Influenza is a respiratory disease caused by the influenza virus, which is highly transmissible in humans. This paper presents a systematic review and meta-analysis of randomized controlled trials (RCTs) and test-negative designs (TNDs) to assess the vaccine effectiveness (VE) of seasonal influenza vaccines (SIVs) in humans aged 15 to 64 years. An electronic search to identify all relevant studies was performed. The outcome measure of interest was VE on laboratory-confirmed influenza (any strain). Quality assessment was performed using the Cochrane risk-of-bias tool for RCTs and the ROBINS-I tool for TNDs. The search identified a total of 2993 records, but only 123 studies from 73 papers were included in the meta-analysis. Of these studies, 9 were RCTs and 116 were TNDs. The pooled VE was 48% (95% CI: 42–54) for RCTs, 55.4% (95% CI: 43.2–64.9) when there was a match between the vaccine and most prevalent circulating strains and 39.3% (95% CI: 23.5–51.9) otherwise. The TNDs’ adjusted VE was equal to 39.9% (95% CI: 31–48), 45.1 (95% CI: 38.7–50.8) when there was a match and 35.1 (95% CI: 29.0–40.7) otherwise. The match between strains included in the vaccine and strains in circulation is the most important factor in the VE. It increases by more than 25% when there is a match with the most prevalent circulating strains. The laboratorial method for confirmation of influenza is a possible source of bias when estimating VE.

Forensic estimation of chronological age has played an increasingly important role as part of cadaver identification, and also in living individuals due to the phenomenon of immigration and sexual abuse of undocumented trafficked children. This research aimed to validate the already used dental mineralization and eruption atlas in normal children and adolescent population in estimating chronological age in a young population, particularly those with special needs, majority of them with systemic diseases. A sample of 163 orthopantomograms from two independent medical institutions was collected from 133 patients aged between 4 and 23 years. The orthopantomograms were divided into two groups, 95 from patients with systemic pathologies that have repercussions on dental development and 68 with systemic pathologies without dental repercussions. Dental ages were estimated by the London Atlas using the left side and then independently the right side of the maxilla. The intraobserver and interobserver agreements were evaluated. The difference between dental age estimates and the chronological age and its absolute value were calculated and analyzed. Statistically significant differences were found between estimates and chronological age, revealing a general prevalence for underestimation; except for those under the age of 12. Nevertheless, the underestimation in individuals under the age of 16 was not significant (with an average of less than one month), while the underestimation was significant for persons who were at least 16 years old (with an average over 26 months). Furthermore, for those persons with systemic diseases with dental repercussions a greater error in underestimation was obtained, which indicates that the midpoint values should be reassessed in persons with Down's syndrome, chromosomal alterations, syndromes and central nervous system disorders. This atlas can be potentially used as a tool for age estimation in a population with special needs and, also, in a population with systemic diseases, but we suggest further studies with larger international samples to create adequate atlases for all the required scenarios, mainly, diagrams for people with systemic diseases who are over the age of 16.

Better understanding of dental age assessment may help in cases of age estimation in Forensic Clinics. The first aim was to provide essential information on method reliability for upcoming studies using dental age assessment by second molar index (I2M), and third molar index (I3M) for age estimation on legal ages of 12 - 14 years. The second aim was to document forensic method outcomes of the Demirjian method which has already been used in forensic clinic. Two samples were used for this purpose: for I2M, 633 orthopantomographs (270 females / 363 males), the age range from 7 to 17 years and for I3M, 471 orthopantomographs (253 females / 218 males), the age range from 10 to 23 years, from the database population of Lisbon North University Hospital Center, approved by the Ethic Committee. The I3M cut-off point (1.133) for 12- year- olds obtained better results than the cut-off point stated by the I2M (0.135). Besides, I2M cut-off point (0.001) for 14- year- olds showed better results when compared with the cut-off point (0.705) established by the I3M. Both methods are reliable for the legal age thresholds of 12 and 14 years. However, using I2M and I3M allows us to vary the cut-off value to privilege sensitivities or specificity, depending on which is more appropriate to the intended application. The accuracy (88.94%) of I3M obtained better results for the 12- year- old cut-off point (1.133) and the accuracy (90.21%) of the I2M performed better for the 14- year- old cut-off point (0.001).