Tag: statistics

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

Int J Urol. 2022 Feb 3. doi: 10.1111/iju.14786. Online ahead of print.

ABSTRACT

OBJECTIVES: Penile urethral stricture disease not associated with hypospadias is rare, and there is a wide range of commonly used surgical repair techniques for this disease. We sought to compile a multi-institutional database of patients who had surgical correction of strictures in the penile urethra not limited to the meatus, and who had no history of hypospadias, for analysis using the Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology classification system.

METHODS: A retrospective database from 13 institutions was compiled of patients who had undergone surgical correction of Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology urethral stricture segments S2b/S2c and excluding E5, with a minimum follow-up time of 4 months. Failure was defined as cystoscopically confirmed recurrence of a stricture measuring less than 16-Fr.

RESULTS: We analyzed 222 patients with a median age of 57 years and a follow-up of 49 months. The overall surgical success rate was 80.2%. On multivariate analysis, the two variables identified that were predictive of surgical success were stricture length ≤2 cm as well as use of a buccal mucosa graft as compared to use of a fasciocutaneous flap, which had success rates of 83% and 52%, respectively (P = 0.0004). No statistically significant differences were found based on incisional approach or surgical technique, nor were outcomes different based on etiology or preoperative patient demographics.

CONCLUSIONS: Surgical repair of penile urethral strictures of non-hypospadiac origin have a favorable overall success rate, at 80.2%. Regardless of incisional approach or surgical technique, all operations appear to have similar outcomes other than repairs using fasciocutaneous flap, which were statistically less successful than those using buccal mucosa graft.

PMID:35118726 | DOI:10.1111/iju.14786

J Clin Lab Anal. 2022 Feb 4:e24271. doi: 10.1002/jcla.24271. Online ahead of print.

ABSTRACT

BACKGROUND: Diagnosing D-Dimer early is essential to optimize clinical treatment and quality of life and reduce mortality. This study aims to identify the difference of D-Dimer levels (ng/ml) in patients with stroke within the 6- and 24-h period compared to patients that mimic stroke.

METHODS: An electronic database search across PubMed/MEDLINE, Cochrane, Web of Science, CINAHL, EMBASE, and Scopus was conducted until December 10, 2021. Studies were eligible if they included adult patients with stroke compared to stroke mimics or controls reporting D-Dimer values. Quality assessment was conducted using GRADE. The standardized mean difference and 95% confidence intervals were calculated in addition to the difference of means in the crude form. Heterogeneity was assessed using Cochran’s Q statistic and the I² index. A random-effects model was used. The statistical analysis was conducted using RevMan 5.4.

RESULTS: Out of 2901, there were 318 (11%) participants from upper-middle-income countries, whereas the others were from high-income countries. Large positive effect size was found for D-Dimer in the stroke group (Cohen’s d = 2.82 [1.73-3.9]; p < 0.00001), meaning that those with stroke had higher D-Dimer values on presentation compared to the stroke mimics/controls. A large difference in means was found in the two groups (MD = 685.1 [324.2, 1045.99]; p < 0.00001), suggesting that there was a significantly higher laboratory value in the stroke group.

CONCLUSION: Our findings must be used in caution as the most reliable diagnostic tests for stroke are CT and MRI. Laboratory testing such as D-Dimer values is a valuable clinical adjuvant in diagnosing total stroke.

PMID:35118733 | DOI:10.1002/jcla.24271

Ultrasound Obstet Gynecol. 2022 Feb 3. doi: 10.1002/uog.24873. Online ahead of print.

ABSTRACT

INTRODUCTION: Outcomes of common arterial trunk (CAT) depend mainly on truncal valve function, coronary artery abnormalities and presence of interrupted aortic arch. The objective of this study was to evaluate the accuracy of prenatal diagnosis in CAT by analyzing: (1) anatomic subtypes, (2) truncal valve function and (3) the potential impact of prenatal CAT diagnosis on postnatal mortality and morbidity in the current era.

METHODS: Retrospective analysis of all prenatally diagnosed CAT patients with postnatal or fetopsy confirmation from 2011- 2019 in a single tertiary center. Cohen’s Kappa statistic was used to measure agreement for pre- and postnatal assessment of anatomic subtypes according to Van Praagh and of truncal valve function. Mortality and morbidity variables were compared.

RESULTS: 84 patients (62 live born with prenatal diagnosis/16 live born with postnatal diagnosis/ 6 terminations of pregnancy with fetopsy) met inclusion criteria. Diagnostic accuracy for prenatal diagnosis of CAT anatomic subtypes was 80.3%. However pre-and postnatal concordance for subtype diagnosis was only moderate (Kappa κ= 0.43) since no fetus had a prenatal diagnosis of CAT type A3, and only half of patients with CAT type A4 (8/17) were diagnosed prenatally. Fetal evaluation of truncal valve function underestimated the presence and severity of insufficiency (slight agreement; κ=0.19). However, 4 of 5 postnatally confirmed significant stenoses were diagnosed prenatally (moderate agreement; κ=0.38). Postoperative mortality was comparable in patients with or without prenatal diagnosis (p=0.87). CAT patients with fetal diagnosis underwent earlier intervention (p<0.001), had shorter intubation time (p=0.047) and shorter global hospital stay (p=0.01).

CONCLUSION: Prenatal accuracy of CAT diagnosis remains insufficient to tailor neonatal management and to predict outcomes. Fetal assessment of truncal valve dysfunction appears unreliable due to perinatal transition changes. Progress should be made to improve fetal diagnosis of anatomic subtypes requiring postnatal prostaglandin infusion. This article is protected by copyright. All rights reserved.

PMID:35118719 | DOI:10.1002/uog.24873