Tag: nevin manimala

J Prosthet Dent. 2021 Apr 15:S0022-3913(21)00142-6. doi: 10.1016/j.prosdent.2021.02.033. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Developing tapered implants with the most appropriate angular characteristics requires an improved analysis of the anatomy of premolar roots.

PURPOSE: The purpose of this observational study was to analyze the 3D anatomy of premolar roots by determining the tapered slope and convergent angle (TS/CA), to transform the TS/CA patterns into those in which the tapered implants mimic natural tooth roots, and to provide TS/CA references for future investigations.

MATERIAL AND METHODS: A total of 73 human single-rooted premolars were surveyed and analyzed by microcomputed tomography and an associated software program. The 3D root surface area (RSA), the radius/diameter (R/D) at the planned first to tenth millimeter levels apical to the cementoenamel junction (CEJ), and the TS/CA at corresponding levels were calculated. The results were statistically analyzed by using an independent samples t test to assess the general differences of tested parameters between maxillary and mandibular premolars. A paired t test was used to examine the significant intragroup TS/CA differences between sequential coronoapical levels. One-way ANOVA was applied to study the general significance of developmental patterns in maxillary and/or mandibular groups. Two-way ANOVA was used to inspect the TS/CA significance at various measurements coronoapically between the maxillary and mandibular premolars (α=.05).

RESULTS: Generally, the RSA, root length, R/D, and TS/CA parameters examined for the maxillary premolar roots differed significantly from those for the mandibular roots at the evaluated levels (P<.05). According to the measurements, the maxillary premolar roots generally exhibited nonsignificant RSA and R/D reduction patterns, with a decreasing angle of TS=13.44 degrees and CA=24.53 degrees coronoapically. However, mandibular premolar roots exhibited a significant reduction pattern, with TS=11.25 degrees and CA=21.06 degrees coronoapically according to both individual and general evaluations.

CONCLUSIONS: Based on the developmental patterns of the evaluated TSs/CAs, tapered implants imitating premolar root anatomy should have a conical rather than a cylindrical shape, and the R/D of these models should be reduced to half at the apical third. However, further studies are warranted to identify more TS/CA characteristics related to the tapered implants, including the TSs/CAs of other tooth types.

PMID:33867165 | DOI:10.1016/j.prosdent.2021.02.033

Surgery. 2021 Apr 15:S0039-6060(21)00153-7. doi: 10.1016/j.surg.2021.02.033. Online ahead of print.

ABSTRACT

BACKGROUND: The universal Surgical Risk Preoperative Assessment System prediction models for postoperative adverse outcomes have good accuracy for estimating risk in broad surgical populations and for surgical specialties. The accuracy in individual operations has not yet been assessed. The objective of this study was to evaluate the Surgical Risk Preoperative Assessment System in predicting adverse outcomes for selected individual operations.

METHODS: The Surgical Risk Preoperative Assessment System models were applied to the top 2 most frequent common procedural terminology codes in 9 surgical specialties and 5 additional common general surgical operations in the 2009 to 2018 database of the American College of Surgeons National Surgical Quality Improvement Program. Goodness of fit statistics were estimated, including c-indices for discrimination, Hosmer-Lemeshow graphs and P values for calibration, overall observed versus expected event rates, and Brier scores.

RESULTS: The total sample size was 2,020,172, which represented 29% of the 6.9 million operations in the American College of Surgeons National Surgical Quality Improvement Program database. Average c-indices across 12 outcomes were acceptable (≥0.70) for 13 (56.5%) of the 23 operations. Overall observed-to-expected rates were similar for mortality and overall morbidity across the 23 operations. Hosmer-Lemeshow graphs over quintiles of risk comparing observed-to-expected rates of mortality and overall morbidity were similar for 52% and 70% of operations, respectively. Model performance was better in less complex operations and those done in patients with lower preoperative risk.

CONCLUSION: Surgical Risk Preoperative Assessment System displayed accuracy in estimating postoperative adverse events for some of the 23 operations studied, but not all. In the procedures where Surgical Risk Preoperative Assessment System was not accurate, developing disease or operation-specific risk models might be appropriate.

PMID:33867167 | DOI:10.1016/j.surg.2021.02.033

Encephale. 2021 Apr 15:S0013-7006(21)00068-3. doi: 10.1016/j.encep.2020.11.009. Online ahead of print.

ABSTRACT

INTRODUCTION: The duration of untreated psychosis has been largely associated with poor outcomes in psychosis. Actual diagnostic tools may be used by very specialized teams and need sustained evaluation. We present a French version of a self-report questionnaire: the 16-item Prodromal Questionnaire (fPQ16). Our objective was to evaluate its predictive value for an ultra-high-risk state (UHR) or psychosis. The population enrolled was consulting in a young adults and adolescents center in Sainte-Anne hospital, Paris, France.

METHODS: PQ16 had first been translated into French and independently back translated and validated by the original authors. Between November 2016 and May 2018, every C’JAAD consulting patient was proposed to fill in the fPQ16. Each patient was next evaluated with the French version of the comprehensive assessment of at-risk mental state (CAARMS), which detects UHR or psychosis. Statistical analysis of fPQ16 concurrent validity was performed using ROC curves. fPQ16 acceptability was studied by four additional questions especially designed for that purpose.

RESULTS: One hundred participants were included. Mean age was 19.85years (SD 3.3 y). Fifty-eight percent of patients included were diagnosed with UHR (40%) or psychotic (18%) state after CAARMS evaluation. Mean score at fPQ16 was 5.7 (SD 3.8). Best cut-off score was 4 positive items, with excellent sensibility (91%) and correct specificity (60%). Positive predictive value of fPQ16 was 76%. Area under the curve was 0.85 (P<0.0001). fPQ16 showed good acceptability.

DISCUSSION: fPQ16 had good screening performances in our population. Cut-off score was lower than in previous studies, but performances were equal or better. As a well-accepted and short questionnaire, the fPQ16 could be a great screening tool in primary care. A version with 18-items, including two items focused on thought content and disorganization that are missing in PQ16, is under evaluation.

PMID:33867141 | DOI:10.1016/j.encep.2020.11.009

Injury. 2021 Apr 7:S0020-1383(21)00322-3. doi: 10.1016/j.injury.2021.04.013. Online ahead of print.

ABSTRACT

INTRODUCTION: Tibial plateau fractures are a heterogenous group of injuries with a variable amount of articular injury and are commonly associated with lateral sided articular impaction. Previous work has focused on describing the morphology of tibial plateau fractures, but has neglected description of medial sided articular impaction. The aim of this investigation was to assess the morphology of medial sided articular impaction in tibial plateau fractures, with specific attention directed toward the frequency, location, size, and associated fracture patterns.

METHODS: Skeletally mature patients presenting to a Level I trauma center from 2008-2018 with a tibial plateau fracture (AO/OTA 41B-C) were identified retrospectively. Fractures were classified by AO/OTA and Schatzker type. Radiographs and computed tomography (CT) scans were reviewed to identify and localize medial sided articular impaction. The location and surface area of impaction was characterized by creating frequency diagram heat maps from axial CT scans. Descriptive statistics were performed using standard measures.

RESULTS: Of the 1032 tibial plateau fractures included, 82 (7.9%) were noted to have medial sided articular impaction. Rate of impaction varied by fracture type (p = 0.03): Schatzker II, 2% (7 of 381); Schatzker IV, 21% (19 of 96); and Schatzker VI, 11% (56 of 524). Average total surface area of impaction was 9% of the total and 19% of the medial plateau area. Area of impaction varied by fracture type (p = 0.004): Schatzker II, 6% (95% confidence interval [CI], 4%-7%); Schatzker IV, 11% (95% CI, 9%-13%), and Schatzker VI, 9% (95% CI, 7%-11%). The area of impaction occurred primarily along the lateral aspect of the medial plateau in Schatzker II fractures, in the anteromedial quadrant of Schatzker IV fractures, and was evenly distributed across the medial plateau in Schatzker VI fractures.

CONCLUSIONS: Surgeons should be aware that medial articular impaction is present in approximately 8% of tibial plateau fractures. Schatzker IV fractures are most likely to have medial impaction and a larger proportion of the joint surface involved in these injuries.

PMID:33867150 | DOI:10.1016/j.injury.2021.04.013

J Pediatr Surg. 2021 Mar 26:S0022-3468(21)00279-7. doi: 10.1016/j.jpedsurg.2021.03.045. Online ahead of print.

ABSTRACT

BACKGROUND/PURPOSE: Gastrostomy tube (GT) placement is a common pediatric procedure with high postoperative resource utilization. We aimed to determine if standardized discharge instructions (SDI) reduced healthcare utilization rates.

METHODS: We performed a retrospective cohort study comparing postoperative hospital utilization of patients who underwent initial GT placement pre- and post-SDI protocol implementation from 2014-2019. Statistical analyses included Chi-square tests, multivariable adjusted logistic regression, adjusted Cox proportion hazard regression, and adjusted Poisson regression models when appropriate.

RESULTS: 197 patients were included, 102 (51.8%) before and 95 (48.2%) after protocol implementation. On primary analysis, SDI patients did not have significantly different total postoperative hospital utilization events at 30-days (48.0% vs. 38.9%, p = 0.25). On secondary analysis, SDI patients had lower rates of ED (8.4% vs. 19.6%, p = 0.026) and office visits (11.6% vs. 25.5%, p = 0.017) at 30-days. Non-SDIs patients had greater odds of ED visits (OR2.7, 95%CI 1.3-5.9, p = 0.01), office visits (OR3.7, 95%CI 1.7-8.1, p = 0.001) and phone calls (OR2.6, 95%CI 1.2-5.7, p = 0.016) at 1-year. The adjusted hazard ratio was 2.0 (95%CI 1.4-3.0, p < 0.001). Incident rate ratio were 1.8 (95%CI 1.2-2.5, p = 0.002) at 30-days and 1.9 (95%CI 1.5-2.4, p < 0.001) at 1-year post-discharge.

CONCLUSIONS: SDIs post-GT placement may reduce multiple aspects of postoperative hospital utilization.

PMID:33867152 | DOI:10.1016/j.jpedsurg.2021.03.045

J Prof Nurs. 2021 Mar-Apr;37(2):306-319. doi: 10.1016/j.profnurs.2020.12.001. Epub 2020 Dec 5.

ABSTRACT

BACKGROUND: Mentoring in nursing education is essential to retaining nurse faculty; whether they are new to academia or experienced, but new to the institution in which they teach. Furthermore, mentoring promotes awareness of faculty roles and responsibilities, decreases ambiguity and increases retention of qualified nurse faculty.

PURPOSE: This study examined whether there was a relationship between nurse educator mentor’s perception of their mentoring effectiveness and nurse educator mentee’s perception of their mentor’s effectiveness.

METHOD: A Spearman’s rho correlation was conducted on a convenience sample of 119 nurse educators who completed the Principles of Adult Mentoring Inventory (PAMI), which measured six core mentoring behaviors. A secondary analysis using an independent samples t-test was also performed.

RESULTS: Statistically significant results were revealed in two of the six mentoring behaviors; relationship emphasis (p = 0.035) and confrontive focus (p = 0.043). The Mentor Role Competency Profile (MRCP), a measure accompanying the PAMI, indicated concerns that could be counterproductive within the mentoring relationship. A secondary analysis using a t-test confirmed concerns as identified in the initial analysis.

CONCLUSION: Continuous improvement and training are critical to acquiring and reinforcing effective mentoring skills. Requiring evaluation and follow up for mentors could result in increased satisfaction for both mentor and mentee and improve retention of new faculty in academia.

PMID:33867085 | DOI:10.1016/j.profnurs.2020.12.001

ISA Trans. 2021 Apr 9:S0019-0578(21)00203-2. doi: 10.1016/j.isatra.2021.04.006. Online ahead of print.

ABSTRACT

BACKGROUND: The 2019 novel coronavirus disease (COVID-19) has spread rapidly worldwide, and the outbreak of the disease was designated a global pandemic by the World Health Organization. Such outbreaks would certainly be catastrophic for some of the best-ranked health systems and would be more catastrophic in countries with more fragile health systems. Accordingly, the World Health Organization and other organizations have been appealing to donor countries to support a rapid response plan. The primary objectives of this response plan are to appeal for funds from donors and to distribute these funds to the most affected countries based on the requirements.

METHODS: In this study, we developed a mathematical model to provide initial insights into the efficient and equitable distribution of urgent funds to high-priority countries. Three phases were proposed for the construction of this mathematical model. In the first phase, the final epidemic sizes in all the target countries were predicted by using three epidemiological models. In the second phase, the urgent requirements for each country were estimated in parallel with the estimates issued by the humanitarian response plan, based on the size of the epidemic and several other factors. In the third and final phase, a multi-objective optimization model was proposed. The first objective was to maximize the funds from donors to cover all the requirements. The second objective was to minimize the unmet demands by ensuring a fair distribution of the urgent funds based on the requirements of the target countries.

RESULTS: Predictions of the basic reproduction numbers and the final epidemic sizes were calculated for all target countries. The urgent requirements were estimated, and the requirements issued by the humanitarian response plan for all target countries were also considered. Moreover, a proposed response plan for the distribution network was demonstrated. Donors must provide urgent funds exceeding US$ 2,608,084,209 to cover at least 40 % of each target country’s requirements. Overall, results demonstrate the importance of an urgent and fair distribution of funds to the target countries to overcome the outbreak of COVID-19.

CONCLUSIONS: Rapid responses by donor countries to humanitarian appeals will facilitate the immediate and fair distribution of relief supplies to the poorest countries. This distribution may help to support health systems, restrain the spread of COVID-19, and prevent an unlimited catastrophe.

PMID:33867131 | DOI:10.1016/j.isatra.2021.04.006

Curr Pharm Teach Learn. 2021 Jun;13(6):705-710. doi: 10.1016/j.cptl.2021.01.030. Epub 2021 Feb 3.

ABSTRACT

INTRODUCTION: The purpose of this analysis was to determine which characteristics increase a candidate’s likelihood of matching with a post-graduate year 1 (PGY1) community-based residency program (CBRP).

METHODS: Current and former CBRP residents’ curriculum vitae (CVs) were collected and reviewed utilizing a survey and standardized rubric. Eligible participants were current PGY1 CBRP residents or had completed a PGY1 program no earlier than 2015. Primary endpoints included number of participants with extensive leadership experience, relevant experiential rotations, presentation history, and involvement in pharmacy organizations. Descriptive statistics were performed to identify the most common characteristics and their relative quantities.

RESULTS: A total of 50 eligible CVs were submitted and reviewed. The majority of participants had extensive (defined as four or more) presentation experiences, at least three mid- to high-level leadership experiences, multiple ambulatory/outpatient pharmacy experiential rotations, and involvement in pharmacy organizations. Few participants (26%) had previous teaching experience.

CONCLUSIONS: Residency candidates who matched with CBRPs tended to have extensive mid- to high-level leadership experiences and presentation experience. Based on these findings, additional studies are warranted to compare existing and/or redesigned postgraduate training preparation curricula and their impact on residency match rates.

PMID:33867068 | DOI:10.1016/j.cptl.2021.01.030

Curr Pharm Teach Learn. 2021 Jun;13(6):711-716. doi: 10.1016/j.cptl.2021.01.029. Epub 2021 Feb 11.

ABSTRACT

BACKGROUND AND PURPOSE: Mental health stigma among healthcare providers remains a significant barrier to patients receiving optimal care for psychiatric conditions. This study’s purpose is to evaluate the impact of a psychiatry elective on pharmacy students’ attitudes toward patients with mental health disorders.

EDUCATIONAL ACTIVITY AND SETTING: This study cohort included pharmacy students enrolled in a Special Topics in Psychiatry elective. Attitudes toward mental health disorders were measured at baseline (first day of class) and post-exposure (last day of class) using the 21-item Beliefs toward Mental Illness (BMI) Scale. Wilcoxon signed-rank tests were used to compare each component of the BMI scale as well as each subscale (dangerousness, poor social and interpersonal skills, and incurability) at baseline and post-exposure.

FINDINGS: Fifty-eight pharmacy students (68% response rate) participated in this study. Most respondents were in their first year of the pharmacy program (44%), female (72%), and Asian (59%). There was a statistically significant decline in each BMI subscale at the end of the course: dangerousness, poor interpersonal and social skills, and incurability. There was no significant difference in mean change for the BMI sub-scores by gender, race, or personal experience with mental health disorders.

SUMMARY: Incorporating a psychiatry elective into the pharmacy school curriculum can improve attitudes toward patients with mental health disorders. Future areas of research are warranted on the influence of specific components of a psychiatry elective that impact BMI scores and whether this translates to improved quality of care during clinical practice.

PMID:33867069 | DOI:10.1016/j.cptl.2021.01.029

J Prof Nurs. 2021 Mar-Apr;37(2):249-254. doi: 10.1016/j.profnurs.2020.12.015. Epub 2020 Dec 29.

ABSTRACT

BACKGROUND: Food insecurity, the limited or uncertain availability of food, is reported in college students, but little is known about its prevalence in nursing students. Nursing students have extensive required clinical hours limiting their ability to work and spend money on academic and living expenses before spending on food.

PURPOSE: To estimate the prevalence of food insecurity and characterize its relationship to social support and first-generation status among nursing students at a public university.

METHODS: A cross-sectional survey study design was used to assess food security and social support in full-time nursing students (n=55).

RESULTS: The prevalence of food insecurity reported by the survey respondents was 60%. Statistically significant correlations between food security and social support scores were found; as food security worsened, so did social support. Food-insecure students had lower grade point averages, and first-generation students (p=.001) reported food insecurity more frequently than did other participants.

CONCLUSIONS: Findings support that food insecurity is negatively associated with academic performance, and level of social support may impact food insecurity in nursing students. Nursing programs should consider early assessments of cohorts to increase the potential for early intervention with food-insecure students. Collaboration with university-based food pantries and student engagement in hunger initiatives through the Student Nurses Association can support early interventions.

PMID:33867076 | DOI:10.1016/j.profnurs.2020.12.015