Category: Nevin Manimala

J Prosthodont. 2023 Jan 24. doi: 10.1111/jopr.13650. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to analyze the fibroblast growth and proliferation on 3D-printed zirconia in presence and absence of porosities.

MATERIAL AND METHODS: Total of 40 bars (8×4×3) were included in this study. Thirty 3D-printed and 10 milled zirconia samples were prepared. The 3D-printed samples had different porosities i.e., 0% (PZ0), 20% (PZ20) and 40% (PZ40) with 10 specimens in each group. Milled zirconia samples were used as the control (MZ). Rat gingival fibroblasts were cultured for 48 hours and the proliferation of fibroblasts on each sample in each group (n = 10) was determined by MTT assays. The differences among the 4 groups were compared by one-way ANOVA. To test the significance of the observed differences between 2 groups, an unpaired Student’s t-test was applied. The significance level was set at p < 0.05. Qualitative analysis for the cell culture was performed using scanning electron microscopy (SEM).

RESULTS: One way ANOVA showed the numbers of the fibroblasts among the 4 groups had a statistical difference. Post Hoc Bonferroni test revealed that there was no significant difference between PZ0 and MZ, however all other groups and among groups were significantly different.

CONCLUSIONS: Fibroblasts had a better affinity towards the MZ and PZ0 in a short period of cell culture time. This article is protected by copyright. All rights reserved.

PMID:36693242 | DOI:10.1111/jopr.13650

Nurs Educ Perspect. 2023 Jan 25. doi: 10.1097/01.NEP.0000000000001098. Online ahead of print.

ABSTRACT

Nursing students have limited opportunities to build team leader skills during their clinical experiences, leaving a practice gap. Senior nursing students participated in a competency-based education unit and a simulation-based learning experience incorporating team leader skills. Presurvey and postsurvey data were collected using the Self-Confidence and Comfort with Utilizing a Standardized Handoff Communication Tool. Participants who completed both surveys were analyzed (n = 85). Statistically significant improvements were found on 14 of the 19 survey items. Results suggest the effectiveness of using competency-based education and simulation-based learning experience to help nursing students build confidence and comfort in team leader skills.

PMID:36693225 | DOI:10.1097/01.NEP.0000000000001098

Menopause. 2023 Jan 24. doi: 10.1097/GME.0000000000002153. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the prevalence of genitourinary syndrome of menopause (GSM) in Japan using the Japanese translation of the Vulvovaginal Symptoms Questionnaire (VSQ) with online survey. In addition, we examined the relationship between sexual activity and GSM symptoms.

METHODS: An online survey on GSM was conducted with 4,134 women aged 40 to 79 years, who were registered in an online survey company. Several questionnaires with Japanese translations of linguistic validity were used in this study. GSM was defined as a condition in women older than 40 years with vulvovaginal symptoms on the VSQ.

RESULTS: The percentage of postmenopausal women 40 years and older was 69.6%. The percentage of women with sexual activity was 22%. The prevalence of GSM with vulvovaginal symptoms was 11.6%, and 31.7% in sexually active women. The prevalence of GSM was associated with age and was significantly lower in the 70s age group than in other age groups. Vulvar hurting and dryness were both age-related only in the sexual activity group, with a statistically significantly higher prevalence in the 70s group than in the 40s group. The prevalence of vulvar dryness during sexual activity was significantly lower in the 40s age group.

CONCLUSIONS: An online epidemiological survey of GSM was conducted for the first time in Japan using the linguistically validated Japanese translation of the VSQ. The prevalence of GSM with genital or sexual symptoms was 11.6% in Japanese women 40 years and older, and 31.7% in sexually active women.

PMID:36693224 | DOI:10.1097/GME.0000000000002153

Clin Transplant. 2023 Jan 24:e14918. doi: 10.1111/ctr.14918. Online ahead of print.

ABSTRACT

Donation after circulatory death (DCD) kidneys are exposed to warm ischemia, which, coupled with cold ischemia time (CIT) exacerbates delayed graft function (DGF) and is possibly associated with worse graft survival. To analyze the risk of CIT-induced DGF on DCD kidney outcomes, we evaluated national data between 2008-2018 of adult kidney-only recipients of paired DCD kidneys where one kidney recipient experienced DGF and the other did not. Of 5602 paired DCD kidney recipients, multivariate analysis between recipients with higher CIT relative to lower CIT showed that increasing CIT differences had a significant dose-dependent effect on overall graft survival. The graft survival risk was minimal with CIT differences of ≥1-hour (adjusted hazard ratio [aHR] 1.07, 95% CI 0.95- 1.20, n = 5602) and ≥5-hours (aHR 1.09, 95% CI 0.93-1.29, n = 2710) and became significant at CIT differences of ≥10-hours (aHR 1.37, 95% CI 1.05-1.78, n = 1086) and ≥15-hours (aHR 1.78, 95% CI 1.15-2.77, n = 1086). Between each of the 4 delta-CIT levels of shorter and longer CIT, there were no statistically significant differences in the proportion of acute rejection. These results suggest that in the setting of DCD kidney transplantation, DGF, specifically mediated by prolonged CIT, impacts long-term graft outcomes. This article is protected by copyright. All rights reserved.

PMID:36693223 | DOI:10.1111/ctr.14918

Ann Fam Med. 2022 Apr 1;(20 Suppl 1). doi: 10.1370/afm.20.s1.2679.

ABSTRACT

Context: Most patients in need of behavioral health (BH) care are seen in primary care, which often has difficulty responding. Some practices integrate behavioral health care (IBH), with medical and BH providers at the same location, working as a team. However, it is difficult to achieve high levels of integration. Objective: Test the effectiveness of a practice intervention designed to increase BH integration. Study Design: Pragmatic, cluster-randomized controlled trial. Setting: 43 primary care practices with on-site BH services in 13 states. Population: 2,460 adults with multiple chronic medical and behavioral conditions. Intervention: 24-month practice change process including an online curriculum, a practice redesign and implementation workbook, remote quality improvement coaching services, and an online learning community. Outcomes: Primary outcomes were changes in the 8 Patient-Reported Outcomes Measurement Information System (PROMIS-29) domain scores. Secondary outcomes were changes in medication adherence, self-reported healthcare utilization, time lost due to disability, cardiovascular capacity, patient centeredness, provider empathy, and several condition-specific measures. A sample of practice staff completed the Practice Integration Profile at each time point to estimate the degree of BH integration in that site. Practice-level case studies estimated the typical costs of implementing the intervention. Results: The intervention had no significant effect on any of the primary or secondary outcomes. Subgroup analyses showed no convincing patterns of effect in any populations. COVID-19 was apparently not a moderating influence of the effect of the intervention on outcomes. The intervention had a modest effect on the degree of practice integration, reaching statistical significance in the Workflow domain. The median cost of the intervention was $18,204 per practice. In post-hoc analysis, level of BH integration was associated with improved patient outcomes independent of the intervention, both at baseline and longitudinally. Conclusions: The specific intervention tested in this study was inexpensive, but had only a small impact on the degree of BH integration, and none on patient outcomes. However, practices that had more integration at baseline had better patient outcomes, independent of the intervention. Although this particular intervention was ineffective, IBH remains an attractive strategy for improving patient outcomes.

PMID:36693208 | DOI:10.1370/afm.20.s1.2679

Environ Sci Technol. 2023 Jan 24. doi: 10.1021/acs.est.2c04302. Online ahead of print.

ABSTRACT

Although quantitative environmental (in)justice research demonstrates a disproportionate burden of toxic chemical hazard risks among racial/ethnic minorities and people in low socioeconomic positions, limited knowledge exists on how racial/ethnic and socioeconomic groups across geographic spaces experience toxic chemical hazards. This study analyzed the spatial non-stationarity in the associations between toxic chemical hazard risk and community characteristics of census block groups in Texas, USA, for 2017 using a multiscale geographically weighted regression. The results showed that the percentage of Black or Asian population has significant positive associations with toxic risk across block groups in Texas, meaning that racial minorities suffered more from toxic risk wherever they are located in the state. By contrast, the percentage of Hispanic or Latino has a positive relationship with toxic risk, and the relationship varies locally and is only significant in eastern areas of Texas. Statistical associations between toxic risk and socioeconomic variables are not stationary across the state, showing sub-state patterns of spatial variation in terms of the sign, significant level, and magnitude of the coefficient. Income has a significant negative association with toxic risk around the Dallas-Fort Worth-Arlington Metropolitan Statistical Area. Proportions of people without high school diploma and the unemployment rate both have positive relationships with toxic risk in the eastern area of Texas. Our findings highlight the importance of identifying the spatial patterns of the association between toxic chemical hazard risks and community characteristics at the census block group level for addressing environmental inequality.

PMID:36693189 | DOI:10.1021/acs.est.2c04302

Environ Sci Technol. 2023 Jan 24. doi: 10.1021/acs.est.2c08524. Online ahead of print.

ABSTRACT

Elevated uranium (U) (>WHO limit of 30 μg L^-1) in Indian groundwaters is primarily considered geogenic, but the specific mineralogical sources and mechanisms for U mobilization are poorly understood. In this contribution, statistical and geochemical analyses of well-constrained metadata of Indian groundwater quality (n = 342 of 8543) were performed to identify key parameters and processes that influence U concentrations. For geochemical predictions, a unified speciation model was developed from a carefully compiled and updated thermodynamic database of inorganic, organic (Stockholm Humic model), and surface complexation reactions and associated constants. Critical U contamination was found at shallow depths (<100 m) within the Indo-Gangetic plain, as determined by bivariate nonparametric Kendall’s Tau_b and probability-based association tests. Analysis of aquifer redox states, multivariate hierarchical clusters, and principal components indicated that U contamination was predominant not just in oxic but mixed (oxic-anoxic) aquifers under high Fe, Mn, and SO₄ concentrations, presumably due to U release from dissolution of Fe/Mn oxides or Fe sulfides and silicate weathering. Most groundwaters were undersaturated with respect to relevant U-bearing solids despite being supersaturated with respect to atmospheric CO₂ (average pCO₂ of reported dissolved inorganic carbonate (DIC) data = 10^-1.57 atm). Yet, dissolved U did not appear to be mass limited, as predicted solubilities from reported sediment concentrations of U were ∼3 orders of magnitude higher. Integration of surface complexation models of U on typical aquifer adsorbents, ferrihydrite, goethite, and manganese dioxide, was necessary to explain dissolved U concentrations. Uranium contamination probabilities with increasing dissolved Ca and Mn exhibited minima at equilibrium solubilities of calcite [∼50 mg L^-1] and rhodochrosite [∼0.14 mg L^-1], respectively, at an average groundwater pH of ∼7.5. A potential indirect control of such U-free carbonate solids on U mobilization was suggested. For locations (n = 37) where dissolved organic carbon was also reported, organic complexes of U contributed negligibly to dominant U speciation at the groundwater pH. Overall, the unified model suggested competitive dissolution-precipitation and adsorption-desorption controls on U speciation. The model provides a quantitative framework that can be extended to understand dominant mobilization mechanisms of geogenic U in aquifers worldwide after suitable modifications to the relevant aquifer parameters.

PMID:36693168 | DOI:10.1021/acs.est.2c08524

Simul Healthc. 2023 Jan 23. doi: 10.1097/SIH.0000000000000713. Online ahead of print.

ABSTRACT

INTRODUCTION: In simulation, students often observe their peers perform a task. It is still unclear how different types of instructional guidance can turn the observational phase into an active learning experience for novices. This mixed-method study aims to understand similarities and differences between use of collaboration scripts and checklists by observers in terms of cognitive load and perception of learning.

METHODS: Second-year pharmacy students (N = 162) were randomly assigned to 1 of 4 conditions when observing a simulation: collaboration scripts (heuristic to analyze in dyads while observing), checklists, both, or no guidance. We measured observers’ intrinsic and extraneous cognitive load and self-perceived learning and conducted focus group interviews.

RESULTS: Intrinsic cognitive load was significantly lower for checklists (M = 3.6/10) than for scripts (M = 4.7/10) or scripts and checklists combined (M = 4.7/10). Extraneous cognitive load was significantly lower for checklists (M = 1.5/10) than for scripts combined with checklists (M = 2.6/10) or no guidance (M = 1.8/10). There was no statistical difference between conditions for self-perceived learning. Coding of focus group interviews revealed 6 themes on observers’ perception of learning under different conditions of instructional guidance. Students explained that collaboration scripts felt more complex, whereas checklists were perceived as a simple fact-checking exercise. Observing the simulation, regardless of guidance, was a meaningful learning experience.

CONCLUSIONS: With or without guidance, observers are actively engaged with the simulation, but their effort differed depending on instructions. When choosing between checklists or collaboration scripts, educators should be guided by the type of simulation task.

PMID:36693158 | DOI:10.1097/SIH.0000000000000713

JMIR Form Res. 2023 Jan 18. doi: 10.2196/39994. Online ahead of print.

ABSTRACT

BACKGROUND: Older adults are particularly at risk from infectious diseases, including serve complications, hospitalization, and death.

OBJECTIVE: This study aimed to explore the drivers of vaccine hesitancy among older adults based on the 3Cs framework, where socioeconomic status and vaccination history played as roles of moderators.

METHODS: A cross-sectional questionnaire survey was conducted in Jiangsu Province, China between June 1, 2021, and July 20, 2021. Older adults (above 60 years) were recruited using a stratified sampling method. Vaccine hesitancy was setting influenced by confidence, complacency, and convenience in the model. Socioeconomic status and vaccination history processed through the item parceling method were used to moderate associations between the 3Cs and hesitancy. Hierarchical regression analyses and structural equation modeling were used to test the validity of the new framework. We performed 5000 trials of bootstrapping to calculate the 95% confidence interval (CI) of the pathway’s coefficients.

RESULTS: A total of 1341 older adults (response rate: 87%) participated. The age was 71.3 ± 5.4 years old and 44.7% of participants were men. Confidence [b = 0.967, 95% CI: 0.759, 1.201, P = .002], convenience (b = 0.458, 95% CI: 0.333, 0.590, P = .002), and less complacency (b = 0.301, 95% CI: 0.187, 0.408, P = .002) were positively associated with less vaccine hesitancy. Socioeconomic status weakened the positive effect of low complacency (b = -0.065, P = .03) on low vaccine hesitancy. Coronavirus disease 2019 (COVID-19) vaccination history negatively moderated the positive association between confidence (b = -0.071, P = .02) and lower vaccine hesitancy.

CONCLUSIONS: Our study identified that confidence was the more influential dimension in reducing vaccine hesitancy among older adults. COVID-19 vaccination history, as well as confidence, have a positive association with less vaccine hesitancy, and it could weaken the role of confidence in vaccine hesitancy. Socioeconomic status had a substitution relationship with less complacency, which suggested a competitive positive association between them on less vaccine hesitancy.

PMID:36693149 | DOI:10.2196/39994

Ear Hear. 2023 Jan 25. doi: 10.1097/AUD.0000000000001338. Online ahead of print.

ABSTRACT

OBJECTIVES: Systemic steroids are the most common first-line therapy in sudden sensorineural hearing loss (SSNHL), with significant improvement in hearing outcomes in over 60% of patients. It is unknown why 40% of patients do not respond to systemic steroid therapy. Salvage treatment includes intratympanic steroids (ITS) and hyperbaric oxygenation (HBO) therapy, with inconsistent results reported. This study aimed to compare the results of ITS and HBO therapy in patients with SSNHL that previously failed systemic steroid therapy.

DESIGN: This is a comparative retrospective nonrandomized interventional cohort study, enrolling 126 patients with SSNHL. Out of these, 35 patients received HBO therapy, 43 patients received ITS, and 48 patients did not receive any second-line therapy (control group). Pure-tone audiograms were performed before and after the salvage therapy in the IT and HBO groups and at the same time interval in the control group. Study variables included age, time until therapy initiation, tinnitus status, and hearing outcomes, with a cutoff criteria of cumulative >30 dB improvement on all frequencies indicating recovery.

RESULTS: ITS and HBO therapy were associated with statistically significant hearing recovery at all frequencies compared to systemic steroids. The results show an average hearing improvement of 13.6 dB overall frequencies (250 to 8000 Hz) after ITS therapy and 7.4 dB in HBO therapy in comparison to the control group. Presence of significant hearing improvement positively correlated with age, ITS therapy, and HBO therapy. Presence of tinnitus before therapy was negatively correlated with hearing improvement. Patients with tinnitus present at the start of therapy improve 4.67 dB less on average compared to those without tinnitus. ITS therapy significantly reduced tinnitus compared to the other two treatment options. Patients with tinnitus present before therapy significantly improve hearing at low frequencies, compared to the control group.

CONCLUSIONS: ITS and HBO therapy show superior hearing results compared to observation alone after failed oral steroid therapy for SSNHL. ITS shows an additional positive impact on tinnitus reduction and shows superior hearing outcomes after salvage therapy.

PMID:36693145 | DOI:10.1097/AUD.0000000000001338