Category: Nevin Manimala

J Esthet Restor Dent. 2023 May 20. doi: 10.1111/jerd.13066. Online ahead of print.

ABSTRACT

OBJECTIVE: the aim of this study was to evaluate the effect of resin composite layering on discolored substrates to obtain masking ability with monolithic ceramics.

MATERIALS AND METHODS: Four groups (n = 8) of computer-aided design/computer aided manufacturing (CAD/CAM) monolithic ceramics, shade A1, with thicknesses of 1.0 and 1.5 mm, were tested: feldspathic (FC), leucite-reinforced (LC), lithium disilicate-reinforced (LD), and translucent zirconia (5YSZ). Five substrates were used: A1 (used as reference), A3.5, C4, and coppery and silvery metals. The substrates were separated as non-layered or layered (with flowable opaque resin composite (FL), white opaque restorative resin composite (WD), and A1-shaded opaque restorative resin composite (A1D)). Resin composite layers of 0.5 and 1.0 mm were tested. The try-in paste, shade A1, was used as a luting agent. Translucency parameter (TP₀₀ ) was assessed for the ceramics. Color differences (∆E₀₀ ) were assessed for the restorative ceramics and resin composite layers over discolored substrates with the CIEDE2000 formula. The results were compared statistically, and descriptively with acceptability (AT, 1.77) and perceptibility (PT, 0.81) thresholds.

RESULTS: Feldspathic showed the highest TP₀₀ (for both ceramic thicknesses) and LD the lowest (for 1.5 mm of ceramic thickness) (P < 0.001). For substrate A3.5, layering with 1.0 mm of A1D or WD ensured ∆E₀₀ below PT for all ceramics tested (P < 0.001). The use of 0.5 mm of FL or 1.0 mm of A1D associated with ceramics LC, LD, and 5YSZ ensured ∆E₀₀ below AT for substrates C4 and coppery metal (P < 0.001). Silvery background layered with 0.5 mm of FL presented ∆E₀₀ below AT for all ceramics and ∆E₀₀ below PT for lithium disilicate of 1.0 mm of thickness (∆E₀₀ = 0.72).

CONCLUSIONS: Layering severely discolored substrates with selected opaque resin composites ensures masking ability for restoration with CAD/CAM monolithic ceramics.

CLINICAL SIGNIFICANCE: Severely discolored substrates are predictably restored with monolithic CAD/CAM ceramics by performing a previous layering of the substrate with opaque resin composite.

PMID:37209028 | DOI:10.1111/jerd.13066

Int Endod J. 2023 May 20. doi: 10.1111/iej.13934. Online ahead of print.

ABSTRACT

AIM: To analyze and compare the root canal microbiome present in root-filled teeth of two different geographical populations, and to study their functional potential using next-a generation sequencing approach.

METHODOLOGY: Sequencing data obtained from surgical specimens from previously treated teeth with periapical bone loss from Spain and USA were included in the study. Taxa were classified using SILVA v.138 database. Differences in genera abundances among the 10 most abundant genera were evaluated using a Kruskal-Wallis test. Alpha diversity indices were calculated in mothur. The Shannon and Chao1 indices were used. Analyses of similarity (ANOSIM) to determine differences in community composition were done in mothur, with Bonferroni correction for multiple comparisons. P values < 0.05 were considered statistically significant. Identification of enriched bacteria function prediction in the study groups (Kegg pathways) was carried out by Linear discriminant analysis Effect Size (LEfSe) via Python 3.7.6.

RESULTS: A greater alpha-diversity (Shannon and Chao1 indices) was observed from samples obtained in Spain (P = 0.002). Geography showed no significant effects on community composition via an ANOSIM using Bray-Curtis dissimilarities (R = 0.03, P = 0.21). Bacterial functional analysis prediction obtained by PICRUSt showed that 5.7% KEGG pathways differed between the Spain and USA samples.

CONCLUSIONS: The taxonomic assessment alone does not fully capture the microbiome’s differences from two different geographical locations. Carbohydrate and amino acid metabolism were enriched in samples from Spain, while samples from the USA had a higher representation of pathways related to nitrogen, propanoate metabolism, and secretion systems.

PMID:37209012 | DOI:10.1111/iej.13934

Scand J Public Health. 2023 May 20:14034948231173473. doi: 10.1177/14034948231173473. Online ahead of print.

ABSTRACT

AIMS: In Denmark, all residents regardless of nationality are ‘de jure’ entitled to a wide range of free-of-charge healthcare services. There is, however, only scarce quantitative knowledge on immigrants’ experiences of their ‘de facto’ access to healthcare and on how access relates to immigrants’ types of residence permits. The study aims to address these gaps.

METHODS: Survey data on access to healthcare, employment and housing were collected among adult, newly arrived immigrants in Denmark (n=1711) at 26 publicly contracted Danish language schools in September-December 2021 by national cluster-random sampling stratified by region. Data were analysed using descriptive statistics and multivariate logistic regression.

RESULTS: In total, 21% reported general difficulties obtaining good healthcare. Commonly experienced barriers related to financial constraints (39%), communication (37%) and lack of knowledge about the healthcare system (37%). Refugees and their families had higher odds of reporting barriers related to finances (odds ratio (OR) 2.58; confidence interval (CI) 1.77-3.76), communication (OR 3.15; CI 2.39-4.14) and knowledge (OR 1.84; CI 1.16-2.90), while other family reunified immigrants had lower odds of reporting knowledge barriers (OR 0.71; CI 0.54-0.93) compared with immigrants with EU/EEA residence permits, adjusted for gender and residential region. These results remained significant when further adjusted for age, length of stay, education, income, rural/urban residence and household size.

CONCLUSIONS: Difficulties accessing healthcare are experienced by a large share of newly arrived immigrants in Denmark and are dependent on residence permit type. The findings suggest strengthened efforts to reduce barriers related to finances, communication and knowledge, while focusing on the most vulnerable immigrants.

PMID:37209005 | DOI:10.1177/14034948231173473

Int J Dermatol. 2023 May 20. doi: 10.1111/ijd.16710. Online ahead of print.

ABSTRACT

BACKGROUND: Incidence of cutaneous melanoma is steadily growing, and its early recognition is of paramount importance. Small, pigmented lesions often represent a challenge for the clinician, as predictors of melanoma have not yet been uniquely identified in this setting.

OBJECTIVES: To identify dermoscopic features that aid in distinguishing small diameter melanomas (≤5 mm) from equivocal melanocytic nevi measuring ≤5 mm.

METHODS: A retrospective multicenter study was conducted to collect demographics, clinical and dermoscopic pictures of (i) histology-proven flat melanomas, measuring ≤5 mm, (ii) histology-proven but clinically/dermoscopically equivocal melanocytic nevi measuring ≤5 mm, and (iii) histology-proven flat melanomas, measuring >5 mm. An independent dermoscopic evaluation was performed. Differences in predefined dermoscopic features were assessed across the three groups.

RESULTS: A total of 103 melanomas measuring ≤5 mm were collected; 166 control lesions, comprising 85 large (>5 mm) melanomas and 81 dubious, clinically equivocal melanocytic nevi measuring ≤5 mm were included. Of the 103 mini-melanomas, only 44 were melanoma in situ. Five dermoscopic predictors of melanoma were identified for the assessment of flat, non-facial melanocytic lesions measuring ≤5 mm, namely: atypical pigment network, blue-white veil, pseudopods, peripheral radial streaks, and presence of more than one color. The latter were combined into a predictive model capable of identifying melanoma with 65% sensitivity and 86.4% specificity, at a cut-off score of 3. Among melanomas measuring ≤5 mm, presence of a blue-white veil (P = 0.0027) or negative pigment network (P = 0.0063) was associated with invasiveness.

CONCLUSION: A set of five dermoscopic predictors of melanoma, atypical pigment network, blue-white veil, pseudopods, peripheral radial streaks, and presence of more than one color is proposed for the assessment of flat, non-facial melanocytic lesions measuring ≤5 mm.

PMID:37208996 | DOI:10.1111/ijd.16710

J Prosthodont. 2023 May 19. doi: 10.1111/jopr.13716. Online ahead of print.

ABSTRACT

PURPOSE: To compare screw surface characteristics between hemi-engaging and non-engaging implant-supported fixed partial denture (FPD) designs after cyclic loading.

MATERIALS AND METHODS: Twenty-four implants measuring 4.3 × 10mm were mounted on acrylic resin blocks. Specimens were divided into 2 groups. An experimental group included twelve 3-unit FPD with a hemi-engaging design; a control group included twelve 3-unit FPD with the conventional design of two non-engaging abutments. Both groups were subjected to two types of cycling loading (CL), first axial loading, and then lateral loading at 30°. Load was applied to the units one million times (1.0×10⁶ cycles) for each loading axis. Data on screw surface roughness in three locations and screw thread depth were collected before (BL) and after (AL) each loading type. Screw surface roughness was measured in μm using a mechanical digital surface profilometer and optical profiler. To evaluate screw thread depth in μm, an upright optical microscope Axio-imager 2 was used. To confirm readings made from the optical microscope, four random samples were selected from each group for scanning electron microscopy (SEM) analysis. The effect of cyclic loading was evaluated by averaging values across the two screws within each specimen, then calculating difference scores (DL) between BL and AL (DL = AL – BL). Additional difference scores were computed between the non-engaging screws in each experimental group specimen, and one randomly selected non-engaging screw in each control specimen. This difference was referred to as the non-engaging DL. Statistical significance was assessed using Mann-Whitney U tests (α = .05).

RESULTS: Comparisons of DL and non-engaging DL by loading type revealed one significant difference regarding surface roughness at the screw thread. Significantly greater mean changes were observed after axial loading compared to lateral loading regarding both DL (axial M = -0.36 ± 0.08; lateral M = -0.21 ± 0.09; U = 20; p = .003) and non-engaging DL (axial M = -0.40 ± 0.22; lateral M = -0.21 ± 0.11; U = 29; p = .013). No significant differences in screw surface roughness in other sites or thread depth were found between the experimental and control abutment designs in DL or in non-engaging DL. No significant differences were found for DL (axial U = 13, P = .423; lateral U = 9, P = .150;) or non-engaging DL (axial U = 13, P = .423; lateral U = 18, P = 1.00).

CONCLUSIONS: Results suggest that overall, changes in screw surface physical characteristics did not differ between hemi-engaging and non-engaging designs after evaluating screw surface roughness and thread depth before and after axial and lateral cyclic loading. This article is protected by copyright. All rights reserved.

PMID:37208973 | DOI:10.1111/jopr.13716

Ophthalmic Physiol Opt. 2023 May 19. doi: 10.1111/opo.13165. Online ahead of print.

ABSTRACT

PURPOSE: Refractions based on the optimisation of single-value wavefront-derived metrics may help determine appropriate corrections for individuals with Down syndrome where clinical techniques fall short. This study compared dioptric differences between refractions obtained using standard clinical techniques and two metric-optimised methods: visual Strehl ratio (VSX) and pupil fraction tessellated (PFSt), and investigated characteristics that may contribute to the differences between refraction types.

METHODS: Thirty adults with Down syndrome (age = 29 ± 10 years) participated. Three refractive corrections (VSX, PFSt and clinical) were determined and converted to vector notation (M, J₀ , J₄₅ ) to calculate the dioptric difference between pairings of each type using a mixed model repeated measures approach. Linear correlations and multivariable regression were performed to examine the relationship between dioptric differences and the following participant characteristics: higher order root mean square (RMS) for a 4 mm pupil diameter, spherical equivalent refractive error and Vineland Adaptive Behavior Scales (a measure of developmental ability).

RESULTS: The least squares mean estimates (standard error) of the dioptric differences for each pairing were as follows: VSX versus PFSt = 0.51 D (0.11); VSX versus clinical = 1.19 D (0.11) and PFSt versus clinical = 1.04 D (0.11). There was a statistically significant difference in the dioptric differences between the clinical refraction and each of the metric-optimised refractions (p < 0.001). Increased dioptric differences in refraction were correlated with increased higher order RMS (R = 0.64, p < 0.001 [VSX vs. clinical] and R = 0.47, p < 0.001 [PFSt vs. clinical]) as well as increased myopic spherical equivalent refractive error (R = 0.37, p = 0.004 [VSX vs. clinical] and R = 0.51, p < 0.001 [PFSt vs. clinical]).

CONCLUSIONS: The observed differences in refraction demonstrate that a significant portion of the refractive uncertainty is related to increased higher order aberrations and myopic refractive error. Methodology surrounding clinical techniques and metric-optimisation based on wavefront aberrometry may explain the difference in refractive endpoints.

PMID:37208971 | DOI:10.1111/opo.13165

J Healthc Risk Manag. 2023 May 19. doi: 10.1002/jhrm.21542. Online ahead of print.

ABSTRACT

As supply chains experienced disruptions early in the COVID-19 pandemic, personal protective equipment (PPE) quickly became scarce. The purpose of this study was to examine the impact of perceptions of inadequate PPE, fear of COVID-19 infection, and self-reported direct COVID-19 exposure on health care workers. Data to assess distress, resilience, social-ecological factors, and work and nonwork-related stressors were collected from June to July 2020 at a large medical center. Stressors were analyzed by role using descriptive statistics and multivariate regression analysis. Our data indicate that job role influenced fear of infection and perceptions of inadequate PPE in the early phase of the COVID-19 pandemic. Perceived organizational support was also related to perceptions of inadequate PPE supply. Interestingly, work location, rather than job role, was predictive of direct COVID-19 exposure. Our data highlight a disconnect between the perception of safety in the health care setting with real risk of exposure to infectious disease. This study suggests that leaders in health care should focus on cultivating supportive organizational cultures, assessing both perceived and actual safety, and provide adequate training in safety practices may improve preparedness and organizational trust during times of both certainty and crisis particularly for clinical workers with less education and training.

PMID:37208959 | DOI:10.1002/jhrm.21542

Bioinformatics. 2023 May 4;39(5):btad324. doi: 10.1093/bioinformatics/btad324.

NO ABSTRACT

PMID:37208919 | DOI:10.1093/bioinformatics/btad324

Health Serv Res. 2023 May 19. doi: 10.1111/1475-6773.14183. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine if income inequality, social cohesion, and neighborhood walkability are associated with physical activity among rural adults.

DATA SOURCE: Cross-sectional data came from a telephone survey (August 2020-March 2021) that examined food access, physical activity, and neighborhood environments across rural counties in a southeastern state.

STUDY DESIGN: Multinomial logistic regression models assessed the likelihood of being active versus inactive and insufficiently active versus inactive in this rural population. Coefficients are presented as relative risk ratios (RRRs). Statistical significance was determined using 95% confidence intervals (CIs). All analyses were performed in STATA 16.1.

DATA COLLECTION/EXTRACTION METHODS: Trained university students administered the survey. Students verbally obtained consent, read survey items, and recorded responses into Qualtrics software. Upon survey completion, respondents were mailed a $10 incentive card and printed informed consent form. Eligible participants were ≥18 years old and current residents of included counties.

PRINCIPAL FINDINGS: Respondents in neighborhoods with relatively high social cohesion versus low social cohesion were more likely to be active than inactive (RRR = 2.50, 95% CI: 1.27-4.90, p < 0.01), after accounting for all other variables in the model. Income inequality and neighborhood walkability were not associated with different levels of physical activity in the rural sample.

CONCLUSIONS: Study findings contribute to limited knowledge on the relationship between neighborhood environmental contexts and physical activity among rural populations. The health effects of neighborhood social cohesion warrant more attention in health equity research and consideration when developing multilevel interventions to improve the health of rural populations.

PMID:37208903 | DOI:10.1111/1475-6773.14183

Med Sci Monit. 2023 May 20;29:e940355. doi: 10.12659/MSM.940355.

ABSTRACT

BACKGROUND Improving the quality of life of scoliosis patients with appropriate preventive measures is critical. This study aimed to investigate the relationships among bone mass, Cobb angle, and complete blood count (CBC) parameters in patients with scoliosis. MATERIAL AND METHODS This joint study was conducted by the pediatric department and orthopedics clinics, which used the medical records of patients aged 10-18 years between 2018 and 2022. Patients were divided into 3 groups according to the Cobb angle. Patient blood count levels from medical records and bone mineral density (BMD) Z scores (g/cm²) were compared among groups. Notably, BMD Z scores were calculated using a (BMD) dataset from local Turkish children after adjusting for height and age. RESULTS A total of 184 individuals (120 females, 64 males) were included in the study. There were statistically significant differences among the groups in platelet-to-lymphocyte ratio (PLR). Significant differences in DXA Z scores among groups were found. There was a significantly strong and positive correlation between DXA Z scores and all CBC parameters in patients with severe scoliosis. CONCLUSIONS This study found that CBC parameters can predict BMD in adolescents. Furthermore, the association between vitamin D deficiency and low BMD may contribute to the follow-up of body adaptation in patients with scoliosis receiving conservative treatment.

PMID:37208892 | DOI:10.12659/MSM.940355