***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: During anticancer treatment , oral lesions considerably aggravate the child 's clinical condition and increase the risk of infection . This prospect i ve study evaluated the incidence , nature and chronology of oral complications arising during the first 6 weeks of chemotherapy .  131 children were included in this study , and their oral and dental health evaluated on enrolment . Each child was observed once a week , for 6 weeks . Fifty-two per cent ( 68/131 ) of the children presented with at least one oral lesion . Two oral healthcare regimens ( with or without tooth brushing ) were evaluated . Tooth brushing significantly reduced the number of children affected . St and ardised multicentre studies should permit the definition of oral care regimens which would eliminate pain and reduce the risk of infection in children hospitalised for cancer OBJECTIVES To assess the hypothesis that there is excessive reporting of statistically significant studies published in prosthodontic and implantology journals , which could indicate selective publication . METHODS The last 30 issues of 9 journals in prosthodontics and implant dentistry were h and - search ed for articles with statistical analyses . The percentages of significant and non-significant results were tabulated by parameter of interest . Univariable/multivariable logistic regression analyses were applied to identify possible predictors of reporting statistically significance findings . The results of this study were compared with similar studies in dentistry with r and om-effects meta-analyses . RESULTS From the 2323 included studies 71 % of them reported statistically significant results , with the significant results ranging from 47 % to 86 % . Multivariable modeling identified that geographical area and involvement of statistician were predictors of statistically significant results . Compared to interventional studies , the odds that in vitro and observational studies would report statistically significant results was increased by 1.20 times ( OR : 2.20 , 95 % CI : 1.66 - 2.92 ) and 0.35 times ( OR : 1.35 , 95 % CI : 1.05 - 1.73 ) , respectively . The probability of statistically significant results from r and omized controlled trials was significantly lower compared to various study design s ( difference : 30 % , 95 % CI : 11 - 49 % ) . Likewise the probability of statistically significant results in prosthodontics and implant dentistry was lower compared to other dental specialties , but this result did not reach statistical significant ( P>0.05 ) . CONCLUSIONS The majority of studies identified in the fields of prosthodontics and implant dentistry presented statistically significant results . The same trend existed in publications of other specialties in dentistry Background — Antibiotic prophylaxis recommendations for the prevention of infective endocarditis are based in part on studies of bacteremia from dental procedures , but toothbrushing may pose a greater threat . The purpose of this study was to compare the incidence , duration , nature , and magnitude of endocarditis-related bacteremia from single-tooth extraction and toothbrushing and to determine the impact of amoxicillin prophylaxis on single-tooth extraction . Methods and Results — In this double-blind , placebo-controlled study , 290 subjects were r and omized to ( 1 ) toothbrushing , ( 2 ) single-tooth extraction with amoxicillin prophylaxis , or ( 3 ) single-tooth extraction with identical placebo .  Blood was drawn for bacterial culturing and identification at 6 time points before , during , and after these interventions . The focus of our analysis was on bacterial species reported to cause infective endocarditis . We identified 98 bacterial species , 32 of which are reported to cause endocarditis . Cumulative incidence of endocarditis-related bacteria from all 6 blood draws was 23 % , 33 % , and 60 % for the toothbrushing , extraction -amoxicillin , and extraction -placebo groups , respectively ( P<0.0001 ) . Significant differences were identified among the 3 groups at draws 2 , 3 , 4 , and 5 ( all P<0.05 ) . Amoxicillin result ed in a significant decrease in positive cultures ( P<0.0001 ) . Conclusions — Although amoxicillin has a significant impact on bacteremia result ing from a single-tooth extraction , given the greater frequency for oral hygiene , toothbrushing may be a greater threat for individuals at risk for infective endocarditis Purpose This retrospective/ prospect i ve study was carried out to implement a st and ardized hospital oral care protocol and record the incidence of oral mucositis for in patients with childhood cancer . Methods The implementation process included stages of collaboration , consultation , education , and evaluation . The retrospective part of the study documented the existing hospital oral care protocol  and audited medical records of all pediatric patients diagnosed with cancer over a 12-month period . The frequency of recorded oral mucositis and the rate of referral to the pediatric dentistry department were assessed . Following evaluation of the retrospective study , the literature was search ed to create a new hospital oral care protocol . Referral to the dental department was st and ardized and frequent in-service presentations were given to staff . The oral mucositis scale was recorded daily for all in patients , and compliance rates were assessed . Results Fifty-nine patients ’ medical records were audited during the retrospective study . Oral mucositis prevalence was clearly documented at 34 % , while an additional 20 % lacked a definitive diagnosis . During the prospect i ve study , 38 patients were followed and had a verified incidence of oral mucositis of 33 % . The rate of compliance of implementing the oral mucositis scale improved from 41 % during the first 4 months to 87 % during last 3 months . Referral rates to the dental department increased from 53 % during the retrospective study to 100 % during the prospect i ve study . Conclusions Mutual underst and ing and collaboration between the oncology and dental departments in hospitals is crucial for st and ardizing patient care and for improving oral care st and ards OBJECTIVES The current format of summary of findings ( SoFs ) tables for presenting effect estimates and associated quality of evidence improve underst and ing and assist users finding key information in systematic review s. Users of SoF tables have dem and ed alternative formats to express findings from systematic review s. STUDY DESIGN AND SETTING We conducted a r and omized controlled trial among systematic review users to compare the relative merits of a new format with the current formats of SoF tables regarding underst and ing , accessibility of information , satisfaction , and preference . Our primary goal was to show that the new format is not inferior to the current format . RESULTS Of 390 potentially eligible subjects , 290 were r and omized . Of seven items testing underst and ing , three showed similar results , two showed small differences favoring the new format , and two ( underst and ing risk difference and quality of the evidence associated with a treatment effect ) showed large differences favoring the new format [ 63 % ( 95 % confidence interval { CI } : 55 , 71 ) and 62 % ( 95 % CI : 52 , 71 ) more correct answers , respectively ] . Respondents rated information in the alternative format as more accessible overall and preferred the new format over the current format . CONCLUSIONS While providing at least similar levels of underst and ing for some items and increased underst and ing for others , users prefer the new format of SoF tables BACKGROUND Adverse long-term general and dental health effects of cancer and cancer therapy during childhood have been reported . AIM To examine the association between chemotherapy before the age of 8 years and ( 1 ) : microdontia ; ( 2 ) : hypodontia of premolars and permanent molars . MATERIAL AND METHODS In The Danish Registry of Childhood Cancer ( DBCR ) , we identified 203 children who met the following inclusion criteria : ( 1 ) age below 8 years at the start of treatment ; ( 2 ) age between 12 to 18 years upon dental examination ; ( 3 ) had received chemotherapy The exclusion criterion was radiotherapy to the head and neck . A total of 150 children fulfilled the inclusion criteria . As controls , a r and om sample of 193 age-matched unexposed children was included . RESULTS Microdontia was found in a total of 88 teeth in 29 ( 19.3 % ) of the 150 children who had been exposed to chemotherapy , while none of the controls had microdontia of premolars or permanent molars ( difference : 19.3 % ; 95 % CL : 13.5 % ; 26.4 % ) . The earlier the exposure , the more frequent was microdontia . We found a total of 27 missing premolars and permanent molars in 14 ( 9.3 % ) of the exposed children and a total of 18 missing premolars and permanent molars in 8 ( 4.1 % ) of the controls ( difference : 5.2 % ; 95 % CL : -0.1 % ; 11.3 % ) . CONCLUSION The present study confirms findings from previous studies that chemotherapy , especially in very young children , causes microdontia and hypodontia of premolars and permanent molars The terms applicability , generalizability , external validity and transferability are related , sometimes used interchangeably and have in common that they lack a clear and consistent definition in the classic epidemiological literature . However , all of these terms generally describe one overarching theme : whether or not available research evidence can be directly utilized to answer the healthcare questions at h and , ideally supported by a judgment about the degree of confidence for this utilization . This concept has been called directness . The objectives of this paper were to delineate how non-r and omized studies ( NRS ) inform judgments in relation to directness and the concepts that it encompasses in the context of systematic review s. We will briefly review what is known and describe the theoretical and practical issues as well as offer guidance to those tackling the challenges of judging directness and using research evidence to answer healthcare questions with evidence from NRS . In particular , we suggest a framework in which authors can use NRS as a complement , sequence or replacement for r and omized controlled trials ( RCTs ) by focusing on judgments about the population , intervention , comparison and outcomes . Authors of systematic review s will use NRS to complement judgments about the inconsistencies , the rationale and credibility of subgroup analysis , the baseline risk estimates for the determination of absolute benefits and downsides , and the directness of surrogate outcomes . This evidence includes context ual or supplementary evidence . Authors of systematic review and other summaries of the evidence use NRS as sequential evidence to provide evidence when insufficient evidence is available for an outcome from RCTs , but NRS evidence is available ( e.g. , long-term harms ) . Use of evidence from NRS may also serve to replace RCT evidence when NRS provide equivalent ( or potentially higher ) confidence in the evidence ( i.e. quality ) compared to indirect evidence from RCTs . These judgments will be made in the context of other domains that influence the overall quality of the body of evidence , including the risk of bias , publication bias ( i.e. limitations in the detailed study design and execution ) , inconsistency , imprecision and factors that increase our confidence in effects . This article will support systematic review ers in their interaction with decision makers , that is , those who use the systematic review to develop guidelines , address health policy makers , and make clinical decisions , by making these judgments transparent . Copyright © 2013 John Wiley & Sons , The maintenance of oral hygiene for hospitalized patients , particularly medically compromised and immune compromised patients , may reduce the risk of oral and systemic infection .  Foam brushes have been recommended for use in these population s , however , the use of a foam brush has not been shown to be an acceptable alternative to the use of a toothbrush . In this study , we demonstrate that the use of a foam brush saturated with chlorhexidine was equally effective in measures of plaque levels and gingivitis as was the use of a toothbrush . Therefore if a toothbrush can not be used in hospitalized patients , an alternative may be the use of chlorhexidine applied with a foam brush 
    Output:
    
Current evidence from childhood cancer survivors indicates that chemotherapy is associated with considerable dental adverse effects that might be associated with greater burden of disease and treatment costs