Category: Nevin Manimala

J Prosthodont. 2023 Mar 14. doi: 10.1111/jopr.13672. Online ahead of print.

ABSTRACT

PURPOSE: To assess the changes in intrapulpal temperature between electric high-speed handpieces of different coolant functions (‘Water Jet’ and ‘Water Spray’), coolant port designs (1- and 4-port), suction use and bur and tooth types using an experimental in vitro set-up.

MATERIALS AND METHODS: Forty-four extracted anterior and posterior teeth were collected. A total of 18 groove cuts (n = 18/coolant port spray design, bur and tooth type group) and 12 groove cuts (n = 12/ tooth type and suction use) was completed, with a total of 264 groove cuts. Real-time temperature and duration was recorded at 1 s intervals throughout the preparation process using a thermocouple and digital data logger set-up (GFX Data Logger Series and EL USB-TC; Lascar Electronics Inc, USA), and the data retrieved using EasyLog Software (EasyLog USB; Lascar Electronics Inc, USA). Statistical analysis was performed (SPSS V.27) for the change in temperature using the ANOVA and post-hoc analysis.

RESULTS: The majority of the specimen cuts, regardless of tooth (anterior or posterior) and bur (diamond or carbide) type, handpiece coolant port design and suction use showed an overall decreasing trend in intrapulpal temperature. No cuts caused a mean temperature change that reached the critical temperature of 42.5°C, or resulted in an overall increase in intrapulpal temperature when the 60 s duration was completed.

CONCLUSIONS: The tested electric handpieces efficiently reduced intrapulpal temperature, with the majority displaying a decreasing trend. A greater decrease in intrapulpal temperature was observed in canines compared to premolars; carbide burs compared to diamond; and with no suction preparations compared to when suction was used. This article is protected by copyright. All rights reserved.

PMID:36918297 | DOI:10.1111/jopr.13672

Rapid Commun Mass Spectrom. 2023 Mar 14:e9504. doi: 10.1002/rcm.9504. Online ahead of print.

ABSTRACT

RATIONAL: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a prevalent complication of cardiac surgery, which may be associated with a great risk of developing chronic kidney disease and mortality. This study aimed to investigate the possible links between gut microbiota metabolism and CSA-AKI.

METHODS: A prospective cohort of patients who underwent cardiac surgery was continuously recruited, who were further divided into CSA-AKI group and Non-AKI group based on the clinical outcomes. Their faecal and plasma samples were collected before the surgery and were separately analysed by non-targeted and targeted metabolomics. The differential metabolites related to CSA-AKI were screened out using statistical methods, and altered metabolic pathways were determined by examining the Kyoto Encyclopedia of Genes and Genomes database.

RESULTS: Nearly 1000 faecal metabolites were detected through high-resolution mass spectrometry (MS) and bioinformatics at high and mid confidence levels, and 49 differential metabolites at high confidence level may perform essential biological functions and provide potential diagnostic indicators. Compared with the Non-AKI group, the patients in the CSA-AKI group displayed dramatic changes in gut microbiota metabolism, including amino acid metabolism, nicotinate and nicotinamide metabolism, purine metabolism, and ABC transporters. Meanwhile, 188 plasma metabolites were identified and quantified by tandem MS, and 34 differential plasma metabolites were screened out between the two groups using univariate statistical analysis. These differential plasma metabolites were primarily enriched in the following metabolic pathways: sulphur metabolism, amino acid biosynthesis, tryptophan metabolism, and ABC transporters. Furthermore, the content of indole metabolites in the faecal and plasma samples of the CSA-AKI group was higher than that of the Non-AKI group.

CONCLUSIONS: Patients with CSA-AKI may have dysbiosis of their intestinal microbiota and metabolic abnormalities in their gut system before cardiac surgery. Thus, some metabolites and related metabolic pathways may be potential biomarkers and new therapeutic targets for the disease.

PMID:36918294 | DOI:10.1002/rcm.9504

J Dr Nurs Pract. 2023 Mar 1;16(1):54-61. doi: 10.1891/JDNP-2022-0003.

ABSTRACT

Background: COVID-19 hand hygiene recommendation had resulted in a hand eczema -exacerbation. The guidelines of care for the management of hand eczema recommend the use of educational interventions for patients. Objective: An educational intervention was designed to increase the patient’s knowledge of appropriate hand hygiene and improve the patient’s symptoms. Methods: The validated self-assessment patient-oriented eczema measure tool and pre- and post-tests were used to measure outcomes prior to educational intervention and again in 1-2 months postintervention. Of the 26 participants enrolled, 21 completed the study. The study included newly diagnosed or established patients with eczema, and the education material was available for all patients. Results: The difference between the average pretest and initial posttest was statistically significant (df = 20, P (T ≤ t) = 0.000663535, p < .05). Similarly, the difference between the average pretest and follow-up posttest was also statistically significant (df = 20, P (T ≤ t) < 0.001, p < .05). Participants also had a 2.04 mean point decrease in symptoms severity. Conclusions: The results demonstrated an improvement in patient’s knowledge and reduction in symptoms. Implications for Nursing: The program can serve as a new guideline for managing hand eczema symptoms due to COVID-19 in the adult population in the private office setting.

PMID:36918285 | DOI:10.1891/JDNP-2022-0003

J Dr Nurs Pract. 2023 Mar 1;16(1):3-8. doi: 10.1891/JDNP-2021-0018.

ABSTRACT

Background: The education of nursing students has changed radically during the COVID-19 pandemic, with more content being delivered virtually. With less face-to-face (F2F) contact with educators, content translation to real-world scenarios is diminished. Objective: To determine if an educational seminar using unfolding case studies will improve students’ understanding of concepts. Method: A pilot study of senior-level nursing students of an intensive unfolding case study application was conducted to focus on concept application. Results: Pre- and post-tests were compared with the increase in understanding of the focused topics, delegation, advanced directives, and safety, which was statistically significant (t[55] = 6.92, p < .001). Conclusion: Using real-world clinical problems through case studies facilitates understanding concepts and developing critical thinking skills/problem-solving abilities. The results of this study provide an impetus for the use of unfolding case studies to help nursing students understand leadership concepts.

PMID:36918280 | DOI:10.1891/JDNP-2021-0018

J Pharmacol Exp Ther. 2023 Mar 14:JPET-AR-2022-001493. doi: 10.1124/jpet.122.001493. Online ahead of print.

ABSTRACT

Type 2 diabetes (T2D) is a rising pandemic worldwide. Diet and lifestyle changes are typically the first intervention for T2D. When this intervention fails, the biguanide, metformin, is the most common pharmaceutical therapy. Yet, it’s full mechanisms of action remain unknown. In this work, we applied an ultrahigh resolution, mass spectrometry-based platform for untargeted plasma metabolomics to human plasma samples from a case-control observational study of non-diabetic and well-controlled T2D subjects, the latter treated conservatively with metformin or diet and lifestyle changes only. No statistically significant differences existed in baseline demographic parameters, glucose control, or clinical markers of cardiovascular disease risk between the two T2D groups, which we hypothesized would allow the identification of circulating metabolites independently associated with treatment modality. Over 3000 blank-reduced metabolic features were detected, with the majority of annotated features being lipids or lipid-like molecules. Altered abundance of multiple fatty acids and phospholipids were found in T2D subjects treated with diet and lifestyle changes as compared to non-diabetic subjects: changes that were often reversed by metformin. Our findings provide direct evidence that metformin monotherapy alters the human plasma lipidome independent of T2D disease control and support a potential cardioprotective effect of metformin worthy of future study. Significance Statement This work provides important new information on the systemic effects of metformin in type 2 diabetic subjects. We observed significant changes in the plasma lipidome with metformin therapy, with metabolite classes previously associated with cardiovascular disease risk significantly reduced as compared to diet and lifestyle changes. While cardiovascular disease risk was not a primary outcome of our study, our results provide a jumping-off point for future work into the cardioprotective effects of metformin, even in well-controlled type 2 diabetes.

PMID:36918276 | DOI:10.1124/jpet.122.001493

Heart. 2023 Mar 14:heartjnl-2022-321930. doi: 10.1136/heartjnl-2022-321930. Online ahead of print.

ABSTRACT

BACKGROUND: Dietary modification is a cornerstone of cardiovascular disease (CVD) prevention. A Mediterranean diet has been associated with a lower risk of CVD but no systematic reviews have evaluated this relationship specifically in women.

OBJECTIVE: To determine the association between higher versus lower adherence to a Mediterranean diet and incident CVD and total mortality in women.

METHODS: A systematic search of Medline, Embase, CINAHL, Scopus, and Web of Science (2003-21) was performed. Randomised controlled trials and prospective cohort studies with participants without previous CVD were included. Studies were eligible if they reported a Mediterranean diet score and comprised either all female participants or stratified outcomes by sex. The primary outcome was CVD and/or total mortality. A random effects meta-analysis was conducted to calculate pooled hazard ratios (HRs) and confidence intervals (CIs).

RESULTS: Sixteen prospective cohort studies were included in the meta-analysis (n=7 22 495 female participants). In women, higher adherence to a Mediterranean diet was associated with a lower CVD incidence (HR 0.76, 95% CI 0.72 to 0.81; I²=39%, p test for heterogeneity=0.07), total mortality (HR 0.77, 95% CI 0.74 to 0.80; I²=21%, p test for heterogeneity=0.28), and coronary heart disease (HR 0.75, 95% CI 0.65 to 0.87; I²=21%, p test for heterogeneity=0.28). Stroke incidence was lower in women with higher Mediterranean diet adherence (HR 0.87, 95% CI 0.76 to 1.01; I²=0%, p test for heterogeneity=0.89), but this result was not statistically significant.

CONCLUSION: This study supports a beneficial effect of the Mediterranean diet on primary prevention of CVD and death in women, and is an important step in enabling sex specific guidelines.

PMID:36918266 | DOI:10.1136/heartjnl-2022-321930

BMJ Support Palliat Care. 2023 Mar 14:spcare-2023-004200. doi: 10.1136/spcare-2023-004200. Online ahead of print.

NO ABSTRACT

PMID:36918258 | DOI:10.1136/spcare-2023-004200

BMJ Open. 2023 Mar 14;13(3):e065276. doi: 10.1136/bmjopen-2022-065276.

ABSTRACT

OBJECTIVES: To estimate the prevalence of common mental health disorders (CMDs) and emotional and behavioural disorders among young people and to explore the correlates of CMDs risk.

SETTING: Five urban and periurban communities in Harare and Mashonaland East, Zimbabwe DESIGN: Population-based cross-sectional study PARTICIPANTS: Young people aged 13-24 years living in households in the study areas.

OUTCOME MEASURES: The primary outcome was the proportion of participants screening positive for probable CMDs defined as a Shona Symptoms Questionnaire (SSQ) score ≥8. Secondary outcomes were emotional and behavioural disorders measured using the Strength and Difficulties Questionnaire (SDQ), and adjusted ORs for factors associated with CMD.

RESULTS: Out of 634 young people, 37.4% (95% CI 33.0% to 42.0%) screened positive for probable CMDs, 9.8% (95% CI 7.5% to 12.7%) reported perceptual symptoms and 11.2% (95% CI 9.0% to 13.8%) reported suicidal ideation. Using UK norms to define normal, borderline and abnormal scores for each of the SDQ domains, a high proportion (15.8%) of Zimbabwean young people had abnormal scores for emotional symptoms and a low proportion had abnormal scores for hyperactivity/inattention scores (2.8%) and prosocial scores (7.1%). We created local cut-offs for the emotional symptoms, hyperactivity/attention and prosocial SDQ domains. The odds of probable CMDs increased with each year of age (OR 1.09, p<0.001) and was higher among those who were out of school and not working compared with those in school or working (adj. OR 1.67 (1.07, 2.62), p=0.04). One in five participants (22.1%) were referred immediately for further clinical assessment but uptake of referral services was low.

CONCLUSIONS: We observed a high prevalence of symptoms of CMDs among general population urban and peri-urban young people especially among those with no employment. There is a need for more accessible and acceptable youth-friendly mental health services.

PMID:36918245 | DOI:10.1136/bmjopen-2022-065276

BMJ Open. 2023 Mar 14;13(3):e068625. doi: 10.1136/bmjopen-2022-068625.

ABSTRACT

OBJECTIVES: To examine the course of fear of falling (FoF) up to 1 year after hip fracture, including the effect of prefracture FoF on the course.

DESIGN: Observational cohort study with assessment of FoF at 6, 12 and 52 weeks after hip fracture.

SETTING: Haaglanden Medical Centre, the Netherlands.

PARTICIPANTS: 444 community-dwelling adults aged 70 years and older, admitted to hospital with a hip fracture.

MAIN OUTCOME MEASURE: Short Falls Efficacy Scale International (FES-I), with a cut-off score ≥11 to define elevated FoF levels.

RESULTS: Six weeks after hip fracture the study population-based mean FES-I was located around the cut-off value of 11, and levels decreased only marginally over time. One year after fracture almost one-third of the population had FoF (FES-I ≥11). Although the group with prefracture FoF (42.6%) had slightly elevated FES-I levels during the entire follow-up, the effect was not statistically significant. Patients with persistent FoF at 6 and 12 weeks after fracture (26.8%) had the highest FES-I levels, with a mean well above the cut-off value during the entire follow-up. For the majority of patients in this group, FoF is still present 1 year after fracture (84.9%).

CONCLUSIONS: In this study population, representing patients in relative good health condition that are able to attend the outpatient follow-up at 6 and 12 weeks, FoF as defined by an FES-I score ≥11 was common within the first year after hip fracture. Patients with persistent FoF at 12 weeks have the highest FES-I levels in the first year after fracture, and for most of these patients the FoF remains. For timely identification of patients who may benefit from intervention, we recommend structural assessment of FoF in the first 12 weeks after fracture.

PMID:36918243 | DOI:10.1136/bmjopen-2022-068625

BMJ Open. 2023 Mar 14;13(3):e066486. doi: 10.1136/bmjopen-2022-066486.

ABSTRACT

OBJECTIVE: We examined the association between partner alcohol consumption and the experience of intimate partner violence among women in Papua New Guinea.

DESIGN: We performed a cross-sectional analyses of data extracted from the 2016-2018 Papua New Guinea Demographic and Health Survey. We included 3319 women in sexual unions. Multilevel binary logistic regression analysis was used to examine the association between partner alcohol consumption and intimate partner violence, controlling for the covariates. Results from the regression analysis were presented using the crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95% confidence intervals (CIs).

SETTING: Papua New Guinea.

PARTICIPANTS: Women aged 15-49 years in sexual unions.

OUTCOME MEASURES: Physical, emotional, and sexual violence.

RESULTS: The prevalence of physical, emotional and sexual violence among women in sexual unions in Papua New Guinea were 45.9% (42.4 to 47.7), 45.1% (43.4 to 46.8) and 24.3% (22.9 to 25.8), respectively. The level of partner alcohol consumption was 57.3%. Women whose partners consumed alcohol were more likely to experience physical violence (aOR=2.86, 95% CI=2.43 to 3.37), emotional violence (aOR=2.89, 95% CI=2.44 to 3.43) and sexual violence (aOR=2.56, 95% CI=2.08 to 3.16) compared with those whose partners did not consume alcohol.

CONCLUSION: This study found a relatively high prevalence of intimate partner violence among women in Papua New Guinea. Most importantly, this study found partner alcohol consumption to be significantly and positively associated with intimate partner violence. The study, therefore, recommends that interventions seeking to reduce intimate partner violence among women in Papua New Guinea should intensify behaviour change and education on reducing or eliminating partner alcohol consumption.

PMID:36918235 | DOI:10.1136/bmjopen-2022-066486