BackgroundSuccessful restorations in dental patients depend largely on the effective control of moisture and microbes during the procedure. The rubber dam technique has been one of the most widely used isolation methods in dental restorative treatments. The evidence on the effects of rubber dam usage on the longevity of dental restorations is conflicting. Therefore, it is important to summarise the available evidence to determine the effects of this method. ObjectivesTo assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients.

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Background Asthma is a common chronic airway inflammatory disease. Exacerbations of asthma not only accelerate the progression of the disease but also increase the incidence of hospitalization and death. Studies have shown that air pollution is a high-risk factor for asthma exacerbations. However, few treatment strategies have been recommended to reduce the risk of severe air pollution-related asthma exacerbations. Methods/design This is a single-centre, prospective, randomized and standard treatment parallel control clinical trial. Seventy-two asthma patients in the nonexacerbation stage according to GINA guidelines 2017 will be recruited and randomized into the rescue intervention strategy (RIS) group and control group. Original treatments for the participants will include no use of inhaled medicine, the use of short-acting β-agonists (SABA) on demand or the use of budesonide/formoterol (160 μg/4.5 μg/dose, 1–2 dose/time, b.i.d.). The rescue intervention strategy for the RIS group will be budesonide/formoterol plus the original treatment until the severe pollution ends (air quality index, AQI < 200). The control group will maintain the original treatment. The follow-up observation period will last 1 year. The primary outcome is the frequency of asthma exacerbations per year. Secondary outcomes include the mean number of unplanned outpatient visits, emergency visits, hospitalizations, medical costs and mortality caused by asthma exacerbations per patient per year. Discussion The results of this trial will provide a novel strategy to guide clinical practice in decreasing the risk of asthma exacerbations under severe air pollution. Trial registration ChiCTR ChiCTR1900026757. Registered on 20 October 2019—retrospectively registered

Background: Asthma exacerbations accelerate the disease progression, as well as increases the incidence of hospitalizations and deaths. There have been studies on the effects of outdoor air pollution and asthma exacerbations; however, evidence regarding single lag0 and lag1 exposure patterns is inconclusive. Objective To synthesize evidence regarding the relationship between outdoor air pollution and the asthma exacerbation risk in single lag0 and lag1 exposure patterns. Methods We performed a systematic literature search using PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials, China National Knowledge Internet, Chinese BioMedical, and Wanfang databases until August 1st, 2020. Additionally, we reviewed the reference lists of the relevant articles. Two authors independently evaluated the eligible articles and performed structured extraction of relevant information. Pooled relative risks (RRs) and 95% confidence intervals (CIs) of lag0 and lag1 exposure patterns were estimated using the random-effect models. Results: Eighty-four studies met the eligibility criteria and provided sufficient information for meta-analysis. Outdoor air pollutants were associated with significantly increased risks of asthma exacerbations in both single lag0 and lag1 exposure patterns [lag0: RR (95%CI) (pollutants), 1.057(1.011, 1.103) (air quality index; AQI), 1.007(1.005, 1.010) (PM2.5), 1.009(1.005, 1.012) (PM10), 1.010(1.006, 1.014) (NO2), 1.030(1.011, 1.048) (CO), 1.005(1.002, 1.009) (O3); lag1: RR (95%CI) (pollutants), 1.064(1.022, 1.106) (AQI), 1.005(1.002, 1.008) (PM2.5), 1.007(1.004, 1.011) (PM10), 1.008(1.004, 1.012) (NO2), 1.025(1.007, 1.042) (CO), 1.010(1.006, 1.013) (O3)], except SO2 [lag0: RR (95%CI), 1.004(1.000, 1.007); lag1: RR (95%CI), 1.003(0.999, 1.006)]. Subgroup analyses revealed stronger effects in children and asthma exacerbations associated with other events (including symptoms, lung function changes, and medication use as required). Conclusion These findings demonstrate that outdoor air pollution significantly increases the asthma exacerbation risk in single lag0 and lag1 exposure patterns.

Objective: The aim of our study is to provide a novel strategy to administer treatment at the first signs of severe air pollution and before patients experience symptoms for preventing airway damage.Methods: This single-center, prospective, randomized and standard treatment parallel control clinical trial recruited adult asthma patients. The patients were randomized into either the rescue intervention strategy (RIS) group or control group. The rescue intervention strategy for the RIS group included budesonide/formoterol plus the original treatment until the severe pollution ended. The control group was maintained on the original treatment. The follow-up observation period was 1 year.Results: Overall, 22 participants were enrolled and 20 completed the follow-up (11 in the RIS group and 9 in the control group). Two participants dropped out of the trial for personal reasons before the first follow-up. In the intention-to-treat analysis, the frequency of asthma exacerbations per year was significantly lower in the RIS group than in the control group (RIS vs. control, 0.55 vs. 2.67; risk rate [RR] [95% confidence interval {CI}], 0.21 [0.08-0.50]; p = 0.001). The mean number of unplanned outpatient visits per person per year was also lower in the RIS group than in the control group (RIS vs. control, 0.18 vs. 1.11; RR [95% CI], 0.16 [0.04-0.75]; p = 0.019). Conclusion:A novel strategy to administer treatment at the first signs of severe air pollution and before patients experience symptoms may decrease the risk of asthma exacerbations and negative outcomes under severe air pollution conditions.