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Context: The Upper Limb Functional Index (ULFI) is a popular tool with valid psychometric properties to assess upper limb function in patients with musculoskeletal conditions. The aim of the study was to cross-culturally adapt and validate the German version of the ULFI. Design: Cross-cultural validation. Methods: A 2-stage cross-cultural adaptation of the ULFI was performed according to international guidelines through consecutive forward and backward translations. Psychometric properties of internal consistency, test–retest reliability, criterion, face and content validity, and factor structure were determined from the included German participants suffering from upper limb conditions (n = 100), who fulfilled the following inclusion criteria: (1) older than 18 years old, (2) German as native language, and (3) medical diagnosis of musculoskeletal upper limb condition. Participants completed the ULFI; Disabilities of the Arm, Shoulder, and Hand; EuroQol Health Questionnaire 5 Dimensions; and Short Form-12 questionnaires. Results: The ULFI-G showed good internal consistency (α =.88); excellent test–retest reliability (intraclass correlation coefficient2:1 =.98); directly strong correlation with Disabilities of the Arm, Shoulder, and Hand (r =.84); fair correlation with Disabilities of the Arm, Shoulder, and Hand-sport (r =.54); inversely fair correlation with EuroQol Health Questionnaire 5 Dimensions (r = −.62); and Short Form 12's physical health domain (r = −.7). A single-factor structure was revealed. Conclusions: The ULFI-G showed adequate psychometric properties and proved to be a valid tool for upper limb functional assessment in German population. [ABSTRACT FROM AUTHOR]

We identified data-driven multidimensional physical activity (PA) profiles using several novel accelerometer-derived metrics. Participants aged 75, 80, and 85 (n = 441) wore triaxial accelerometers for 3–7 days. PA profiles were formed with k-means cluster analysis based on PA minutes, intensity, fragmentation, sit-to-stand transitions, and gait bouts for men and women. Associations with physical capacity and life-space mobility were examined using age-adjusted general linear models. Three profiles emerged: "Exercisers" and "actives" accumulated relatively high PA minutes, with actives engaging in lighter intensity PA. "Inactives" had the highest activity fragmentation and lowest PA volume, intensity, and gait bouts. Inactives showed lower scores in physical capacity and life-space mobility compared with exercisers and actives. Exercisers and actives had similar physical capacity and life-space mobility, except female exercisers had higher walking speed in the 6-min walk test. Our findings demonstrate the importance of assessing PA as multidimensional behavior rather than focusing on a single metric. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the dimensional accuracy of implant impressions obtained using five different tray types and two techniques. Materials and Methods: A partially dentate maxillary Kennedy Class II model was created as a reference model through 3D printing. Then, implant analogs 4.3 mm in diameter were placed at the first premolar, first molar, and second molar sites. Five types of trays were used to create impressions: (1) metal stock trays, (2) plastic stock trays, (3) custom trays fabricated using liquid crystal display (LCD), (4) custom trays fabricated using fused deposition modeling (FDM), and (5) custom trays fabricated using urethane dimethacrylate (UDMA) resin. Open and closed tray techniques were also compared. In total, 150 impressions were obtained. The reference model and impressions were scanned using a laboratory scanner. Additionally, the positional and angular deviations of implants with different tray types and techniques were evaluated using the superimposition method. Results: There was no statistically significant difference (P > .05) between the impression accuracy with the different tray types and impression techniques. The angular deviations with plastic and UDMA trays were greater than those with metal, FDM, and LCD trays. Angular deviation at the second molar was greater when using closed plastic trays compared to open plastic trays. The highest and lowest positional deviations were observed at the first molar implant with an open plastic tray impression (mean ± SD of 62.46 ± 28.54 mm) and a closed LCD tray impression (36.59 ± 29.93 mm). The greatest angular deviation was observed with an open FDM tray impression at the first premolar implant (0.067 ± 0.024 degree), and the lowest angular deviation was observed with a closed metal stock tray impression at the second molar implant (0.039 ± 0.025 degree). Statistical differences were detected using the Mann-Whitney U test for paired groups and the Kruskal-Wallis test for groups with more than three comparisons (P > .05). Conclusions: Plastic and metal stock trays or conventional and 3D-printed custom trays can be used to obtain implant impressions for maxillary partially edentulous arches with similar dimensional accuracy. The five tray types and two techniques may be safely used to obtain impressions of partially edentulous maxillary arches with three implants. [ABSTRACT FROM AUTHOR]

This article investigated the effects of airborne-particle abrasion and nanosilica (nano-Si) infiltration treatment on the surface characteristics of dental zirconia. A total of 15 unsintered zirconia ceramic green bodies (10 × 10 × 3 mm) were divided into three groups (n = 5): Group C, no treatment after sintering; Group S, airborne-particle abrasion with 50-µm aluminum oxide particles after sintering; and Group N, infiltration of nano-Si followed by sintering and hydrofluoric acid (HF) etching. The zirconia disks' surface roughness was analyzed by atomic force microscopy (AFM). The surface morphology of the specimens was analyzed using scanning electron microscopy (SEM), and the chemical composition was analyzed by energy-dispersive x-ray (EDX). Data were statistically analyzed by Kruskal-Wallis test (P < .05). Zirconia surface treatments by infiltration of nano-Si, sintering, and HF etching showed multiple changes in the surface features. The surface roughness of Groups C, S, and N were 0.88 ± 0.07 µm, 1.26 ± 0.10 µm, and 1.69 ± 0.15 µm, respectively. The surface roughness of Group N was significantly higher than that of Groups C and S (P < .05). EDX analysis showed peaks that corresponded to silica (Si) after infiltration with colloidal Si that disappeared following acid etching. Infiltrating nano-Si increases the surface roughness of zirconia. The formation of retentive nanopores on the surface potentially improves the zirconia-resin cement bonding strengths. [ABSTRACT FROM AUTHOR]

Context: The purpose of the study was to develop normative ranges and standards for knee and shoulder isokinetic and anthropometric values. These standards can be qualitatively interpreted and allow practitioners to classify isokinetic and anthropometric values more objectively for university-level netball players. Design: Posttest only observational study design. All players were only evaluated once during the in-season to generate normative ranges. Methods: A total of 51 female players volunteered. Participants were evaluated on an isokinetic dynamometer at 60° per second to obtain knee-extensor and knee-flexor values as well as shoulder-flexor and shoulder-extensor values. A total of 16 anthropometric variables were collected including stature, body mass, 8 skinfolds, and 6 circumferences. Between-group differences were calculated to determine whether playing level was a differentiating factor in data. Results: Normative standards were developed for isokinetic parameters associated with the knee and shoulder joints as well as skinfolds and circumference measures. No statistically significant between-group differences were evident (χKruskal-Wallis²[2] = 3.96, P = .140). Conclusion: These standards can be used by coaches and practitioners to set attainable goals for individual players or those from secondary leagues, classify individual and team-based performances, and facilitate decision-making processes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of combined therapy of teriparatide and raloxifene on the osseointegration of titanium dental implants in a rabbit model of osteoporotic bone. Materials and Methods: Sixty female rabbits were randomly divided into six groups. The sham ovariectomy group (control) consisted of animals that received no medication. Animals in the ovariectomy group (OVX) underwent ovariectomy and received no medication. The combined group consisted of ovariectomized animals that received combined teriparatide (10 mg/kg) for 12 weeks and raloxifene (10 mg/kg) for 12 weeks. The sequential group (SEQ) consisted of ovariectomized animals that received teriparatide (10 mg/kg) for the first 6 weeks and raloxifene therapy (10 mg/kg) for the following 6 weeks sequentially. The parathormone (PTH) and raloxifene (RAL) groups consisted of ovariectomized animals that received only teriparatide (10 mg/kg) for 12 weeks or raloxifene (10 mg/kg) for 12 weeks, respectively. Dental implants (Bilimplant) were placed in the proximal metaphysis of both tibias in all rabbits. Histomorphometric and microCT studies were performed on the specimens obtained from the right tibia bone. Removal torque (RTQ) and implant stability quotient (ISQ) tests were performed on the specimens obtained from the left tibia bone. The results were compared and evaluated statistically. Results: RTQ analysis revealed a statistically significant difference between the mean values of the combined group (93.01 ± 27.19 Ncm) and the OVX group (49.6 ± 12.5 Ncm) (P = .015). The highest mean T0 (implantation day) value was obtained in the control group (67.1 ± 3.4 Ncm), and the lowest mean value was obtained in the OVX group (61.4 ± 3.8 Ncm). The highest T1 mean (3 months after implantation) was obtained by the combined group (76.6 ± 3.8 Ncm), and the lowest mean was obtained by the OVX group (68.9 ± 6.2 Ncm). Histomorphometric analyses showed that the mean percentage of bone-to-implant contact (BIC%) of the combined group (51.2%) was significantly higher than that of the OVX group (28.6%) (P =.006). In the microCT examinations, it was found that the mean BIC% value of the combined group (41.1%) was significantly higher than that of the OVX group (24.1%) (P < .001). Conclusions: According to the results of the current study, combined therapy of teriparatide and raloxifene improves the BIC and osseointegration of titanium dental implants in osteoporotic bone compared with sequential or independent therapy with these agents. [ABSTRACT FROM AUTHOR]

The primary purpose of this study was to adapt selected accuracy and precision tests in table tennis to the specific skills of elite table tennis players with impairment. The study included a sample of 23 Para table tennis players with an average age of 31.8 ± 12.22 years (including 30.4% females) who belonged to the senior Polish Para table tennis team. A battery of six tests evaluating stroke accuracy and serve precision was assessed. The analysis of the reliability of these tests confirmed the legitimacy of using this battery of accuracy and precision tests to assess the skills of Para table tennis players in all three integrated sport classes: players in wheelchairs, in a standing position, and with intellectual impairment. Analysis of the data obtained from the tests could provide coaches with relevant information regarding elite Para table tennis players' level of performance and examine selected accuracy and precision elements of their individual technique. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 caused major disruptions across the super-aged nation of Japan, yet few studies explored temporal changes among middle-aged and older cohorts from baseline to the height of community transmission. Changes in physical activity and sedentary behavior during global pandemics may alter patterns of morbidity and mortality among susceptible aging populations. Objectives: This study investigated patterns of physical activity, sitting behavior, and health among representative samples of middle-aged and older adults in Tokyo before and during the pandemic. Methods: Repeated online surveys were conducted with quota samples of 800 Tokyo residents in 2019 and 2021 using validated Japanese-language measures, including the short form-International Physical Activity Questionnaire and the Basic Ecological Health Scale-6. Statistical analyses included comparative evaluations of activity parameters by age cohort, gender, and selected covariates. Statistical tests included the Kruskal–Wallis test, Mann–Whitney U test, chi-square test for Independence and Hierarchical Regression. Results: Over 34% of respondents were inactive at each data collection point, and 72% reported negative impacts of COVID-19 on their physical activities. Older adults showed no significant changes in their activity and sitting behavior and reported better health compared with those in middle age across the pandemic. Middle-aged males reported a significant decline in total activity of 33% across the pandemic period (U = 16,958, z = −2.64, p =.008, r =.13). Middle-aged females reported the lowest levels of physical activity, and health, and showed a 29% increase in sitting behavior across the pandemic (U = 16,925, z = −2.68, p =.007, r =.13). Subjective health status was consistently associated with higher overall activity and walking before and during the pandemic. Conclusion: Differential outcomes were identified between age and gender regarding health, physical activity, walking, and sitting across the pandemic with significantly worse impacts reported among middle-aged samples. Implications: These results have implications for healthy transitions to later life and the design of postpandemic interventions to address activity opportunities in Japan. [ABSTRACT FROM AUTHOR]

Purpose: To compare the treatment time of digital and conventional workflows for single-implant crowns, as well as prostheses made of polymer-infiltrated ceramic-network (PICN; Vita Enamic, Vita Zahnfabrik) and lithium disilicate (LS2; n!ce, Straumann). Materials and Methods: A total of 40 patients who needed a single-implant crown in posterior regions were considered and randomly divided into digital workflows (n = 20) that used an intraoral scanner (IOS; iTero Element 5D, Align Technologies) and conventional workflows (n = 20) that used polyether impressions (3M ESPE Impregum Penta). Then, each group was again distributed into two subgroups based on the crown material used: PICN (n = 10) and LS2 (n = 10). Treatment time was calculated for both digital and conventional workflows. Analysis was done at a 5% confidence interval (P < .05). An independent two-sample t test was used to compare treatment time between the groups. The Kruskal--Wallis test was used to compare clinical try-in time among subgroups. Any of the implant crowns that had to be remade in each subgroup were evaluated using the Fisher exact test. Results: The entire process of digital and conventional workflows required 104.31 ± 20.83 and 153.48 ± 16.35 minutes, respectively. Digital workflows saved 39.2% more time than the conventional protocol for the single-implant crown treatment (P < .0001). Conclusions: Both digital and conventional workflow protocols can achieve a successful outcome for single-implant monolithic crowns in posterior areas. The digital protocol yielded greater timesaving over the conventional procedure in data acquisition and laboratory steps, while the time for clinical try-in and delivery were similar. [ABSTRACT FROM AUTHOR]

Context: Plantar intrinsic foot muscle strength training is difficult to master to a degree sufficient to elicit muscle hypertrophy in most individuals. It is possible that combining neuromuscular electrostimulation (NMES) and blood flow restriction (BFR) can elicit plantar intrinsic foot muscle hypertrophy regardless of the individual's technique. This study aimed to determine the effects of NMES training with BFR on acute muscle swelling in the abductor hallucis. Design: Randomized, controlled, single-blind trial design. Methods: Forty-eight participants were randomly allocated to the NMES + BFR, NMES, or Sham NMES + BFR groups. All participants received abductor hallucis NMES for 15 minutes. Participants in the NMES + BFR and Sham NMES + BFR groups received NMES with BFR. The intensity of NMES was the sensory threshold in the Sham NMES + BFR group. The cross-sectional area of the abductor hallucis was measured pretraining and posttraining using ultrasonography by a single investigator blinded to the participants' allocations. Results: After 15 minutes of training, the cross-sectional area of the abductor hallucis was significantly increased in the NMES + BFR (P<.001) and the Sham NMES + BFR (P = .004) groups. Moreover, the rate of increase was significantly higher in the NMES + BFR group than in the NMES or the Sham NMES + BFR groups (P<.001 and P = . 001, respectively). Conclusions: Since it is possible that the amount of muscle swelling immediately after training correlates with muscle hypertrophy when training is continued, the results of this study suggest that NMES training with BFR is a training method that can be expected to produce plantar intrinsic foot muscle hypertrophy. Further studies are needed to confirm the long-term effects of NMES training with BFR. [ABSTRACT FROM AUTHOR]

Context: Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes. Design: A parallel, single-blinded, randomized controlled trial. Methods: Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups. Results: No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750). Conclusions: Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the antibacterial effects of Terminalia catappa Linn (TCL) leaf extracts at different concentrations and the effects of these extracts used as primers on the long-term adhesive properties of two universal adhesives. Materials and Methods: After extract preparation, the antimicrobial and antibacterial activities of TCL against Streptococcus mutans (UA 159) were assessed in microdilution assays to provide the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Additionally, to provide quantitative data on the ability of TCL extract to reduce cell viability, colony forming units (CFU) were counted. To examine adhesive properties, 288 human molars were randomly assigned to 32 experimental conditions (n = 9) according to the following variables: (1) treatment agent: negative control (untreated surface), and primers at concentrations of 1xMIC, 5xMIC, and 10xMIC; (2) adhesives: Scotchbond Universal (SBU) and Futurabond Universal (FBU); (3) adhesive strategy: etch-and-rinse (ER) or self-etch (SE); and (4) storage time: 24 h or after 2 years. Primers were applied for 60 s, upon which the teeth were incrementally restored and sectioned into adhesive-dentin bonded sticks. These were tested for microtensile bond strength (pTBS) and nanoleakage (NL) after 24-h and 2-year water storage, as well as in-situ degree of conversion (DC) at 24 h. The chemical profile of the hybrid layer was determined via micro-Raman spectroscopy. Biofilm assay data were analyzed using the Kruskal-Wallis test; the pH of culture media and the chemical profile were analyzed by one-way ANOVA. The adhesive properties (pTBS, NL, DC) were evaluated using a four-way ANOVA and Tukey's test. Significance was set at 5%. Results: Similar values of MIC and MBC were observed (2 mg/ml), showing bactericidal potential. CFU analysis demonstrated that concentrations of 5xMIC and 10xMIC significantly inhibited biofilm formation (p < 0.001). The application of the TCL primer at all concentrations significantly increased the immediate pTBS and DC, and decreased the immediate NL values when compared to the control group (p < 0.05), regardless of the adhesive and adhesive strategies. Despite an increase in the NLvalues for all groups after2years (p > 0.05), in groups where the TCL primerwas applied, the pTBS remained constant after 2 years for both adhesives, while a decrease in the pTBS was observed in the control groups (p < 0.05). Usually, IOxMIC showed better results than 1xMIC and 5xMIC (p < 0.05). The application of TCL promoted cross-linking; cross-linking rates increased proportionally to the concentration of TCL (p < 0.05). Conclusion: Primers containing TCL promoted bactericidal and bacteriostatic action, as well as cross-linking with dentin, while maintaining the adhesive properties of the adhesive-dentin interface after 2 years of water storage. [ABSTRACT FROM AUTHOR]

Few studies have reported the outcomes of short implants with a follow-up time > 10 years. This retrospective study aimed to evaluate the long-term outcomes of short locking-taper implants supporting single crowns in the posterior region. Patients who received these supporting implants (≤ 8 mm) in the posterior region from 2008 to 2010 were included. The clinical and radiographic outcomes and patient satisfaction were recorded. A total of 18 patients with 34 implants were included. The cumulative survival rate was 91.4% and 83.3% at implant and patient levels, respectively. Tooth brushing habit and history of periodontitis were significantly associated with implant failure (P < .05). The median marginal bone loss (MBL) was 0.24 mm (IQR: 0.01 to 0.98 mm). Biologic and technical complications occurred in 14.7% and 17.8% of implants, respectively. The mean modified Sulcus Bleeding Index was 0.52 ± 0.63, and the mean peri-implant probing depth was 2.38 ± 0.79 mm. All patients were at least quite satisfied, with the majority of patients (88.9%) being fully satisfied with the treatment. Within the limitations of this study, the short locking-taper implants supporting single crowns in the posterior region achieved promising outcomes in the long-term follow-up. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the marginal leakage of three different types of bonding agents used with two posterior composites and a giomer, available commercially. Material and methods: Class II box-only cavities were prepared on 90 mandibular first molars with margins extending 1 mm beyond the cementoenamel junction. The samples were divided into nine groups based on three different bonding agents, two different composites, and a giomer. Cavities were restored per the manufacturer's description. Teeth were subjected to a thermocycling procedure (500Ã--, 5°C to 55°C) and dye penetration by immersing in a 2% methylene blue solution (Merck Specialties) for 24 hours. The marginal adaptation was evaluated as a continuous margin at the gingival level under a stereomicroscope. The results were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results: The results of the groups with the total-etch technique showed no statistical difference between the nanohybrid Filtek Z250 XT (3M ESPE) and fine hybrid SwissTEC composite (Coltène\Whaledent AG). The groups with the self-etch technique showed no statistical difference when used with either of the two composites. The acid-etch technique showed better marginal adaptation than the self-etch technique. When the giomer (Beautifil II, Shofu) was used with the total-etch technique, it showed better adaptation than when used with the self-etch technique but overall showed more marginal leakage than the composites. Conclusion: The total-etch technique provided better marginal adaptation for the composites and giomer compared to the self-etch technique. Clinical significance: The demand for esthetic restorations continues to increase, and composite restorations are now considered the material of choice for Class II cavities. There are various concerns with composite restorations, one of them being good marginal adaptation to increase the life of the restoration. This study evaluated marginal leakage with the nanohybrid composite Filtek Z250 XT, fine hybrid composite SwissTEC, and a giomer when used with the total-etch technique and self-etch technique and reported satisfactory adaptation with the total-etch technique. [ABSTRACT FROM AUTHOR]

This article investigated the effects of airborne-particle abrasion and nanosilica (nano-Si) infiltration treatment on the surface characteristics of dental zirconia. A total of 15 unsintered zirconia ceramic green bodies (10 x 10 x 3 mm) were divided into three groups (n = 5): Group C, no treatment after sintering; Group S, airborne-particle abrasion with 50-p.m aluminum oxide particles after sintering; and Group N, infiltration of nano-Si followed by sintering and hydrofluoric acid (HF) etching. The zirconia disks' surface roughness was analyzed by atomic force microscopy (AFM). The surface morphology of the specimens was analyzed using scanning electron microscopy (SEM), and the chemical composition was analyzed by energy-dispersive x-ray (EDX). Data were statistically analyzed by the Kruskal-Wallis test (P < .05). Zirconia surface treatments by infiltration of nano-Si, sintering, and HF etching showed multiple changes in the surface features. The surface roughness of Groups C, S, and N were 0.88 ± 0.07 µm, 1.26 ± 0.10 µm, and 1.69 ± 0.15 µm, respectively. The surface roughness of Group N was significantly higher than that of Groups C and S (P < .05). EDX analysis showed peaks that corresponded to silica (Si) after infiltration with colloidal Si that disappeared following acid etching. Infiltrating nano-Si increases the surface roughness of zirconia. The formation of retentive nanopores on the surface potentially improves the zirconia-resin cement bonding strengths. [ABSTRACT FROM AUTHOR]

This article evaluated tooth discoloration after the use of calcium silicate-based materials to examine the effect of internal bleaching on tooth discoloration. The specimens were randomly divided into two experimental groups (n = 45) and a control group (n = 6). Cavities were filled with ProRoot MTA (Dentsply Sirona) in Group 1 and Biodentine (Septodont) in Group 2. Color measurements were taken with a spectrophotometer before and after the application of materials at 1 week, 13 weeks, and 6 months. After 6 months, Groups 1 and 2 were divided into three subgroups according to internal bleaching techniques. All color change ratios and lightness differences were calculated using the CIE L*a*b* system. Data were analyzed using repeated ANOVA and Kruskal-Wallis test (P = .05). There were statistically significant differences between Groups 1 and 2 at all time intervals (P < .05). Group 1 showed more discoloration than Group 2 (P < .05). There were no significant differences between the bleaching agents (P > .05). Additionally, specimens in both groups became lighter than their initial color (P < .05). Teeth treated with ProRoot MTA exhibited darkening at 1 week that increased over time, whereas those treated with Biodentine maintained the lightness for 6 months. [ABSTRACT FROM AUTHOR]

Purpose: To compare the 3D accuracy of three scanning strategies and conventional impressions using an edentulous model with six implants. Materials and Methods: An edentulous maxillary master model was fabricated with six equigingival internal connection implants at 0 degrees of angulation. Ten conventional open-tray splinted implant-level impressions were made and poured in stone. A master model and conventional casts were digitized with a reference scanner. Digital impressions were made by calibrated clinicians with a TRIOS 3 intraoral scanner ([IOS] 3Shape) according to three scanning strategies: DIG1 (occlusal-palatal-lingual), DIG2 (S-type motion from buccal to palatal), and DIG3 (scanning two half arches and connecting them at the midline). Each technique was repeated 10 times on the master model. Deviations from the STL datasets (N = 40) were compared to those of the reference master model using the Hexagon Metrology software system PC-DMIS CAD++. Linear distortions (dX, dY, dZ), global linear distortion (dR), and angular distortions (Absdθx, Absdθy) were calculated. Kruskal-Wallis test and mixed linear and logistic regression models were used to compare the original and binary distortion measures between the techniques. Results: The mean dR ranged from 91 μm (conventional method) to 183 μm (DIG1). The mean angular distortion ranged from 0.20 degrees (Absdθx for DIG2) to 0.69 degrees (Absdθy for DIG3). No scan pattern resulted in a more accurate reproduction in any of the measured parameters than the conventional impression method. There were significant differences between the methods for all distortion measures. Conclusions: No group reproduced the 3D position of the six-implant master model below the thresholds for both global linear and angular distortions. All the digital strategies tested were less accurate than the conventional open-tray splinted implant-level impression technique. [ABSTRACT FROM AUTHOR]

Background: Auditory electrophysiological tests of the cortex, which are processed in or close to the auditory cortex, are brain reactions to sound. A variation in a continuous stimulus causes the acoustic change complex potential (ACC), which is a wave following the P1-N1-P2 response. Objective: To measure the amplitude and latency of different components of ACC in normal subjects and across individuals with mild and moderate degrees of sensorineural hearing loss (SNHL). Patients and methods: The study includes 100 individuals with the age ranged from 10 to 50 years with different degrees of SNHL. The ACC was evoked by a change of second formant in the middle of ongoing steady-state synthetic, 3 formant vowels (ooee). The total duration was 500 ms. Changing occurred at 250 ms. Results: The SNHL subgroups showed statistically significantly longer P1 and N1 latencies. N1 and P2 amplitudes of ACC onset response were larger with a statistical significance as compared to controls. Post hoc analysis revealed no statistically significant difference between mild and moderate SNHL on ACC parameters. Age showed a significant negative correlation with ACC N1 and P2 latency, ACC P1 and N1 amplitude, and onset P2 latency. Onset response P1 latency was significantly higher in children than adults. Median ACC P1 amplitude significantly increased in children than adults. Conclusion: ACC is a reliable tool for testing the auditory cortex function of detecting difference in sounds presented that can be recorded readily in patients with mild and moderate SNHL. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relationship between high school sport participation among university students and whether previous sports participation was associated with current levels of exercise-self efficacy, resilience, and psychological need satisfaction physical activity behaviors. Participants: College freshmen (n = 152) in the United States responded to an electronic survey sent out by their university. Methods: Participants completed a set of questionnaires assessing resilience, psychological need satisfaction in exercise, self-efficacy, and current PA. Results: Analysis of variance, Kruskal-Wallis H tests, independent samples t-tests, and ordinary least squares regression modeling were used. Total PA and having met moderate PA guidelines were both associated with exercise SE and PNSE. HS GPA, total PA, and being a college athlete were associated with both resilience and exercise SE. Conclusions: Sport participation may serve as an effective method for students to develop exercise SE, resilience, and PNSE. The development of these skills may support lifelong PA behaviors. [ABSTRACT FROM AUTHOR]

Objective: To investigate attitudes and practices toward smoking among university students and to identify associated factors. Methods: A cross-sectional study was conducted among 1,299 students from five public universities in Thailand. Factor analysis and multiple regression were used for analysis. Results: A higher score of anti-smoking attitude was associated with female gender, majoring in science, living on campus, having a father with primary or secondary school, and those whose father was employed in the private sector. A more positive perceptions about smoking was associated with male gender, having a family income of 30,001–50,000 baht, and having a smoking friend. High positive preventive practice score was associated with those who came from rural areas, having a mother who was self-employed, and having a smoking family member. Conclusions: Although students showed strong anti-smoking attitudes, their preventive practices were poor. These findings should be taken into consideration when developing preventive smoking programs. [ABSTRACT FROM AUTHOR]

Objective: During COVID-19, many colleges offered mental health services to their students through telehealth or through a combination of telehealth and in-person (hereby hybrid) services. This study examines the experiences and perceptions among students who received telehealth, hybrid, or in-person services. Participants: Data was collected from the Healthy Minds Survey, a national survey of college students, during Fall 2020 and Spring/Winter 2021 (n = 13,976). Methods: Chi-square and Kruskal-Wallis H tests were conducted to examine how students who received campus mental health services through different modes of delivery differed in reported barriers to care, satisfaction with care, and perceived support. Results: Students receiving in-person services differed from students receiving telehealth or hybrid services on multiple metrics. For example, they were less likely to be satisfied with the quality of therapists or the ability to schedule appointments without long delays. However, effect sizes were small. Conclusion: There may be unique strengths to telehealth and hybrid services. [ABSTRACT FROM AUTHOR]

Objective: We examined COVID-19-related experiences, mental health, and future plans among US undergraduate and graduate students in the initial months of the pandemic. Participants: 72 students (68% female; 51.4% white; age x– =24.4) from 21 colleges in the US southwest concurrently enrolled in a stress-reduction study. Methods: Between March and June 2020, participants completed an online survey about demographics, personal and vicarious COVID-19 experiences, mood, and future plans. Anxiety and depression symptoms were assessed with the GAD-7 and PHQ-9, respectively. Results: Worry about COVID-19 was associated with anxiety and depression symptoms and personal and vicarious experiences with COVID-19. COVID-19 worry varied by illness severity and level of intimacy with those impacted. Most participants reported changing educational (66.7%) and life (55.6%) plans due to COVID-19. Conclusions: Given the continued impact of COVID-19 on physical/emotional health and future plans, universities should assist students in managing COVID-19-related stress so they can continue to learn and grow. [ABSTRACT FROM AUTHOR]

Background: Sleep problems are prevalent among individuals diagnosed with gestational diabetes mellitus (GDM), significantly impacting their overall quality of life. Objective: This study sought to adopt a person-centered methodology to unveil the latent profiles of sleep quality and identify factors influencing sleep patterns in patients with GDM. Methods: The cross-sectional study gathered sociodemographic features, clinical information, sleep problems (Pittsburgh Sleep Quality Index), personality traits (Type D Personality Scale), social support (Perceived Social Support Scale), and self-efficacy (General Self-efficacy Scale). Latent profile analysis was conducted to identify profiles of sleep quality, while multinomial logistic regression was employed to ascertain the factors influencing these identified profiles. Results: Among the 431 participants, 423 (98.1%) completed the questionnaire, with 53.0% reporting moderate-to-poor sleep quality. This study identified 4 distinct profiles of sleep quality among patients with GDM: the "good sleep quality" group (47.0%), the "poor sleep quality—long sleep duration" group (10.0%), the "moderate sleep quality" group (25.3%), and the "poor sleep quality—short sleep duration" group (17.7%). Individuals with type D personality were associated with the "poor sleep quality—long sleep duration" [odds ratio (OR) = 3.21, P =.005], "moderate sleep quality" (OR = 2.65, P =.003), and "poor sleep quality—short sleep duration" group (OR = 2.31, P =.018). Individuals with a history of GDM were associated with "poor sleep quality—long sleep duration" group (OR = 3.46, P =.005). Conclusions: The research revealed significant classification characteristics of sleep quality in patients with GDM, offering valuable insights for tailoring interventions to address distinct subcategories of sleep-related issues. [ABSTRACT FROM AUTHOR]

Aim: To assess a commercially available electronic whiteboard's usability and acceptability in isolation rooms, focusing on improving nurse–patient communication and supporting data input. Design: A cross‐sectional study with quantitative and qualitative mixed methods. Methods: We evaluated the usability and acceptability of electronic whiteboards among nurses using scenarios in a virtual isolation room environment. Results: Nurses recognised the electronic whiteboard as a valuable tool for communication and error reductions in record‐keeping but noted a learning curve for less tech‐savvy users. Positive correlations were found between perceived usefulness, ease of use and adoption intent. Despite challenges, electronic whiteboards show promise for enhancing patient care, requiring comprehensive training and management systems. Time allocation in patient wards and nurse–patient interactions are crucial considerations. Conclusion: Electronic whiteboards have usability and acceptability as a tool to improve nurse–patient communication. However, considering technical issues and staff resistance, a management system and user training are necessary. Implications for the Profession and/or Patient Care: Nurses perceive electronic whiteboards as user‐friendly and as facilitating data input. Reporting Method: TREND (Nonrandomised evaluations of behavioural and public health interventions). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the psychosocial adjustment of enterostomy patients on a national scale. Design: Based on a national cross‐sectional survey. Methods: From December 2021 and February 2023, a total of 22,040 enterostomy patients were assessed using the ostomy adjustment inventory‐20. Initial analysis involved employing the chi‐square test or Kruskal‐Wallis H test to identify factors influencing the psychosocial adjustment of these patients. Subsequently, multinomial logistic regression was used to determine the factors affecting the classification of psychosocial adjustment levels of enterostomy patients. The reporting of this study adhered to the STROBE checklist. Results: Eventually 21,124 patients with enterostomy were included in this study, out of which 7788 (36.9%) patients with low level of psychosocial adjustment, 11,803 (55.8%) patients with medium level of psychosocial adjustment and 1533 (7.3%) patients with high level of psychosocial adjustment. The factors influencing the classification of psychosocial adjustment levels of enterostomy patients were gender, educational background, carer, enterostomy self‐care knowledge score and medical payment method. Conclusions: The overall psychosocial adjustment level of enterostomy patients is not optimistic, and the factors that may affect the classification of their psychosocial adjustment level are analysed. Individualised intervention should be given according to different psychosocial adjustment levels of enterostomy patients. Relevance to Clinical Practice: The number of enterostomy patients with a high level of psychosocial adjustment is small in relation to the total number of enterostomy patients, and caregivers can provide health education to enterostomy patients by analysing the factors affecting the level of psychosocial adjustment of enterostomy patients. Patient or Public Contribution: None. [ABSTRACT FROM AUTHOR]

Purpose: In pain assessment, the commonly used Numeric Rating Scale (NRS) offers an incremental 0-to-10 range of response options. But this broad range often leads to discordant evaluations between nurses and their patients. This study aimed to compare the NRS to the three-category Interventional Pain Assessment (IPA) scale, validate the IPA scale in an inpatient setting, and determine RN and patient scale preferences. Methods: This prospective study enrolled 122 postoperative orthopedic patients and their designated 104 RNs at a level 1 trauma center in the midwestern United States. Patients were asked to verbally rate their pain from 0 to 10 using the NRS and from 0 to 2 on the IPA scale. Patients were also asked which scale best conveyed their pain. The RNs were asked which scale best informed them of their patient's pain situation and which scale they preferred. To establish a correlation between the two scales, we considered NRS values of 0 to 7 (signifying no pain to moderate pain) to correspond to IPA scale values of 0 to 1 (signifying no pain to tolerable pain). NRS values of 8 to 10 (signifying severe pain) were considered to correspond to IPA scale values of 2 (signifying intolerable pain). Responses in which patients reported IPA scores indicating no pain to tolerable pain but NRS scores above 7 or IPA scale scores indicating intolerable pain but NRS scores of 7 or below were defined as discordant answers. Results: Data analysis revealed a strong significant correlation between the NRS and IPA scale (τ = 0.597), with an 82.7% concordance rate. Once an NRS score rose above 7, more discordance between the two scales became increasingly prevalent, as evidenced by the 45% of patients who also reported tolerable pain on the IPA scale. Significantly more patients (89.3%) preferred the IPA scale to communicate their pain level than the NRS (10.7%). Significantly more RNs (76%) felt the IPA scale best informed them of their patient's pain and was a better guide for treatment than felt the NRS did so (24%). Conclusions: The IPA scale asks about pain tolerability and thus has a direct role in the management of pain medications. Both patients and nurses felt they were better able to convey and understand pain when using the IPA scale than when using the NRS. There was consensus regarding pain scale preference among patients and their RNs, with both groups preferring the IPA scale due to its simplicity and, among the RNs, its usefulness in guiding treatment. The IPA scale may be a much better tool for accurately assessing a patient's pain experience and needs, with the potential to change practice and improve pain management. This study aimed to compare the Numeric Rating Scale with the Interventional Pain Assessment (IPA) scale, validate the IPA scale in an inpatient setting, and determine RN and patient scale preferences. [ABSTRACT FROM AUTHOR]

Objectives: Dexamethasone has become the standard of care for pediatric patients with status asthmaticus in the emergency department (ED) setting. Inpatient providers often must decide between continuing the second dose of dexamethasone or transitioning to prednisone. The effectiveness of receiving dexamethasone followed by prednisone (combination therapy) compared to only prednisone or dexamethasone remains unclear. This study compares patient characteristics and ED reutilization/hospital readmission outcomes of dexamethasone, prednisone, and combination therapy for inpatient asthma management. Methods: A retrospective study was conducted at our tertiary children's hospital of children aged 2 to 18 years hospitalized between March 2016 and December 2018 with a primary discharge diagnosis of asthma, reactive airway disease, or bronchospasm. The differences between steroid groups were compared using Fisher's exact or Chi-square tests for categorical variables, and a Kruskal-Wallis test for continuous variables. A multivariable logistic regression was performed to analyze ED reutilization and hospital readmission rates. Results: 1697 subjects met inclusion criteria. 115 (6.8%) patients received dexamethasone, 597 (35.2%) received prednisone, and 985 (58.0%) received combination therapy. Patients prescribed combination therapy had a lower exacerbation severity than patients prescribed prednisone, but higher severity than patients prescribed dexamethasone (p <.001, p =.001, respectively). Dexamethasone and combination therapy were not associated with increased 30-day ED reutilization/hospital readmissions compared to prednisone (p >.05). Conclusions: In our study, most patients hospitalized for status asthmaticus received combination therapy. Despite the differences in severity between steroid groups, outcomes of combination therapy and dexamethasone monotherapy, as measured by frequency of ED reutilizations/hospital readmissions, are comparable to prednisone monotherapy. [ABSTRACT FROM AUTHOR]

Background: Parents' low health literacy (HL) has negative impacts on child health. Parental interventions may improve parents' HL and thus impact child health positively. Objectives: This study aimed to gain knowledge about associations between parents' comprehensive HL (CHL) and child health after an extended postnatal home visiting program in Swedish multicultural, disadvantaged settings compared to parents receiving regular child healthcare (CHC). Materials and Methods: This quasi‐experimental study used a case–control sampling method to recruit first‐time parents through two CHC centres in Stockholm (2017–2020). Participants (N = 151) were interviewed twice through structured questionnaires when their child was <2 months and 15–18 months old. HLS‐EU‐Q16 assessed parents' CHL. Children's medical records (0–18 months) were reviewed regarding breastfeeding, children's exposure to smoking, language development and healthcare utilisation. Data were analysed with regression models and non‐parametric tests. Results: No significant association was found between parents' CHL and child health. However, significantly fewer unplanned visits to the CHC centre were observed among children (0–18 months) in the intervention group irrespective of CHL, compared with children to parents with improved CHL in the comparison group (F = 3.856, p = 0.011). Conclusions: Postnatal home visiting interventions practicing proportional universalism and family‐centred care may reduce unplanned visits within CHC in disadvantaged settings despite parents' CHL. Further studies with long‐term follow‐up are suggested to explore associations between parents' CHL and child health. Trial Registration: As a clinical study (not a clinical trial) with appropriate ethical permission with participants' consents, this study was retrospectively registered (18 February 2020) in the ISRCTN registry (ISRCTN10336603). [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the fit of interim crowns produced using DLP‐based 3D printing with different manufacturing workflows—open and proprietary—versus milling technology. Methods: A total of 120 crowns were evaluated using the replica technique. The control group (Mill, n = 30) was manufactured via subtractive technology. Experimental groups were printed using a DLP printer (SprintRay Pro95). In the proprietary mode (SR100, n = 30), manufacturer resin was used with a 100‐μm layer thickness (LT) and a splashing cleaning postprocessing. In the open mode, validated resin was used. Group B100 (n = 30) had a 100‐μm LT, and group B50 (n = 30) had a 50‐μm followed by postprocessing in an ultrasonic bath with full immersion in isopropyl alcohol. Kruskal–Wallis tests with Bonferroni correction was applied after normal analysis (α = 0.05). Results: Group B50 exhibited the best overall fit (123.87 ± 67.42 μm), which was comparable to the gold standard Milling group, which demonstrated the lowest marginal fit (p = 0.760). SR100 showed significantly poorer performance compared to Mill, B50, and B100 (p < 0.001). Conclusions: 3D printed and milled interim crowns generally demonstrated clinically acceptable fit, with the exception of the SR100 group. Postprocessing notably influenced crown fit, with the open mode with total immersion in isopropyl alcohol being superior. Clinical Significance: The present study demonstrates that the selection of an optimal manufacturing and postprocessing workflow results in superior fit for interim crowns. This enables dental professionals to evaluate protocols and ensure reliable outcomes with improved clinical outcomes in interim crown fabrication. [ABSTRACT FROM AUTHOR]

Rationale: Nomophobia becoming widespread can have negative effects on the psychology of nursing students, who are the nurses of the future. Yet, the psychological well‐being of the nursing group dealing with human health is essential for psychologically supporting the individuals they care for and reducing the potential for errors in nursing care. Therefore, it is necessary to determine nomophobia in nursing students and examine its relationship with psychological states. Aims: This research was conducted to determine the effect of nomophobia levels on depression, anxiety and stress levels of nursing students. Method: The descriptive and correlational research was completed with 544 nursing students. Data were collected using the Data Collection Form, Nomophobia Scale, Depression, Anxiety and Stress Scale (DASS‐21) and analysed using descriptive statistics, Kolmogorov‐Smirnov, Shapiro‐Wilk, Spearman, Mann‐Whitney U and Kruskal‐Wallis tests. p < 0.05 was considered statistically significant. Results: The students' mean age was 21.10 ± 1.32. Their mean nomophobia score was 102.51 ± 27.06. 65.6% had depression, 66.2% had anxiety, and 35.8% had stress at different levels. A relationship was found between the students' nomophobia mean scores and their depression, anxiety and stress subscale scores (p < 0.001). Conclusion: The students' nomophobia levels were high. As students' nomophobia levels increased, their depression, anxiety and stress levels increased. Our recommendation is to inform nurses about nomophobia, support conscious phone use, and direct students affected by nomophobia to relevant units. Our recommendation is to inform nursing students about nomophobia, direct students affected by nomophobia to relevant units, and support their participation in activities that will raise awareness among students. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the orofacial myofunctional characteristics, masticatory performance and facial thermal profile in individuals with Parkinson disease (PD) and spinocerebellar ataxia (SCA3), comparing with healthy control ones. Method: Seventy‐two participants aged between 30 and 85 years were evaluated and divided into PD, SCA3 and control groups. The assessments included clinical evaluation using the Orofacial Myofunctional Evaluation with Scores protocol (orofacial structures, mastication, swallowing and breathing aspects), masticatory performance assessed with a colour‐changeable chewing gum and infrared thermography. The Kruskal–Wallis, one‐way ANOVA and Wilcoxon tests were applied. Results: With the exception of face and tongue, a difference was seen in the cheek, maxillomandibular relationship, lips, mentalis muscle and palate appearance and posture between patients and healthy control participants. Orofacial mobility, swallowing and masticatory function also scored higher in the control group. The SCA3 and PD groups required more time to eat the test‐food and showed greater facial temperature asymmetries than the control one (p < 0.05). Masticatory performance measured by chewing gum did not differ. Conclusion: Facial temperature asymmetries, swallowing and masticatory function scores and the time needed by the SCA3 and PD groups to eat the test‐food were different from healthy participants, drawing attention to the impaired orofacial functions in patients with neurodegenerative disorders. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between prestroke frailty and nonhome discharge, prolonged length of stay as well as functional outcomes. Design: Prospective observational study. Setting: Single urban teaching hospital in Guangzhou, China. Participants: Consecutive sample of 271 older patients admitted with acute stroke. Intervention: N/A. Main measures: A five-item FRAIL scale (0∼5 points) and the stroke severity at onset were measured. The primary outcome of interest was nonhome discharge, with secondary outcomes including prolonged length of stay and worse short-term prognosis. Multivariable logistic regression adjusting for confounding factors was used to determine the association between patient-reported frailty and nonhome discharge, prolonged length of stay, worse short-term prognosis. Results: The population had a median age of 68 [interquartile range (IQR), 64∼74)]years, with 50 individuals (18.5%) identified as frail. After adjusting for age, sex, Barthel index, National Institutes of Health Stroke Scale, and Mini-Mental Status Exam score at admission, patients with self-reported frailty were significantly likely to experience nonhome discharge (Odds Ratio [ OR ] = 4.788; 95% confidence interval [CI] = 1.272∼18.017; p =.021), prolonged length of stay (OR = 4.76; 95% CI = 1.80∼12.56; p =.002), mRS scores at 30 days (OR = 6.72;95% CI = 1.79∼25.20; p =.005) and three months postdischarge and three-month (OR = 8.94; 95% CI = 2.10∼38.08; p =.003). Conclusions: In older adults with stroke, frailty is associated with nonhome discharge, prolonged length of stay, and worse short-term prognosis, regardless of the stroke severity, cognition, and Barthel index score at admission. FRAIL scale can be used as a practical screening tool in acute care setting by multidisciplinary team in supporting discharge process. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether nerve mobilization related to nerve mobility or the removal of edema using lymphatic drainage affects the cross-sectional area of the nerve, hand function, and symptom severity in carpal tunnel syndrome. Design: The study is a prospective randomized controlled trial. Data were analyzed between groups using ANOVA, Chi-squared test, and Kruskal–Wallis test. Setting: Treatment lasted 4 weeks. Splint group wore the splint daily. Splint+manual lymphatic drainage received lymphatic drainage 5 days a week. Splint+nerve mobilization performed neuromobilization exercises as home exercises 5 days a week. Evaluations were conducted before and after 4 weeks of treatment. Participants: The study included 80 patients with mild-to-moderate carpal tunnel syndrome. Interventions: The patients were randomly divided into three groups: splint (n = 27), splint+manual lymphatic drainage (n = 27), or the splint+nerve mobilization (n = 26). Main Outcome Measures: The main outcome measures were ultrasound assessments and the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Boston Functional Status Scale). Results: Compared to the other groups, the nerve cross-sectional area decreased at both the carpal tunnel (p = 0.003) and mid-forearm (p = 0.014) levels in the drainage group. Nerve mobilization did not result in a significant change in the nerve cross-sectional area. All groups showed significant improvements in both symptom severity and functional status scores (p < 0.001). Conclusion: The reduction of edema through lymphatic drainage contributes to a decrease in the cross-sectional area of the median nerve. Additionally, all three methods appear to positively impact the functional capacity of the hand and alleviate symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Aplastic anemia (AA) and hypoplastic myelodysplastic syndrome (MDS‐h) are bone marrow failure disease and difficult to distinguish merely by morphological analysis. In this study, we investigated the value of flow cytometry (FCM) in the differential diagnosis of AA and MDS‐h. Methods: We included 822 patients (626 control, 69 AA, 22 MDS‐h and 105 dilution patients) from January 2017 to December 2022 for a retrospective study. Bone marrow myeloid progenitor (MP) cell and mature lymphocytes proportions were analyzed by FCM. The ratio of MP cell proportion and mature lymphocytes proportion, MPLR, was calculated. Data were compared by Kruskal–Wallis test. Differential diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve. Cutoff value was determined by the maximum Youden index. Results: Bone marrow MP cell proportion and MPLR of MDS‐h patients were higher than AA patients. Mature lymphocytes proportion of MDS‐h patients was lower than AA patients. Area under ROC curve (AUC of ROC) of MP cell proportion, MPLR and mature lymphocytes proportion to distinguish AA from MDS‐h were 0.992, 0.988, and 0.850, respectively. Moreover, MPLR of dilution patients was higher than AA patients but lower than MDS‐h patients. The AUC of ROC curves of MPLR to distinguish MDS‐h and AA from dilution were 0.854 and 0.871, respectively. Conclusion: Bone marrow MP cell proportion and MPLR can effectively discriminate AA from MDS‐h with similar differential efficacy, which is higher than mature lymphocytes proportion. Moreover, MPLR can evaluate the quality of bone marrow aspirates, which would interfere with the differential diagnosis. [ABSTRACT FROM AUTHOR]

The objectives were to assess the self-efficacy and consistent condom use by people living with HIV (PLHIV). A cross-sectional, comparative study was carried out in outpatient clinics in Ceará State, Brazil, with a sample of 190 PLHIV, 95 serodiscordant and 95 seroconcordant. Interviews were conducted using the Socio-Demographic, Clinical, Epidemiological and Vulnerability Form and the Condom Use Self-Efficacy Scale. Descriptive analysis, associations between variables, odds ratio and 95% confidence interval were determined. P < 0.05 was considered statistically significant. Of the sample, 43.1% consistently used condoms (50.5% serodiscordant and 35.7% seroconcordant). Serodiscordant PLHIV without guidance on HIV prevention (P = 0.027) and without access to testing (P = 0.002) had lower self-efficacy and 11.5 times more chances for inconsistent condom use (P = 0.006), while those satisfied with follow-up in health were less likely to use condoms inconsistently (P = 0.011). We conclude that there is low consistent use of condoms among PLHIV, which increases the risk of HIV transmission and the acquisition of other sexually transmitted infections. Consistent condom use was greater among serodiscordant individuals, although there was no difference in self-efficacy in condom use between the groups. [ABSTRACT FROM AUTHOR]

The purpose of this review was to assess the effectiveness of tablet-based speech-generating devices (SGDs) in improving communication skills for individuals with autism spectrum disorder (ASD). A total of 31 single-case design intervention studies involving 84 individuals with ASD were reviewed and included in the analysis. We calculated Tau-U to evaluate the impact of interventions involving tablet-based SGDs on four different communication responses: specifically, mands, intraverbals, tacts, and vocalizations. To explore potential moderating variables for mand outcomes, we used the Kruskal–Wallis one-way test. The analysis revealed that interventions utilizing tablet-based SGDs led to improvements in communication responses. Specifically, large to very large changes were observed in mand and intraverbal responses, whereas moderate changes were noted in tact responses and vocalizations. The findings of this review underscore the potential of tablet-based SGDs in enhancing communication among individuals with ASD. We discuss the findings and provide implications for future research and practice. [ABSTRACT FROM AUTHOR]

Liquiritigenin is a natural medicine. However, its inhibitory effect and its potential mechanism on bladder cancer (BCa) remain to be explored. It was found that it could be visualized that the transplanted tumours in the low-dose liquiritigenin -treated group and the high-dose liquiritigenin -treated group were smaller than those in the model group. Liquiritigenin treatment led to alterations in Lachnoclostridium, Escherichia-Shigella, Alistipes and Akkermansia. Non-targeted metabolomics analysis showed that a total of multiple differential metabolites were identified between the model group and the high-dose liquiritigenin-treated group. This provides a new direction and rationale for the antitumour effects of liquiritigenin. [ABSTRACT FROM AUTHOR]

Given the rising prevalence of pediatric obesity, new approaches to the delivery of targeted nutrition counseling to not only prevent but also treat pediatric obesity are needed. The integration of a dietitian virtually was a successful quality improvement measure in this academic pediatric primary care clinic. The virtual dietitian provided age-appropriate nutrition counseling at well-child visits from 9 months to 6 years of age. Dietary counseling was also provided for children with overweight and obesity regardless of age. Vegetable, fruit, snack, and dairy intake was assessed in children who received counseling versus those who had traditional well childcare. Improved dairy habits were noted in the counseling cohort. A decrease in body mass index was not demonstrated in the patients with obesity or overweight; however, patient and provider satisfaction was quite high with this novel quality improvement measure. Virtual nutrition counseling can be easily integrated to facilitate a comprehensive pediatric medical home. [ABSTRACT FROM AUTHOR]

This study aimed to identify and rank the barriers faced by disabled elderly in China while accessing eHealth primary care services. Primary data were collected from the disabled elderly based on technological, individual, relational, environmental, and organizational constructs. The Dynamic Grey Relational Analysis (DGRA) and Multiple-criteria Decision-making (MCDM) based TOPSIS techniques were used to identify and rank the barriers. We found that the most significant barrier was "aging limitation (reduction in hearing, sight, memory, and fine motor control)" in both (DGRA and MCDM) cases. The Kruskal-Wallis test was used to investigate the significance of this barrier in different age groups of disabled elderly. We found no significant differences among the three age groups of disabled elderly, which shows that the barrier "aging limitation (reduction in hearing. sight, memory, and fine motor control) " is the most significant barrier at each age group (when age ≥ 60) of disabled elderly. The average value of Grey Relational Grades (GRGaverage) and the sorting outcomes of the MCDM of the construct individual were higher than those of all other constructs. This study is the first of its kind to apply the DGRA. MCDM and KWT to expose the barriers while accessing eHealth services for the disabled elderly in China. [ABSTRACT FROM AUTHOR]

Objective Management of neonatal abstinence syndrome includes nonpharmacological interventions, but their effectiveness may not be verified before implemented. The objective of this study is to evaluate the effectiveness of a type of bassinet in the treatment of infants with neonatal abstinence syndrome. Study Design This is a retrospective observational cohort study. Study setting involved a 24-bed open-bay Level III neonatal intensive care unit located in a metropolitan academic trauma facility. Participant inclusion criteria involved prenatally opioid-exposed infants ≥ 35 weeks with confirmed maternal opioid urine toxicology, required pharmacological treatment for withdrawal symptoms, and were admitted to the neonatal intensive care unit. Three subsets of study participants were analyzed over three different time periods: Group 1 were infants admitted during 2019 without nonpharmacological intervention, Group 2 who were admitted from September 2021 to February 2022 and received nonpharmacological interventions, and Group 3 included those admitted from February 2022 to March 2023 who received the same interventions as Group 2 but were managed in bassinets being used in other local facilities for neonatal abstinence syndrome. Results Group 3 had significant increases in length of stay compared with Group 1 (p = 0.006) and Group 2 (p = 0.013). Group 3 had a significantly greater length of treatment than Group 1 (p = 0.041) and a significantly higher total mg/kg morphine exposure than Group 1 (p = 0.006). Conclusion Addition of the bassinet for nonpharmacological management of infants with neonatal abstinence syndrome appeared to prolong length of stay, length of treatment, and increase total mg/kg morphine exposure. As a retrospective nonrandomized study, weakness of low certainty of causality is of concern but findings strongly warrant further research before devices such as the bassinet used in this study are adopted for routine neonatal abstinence syndrome care. Key Points Special bassinets are promoted to enhance sleep and decrease agitation. Such bassinets may assist infants undergoing drug withdrawal. Study of the bassinet failed to show benefit to this population. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the bioavailability of vitamin B12 from nori and to evaluate the required dosage for improving vitamin B12 nutritional status in vegetarians not using supplements. Methods: The study design is an open-label, parallel, dose-response randomized controlled trial. Thirty vegetarians were assigned to control (no nori), low-dose (5 g nori, aiming to provide 2.4 µg vitamin B12 per day), or high-dose (8 g nori, aiming to provide 4 µg vitamin B12 per day) groups. The primary outcome was changes in vitamin B12 status as measured by serum vitamin B12, holotranscobalamin (holoTC), homocysteine (Hcy), and methylmalonic acid (MMA), and a combined score of these four markers (4cB12 score) during the four-week intervention. Dietary vitamin B12 intakes were assessed at baseline and end of the trial with a 17-item food frequency questionnaire designed for vitamin B12 assessment. General linear model was used to compare least square means of changes in each biomarker of vitamin B12 status, among the three groups, while adjusting for respective baseline biomarker. Results: After adjusting for baseline status, nori consumption led to significant improvement in serum vitamin B12 (among-group P-value = 0.0029), holoTC (P = 0.0127), Hcy (P = 0.0225), and 4cB12 (P = 0.0094). Changes in MMA did not differ significantly across groups, but showed within-group pre-post improvement in the low-dose group (median [p25, p75] = -339 [-461, -198] nmol/L). Vitamin B12 status appeared to plateau at low dose (5 g of nori), which compared with control group, improved serum vitamin B12 (lease square mean [95% CI] = + 59 [25, 93] pmol/L, P = 0.0014); holoTC (+ 28.2 [10.1, 46.3] pmol/L, P = 0.0035); Hcy (-3.7 [-6.8, -0.6] µmol/L, p = 0.0226); and 4cB12 score (+ 0.67 [0.24, 1.09], p = 0.0036). High-dose resulted in similar improvements. There was no significant difference between low-dose and high-dose groups in all biomarkers of vitamin B12. Conclusions: Consuming 5 g of nori per day for 4 weeks significantly improved vitamin B12 status in vegetarians. A higher dose (8 g) may not confer additional benefits. Clinical trial registration: ClinicalTrials.gov Identifier: NCT05614960. Date of registration: November 14th 2022. [ABSTRACT FROM AUTHOR]

Microplastics are emerging pollutants that cause health problems for aquatic organisms. Fish is one of the important organisms because of its consumption by humankind. The present study examines the abundance and prevalence of microplastics in freshwater fish species through a systematic review study while considering five important factors, i.e. water resources, habitat, feeding behavior, Fulton's condition factor, and microplastic characteristics. A comprehensive meta-analysis was undertaken to evaluate relevant publications in terms of microplastic abundance. Articles published up to July 30, 2022 were found through Global search engines including, Web of Science, Scopus, and PubMed. In total, 786 articles were found that 53 and 42 articles were used for qualitative review and meta-analysis, respectively. This was carried out by a random-effects model with high heterogeneity (I2 = 99.76%). According to the data, the highest attention in microplastic research in body part and water sources are related to gastrointestinal tract (n = 259 (~ 80%)) and rivers (n = 189 (~ 58%)), respectively. According to the results, the average microplastic prevalence range was 5 -100%, and microplastic abundance was within the 0.04–204 items range per individual. The difference between microplastic prevalence and abundance for the key factors for parametric and nonparametric data were analyzed using Analysis of variance (ANOVA) and the Kruskal-Wallis test, respectively. According to the Baujat plot, two studies (ID: 27 and 25) revealed the minimal influence of microplastics abundance. Conclusively, the average microplastics abundance according to the pooled data, varied between 2.23 and 2.48, with a mean of 2.35 items per individual in the studies overall. It is concluded that the amount of ingested microplastics by fish is related only to physiology (height, weight, and body structure) but not feeding behavior, habitat, and surrounding water. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to examine the relationship between compassion fatigue and moral sensitivity of intensive care nurses. Method: Permission was obtained from the ethics committee, institution, and nurses prior to the study. The population of the study consisted of all nurses working in a university hospital, and the sample consisted of 144 intensive care nurses who agreed to participate in the study. The data were collected through the Questionnaire, the Compassion Fatigue Scale, and the Moral Sensitivity Scale. The total score of the compassion fatigue scale ranges between 24 and 120, and a high score indicates a "high level of compassion". The total score of the moral sensitivity scale, on the other hand, varies between 30-210, and as the score increases, moral sensitivity decreases. The obtained data were evaluated with Student t, One-Way Anova, Kruskal Wallis, Mann Whitney U, and correlation analysis. Results: It was found that 55.6% of the nurses had a bachelor's degree, 44.4% had been working in the intensive care unit for 4-6 years, 39.6% had professional ethical dilemmas, and 44.6% of those who had ethical dilemmas could not solve this problem. Compassion fatigue and moral sensitivity scale mean scores were found to be 83.3 ± 6.7 and 125.4 ± 7.2, respectively, and there was a positive correlation between compassion fatigue and moral sensitivity mean scores (p < 0.05). Conclusion: The mean score of the compassion fatigue and moral sensitivity scale of intensive care nurses was at a "moderate" level, and there was a positive correlation between the nurses' moral sensitivity scale and compassion fatigue scale scores. In line with these results, it can be suggested that the compassion fatigue and moral sensitivities of nurses especially those working in intensive care be evaluated in terms of resolving the ethical dilemmas they may experience in patient care, and these nurses be supported on these matters. [ABSTRACT FROM AUTHOR]

Background: Research findings on skeletal muscle degeneration in post-stroke sarcopenic obesity are limited. Thus, this study aimed to investigate the association between post-stroke sarcopenic obesity and quantitative and qualitative changes in skeletal muscles. Methods: This was a cross-sectional study conducted on patients with stroke admitted to the convalescent rehabilitation ward. For skeletal muscle assessment, an ultrasound system was used to measure quadriceps muscle thickness and echo intensity (QMT and QEI) on the paretic and non-paretic sides. Sarcopenic obesity was defined as the presence of both sarcopenia and obesity. Multiple regression analysis was performed to determine the relationships between sarcopenic obesity and QMT and QEI. Results: A total of 130 patients with stroke were included in this study (mean age: 69.4 ± 12.7 years). The prevalence of sarcopenic obesity was 23.1%. The multiple regression analysis showed that sarcopenic obesity was significantly negatively associated with QMT on both the paretic and non-paretic sides (paretic side: β = −0.28, p < 0.001; non-paretic side: β = −0.37, p < 0.001) and significantly positively associated with QEI (paretic side β = 0.21, p = 0.034; non-paretic side: β = 0.20, p = 0.029). Conclusions: Post-stroke sarcopenic obesity was independently associated with quantitative and qualitative changes in skeletal muscles on both the paretic and non-paretic sides. [ABSTRACT FROM AUTHOR]

Background: Post-stroke lateropulsion is prevalent and associated with poor rehabilitation outcomes; however, data regarding long-term function associated with lateropulsion are lacking. Objectives: This study aimed to explore lateropulsion resolution and associations between lateropulsion, functional outcomes, and fall occurrence up to 12 months post-stroke. Methods: Participants for this prospective, longitudinal cohort study were recruited from a Stroke Rehabilitation Unit (SRU). Assessments were conducted at SRU admission, at discharge, and at three, six, nine, and twelve months post-stroke. Outcomes included the Four-Point Pusher Score (4PPS), Functional Independence Measure (FIM), and fall occurrence. Longitudinal outcomes were modeled using generalized linear mixed-effects models. Results: The final analyses included data from 144 participants. Eighty-two participants (56.9) had lateropulsion (4PPS ≥ 1) on admission. Odds of resolved lateropulsion (4PPS = 0) increased longitudinally from discharge for people who participated in rehabilitation physiotherapy (OR: 9.7, 28.1, 43.1, 81.3: <0.001 at three, six, nine, and twelve months respectively). The greatest FIM improvement among participants in all 4PPS categories occurred during the SRU inpatient phase. The probability of falls post-discharge was greatest among participants with 4PPS = 1 at three months, when compared with 4PPS = 0 (p= 0.022). Conclusions: This study showed that lateropulsion can continue to resolve up to one year post-stroke. Earlier lateropulsion resolution was associated with ongoing rehabilitation physiotherapy participation. Long-term functional gains were maintained among people discharged home, whereas functional status deteriorated after six months among those in residential care. Study findings will allow rehabilitation and service providers to better plan for and accommodate the long-term rehabilitation and care needs of people with post-stroke lateropulsion. [ABSTRACT FROM AUTHOR]

Background Over the past decade, the use of poly-4-hydroxybutyrate (P4HB) in aesthetic breast surgery has grown in popularity. Published data on long-term outcomes, however, is scarce. Objectives The purpose of this study was to assess long-term outcomes with utilization of P4HB in various aesthetic breast procedures. Methods A retrospective review of all patients undergoing breast procedures with P4HB was performed by the senior author between July 2012 and March 2022. All patients with greater than 1 year of follow-up were evaluated, including demographics, surgical indications, complications, secondary procedures, and patient satisfaction. A Kruskal-Wallis test was performed to assess the stability of satisfaction over time. Results A total of 248 patients were evaluated. The mean follow-up length was 2.9 years (range, 1-9.3 years). The most common surgical indication was breast ptosis, which comprised 68% (n = 167) of patients. The overall complication rate was 8.0% (n = 20), with an unplanned reoperation rate of 2.8% (n = 7). Across the entire study population, the mean satisfaction score was 3.42 out of 4. When satisfaction scores were compared to follow-up length, Kruskal-Wallis test demonstrated no statistical differences (H = 18.2, P =.89, degrees of freedom [df]= 2), suggesting stability of satisfaction over time. Conclusions This study presents the senior author's entire experience with P4HB across a wide range of aesthetic breast procedures. With an average follow-up length of almost 3 years, P4HB appears to be a both safe and effective tool to support soft tissue in aesthetic breast surgery. Further, high patient satisfaction appears stable. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

Objectives: Psychoactive substance (PS) use is a public health problem that affects society in general and particularly adolescents. Therefore, knowing adolescents' levels and patterns of PSs use is essential for developing public health policies. Methods: During 2016, 2018, and 2019, a total of 1121 students (from Rosario-Argentina) were surveyed to evaluate their levels and patterns of use of alcohol, energy drinks, tobacco, and marijuana, among others. Results: The results showed a decrease in the age of onset as well as in the risk perception of PS use, especially in 2018 and 2019. The reported reason for first use over the 3 years was "curiosity," followed by "feeling good." Moreover, the most consumed PSs (in order of preference) were alcohol, followed by energy drinks, tobacco, and marijuana. It was also found that more women reported consuming alcohol compared to men. Conclusions: Interestingly, in terms of age at first use, it was found that adolescents tried energy drinks first, followed by alcohol, tobacco, and then marijuana. The decrease in the age of onset and the risk perception of the use of a PS and the pattern of use reported by adolescent students suggests the need to implement age-specific public prevention policies. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers. Methods: We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROMs). Kruskal–Wallis tests investigated differences between mode of delivery and changes in PROM scores. Logistic and Cox-proportional hazard regression examined associations between mode of delivery and RTW status or days receiving wage replacement benefits in the first-year post-discharge, respectively, while controlling for potential confounders. Results: A slightly higher percentage of the 3,708 worker sample were male (52.8%). Mean (standard deviation (SD)) age across all delivery formats was 45.5 (12.5) years. Edmonton zone had the highest amount of telerehabilitation delivery (53.5%). The majority of workers had their program delivered in a hybrid format (54.1%) and returned to work (74.4%) at discharge. All PROMs showed improvement although differences across delivery formats were not clinically meaningful. Delivery via telerehabilitation had significantly lower odds of RTW at discharge (Odds Ratio: 0.82, 95% Confidence Interval: 0.70–0.97) and a significantly lower risk of experiencing suspension of wage replacement benefits in the first year following discharge (Hazard Ratio: 0.92, 95% Confidence Interval: 0.84–0.99). Associations were no longer significant when confounders were controlled for. Conclusion: RTW outcomes were not statistically different across delivery formats, suggesting that telerehabilitation is a novel strategy that may improve equitable access and earlier engagement in occupational rehabilitation. Factors such as gender and geographic location should be considered when deciding on service delivery format. [ABSTRACT FROM AUTHOR]

Introduction: The antioxidant effects of vitamins may attenuate the oxidative stress on organs imposed by ischemia–reperfusion injury during the process of organ transplantation from brain-dead donors. Circulating levels of vitamins A, C, and E-α in donors after brain death and their relationships to donor demographics, management, organ utilization, and recipient outcomes are largely unknown. Methods: An observational, prospective, cohort study of 84 consecutive brain-dead organ donors managed at a single organ procurement recovery center was conducted. Vitamin levels were drawn immediately prior to procurement. Results: Levels of serum vitamins A and E-α and plasma vitamin C were below normal in 80%, 85%, and 92% of donors and deficient in 40%, 62%, and 63%, respectively. Vitamin C deficiency was associated with a longer time between death and specimen collection (P =.004). Death from head trauma and stroke were associated with lower levels of vitamin A than from anoxic causes (P =.003) and smokers had greater vitamin C deficiency (P =.03). During donor management, vitamin C deficiency was associated with longer vasopressor support (P =.03) and normal levels of vitamin E-α were associated with reaching a lower alanine transferase compared to those with subnormal levels (P <.05). Donors deficient in vitamin E-α were less likely to have a liver recovered for transplantation (P =.005). Vitamin levels were not associated with the recipient outcomes examined. Conclusion: Circulating vitamins A, C, and E-α is profoundly low in brain-dead organ donors, associated with relevant demographic features of the donor, and may influence donor management and organ utilization. [ABSTRACT FROM AUTHOR]

Introduction: An inverse relationship has been identified between tacrolimus serum concentrations and donor-derived cell-free DNA (dd-cfDNA) levels after lung transplant, but limited data exists on this relationship in the kidney transplant population. Project Aim: The purpose of this evaluation was to examine the relationship between high tacrolimus variability and elevated dd-cfDNA levels in kidney and simultaneous pancreas-kidney transplant recipients at a single center. Design: Single-center, retrospective, descriptive comparative evaluation of kidney and pancreas-kidney transplant recipients who received longitudinal ddcfDNA surveillance. Intrapatient tacrolimus variability was assessed using the coefficient of variation (%CV) measured between 1 and 12 months posttransplant. Pediatrics, retransplant or multiorgan transplant recipients, and pregnant recipients were excluded. Results: One hundred fifteen recipients with 518 dd-cfDNA levels and 3028 tacrolimus troughs were assessed. Pancreas-kidney recipients had significantly higher median dd-cfDNA (0.29% vs. 0.18%, P =.034) and were excluded from analysis. Ninety-nine kidney transplant recipients were included for analysis. Recipients with tacrolimus %CV ≥30 (N = 66) had significantly higher median dd-cfDNA than %CV <30 (0.22% vs. 0.17%, P =.031). Tacrolimus %CV ≥30 demonstrated higher median peak dd-cfDNA than %CV <30, though this was not statistically significant (0.36% vs. 0.28%, P =.058). Conclusion: These data demonstrated that high intrapatient tacrolimus variability may be associated with elevated dd-cfDNA in the first year after kidney transplant. [ABSTRACT FROM AUTHOR]