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Different distraction techniques have been used in dentistry and have shown great results in managing anxious pediatric patients, especially during local anesthesia (LA) administration. Various physiological parameters are used to measure anxiety, among which peripheral perfusion index (PI) provides information about vascular tone and fluid status by interpreting the data obtained from pulse oximetry. In the present study, we aimed to evaluate the relationship between anxiety and PI values and also compare different distraction techniques in single-visit pulpectomy. Healthy, cooperative 5-7 years old participants were selected for single-visit pulpectomy. Four groups were formed by simple random sampling. Group I (control), group II (illumination cap), group III (laser light), and group IV [audiovisual (AV)]. Two physiological parameters are recorded [pulse rate (PR), PI] at three intervals: (1) baseline-when the patient sat on the dental chair, (2) second reading-5 minutes after introduction of the distraction technique during LA administration, and (3) third reading-25 minutes after the second reading. Intergroup comparison and post hoc analysis are done for all the groups with two key parameters. It has been found that the illumination cap group was most effective in reducing anxiety, followed by laser light, AV, and the control group (p-value < 0.05). PI can be used as an important parameter for assessing anxiety, and use of the illumination cap as a distraction tool can show promising results in reducing anxiety. Payak R, Gangwar A, Gangwar C, et al. Comparing Two Distraction Techniques with Illumination Caps for Assessing Dental Anxiety in Pediatric Patients during Single-visit Pulpectomies Based on the Perfusion Index Parameter. Int J Clin Pediatr Dent 2026;19(3):331-336.

Molar-incisor-hypomineralization (MIH), a developmental defect that alters normal mineralization, causing permanent damage to the enamel. The affected enamel shows a reduction in mineral composition, calcium: phosphorus (Ca:P) ratio, and relatively increased carbon content. Among the numerous factors that affect the enamel integrity in MIH, the properties such as salivary and plaque pH might have an impact, but recent studies suggest only minimal data regarding the various factors, making it still obscure to the clinician. To determine the salivary and plaque pH in 8-15-year-old children with and without MIH and to correlate it with caries severity in children with MIH. In this study, 209 children aged 8-15 years were selected by stratified sampling. Hypomineralized teeth and caries were assessed using the European Academy of Paediatric Dentistry (EAPD) criteria and International Caries Detection and Assessment System, version II (ICDAS II) criteria, respectively. Salivary and plaque samples were collected, and pH was determined. Statistically significant difference in salivary pH was observed between the groups A1, A2, B, C, and A, B, C (p = 0.001*). On pairwise comparison, significant differences were observed in all pairs of groups except groups B and A. Statistically significant differences in plaque pH were seen between groups A2 and C (p = 0.001*). On pairwise comparison, significant differences were seen in all pairs of groups except groups A1, B, and A, B. The ICDAS II criteria scores were significantly higher in the MIH group. Statistically significant increase in caries severity and a fall in the mean salivary and plaque pH associated with posteruptive enamel breakdown (PEB) in the MIH-affected population was observed. Sonali KS, Jain M, Sogi HPS, et al. Clinical Evaluation of Association of Salivary and Plaque pH with Caries Severity in Children with Molar-incisor-hypomineralization in Haryana: A Cross-sectional Study. Int J Clin Pediatr Dent 2026;19(3):296-302.

Dentigerous cyst is a developmental odontogenic cyst. It is also named as follicular cyst in which there is accumulation of fluid between reduced enamel epithelium and follicle. It most commonly involves the mandibular third molars. Their occurrence in anterior maxilla is rare and may mimic other radiolucent lesion, posing diagnostic challenge. A 9-year-old boy presented to the Department of Pediatric and Preventive Dentistry, Mahatma Gandhi Dental College & Hospital, Jaipur, with a chief complaint of progressive painless swelling in upper right front region since 2-3 months. This swelling was initially smaller in size, but increased gradually. Surgical enucleation of cystic lesion with secondary healing was performed.The histopathological examination confirmed the diagnosis of dentigerous cyst. Dentigerous cyst is one of the typically frequent cysts of odontogenic origin. This developmental cyst is invariably connected with an erupting tooth and is formed as a result of fluid accumulation between the follicle and the reduced enamel epithelium of an erupting tooth. Early diagnosis and management are important to prevent complications such as bone destruction and displacement of unerupted teeth. In this case, enucleation of the entire cystic lining without extracting the involved permanent tooth was done to advocate secondary healing of the site instead of primary closure. This case highlights an unusual presentation of dentigerous cyst in anterior maxilla. Timely diagnosis and quicker management can save the affected tooth and help in chewing, speech, occlusion maintenance, and overall health of the growing child. Amit, Meghpara M, Marwah N, et al. Dentigerous Cyst in Anterior Maxilla: A Rare Occurrence. Int J Clin Pediatr Dent 2026;19(3):408-411.

Behaviour management techniques converge on the fundamental aim of facilitating the child&#xb4;s adaptation by promoting familiarity and gradual desensitisation, thereby reducing stress levels and enhancing cooperation during dental procedures. This study aimed to evaluate the use of virtual reality (VR) as a behavioural management technique to reduce anxiety in paediatric patients during dental treatments. A research strategy was conducted including articles that have been published in the past 5 years using MeSH Terms in five different databases (PubMed, Scopus, ScienceDirect, EMBASE, and Web of Science). The studies included in the review involved children under 17 years old who used virtual reality to control their anxiety in the dental clinic. The use of VR in paediatric dentistry improved behaviour in children with higher positive responses in VR groups, vs. control groups. The Frankl scale showed significant improvements after the use of VR before treatment. Furthermore, audiovisual distraction with VR was the most effective technique for reducing fear and anxiety in uncooperative children. Virtual reality is an effective technique for managing behaviour and reducing anxiety in paediatric patients during dental treatments, often outperforming conventional techniques. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251015748, PORSPERO CRD420251015748.

Molar-incisor hypomineralisation (MIH) is a prevalent dental condition that poses significant management challenges. This case report details the multidisciplinary management of an 11-year-old female patient diagnosed with MIH, presenting with severe pain associated with the lower right first molar. Clinical examination revealed extensive enamel defects, characterised by demarcated yellowish and whitish hypomineralised areas on her incisors and molars, alongside significant dental caries. A comprehensive treatment plan was developed, involving preventive measures such as oral hygiene education and dietary counseling, alongside restorative interventions. Initial management focused on alleviating pain and restoring function, which included the extraction of nonrestorable teeth and the placement of resin restorations in affected molars. Additionally, the application of fluoride varnishes, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) was implemented to enhance enamel remineralisation. Behavioural management strategies were introduced to address the patient's dental anxiety, stemming from previous negative experiences with anaesthesia. Follow-up appointments were scheduled to monitor the effectiveness of treatments and to reinforce oral hygiene practices. The patient's symptoms improved, root canal and restorative procedures were successfully completed and orthodontic treatment was initiated. She remains under regular follow-up, demonstrating good cooperation and stable progress. This case emphasises the importance of early diagnosis and a collaborative approach in the management of MIH. By integrating restorative dentistry, preventive care and psychological support, the management plan is aimed not only at addressing the immediate dental concerns but also at improving the patient's overall quality of life and long-term dental health.

Glass ionomer cement (GIC) dentin conditioners are considered a useful step in the restorative process, as they increase the bond strength of GIC to dentin. Delivering antimicrobial agents through the dentin conditioner may minimize the impact on the physical properties of GIC. It is not known whether such antibacterial conditioning agents may affect the bond strength of GIC to dentin. The objective of the study was to evaluate the effect of various dentin conditioners with and without antimicrobial agent on the shear bond strength (SBS) of GIC to dentin. A total of 105 noncarious, unrestored, and sound human maxillary premolars extracted for orthodontic treatment were selected for the study. Tooth specimens were ground to expose a flat dentinal surface. The tooth specimens were embedded in self-cured acrylic resin on metallic molds. Specimens were randomly assigned into seven groups with 15 specimens each, according to the dentin conditioning agent used: Group I with no conditioning, group II with GC dentin conditioner, group III with 50% citric acid, group IV with 36% phosphoric acid, group V with GC conditioner + 1% cetrimide, group VI with 50% citric acid + 1% cetrimide, and group VII with 36% phosphoric acid + 1% cetrimide. After conditioning for 10 seconds, the specimens were thoroughly washed and air-dried. GC Fuji IX was condensed into the Teflon molds. The specimens were then subjected to SBS testing using universal testing machine (UTM). The SBS values decreased when 1% cetrimide was added to the dentin conditioners which were, however, statistically insignificant (p > 0.05). The GC dentin conditioner group (group II) showed the highest SBS values and no-conditioning group (group I) showed the least. Delivering 1% cetrimide as an antibacterial agent with dentin conditioner showed no significant adverse effect on the SBS of GIC to dentin. Hence, 1% cetrimide can be added to dentin conditioning agent used with GIC in atraumatic restorative treatment (ART) with minimal impact on the physical properties of GIC. In Pediatric Dentistry, GIC is most commonly used with ART of cavity preparation. The dental hand instruments used in this technique are less effective when compared to rotary burs in removal of carious dentin, and in such situations, residual caries are most likely to be restored over. If GIC is unable to arrest the caries, the result will be a restoration failure. Incorporating antibacterial agents into glass ionomer powder may cause basic mechanical changes in the physical properties of the GIC. The use of an antibacterial dentin conditioner may be useful when restoring cavities that have residual carious dentin. Alex V, Abraham KK, Khosla E, et al. The Comparative Evaluation of Various Dentin Conditioners with and without Antimicrobial Agent on the Shear Bond Strength of Glass Ionomer Cement to Dentin: An In Vitro Study. Int J Clin Pediatr Dent 2026;19(3):350-356.

This study aims to evaluate and compare the efficacy of articaine buccal infiltration for the extraction of deciduous maxillary molars, assessing its effectiveness as a potential alternative to conventional local anesthesia techniques in pediatric dentistry. A randomized clinical trial was conducted involving children aged 6-12 years requiring extraction of primary maxillary molars. Bilateral extraction was done in children, with one side receiving buccal infiltration with 4% articaine and the other side undergoing traditional infiltration with lidocaine. Pain perception during injection and extraction, onset and duration of anesthesia, and any adverse effects were recorded and analyzed using validated pain scales and statistical methods. There was no statistically significant difference in pain intensity between the two groups for pain on administration of the local anesthetic agent. Intraoperative pain rating was similar in both groups. Articaine buccal infiltration appears to be equally effective as traditional infiltration with lidocaine and can be used as an alternative for the extraction of deciduous maxillary molars in children. Ragulakollu RK, Namineni S, Cheruku S. Efficacy of Articaine with Single Buccal Infiltration in Extraction of Maxillary Molars in Pediatric Patients. Int J Clin Pediatr Dent 2026;19(3):324-330.

Enterococcus faecalis is a gram-positive facultative anaerobe frequently associated with persistent root canal infections. Since complete disinfection through conventional methods is often challenging, herbal agents with antimicrobial properties are being explored as safer alternatives to synthetic chemicals. To assess and compare the antibacterial potential of Murraya koenigii (curry leaves), Camellia sinensis (green tea), and 2% chlorhexidine against E. faecalis. A pure culture of E. faecalis was subcultured in brain heart infusion (BHI) broth. Mueller-Hinton agar plates were prepared, and six wells were made in each plate. Aqueous extracts of M. koenigii and C. sinensis at concentrations of 1-5%, and 2% chlorhexidine as control, were introduced into the wells. The plates were incubated at 37&#xb0;C for 24 hours. The inhibition zones were measured in millimeters using a zone-measuring scale. Data were analyzed using nonparametric tests. The Kruskal-Wallis test was applied for overall comparison, followed by the Mann-Whitney U test for pairwise analysis. The inhibition zones produced by C. sinensis were statistically comparable to those of 2% chlorhexidine, suggesting that green tea exhibits significant antibacterial activity against E. faecalis. Since mechanical debridement alone cannot ensure complete bacterial elimination, intracanal medicaments are essential. Green tea extract demonstrated antibacterial efficacy equivalent to chlorhexidine, indicating its potential as an herbal antimicrobial agent. Given the limitations of chemical disinfectants, herbal extracts such as green tea and curry leaf hold promise as biocompatible, ecofriendly, and cost-effective alternatives for endodontic disinfection, encouraging a shift toward natural therapeutic agents in dentistry. Bedarkar SM, Musale P, Dave PN, et al. To Compare and Evaluate the Antibacterial Efficacy of Murraya koenigii (Curry Leaves), Camellia sinensis (Green Tea), and 2% Chlorhexidine against Enterococcus faecalis. Int J Clin Pediatr Dent 2026;19(3):314-317.

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals that persist in the environment and have potential health risks. Among them, 8:2 fluorotelomer alcohol (FTOH) undergoes microbial biotransformation in the environment into perfluorooctanoic acid (PFOA) and releases fluoride. While PFOA's toxic effects have been well-studied, the impact of PFOA (and its precursor 8:2 FTOH) on dental health is largely unknown. Moreover, it is not established whether, and to what extent, defluorination and fluoride bioaccumulation occur during the in vivo 8:2 FTOH metabolism. This study is the first to comprehensively demonstrate the pathophysiology of PFAS-associated developmental dental anomalies&#x2500;enamel and dentin hypoplasia&#x2500;in the context of fluoride bioaccumulation after exposure to 8:2 FTOH in mice. Over 90 days, mice (male and female C57BL/6J) received daily oral doses of 8:2 FTOH. At the high dose, the levels of PFOA and 7:3 FTCA (the main 8:2 FTOH metabolites) in blood increased significantly, reaching PFOA concentrations comparable to those in occupationally exposed humans, underscoring the relevance of high-exposure scenarios. Fluoride levels significantly increased in the blood, urine, and bone, approaching levels linked to dental fluorosis in animal models. Dental defects included enamel and dentin hypoplasia, discoloration, reduced mineral density, and structural abnormalities, including damaged ameloblasts and immature mineral composition. Although some features resembled fluorosis, the defects were distinct. 8:2 FTOH and other PFAS capable of similar metabolic conversion may represent an understudied source of fluorine accumulation and a potential, previously unrecognized contributor to cryptogenic odontogenic abnormalities.

The global impact of the COVID-19 pandemic has instigated a profound public health crisis, particularly affecting professionals like dentists who, due to their close interaction with saliva-a potential viral reservoir-and the aerosols generated during specific procedures, face elevated risks of infection. To mitigate this, the Centers for Disease Control and Prevention (CDC) and the Philippine Dental Association (PDA) have established guidelines for averting cross-infection in dental settings. This study, conducted in an urbanized Metro Manila City, delves into the infection control practices of dentists amid the pandemic. Dentists from a Metro Manila city dental chapter were invited to participate in an online survey (Google Forms) consisting of participants' demographics, patient triage, engineering, administrative controls, disinfection personal hygiene, personal protective equipment (PPE), and waste management practices. Descriptive statistics, employing frequency distributions and percentages, summarized the dentists' adherence to infection control protocols. Out of forty-nine respondents (49), the majority (92%) provided their teams' orientation on COVID-19 infection control protocols before reopening. Notably, 57% deferred elective procedures and 43% postponed aerosol-generating procedures (AGPs). Only 39% utilized rubber dam isolation during AGPs. Most respondents reported full implementation of recommended administrative controls during the pandemic, with 92% isolating their treatment areas from other parts of the clinic. Most respondents adopted high-efficiency particulate air (HEPA) filtration units (82%) as one of their clinic's engineering controls, and an extraoral vacuum machine, accounting for 71% of the respondents. The most common disinfection product used by the participants was alcohol, which was at 94%. Additionally, over 90% adhered to all recommended hand hygiene practices for both dental staff and patients. For the waste management protocols, only 55% of the respondents have their infectious waste collected by third-party Treatment Storage and Disposal (TSD) facilities. The data shows that with the guidelines posted by both the PDA and CDC, the city's dental practitioners could still provide services to the community in the safest manner at the time by being updated and following the infection control practices suggested by both organizations. Although some areas could have been improved, such as third-party waste management and the utilization of RT-PCR testing, some of these problems could have been attributed to the lack of availability in their areas.

Photochemical reactions compatible with physiological conditions are powerful tools for chemical biology and medicinal chemistry. Herein, we report that 3,4-dimethoxy-o-nitrobenzyl (o-nitroveratril) amidoxime ethers generate amidinyl radicals upon photoirradiation, yielding 6-aminophenanthridines via the intramolecular cyclization of the corresponding biaryl precursors. This photoreaction proceeds under physiologically relevant conditions, specifically in the aqueous buffers, to yield a series of substituted amino-phenanthridines in moderate yields. Mechanistic studies demonstrated that the reaction proceeds through homolytic N-O bond cleavage triggered by the photoexcitation of the o-nitroveratril moiety. Detailed analysis also identified amino-azaspirolactam as a side product, highlighting the bilateral reaction modes of amidoxime-derived radical species. Finally, the photoinduced cyclization was demonstrated within HeLa cells, highlighting its potential for light-induced construction and control of bioactive compounds.

Periodontitis involves dysregulated immunity where the NLRP3 inflammasome plays a key role, while the role of TRIM31, an E3 ubiquitin ligase, remains unknown in periodontitis. Human gingival fibroblasts (HGFs) and macrophages were stimulated with LPS and ATP; TRIM31 was overexpressed via AAV, and NLRP3 was knocked out via CRISPR; periodontitis was induced in WT and NLRP3-KO mice treated with AAV-TRIM31; bone loss, osteoclasts, and apoptosis were assessed. TRIM31 was downregulated in inflammation and correlated with M2 polarization. TRIM31 overexpression protected HGFs, promoted M2 polarization, and bound to NLRP3, thereby promoting K48-linked ubiquitination and degradation. In vivo, TRIM31 reduced bone loss, osteoclasts, and apoptosis; these effects were abolished in NLRP3-KO cells and mice. TRIM31 negatively regulates periodontal inflammation via ubiquitin-dependent NLRP3 degradation.

Silver diamine fluoride (SDF) is a desensitizing agent approved by the U.S. Food and Drug Administration. However, limited evidence is available to guide the optimal application protocol for SDF. This in situ study aimed to compare dentinal tubule occlusion scores and examine the elemental composition of occluding materials after single versus weekly applications of 38% SDF over 2 weeks. Five healthy participants took part in this in situ study, which included three 14-day experimental periods and a 7-day washout between periods. In the first experimental period, distilled water (DI) was applied on Day 1. In the second experimental period, SDF was applied once on Day 1. In the third experimental period, SDF was applied on Days 1 and 8. Each participant wore an intraoral palatal appliance containing four treated dentine blocks during the experimental periods. The dentine blocks were removed from the participants' mouths and exposed extraorally to citric acid (pH 3.2) for 2&#x2005;min, five times daily, for 14 days. Dentinal tubule occlusion scores and the elemental composition of the occluding materials were evaluated using scanning electron microscopy (SEM) images and energy-dispersive x-ray spectroscopy (EDS), respectively. Dentinal tubule occlusion scores were analyzed using one-way analysis of variance (ANOVA) followed by Tukey's HSD post hoc test, whereas EDS elemental composition data were analyzed using the Kruskal-Wallis test followed by Dunn's post hoc test with Bonferroni correction. All five participants completed all three experimental periods. The mean dentinal tubule occlusion scores were 1.80&#x2009;&#xb1;&#x2009;0.35 for the DI group, 3.29&#x2009;&#xb1;&#x2009;0.27 for the single-application SDF group, and 4.10&#x2009;&#xb1;&#x2009;0.10 for the weekly-application SDF group (DI&#x2009;<&#x2009;single-application SDF <&#x2009;weekly-application SDF; p&#x2009;<&#x2009;0.001). EDS analysis of dentine blocks revealed a silver peak in both SDF groups, with a higher silver weight percentage in the weekly-application SDF group than in the single-application SDF and DI groups (DI&#x2009;<&#x2009;single-application SDF <&#x2009;weekly-application SDF; p&#x2009;<&#x2009;0.001). Although not without limitations, this study reveals that a weekly protocol results in superior dentinal tubule occlusion scores compared to a single application, and that increased frequency of SDF application directly contributes to a higher weight percentage of silver in the resulting occluding materials.

This study estimated the prevalence of TMD symptoms among Southeast Asian nurses, examined their associations with psychological, somatic, musculoskeletal symptoms, and identified biopsychosocial factors related to TMD and musculoskeletal symptom burden. A cross-sectional study of 438 nurses from two hospitals collected sociodemographic and occupational data. Validated instruments assessed TMD symptoms , somatic burden, psychological distress , and musculoskeletal complaints. TMD symptoms were present in 22.8% of participants, with combined intra-articular and pain-related TMD (CT) having the highest burden. CT participants demonstrated significantly greater psychological distress, somatic symptom burden, and musculoskeletal complaints. spanning the cranio-cervical region, spine, upper limbs, and lower limbs. Somatic symptom burden showed moderate correlations with psychological distress, global musculoskeletal, spinal, and lower limb burden. TMD symptoms are prevalent among nurses and influenced by occupational conditions. Findings support the inclusion of TMDs in occupational health surveillance and integrated biopsychosocial care to address cumulative burdens in nursing populations.

Children's oral and dental health are vital components of overall health, affecting their growth, education, employment, and future prospects. Early childhood caries is a prevalent issue globally, placing significant financial strain on families and healthcare systems. This study aims to explore how children use the Primary Health Care oral health package to achieve Universal Health Coverage. This descriptive, cross-sectional study examined children's utilization of services provided through the oral health package at PHC centers. Data on services delivered under the package were gathered from national systems and performance reports from insurance organizations. Multivariate linear regression using the Ordinary Least Squares method was used in STATA software to identify factors influencing the utilization of dental services at PHC centers. In 2019, 2225196 dental services were administered to children through the dental care package in 6157 PHC centers across 31 provinces. On average, each center provided 361 services. Zanjan Province had the highest rate of children's utilization of dental services per capita in PHC centers (46,602 services per 100,000 population), which was more than seven times the lowest rate in Yazd Province (6,118). There was a positive correlation with the per capita availability of dentists, whereas a negative relationship was observed with the per capita tertiary education among the rural population. The per capita utilization of children's dental services under the oral health package varied significantly across provinces. A notable portion of children nationwide did not access dental services at PHC levels. Although increasing the number of dentists can boost utilization, it is crucial to ensure an equitable distribution. Further national research is necessary to determine where these children are receiving the necessary dental services.

Breast cancer remains one of the leading causes of cancer-related mortality amongst women worldwide, with rising incidence rates paralleling the global obesity epidemic. Obesity has been increasingly recognised as a risk factor for breast cancer, yet the molecular mechanisms underlying the association remain poorly understood. This review explores the role of angiogenesis as the central mechanism linking obesity to breast cancer progression. Angiogenesis is essential for both adipose tissue expansion and tumour growth. It is dysregulated in obesity and breast cancer, resulting in the formation of abnormal vasculature that perpetuates hypoxia and malignancy. Obesity contributes to this process through hypertrophic adipose tissue, altered adipokine profiles and elevated expression of proangiogenic factors, such as VEGF. These changes create a tumour microenvironment conducive to cancer progression, treatment resistance and poor clinical outcomes. Emerging evidence also implicates endothelial cells, pericytes and lipid metabolism in this interaction, suggesting novel therapeutic targets.

Pulmonary embolism (PE) remains a major cause of cardiovascular mortality, and atrial fibrillation (AF) significantly worsens its outcomes. However, long-term trends and disparities in PE mortality among patients with AF remain poorly characterized. Using the CDC WONDER database (1999-2020), we identified adults with PE as the underlying cause of death and AF as a contributing cause using ICD-10 codes I26 and I48. Age-adjusted mortality rates (AAMRs) and annual percentage changes (APCs) were calculated via Joinpoint regression. Subgroup analyses were done based on the pre-, during, and post-COVID-19 pandemic era. A total of 5499 deaths were recorded with PE and coexisting AF. Overall mortality remained stable from 1999 to 2009 (APC: -0.27; 95% CI: -2.12 to 1.60), then rose sharply from 2009 to 2020 (APC: 3.68; 95% CI: 2.29-5.10). Males had higher mortality (AAMR: 0.077) than females (0.065), with faster increases over time. Non-metropolitan areas showed greater mortality (AAMR: 0.082) than metropolitan areas (0.063), with steeper APCs (2.73% vs. 2.00%). Regionally, the Midwest (AAMR: 0.077) and South (0.073) bore the highest burden. States with the highest mortality included Vermont and Maryland. Most deaths occurred in inpatient settings (55.7%), followed by nursing homes (15.8%) and decedents' homes (14.5%). Notably, states with the lowest AAMRs were New York, Louisiana, and Florida. Mortality due to PE with AF as a contributor has increased significantly since 2009, with marked sex, regional, and urban-rural disparities. These findings underscore the growing public health burden and the need for targeted regional responses.

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[This corrects the article DOI: 10.1016/j.cjco.2025.09.004.].