Tag: pubmed

Death Stud. 2023 Jul 13:1-10. doi: 10.1080/07481187.2023.2231388. Online ahead of print.

ABSTRACT

The purpose of this study was to (1) explore associations between preparedness for caregiving and preparedness for death among family caregivers of patients with advanced cancer and (2) explore modifiable preparedness factors, such as communication and support. Data was derived from a baseline questionnaire collected in specialized home care. The questionnaire included socio-demographics, the Preparedness for Caregiving Scale, and single items addressing preparedness for death, received support and communication about incurable illness. Data was analyzed using descriptive statistics and Spearman correlations. Altogether 39 family caregivers participated. A significant association was found between preparedness for caregiving and preparedness for death. Received support and communication about the illness was associated with higher levels of preparedness for caregiving and death. This study contributes to evidence on the association between preparedness for caregiving and death, but also that communication and support employed by healthcare professionals could improve family caregiver preparedness and wellbeing.

PMID:37441803 | DOI:10.1080/07481187.2023.2231388

Obstet Gynecol. 2023 Jul 13. doi: 10.1097/AOG.0000000000005310. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the association between coronavirus disease 2019 (COVID-19) vaccination and female assisted reproduction outcomes through a systematic review and meta-analysis.

DATA SOURCES: We searched Medline (OVID), EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov on January 11, 2023, for original articles on assisted reproduction outcomes after COVID-19 vaccination. The primary outcome was rates of clinical pregnancy; secondary outcomes included number of oocytes retrieved, number of mature oocytes retrieved, fertilization rate, implantation rate, ongoing pregnancy rate, and live-birth rate.

METHODS OF STUDY SELECTION: Two reviewers independently screened citations for relevance, extracted pertinent data, and rated study quality. Only peer-reviewed published studies were included.

TABULATION, INTEGRATION, AND RESULTS: Our query retrieved 216 citations, of which 25 were studies with original, relevant data. Nineteen studies reported embryo transfer outcomes, with a total of 4,899 vaccinated and 13,491 unvaccinated patients. Eighteen studies reported data on ovarian stimulation outcomes, with a total of 1,878 vaccinated and 3,174 unvaccinated patients. There were no statistically significant results among our pooled data for any of the primary or secondary outcomes: clinical pregnancy rate (odds ratio [OR] 0.94, 95% CI 0.88-1.01, P=.10), number of oocytes retrieved (mean difference -0.26, 95% CI -0.68 to 0.15, P=.21), number of mature oocytes retrieved (mean difference 0.31, 95% CI -0.14 to 0.75, P=.18), fertilization rate (OR 0.99, 95% CI 0.87-1.11, P=.83), implantation rate (OR 0.92, 95% CI 0.84-1.00, P=.06), ongoing pregnancy rate (OR 0.95, 95% CI 0.86-1.06, P=.40), or live-birth rate (OR 0.95, 95% CI 0.78-1.17, P=.63). A subanalysis based on country of origin and vaccine type was also performed for the primary and secondary outcomes and did not change the study results.

CONCLUSION: Vaccination against COVID-19 is not associated with different fertility outcomes in patients undergoing assisted reproductive technologies.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42023400023.

PMID:37441788 | DOI:10.1097/AOG.0000000000005310

J Chem Theory Comput. 2023 Jul 13. doi: 10.1021/acs.jctc.3c00285. Online ahead of print.

ABSTRACT

Many simulation methods concerning solvated molecules are based on the assumption that the solvated species and the solvent can be characterized by some representative structures of the solute and some embedding potential corresponding to this structure. While the averaging of the solvent configurations to obtain an embedding potential has been studied in great detail, this hinges on a single solute structure representation. This assumption is re-examined and generalized for conformationally flexible solutes and tested on 4 nonrigid systems. In this generalized approach, the solute is characterized by a set of representative structures and the corresponding embedding potentials. The representative structures are identified by means of subdividing the statistical ensemble, which in this work is generated by a constant-temperature molecular dynamics simulation. The embedding potential defined in the Frozen-Density Embedding Theory is used to characterize the average effect of the solvent in each subensemble. The numerical examples concern the vertical excitation energies of protonated retinal Schiff bases in protein environments. It is comprehensively shown that subensemble averaging leads to huge computational savings compared with explicit averaging of the excitation energies in the whole ensemble while introducing only minor errors in the case of the systems examined.

PMID:37441785 | DOI:10.1021/acs.jctc.3c00285

J Glob Health. 2023 Jul 14;13:06026. doi: 10.7189/jogh.13.06026.

ABSTRACT

BACKGROUND: The coronavirus (COVID-19) pandemic caused enormous adverse socioeconomic impacts worldwide. Evidence suggests that the diagnostic accuracy of clinical features of COVID-19 may vary among different populations.

METHODS: We conducted a systematic review and meta-analysis of studies from PubMed, Embase, Cochrane Library, Google Scholar, and the WHO Global Health Library for studies evaluating the accuracy of clinical features to predict and prognosticate COVID-19. We used the National Institutes of Health Quality Assessment Tool to evaluate the risk of bias, and the random-effects approach to obtain pooled prevalence, sensitivity, specificity, and likelihood ratios.

RESULTS: Among the 189 included studies (53 659 patients), fever, cough, diarrhoea, dyspnoea, and fatigue were the most reported predictors. In the later stage of the pandemic, the sensitivity in predicting COVID-19 of fever and cough decreased, while the sensitivity of other symptoms, including sputum production, sore throat, myalgia, fatigue, dyspnoea, headache, and diarrhoea, increased. A combination of fever, cough, fatigue, hypertension, and diabetes mellitus increases the odds of having a COVID-19 diagnosis in patients with a positive test (positive likelihood ratio (PLR) = 3.06)) and decreases the odds in those with a negative test (negative likelihood ratio (NLR) = 0.59)). A combination of fever, cough, sputum production, myalgia, fatigue, and dyspnea had a PLR = 10.44 and an NLR = 0.16 in predicting severe COVID-19. Further updating the umbrella review (1092 studies, including 3 342 969 patients) revealed the different prevalence of symptoms in different stages of the pandemic.

CONCLUSIONS: Understanding the possible different distributions of predictors is essential for screening for potential COVID-19 infection and severe outcomes. Understanding that the prevalence of symptoms may change with time is important to developing a prediction model.

PMID:37441773 | DOI:10.7189/jogh.13.06026

Fam Med. 2023 Jul 10. doi: 10.22454/FamMed.2023.996183. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: In Canada, competency-based medical education prepares family medicine (FM) graduates to provide a broad scope of practice (SoP). We compared the practice intentions of FM residents at the end of training with actual practice patterns of early career family physicians (FPs) for SoP activities reflective of comprehensive family medicine.

METHODS: We collected self-reported data from cross-sectional family medicine longitudinal surveys for exiting FM residents in 2015 and 2016 and from a separate cohort of FPs who were 3 years into practice in 2018 and 2019 from 15 programs. We measured outcomes from exiting FM residents intending to participate in SoP activities and FPs participating in 15 SoP domains of family medicine.

RESULTS: A total of 1,409 exiting FM residents (58.2% response rate) and 523 early career FPs (21% response rate) responded to the surveys. A high correlation existed between the percentage of exiting residents who intended to participate in each SoP activity and the percentage of FPs who participated in those activities (r 2=0.95). However, we found statistically significant declines in the percentage of FPs reporting involvement in the SoP activities compared to their reported practice intentions for 14 of the 15 domains. We saw the greatest declines in providing care in long-term care facilities, rural communities, emergency departments, intrapartum care, and care for Indigenous populations (P<.001).

CONCLUSIONS: While SoP patterns are highly correlated with practice intentions, early-career FPs are less likely to provide care as intended for all SoP activities. Further research is needed on the factors influencing practice patterns in specific areas to determine how FP graduates can be supported to provide comprehensive care.

PMID:37441758 | DOI:10.22454/FamMed.2023.996183

Cir Cir. 2023;91(3):375-380. doi: 10.24875/CIRU.22000564.

ABSTRACT

BACKGROUND: COVID-19 pandemic had a negative impact on colorectal cancer (CRC) screening programs.

OBJECTIVE: The care strategy was modified throughout the pandemic, this paper evaluates its impact and short-term consequences.

METHODS: A retrospective, descriptive and cross-sectional study was carried out in a private ambulatory endoscopic center, in average risk subjects. The study compared two periods: pre-pandemic and pandemic (subdivided into pre-vaccination and vaccination).

RESULTS: During this period, 54.4% of scheduled colonoscopies were due to the screening program. The average age was 60.4 ± 7 years. Women were 52.0%. The overall cancellation rate was 41.1%, higher during pre-vaccination period. There were no differences in the degree of colonic cleansing, colonoscope exit time, and patient satisfaction. The adenoma detection rate (38.4% vs. 42.8% vs. 36.4%; p = 0.8) and the total number of adenomas (p = 0.02) was statistically significant during the pre-vaccination period. The rate of adenoma/patient showed a higher trend during this period (p = 0.06). The number of colorectal cancers was 10, without differences between periods.

CONCLUSION: In conclusion, the impact of the decrease in screening colonoscopy procedures for CRC detection was similar to what was seen worldwide. In this period no increase in cancer cases, although this effect may be observed in the long term.

PMID:37441724 | DOI:10.24875/CIRU.22000564

J Adv Prosthodont. 2023 Jun;15(3):155-170. doi: 10.4047/jap.2023.15.3.155. Epub 2023 Jun 28.

ABSTRACT

PURPOSE: This study aims to clinically compare the fitness and trueness of zirconia crowns fabricated by different combinations of open CAD-CAM systems.

MATERIALS AND METHODS: Total of 40 patients were enrolled in this study, and 9 different zirconia crowns were prepared per patient. Each crown was made through the cross-application of 3 different design software (EZIS VR, 3Shape Dental System, Exocad) with 3 different processing devices (Aegis HM, Trione Z, Motion 2). The marginal gap, absolute marginal discrepancy, internal gap(axial, line angle, occlusal) by a silicone replica technique were measured to compare the fit of the crown. The scanned inner and outer surfaces of the crowns were compared to CAD data using 3D metrology software to evaluate trueness.

RESULTS: There were significant differences in the marginal gap, absolute marginal discrepancy, axial and line angle internal gap among the groups (P < .05) in the comparison of fit. There was no statistically significant difference among the groups in terms of occlusal internal gap. The trueness ranged from 36.19 to 43.78 µm but there was no statistically significant difference within the groups (P > .05).

CONCLUSION: All 9 groups showed clinically acceptable level of marginal gaps ranging from 74.26 to 112.20 µm in terms of fit comparison. In the comparison of trueness, no significant difference within each group was spotted. Within the limitation of this study, open CAD-CAM systems used in this study can be assembled properly to fabricate zirconia crown.

PMID:37441720 | PMC:PMC10333096 | DOI:10.4047/jap.2023.15.3.155

J Adv Prosthodont. 2023 Jun;15(3):114-125. doi: 10.4047/jap.2023.15.3.114. Epub 2023 Jun 28.

ABSTRACT

PURPOSE: The aim of the study was to evaluate the optical properties of new generation (3Y-TZP) monolithic zirconia (MZ) with different abutment types and resin cement shades.

MATERIALS AND METHODS: A1/LT MZ specimens were prepared (10 × 12 × 1 mm, N = 30) and divided into 3 groups according to cement shades as transparent (Tr), yellow (Y) and opaque (O). Abutment specimens were obtained from 4 different materials including zirconia (Group Z), hybrid (Group H), titanium (Group T) and anodized yellow titanium (Group AT). MZ and abutment specimens were then cemented. L^*, a^*, and b^* parameters were obtained from MZ, MZ + abutment, and MZ + abutment + cement. ΔE₀₀₁^* (between MZ and MZ + abutment), ΔE₀₀₂^* (between MZ and MZ + abutment + cement) and ΔE₀₀₃^* (between MZ + abutment and MZ + abutment + cement) values were calculated. Statistical analyses included 2-way ANOVA, Bonferroni, and Paired Sample t-Tests (P < .05).

RESULTS: Abutment types and resin cements had significant effect on L^*, a^*, b^*, ΔE₀₀₁^*, ΔE₀₀₂^*, and ΔE₀₀₃^* values (P < .001). Without cementation, whereas zirconia abutment resulted in the least discoloration (ΔE₀₀₁^* = 0.68), titanium abutment caused the most discoloration (ΔE₀₀₁^* = 4.99). The least ΔE₀₀₂^* = 0.68 value was seen using zirconia abutment after cementation with yellow shaded cement. Opaque shaded cement caused the most color change (ΔE₀₀₃^* = 5.24). Cement application increased the L^* values in all groups.

CONCLUSION: The least color change with/without cement was observed in crown configurations created with zirconia abutments. Zirconia and hybrid abutments produced significantly lower ΔE₀₀₂^* and ΔE₀₀₃^* values in combination with yellow shaded cement. The usage of opaque shaded cement in titanium/anodized titanium groups may enable the clinically unacceptable ΔE₀₀^* value to reach the acceptable level.

PMID:37441718 | PMC:PMC10333101 | DOI:10.4047/jap.2023.15.3.114

J Adv Prosthodont. 2023 Jun;15(3):145-154. doi: 10.4047/jap.2023.15.3.145. Epub 2023 Jun 28.

ABSTRACT

PURPOSE: The objective of this study was to investigate how internal structures influence the overall and marginal accuracy of full arch preparations fabricated through additive manufacturing in different printing systems.

MATERIALS AND METHODS: A full-arch preparation digital model was set up with three internal designs, including solid, hollow, and grid. These were printed using three different resin printers with nine models in each group. After scanning, each data was imported into the 3D data processing software together with the master cast, aligned and trimmed, and then put into the 3D data analysis software again to compare the overall and marginal deviation whose results are expressed using root mean square values and color maps. To evaluate the trueness of the resin model, the test data and reference data were compared, and the precision was evaluated by comparing the test data sets. Color maps were observed for qualitative analysis. Data were statistically analyzed by one-way analysis of variance and Bonferroni method was used for post hoc comparison (α = .05).

RESULTS: The influence of different internal structures on the accuracy of 3D printed resin models varied significantly (P < .05). Solid and grid models showed better accuracy, while the hollow model exhibited poor accuracy. The color maps show that the resin models have a tendency to shrink inwards.

CONCLUSION: The internal structure design influences the accuracy of the 3D printing model, and the effect varies in different printing systems. Irrespective of the kind of printing system, the printing accuracy of hollow model was observed to be worse than those of solid and grid models.

PMID:37441717 | PMC:PMC10333097 | DOI:10.4047/jap.2023.15.3.145

J Adv Prosthodont. 2023 Jun;15(3):101-113. doi: 10.4047/jap.2023.15.3.101. Epub 2023 Jun 28.

ABSTRACT

PURPOSE: This randomized controlled trial aimed to evaluate the effect of implants’ two different diameters and cantilever lengths on the marginal bone loss and stability of mplants supporting maxillary prostheses.

MATERIALS AND METHODS: Ninety-six implants were placed in sixteen completely edentulous maxillary ridges. Patients were randomly divided into two groups: Group A, implants were placed with a cantilever to anterior-posterior AP spread length (CL:AP) at a ratio of 1:3; Group B, implants were placed with a CL:AP at a ratio of 1:2. Patients were further divided into four sub-groups: Groups A1, A2, B1, and B2. Groups A1 and B1 received small diameter implants while Groups A2 and B2 received standard diameter implants. Bone height and stability measurements around each implant were performed at 0, 4, 8 and 24 months after definitive prostheses delivery.

RESULTS: Statistical analysis of the mean implant stability and height values revealed an insignificant difference between Group A1 and Group A2 at all the different time intervals while significantly higher values in Group B1 in comparison with Group B2. Results also showed significantly higher values in Group A1 in comparison with Group B1 and an insignificant difference between Group A2 and Group B2 at all the different time intervals.

CONCLUSION: It can be concluded that the use of small diameter implants placed with a CL:AP at a ratio of 1:3 provided predictable results and that the 1:2 CL:AP significantly induced more critical bone loss in the small diameter implants group, which can significantly reduce long term success and survival of implants.

PMID:37441715 | PMC:PMC10333100 | DOI:10.4047/jap.2023.15.3.101