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Aim: This study examined the bond strength associated with Denteshield® Primer as a replacement for a conventional, non-antimicrobial, orthodontic primer. Materials/methods: Sixty human premolar teeth were divided into three groups (n=20). Each group was assigned to receive either Denteshield®, Pro Seal® or Transbond XT TM primer. Light-cured Transbond XTTM adhesive resin was utilised to bond a bracket to each sample tooth following the application of the assigned primer. Ten samples from each group were tested for shear bond strength using a universal testing machine. The remaining 10 samples from each group underwent bracket debonding using a debonding plier. Applying an adhesive remnant index, each sample was scored under a microscope at 2.5× magnification. The data were analysed using One-way ANOVA, the Tukey post hoc test and the Kruskal–Wallis test. Results: The mean shear bond strength (MPa) of the three groups was: Denteshield® (33.18 ± 13.56), Pro Seal® (23.68 ± 12.04) and Transbond XTTM primer (26.19 ± 9.44). There was no significant difference in the shear bond strength across all three groups (p = 0.19). The adhesive remnant index results also showed no significant differences between the three groups (p = 0.278). Conclusion: Based on the shear bond strengths obtained in this study and the previously reported values necessary for clinical use, all three primers appear adequate for clinical use. (Aust Orthod J 2022; 39: 49 - 54. DOI: 10.2478/aoj-2023-0009)

Immune-checkpoint inhibitor (ICI) therapy has been widely used to treat different human cancers, particularly advanced solid tumors. However, clinical studies have reported that ICI immunotherapy benefits only ∼15% of patients with colorectal cancer, specifically those with tumors characterized by microsatellite instability (MSI), a molecular marker of defective DNA mismatch repair (dMMR). For the majority of patients with colorectal cancer who carry proficient MMR (pMMR), ICIs have shown little clinical benefit. In this study, we examined the efficacy of sulindac to enhance the response of pMMR colorectal cancer to anti–PD-L1 immunotherapy. We utilized a CT26 syngeneic mouse tumor model to compare the inhibitory effects of PD-L1 antibody (Ab), sulindac, and their combination on pMMR colorectal cancer tumor growth. We found that mice treated with combination therapy showed a significant reduction in tumor volume, along with increased infiltration of CD8+ T lymphocytes in the tumor tissues. We also demonstrated that sulindac could downregulate PD-L1 by blocking NF-κB signaling, which in turn led to a decrease in exosomal PD-L1. Notably, PD-L1 Ab can be bound and consumed by exosomal PD-L1 in the blood circulation. Therefore, in combination therapy, sulindac downregulating PD-L1 leads to increased availability of PD-L1 Ab, which potentially improves the overall efficacy of anti–PD-L1 therapy. We also show that low-dose sulindac does not appear to have a systemic inhibitory effect on prostaglandin E2 (PGE2). In conclusion, our findings provide unique insights into the mechanism of action and efficacy for sulindac as an immunomodulatory agent in combination with anti–PD-L1 therapy for the treatment of pMMR colorectal cancer.

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We investigated the impact of a health sciences centre-wide, high-fidelity, simulation-based interprofessional team training program on participants’ knowledge, skills and attitudes towards teams and teamwork. Senior medical, nurse anaesthesia and allied health profession students participated in dual-scenario, simulation-based, interprofessional team training sessions with immediate debriefings about team-based competencies (2015–2017). Pre- and post-intervention, students completed the Interprofessional Teamwork (IPT) questionnaire and the Readiness for Interprofessional Learning Scale (RIPLS). Observers and students rated team performance using the Teamwork Assessment Scales (TAS). Descriptive statistics were determined for IPT and RIPLS items and TAS subscales; student Students from five health professions participated ( A health sciences centre-wide high-fidelity, simulation-based, interprofessional team training program improves students’ team-based behaviours, teamwork attitudes and interprofessional learning attitudes. Widespread adoption of such large-scale team training programs has the potential to improve teamwork among healthcare providers over time.

Background Current team assessment instruments in healthcare tend to involve rater-based evaluations that are susceptible to well-known biases. Recent advances in technology include portable devices to measure team-based activities. Consequently, the possibility exists to move away from rater-based assessments of team function by identifying quantitative measures to replace them. Aim This article aims to provide potential approaches to developing quantitative measurement suites involving large amounts of data to address the challenges of assessment presented by the complex nature of teamwork. Conclusion By addressing construct, measurement, and context components, we provide a practical approach to developing a suite to capture quantitative measurements that, through incorporation of social network analysis and aggregated other values, aligns with the Team Strategies & Tools to Enhance Performance and Patient SafetyTM (TeamSTEPPSTM) dimensions for fostering teamwork.

OBJECTIVE: The aim of this study was to compare the tie wing fracture resistance of 4 different manufacturers’ ceramic brackets currently on the market. METHODS: The tie wings of ceramic brackets from 4 manufacturers were tested with 10 samples in each group. The brackets were Ormco Symetri, 3M Clarity, American Radiance Plus, and Dentsply Ovation S. The brackets were mounted and fixed in a universal testing machine. A stainless steel ligature wire was looped around a tie wing and the mean tensile strength was both tested and recorded. RESULTS: There was a significant overall difference in tensile strength among the 4 groups (P < .0001) with the 3M Clarity brackets having the highest MPa. When the groups were compared to each other, they also showed a significant difference in mean tensile strength with the exception being the American Radiance Plus and Ormco Symetri brackets. CONCLUSION: Test results concluded that the 3M Clarity brackets had the highest resistance to tie wing fracture, while the Dentsply Ovation S brackets had the lowest resistance.

Developmental dental anomalies are a common finding in adolescent populations. The objective of this study was to utilize panoramic radiographs to determine the prevalence of dental anomalies and developmental disturbances in a heterogenous adolescent orthodontic patient population seeking care at a North American orthodontic residency program. A total of 1042 panoramic radiographs of 457 male and 585 female orthodontic patients aged 10 to 18 years were evaluated. Developmental and eruption anomalies were recorded and categorized, and chi-square and Fisher exact tests were used for statistical analysis. The evaluation revealed that 40.88% of patients had at least 1 anomalous finding. The most common finding overall was agenesis (12.00%), followed by deviations in eruption path (9.12%), delayed eruption (7.39%), and impaction (7.29%). There was no difference in the prevalence of having any anomalous finding or the prevalence of any specific category of anomalies based on the sex or Angle classification of the patients. Comparison of developmental dental anomalies in 3 age groups (10 to 12, 13 to 15, or 16 to 18 years) revealed no statistically significant difference in the overall prevalence of anomalous findings. Statistically significant differences for some specific categories of anomalies were explainable by correlating dental development with chronologic age, such as a greater frequency of blocked out teeth and eruption path deviation among patients aged 10 to 12 years. Black patients were found to have a significantly greater prevalence of impactions (P = 0.030), and Asian patients had a significantly greater prevalence of anomalies categorized as "other pathology," which could not be definitively diagnosed by panoramic radiograph alone (P = 0.007).

WeChat is the largest social media platform in China, yet few WeChat-based smoking cessation interventions have been investigated to date. The objective of this study was to develop and test the feasibility of a WeChat-based smoking cessation intervention for smokers in China. Participants were recruited using WeChat and were then randomized into one of three groups: the Standard Group, the Enhanced Group, and the wait-list Control Group. Feasibility indicators including program reach, recruitment rate, recruitment efficiency, cost per person, attrition rate, intervention message exposure, group discussion utilization rate, intervention message engagement, satisfaction, and the likelihood of recommending to others were measured with assessed. Analyses included Chi-square and Fisher exact test, as well as analysis of variance test. A responsive participant is defined as a participant that responded to a certain assessment. A total of 1,132 individuals connected with (“friended”) our project on WeChat between July 1 and August 5, 2019. Of these, 403 were eligible to participate, consented, and completed the baseline assessment. As a result, 136, 135, and 132 smokers were randomly assigned to the Standard Group, the Enhanced Group, and the Control Group, respectively. The total program recruitment rate was 35.6% and the attrition rate was 46.4%. The program cost was $0.85 per person. All responsive participants read at least one message during the intervention and engaged with intervention messages 56.8% of the time. Most responsive participants reported being very or somewhat satisfied, highly or somewhat engaged, and were willing to recommend our program to others. This study demonstrated the feasibility of a smoking cessation interventions using WeChat. The program could be expanded to deliver smoking cessation interventions to a large population of smokers.

ObjectivesTo investigate relationships between race and COVID-19 hospitalizations, intensive care unit (ICU) admissions, and mortality over time and which characteristics, may mediate COVID-19 associations.MethodsWe analyzed hospital admissions, ICU admissions, and mortality among positive COVID-19 cases within the ten-hospital Franciscan Ministries of Our Lady Health System around the Mississippi River Industrial Corridor in Louisiana over four waves of the pandemic from March 1, 2020 – August 31, 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race-outcome relationships.ResultsRace was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed these rates became greater in White patients. However, Black patients were still disproportionately represented in these measures. Age was a significant mediator for all outcomes across waves, while comorbidity and emissions of naphthalene and chloroprene acted as mediators for the full study period.ConclusionsThe role of race evolved throughout the pandemic in Louisiana, but Black patients bore a disproportionate impact. Naphthalene and chloroprene air pollution partially explained the long-term associations. Our findings imply that air pollution might contribute to the increased COVID-19 hospitalizations and mortality among Black residents in Louisiana but likely do not explain most of the effect of race.What is already known on this topicEarly in the pandemic, there was evidence of disparities in COVID-19 cases, hospitalizations, intensive care unit (ICU) admissions, and mortality due to race. Studies were emerging to indicate that strength of these relationships was waning over time.What this study addsThis study tests relationships between race and hospitalizations, ICU admissions, and mortality and finds that Black patients continue to be disproportionately represented, although that inequity diminished over time. This study, the first to use multiple mediation analysis to study COVID-19 associations, suggests that the relationship between race and health outcome can be explained by mediators including age and, to a lesser extent, comorbidity and air pollution.How this study might affect research, practice or policyThis study supports the need for healthcare resources to be available to Louisiana’s communities of color, for policy to support increased access to health care in the Industrial Corridor region, and for policy to support the reduction of air pollution emissions to disproportionately impacting the health of the Industrial Corridor’s communities of color.

The distribution of multiple primary cancers has been described previously using data from the Surveillance, Epidemiology, and End Results (SEER) Program. However, a complete picture regarding the distribution of multiple primary cancers in the United States is still lacking. The objective of the current study is to present a comprehensive description of multiple primary cancers in the United States.Invasive cancer cases (including in situ bladder cancers) diagnosed between 2001 and 2016 from 49 population-based state cancer registries in the United States were evaluated for this study. The sequence number central assigned to each tumor was used to determine whether a tumor was a first primary cancer or a subsequent multiple primary cancer. Tumors with a sequence number 00 or 01 were classified as the first primary cancer, while tumors with a sequence number 02 or above were classified as a multiple primary cancer. The percentage of multiple primary cancers was calculated by sex, age, race/ethnicity, cancer site, registry, and diagnosis year. In addition, the percentage of cancers diagnosed at a local stage among multiple primaries was compared with that among first primaries.Overall, about 19.0% of cases were reported as multiple primary cancers; the percentage was higher among non-Hispanic Whites and among older patients. Bladder, melanoma of the skin, and lung cancers had the highest percentage of cases reported as multiple primaries. The percentage of multiple primary cancers also varied by registry and has been increasing over time. Cancers reported as multiple primaries were more likely to be diagnosed at a local stage than those reported as first primaries.Cancers registered as multiple primaries are common in the United States, showing an increasing trend over time and wide variation by race/ethnicity, age, cancer type, and registry. The findings have some practical implications for cancer registries that collect data and for researchers conducting investigations using information on multiple primary cancers.

BACKGROUND: Intensive lifestyle interventions (ILIs) stimulate weight loss in underserved patients with obesity, but the mediators of weight change are unknown. OBJECTIVES: We aimed to identify the mediators of weight change during an ILI compared with usual care (UC) in underserved patients with obesity. METHODS: The PROPEL (Promoting Successful Weight Loss in Primary Care in Louisiana) trial randomly assigned 18 clinics (n = 803) to either an ILI or UC for 24 mo. The ILI group received an intensive lifestyle program; the UC group had routine care. Body weight was measured; further, eating behaviors (restraint, disinhibition), dietary intake (percentage fat intake, fruit and vegetable intake), physical activity, and weight- and health-related quality of life constructs were measured through questionnaires. Mediation analyses assessed whether questionnaire variables explained between-group variations in weight change during 2 periods: baseline to month 12 (n = 779) and month 12 to month 24 (n = 767). RESULTS: The ILI induced greater weight loss at month 12 compared with UC (between-group difference: −7.19 kg; 95% CI: −8.43, −6.07 kg). Improvements in disinhibition (−0.33 kg; 95% CI: −0.55, −0.10 kg), percentage fat intake (−0.25 kg; 95% CI: −0.50, −0.01 kg), physical activity (−0.26 kg; 95% CI: −0.41, −0.09 kg), and subjective fatigue (−0.28 kg; 95% CI: −0.46, −0.10 kg) at month 6 during the ILI partially explained this between-group difference. Greater weight loss occurred in the ILI at month 24, yet the ILI group gained 2.24 kg (95% CI: 1.32, 3.26 kg) compared with UC from month 12 to month 24. Change in fruit and vegetable intake (0.13 kg; 95% CI: 0.05, 0.21 kg) partially explained this response, and no variables attenuated the weight regain of the ILI group. CONCLUSIONS: In an underserved sample, weight change induced by an ILI compared with UC was mediated by several psychological and behavioral variables. These findings could help refine weight management regimens in underserved patients with obesity. This trial was registered at clinicaltrials.gov as NCT02561221.

Louisiana ranks among the bottom five states for air pollution and mortality. Our objective was to investigate associations between race and Coronavirus Disease 2019 (COVID-19) hospitalizations, intensive care unit (ICU) admissions, and mortality over time and determine which air pollutants and other characteristics may mediate COVID-19-associated outcomes. In our cross-sectional study, we analyzed hospitalizations, ICU admissions, and mortality among positive SARS-CoV-2 cases within a healthcare system around the Louisiana Industrial Corridor over four waves of the pandemic from 1 March 2020 to 31 August 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race–outcome relationships after adjusting for all available confounders. Race was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed, these rates became greater in White patients. However, Black patients were disproportionately represented in these measures. Our findings imply that air pollution might contribute to the disproportionate share of COVID-19 hospitalizations and mortality among Black residents in Louisiana.

Effective teamwork remains a crucial component in providing high-quality care to patients in today’s complex healthcare environment. A prevalent ‘us’ versus ‘them’ mentality among professions, however, impedes reliable team function in the clinical setting. More importantly, its corrosive influence extends to health professional students who model the ineffective behaviour as they learn from practicing clinicians. Simulation-based training (SBT) of health professional students in team-based competencies recognized to improve performance could potentially mitigate such negative influences. This quasi-experimental prospective study will evaluate the effectiveness and impact of incorporating a multi-year, health science centre-wide SBT curriculum for interprofessional student teams. It targets health professional students from the Schools of Medicine, Nursing and Allied Health at Louisiana State University (LSU) Health New Orleans. The intervention will teach interprofessional student teams key team-based competencies for highly reliable team behaviour using SBT. The study will use the Kirkpatrick framework to evaluate training effectiveness. Primary outcomes will focus on the impact of the training on immediate improvements in team-based skills and attitudes (Level 2). Secondary outcomes include students’ perception of the SBT (Level 1), its immediate impact on attitudes towards interprofessional education (Level 2) and its impact on team-based attitudes over time (Level 3). The Institutional Review Board at LSU Health New Orleans approved this research as part of an exempt protocol with a waiver of documentation of informed consent due to its educational nature. The research description for participants provides information on the nature of the project, privacy, dissemination of results and opting out of the research.

Objective: An ideal local anesthetic would be effective, minimally reduce pulpal blood flow (PBF), and not require injection. This study compared the effects of 3% tetracaine plus 0.05% oxymetazoline nasal spray (Kovanaze; KNS) and injections using 2% lidocaine with 1:100,000 epinephrine (LE) or 3% mepivacaine plain (MP) on PBF, anesthetic efficacy, and participant preference. Methods: In a double-blind cross-over design, 20 subjects randomly received a test anesthetic and placebo at each of 3 visits (KNS/mock infiltration; mock nasal spray/LE; or mock nasal spray/MP). Nasal sprays and infiltration apical to a maxillary central incisor were delivered ipsilaterally. PBF was evaluated by laser Doppler flowmetry, and local anesthetic success was assessed with electric pulp testing. Postoperative pain levels, participant preference, and adverse events were also assessed. Results: LE injections demonstrated significant reductions in PBF at all time intervals compared with baseline (P < .05), whereas KNS and MP did not. Pulpal anesthesia success rates were higher for LE (85%) compared with MP (35%) and KNS (5%). Participants reported significantly higher postoperative pain levels for KNS compared with LE and MP. Additionally, KNS was the least preferred of the anesthetics administered and resulted in more reported adverse events. Conclusion: Although KNS showed no significant effect on PBF, it was not effective in achieving pulpal anesthesia as used in this study.

The purpose of this pilot randomized controlled trial was to analyze and compare the effects of advanced platelet-rich fibrin (A-PRF) and plasma rich in growth factors (PRGF) combined with deproteinized bovine bone mineral (DBBM) on bone regeneration outcomes in maxillary sinus augmentation (MSA) procedures. A total of 15 patients in need of MSA were consecutively recruited. Maxillary sinuses were grafted with DBBM alone (control group), DBBM mixed with A-PRF (PRF group), or DBBM mixed with PRGF (PRGF group). After a 6-month healing period, bone core biopsy samples were collected prior to implant placement for histologic and histomorphometric analyses. The mean percentage of mineralized tissue (MT) was 20.33 ± 11.50 in the control group, 32.20 ± 7.29 for the PRF group, and 34.80 ± 6.83 for the PRGF group, with no statistically significant differences across the three groups (P.05). The mean percentage of remaining bone grafting material (RBGM) was 24.00 ± 7.94 for the control group, 26.00 ± 7.78 for the PRF group, and 15.80 ± 8.23 for the PRGF group, with no statistically significant differences across the three groups (P.05). Finally, the mean percentage of nonmineralized tissue (NMT) was 55.66 ± 7.77 for the control group, 41.40 ± 8.32 for the PRF group, and 49.60 ± 5.68 for the PRGF group, with no statistically signifcant differences across the three groups (P.05). These findings suggest that the addition of A-PRF and PRGF to DBBM does not enhance new bone formation outcomes in maxillary sinus augmentation procedures. Neither of the two platelet concentrates were superior to the other in any of the variables assessed.