Search

Objective: This systematic review evaluated how different storage times and conditions affect universal adhesives' bond strength and degree of conversion (DC).Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar databases for articles published from January 1st, 2000, until May 15th, 2022. The researchers comprehensively evaluated the articles using a multi-step process to identify articles relevant to the topic of interest. Quality assessment was performed through the ROBDEMAT tool. Due to the high heterogeneity in the preliminary data, performing a meta-analysis was not feasible.Results: A total of 3169 records were obtained, and after removing duplicates, 2267 remained. Following title and abstract screening, 2253 studies were excluded based on the predetermined exclusion criteria. Of the 14 remaining studies, seven were further excluded due to the use of non-universal adhesives, experimental adhesives, or lack of aging protocols. Ultimately, seven studies were included in this systematic review. All studies focused on bond strength, with only one addressing DC. The Findings showed that aging or different storage conditions generally led to reduced bond strength and DC values in universal adhesives, although exceptions with stable or improved properties were noted.Conclusions: Adhesives with higher pH and those containing methacrylamides, HEMA-free compositions, or hydrolytically stable monomers showed better durability than others. Strict adherence to storage instructions, lower storage temperatures, and immediate recapping of adhesive bottles after use is recommended to maintain adhesive properties. These findings provide insights for optimizing the long-term performance of universal adhesives in clinical settings.

ABSTRACT Objectives This study aimed to identify the prevalence of the middle mesial canal (MMC) in mandibular first permanent molars in a Persian subpopulation sample using cone‐beam computed tomography (CBCT). The secondary aim was to correlate the incidence of MMC with variables such as gender, age, and the presence of an additional distal canal. Materials and Method A total of 390 mandibular first molars from 314 CBCT images were retrospectively evaluated. The presence of the MMC was recorded while considering related factors such as additional distal canal and demographic information of the patients (age and gender). Fisher's exact tests and independent‐samples t‐test were used for the statistical comparisons with a significance level of 0.05. Results Among 390 mandibular first molars, 34 teeth contained an MMC (8.7%). The number of teeth with the MMC in women was equal to that of men. There was no significant difference between the two genders in the prevalence of the MMC (p > 0.05). The prevalence of patients' MMC had no significant relationship with their age (p > 0.05). However, there was a significant association between the presence of the MMC and an additional distal canal (p

Abstract Cervical resorption is a serious threat to the longevity of the teeth. In this study, the Canny edge-detection algorithm was applied on CBCT images to compare the accuracy of original and Canny views for diagnosing cervical resorption in endodontically treated teeth. Intracanal metallic posts were inserted in 60 extracted teeth being randomly divided into three groups: control, 0.5 mm, and 1 mm cervical resorption. CBCT scans of the teeth were presented to three observers in both original and Canny formats with the accuracy being determined by receiver operating characteristic (ROC) analysis. The DeLong test was used for paired comparisons with the significance level set at 0.05. The highest accuracy belonged to Canny images in 1 mm resorption, followed by Canny images in 0.5 mm resorption, original images in 1 mm resorption, and original images in 0.5 mm resorption, respectively. The Canny images were significantly more accurate in the diagnosis of 0.5 mm (p

Objective: This systematic review evaluated how different storage times and conditions affect universal adhesives' bond strength and degree of conversion (DC). Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar databases for articles published from January 1st, 2000, until May 15th, 2022. The researchers comprehensively evaluated the articles using a multi-step process to identify articles relevant to the topic of interest. Quality assessment was performed through the ROBDEMAT tool. Due to the high heterogeneity in the preliminary data, performing a meta-analysis was not feasible. Results: A total of 3169 records were obtained, and after removing duplicates, 2267 remained. Following title and abstract screening, 2253 studies were excluded based on the predetermined exclusion criteria. Of the 14 remaining studies, seven were further excluded due to the use of non-universal adhesives, experimental adhesives, or lack of aging protocols. Ultimately, seven studies were included in this systematic review. All studies focused on bond strength, with only one addressing DC. The Findings showed that aging or different storage conditions generally led to reduced bond strength and DC values in universal adhesives, although exceptions with stable or improved properties were noted. Conclusions: Adhesives with higher pH and those containing methacrylamides, HEMA-free compositions, or hydrolytically stable monomers showed better durability than others. Strict adherence to storage instructions, lower storage temperatures, and immediate recapping of adhesive bottles after use is recommended to maintain adhesive properties. These findings provide insights for optimizing the long-term performance of universal adhesives in clinical settings. [ABSTRACT FROM AUTHOR]

Introduction: This research aimed to determine the relationship between personality dimensions with the rate of resiliency and internal cohesion regarding the intermediary role of spiritual health in candidate patients for eye surgery. Methods: The method used in this is of correlation type, and statistical population in this project included all eye patients chosen for eye surgery who were examined at technical eye clinics in Tehran. The statistical sample included 200 patients from the statistical population who were chosen through a targeted sampling method. The data collection tools were Conner and Davidson's tolerance questionnaire (2003), Maccary and Costa's personality questionnaire (1985), Antonowski's internal cohesion scale (1970), and Politzin and Elison's spiritual health questionnaire (1982). The research hypotheses were examined through regression analysis, Pearson's correlation, and path analysis. Results: The results showed that the calculated fit indices of the structural model of the research were correlated with the five dimensions of personality and internal cohesion of patients undergoing eye surgery with respect to the mediator role of spiritual health with 88% confidence. Investigation of path analysis coefficients showed a significant relationship between exogenous and intermediary variables on resiliency and internal cohesion (P value = 0.00). Conclusion: According to the results of the research, the spiritual health variable plays a significant mediating role for exogenous and endogenous variables in this model. Therefore, personality traits not only directly influence resilience and internal cohesion but also indirectly influence spiritual well-being.

Introduction: Phobia is a mental disorder that can occur following rape and pose a serious threat to women's health. The aim of this study was to determine the frequency of paranoia in female victims of rape referred to Isfahan Forensic Medicine Center in 2014. Methods: This descriptive study included 93 women rape victims referred to Isfahan Forensic Medicine Center who were randomly selected. The study tool was the demographic information and mental health questionnaire scl-90. Descriptive statistics and Spearman correlation, independent t test, one-way analysis of variance in SPSS version 17 were used to analyze the data. Results: This study showed that there was a significant positive correlation between rape and phobia (P < 0.001) so that the prevalence of phobia in people who were raped was moderate to high. Also 9.1% (8 people) of mild phobias (scores 1–0), 79.5% (70 people) moderate phobias (scores 1–1) and 11.4% (10 people) phobias in the range Severe (scores 4–3) reported. Of the seven sub-indices in the phobia section, 52.3% (46 people) had very unreasonable fears. Approximately 52.3% (46 people) were afraid of traveling, 46.6% (41 people) were afraid of being alone. Going, 38.6% (34 people) fear of the market, 51.1% (45 people) anxiety, 12.5% (11 people) feeling of alienation, 1.1% (1 person) fear of fainting in total. Conclusion: Due to the increasing number of rapes in women and the recognition of rape as a factor disrupting mental health, strategies and resources should be provided to prevent rape against women and its adverse consequences, including phobia and early diagnosis and treatment of this complication and other complications Be allocated.

Evidence-based design has been fundamental to designing healthcare environments for patient outcomes and experience, yet few studies have studied how design factors drive patient choice. 652 patients who recently received care at hospitals across the United States were administered an online discrete choice survey to investigate the factors playing into their choice between hypothetical hospitals. Discrete choice models are widely used to model patient preferences among treatment alternatives, but few studies have utilized this approach to investigate healthcare design alternatives. In the current study, respondents were asked to choose between hypothetical hospitals that differed in patient room design, window features of the room, appointment availability, distance from home, insurance coverage, and HCAHPS ratings. The results demonstrate that patient room design that allowed unobscured access to daylight and views through windows, in-network insurance coverage, closer distance from home, and one-star higher patient experience rating increased the likelihood of a patient's hospital choice. The study broadly explores discrete choice model's applicability to healthcare design and its ability to quantify patient perceptions with a metric meaningful for hospital administrators.

Background and purpose: Radiation therapy as a part of cancer treatment is used in almost 50-60% of involved cases. In prostate cancer radiation therapy, a large volume of pelvis is irradiated, so, it is necessary to preserve sensitive organs around the treatment area, especially rectum and bladder. In this study, some dosimetric parameters such as minimum dose (Dmin), maximum dose (Dmax), mean dose (Dmean) to target (PTV) and organs at risk (OAR), Integral dose, Homogeneity Index and Conformity Index were compared between two techniques. Materials and methods: In this analytical study, computed tomography scans of 50 patients (mean age: 52 years) attending Sari Imam Khomeini Hospital were acquired and transferred to the 3D treatment planning system (TPS). For each patient, a conventional plan (Box Fields) and modified oblique four-field (MOFF) plan were prepared using TPS for 15 MV photon energy. A total dose of 7200 cGy was prescribed for each patient. Data analysis was carried out in SPSS applying paired-t-test. Results: In current study, 15-MV energies for radiation of pelvis and bladder using box radiation fields (routine plan) lead to maximum uniformity and homogeneity of dose in irradiated tumor tissue. The results also showed that 15-MV energies for radiation of pelvis and bladder and the new plan could decrease the average integrated dose in femur heads. Conclusion: We observed a significant effect of the geometrics of radiation fields on distribution of dose in tumor tissue and also the amount of dose received by organs at risk in radiotherapy of patients with prostate cancer.

Objectives: This study aimed to identify the prevalence of the middle mesial canal (MMC) in mandibular first permanent molars in a Persian subpopulation sample using cone‐beam computed tomography (CBCT). The secondary aim was to correlate the incidence of MMC with variables such as gender, age, and the presence of an additional distal canal. Materials and Method: A total of 390 mandibular first molars from 314 CBCT images were retrospectively evaluated. The presence of the MMC was recorded while considering related factors such as additional distal canal and demographic information of the patients (age and gender). Fisher's exact tests and independent‐samples t‐test were used for the statistical comparisons with a significance level of 0.05. Results: Among 390 mandibular first molars, 34 teeth contained an MMC (8.7%). The number of teeth with the MMC in women was equal to that of men. There was no significant difference between the two genders in the prevalence of the MMC (p > 0.05). The prevalence of patients' MMC had no significant relationship with their age (p > 0.05). However, there was a significant association between the presence of the MMC and an additional distal canal (p < 0.05). Conclusion: The incidence of an additional distal canal in teeth with a diagnosed MMC was statistically significant. The prevalence of the MMC in mandibular first molars in the study population was low; however, accurate knowledge of root canal morphology in terms of the presence of an additional root canal in these teeth should be considered. [ABSTRACT FROM AUTHOR]

Background and purpose: Radiation therapy make an important contribution in the control and treatment of cancers. Lungs are the main organs at risk in esophageal cancer radiotherapy. Difference between the dose distribution due to the treatment planning system (TPS) and the patient's body dose is dependent on the calculation of the treatment planning system algorithm, which is more pronounced in heterogeneities such as the lung. In this study, the dose distribution of treatment planning system was compared with Monte Carlo calculations in both homogeneous and heterogeneous tissues. Materials and methods: Three dimensional planning composed of four fields were done on the CT images using the CorPLAN TPS of a SIEMENS PRIMUS linac. EGSnrc Monte Carlo simulation code was used for the same conditions. The dose distributions obtained from Monte Carlo simulation and the TPS were compared using PDD curve and Dose Difference Percentage index obtained from the two modes. Results: According to the findings, the error rate from the TPS was less than 3% in the homogeneous tissue, whereas the error in the heterogeneous tissue was higher than the standard value (more than 5%). Conclusion: The accuracy of CorPLAN TPS at homogeneous tissue is more than that in the heterogeneous tissue and this should be considered in the clinic. This study suggests that the Monte Carlo code can be used to simulate and estimate the dose distribution in radiotherapy, and in cases where the practical measurement of some dosimetric parameters is impossible or difficult, this code can be used for prediction and optimization of treatment plans.

Background: Diode lasers can be used in the treatment of periodontal diseases as they have an anti-bactericidal effect, and regulate oral tissue inflammatory responses. This study aimed to evaluate the adjunctive effects of Diode 940 nm laser on mechanical periodontal debridement. Materials and Methods: In this split-mouth single-blind randomized clinical trial, 12 patients were selected. Forty-four oral segments were enrolled in the scaling and root planing (SRP) group and SRP + Laser group with a 1:1 allocation ratio following a simple randomization procedure (coin flip). Clinical parameters (pocket depth, clinical attachment loss [CAL], and bleeding on probing [BOP]) were measured at baseline. After the SRP, a 940 nm Diode laser (1 Watt power and continuous wave mode) was used in the SRP + Laser group as an adjunctive treatment. The clinical parameters were remeasured 2 months posttreatment. Statistical analysis was carried out using an unpaired t-test with a 5% significant level by SPSS. Results: Although all clinical parameters had more improvements in the SRP + Laser group, the differences were not significant between the two study groups (P > 0.05). Only in individual tooth evaluations, CAL changes in first and second premolars and BOP changes in second premolars show statistically significant improvement in the SRP + L group compared to the SRP group (P < 0.05). Conclusion: Using diode 940 nm laser as an adjunctive treatment for SRP may be helpful and be suggested for periodontal treatment.

Background: Despite sharing common evolutionary features, Viperidae species including Echis carinatus and Macrovipera lebetina possess venoms with different proportions of toxic agents, thereby causing clinical effects with potentially variable severity. This study was an effort to differentiate the clinical effects and outcomes of E. c. sochureki and M. l. obtusa victims. Methods: In this prospective cross-sectional study, snakebite patients treated at a reference poisoning center in northeast of Iran in 2012 were enrolled. The features of snakebite event, demographic and clinical data of patients were recorded in checklists. Results: Twenty-seven patients (63% male) with mean age of 34.8 ± 18.1 years were included. The offending snakes were recorded as "E. c. sochureki" in 63%, "M. l. obtusa" in 25.9% and "unknown" in 11.1% of cases. The most common clinical findings were fang mark in 100%, local pain in 81.5% and local edema in 74% of patients. Although the victims of both species showed classic features of viper envenoming syndrome including marked local effect and hemostatic disturbances, the victims of M. l. obtusa had significantly higher creatine kinase levels (P = 0.031) and lower platelet counts (P = 0.043), whereas marked edema (> 15cm) was significantly more common in E. c. sochureki victims (P = 0.028). Envenomation severity, other clinical effects and outcomes did not differ between the two species. Patients with delayed presentation to hospital had greater envenomation severity and edema extent and higher rate of coagulopathy. Conclusions: Species-specific description of clinical effects following snakebite envenoming is useful for syndromic approach to human victims. The clinical envenoming syndromes by E. c. sochureki and M. l. obtusa show many common similarities despite the difference in severity of some effects. The delay in hospital admission and antivenom therapy is a risk for increased severity of envenomation and development of poorer clinical outcomes.

Background: Thermoplastic immobilization devices are used to position the patient on the table in order to correctly reposition the patient during treatment courses. Objective: The Purpose of this work is investigating the degradation of surface dose and the dose distribution in the build-up region for photon beams associated with immobilization devices using Gafchromic films. Materials and Methods: After heating, these masks are stretched and fitted over the considered location of body before treatment simulation for insuring the reproducibility of patient position during treatment fractions. In this research, dosimetry was carried out using Gafchromic EBT3 film and three kinds of thermoplastic masks (Orfit with thickness 2.2mm, holes diameter 2.5mm, Orfit with thickness 2mm, holes diameter 1mm, and Klarity mask, thickness 2mm, holes diameter 3mm). Measurements were made with and without the mask materials on the surface of the Perspex phantom for 6 and 15 MV X-ray beams of a LINAC machine. Results: The results showed that surface dose increases 2.1 to 6.7 times and 2 to 3.9 times than the surface dose in the open field for 15 MV and 6 MV photons, respectively. According to the obtained results from the Analyses of Variances (ANOVA) test , it is defined that there is a significant difference in surface dose among three kind of thermoplastic masks (χ2 = 49.78 and df = 3 and P0.05). Conclusion: According to the results, Klarity mask is more acceptable immobilization device when compared with other masks in the test.

Introduction: Professional socialization is an essential process of learning skills, attitudes and behaviors necessary to fulfill professional roles. The consequences of professional socialization are widely varied and influenced by personal, situational and organizational factors. The aim of this study was to review the role of educational activities on professional socialization of nursing students. Methods: This narrative review study was carried out by searching library resources and the databases of CINAHL, Science Direct, Scopus, Google Scholar, Elsevier, SID, and Magiran for articles published during 2002-17. The keywords used for the search included socialization, professional, educational activity, and nursing students. Preliminary results yielded 106 articles of which 10 articles were selected for the review. Results: Contemporary studies show that professional socialization of nursing students is influenced by different factors among which the role of mentors, peers and effective role models is of great importance. Personal experiences and the role of clinical trainers are also important in facilitating students’ learning development and socialization. Conclusion: Improvement and organization of the educational system and focus on selection of effective and interested clinical trainers, as well as utilization of mentors, peers and effective role models are the proposed solutions to facilitate and promote the professional socialization of nursing students.

The aviation sector has highlighted the importance of economic and legal regulations in conjunction with the changes in the conditions of competition with the acceleration of globalization. The regulations in the aviation sector directly or indirectly affect the airline operators, which is critical as a result of its effects on the economic systems of the countries. Legal responsibilities in terms of influencing passenger rights and competition law issues; has a natural impact on shaping aviation regulations, sector dynamics and competitive conditions which is effecting the dynamic structure of the sector. This study aims to examine the economic and legal aspects of air transportation carried out in Turkey and to contribute to the literature as a result of the researches.

Objective: This study aimed to identify latent conditions in a pediatric intensive care unit (PICU) by analyzing characteristics of flow disruptions (FD) during a simulation of a three-phased scenario. Background: The built environment of healthcare facilities contributes to FD that can lead to clinical errors and patient harm. In the facility design process, there is an opportunity to identify built environment features that cause FD and pose safety risks. Simulation-based evaluation of proposed designs may help in identifying and mitigating safety concerns before construction and occupancy. Methodology: During design development for a new 400-bed children's hospital, a series of simulations were conducted using physical mock-ups in a large warehouse. A three-phased scenario, (1) admission and intubation, (2) cardiac arrest, and (3) bedside surgery involving a cannulation to extracorporeal membrane oxygenation, was conducted in a PICU room mock-up. Each scenario was video recorded from four angles. The videos were systematically coded to identify FD. Results: Analysis identified FDs in three ICU zones: respiratory therapists (RT) zone, nurse zone, and head of the patient. Challenges in these zones were related to spatial constraints in the RT zone and head of the bed, equipment positioning in the RT zone and nurse zone, and impeded visibility related to the location of the boom monitor in the nurse zone. Conclusion: Simulation-based evaluation of prototypes of patient care spaces can help identify characteristics of minor and major FD related to the built environment and can provide valuable information to inform the iterative design process. [ABSTRACT FROM AUTHOR]

Background: Studies show that workspace for the anesthesia providers is prone to interruptions and distractions. Anesthesia providers experience difficulties while performing critical medication tasks such as medication preparation and administration due to poor ergonomics and configurations of workspace, equipment clutter, and limited space which ultimately may impact patient safety, length of surgery, and cost of care delivery. Therefore, improving design of anesthesia workspace for supporting safe and efficient medication practices is paramount. Objectives: The objective of this study was to develop a set of evidence-based design guidelines focusing on design of anesthesia workspace to support safer anesthesia medication tasks in operating rooms (ORs). Methods: Data collection was based on literature review, observation, and coding of more than 30 prerecorded videos of outpatient surgical procedures to identify challenges experienced by anesthesia providers while performing medication tasks. Guidelines were then reviewed and validated using short survey. Results: Findings are summarized into seven evidence-based design guidelines, including (1) locate critical tasks within a primary field of vision, (2) eliminate travel into and through the anesthesia zone (for other staff), (3) identify and demarcate a distinct anesthesia zone with adequate space for the anesthesia provider, (4) optimize the ability to reposition/reconfigure the anesthesia workspace, (5) minimize clutter from equipment, (6) provide adequate and appropriately positioned surfaces for medication preparation and administration, and (7) optimize task and surface lighting. Conclusion: This study finds many areas for improving design of ORs. Improvements of anesthesia work area will call for contribution and cooperation of entire surgical team. [ABSTRACT FROM AUTHOR]

Background & Aim: The education and training of nursing PhD students is of great importance because they are expected to act as factors for the advancement of nursing science, professional counselors and future nursing researchers. The aim of this study was to compare the Iranian nursing curriculum with the two countries of Turkey and Jordan. Methods & Materials: A descriptive-comparative study was conducted in 2017. In this study, Iran's nursing education system was compared in PhD level with the components of educational program of the two countries of Turkey and Jordan. After searching the Internet, the required data was collected and using the Bread Model, four stages of description, interpretation, juxtaposition and comparison were done. Results: The beginning of Ph.D. nursing education in Turkey, Iran and Jordan was in 1972, 1995 and 2005, respectively. With regard to the characteristics and structure of the course among the three countries, there were many similarities. The only difference was that in Turkey, there were different branches in nursing and the possibility to enter the Ph.D. from the bachelor's degree. None of these three mentioned countries, uses advanced educational and telemedicine technologies. Conclusion: According to the results of this study, while considering the role and duties of nursing graduates and taking into account the complex and changing needs of society, it is suggested to make reviews in the goals, mission, curriculum content, presentation and evaluation of this course

Background: Diode lasers can be used in the treatment of periodontal diseases as they have an anti-bactericidal effect, and regulate oral tissue inflammatory responses. This study aimed to evaluate the adjunctive effects of Diode 940 nm laser on mechanical periodontal debridement. Materials and Methods: In this split-mouth single-blind randomized clinical trial, 12 patients were selected. Forty-four oral segments were enrolled in the scaling and root planing (SRP) group and SRP + Laser group with a 1:1 allocation ratio following a simple randomization procedure (coin flip). Clinical parameters (pocket depth, clinical attachment loss [CAL], and bleeding on probing [BOP]) were measured at baseline. After the SRP, a 940 nm Diode laser (1 Watt power and continuous wave mode) was used in the SRP + Laser group as an adjunctive treatment. The clinical parameters were remeasured 2 months posttreatment. Statistical analysis was carried out using an unpaired t-test with a 5% significant level by SPSS. Results: Although all clinical parameters had more improvements in the SRP + Laser group, the differences were not significant between the two study groups (P > 0.05). Only in individual tooth evaluations, CAL changes in first and second premolars and BOP changes in second premolars show statistically significant improvement in the SRP + L group compared to the SRP group (P < 0.05). Conclusion: Using diode 940 nm laser as an adjunctive treatment for SRP may be helpful and be suggested for periodontal treatment. [ABSTRACT FROM AUTHOR]

High throughput particle/cell concentration is crucial for a wide variety of biomedical, clinical, and environmental applications. In this work, we have proposed a passive spiral microfluidic concentrator with a complex cross-sectional shape, i.e., a combination of rectangle and trapezoid, for high separation efficiency and a confinement ratio less than 0.07. Particle focusing in our microfluidic system was observed in a single, tight focusing line, in which higher particle concentration is possible, as compared with simple rectangular or trapezoidal cross-sections with similar flow area. The sharper focusing stems from the confinement of Dean vortices in the trapezoidal region of the complex cross-section. To quantify this effect, we introduce a new parameter, complex focusing number or CFN, which is indicative of the enhancement of inertial focusing of particles in these channels. Three spiral microchannels with various widths of 400 µm, 500 µm, and 600 µm, with the corresponding CFNs of 4.3, 4.5, and 6, respectively, were used. The device with the total width of 600 µm was shown to have a separation efficiency of ~98%, and by recirculating, the output concentration of the sample was 500 times higher than the initial input. Finally, the investigation of results showed that the magnitude of CFN relies entirely on the microchannel geometry, and it is independent of the overall width of the channel cross-section. We envision that this concept of particle focusing through complex cross-sections will prove useful in paving the way towards more efficient inertial microfluidic devices.