Višnja Katić

Dynamic Consent: a potential solution to some of the challenges of modern biomedical research.

BackgroundInnovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment.MethodsAn interdisciplinary workshop jointly organised by the University of Oxford and the COST Action CHIP ME gathered clinicians, researchers, ethicists, lawyers, research participants and patient representatives to discuss experiences of using Dynamic Consent, and how such use may facilitate the conduct of specific research tasks. The data collected during the workshop were analysed using a content analysis approach.ResultsDynamic Consent can provide practical, sustainable and future-proof solutions to challenges related to participant recruitment, the attainment of informed consent, participant retention and consent management, and may bring economic efficiencies.ConclusionsDynamic Consent offers opportunities for ongoing communication between researchers and research participants that can positively impact research. Dynamic Consent supports inter-sector, cross-border approaches and large scale data-sharing. Whilst it is relatively easy to set up and maintain, its implementation will require that researchers re-consider their relationship with research participants and adopt new procedures.

Influence of surface layer on mechanical and corrosion properties of nickel-titanium orthodontic wires

OBJECTIVE To analyze the effect of various coating formulations on the mechanical and corrosion properties of nickel-titanium (NiTi) orthodontic wires. MATERIALS AND METHODS Uncoated, rhodium-coated, and nitrified NiTi wires were observed with a three-point-bend test, surface roughness (Ra) measurement, scanning electron microscopy, energy dispersive spectroscopy, and electrochemical testing (open circuit potential, electrochemical impedance spectroscopy, and cyclic polarization scan). Differences in the properties of tested wire types were analyzed with analysis of variance and Tukey post hoc test. RESULTS Uncoated and nitrified NiTi wires showed similar mechanical and anticorrosive properties, while rhodium-coated NiTi wires showed the highest Ra and significantly higher modulus of elasticity, yield strength, and delivery of forces during loading but not in unloading. Rhodium-coated NiTi wires also had the highest corrosion current density and corrosion potential, lowest impedance modulus, and two time constants on Bode plot, one related to the Rh/Au coating and the other to underlying NiTi. CONCLUSION Working properties of NiTi wires were unaffected by various coatings in unloading. Nitrification improved corrosion resistance. Rhodium coating reduced corrosion resistance and pronounced susceptibility to pitting corrosion in artificial saliva because of galvanic coupling between the noble coating and the base alloy.

Geometrical design characteristics of orthodontic mini-implants predicting maximum insertion torque

Objective To determine the unique contribution of geometrical design characteristics of orthodontic mini-implants on maximum insertion torque while controlling for the influence of cortical bone thickness. Methods Total number of 100 cylindrical orthodontic mini-implants was used. Geometrical design characteristics of ten specimens of ten types of cylindrical self-drilling orthodontic mini-implants (Ortho Easy®, Aarhus, and Dual Top™) with diameters ranging from 1.4 to 2.0 mm and lengths of 6 and 8 mm were measured. Maximum insertion torque was recorded during manual insertion of mini-implants into bone samples. Cortical bone thickness was measured. Retrieved data were analyzed in a multiple regression model. Results Significant predictors for higher maximum insertion torque included larger outer diameter of implant, higher lead angle of thread, and thicker cortical bone, and their unique contribution to maximum insertion torque was 12.3%, 10.7%, and 24.7%, respectively. Conclusions The maximum insertion torque values are best controlled by choosing an implant diameter and lead angle according to the assessed thickness of cortical bone.

Feedback of Individual Genetic Results to Research Participants: Is It Feasible in Europe?

Background: There is growing consensus that individual genetic research results that are scientifically robust, analytically valid, and clinically actionable should be offered to research participants. However, the general practice in European research projects is that results are usually not provided to research participants for many reasons. This article reports on the views of European experts and scholars who are members of the European COST Action CHIP ME IS1303 (Citizens Health through public-private Initiatives: Public health, Market and Ethical perspectives) regarding challenges to the feedback of individual genetic results to research participants in Europe and potential strategies to address these challenges. Materials and Methods: A consultation of the COST Action members was conducted through an email survey and a workshop. The results from the consultation were analyzed following a conventional content analysis approach. Results: Legal frameworks, professional guidelines, and financial, organizational, and human resources to support the feedback of results are largely missing in Europe. Necessary steps to facilitate the feedback process include clarifying legal requirements to the feedback of results, developing harmonized European best practices, promoting interdisciplinary and cross-institutional collaboration, designing educational programs and cost-efficient IT-based platforms, involving research ethics committees, and documenting the health benefits and risks of the feedback process. Conclusions: Coordinated efforts at pan-European level are needed to enable equitable, scientifically sound, and socially robust feedback of results to research participants.

Effect of pH, fluoride and hydrofluoric acid concentration on ion release from NiTi wires with various coatings

Aim was to determine effect of pH, fluoride (F-) and hydrofluoric acid concentration (HF) on dynamic of nickel (Ni2+) and titanium (Ti4+) ions release. Nickel-titanium wires with untreated surface (NiTi), rhodium (RhNiTi) and nitride (NNiTi) coating were immersed once a week for five min in remineralizing agents, followed by immersion to artificial saliva. Ion release was recorded after 3, 7, 14, 21 and 28 days. Pearson correlations and linear regression were used for statistical analysis. Release of Ni2+ from NiTi and NNiTi wires correlated highly linearly positively with HF (r=0.948 and 0.940, respectively); for RhNiTi the correlation was lower and negative (r=-0.605; p<0.05). The prediction of Ti4+ release was significant for NiTi (r=0.797) and NNiTi (r=0.788; p<0.05) wire. Association with F- was lower; for pH it was not significant. HF predicts the release of ions from the NiTi wires better than the pH and F- of the prophylactic agents.

Initial Results of Multilevel Principal Components Analysis of Facial Shape

Traditionally, active shape models (ASMs) do not make a distinction between groups in the subject population and they rely on methods such as (single-level) principal components analysis (PCA). Multilevel principal components analysis (mPCA) allows one to model between-group effects and within-group effects explicitly. Three dimensional (3D) laser scans were taken from 250 subjects (38 Croatian female, 35 Croatian male, 40 English female, 40 English male, 23 Welsh female, 27 Welsh male, 23 Finnish female, and 24 Finnish male) and 21 landmark points were created subsequently for each scan. After Procrustes transformation, eigenvalues from mPCA and from single-level PCA based on these points were examined. mPCA indicated that the first two eigenvalues of largest magnitude related to within-groups components, but that the next eigenvalue of largest magnitude related to between-groups components. Eigenvalues from single-level PCA always had a larger magnitude than either within-group or between-group eigenvectors at equivalent eigenvalue number. An examination of the first mode of variation indicated possible mixing of between-group and within-group effects in single-level PCA. Component scores for mPCA indicated clustering with country and gender for the between-groups components (as expected), but not for the within-group terms (also as expected). Clustering of component scores for single-level PCA was harder to resolve. In conclusion, mPCA is viable method of forming shape models that offers distinct advantages over single-level PCA when groups occur naturally in the subject population.

Influence of various fluoride agents on working properties and surface characteristics of uncoated, rhodium coated and nitrified nickel-titanium orthodontic wires

Abstract Objective. To analyze the effect of various fluoride formulations in commercially available agents on working properties of various nickel-titanium orthodontic wires. Materials and methods. Uncoated (NiTi), rhodium coated (RhNiTi) and nitrified (NNiTi) wires were immersed to dH2O, MiPaste, Elmex and Mirafluor for 1 h. Unloading slope characteristics (average force, bending action of the force and average plateau length) and the percentage of useable constant force during unloading were observed. Surface roughness (Ra) was measured. SEM and EDS were used for observation of the surface. Results. NiTi had decreased loading and unloading elastic modulus (E) and yield strength (YS) after immersion to MIPaste and Mirafluor. The unloading YS decreased in the RhNiTi by the MIPaste. The loading and unloading YS of the NNiTi increased in Elmex and increased average plateau force. RhNiTi showed higher average plateau length and the percentage of useful constant force during unloading in Mirafluor and the average plateau force lowered after immersion to MIPaste. The unloading slope characteristics for NiTi were affected by all three prophylactic agents, mostly by Mirafluor, and produced significantly lower forces during both loading and unloading, similarly to the NNiTi wires. The RhNiTi had the lowest forces during both loading and unloading in MIPaste. All results were at significance; p < 0.05. Difference in Ra was observed for RhNiTi after immersion to the MI Paste (p < 0.001; η2 = 0.761). Conclusion. The NiTi and NNiTi wires lose less working force when combined with Elmex. The RhNiTi improve their working properties with Mirafluor and deteriorate when combined with MiPaste.

Comparison of Activator-Headgear and Twin Block Treatment Approaches in Class II Division 1 Malocclusion

The purpose was to compare the treatment effects of functional appliances activator-headgear (AH) and Twin Block (TB) on skeletal, dental, and soft-tissue structures in class II division 1 malocclusion with normal growth changes in untreated subjects. The sample included 50 subjects (56% females) aged 8–13 years with class II division 1 malocclusion treated with either AH (n = 25) or TB (n = 25) appliances. Pre- and posttreatment lateral cephalograms were evaluated and compared to 50 untreated class II division 1 cases matched by age, gender, ANB angle, and skeletal maturity. A paired sample, independent samples tests and discriminant analysis were performed for intra- and intergroup analysis. Treatment with both appliances resulted in significant reduction of skeletal and soft-tissue facial convexity, the overjet, and the prominence of the upper lip in comparison to untreated individuals (p < 0.001). Retroclination of maxillary incisors and proclination of mandibular incisors were seen, the latter being significantly more evident in the TB group (p < 0.05). Increase of effective mandibular length was more pronounced in the TB group. In conclusion, both AH and TB appliances contributed successfully to the correction of class II division 1 malocclusion when compared to the untreated subjects with predominantly dentoalveolar changes.

Mediation and moderation effect of the big five personality traits on the relationship between self-perceived malocclusion and psychosocial impact of dental esthetics

OBJECTIVE To explore the mediation and moderation effects of personality traits on the relationship between self-perceived malocclusion and the psychosocial impact of dental esthetics. MATERIALS AND METHODS The sample included 252 subjects (62% female) aged 12-39 years. Self-perceived malocclusion was estimated using the 10-point scale Aesthetic Component of the Index of Orthodontic Treatment Need. The Psychosocial Impact of Dental Aesthetics Questionnaire was used to assess the psychological impact and the Big Five Inventory for personality traits. Moderation and mediation effects were evaluated with Pearson correlations and stepwise regression analysis, respectively. RESULTS Self-perceived malocclusion ranged from 1 to 8 and was the most significant predictor of psychosocial impact of dental esthetics, whose unique contribution accounted for 11%-36.4% of variability, while age and sex accounted for 1.2%-2.5%. Personality traits had no mediating effect on this relationship. The moderating effect of agreeableness was present in the relationship between self-perceived degree of malocclusion and Social Impact (SI), Psychological Impact (PI), and Aesthetic Concern (AC) (ΔR2  =  0.035, 0.020, and 0.013, respectively; P < .001), while conscientiousness affected the relationship between perception of malocclusion and SI and PI (ΔR2  =  0.018 and 0.016, respectively; P < .05). In people with lower agreeableness and conscientiousness, increasing the severity of self-perceived malocclusion leads to less increase in SI and PI. In people with lower agreeableness, the increase influences AC in a similar manner. Extraversion, neuroticism, and openness do not have a moderating effect. CONCLUSIONS The relationship between self-perceived malocclusion and the psychosocial impact of dental esthetics appears to be moderated and not mediated by personality traits. Adolescents and young adults with lower agreeableness and conscientiousness seem to be less affected by the increased severity of self-perceived malocclusion, as demonstrated in reporting some psychosocial impacts.

Correlation between the DAI and ICON indices used for assessment of orthodontic treatment need in Croatian schoolchildren

Abstract Introduction The aims were: evaluation of the correlation between the Dental Aesthetic Index (DAI) and Index of Complexity, Outcome and Need (ICON); the assessment of orthodontic treatment need for schoolchildren in a population with two indices, separately for schoolchildren with mixed and permanent dentition; the estimation of the population share that could not receive orthodontic treatment because of the presence of caries and/or gingivitis. Methods A total of 2652 Zagreb school children (7 - 19 years old, 52.4% of them were females) completed a questionnaire regarding previous orthodontic treatment and the type of appliance used. Their oral cavity was also inspected. The DAI and ICON indices were used for the assessment of malocclusion prevalence. Results The subjects with mixed dentition had a greater need for orthodontic treatment, when compared to subjects with permanent dentition, when using the DAI index (p<0.001). When using the ICON index, 11.7% of subjects with mixed dentition had very severe malocclusion, as opposed to 5.8% of subjects with permanent dentition. The DAI and ICON scores correlated positively linearly (r=0.521; p<0.001). A higher prevalence of both gingivitis and caries was recorded more often in boys; caries more often in the group with the mixed dentition, and gingivitis in the group with permanent dentition (p<0.05). Conclusion The DAI and ICON indices have moderate agreement in assessment of malocclusion severity scores. One third of all schoolchildren with various degrees of both ICON and DAI indices have gingivitis, and half of them have caries.