Sample Student's T-test Research Articles

Comparison of intubating laryngeal mask airway and fiberoptic bronchoscopy for endotracheal intubation in patients undergoing cervical discectomy.

Background and Aims:Direct laryngoscopy is hazardous in patients with cervical posterior intervertebral disc prolapse (PIVD) as it may worsen the existing cord compression. To achieve smooth intubation, many adjuncts such as fiberoptic bronchoscope (FOB), video laryngoscopes, lighted stylets, and intubating laryngeal mask airways (ILMAs) are available. However, there is a paucity of literature comparing ILMA with fiberoptic intubation in patients with PIVD. Hence, this study was designed to compare the effectiveness of ILMA technique with FOB to accomplish endotracheal intubation in patients undergoing cervical discectomy.Material and Methods:Sixty patients of age group 20–60 years, of American Society of Anesthesiologists status I or II, were enrolled in this prospective and randomized study. They were allocated to one of the two groups, ILMA group and FOB group. The patients were intubated orally using either equipment, after dexmedetomidine premedication and induction of general anesthesia. Chi-square and Fisher exact tests were used to find the significance of study parameters on a categorical scale. Paired samples t-test and Student's t-test were used to find the significance of study parameters on a continuous scale. Significance was assessed at 5% level of significance.Results:Bronchoscopy was a faster method of securing airway as compared with ILMA (38.13 ± 11.52 vs. 29.83 ± 13.75 s). Tracheal intubation was successful in all 60 patients (100%), belonging to both groups.Conclusion:ILMA and FOB were comparable with regards to ease of intubation in terms of time, the number of attempts and hemodynamic stability.

Marginal adaptation, fracture load and macroscopic failure mode of adhesively luted PMMA-based CAD/CAM inlays

ObjectivesTo evaluate marginal adaptation, fracture load and failure types of CAD/CAM polymeric inlays. MethodsStandardized prepared human molars (48) were divided into four groups (n=12): (A) PCG (positive control group); adhesively luted glass–ceramic inlays, (B) TRX; CAD/CAM polymeric inlays luted using a self-adhesive resin cement, (C) TAC; CAD/CAM polymeric inlays luted using a conventional resin cement, and (D) NCG (negative control group); direct-filled resin-based composite restorations. All specimens were subjected to a chewing simulator. Before and after chewing fatigue, marginal adaptation was assessed at two interfaces: (1) between dental hard tissues and luting cement and (2) between luting cement and restoration. Thereafter, the specimens were loaded and the fracture loads, as well as the failure types, were determined. The data were analysed using three- and one-way ANOVA with post hoc Scheffé test, two sample Student's t-test (p<0.05). ResultsBefore and after chewing fatigue, marginal adaptation for interface 1 showed significantly better results for TRX and PCG than for TAC (p=0.001–0.02) and NCG (p=0.001–0.047). For interface 2, marginal adaptation for TAC was significantly inferior to TRX (p<0.001) and PCG (p<0.001). Chewing fatigue had a negative impact on the marginal adaptation of TAC and NCG. No significant differences in fracture load were found between all tested groups. SignificanceSelf-adhesive luted polymeric CAD/CAM inlays showed similar marginal adaptation and fracture load values compared to adhesively luted glass–ceramic inlays.

Thermal Pain and Pain Anticipation Induce a Decrease in Microvascular Perfusion in Sickle Cell and Normal Subjects

INTRODUCTION: Sickle cell disease is an inherited blood disorder characterized by vaso-occlusive crises (VOC). HbS in red blood cells (RBC) polymerizes rapidly after it releases oxygen to tissues, causing RBC to become rigid. Anything that decreases flow in the microvasculature increases the chance that this flexible-to-rigid transformation occurs causing the rigid blood cell to lodge in the microvasculature, therefore increasing the chance of vaso-occlusion and the risk of VOC. Although hypoxia and stress are known risk factors for crises, the exact mechanism that initiates VOC events is not well known. We have previously shown that transient hypoxia causes parasympathetic withdrawal and sighs cause vasoconstriction more frequently in SCD subjects than in normal controls. Pain is the hallmark of SCD and is a consequence of VOC but has not been considered as a possible trigger of vasoconstriction that may lead to VOC.OBJECTIVES: To determine if heat induced pain causes decrease in peripheral blood flow (PBF) in SCD.METHODS: 30 SCD and 30 control subjects (healthy and sickle cell traits) were recruited at Children's Hospital Los Angeles (CHLA). Quasi-periodic pulses of pain were induced on the right forearm using TSA-II neuro analyzer heating thermode.We implemented a technique using cross correlation analysis to detect changes in complex microvascular flow signals measured bilaterally on the hands, using laser-Doppler flowmeter (LDF), Peripheral Arterial Tonometer (PAT) and photo-plethysmography (PPG).We also measured the average drop from baseline in the microvascular flow during the heat pain. Data were analyzed using one- and two- sample Student t-test.RESULTS: Data on 53 subjects were analyzed. There was a significant correlation between heat pain pulses and PBF responses, as well as a significant drop in blood flow in all study participants (PPG signal, both p<0.001), indicating that heat pain pulses lead to vasoconstriction.Males had higher correlation (p<0.005) and stronger vasoconstriction (p<0.05) during heat stimuli compared to females. Other Signals (LDF and PAT) had a similar pattern but were less significant.The vasoconstriction response consisted of two components, the first one occurred prior to administration of the painful stimulus indicating that anxiety or anticipation of pain causes significant vasoconstriction. Application of the painful stimulus causes further vasoconstriction.CONCLUSIONS: The findings demonstrate a significant decrease in PBF in both SCD and controls in response to heat pain and possibly to pain anticipation. The decrease in PBF could play a critical role in the genesis of VOC in SCD by markedly prolonging microvascular transit time, increasing the likelihood of red cell entrapment when sickle red cells transform from flexible to rigid. Furthermore, the potent vasoconstriction response to pain in SCD means that pain resulting from VOC could potentially trigger a cascade effect in which vasoconstriction could lead to even more serious VOC. Since regional blood flow is regulated by the autonomic nervous system (ANS), which has been described to be dysfunctional in SCD, our study calls attention to the ANS as a factor in the genesis of crisis in this disorder. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Complex evaluation of left atrial dysfunction in patients with type 1 diabetes mellitus by three-dimensional speckle tracking echocardiography: results from the MAGYAR-Path Study.

Objective:Changes in left atrial (LA) function can be observed in type 1 diabetes mellitus (T1DM). Three-dimensional (3-D) speckle tracking echocardiography (STE) seems to be a promising tool for volumetric and functional evaluation of LA. The objective of the present study was to compare 3DSTE-derived LA volumetric and strain parameters between T1DM patients and matched healthy controls.Methods:This prospective study consists of 17 subcutaneous insulin pump-treated non-obese patients with T1DM (mean age: 33.5±8.2 years, 8 males). To exclude possible cardiovascular disease, patients with complaints of chest pain, dyspnea, or signs of cerebrovascular disease or peripheral artery disease were not included. Their results were compared with 20 age-matched and gender-matched healthy controls (mean age: 36.9±11.0 years, 9 males). Independent sample Student t-test and Fisher’s exact test were used for comparisons. Bland–Altman method was used for evaluating intraobserver and interobserver correlations.Results:Anemia and impaired renal function were not confirmed in T1DM patients. Calculated LA maximum and minimum volumes and LA volume before atrial contraction were significantly increased in T1DM patients. Total atrial stroke volume was increased (23.6±6.9 mL vs. 19.6±4.6 mL, p=0.04), whereas mean segmental circumferential peak strain was decreased (28.9%±11.4% vs. 37.3%±12.5%, p=0.04). Segmental basal longitudinal and area strains were increased, whereas segmental superior circumferential and area strains and midatrial 3-D strain were decreased in T1DM.Conclusion:Both 3DSTE-derived volumetric and strain analysis confirmed alterations in LA function, suggesting early LA remodeling in patients with T1DM. (Anatol J Cardiol 2016; 16: 587-93)

Predicting ischemic mitral regurgitation in patients with acute ST-elevation myocardial infarction: Does time to reperfusion really matter and what is the role of collateral circulation?

Background/ObjectivesIschemic mitral regurgitation (MR) is an adverse prognostic factor. We aimed to assess the role of time delay from symptom onset to reperfusion, and the impact of collateral circulation to incidence of MR in relation to established echocardiographic and clinical risk factors. MethodsPatients with STEMI presenting within 12h from symptom onset and treated with primary percutaneous coronary intervention (PPCI) at Hospital of Lithuanian University of Health Sciences were enrolled. Echocardiography was performed after PPCI. Based on MR grade, patients were divided into no significant MR (NMR, grade 0-I MR, N=102) and ischemic MR (IMR, grade ≥2 MR, N=71) groups. Well-developed collaterals were defined as grade ≥2 by Rentrop classification. Continuous variables were compared by independent samples Student's T-test. Multivariate logistic regression analysis was used to identify independent predictors of ischemic MR. ResultsTime to reperfusion, MI localization, TIMI flow before/after PCI was similar between the groups. IMR group patients were elder, more often females and non-smokers, had lower body mass index, higher prevalence of multi-vessel coronary artery disease (CAD), better-developed collateral supply, greater left ventricular end-diastolic diameter index, left atrial index, pulmonary artery systolic pressure and lower ejection fraction. Multivariate logistic regression analysis revealed that ischemic MR is predicted by female gender, well-developed collateral supply, presence of multi-vessel CAD, and lower EF. ConclusionIn acute STEMI significant MR is unrelated to ischemic time and is predicted by female gender, lower EF, multi-vessel CAD and well-developed collateral supply to the infarct region.

Assessing biofiltration repeatability: statistical comparison of two identical toluene removal systems

ABSTRACTBiofiltration of volatile organic compounds is still considered an emerging technology. Its reliability remains questionable as no data is available regarding process intrinsic repeatability. Herein, two identically operated toluene biofiltration systems are comprehensively compared, during long-term operation (129 days). Globally, reactors responded very similarly, even during transient conditions, with, for example, strong biological activities from the first days of operation, and comparable periods of lower removal efficiency (81.2%) after exposure to high inlet loads (140 g m−3 h−1). Regarding steady states, very similar maximum elimination capacities up to 99 g m−3 h−1 were attained. Estimation of the process repeatability, with the paired samples Student's t-test, indicated no statistically significant difference between elimination capacities. Repeatability was also established for several descriptors of the process such as the carbon dioxide and biomass production, the pH and organic content of the leachates, and the moisture content of the packing material. While some parameters, such as the pH, presented a remarkably low divergence between biofilters (coefficient of variability of 1.4%), others, such as the organic content of the leachates, presented higher variability (30.6%) due to an uneven biomass lixiviation associated with stochastic hydrodynamics and biomass repartitions. Regarding process efficiency, it was established that less than 10% of fluctuation is to be expected between the elimination capacities of identical biofilter set-ups. A further statistical comparison between the first halves of the biofilter columns indicated very similar coefficients of variability, confirming the repeatability of the process, for different biofilter lengths.

Deproteinized Bovine Bone Graft in Maxillary Alveolar Cleft Reconstruction

Though alveolar grafting continues to be a viable treatment regimen, its associated protocols and techniques are many and varied. The present study was conducted to evaluate the use of deproteinized bovine bone xenograft mixed with autogenous mandibular symphyseal bone graft in secondary maxillary alveolar cleft reconstruction compared to the gold standard anterior iliac crest autogenous graft. 10 patients (mean age 9.3years 1.33) with unilateral maxillary alveolar cleft defect requiring secondary alveolar cleft grafting were included in this study. Patients were selected from the outpatient clinic, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University. The study was conducted from June 2012 till February 2013. Patients were divided randomly into 2 equal groups. Group A received the gold standard anterior iliac crest graft. Group B received mandibular symphyseal bone mixed with deproteinized bovine bone in a 1:1 ratio. For each patient, 3 CBCT scans were ordered: preoperatively, immediately postoperatively and 6 months postoperatively. Volumetric and densitometric measurements were made using the Mimics[1] software. Data were collected and statistical analysis was performed using SPSS (Statistical package for the social sciences)[2]. Data were represented as mean standard deviation. Paired sample student t-test was used to compare each pair of the studied variables within the studied group of patients. Independent sample t test was used to compare variables between the two studied groups. The test result was considered statistically significant if the Pvalue was equal to or less than 0.05. Results showed the percentage of defect filling immediately postoperatively to be 90.8 9.2% for Group A and 94.2 4.3% for Group B, while percentage of defect filling 6 months postoperatively was 86.6 10.0% for Group A and 88.4 2.8% for Group B. Comparison of the 2 groups regarding the percentage of defect filling by the graft immediately postoperatively and at 6 months showed no statistical significant difference with a P-value of 0.483 and 0.736 respectively. Comparison of the percentage of graft resorption between the 2 groups also showed no statistical significant difference. (P-value 0.704) Similarly, comparison of graft density between Group A and Group B immediately postoperatively (P-value 0.52) and after 6 months (P-value 0.81) showed no statistical significant

Evaluation of left atrial volume and function in systemic sclerosis patients using speckle tracking and real-time three-dimensional echocardiography.

Objective:The aim of the present study was to evaluate left atrial (LA) volume and functions using real-time three-dimensional echocardiography (RT3DE) and speckle tracking in systemic sclerosis (SSc) patients.Methods:The study was designed as a cross-sectional observational study. We studied 41 consecutive SSc patients (38 females, mean age: 49.5±11.6 years) and 38 healthy controls (35 females, mean age: 48.5±10.8 years). Patients with evidence or history of cardiovascular disease and patients with risk factors as hypertension, diabetes and chronic renal failure were excluded from the study. All study subjects underwent standard echocardiography; LA speckle tracking and RT3DE was performed to assess LA volume and phasic functions. Differences between numeric variables were tested using the independent sample Student’s t-test or Mann-Whitney U test, where appropriate.Results:There were no significant differences between SSC patients and controls regarding left ventricular (LV) systolic functions and two-dimensional (2-D) atrial diameters. Presence of LV diastolic dysfunction (LVDD) was evaluated and graded according to recommendations of the American Society of Echocardiography. Accordingly, LVDD was observed to be significantly more frequent in SSc patients; 16 SSc patients (39%) and 5 controls (12.8%) were observed to have LVDD (p=0.007). With regard to results obtained from RT3DE, LA maximum, minimum, and before atrial contraction volumes were significantly higher (40.5±14.6 vs. 32.6±8.9, 15.5±8.4 vs. 9.9±3.5 and 28.7±11.7 vs. 21.4±7.0 mL respectively, p<0.05 for all), whereas LA active emptying fraction, LA total emptying fraction, LA expansion index, and passive emptying fraction values were significantly (47.1±12.0 vs. 52.9±10.1%, 62.8±10.5 vs. 69.5±6.7%, 187.5±76.0 vs. 246.6±96.0, 29.6±9.3 vs. 34.4±11.0% respectively, p<0.05 for all) in SSc patients than in controls. In addition, regarding results obtained from speckle tracking echocardiography, atrial peak-systolic longitudinal strain (e), early negative strain rate (SR), late negative SR, and peak positive SR values were observed to be significantly lower in SSc patients.Conclusion:LA volumes were significantly increased, and LA reservoir, conduit, and contractile functions were significantly impaired in SSc patients compared with controls. LA volume and functional analyses with RT3DE and speckle tracking may facilitate the recognition of subtle LA dysfunction in SSc patients.

Implant Instability, Proximal Fractures, Quality of Life, and Outcomes of Global Spinal Alignments Correction using Short Fusion in Adults and Elderly

Introduction The purpose of our research is studying of incidence of implant instability, proximal fractures of instrumented and adjacent vertebras, and evaluation of health-related quality of life (HRQOL) parameters depending on extent of the sagittal balance correction after short fusion using a posterior approach. Patients and Methods A study of 83 patients with Type L (SRS-Schwab) deformity, operated in our institute was held in the period between 2008 and 2011. Patients were divided into two groups. The first retrospective group included 43 patients who underwent short fusion of lumbar curve from T12 or L1 to L5. The second prospective group consisted of 40 patients, which were treated using short fusion from T9 to S1 extending to the pelvis. Groups were evaluated with HRQOL-scales including VAS, ODI, SF36, and SRS-24. Radiographical assessment included Cobb coronal angle, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS), sagittal vertical axis (SVA). Radiographical, HRQOL-parameters and complications with a 3-year minimum follow-up were analyzed and compared between two groups. The comparisons were done by using independent sample Student t-test. A p-value of less than 0.05 was accepted as significant. Results In the first group the ideal sagittal balance was not achieved. The second group showed a better restoration of global spinal alignments compared with the first one ( p &lt; 0.05). The HRQOL-scores (VAS, ODI, SF36, and SRS-24) of the patients after 3 years are slightly higher in the second group, but we did not get significant difference between groups ( p &gt; 0.05). In the first group the number of complications in the form of implant instability ( n = 15, 35%) consists of loosening of screws at the end of fusion (T12/L1 or L4/5). The second group was obtained by a higher number of patients with complications ( n = 25, 63%) including loosening of screws at pelvis ( n = 15, 37.5%), proximal fractures of upper instrumented vertebra ( n = 7, 17.5%) and upper adjacent vertebra ( n = 8, 20%). Incidence of implant instability and proximal fractures in the second group was statistically more frequent ( p &lt; 0.05). Conclusion The research showed that short fusion extending to the pelvis provided good sagittal balance, global spinal alignments, and likely HRQOL-parameters after 3 years follow-up. But, eventually, we obtained higher number of complications.

Body Composition Evolution in Elite Football Referees; an Eleven-years Retrospective Study.

Fitness, and specifically body composition of football referees requires attention in order to achieve the highest possible standards. The aim of the present study was to describe body composition of elite Spanish football referees over 11 years. Data from 2001 to 2012 pre-seasons were analyzed from a total of 470 referees of 1(st) and 2(nd) categories in Spanish male football (1C and 2C respectively). Body mass index (BMI), sum of 6 skinfolds (6SS) and percentage of body fat (%BF) were assessed. 2-independent samples Student's t-test between categories, and ANOVA tests with Bonferroni post-hoc analyses among seasons were applied. Overall, 1C referees were older than 2C in every season, and both 1C and 2C showed a decrease in 6SS, BMI and %BF throughout seasons (all p<0.05; from 82.5 to 62.9 mm, from 23.7 to 22.4 kg/m(2) and from 13.7 to 11.7%). No differences were observed between categories in any season. Since football referees at the highest levels need to have a low %BF for the intense matches nowadays, an improvement in their body composition profile has been observed in a highly competitive league as 'La Liga' in Spain over the last decade.

Comparison of Medical and Surgical Nurses Attitudes toward Usage of Electronic Health Records

Background: Health care is an organizational field that information and technology improves quickly. With ensuring health professionals adaptation to this new information and technology environment, it is possible to achieve quality and productivity improvement goal in health care. It is known that different clinical expertises bring differences in presentation of health services. Aim: In this study it was aimed to compare nurses’ assessments about electronic health records usage. Materials and methods: Data analyzed by using descriptive statistics, Chi-square test and independent sample student-t test. Results: At the end of the analysis it was found that nurses’ assessments about electronic health records usage has a meaningful difference according to different clinical expertise (t=2.40, p < 0.05). Conclusion: Results of this study shows that surgical nurses’ who are forefront with “technical abilities” have more positive assessments about usage of electronic health records when they compared with medical nurses who are forefront with “patient centered” abilities.

Final height and body mass index in adult survivors of childhood acute lymphoblastic leukemia treated without cranial radiotherapy: a retrospective longitudinal multicenter Italian study.

BackgroundYoung adult survivors of childhood acute lymphoblastic leukemia (ALL) treated with protocols including cranial radiotherapy demonstrate a persistent weight gain and reduced final height. Published reports on the effects on growth of different oncologic therapies are conflicting and difficult to interpret because they combined children treated with both cranial irradiation and multi-agent chemotherapy. Our study investigated the effect of chemotherapy alone on body mass index (BMI) and on growth at the achievement of final height in a homogeneous cohort of Italian childhood ALL survivors.MethodsWe retrospectively studied 162 Caucasian patients treated on the Italian Association of Pediatric Hematology and Oncology protocols without radiotherapy between 1989 and 2000 at five Italian centers with 107 inclusions (58 males). Height- and BMI-standard deviation score (SDS) were collected at diagnosis of ALL, at the end of treatment and at the achievement of final height. Changes in height SDS and BMI SDS with time were analyzed using dependent sample Student's t-test.ResultsA significant reduction of height-SDS was documented during treatment in both genders. This reduction of height-SDS was not followed by an appropriate catch-up growth, despite the achievement of a mean final height within the normal range. At diagnosis females showed a lower mean BMI-SDS than males. During treatment, in the whole population, BMI-SDS increased significantly. After it, while males lost BMI-SDS, females showed its persistent increase.ConclusionsSurvivors of childhood ALL generally seemed to achieve a normal final height with a BMI within the normal range. These parameters appeared to be only minimally affected by chemotherapy. Nevertheless, height catch-up growth was not completed after chemotherapy in both genders and all patients experienced an increase of BMI-SDS during chemotherapy that only females seemed to conserve until the achievement of final height.

Nursing students' knowledge of and performance in communicating with patients with hearing impairment.

The present study aimed to investigate nursing students' knowledge of and performance in communicating with patients with hearing impairment. A cross-sectional study was conducted on all senior nursing students (n = 71) in a nursing school in Iran in 2013. Data collection was performed with a demographics questionnaire, knowledge questionnaire, and performance assessment checklist. Two stages were designed to evaluate the students. In the first stage, students conducted an interview with a simulated patient with hearing impairment who experienced chest pain. In the second stage, students answered the knowledge questionnaire. Descriptive statistics, independent sample Student's t-test, and Pearson correlation coefficient were used to analyze the data. In total, 11.3% of participants had a history of caring for a patient with hearing impairment. The majority of students evaluated their performance in communicating with such patients at a moderate level. A significant difference was observed between the mean score of knowledge in men and women (P = 0.05), and male students gained higher scores. In total, 61.5% of the students had low to very low levels of knowledge and 87.3% of them had weak to very weak performance in communicating with patients with hearing impairment. Nursing students are lacking in knowledge and skills required for effective communication with patients with hearing impairment. Nurse educators should pay more attention to this issue as it is their responsibility to prepare nurses who are competent to deal with common issues they will face in practice.

Younger age at onset of sporadic Parkinson's disease among subjects occupationally exposed to metals and pesticides.

An earlier age at onset of Parkinson's disease (PD) has been reported to be associated with occupational exposures to manganese and hydrocarbon solvents suggesting that exposure to neurotoxic chemicals may hasten the progression of idiopathic PD. In this study the role of occupational exposure to metals and pesticides in the progression of idiopathic PD was assessed by looking at age at disease onset. The effects of heritable genetic risk factors, which may also influence age at onset, was minimized by including only sporadic cases of PD with no family history of the disease (n=58). Independent samples Student t-test revealed that subjects with occupational exposure to metals and/or pesticides (n=36) were significantly (p=0.013) younger than unexposed controls (n=22). These subjects were then divided into three groups [high (n=18), low (n=18), and unexposed (n=22)] to ascertain if duration of exposure further influenced age at onset of PD. One-way ANOVA revealed that subjects in the high exposure group were significantly (p=0.0121) younger (mean age: 50.33 years) than unexposed subjects (mean age: 60.45 years). Subjects were also stratified by exposure type (metals vs. pesticides). These results suggest that chronic exposure to metals and pesticides is associated with a younger age at onset of PD among patients with no family history of the disease and that duration of exposure is a factor in the magnitude of this effect.

Cluster-based computational methods for mass univariate analyses of event-related brain potentials/fields: A simulation study

BackgroundIn recent years, analyses of event related potentials/fields have moved from the selection of a few components and peaks to a mass-univariate approach in which the whole data space is analyzed. Such extensive testing increases the number of false positives and correction for multiple comparisons is needed. MethodHere we review all cluster-based correction for multiple comparison methods (cluster-height, cluster-size, cluster-mass, and threshold free cluster enhancement – TFCE), in conjunction with two computational approaches (permutation and bootstrap). ResultsData driven Monte-Carlo simulations comparing two conditions within subjects (two sample Student's t-test) showed that, on average, all cluster-based methods using permutation or bootstrap alike control well the family-wise error rate (FWER), with a few caveats. Conclusions(i) A minimum of 800 iterations are necessary to obtain stable results; (ii) below 50 trials, bootstrap methods are too conservative; (iii) for low critical family-wise error rates (e.g. p=1%), permutations can be too liberal; (iv) TFCE controls best the type 1 error rate with an attenuated extent parameter (i.e. power<1).

Palatal surface and volume in mouth-breathing subjects evaluated with three-dimensional analysis of digital dental casts-a controlled study.

To compare the anatomical characteristics of the maxillary arch, identified as palatal surface area and volume, between mouth-breathing and nose-breathing subjects using a three-dimensional (3D) analysis of digital dental casts. Twenty-one Caucasian subjects (14 females and 7 males) with a mean age of 8.5 years [standard deviation (SD) 1.6 years] were selected according to the following criteria: mouth-breathing pattern due to allergic rhinitis, early mixed dentition, skeletal Class I relationship, and pre-pubertal stage of cervical vertebral maturation. This study group (SG) was compared with a control group (CG) of 17 nose-breathing subjects (9 females and 8 males, mean age: 8.5 years; SD: 1.7 years). For each subject, initial dental casts were taken and the upper arch was scanned using a 3D laser scanner. On each digital model, 3D measurements were performed to analyse maxillary arch morphology. Between-group differences were tested with the independent sample Student's t-test (P < 0.05). In mouth-breathing subjects, changes in physiological function of the upper respiratory tract resulted in skeletal adaptations of the maxillary arch. In the SG, both palatal surface area and volume were significantly smaller when compared with values of the CG. In particular, the palatal surface area and palatal volume were, respectively, 13.5 and 27.1 per cent smaller in the SG when compared to the CG. Subjects with prolonged mouth breathing showed a significant reduction of the palatal surface area and volume leading to a different development of the palatal morphology when compared with subjects with normal breathing pattern.

Fit of 4-unit FDPs made of zirconia and CoCr-alloy after chairside and labside digitalization – A laboratory study

ObjectivesTo analyse the marginal fit of 4-unit fixed dental prostheses (FDPs) and the accuracy of three-dimensional cast-datasets using both approaches to Computer Aided Design (CAD)/Computer Aided Manufacturing (CAM): direct and indirect digitalization. MethodsA titanium model of a 4-unit FDP was digitized by an intraoral scanning device (iTero, Align Technology, Carlstadt, US; DD, n=12). Additionally 12 conventional impressions were taken and referring master casts were digitized by a laboratory scanner (CS2, Straumann, Basel, Switzerland; ID, n=12). Frameworks were fabricated (CARES CADCAM GmbH, Straumann, Markkleeberg, Germany) from base metal alloy (coron, Straumann; DD-C: n=12; ID-C: n=12) and zirconia (zerion, Straumann; DD-Z: n=12; ID-Z: n=12) from the same datasets. The marginal fit of the resulting frameworks and the accuracy of the underlying datasets from DD and ID were evaluated. Data were analyzed by unpaired two sample Student's t-test with Levene-test (p<0.05). ResultsFrameworks from group DD-C showed significantly better marginal fit than ID-C (DD-C: 56.90±27.37μm, ID-C: 90.64±90.81μm). For zirconia frameworks no differences between both digitalization methods (DD-Z: 127.23±66.87μm, ID-Z: 141.08±193.17μm) could be observed. Base metal alloy frameworks exhibited significantly better marginal fit than zirconia frameworks (DD: p<0.001; ID: p=0.022). Regarding the accuracy group DD showed significantly higher “trueness” than ID. SignificanceDirect and indirect digitalization lead to clinically acceptable marginal fit of 4-unit FDPs from base metal alloy and zirconia. Higher accuracy of datasets from DD leads to better marginal fit of frameworks from base metal alloy but not for ones from zirconia.

Phacoemulsification without preoperative topical mydriatics: Induction and sustainability of mydriasis with intracameral mydriatic solution

Context:Intracameral mydriatic solution can eliminate the disadvantages of repeated eye drop instillation regimen and provide adequate mydriasis for phacoemulsification with added advantages.Aims:Evaluating the role of intracameral irrigating solution (0.5% lignocaine + 0.001% epinephrine) in initiating and maintaining the pupillary mydriasis during phacoemulsification. Secondary aims were to observe the effect of surgical time, nucleus density and ultrasound time on mydriasis during the procedure.Settings and Design:The study is a prospective interventional case series, conducted at tertiary care institution.Materials and Methods:Thirty patients underwent phacoemulsification under topical anesthesia for visually significant cataract. Pupillary dilatation was achieved by intracameral irrigation of mydriatic solution alone. Pupillary diameter was measured serially during surgery and ultrasound time and total surgical time were noted.Statistical Analysis Used:Paired samples student–t test was done to compare means. Spearman correlation coefficient was used to study the effect of various parameters on mydriasis.Results:Thirty eyes completed the study. The pupil size increased from 2.1 mm (Range 2-3.5 mm SD ± 0.32) to 6.9 mm (Range 5-9 mm SD ± 1.02) in 30 seconds time after intracameral mydriatic solution delivery, and was 7.0 mm (Range 3.5 - 9 mm SD ± 0.20) at the end of surgery. Duration of surgery, grade of nucleus and ultrasound time had statistically insignificant effect on mydriasis.Conclusions:Intracameral solution containing 0.5% lignocaine and 0.001% epinephrine provides rapid mydriasis which is adequate for safe phacoemulsification and is unaffected by other parameters.

Effect of Bhramari pranayama and OM chanting on pulmonary function in healthy individuals: A prospective randomized control trial.

Background/Aim:Yoga is an ancient Indian science as well as the way of life. Pranayama is a part of yoga, which improves pulmonary function in combination of many pranayama, but the aim of our study is to evaluate the effect of only Bhramari pranayama and OM chanting on pulmonary function in healthy individuals.Materials and Methods:A total of 82 subjects were randomized into the study group (SG) (n = 41) and control group (CG) (n = 41). Baseline assessment was performed before intervention for both groups. SG practiced Bhramari pranayama and OM chanting for the duration of 10 min (5 min for each practice)/day for the period of 6 days/week for 2 weeks and CG did not practice so. After intervention post-assessment was performed for SG (n = 40) and CG (n = 39). Statistical analysis was performed by Independent samples t-test and Student's paired t-test with the use of Statistical Package for the Social Sciences version 16 (2007, USA).Results:The result showed a significant improvement in peak expiratory flow (PEF), forced expiratory flow (FEF)25% and maximal voluntary ventilation (MVV) along with a significant reduction in weight in SG compared with CG in independent samples t-test. Significant improvement in slow vital capacity (SVC), forced expired volume in 1 s (FEV1) along with PEF, FEF25% and MVV; Significant reduction in weight and body mass index were observed in SG unlike in CG in Student's paired t-test. No significant changes were found in forced vital capacity, FEV1 /SVC and FEF50% , between and within the group analysis of SG and CG.Conclusion:Bhramari pranayama and OM chanting are effective in improving pulmonary function in healthy individuals.

Board 424 - Research Abstract Validation of a Tool for the Assessment of Trainees During Simulated Pediatric Resuscitation (Submission #967)

Introduction/Background Dealing with a patient in an emergency situation, such as cardiac arrest, is among the most challenging scenarios that a physician may face in their career. To better prepare trainees for such events, a growing number of residency programs are incorporating high-fidelity simulation into their training.1 As part such a curriculum, it is crucial to have a tool that can objectively assess performance of trainees during simulated resuscitations. Many tools have been proposed to measure clinical skills, but recently Grant2 developed a tool that assesses not only clinical performance but also leadership skills during simulated pediatric resuscitations. We aimed to validate Grant’s tool and assess inter-rater reliability of the instrument when used by providers not involved in the tool’s development. Methods This study took place in the simulation lab of a tertiary care pediatric center. In the setting of a previous study,3 a total of 13 first-year and 11 third-year residents were videotaped during simulated pediatric resuscitation scenarios. Each resident led five scenarios before and after their Pediatric Advanced Life Support (PALS) course. The pre and post-PALS scenarios were paired, such that each resident acted as team leader in a pulseless non-shockable arrest, pulseless shockable arrest, dysrhythmia, respiratory and shock scenario. Five subspecialists in the fields of pediatric emergency medicine and intensive care from North America and Europe were trained to evaluate the residents’ performance using Grant’s assessment tool. All raters were blinded to the pre and post-PALS phases of the scenarios. Inter-rater reliability was assessed by having two expert raters independently evaluate the residents performance. In the absence of a gold standard scoring tool, we used construct validity to validate the tool. Knowing that the PALS course has been shown to increase immediate short-term knowledge of healthcare professionals,4 it was determined that, for the tool to be valid, participants should improve their score after participating in the PALS course. Pre and post-PALS scores were compared using a paired sample Student T-test. Inter-rater reliability was measured for the five scenarios using intra-class correlation coefficient (ICC). Results Following the PALS course, the residents scores improved by 11% (95%CI 6.1-16) for the pulseless non-shockable arrest, 17% (95%CI 11-24) for the pulseless shockable arrest, 6% (95%CI 0.1-12) for the dysrhythmias, 12% (95%CI 4.3-21) for the respiratory scenario, 14% (95%CI 7.3-21) for the shock scenarios. Inter-rater reliability was excellent as demonstrated by an overall intra-class correlation coefficient of 0.91 (95%CI 0.88-0.93). Conclusion Grant’s scoring instrument demonstrated construct validity and excellent reliability as a measure of clinical performance for simulated pediatric resuscitations. Moreover, we were able to show that it is a generalizable tool, as it was valid for all of our five simulated scenarios. Further research should be done to assess whether this tool is reliable when used to assess trainees in real-time rather than video-based assessments.