Category: Nevin Manimala

Am J Transplant. 2022 Feb 4. doi: 10.1111/ajt.16985. Online ahead of print.

ABSTRACT

Questions have arisen around new metrics for organ procurement organizations (OPO) due to the perception that low-performing OPOs may be limited by local centers’ acceptance of marginal organs. We reviewed 2013-2019 Organ Procurement and Transplantation Network (OTPN) and National Centers for Health Statistics (NCHS) data to explore the relationship between objectively measured OPO performance and utilization of deceased donor kidneys. We found that although donor recovery declined with rising age and kidney donor profile index (KDPI), OPO performance differences were evident within each age/KDPI group. By contrast, the number of discards per donor did not vary with OPO performance. Centers in donor service areas (DSAs) with lower-performing OPOs had higher local utilization and greater import of high-KDPI kidneys than did those with higher-performing OPOs. Lower rates of donor availability relative to waitlist additions may contribute to observed center acceptance behavior. Differences in center-level performance were highly visible in Scientific Registry of Transplant Recipients (SRTR) organ acceptance metrics, while SRTR OPO metrics did not detect large or persistent variation in procurement performance. Cumulatively, our findings suggest that objective measures of procurement performance can inform discussions of organ utilization, allowing for alignment of metrics in all elements of the procurement-transplantation system.

PMID:35118830 | DOI:10.1111/ajt.16985

Res Synth Methods. 2022 Feb 4. doi: 10.1002/jrsm.1550. Online ahead of print.

NO ABSTRACT

PMID:35118805 | DOI:10.1002/jrsm.1550

Endocrinol Diabetes Metab. 2022 Feb 4:e00324. doi: 10.1002/edm2.324. Online ahead of print.

ABSTRACT

INTRODUCTION: To determine the impact of real-time continuous glucose monitoring (RT-CGM) in conjunction with ‘Open loop’- continuous subcutaneous insulin infusion (CSII) as compared to conventional multiple daily injections (MDI) in type 1 diabetes.

METHODS: We explored the COCHRANE database, MEDLINE, WEB OF SCIENCE, GOOGLE SCHOLARS, PUBMED, EMBASE, and cited literature in articles retrieved (2010-2021) for all randomized controlled trials and real-world trials of more than 6 months duration in patients with type 1 diabetes that compared RT-CGM+CSII vs RT- CGM+MDI. A total of 1645 publications have been identified; however, only 3 trials fulfilled our inclusion criteria with a total number of 150 patients (72 patients using RT-CGM+CSII and 78 patients on RT-CGM+MDI). A Systematic Review and Meta-analysis were carried out.

RESULTS: No statistically significant reduction in HbA1c was found on comparing RT-CGM+CSII vs RT- CGM + MDI, with p-value = .75. Likewise, impact on TIR, weight and insulin usage was found to be statistically insignificant with p-value of 0.15, 0.75 and 0.20 respectively. There was an overall homogeneity between the 3 trials in respect to all previous variables with I² being 0%.

CONCLUSIONS: Real-time continuous glucose monitors in conjunction with MDI open-loop CSII had a similar impact on HbA1c, weight, insulin usage and TIR. In addition, RT-CGM when combined with CSII was associated with higher costs and reduced quality of life, hence RT- CGM+MDI can be considered as a cheaper, safer yet equivalent substitute.

REVIEW REGISTRATION: This study was registered in PROSPERO (International prospective register of systematic reviews). Registration Name: RT-CGM in conjunction with CSII vs MDI in optimizing glycaemic control in T1DM: a systematic review. Registration No: CRD42021255333. Accessible at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255333. Amendments: Few amendments to the above-mentioned registration were made: (1) Title (Meta-analysis was added). (2) Prof. Gleeson was added as an author. (3) Real-world trials were included. (4) Outcomes required in studies as per our inclusion criteria amended to include at least 1 outcome. (5) Bias risk was assessed by the CASP tool.

PMID:35118826 | DOI:10.1002/edm2.324

J Esthet Restor Dent. 2022 Feb 4. doi: 10.1111/jerd.12879. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the color stability and microhardness of three bulk-fill composites with different polymerization characteristics, after immersion in four different solutions.

MATERIALS AND METHODS: Color measurements of three bulk fill (Viscalor (VIS), Tetric PowerFill (TPF), Fill Up! (FUP)) and a microhyrid composite resin (G-aenial posterior [GCP]) were performed after polymerization. The specimens were immersed in coffee, cola, red wine and distilled water. Discolorations were recorded after 24 h (T1), 10 days (T2) and 30 days (T3) of immersion. ΔE (CIEDE2000) values were calculated. Vickers microhardness (VHN) was measured from top and bottom surfaces at T0 and T3. Data was analyzed with Two-way ANOVA, One-way ANOVA and Tukey post hoc tests.

RESULTS: The highest discoloration was seen in wine and the lowest in distilled water and cola. At T3, there was no difference in distilled water groups, while the statistically highest ΔE₀₀ were obtained in TPF and GCP in coffee, cola and wine. VIS groups had the highest VHN values at T0 and T3 in all solutions.

CONCLUSIONS: Samples immersed in coffee and wine showed discoloration beyond clinically acceptable limits. After 30 days, discoloration occurred in all materials immersed in all solutions. At T3, VIS microhardness generally decreased, while TPF did not.

CLINICAL SIGNIFICANCE: After 30 days, all bulk-fill composites immersed in distilled water, coffee and wine showed clinically unacceptable ΔE₀₀ .

PMID:35118802 | DOI:10.1111/jerd.12879

Water Environ Res. 2022 Jan 12;94(2):e10688. doi: 10.1002/wer.10688. Online ahead of print.

ABSTRACT

The ever-increasing need for access to safe water has meant that alternative water sources and innovative water reclamation approaches are often required to meet the global water demand. As a result, many wastewater treatment facilities have faced regulatory pressure to seek alternative disinfection methods that ensure public health safety, while adhering to regulations that set limits on carcinogenic disinfection by-products (DBPs). Peracetic acid (PAA) is an emerging wastewater disinfectant in the United States that has been widely used in other industries such as food sanitization and does not produce carcinogenic DBPs. However, several factors such as transport, storage, and physical and chemical effects have stymied its widespread use in wastewater markets. Therefore, the purpose of this study was to examine the antimicrobial efficacy of an on-site generated PAA compared against a commercially available PAA. Antimicrobial efficacy was assessed using standard fecal contamination indicators (i.e., total coliforms and Escherichia coli) in six urban wastewater treatment facilities ranging in size and treatment processes. Overall, few statistical differences were found between the antimicrobial efficacies of on-site generated PAA and commercially available PAA; however, before becoming more widely utilized, the on-site PAA should be tested against emerging fecal contamination indicators (e.g., human norovirus and enterovirus) and be assessed in terms of economic and sustainability impacts. PRACTITIONER POINTS: Alternative Ct approaches should be considered when using disinfectants like PAA. On-site generated PAA can achieve the same level of disinfection as commercial PAA. On-site generation of PAA may help further its use as a wastewater disinfectant.

PMID:35118781 | DOI:10.1002/wer.10688

Br J Health Psychol. 2022 Feb 3. doi: 10.1111/bjhp.12584. Online ahead of print.

ABSTRACT

OBJECTIVES: The psychological impact of Inflammatory Bowel Disease (IBD) can be profound, leading to challenges with illness self-management. One such impact can be an identity discrepancy, where illness identity is rejected as part of the self. The aim of this study is to examine the relationship between illness identity and self-management of IBD.

DESIGN: A mixed-methods approach was taken using an online survey with 167 participants living with IBD.

METHODS: The Illness Identity Questionnaire and Patient Activation Measure were utilized to ascertain the correlational relationship between illness identity and self-management, triangulated with a thematic analysis of two open-ended questions on this topic.

RESULTS: The results revealed a statistically significant relationship after controlling for possible confounders of age, illness duration, illness severity, and number of comorbidities. Positive illness identity types (acceptance and enrichment) had a moderate, positive correlation with self-management. Negative identity types (rejection and engulfment) had a weak, negative correlation. This was supported by three main themes found from a thematic analysis and provided further insight into this relationship. Theme 1: negotiating with self as a process of acceptance; Theme 2: resigned acceptance that protects sense of self; and Theme 3: Self-management expands from behavioural strategies to psychological processes through acceptance.

CONCLUSIONS: These results suggest that the more illness is accepted into a sense of self, the better an individual is able to self-manage IBD as more psychological resources are activated. These findings provide individuals and clinicians alike insight into utilizing identity change to improve the overall self-management of IBD.

PMID:35118770 | DOI:10.1111/bjhp.12584

J Prosthodont. 2022 Feb 3. doi: 10.1111/jopr.13488. Online ahead of print.

ABSTRACT

PURPOSE: Pre-ceramic soldering of zirconia may deliver better fitting restorations. However, there is not sufficient evidence regarding the influence of pre-ceramic soldering of zirconia restorations on mechanical strength. The aim of this study was to evaluate the effect of pre-ceramic soldering on the fracture load of 4-unit zirconia fixed dental prostheses (FDPs).

MATERIALS AND METHODS: Eighty samples of 4-unit FDPs between maxillary right first premolar and maxillary right second molar were prepared and two restorative materials were used as a framework (Z) and monolithic restoration (M). The samples were divided into two subgroups as control (C) and study (S). The restorations of study groups (S) were divided into two pieces and soldered with a bonding material (DCM HotBond Zirkon). The groups were divided into two subgroups for thermal cycle (T) application. After soldering and thermal cycling application, 4-point bending test was applied to the samples at a cross-head speed of 1 mm/min in a universal testing machine and the fracture load was recorded. The data was analyzed statistically, and the level of significance was set at α = .001.

RESULTS: Statistically significant differences were found among the groups, based on the results of maximum failure loads (p<0.001). The highest mean failure load was observed in the ZCT(-) group (1094.1 +139.77 N), while the lowest mean failure load was obtained in the ZST(+) group (627.7 +82.14 N). No significant difference was found among the groups MC and MS, MC and ZC groups (p>.001). Thermal aging application caused lower fracture resistance in control and soldering groups (p<0.001).

CONCLUSIONS: The pre-ceramic soldering applications affected zirconia group negatively. However, the values were above the clinically acceptable static load bearing capacity for posterior teeth. Soldering did not cause a statistically significant difference for the fracture strengths of monolithic zirconia groups. Thermal cycling affected the fracture strength of zirconia and monolithic zirconia restorations negatively. This article is protected by copyright. All rights reserved.

PMID:35118772 | DOI:10.1111/jopr.13488

J Clin Nurs. 2022 Feb 3. doi: 10.1111/jocn.16238. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVES: To determine whether interventions that use the Specific Thematic Nursing Care Action Modules (STNC-AM) platform improve patients’ psychological health over a two-month period.

BACKGROUND: Stroke survivors often are left with a disability after a stroke, which can have an impact on their physical and mental health. Therefore, it is necessary for stroke patients to have tailored programmes in the face of post-stroke mental health concerns and the need for care information.

DESIGN: A non-randomised controlled pilot study was conducted.

METHODS: Participants included 44 post-stroke patients at a medical university hospital, between 1 August 2019-28 February 2021, of whom 24 were assigned to the control group and 20 were assigned to the intervention (STNC-AM). Data were analysed on an intention-to-treat basis. We used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist (case-control studies) for this study.

RESULTS: There were no statistical differences between the two groups at baseline. At the end of two months, however, the scores for resilience, depression and positive factors illness representation were statistically different between the two groups (p < .05). The results of the generalised estimating equation model analysis indicated that resilience and anxiety remained more significant in decreasing depression in the intervention group than in the control group.

CONCLUSION: This preliminary trial suggests that, although action modules may be associated with a decrease in depression post-stroke, part of this effect was likely associated with an increase in resilience and a decrease in anxiety of the patients.

RELEVANCE TO CLINICAL PRACTICE: The STNC-AM platform provides a coaching platform that helps patients and caregivers to be effective and accessible.

PMID:35118746 | DOI:10.1111/jocn.16238

Nurs Crit Care. 2022 Feb 3. doi: 10.1111/nicc.12757. Online ahead of print.

ABSTRACT

BACKGROUND: Central line-associated bloodstream infections (CLABSI) have been a significant challenge in care, increasing healthcare costs and leading to adverse outcomes, including mortality.

AIMS AND OBJECTIVES: The present study aimed to assess the knowledge of intensive care unit (ICU) nurses on the prevention of CLABSI and the implementation barriers of evidence-based guidelines in practice.

DESIGN: A cross-sectional study.

METHODS: Data were collected from adult, paediatric, and neonatal ICU nurses working in seven hospitals in Iran, using census sampling from April to July 2020.

RESULTS: A number 209 out of 220 ICU nurses participated in the present study (response rate of 95%). The median score of knowledge of ICU nurses towards the prevention of CLABSI was 3.00 out of 11. 50.72% of ICU nurses had insufficient knowledge. The most critical implementation barriers of evidence-based guidelines were high workload, shortage of necessary equipment, and lack of CLABSI prevention workshops.

CONCLUSIONS: Overall, the knowledge of ICU nurses towards the prevention of CLABSI was insufficient. Study findings suggest that the knowledge of ICU nurses may be improved by reducing the workload, increasing the number of nursing staff in the ICU, having an adequate supply of equipment needed to ensure safe practice in the ICU, and providing regular related educational workshops for nurses working in the ICU.

RELEVANCE TO CLINICAL PRACTICE: The present study’s findings suggest that regular training programs should be developed to improve the knowledge of ICU nurses in the care and prevention of CLABSI. Nursing policymakers and managers need to identify and address implementation barriers of evidence-based guidelines to improve nursing, such as high workload, shortage of necessary equipment, and lack of CLABSI prevention workshops.

PMID:35118750 | DOI:10.1111/nicc.12757

J Prosthodont. 2022 Feb 4. doi: 10.1111/jopr.13490. Online ahead of print.

ABSTRACT

PURPOSE: To verify whether 3D surface deviation analysis software can detect the surface changes of composite veneered polyetheretherketone posterior crowns following wear simulation compared to optical digital profilometry.

MATERIALS AND METHODS: Twenty dental crowns, fabricated from computer-aided design and computer-aided manufacture polyetheretherketone (PEEK) and veneered with high impact polymer composite (HIPC), were subjected to wear test (50N, 5/55◦C; 120,000 chewing cycles). Optical digital profilometry and 3D surface deviation using Geomagic design X software was used before and after the wear test to measure volumetric wear loss (mm³ ). The data were statistically analyzed with Wilcoxon signed-rank test to compare the two methodologies. The significance level was set at p ≤ 0.05.

RESULTS: There was no statistically significant difference between the two assessment methods (P-value = 0.075, Effect size = 0.854). Regarding the optical digital profilometry analysis, HIPC veneered PEEK crowns showed 0.01686 (0.018-0.02155) mm³ as a median volumetric wear loss value. While the crowns analyzed by 3D surface deviation showed -0.0398 (-0.0913 – -0.0042) mm³ as a median volumetric loss value (P-value = 0.075, Effect size = 0.854). In addition, there was no statistically significant correlation between wear measurements by optical digital profilometry and 3D surface deviation analyses (ρ = -0.177, P-value = 0.685).

CONCLUSIONS: There was no significant difference or correlation between optical digital profilometry and 3D surface deviation analyses for volumetric wear loss of veneered PEEK crowns. This article is protected by copyright. All rights reserved.

PMID:35118735 | DOI:10.1111/jopr.13490