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When patients lose the capacity to make their own decisions, current practice relies on their family and loved ones to try to identify the treatment course the patient would have chosen for themselves. The fact that this approach has remained essentially unchanged for over 40 years raises the question of whether it successfully provides care that is consistent with patients' treatment preferences.

Published studies on the outcomes and impact of surrogate decision-making.

All identified articles.

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Surrogates frequently are not able to identify the treatment preferences of decisionally incapacitated patients and can experience significant distress as a result of making decisions for them.

Revisions to existing practice are needed to increase the extent to which surrogates are able to identify the treatment preferences of decisionally incapacitated patients. One possibility is to assess whether predicting patients' treatment preferences based on the preferences of similar patients might increase the extent to which patients are treated consistent with their preferences and thereby reduce the burden on their surrogates.

Revisions to existing practice are needed to increase the extent to which surrogates are able to identify the treatment preferences of decisionally incapacitated patients. One possibility is to assess whether predicting patients' treatment preferences based on the preferences of similar patients might increase the extent to which patients are treated consistent with their preferences and thereby reduce the burden on their surrogates.

The present study aimed to analyze in a Spanish population sample the compliance of the anterior maxillary teeth to the dental esthetic proportions described in the literature.

Photographs of the smiles of 78 individuals were calibrated and digitally analyzed considering the following proportions golden proportion (GP), recurring esthetic dental (RED), golden percentage (GPG), Preston's proportion and Modified golden percentage (MGPG). For statistical analysis, the t-test of an independent sample was applied, and compliance percentages for each standard were recorded.

The existence of RED 70% or 80% has not been registered. The percentages of compliance with GP were within a range between 0% and 16%. The mean tooth width ratios were adjusted to the values described by Preston (P > 0.05), but the compliance percentages were low (3.33-25%). GPG only presented high percentages of compliance in the lateral incisors (53.33-62.5%). MGPG showed the highest percentages of compliance (50-68%).

After analyzing a Spanish population sample using smile photographs for the first time, GP, RED, GPG and Preston's proportion standards are not fulfilled and therefore, not suitable for treatments that seek a smile that reproduces natural principles. However, the values designated by MGPG with a deviation of ±1% are largely applicable for treatments that aim for a natural smile.

After analyzing a Spanish population sample using smile photographs for the first time, GP, RED, GPG and Preston's proportion standards are not fulfilled and therefore, not suitable for treatments that seek a smile that reproduces natural principles. However, the values designated by MGPG with a deviation of ±1% are largely applicable for treatments that aim for a natural smile.

Many studies of tooth dimensions have reported both diversity among populations and sexual dimorphism. This study aimed to collect data on mesiodistal dimensions and sexual dimorphism of permanent teeth of contemporary Western Australian adolescents.

The mesiodistal dimensions of teeth from 500 adolescents (177 males, 323 females; age, 13-18 years) were obtained from pre-orthodontic treatment digital dental records of examinations using Invisalign technology. Differences between contralateral teeth and sexual dimorphism were analyzed by using SPSS.

Mesiodistal dimensions significantly differed between right and left teeth in both sexes. Males had larger teeth than females, and the difference was significant for most teeth. Reverse dimorphism (females had slightly larger teeth than males) was observed for the maxillary second premolar. Mandibular canines exhibited the greatest dimorphism. In addition, secular trends-specifically, a reduction in the degree of dimorphism-were observed in mesiodistal dimensions.

Mesiodistal dimensions significantly differed between teeth in contralateral quadrants, in both arches. Most teeth exhibited sexual dimorphism, which was the greatest for permanent mandibular canines. Dimorphism was less obvious in this population than in other populations.

Mesiodistal dimensions significantly differed between teeth in contralateral quadrants, in both arches. Most teeth exhibited sexual dimorphism, which was the greatest for permanent mandibular canines. U18666A Dimorphism was less obvious in this population than in other populations.

Recent studies suggest that cumulative exposure to low-density lipoprotein-cholesterol (LDL-C) leads to the development of atherosclerotic cardiovascular disease (ASCVD). However, few studies have investigated whether this link extends to individuals with familial hypercholesterolemia (FH), a relevant patient population.Methods and ResultsWe retrospectively investigated the health records of 1,050 patients with clinical FH diagnosis between April 1990 and March 2019. We used Cox proportional hazards models adjusted for established ASCVD risk factors to assess the association between cholesterol-year-score and major adverse cardiovascular events (MACEs), including death from any cause or hospitalization due to ASCVD events. Cholesterol-year-score was calculated as LDL-C max × [age at diagnosis/statin initiation] + LDL-C at inclusion × [age at inclusion - age at diagnosis/statin initiation]. The median follow-up period for MACE evaluation was 12.3 (interquartile range, 9.1-17.5) years, and 177 patients experienced MACEs during the observation period. Cholesterol-year-score was significantly associated with MACEs (hazard ratio, 1.35; 95% confidence interval, 1.07-1.53; P=0.0034, per 1,000 mg-year/dL), independent of other traditional risk factors including age and LDL-C, based on cross-sectional assessment. Cholesterol-year-score improved the discrimination ability of other traditional risk factors for ASCVD events (C-index, 0.901 vs. 0.889; P=0.00473).

Cumulative LDL-C exposure was strongly associated with MACEs in Japanese patients with FH, warranting early diagnosis and treatment initiation in these patients.

Cumulative LDL-C exposure was strongly associated with MACEs in Japanese patients with FH, warranting early diagnosis and treatment initiation in these patients.