Data Analytics for Diagnosis and Prediction of Central Line–Associated Bloodstream Infections in Critical Care Units

alexandrossfakianakis shared this article with you from Inoreader Data Analytics for Diagnosis and Prediction of Central Line–Associated Bloodstream Infections in Critical Care Units via Computers Informatics Nursing - Current Issue Central line–associated bloodstream infections are among the leading causes of in-hospital deaths in the United States and are a significant factor for increased morbidity, mortality, and healthcare costs. This study integrates several hospital data systems into a case-controlled database to use data analytics for the identification of significant central line–associated bloodstream infection risk factors and develop time-varying patient risk scores for central line–associated bloodstream infections. A case-control study was performed utilizing patient data collected from various sources then gathered and organi zed into a case-controlled dataset for analysis examining various patient-specific attributes for central line–associated bloodstream infections. Training and testing sets were created, and multivariate logistic regressions were used to identify risk factors for central line–associated bloodstream infection. Furthermore, the Cox proportional hazards model was used to infer the hazard rate and risk score for central line–associated bloodstream infections for each individual patient during hospitalization. Significant attributes for central line–associated bloodstream infection cases were the ICU location (P = .008), time from insertion (P ≤ .001), number of surgeries (P = .003), and number of central line manipulations (P = .003). Real-time data analytics and point of care at the bedside can facilitate precision care for patients with an elevated central line–associated bloodstream infection risk, subsequently changing the way healthcare prevents hospital-acquired infecti ons. View on Web

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In Vitro Analysis of Shear Stress: CAD Milled vs Printed Denture Base Resins with Bonded Denture Tooth

alexandrossfakianakis shared this article with you from Inoreader In Vitro Analysis of Shear Stress: CAD Milled vs Printed Denture Base Resins with Bonded Denture Tooth via Journal of Prosthodontics Abstract Purpose : As the fabrication of computer-aided design (CAD) milled and 3D printed denture base resins with bonded denture teeth increase in popularity, there is a need for research comparing the shear bond stress of milled and printed denture base resins with bonded denture teeth to that of a conventional heat processed denture base. Materials and methods : Denture base resin specimens (n = 9) were fabricated according to manufacturers' instructions using a novel test design. Two milled (Ivobase CAD PMMA, Ivoclar Vivadent and Polident PMMA, Polident Dental) and two 3D printed (Denture Base LP Resin, Formlabs and Lucitone Digital Print, Dentsply Sirona) materials were used. Conventional heat processed polymethylmethacrylate was used as the control (Lucitone 199, Dentsply Sirona, USA). Denture teeth (VITA Vitapan XL T44, #8, VITA Zahnfabrik) were bonded to their respective bases using denture tooth bonding agent (Ivobase CAD bonding system, Ivoclar). Specimens were aged in water for 600 hours at 37˚C and loaded until failure in a Universal testing machine. Shear bond stress was calculated. All specimens were evaluated for mode of failure and select specimens under scanning electron microscope and vertical scanning interferometry. Data were analyzed with one-way ANOVA followed by Tukey test (IBM SPSS) and fracture analysis performe d. Results : Shear stress was highest for the heat processed control (mean = 180 N ±26.76) and Polident test groups (mean = 180 N ±34.90). Milled specimens were not significantly different from the control (p = 0.076 for IvoBase CAD and 1.00 for Polident), while the printed groups were significantly different from the control (p = 0.012 for Formlabs Denture Base Resin and p = 000 for Carbon Lucitone Digital Print). Milled denture base resins perform similarly to heat processed denture base resin and better than 3D printed denture bases. Conclusion : For complete denture wearers, all resin materials used in this study may be clinically acceptable, as the sheer stress for all groups was higher than the reported maximum biting force of complete denture patients. However, for implant retained prostheses, the incorporation of additional retentive features should be considered when bonding denture teeth to printed bases. More research is needed to evaluate methods to increase the bond strength of denture teeth to printed denture base resins. This article is protected by copyright. All rights reserved View on Web

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Investigational PET tracers in neuro-oncology—What’s on the horizon? A report of the PET/RANO group

alexandrossfakianakis shared this article with you from Inoreader Investigational PET tracers in neuro-oncology—What's on the horizon? A report of the PET/RANO group via Neuro-Oncology Advance Access Abstract Many studies in patients with brain tumors evaluating innovative PET tracers have been published in recent years, and the initial results are promising. Here, the Response Assessment in Neuro-Oncology (RANO) PET working group provides an overview of the literature on novel investigational PET tracers for brain tumor patients. Furthermore, newer indications of more established PET tracers for the evaluation of glucose metabolism, amino acid transport, hypoxia, cell proliferation, and others are also discussed. Based on the preliminary findings, these novel investigational PET tracers should be further evaluated considering their promising potential. In particular, novel PET probes for imaging of translocator protein and somatostatin receptor overexpression as well as for immune system reactions appear to be of additional clinical value for tumor delineation and therapy monitoring. Progress in developing these radiotracers may contribute to improvi ng brain tumor diagnostics and advancing clinical translational research. View on Web

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SARS‐CoV‐2and Mutation RT‐qPCR Test Positivity Correlation with ABO and Rh Blood Types

alexandrossfakianakis shared this article with you from Inoreader SARS‐CoV‐2and Mutation RT‐qPCR Test Positivity Correlation with ABO and Rh Blood Types via Journal of Medical Virology ABSTRACT Introduction Studies show that there may be a relationship between ABO blood type and SARS-CoV-2transmission. It was aimed to determine by investigating the blood type of patients whose one-step reverse transcription and real-time polymerase chain reaction (RT-qPCR) test was positive for Sars-CoV-2. Materials and Methods ABO and Rh blood type of individuals whose RT-qPCR test was positive for SARS-CoV-2were examined and an evaluation was made to identify whether there was a relationship between them or not. Results The blood type data of 44.928 SARS-CoV-2positive RT-qPCR test results has been obtained. 17.656 (39.29%) were delta, 8048 (17.91%) were alpha, 800 (1.78%) were beta and 3000 (6.67%) were omicrons while 15.424 (34.33%) SARS-CoV-2positive mutation was found to be negative. Discussion Our study suggests that O and Rh (-) blood types may provide protection against delta, AB and Rh (+) blood types may hinder omicron infection while A and Rh (+) blood types may be more vulnerable to alpha and delta while B and Rh (+) are more sensitive to beta mutation. Conclusion Molecular mechanism underlying the relationship between blood types and SARS-CoV-2infection needs further molecular studies and multi-centered studies. This article is protected by copyright. All rights reserved. View on Web

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T cell epitopes are largely conserved in the SARS‐CoV‐2 Omicron subvariant (BA.1, BA.2, BA.3 and GKA)

alexandrossfakianakis shared this article with you from Inoreader T cell epitopes are largely conserved in the SARS‐CoV‐2 Omicron subvariant (BA.1, BA.2, BA.3 and GKA) via Journal of Medical Virology Abstract The SARS-CoV-2 variant Omicron (B.1.1.529) was first reported in South Africa by the World Health Organization (WHO) in November 2021 and the Omicron variant is now the predominant globally prevalent variant and account for almost all sequences recently reported to GISAID1. This article is protected by copyright. All rights reserved. View on Web

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Efficacy and safety of piezocision in accelerating maxillary anterior teeth en-masse retraction: study protocol for a randomized controlled trial

alexandrossfakianakis shared this article with you from Inoreader Efficacy and safety of piezocision in accelerating maxillary anterior teeth en-masse retraction: study protocol for a randomized controlled trial via Trials - Latest Articles Orthodontic treatment is commonly more time-consuming in adults than in teenagers, especially when it comes to the maxillary en-masse retraction, which may take 9 months or even longer. As to solve this concer... View on Web

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Intraoperative Redosing of Surgical Antibiotic Prophylaxis in Addition to Preoperative Prophylaxis Versus Single-dose Prophylaxis for the Prevention of Surgical Site Infection: A Meta-analysis and GRADE Recommendation

alexandrossfakianakis shared this article with you from Inoreader Intraoperative Redosing of Surgical Antibiotic Prophylaxis in Addition to Preoperative Prophylaxis Versus Single-dose Prophylaxis for the Prevention of Surgical Site Infection: A Meta-analysis and GRADE Recommendation via Annals of Surgery - Most Popular Articles Objective: The aim of this study was to determine the effect of preoperative surgical antibiotic prophylaxis (SAP) with additional intraoperative redosing compared to single-dose preoperative surgical antibiotic prophylaxis on the incidence of surgical site infections (SSI). Summary Background Data: Preoperative SAP is standard care for the prevention of SSI. During long surgical procedures, additional intraoperative redosing of SAP is advised, but there is great variability in redosing strategies and compliance rates. Methods: We performed a systematic search of MEDLINE (PubMed), Embase, CINAHL and CENTRAL on June 25th, 2021 according to PROSPERO registration CRD42021229035. We included studies that compared the effect of preoperative SAP with additional intraoperative redosing to single dose preoperative SAP (no redosing) on SSI incidence in patients undergoing any type of surgery. Two researchers performed data appraisal and extraction of summary data independently. Meta-analyses were stratified per study type. We used a generic inverse variance random-effects model to estimate a pooled odds ratio with corresponding 95% confidence intervals (CIs). Results: We included 2 randomized controlled trials (RCT) and 8 cohort studies comprising of 9470 patients. Pooled odds ratios for SSI in patients receiving intraoperative redosing compared to those without redosing were 0.47 (95% CI: 0.19–1.16. I2 = 36%) for RCTs and 0.55 (95% CI: 0.38–0.79, I2 = 56%) for observational cohorts. There was considerable clinical heterogeneity among antibiotics used and redosing protocols. GRADE-assessment showed overall low certainty of evidence. Conclusion: Intraoperative redosing of SAP may reduce incidence of SSI compared to a single dose preoperative SAP in any type of surgery, based on studies with considerable heterogeneity of antibiotic regimens and redosing protocols. View on Web

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Amylase as a Diagnostic Tool for Plunging Ranula: Clinical Series and Description of the Technique

alexandrossfakianakis shared this article with you from Inoreader Amylase as a Diagnostic Tool for Plunging Ranula: Clinical Series and Description of the Technique via The Laryngoscope Objectives This study describes a technique of measurement for neck cyst amylase content and reviews the experience of a tertiary referral center for cases of suspected plunging ranula. Methods A retrospective study was performed at the Manukau Surgical Center in Auckland, New Zealand. Patients with a possible diagnosis of plunging ranula based on clinical presentation and diagnostic aspiration of the cyst contents were included. Demographic data, imaging and laboratory findings were collected, along with findings from surgery and histology. The technique for measuring the amylase of the aspirated cyst contents was also carefully recorded. Results The 37 cases of confirmed plunging ranula included in this study had a submandibular cystic swelling that was aspirated. Imaging features consistent with a plunging ranula were seen in 89% of the study group. All cases had detectable levels of amylase of ≥3 U/L in the ranula contents. There was large variability (range: 5–560 U/L) in the concentration of amylase, with 70% of the cases demonstrating an amylase concentration below 200 U/L. Aspirates were typically described as viscous (87.5%) and yellow or straw-colored. Conclusion The combination of clinical presentation, imaging and the presence of amylase in the cyst contents is diagnostic for plunging ranula. Level of Evidence IV Laryngoscope, 2022 View on Web

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Long-term outcomes and late toxicity of adult medulloblastoma treated with combined modality therapy: a contemporary single-institution experience

alexandrossfakianakis shared this article with you from Inoreader Long-term outcomes and late toxicity of adult medulloblastoma treated with combined modality therapy: a contemporary single-institution experience via Neuro-Oncology Advance Access Abstract Background Medulloblastoma (MB) is a rare central nervous system malignancy of adults, with limited contemporary studies to define treatment guidelines and expected late toxicity. Methods A single-center, retrospective study was conducted of patients age ≥18-years from 1997-2019 with MB and who were treated with postoperative radiotherapy. Late toxicity was defined as a minimum of 18-months from diagnosis. Overall survival (OS) and progression-free survival (PFS) were characterized using Kaplan-Meier and Cox regression analyses. Results Fifty-nine patients met criteria, with median age of 25-years (range 18-62y) and median follow-up of 6.5-years (range 0.7-23.1y). At diagnosis, 68% were standard-risk, 88% Chang M0, and 22% with anaplastic histology. Gross total resection was achieved in 75%; median craniospinal irradiation dose was 30.6Gy(relative biological effectiveness [RBE]), median total dose was 54.0Gy(RBE), 80 % received proton radiotherapy; 81% received chemotherapy. 5-year PFS and OS were 86.5% and 95.8%, respectively; 10-year PFS and OS were 83.9% and 90.7%, respectively. Anaplastic histology was associated with worse PFS (p=0.04). Among eight recurrences, 25% presented after 5-years. Most common grade ≥2 late toxicities were anxiety/depressive symptoms (30%), motor dysfunction (25%), and ototoxicity (22%). Higher posterior fossa radiation dose was associated with increased risk of late toxicity, including worse cognitive dysfunction (p = 0.05). Conclusions Adults with MB have favorable survival outcomes, but late failures and toxicity are not uncommon. Better understanding of prognostic factors, possibly from molecular subtyping, may help to define more personalized treatments for patients with high risk of recurrence and long-term treatment sequelae. View on Web

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Effectiveness of root canal instrumentation for the treatment of apical periodontitis: A systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Effectiveness of root canal instrumentation for the treatment of apical periodontitis: A systematic review and meta‐analysis via International Endodontic Journal Abstract Background The development of endodontic instruments has rapidly advanced but their impact on endodontic outcome parameters remain unclear. Objectives This systematic review aimed to answer the following PICOT questions: In patients with apical periodontitis (P) what is the effectiveness of root canal instrumentation [(Q1) performed with contemporary techniques (I) in comparison with "traditional" techniques (C)] and [(Q2) performed with contemporary engine-driven NiTi instruments (I) compared with other types of contemporary engine-driven NiTi instruments (with different design and/or technology) (C)] in terms of clinical and patient-related outcomes (O)? Methods After PROSPERO protocol registration, a literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed, and Cochrane Central Register of Controlled Trials. Grey literature and major journal contents were examined. Two independent reviewers performed the study selection, data extraction, and appraisal of included studies. A quantitative meta-analysis was considered and statistical heterogeneity and overall quality of evidence were assessed. Results Nine studies were identified showing substantial methodological differences. Five studies addressed PICOT 1 and three PICOT 2, whereas one study aimed both. A random-effects meta-analysis model was considered for the outcome "radiographic evidence of normal periodontal ligament space or reduction of apical lesion size" (PICOT 1) based in three studies with 332 evaluable participants and showed that contemporary instrumentation was associated with a more favourable outcome (p= .005) compared to root canal preparation with stainless steel instruments (odds ratio=2.07 [95%-confidence interval=1.25-3.44]) with no evidence of statistical heterogeneity (I2=0%) but low quality of evidence. Discussion Albeit a few studies fulfilled eligible criteria, no study had a low risk of bias. Compelling evidence indicating significantly different outcome rates using different endodontic instruments when treating teeth with apical periodontitis is lacking. Conclusions In terms of healing, the results of the meta-analysis determined the higher effectiveness of root canal instrumentation performed with contemporary techniques in comparison with conventional stainless steel instruments in patients with apical periodontitis followed for a minimum of 1 year with low quality of evidence. No differences could be demonstrated between preparations with traditional stainless steel and contemporary NiTi instruments for other clinical and patient-related outcomes. View on Web

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