Tag: nevin manimala

J Robot Surg. 2023 Apr 22. doi: 10.1007/s11701-023-01593-z. Online ahead of print.

ABSTRACT

This study aimed to comparatively evaluate postoperative pain, anxiety, and sleep quality in patients after robotic-assisted and manual total knee replacement surgery. Patients who underwent either robotic or manual total knee replacement (TKR) surgery were analyzed in this cross-sectional observational study. Volunteers who were conscious, mentally healthy, without primary sleep disorders, without chronic uncontrolled diseases, 18 years of age or older, able to understand verbal warnings, and who agreed to participate in the study after being informed about the purpose of the study were included in the study. A total of 80 patients who underwent robotic-assisted TKR and 87 patients who underwent manual TKR were participated in the study. Data were collected using the “Patient Description Form” Visual Analog Scale, Richards-Campbell Sleep Scale, and State Anxiety Scale. All patients were operated on by the same physicians and received standard perioperative care. In the study, a statistically significant difference was found between the education level of the patients and the type of surgery (p = 0.007). According to the average scores, it was observed that the patients in the robotic group had higher pain levels, better sleep quality, and higher anxiety levels compared to the manual group. There was a significant correlation between the level of pain felt on the 1st and 2nd day (p = < 0.001) and state anxiety levels with gender (p = 0.010) in the robotic group. For the robotic group, pain on day 2 was mostly affected by pain on day 1 and state anxiety. For the manual group, pain on day 2 was mostly affected by pain on day 1. According to our results, patients who underwent robotic-assisted TKR had higher pain levels, better sleep quality, and higher anxiety levels than patients who underwent manual TKR.

PMID:37086363 | DOI:10.1007/s11701-023-01593-z

Support Care Cancer. 2023 Apr 22;31(5):292. doi: 10.1007/s00520-023-07740-4.

ABSTRACT

PURPOSE: All patients living with cancer, including those with metastatic cancer, are encouraged to be physically active. This paper examines the secondary endpoints of an aerobic exercise intervention for men with metastatic prostate cancer.

METHODS: ExPeCT (Exercise, Prostate Cancer and Circulating Tumour Cells), was a multi-centre randomised control trial with a 6-month aerobic exercise intervention arm or a standard care control arm. Exercise adherence data was collected via heart rate monitors. Quality of life (FACT-P) and physical activity (self-administered questionnaire) assessments were completed at baseline, at 3 months and at 6 months.

RESULTS: A total of 61 patients were included (69.4 ± 7.3 yr, body mass index 29.2 ± 5.8 kg/m²). The median time since diagnosis was 34 months (IQR 7-54). A total of 35 (55%) of participants had > 1 region affected by metastatic disease. No adverse events were reported by participants. There was no effect of exercise on quality of life (Cohen’s d = – 0.082). Overall adherence to the supervised sessions was 83% (329 out of 396 possible sessions attended by participants). Overall adherence to the non-supervised home exercise sessions was 72% (months 1-3) and 67% (months 3-6). Modelling results for overall physical activity scores showed no significant main effect for the group (p-value = 0.25) or for time (p-value = 0.24).

CONCLUSION: In a group of patients with a high burden of metastatic prostate cancer, a 6-month aerobic exercise intervention did not lead to change in quality of life. Further exercise studies examining the role of exercise for people living with metastatic prostate cancer are needed.

TRIAL REGISTRATION: The trial was registered at clinicaltrials.gov (NCT02453139) on May 25th 2015.

PMID:37086362 | DOI:10.1007/s00520-023-07740-4

Prev Sci. 2023 Apr 22. doi: 10.1007/s11121-023-01521-5. Online ahead of print.

ABSTRACT

Transgender and gender diverse (TGD) youth experience significant risk for negative health outcomes, yet few studies exist that address TGD youth’s experiences of health care. This paper explores the equitable access and utilization of health care in a sample of TGD youth of diverse gender and racial/ethnic identities. Data for this analysis are from the TGD subsample (n = 1415) of the 2018 Survey of Today’s Adolescent Relationships and Transitions (START) Project. We assessed five health care experiences: being insured, having a current health care provider, being out to one’s provider, believing your provider was knowledgeable about transgender issues, and barriers to accessing care due to gender identity/expression. We examined the proportion of TGD youth who reported each of these outcomes and within-group differences by gender identity and race/ethnicity using descriptive statistics, logistic regression, and predicted probabilities. When differences were examined by gender identity, barriers to equitable care were consistently more present among transgender females than youth of other gender identities. There were few significant differences by race/ethnicity; however, dual referent models demonstrated barriers to equitable care were particularly evident among Black and Hispanic transgender women. We discuss these findings through the lens of intersectionality and highlight the importance of research and intervention work focused on reducing barriers to equitable care for TGD youth.

PMID:37086334 | DOI:10.1007/s11121-023-01521-5

Clin Rheumatol. 2023 Apr 22. doi: 10.1007/s10067-023-06558-z. Online ahead of print.

ABSTRACT

This study aims to determine the number and type of incidental findings detected on positron emission tomography (PET)/CT in a cohort of patients with large vessel vasculitis (LVV). Reports from PET/CT studies along with the medical charts of a cohort of patients with LVV from a Rheumatology clinic in Edmonton, Alberta, Canada, were retrospectively reviewed. Incidental findings from PET/CT, along with follow-up studies and their diagnosis were documented. The data was analyzed with descriptive statistics. The disease activity of 40 patients, with an average age of 65.8 years, was investigated using PET/CT. A statistically significant increase in incidental findings with age was observed. A total of 61 incidental findings were found in 26 (65%) patients. Of these findings, 25 were in the abdomen and pelvis. The most common incidental finding was lymphadenopathy. Follow-up investigations of incidental findings lead to 5 clinically significant findings including metastatic adenocarcinoma, Mycobacterium avium infection, papillary thyroid carcinoma, pheochromocytoma, and stroke. PET/CT is a reliable tool for determining disease activity in LVV patients and the implications of incidental findings need to be discussed with patients by the ordering care provider. This study demonstrates that incidental findings on PET/CT scan are common and increase with age in patients with LVV. A significant number of patients required further investigation for incidental findings. Key Points • Incidental findings on PET/CT scan are common in our patient population with LVV. • Frequency of incidental findings in our patient population with LVV increased with age. • Findings from this study can be used by ordering providers to have an informed conversation with their patient about the frequency of incidental findings on PET/CT scans.

PMID:37086310 | DOI:10.1007/s10067-023-06558-z

Eur J Clin Microbiol Infect Dis. 2023 Apr 22. doi: 10.1007/s10096-023-04594-w. Online ahead of print.

ABSTRACT

The aim of this study is to evaluate the chlorhexidine gluconate (CHG) susceptibility in both planktonic cells and biofilm of 32 Gram-negative (Gn) and 6 Gram-positive (Gp) isolates by minimal inhibitory concentration (2-256 μg/mL for Gn and 2-32 μg/mL for Gp), minimal bactericidal concentration (4-256 μg/mL for Gn and 2-32 μg/mL for Gp) in planktonic cells, and minimal biofilm elimination concentration (128 ≥ 16,384 μg/mL in Gn and 32 ≥ 16,384 μg/mL in Gp) in biofilm environment. Our study showed that Gn isolates have higher minimal concentrations than Gp and bacteria in biofilms are more tolerant than planktonic ones. No correlation between MBC or MBEC and biofilm formation was statistically confirmed. The Eagle effect, previously described for antimicrobials and antifungals, was evidenced in this work for CHG, an antiseptic. Besides that, the phenomenon was described in 23/38 isolates (60.5%), raising minimal concentration up to ≥ 16,384 μg/mL. Our study showed that clinical isolates have a high ability to form biofilm allowing them to tolerate CHG concentrations as high as the ones used in clinical practice. Therefore, attention should be given to the occurrence of this phenomenon to avoid false susceptibility results.

PMID:37086303 | DOI:10.1007/s10096-023-04594-w

J Math Biol. 2023 Apr 22;86(5):79. doi: 10.1007/s00285-023-01913-9.

ABSTRACT

We analyse a generalisation of the stochastic gene expression model studied recently in Fromion et al. (SIAM J Appl Math 73:195-211, 2013) and Robert (Probab Surv 16:277-332, 2019) that keeps track of the production of both mRNA and protein molecules, using techniques from the theory of point processes, as well as ideas from the theory of matrix-analytic methods. Here, both the activity of a gene and the creation of mRNA are modelled with an arbitrary Markovian Arrival Process governed by finitely many phases, and each mRNA molecule during its lifetime gives rise to protein molecules in accordance with a Poisson process. This modification is important, as Markovian Arrival Processes can be used to approximate many types of point processes on the nonnegative real line, meaning this framework allows us to further relax our assumptions on the overall process of transcription.

PMID:37086292 | DOI:10.1007/s00285-023-01913-9

Clin Oral Investig. 2023 Apr 22. doi: 10.1007/s00784-023-05027-w. Online ahead of print.

ABSTRACT

OBJECTIVES: A variety of dental materials are available for the fabrication of telescopic crowns. The aim was to investigate the impact of material combinations and removal and insertion cycles on their retention forces.

MATERIALS AND METHODS: CAD/CAM-fabricated cobalt-chromium-molybdenum (CoCr) and zirconia (ZrO₂) primary crowns were combined with polyetheretherketone (PEEK), polyetherketoneketone (PEKK), CoCr, and ZrO₂ secondary crowns (four combinations included PEEK/PEKK secondary crowns in a thickness of 0.5 mm bonded to the CoCr tertiary construction), resulting in 12 different material combinations: CoCr-PEEK; CoCr-PEKK; CoCr-ZrO₂; CoCr-CoCr; CoCr-PEEK 0.5; CoCr-PEKK 0.5; ZrO₂-PEEK; ZrO₂-PEKK; ZrO₂-ZrO₂, ZrO₂-CoCr; ZrO₂-PEEK 0.5; and ZrO₂-PEKK 0.5 (n = 15 pairings per material combination). Pull-off tests were performed with a universal testing machine initially and after 500, 5000, and 10,000 removal and insertion cycles in a mastication simulator. Descriptive statistics with the Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests were computed (α = 0.05).

RESULTS: The tested parameters, material combination, and removal and insertion cycles had significant impact on the retention force values (p < 0.001). An increase in removal and insertion cycles was associated with a decrease in retention forces within CoCr and ZrO₂ secondary crowns, regardless of the primary crown material. In contrast, PEEK and PEKK secondary crowns presented higher retention load values after 10,000 cycles than initially.

CONCLUSION: Different material combinations behaved differently after simulated removal and insertion regimens. This difference should be considered during treatment planning.

CLINICAL RELEVANCE: Telescopic crown systems should be made of materials with predictable retention forces that do not deteriorate with time. The implementation of new materials and technologies facilitates reproducibility and time-saving fabrication.

PMID:37086284 | DOI:10.1007/s00784-023-05027-w

Eur Heart J. 2023 Apr 22:ehad238. doi: 10.1093/eurheartj/ehad238. Online ahead of print.

ABSTRACT

AIMS: Evidence suggests that a high-dose statin loading before a percutaneous coronary revascularization improves outcomes in patients receiving long-term statins. This study aimed to analyse the effects of such an additional statin therapy before surgical revascularization.

METHODS AND RESULTS: This investigator-initiated, randomized, double-blind, and placebo-controlled trial was conducted from November 2012 to April 2019 at 14 centres in Germany. Adult patients (n = 2635) with a long-term statin treatment (≥30 days) who were scheduled for isolated coronary artery bypass grafting (CABG) were randomly assigned to receive a statin-loading therapy or placebo at 12 and 2 h prior to surgery using a web-based system. The primary outcome of major adverse cardiac and cerebrovascular events (MACCE) was a composite consisting of all-cause mortality, myocardial infarction (MI), and a cerebrovascular event occuring within 30 days after surgery. Key secondary endpoints included a composite of cardiac death and MI, myocardial injury, and death within 12 months. Non-statistically relevant differences were found in the modified intention-to-treat analysis (2406 patients; 1203 per group) between the statin (13.9%) and placebo groups (14.9%) for the primary outcome [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.74-1.18; P = 0.562] or any of its individual components. Secondary endpoints including cardiac death and MI (12.1% vs. 13.5%; OR 0.88, 95% CI 0.69-1.12; P = 0.300), the area under the troponin T-release curve (median 0.398 vs. 0.394 ng/ml, P = 0.333), and death at 12 months (3.1% vs. 2.9%; P = 0.825) were comparable between treatment arms.

CONCLUSION: Additional statin loading before CABG failed to reduce the rate of MACCE occuring within 30 days of surgery.

PMID:37086268 | DOI:10.1093/eurheartj/ehad238

Res Nurs Health. 2023 Apr 22. doi: 10.1002/nur.22313. Online ahead of print.

ABSTRACT

Nurses are greatly affected by patient safety incidents, but little is known about the classifications of nurses’ second victim experiences and their effects on job insecurity and turnover intention. This study aimed to identify the profiles of nurses’ second victim experiences, including perceived support and distress, and explore the effects of the different experiences on nurses’ job insecurity and turnover intention. A convenience sample of 2000 nurses, who were directly involved in patient safety incidents within a year at 25 hospitals in 13 provinces in China, was invited to participate. The online surveys included the Second Victim Experience and Support Tool-Chinese version, job insecurity scale, and turnover intention scale. Data were analyzed using regression and latent profile analysis to identify second-victim nurses’ different experience predictors and examine the relationships among the factors. A total of 1298 valid questionnaires were obtained. Three profiles of second victim experiences were identified. Univariate analysis demonstrated that nurses’ experience, education level, hospital type, specialty, working hours, credentials, clinical ladder, type of employment, income, training on adverse events, and the type of adverse event were statistically significant (p < 0.05) variables differentiating the three profiles. After controlling these significant variables, the multiple regression analysis showed that the higher the support and the lower the distress level of the second victim, the lower the job insecurity and turnover intention. This study highlights the significance of nurse’ leader and organizational support. Nursing leaders should recognize nurses’ second-victim experiences, provide the support nurses need, and help them reduce job insecurity and turnover intention.

PMID:37086263 | DOI:10.1002/nur.22313

J Esthet Restor Dent. 2023 Apr 22. doi: 10.1111/jerd.13056. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the influence of the group and individual education of students on shade matching quality. Secondary study objective included a survey-assessment of quality and difficulty level of color matching.

MATERIALS AND METHODS: Forty dental student participants in Integrated Academic Studies of Dentistry at the Faculty of Medicine, University of Niš (26 female, 14 male) 21-25 years old, signed consent to voluntarily participate in the research. The Ethics Committee of the Clinic of Dentistry, Faculty of Medicine, University of Niš, approved the study under number 14/11-2019-2EO. They were randomly divided into two groups (n = 20), experimental (IE, individual education) and control (GE, group education). Each group was divided into four subgroups (n = 5). The study was performed in three phases. In Phase I (I) and III (III), students matched the shade of the maxillary central left incisor (#9) using three different shade guides. Each of the students served as a “patient” for shade matching, while the other members of the subgroup, individually (VM_I ) and as a team (VM_T ), visually matched the tooth shade. In Phase II (between phases I and III), group IE received standard group and individual education and training, while group GE had only group education. Shade matching results in before and after education were compared with results obtained by an intraoral spectrophotometer. CIELAB (∆E*), and CIDE2000 color differences (∆E₀₀ ) were calculated. The color differences between VM_I or VM_T and ES readings were graded. In addition, the students rated the level of difficulty and quality of shade matching from 1 to 5, signifying the most to least difficult, and the worst to best match, respectively. Means and standard deviations were calculated. Differences were compared using the Student t-test.

RESULTS: Means (s.d.) of CIEDE2000 color differences for VM_I before and after IE were 4.5 (1.5) and 3.3 (0.9), respectively. Corresponding values for group GE were 4.4 (1.4) and 4.0 (1.0), respectively. As compared with GE, group IE achieved 15% better results for the best matches and 27.5% for one of the three best matches in by-point comparison. Mean (s.d.) results for VM_T in the experimental group before and after IE were 3.6 (2.4) and 2.8 (1.6), respectively. Corresponding results for the control group were 4.4 (2.1) and 3.5 (1.7), respectively. Group IE had statistically higher VM_I and VM_T scores than GE, while, for GE, only VM_T scores were statistically higher. Group IE achieved better results in by-point comparison. After education and training, the students rated the shade matching as more precise and less difficult. Results were significantly better for Quality (IE) (sig = 0.010) and Difficulty (GE) (sig = 0.021).

CONCLUSIONS: Within the limitations of the study, the experimental group achieved significantly better results in individual color matching after education and training than the control group, while both groups made progress in team color matching. Both groups rated shade matching more accurate and easier after education.

CLINICAL SIGNIFICANCE: Improving the quality of shade matching is expected to enhance the esthetics of dental restorations, increase patient satisfaction, and reduce color corrections.

PMID:37086204 | DOI:10.1111/jerd.13056