the Hawley and bonded retainer groups for all teeth except incisors. The bonded retainer group showed the greatest amount of settling, but differences with the Hawley group were not statistically significant. However, statistically significant decreases in occlusal contact areas were recorded for the Essix group except for incisors. A decrease of CRE scores was seen in the Hawley group, whereas a statistically significant increase was recorded in the Essix group. CONCLUSIONS Both Hawley and bonded retainers allowed settling of the occlusion during the retention phase, whereas the Essix retainer did not allow relative vertical movement of the posterior teeth. The Hawley group showed improvement in the total CRE score, whereas the Essix group showed worsening. INTRODUCTION This study aimed to evaluate the factors that influence potential orthodontic patients choosing an orthodontist, general dentist, or direct-to-consumer (DTC) aligners for their treatment, and to determine the level of interest in each provider type. METHODS An electronic survey was administered to 249 adults among the general population in the United States to determine and evaluate the level of interest in pursuing orthodontic treatment with each provider type. RESULTS When asked their preference for provider type, 44% of respondents selected orthodontist, 34% selected DTC aligners, and 22% selected general dentist. Among respondents with the highest level of interest in pursuing orthodontic treatment, 50% selected orthodontist, and 27% selected DTC aligners (P = 0.002). For respondents with a moderate interest in pursuing treatment, only 21% selected orthodontist, and 48% selected DTC aligners (P = 0.002). The biggest perceived advantage of treatment with orthodontists was the quality of treatment, and for DTC aligners, it was convenience, followed by cost.