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Purpose: To evaluate the clinical performance of implant-prosthetic rehabilitations carried out using ceramic-coated CAD/ CAM titanium abutments. Materials and Methods: Thirty implants were placed in 30 patients and rehabilitated with 30 single crowns attached to CAD/CAM titanium abutments. A conventional procedure was applied, implants were placed after postextraction socket healing, and prosthetic restorations were placed after implant healing. Implant lengths ranged from 6 to 15 mm, and widths were 3.6, 4.2, and 4.8 mm. At the time of prosthesis delivery (T0), after 2 years (T1), and after 5 years (T2), the Plaque Index (PI), bleeding on probing (BoP), pocket probing depth (PPD), marginal bone level (MBL), and pink/white esthetic scores (PES/WES) were evaluated for each implant. Results: No patient dropped out of the study during the follow-up period. All 30 implants were clinically successful 5 years after prosthesis delivery (survival rate: 100%) and showed no signs of peri-implant infection. Peri-implant soft tissues were in good health (BoP at T2: 0% in 73% of patients; 25% in 13% of patients; 50% in 10% of patients; and 75% in 3% of patients). The mean PPD was 2.05 ± 0.56 mm at T0, 1.992 ± 0.6 mm at T1, and 1.867 ± 0.439 mm at T2. The mean MBL was 0.413 ± 0.440 mm at T0, 0.306 ± 0.388 mm at T1, and 0.263 ± 0.368 mm at T2. The mean PES, WES, and PES/WES indices (7.43 ± 1.04, 7.57 ± 0.82, and 15.00 ± 1.17, respectively) indicate good integration of soft tissues, satisfactory esthetics, and overall positive outcomes. Conclusions: The success rates, maintenance of MBLs, and periodontal and esthetic indices suggest the validity of implant-prosthetic rehabilitations with CAD/CAM abutments in cases of single crowns. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Introduction.: Integrated clinical education (ICE) courses require opportunities for practice, assessment of performance, and specific feedback. The purposes of this study were to 1) analyze the internal consistency of a tool for evaluating students during ICE courses, 2) examine the responsiveness of the tool between midterm and final assessments, and 3) develop a model to predict the final score from midterm assessments and explore relationships among the 6 domains. Review of Literature.: Several clinical education assessment tools have been developed for terminal clinical experiences, but few have focused on the needs of learners during the ICE. Subjects.: Eighty-five student assessments were collected from 2 consecutive cohorts of physical therapist students in a first full-time ICE course. Methods.: The tool contained 29 items within 6 domains. Items were rated on a 5-point scale from dependent to indirect supervision. Cronbach's alpha was used to analyze the internal consistency of the tool, whereas responsiveness was examined with paired t -test and Cohen's d. A best subsets regression model was used to determine the best combination of midterm variables that predicted the final total scores. Coefficients of determination (R 2) were calculated to explore the relationships among domains. Results.: The tool was found to have high internal consistency at midterm and final assessment (α = 0.97 and 0.98, respectively). Mean scores increased over time for each domain score and for the total score (P <.001; d = 1.5). Scores in 3 midterm domains predicted more than 57% of the variance in the final total score. Discussion and Conclusion.: Results support the use of this tool to measure student performance and growth in a first full-time ICE course. Targeted measurement of students' abilities in ICE courses assists with differentiating formative and summative learning needed to achieve academic success. [ABSTRACT FROM AUTHOR]

Background: There is a need for additional longitudinal studies with the Aptima messenger RNA human papillomavirus test (AHPV) to support the safety of extended screening intervals. RNA‐based extended interventional nucleic acid (REINA) provides relevant information on the clinical performance of AHPV. Methods: This is a longitudinal prospective analysis of 1538 participants after AHPV and liquid‐based cytology (LBC) co‐test complemented with REINA interventional protocol with a second co‐test 4 years after negative screening on 2000 women. Diagnostic accuracy and cumulative risks for CIN2+ up to 9 years were calculated for all test combinations. Results: Sensitivity and specificity for CIN2+ were 96.9% and 88.0% for AHPV and 72.3% and 92.0% for LBC. Negative predictive value (NPV) and positive predictive value (PPV) of AHPV were 99.9% and 23.6%. The 5‐ and 9‐year risks of AHPV‐negative women were 0.4% and 1.0% (CIN2+) and 0.3% and 0.7% (CIN3+), a 73% and 64% lower risk than with negative LBC (p ≤.002). REINA participants with an AHPV‐positive result at second co‐test after a negative AHPV in first round had a significantly lower 5‐year risk of CIN2+ (11.1%) than AHPV‐positive women with unknown HPV history (29.5%). Conclusions: Currently, this constitutes the longest European longitudinal study with AHPV testing in screening population. It reveals 99.9% NPV and a significant protective effect of a previous negative test 5 years after a new HPV infection. These findings support the safety of Aptima for screening intervals beyond 5 years. The risk of disease is lower 9 years after a negative AHPV test than 3 years after a negative LBC. High specificity and PPV of Aptima may benefit controlling overtreatment and colposcopy referrals. This is the first European study to show a safe screening interval of 9 years with messenger RNA (mRNA) human papillomavirus (HPV) Aptima testing with a 99.9% negative predictive value. REINA study demonstrated the protective role of a previous negative Aptima mRNA HPV test with a low 5‐year cumulative risk of CIN2+ following a new HPV infection. [ABSTRACT FROM AUTHOR]

To evaluate the clinical performance of two flowable composites based on methacrylate and one based on ormocer in treating non-carious cervical lesions (NCCLs) after 48-month evaluation in a split-mouth double-blind clinical study design. A total of 183 restorations were performed on NCCLs using a universal adhesive system (Futurabond U, Voco GmbH) with selective enamel etching on 27 participants: two participants received twelve restorations each, three received nine restorations each, and 22 participants received six restorations each. Three different flowable composites were employed (n = 61): a low-viscosity methacrylate-based composite (GrandioSO Flow, LVM), a high-viscosity methacrylate-based composite (GrandioSO Heavy Flow, HVM), and an ormocer-based flowable composite (Admira Fusion Flow, ORM). All restorations were evaluated using FDI and USPHS criteria after 48 months. Statistical analysis was conducted using Kaplan-Meier Survival analysis and Kruskal-Wallis analysis of variance rank (α = 0.05). After 48 months, 17 restorations were lost: LVM 6, HVM 9, ORM 2. The retention rates (95 % confidence interval) were 89.4 % for LVM, 80.4 % for HVM, and 95.6 % for ORM, with a significant difference between HVM vs. LVM and HVM vs. ORM (p < 0.05). Minor defects were observed in 30 restorations for marginal staining criteria (LVM 12, HVM 10, ORM 8) and in 71 restorations for marginal adaptation criteria (LVM 24, HVM 20, ORM 27) without significant difference between groups (p > 0.05). No restorations showed postoperative sensitivity or recurrence of caries. The increased viscosity of flowable composites could reduce the clinical longevity in NCCLs after 48 months. Ormocer-based and low-viscosity methacrylate-based flowable composites showed a successful clinical performance in NCCLs after 48 months. [ABSTRACT FROM AUTHOR]

Background/Objectives: To evaluate the clinical performance of two optical coherence tomography angiography (OCTA) devices, including a semi-automated device, with respect to image quality and pathology detection, with fluorescein angiography (FA) and indocyanine green angiography (ICGA) serving as the reference standards. Methods: In this prospective cross-sectional study, normal eyes and those with various retinal and choroidal pathologies were enrolled and underwent OCTA scanning using semi-automated 3D OCT-1 Maestro2 and Cirrus™ HD-OCT 5000 devices, as well as FA/ICGA imaging. OCTA scans and FA/ICGA images were independently graded for image quality and the visibility of prespecified anatomic vascular features, along with the presence or absence of pathology on the OCTA scans and the FA/ICGA images (within regions corresponding to the OCTA scan areas). Positive percent agreement (PPA), defined as the proportion of eyes in which the OCTA demonstrated pathology when the corresponding FA/ICGA showed pathology, and negative percent agreement (NPA), defined as the proportion of eyes in which the OCTA showed no pathology when the FA/ICGA also showed no pathology, were calculated. Results: In total, 38 normal eyes and 86 pathologic eyes were enrolled in the study. The majority of images for both devices were considered clinically useful. The PPA and NPA were high for both devices, indicating a good ability to identify disease when present and to rule it out when not present. Conclusions: The findings of this study suggest that the semi-automated Maestro2 and Cirrus have comparably good clinical performance, particularly with regard to accuracy when identifying vascular pathologies. [ABSTRACT FROM AUTHOR]

Academic self-efficacy is recognized as a vital element influencing students' academic performance, while social support and resilience have been recognized as potential predictors of academic self-efficacy. The purposes of this study are twofold: (1) to examine the influence of academic self-efficacy on learning outcomes in nursing students, and (2) to explore whether social support and resilience serve as predictors of academic self-efficacy. A quantitative cross-sectional research design was utilized in this study. A total of 265 Filipino student nurses registered in a government nursing school participated in the study. Student nurses reported moderate to high levels of general academic self-efficacy. Increased levels of academic self-efficacy were associated with better academic performance and clinical performance. Resilience emerged as a strong predictor of academic self-efficacy. The findings of this study highlighted the value of resilience in promoting academic self-efficacy among student nurses. Furthermore, the research establishes the significance of academic self-efficacy in enhancing positive learning outcomes for these students. The findings underscore the need for interventions targeting the development of resilience to enhance academic self-efficacy, leading to improved learning outcomes. • Student nurses reported moderate to high levels of general academic self-efficacy. • Resilience emerged as a significant and positive predictor of academic self-efficacy in student nurses. • Academic self-efficacy plays a key role in improving both academic and clinical performance in student nurses. [ABSTRACT FROM AUTHOR]

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This research aims to determine the relationship between the level of acceptance of heteronormative beliefs to the clinical performance of 4th-year BSN students of Riverside College, Inc. Different variables were examined, such as sex, sexual orientation, and religion. The descriptive-correlational research design was utilized using a quantitative method conducted with 97 4th-year BSN students using Habarth's Heteronormative Attitudes and Beliefs Scale (HABS). This study revealed that there is no significant correlation using Pearson Correlation between the level of acceptance of heteronormative beliefs when correlated to the clinical performance of 4th-year BSN students. Their level of acceptance of heteronormative beliefs, when grouped according to the aforementioned variables, posited a high acceptance level. As to their clinical performance, 4th-year BSN students have very good clinical performance regardless of sex, sexual orientation, and religion, and it does not affect the quality of care that they provide among patients with diverse beliefs and sexual identities. The researcher proposed that a gender equality program be implemented to enhance gender inclusion among nursing students and clinical instructors while also increasing the quality of nursing practice and education in both academic and clinical settings. [ABSTRACT FROM AUTHOR]

Particle-enhanced turbidimetric immunoassay (PETIA) is a new measurement procedure for detecting fecal calprotectin (FC). We aimed to investigate the accuracy and clinical performance of PETIA for FC. We assessed the accuracy of PETIA for FC measurements through concordance analysis, Passing-Bablok regression and Bland-Altman analysis, using enzyme-linked immunosorbent assay (ELISA) as the reference. To evaluate the clinical performance of PETIA, the FC levels of individuals with significant and non-significant bowel diseases were compared. The receiver operating characteristic (ROC) analysis was performed to determine the appropriate cut-off value of FC detected by PETIA for discriminating subjects with significant and non-significant colorectal lesions. Of the 413 cases analyzed, 340 (82.3%) were concordant between PETIA and ELISA. No significant discordance was observed. There was a good agreement (y = −7.710+0.957x) between PETIA and ELISA for detecting FC. The FC level detected by PETIA in patients with significant bowel diseases (159.1 [31.3, 821.0] µg/g) was significantly higher than that of subjects with non-significant bowel diseases (10.3 [4.2, 38.5] µg/g) (p < 0.001). The AUC of FC for identifying significant bowel diseases detected by PETIA was 0.82 (p < 0.001). With a cut-off value of 77.6µg/g, the specificity and positive predictive value were 92.2% and 97.1%, respectively. The PETIA for FC measurement showed good clinical performance for detecting bowel diseases. [ABSTRACT FROM AUTHOR]

The rise of computer-aided design and computer-aided manufacturing (CAD/CAM) and 3D printing technologies in orthodontics has revolutionized the development of customized labial and lingual bracket systems with a variety of materials, which offer potential advantages over traditional orthodontic brackets. To highlight the current state of knowledge regarding the mechanical and clinical properties of CAD/CAM and 3D-printed custom bracket systems, we conducted a comprehensive search across the PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases to identify relevant articles published before April 2024. Mechanical (including fracture toughness, hardness, modulus of elasticity, frictional resistance, slot accuracy, torque transmission, and shear bond strength) and clinical (including treatment efficiency and duration, cost, and comfort) properties were compared between traditional and customized orthodontic bracket systems in the current review. Our findings suggest that customized brackets have the potential to increase bracket slot precision, reduce treatment time, and offer cost-efficiency. However, it is worth noting that the advantages and disadvantages of customized bracket systems vary depending on the bracket material and the manufacturing methods, warranting comprehensively controlled investigations in the future. [ABSTRACT FROM AUTHOR]

Abstract Background Female nurses with high occupational stress are one of the groups at risk of premenstrual syndrome (PMS). The symptoms of this syndrome may affect the reduction of work efficiency, accuracy in doing work, concentration, and increased absenteeism of nurses and can lead to significant economic losses. This study aimed to determine the predictive role of common PMS symptoms in the clinical performance of nurses in public hospitals in Sanandaj, Iran. Methods The present study was a descriptive-analytical and cross-sectional study. In this study, 318 nurses participated in the census method based on the inclusion criteria. Data collection tools were premenstrual symptom screening questionnaires and nurses’ clinical performance evaluations. Data analysis was done with Spearman’s correlation tests, simple linear regression, multiple regression, t-test, one-way variance analysis, Tukey’s post hoc tests, and LSD using SPSS version 22 statistical software. Results The average PMS score of the participants was 30.8 ± 11.45, which indicates severe PMS. Nurses’ average clinical performance score was 45.78 ± 35.29, indicating an average performance. The findings showed that PMS has a significant inverse correlation with clinical performance and its components. Simple linear regression showed that PMS can predict 26.5% of nurses’ clinical performance variance. Simple regression showed that with an increase of one standard deviation in the PMS score, the nurses’ clinical performance score decreased by 0.517 standard deviations and vice versa. However, by controlling confounding variables, with an increase of one standard deviation in the PMS score, the clinical performance score of nurses will decrease by 0.396 standard deviations and vice versa. Conclusions Paying attention to reducing or controlling PMS symptoms may help improve nurses’ performance. Therefore, hospital and nursing managers can improve the performance and efficiency of their workforce by identifying nurses and other employees suffering from PMS and planning and using different methods to reduce its symptoms.

Abstract Successful entrance into specialty training represents a pivotal stage in the careers of medical officers. Selection for entrance into specialty training programs may encompass criteria including research experience, regional exposure, clinical experience, professional achievements, diversity, equity and inclusion factors, and extracurricular activities. Despite multiple syntheses on the topic, the extent to which these individual criteria predict performance during training and practice remains unclear. The objective of this study are to robustly conclude, through an umbrella review of systematic reviews on the topic, which selection criteria used in the selection process for medical and surgical specialty training applicants best predict clinical performance during and after specialty training.

Statement of Problem: Computer‐aided design and manufacturing (CAD/CAM) have been increasingly used to enhance the patient and clinician experiences with removable complete dentures (CDs). Yet, evidence from systematic reviews is lacking to validate the clinical significance of these digital prostheses. Purpose: The purpose of this systematic review was to compare CAD/CAM CDs with the traditional ones in terms of patient and clinician‐reported outcomes, post‐insertion adjustment visits and costs. Materials and Methods: An electronic search of four databases [Medline (Ovid), Embase, Scopus and Cochrane CENTRAL; last update: May 2022] was performed to retrieve clinical studies comparing CAD/CAM and traditional CDs. Two independent reviewers screened the articles, extracted data (methods and outcomes) and assessed risk of bias of the included studies. The following outcomes underwent meta‐analysis (random‐effects model): overall patient and clinician satisfaction, oral health‐related quality of life (OHRQoL), number of post‐insertion adjustment visits, as well as laboratory and total costs. Results: This review included 11 studies. Meta‐analysis revealed that CAD/CAM CDs are comparable to the traditional CDs in terms of overall patient satisfaction and OHRQoL. Clinician‐reported data depended on the manufacturing technique: whereas milled CDs performed better than traditional CDs in terms of clinician satisfaction and number of adjustments, 3D printed and traditional CDs were similar. Fabrication of CAD/CAM CDs required significantly less laboratory and overall costs than the traditional CDs. Conclusions: There is some evidence showing that CAD/CAM CDs are at least comparable to traditional CDs. Further well‐designed randomized clinical trials are needed to evaluate the performance of specific CAD/CAM approaches for manufacturing CDs, however. [ABSTRACT FROM AUTHOR]

Background: Entrustable professional activities (EPAs) are used in competency-based clinical assessment. Problem: Faculty in a Family Nurse Practitioner program aimed to improve their clinical assessment tool to more effectively measure students' clinical performance, outline expectations, track progress, and document evidence related to clinical competence. Approach: EPAs that aligned with the American Association of Colleges of Nursing Essentials and National Organization of Nurse Practitioner (NP) Faculties Core NP Competencies were integrated into a clinical assessment tool. Student performance expectations at different points in the program were outlined. Students documented each time they performed an EPA during clinical experiences. Outcome: The EPA-based clinical assessment tool captured valuable information about student performance during clinical experiences and contributed to evidence related to competencies. Conclusions: EPAs can be used to assess clinical performance and document evidence of competence and readiness for practice. Tracking the frequency of EPA performance was essential to ensure students had sufficient practice. [ABSTRACT FROM AUTHOR]

Copyright of China Tropical Medicine is the property of China Tropical Medicine Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Female nurses with high occupational stress are one of the groups at risk of premenstrual syndrome (PMS). The symptoms of this syndrome may affect the reduction of work efficiency, accuracy in doing work, concentration, and increased absenteeism of nurses and can lead to significant economic losses. This study aimed to determine the predictive role of common PMS symptoms in the clinical performance of nurses in public hospitals in Sanandaj, Iran. Methods: The present study was a descriptive-analytical and cross-sectional study. In this study, 318 nurses participated in the census method based on the inclusion criteria. Data collection tools were premenstrual symptom screening questionnaires and nurses' clinical performance evaluations. Data analysis was done with Spearman's correlation tests, simple linear regression, multiple regression, t-test, one-way variance analysis, Tukey's post hoc tests, and LSD using SPSS version 22 statistical software. Results: The average PMS score of the participants was 30.8 ± 11.45, which indicates severe PMS. Nurses' average clinical performance score was 45.78 ± 35.29, indicating an average performance. The findings showed that PMS has a significant inverse correlation with clinical performance and its components. Simple linear regression showed that PMS can predict 26.5% of nurses' clinical performance variance. Simple regression showed that with an increase of one standard deviation in the PMS score, the nurses' clinical performance score decreased by 0.517 standard deviations and vice versa. However, by controlling confounding variables, with an increase of one standard deviation in the PMS score, the clinical performance score of nurses will decrease by 0.396 standard deviations and vice versa. Conclusions: Paying attention to reducing or controlling PMS symptoms may help improve nurses' performance. Therefore, hospital and nursing managers can improve the performance and efficiency of their workforce by identifying nurses and other employees suffering from PMS and planning and using different methods to reduce its symptoms. [ABSTRACT FROM AUTHOR]

Trial design: This is a randomized, controlled, superiority, double-blinded, parallel-group, two-arms trial with an allocation ratio of 1:1. This study aimed to assess whether the cavity design could affect the clinical performance of the CAD/CAM generated indirect resin composite restoration in endodontically treated teeth (ETT) evaluated using the Modified USPHS criteria after a two-year follow up. Methods: A total of 30 participants who underwent endodontic treatment for MOD cavities in permanent molars were divided randomly into two parallel groups (n = 30 restorations) according to the performed cavity design to group 1 in which there was no cuspal reduction (inlay) and group 2 in which cuspal reduction was performed (overlay). All pulp chambers were filled with bulk fill flowable composite, and the cavities were prepared following the criteria of the cavities for indirect restorations and restored using nano-hybrid composite resin blocks (Brilliant, Coltene, Switzerland). The restorations were evaluated using the modified USPHS criteria at baseline, six months, one-year and two years follow-up visits. For qualitative data, frequencies (n) and percentages (%) were used to display the data, while mean and standard deviation (SD) were used for quantitative data. The normality of the data was evaluated using the Shapiro-Wilk and Kolmogorov-Smirnov tests. For every test, P ≤ 0.05 was used as the significance threshold. Results: Twenty-six individuals completed the follow-up period after receiving the assigned intervention.The inter-group comparison showed that, at the 6- months and 12- months observation points, the overlay design had significantly better marginal adaptation, less incidence of discoloration or tooth/restoration fracture, and similar marginal integrity and caries incidence to the inlay design. After 24- months, the overlay design still had better marginal adaptation, less incidence of discoloration or tooth/restoration fracture and less caries incidence in comparison to the inlay design, while there was no difference in the marginal integrity between either design. Conclusions and clinical relevance: Cuspal reduction in endodontically treated teeth showed better clinical performance than the cusp preservation thus, the former is more reliable. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal (GI) tract. Fecal calprotectin (fCAL) is a noninvasive laboratory test used in the diagnosis and monitoring of IBDs such as Crohn's disease and ulcerative colitis. The fCAL send-out test that our facility has been offering so far uses an ELISA-based method. In the current study, we sought to validate the performance of a Buhlmann fCAL turbo assay in an automated Abbott Alinity C analyzer (AFCAL) in our core laboratory. Five-day imprecision studies showed good performance for both within-run (5.3%) and between-day (2.5%) measurements. The reportable range was verified as 30–20,000 µg/g. Deming regression and Bland–Altman analysis indicated a strong correlation of r = 0.99 with a low, acceptable bias of 1.8% for AFCAL relative to the predicate Buhlmann fCAL ELISA results. AFCAL's clinical performance was determined retrospectively in 62 patients with ICD codes for IBD. Overall, the implementation of AFCAL in our routine clinical testing has improved our turnaround time, reduced the cost per test, and significantly increased our clinician satisfaction. [ABSTRACT FROM AUTHOR]

Featured Application: Our research is the second step toward both establishing a standard aging protocol as well as selecting methods useful for evaluating the degradation of dental materials. The durability and performance of dental composites are essential for ensuring long-lasting dental restorations. However, there is a lack of a standardized procedure for evaluating the lifespan of dental materials. Our proposal assumed that dental materials should be tested under aggressive aging conditions to accelerate materials' degradation in vitro and such an approach should simulate prolonged material usage in the oral cavity. A comprehensive examination of the impacts of three aging methodologies on various mechanical properties, including the flexural strength (FS), diametral tensile strength (DTS), hardness (HV), fracture toughness (FT), flexural fatigue limit (FFL), and microstructure of selected dental materials (Resin F, Flow-Art and Arkon), was conducted. The findings revealed that preformed aging results in an average reduction of 30% in the mechanical strength properties of the dental composites when compared to the control. Notably, a strong correlation was identified between FS and FFL post-aging whereas no such relationship was observed between these parameters and FT. This paper highlights the significance of aging tests for new dental composites and recommends a focus on flexural strength and fracture toughness to optimize costs and time efficiency. Furthermore, the establishment of a standardized test for fracture toughness in dental composites is recommended. It is proposed that a minimum flexural strength of more than 32–48 MPa after aging should be maintained. A more extensive analysis of commercially available materials is suggested to refine the proper evaluation methods for composite materials. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the clinical performance of bulk‐fill resin composite systems with different viscosities in class II cavities. Materials and Methods: A total of 80 class II restorations were performed with a single operator in 50 patients using four different bulk‐fill resin composite materials: Filtek™ Bulk Fill, Heated Filtek™ Bulk Fill, G‐ænial™ BULK Injectable, and SonicFill3. A double‐blinded randomized clinical trial was designed to evaluate the two‐year clinical performance of the four bulk‐fill composite resins using modified FDI criteria. Data were analyzed descriptively. Level of significance was set at 0.05. Differences between groups were tested using Wilcoxon‐signed‐rank and Mann–Whitney‐U test as nonparametric tests. Results: Data were analyzed using Kruskal‐Wallis, Mann–Whitney U, and Wilcoxon signed rank tests (p < 0.05). Eighty restorations were available for evaluation, with a survival function of 100%. No statistically significant differences were observed between the four groups regarding assessing esthetic, functional, and biological properties during different follow‐up periods. Conclusions: After 2 years of clinical follow‐up, the bulk‐fill composite systems with different viscosities seem to be esthetically, functionally, and biologically acceptable, with a promising clinical performance in class II cavities. [ABSTRACT FROM AUTHOR]

Successful entrance into specialty training represents a pivotal stage in the careers of medical officers. Selection for entrance into specialty training programs may encompass criteria including research experience, regional exposure, clinical experience, professional achievements, diversity, equity and inclusion factors, and extracurricular activities. Despite multiple syntheses on the topic, the extent to which these individual criteria predict performance during training and practice remains unclear. The objective of this study are to robustly conclude, through an umbrella review of systematic reviews on the topic, which selection criteria used in the selection process for medical and surgical specialty training applicants best predict clinical performance during and after specialty training. [ABSTRACT FROM AUTHOR]

Purpose: This review aimed to summarize the evidence on patient‐reported outcomes and clinical performance of digitally fabricated removable partial dentures (RPDs) compared to traditionally fabricated dentures. Methods: Three databases were systematically searched (PubMed, CENTRAL, and Wiley online library) for clinical studies comparing digitally and conventionally fabricated RPDs regardless of data acquisition methods used for fabrication. The Cochrane Collaboration risk of bias assessment tool 2 and the Oxford Center for Evidence‐based Medicine tool were used to assess risk of bias, and level of evidence, respectively. Descriptive narrative analysis was used to summarize data on patient‐reported outcomes, as there were inadequate studies to pool data in a meta‐analysis. A random‐effects model was used to analyze the data of framework fit accuracy. Results: Ten randomized controlled trials were included in the systematic review, and 4 were included in the meta‐analysis. Two studies showed that digitally fabricated RPDs are associated with higher patient satisfaction than conventionally fabricated RPDs (with a mean difference of 12.5 mm on a 100‐satisfaction scale, p =.008). The pooled standardized mean difference for framework fit accuracy was 0.49 (p = 0.02) in favor of conventionally fabricated RPDs, which showed that conventionally fabricated RPDs have a quantitatively better fit compared to digitally fabricated RPDs. However, clinical evaluation studies showed that both frameworks have clinically acceptable fit. Conclusions: Current evidence shows that digitally fabricated RPDs are associated with higher patient satisfaction compared to conventionally fabricated RPDs. However, the scarcity of literature here warrants the generalization of this conclusion. Both digitally and conventionally fabricated metal RPD frameworks showed acceptable fit clinically. [ABSTRACT FROM AUTHOR]

Background: Timing of surgery remains a topic of debate for hip fracture treatment in the geriatric patient population. The quality indicator "early surgery" was implemented in 2014 at the Department of Trauma Surgery of the University Hospitals Leuven to enhance timely operative treatment. In this follow-up study, we aim to evaluate the performance of this quality indicator, the clinical outcomes, and room for improvement. Methods: The charts of 1190 patients surgically treated for an acute hip fracture were reviewed between June 2017 and May 2022 at the University Hospitals Leuven. Primary endpoints were adherence to early surgery, defined as surgery within the next calendar day, and the evaluation of the reasons for deviating from this protocol. Secondary endpoints were length of stay (LOS); intensive care unit (ICU) admission and length of ICU stay; mortality after 30 days, 60 days, 90 days, and 6 months; and 90-day readmission rate. Pearson's Chi-square test and Mann–Whitney U test were used for data analysis. Results: One thousand eighty-four (91.1%) patients received early surgery versus 106 (8.9%) patients who received delayed surgery. The main reasons for surgical delay were the use of anticoagulants (33%), a general health condition not allowing safe surgery and/or existing comorbidities requiring workup prior to surgery (26.4%), and logistical reasons (17.9%). Patient delay and transfer from other hospitals were responsible for respectively 8.5% and 6.6% of delayed surgery. Early surgery resulted in a significantly shorter LOS and ICU stay (12 [8–25] vs. 18 [10–36] and 3 [2–6] vs. 7 [3–13] days, early vs. delayed surgery, respectively). No significant reduction was observed in ICU admission, mortality, and readmission rate. Conclusion: We have been able to maintain the early surgery hip fracture protocol in approximately 90% of the patients. Comorbidities and anticoagulant use were responsible for delayed surgery in the majority of the patients. Correct implementation of the existing protocol on anticoagulant use could lead to a one-third decrease in the number of delayed surgeries. Subsequently, since the LOS and ICU stay in the delayed surgery group were significantly longer, a further increase of early surgery will lower the current economic burden. [ABSTRACT FROM AUTHOR]

Analytical performance specifications (APS) based on outcomes refer to how 'good' the analytical performance of a test needs to be to do more good than harm to the patient. Analytical performance of a measurand affects its clinical performance. Without first setting clinical performance requirements, it is difficult to define how good analytically the test needs to be to meet medical needs. As testing is indirectly linked to health outcomes through clinical decisions on patient management, often simulation-based studies are used to assess the impact of analytical performance on the probability of clinical outcomes which is then translated to Model 1b APS according to the Milan consensus. This paper discusses the related key definitions, concepts and considerations that should assist in finding the most appropriate methods for deriving Model 1b APS. We review the advantages and limitations of published methods and discuss the criteria for transferability of Model 1b APS to different settings. We consider that the definition of the clinically acceptable misclassification rate is central to Model 1b APS. We provide some examples and guidance on a more systematic approach for first defining the clinical performance requirements for tests and we also highlight a few ideas to tackle the future challenges associated with providing outcome-based APS for laboratory testing. [ABSTRACT FROM AUTHOR]

This review article will discuss the origin of resin-based dental composite materials and their adoption as potentially useful adjuncts to the primary material used by most dentists for direct restorations. The evolution of the materials, largely driven by the industry's response to the needs of dentists, has produced materials that are esthetic, strong, and versatile enough to be used in most areas of the oral cavity to replace or restore missing tooth structures. Significant advancements, such as the transition from chemical to light-curing materials, refinements in reinforcing particles to produce optimum polishing and wear resistance, formulating pastes with altered viscosities to create highly flowable and highly stiff materials, and creating materials with enhanced depth of cure to facilitate placement, will be highlighted. Future advancements will likely reflect the movement away from simply being a biocompatible material to one that is designed to produce some type of beneficial effect upon interaction within the oral environment. These new materials have been called "bioactive" by virtue of their potential effects on bacterial biofilms and their ability to promote mineralization of adjacent tooth structures. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate undergraduate students’ clinical ability to extract teeth, we created a new, coordinated, and quantitative assessment form containing nine items that were required to measure the various skills, using the visual analog scale. Materials and Methods: A pilot study was performed with 30 students, each of whom was rated by three examiners. In addition, 118 students (59 fourth-year and 59 fifth-year) were reviewed halfway through the year and at their final examinations. The assessment form was then used to evaluate students’ abilities for tooth extraction throughout the academic year 2022–2023. Results: High inter-examiner reliability and a significant association of mean scores (p

Objectives: To evaluate the clinical performance of two methacrylate-based flowable composites and an ormocer-based flowable composite in noncarious cervical lesions (NCCLs) in adult participants. Method and materials: In total, 183 restorations were performed on NCCLs. All cavities were restored using a universal adhesive system (Futurabond U, Voco) with selective enamel etching and with one of the three evaluated flowable composites (n = 61): low-viscosity methacrylate-based composite (GrandioSO Flow, LV), high-viscosity methacrylate-based composite (GrandioSO Heavy Flow, HV), and an ormocer-based flowable composite (Admira Fusion Flow, ORM). All restorations were evaluated using FDI and USPHS criteria after 24 months. Kruskall-Wallis analysis of variance rank (α = .05) was used for statistical analysis. Results: After 24 months of clinical evaluation, 16 restorations were lost (LV = 3, HV = 10, ORM = 3) and the retention rates (95% confidence interval) were 95.0% for LV, 82.2% for HV, and 95.0% for ORM, with statistical differences observed between HV and LV as well as HV and ORM (P < .05). When secondary parameters were evaluated, no significant differences between groups were observed (P > .05). Thirty-three restorations (LV = 8, HV = 13, ORM = 12) showed minor marginal staining, 71 restorations (LV = 26, HV = 20, ORM = 25) presented small marginal adaptation defects, and one restoration for HV presented recurrence of caries. Conclusion: The universal adhesive associated with the ormocer-based and methacrylate-based flowable composite showed promising clinical performance after 24 months. However, the heavy-flow restorations showed significantly more failures. [ABSTRACT FROM AUTHOR]

Background: Many practitioners have questioned whether the construction method of pediatric zirconia crowns impacts the periodontal health and clinical performance of severely decayed primary molars. The objective of this study was to compare the periodontal health and clinical performance of primary molars restored with custom-made zirconia crowns (CZCs) and prefabricated zirconia crowns. Methods: Twenty primary molars indicated for crown restorations were selected from ten patients (5–9 years old) randomly. Each patient received two pediatric zirconia crowns constructed by two different methods: one custom-made and one prefabricated. The primary molars were divided into two groups: Group 1: primary molars received CZCs and Group 2: primary molars received prefabricated zirconia crowns (PZCs). Results: After a 12-month follow-up, there was no statistically significant difference between the periodontal health of primary molars restored with custom-made and prefabricated zirconia crowns. The clinical performance of primary molars restored with CZCs was statistically significantly higher than those restored with PZCs in terms of retention and fracture resistance (P ≤ 0.05). Conclusions: The construction method of pediatric zirconia crowns does not significantly affect the periodontal health of primary molars; however, clinical performance is significantly affected in terms of retention and fracture resistance. Clinical Significance: A CZC is an excellent alternative option, especially for primary molars whose permanent successors still have a long time to erupt. The PZC is a quick and easy restoration, but the technique is sensitive.

Resin composites are the first choice for direct restoration of posterior teeth in the treatment of dental caries. This article reviews factors that influence the clinical performance of composite restorations and the results of clinical trials assessing longevity of posterior resin composite restorations. Materials and method. PubMed, and Web of Science electronic databases were searched for articles investigating the clinical performance of direct resin composite restorations placed in posterior teeth. Results and discussions. Factors with significant influence on longevity of posterior composite restorations include patient-related factors (age, carious risk, periodontal disease, bruxism), dental group, cavity size and volume, cervical margin extension, root-filled teeth, oclusal stress. Conclusions. Dental resin composites are material of choice for use in direct minimal interventions in posterior teeth. For patients without bruxism, in medium size cavities, direct composite resins demonstrate similar clinical performance with amalgam restorations. The clinical performance of restorations depends on a number of factors including variables related to the restored tooth, the materials and techniques employed, the patient’s risks, and professional clinical decisions.

Nursing Students' Self-Efficacy Levels in Clinical Performance and their Perceptions of the Nursing Process

AimsHeart failure (HF) remains a major public health problem with increasing prevalence in China. This study evaluated the clinical performance and quality measures for HF management to identify gaps in the standardization of care for patients hospitalized for HF in China.Methods and resultsFollowing the results of China-HF stage I (2012-2015), the second stage of the China-HF was launched in 2017. Among 113 hospitals with ≥100 cases, the China-HF Stage II assessed the quality of care measures for HF and compared results with previous data in China and the US-based Get with The Guidelines-Heart Failure (GWTG-HF) registries. In total, 34 938 patients hospitalized with HF were enrolled from January 2017 to October 2020. Echocardiographic left ventricular function and natriuretic peptide test were performed in 93.7% and 93.0% of the cases, respectively. Adherence to standardized guidelines in China-HF stage II was higher than that in the China-HF stage I, but generally lower than GWTG-HF registry with 78.2% of eligible patients was prescribed oral diuretics, 78.7% renin-angiotensin-system inhibitors, and 82.2% beta-blockers. Implantable cardioverter-defibrillators and cardiac resynchronization devices were implanted in 3.9% and 14.6%, respectively. In contrast, the proportion of eligible patients discharged with spironolactone (87.8%) was higher than GWTG-HF. The median length of hospitalization was 9 (6, 12) days, and 938 (2.8%) patients died or withdrew from treatment during hospitalization.ConclusionsDespite significant improvements in the use of guideline-recommended testing and therapy, there remain major gaps in quality of care for patients hospitalized for HF in China that are generally larger than gaps observed in the United States.

The objective of this evaluation was to determine the analytical and clinical performance of the AFIAS point-of-care (POC) Tn-I Plus assay (Boditech Med Inc). Limit of detection (LOD), limit of quantification (LOQ), repeatability, reproducibility, inter- and intra-individual CV were evaluated using the CLSI guidelines. The study was also designed to estimate the 99th percentile upper reference limit (URL) and to assess the diagnostic sensitivity and specificity. The precision repeatability CVs were 6.7–8.5% and reproducibility was 7.5–7.6%. The LOD and LOQ were consistent with the manufacturer's specified values of 0.010 ng/mL and 0.030 ng/mL, respectively. The 99th percentile URLs for males (aged 18–75 years) and females (aged 17–65 years) in serum were 0.0300 ng/mL (7.8% CV) and 0.0239 ng/mL (9.4% CV) respectively. Overall 99th percentile URL was 0.0296 ng/mL (8.2% CV). For the overall apparently healthy population, the percentage of measurable cardiac troponin I (cTn-I) values below the 99th percentile (i.e. 0.0296 ng/mL) and above the assay's LOD (= 0.010 ng/mL) was 47,68% (391/820 samples). The diagnostic sensitivity and specificity were 100% with 95% CI (97% − 100%) and 95.2% with 95% CI (93.6% − 96.5%), respectively. No significant differences were observed for the diagnosis of acute myocardial infarction (AMI) between AFIAS Tn-I plus and Abbott ARCHITECT High Sensitive Troponin-I. The clinical performance of AFIAS Tn-I Plus assay for AMI is comparable to the established Abbott ALINITY STAT High Sensitive Troponin-I. This assay is suitable for routine use in clinical laboratories. [ABSTRACT FROM AUTHOR]

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Additive manufacturing (AM) permits sustainable production of personalized load‐bearing metal implants with complex structures. Regulations prescribe that implants have to meet strict requirements to not harm patients, and production technique should allow the certification of their performance. Process, materials, operating parameters, and customization to patient's needs could limit AM. Layer‐by‐layer material deposition and repeated thermal cycles may make outer surface of AM implants chemically and physically uneven and rough, eliciting biological response of host tissue and hindering therapeutic success. In this paper, we discuss the clinical challenges that AM must overcome to replace traditional techniques in implant and prostheses design. [ABSTRACT FROM AUTHOR]

Background: Many practitioners have questioned whether the construction method of pediatric zirconia crowns impacts the periodontal health and clinical performance of severely decayed primary molars. The objective of this study was to compare the periodontal health and clinical performance of primary molars restored with custom‑made zirconia crowns (CZCs) and prefabricated zirconia crowns. Methods: Twenty primary molars indicated for crown restorations were selected from ten patients (5–9 years old) randomly. Each patient received two pediatric zirconia crowns constructed by two different methods: one custom‑made and one prefabricated. The primary molars were divided into two groups: Group 1: primary molars received CZCs and Group 2: primary molars received prefabricated zirconia crowns (PZCs). Results: After a 12‑month follow‑up, there was no statistically significant difference between the periodontal health of primary molars restored with custom‑made and prefabricated zirconia crowns. The clinical performance of primary molars restored with CZCs was statistically significantly higher than those restored with PZCs in terms of retention and fracture resistance (P ≤ 0.05). Conclusions: The construction method of pediatric zirconia crowns does not significantly affect the periodontal health of primary molars; however, clinical performance is significantly affected in terms of retention and fracture resistance. Clinical Significance: A CZC is an excellent alternative option, especially for primary molars whose permanent successors still have a long time to erupt. The PZC is a quick and easy restoration, but the technique is sensitive. [ABSTRACT FROM AUTHOR]

This article from the Romanian Journal of Oral Rehabilitation discusses the clinical performance of resin composite restorations in posterior teeth. It reviews factors that influence the longevity of these restorations, such as patient-related factors, dental group, cavity size, and cervical margin extension. The article concludes that resin composites are the material of choice for minimal interventions in posterior teeth, and they demonstrate similar clinical performance to amalgam restorations in medium-sized cavities. The success of these restorations depends on various factors, including the restored tooth, materials and techniques used, patient risks, and clinical decisions. The text discusses the factors that contribute to the failure of posterior resin composite restorations in dental patients. Patient-related risk factors include high cariogenic risk, occlusal stress, periodontal status, smoking, dietary habits, and parafunctional habits. The type of resin composite used, adhesive systems, restorative technique, and isolation technique also play a role in the success of the restorations. The main reasons for failure are fractures within the restoration and secondary marginal caries. The text emphasizes the importance of using minimal interventions such as marginal sealing or refurbishment to extend the lifespan of the restorations. The overall success rate of posterior composite restorations is reported to be between 43.4% and 98.7%. It is suggested that resin composites may be inferior to amalgam in terms of cost-effectiveness. However, various research groups have reported satisfactory results with resin [Extracted from the article]

Introduction: To evaluate undergraduate students' clinical ability to extract teeth, we created a new, coordinated, and quantitative assessment form containing nine items that were required to measure the various skills, using the visual analog scale. Materials and Methods: A pilot study was performed with 30 students, each of whom was rated by three examiners. In addition, 118 students (59 fourth-year and 59 fifth-year) were reviewed halfway through the year and at their final examinations. The assessment form was then used to evaluate students' abilities for tooth extraction throughout the academic year 2022-2023. Results: High inter-examiner reliability and a significant association of mean scores (p<0.001) between three examiners at the beginning and final of the block for both 4th and 5th students. Both groups showed considerable improvement in their mean scores between the beginning and final examinations. The result shows the association between socio-demographic characteristics of patients treated by fourth and fifth-stage students, (52.54% and 54.24%) of the participants were males in fourth and fifth-stage students respectively. At the same time (47.46% and 45.76%) of the participants were females in fourth and fifth stage students respectively. The age of majority of the participants was more than 30 years old, representing (76.27%), and only (10.17%) were between 25-30 years in fourth stage students, and (8.47%) were between 25-30 years in fifth stage students. Conclusion: The use of a newly developed assessment scale during tooth extraction offered an objective, standardized, and feasible method for the assessment of clinical skills of undergraduate students for both formative and summative purposes. [ABSTRACT FROM AUTHOR]

Lizy Sonia Benjamin,1 Eddieson Pasay-an,2 Petelyne Pangket,3 Aidah Sanad Alqarni,4 Ferdinand Gonzales,4 Lailani Sacgaca,5 Dawlat Ahmed Mahmoud,1 Maysa M Mohsen,4 Yahya Showkan Ali Hamdi,6 Sumathi Robert Shanmugam7 1Department of Medical-Surgical Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 2Department of Nursing Administration, College of Nursing, King Khalid University, Abha, Saudi Arabia; 3Department of Medical Surgical Nursing, University of Hail, Hail City, Saudi Arabia; 4Department of Fundamental of Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 5Department of Nursing, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia; 6Nursing Service, Aseer Central Hospital, Aseer, Saudi Arabia; 7Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi ArabiaCorrespondence: Sumathi Robert Shanmugam, Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia, Email srshanmugm@pnu.edu.saIntroduction: Nursing students frequently encounter the challenge of balancing their studies with the demanding requirements of hands-on practice and this can greatly affect their mental wellbeing. This study aimed to investigate the impact of sleep and psychological well-being on the academic and clinical performance of nursing students in Saudi Arabia.Methods: This study used a cross-sectional approach with 218 student nurses selected through convenience sampling from King Khalid University, Abha, Saudi Arabia. The sleep quality, psychological wellbeing, academic performance and clinical performance questionnaires were adopted to measure the variables. The Google Forms survey was used to gather the data, which were collected in August through October 2023. t-test and chi-square were used to analyze the data.Results: The sleep quality was higher with good/very good performers (p < 0.001). There was a significant difference with academic performance on positive relations (p < 0.007) and purpose in life (p < 0.004). Additionally, there was a significant difference in autonomy (p < 0.01), environmental mastery (p < 0.026), positive relations (p < 0.001), and purpose in life (p < 0.001) with clinical performance. Among students with good academic performance, those who were older than 25 years of age (p < 0.043) and level 3 students (p < 0.001) were found to have a significant correlation. Furthermore, those who were 25 years of age (p < 0.012) and level 3 students (p < 0.001) were also found to have a significant correlation with clinical performance.Conclusion: The sleep quality, positive relations, purpose in life, autonomy, and environmental mastery are all important factors for academic and clinical success. Moreover, older students and level 3 students may be more likely to have the skills and knowledge necessary to succeed in these areas. Further research exploring factors influencing academic and clinical success must be conducted.Keywords: sleep quality, psychological well-being, academic performance, clinical performance, nursing students, Saudi Arabia

Clinical coaching is one educational intervention that researchers have identified to help students achieve their clinical performance goals. However, in northwest Nigerian nursing schools, coaching services are not available. The current study used a quantitative, quasi-experimental design with pre-post-test approach. Four clinical instructors received training on the coaching package before providing coaching to the study group. Data was collected using clinical checklists before coaching and two months later. The coaching was provided to the study group for six weeks. The study compares nursing students' clinical performance before and after coaching. It also established relationship between academic stress and clinical performance.

Objective In recent years, the infant development and assessment programs have received attention by the health system of Iran. In this regard, the training of examiners for performing the Bayley tests has become one of the needs of the health system. This study aims to design and evaluate the validity and reliability of the Bayley-III examiner clinical performance scale. Materials & Methods In this study, participants were Bayley-III test examiners from medical universities in Iran, who were selected using a purposive sampling method. First, in focused group discussion sessions with 10 Bayley-III test experts, the items of instrument were formulated. Then, to evaluate the face validity, the questionnaire was sent to a panel of expert consisting of 8 Bayley-III experts and examiners and they were asked to rate the items from 1 to 5 in terms of importance. The items with an impact score of less than 1.5 were deleted, and other items were revised, if needed. To evaluate content validity, the questionnaire was sent to 10 Bayley-III test experts, and then the content validity ratio (CVR) and content validity index (CVI) were measured. The items with CVR

This article discusses the challenges faced by Contract Research Organizations (CROs) in complying with the European Union's Regulation (EU) 2017/746 on In Vitro Diagnostic Devices (IVDR). CROs play a crucial role in assisting manufacturers of IVDs in navigating the complex regulatory requirements. Compliance with the IVDR requires specialized expertise in areas such as clinical research, data management, and risk assessment. CROs can provide guidance and support to manufacturers in areas such as clinical performance evaluation, access to human specimens for validation, and analytical and clinical performance assessment. CROs that are part of a larger medical laboratory group have access to reference assays and instruments, ensuring high-quality standards. ISO 15189-certified laboratories offer a controlled environment for data quality. CROs can also provide regulatory counseling and utilize innovative digital systems to simplify data collection and analysis. Compliance with the IVDR is crucial for ensuring the safety and efficacy of IVDs in the European market, and CROs are valuable partners in this process. [Extracted from the article]

The rise of computer-aided design and computer-aided manufacturing (CAD/CAM) and 3D printing technologies in orthodontics has revolutionized the development of customized labial and lingual bracket systems with a variety of materials, which offer potential advantages over traditional orthodontic brackets. To highlight the current state of knowledge regarding the mechanical and clinical properties of CAD/CAM and 3D-printed custom bracket systems, we conducted a comprehensive search across the PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases to identify relevant articles published before April 2024. Mechanical (including fracture toughness, hardness, modulus of elasticity, frictional resistance, slot accuracy, torque transmission, and shear bond strength) and clinical (including treatment efficiency and duration, cost, and comfort) properties were compared between traditional and customized orthodontic bracket systems in the current review. Our findings suggest that customized brackets have the potential to increase bracket slot precision, reduce treatment time, and offer cost-efficiency. However, it is worth noting that the advantages and disadvantages of customized bracket systems vary depending on the bracket material and the manufacturing methods, warranting comprehensively controlled investigations in the future.

AbstractIntroductionMethodsResultsConclusionsDoctors need to consistently maintain their clinical performance across a range of different situations by managing the stress response provoked by these situations. Six performance-related adaptive and maladaptive psychological characteristics and psychological skills can distinguish between how athletes manage their stress response and consistently maintain an optimal level of performance across a variety of situations. The aim of the study was to understand how the performance-related psychological characteristics and skills identified in athletes are applied by doctors.An exploratory qualitative study was conducted with semi-structured interviews. A purposive sample of 10 doctors were interviewed and the data were analysed by template analysis.Doctors have similar performance-related psychological characteristics and skills as identified in athletes for managing their stress response to consistently maintain optimal clinical performance. The importance of maladaptive characteristics was also identified, especially in junior doctors.The findings of this pilot study can be used for informing the design of performance-related educational interventions for doctors to manage their stress response for consistently maintaining optimal clinical performance. An important consideration will need to be a focus on specific groups in their career journey and the development of a multi-dimensional, reflective, and problem-solving approach. [ABSTRACT FROM AUTHOR]

Introduction.: The purposes of this study were to (1) explore the relationship of preclinical assessment outcomes and grade point averages (GPAs) with full-time clinical education experience (CEE) performance and (2) determine the predictive value of associated variables to full-time CEE performance. Review of Literature.: In-program academic variables such as performance tests, comprehensive examinations, and GPAs reflect a measure of student performance before clinical education. Limited and conflicting physical therapist education research exists examining the relationship between preclinical in-program academic variables and CEE performance. Subjects.: A retrospective convenience sample of 130 graduated PT student academic records with expected graduation years of 2018, 2019, and 2020. Methods.: Academic records related to performance test outcomes, cumulative program GPAs, utilization of a practical retake appeal policy, and comprehensive examination performance were correlated with CEE performance. A dichotomous ordinal rating scale quantified CEE performance per full-time experience based on the presence of a learning contract. Overall CEE performance was defined as the percentage from the combined CEE performance scores across all experiences. Data analyses included Pearson's correlation coefficient, Spearman's rho, and a multiple linear regression analysis. Results.: Ten of 25 course-specific performance tests had significant associations with CEE performance. Cumulative GPA and the practical retake appeal were significantly associated with the CEE III score and overall CEE performance. The practical retake appeal was a significant contributor to clinical performance, explaining 5.3% of the variance (β = 0.24, P =.01, 95% CI 0.01 to 0.09, part correlation = 0.23, tolerance = 0.91). Discussion and Conclusion.: These findings support the use of performance tests as an effective assessment strategy before CEEs but only represent one aspect of the full picture of readiness to practice. Academic progression policies can offer a mechanism for early identification to support at-risk students before the CEEs. [ABSTRACT FROM AUTHOR]

Background: Noise is a relatively new concept highlighting the variability of cognitive inputs people grapple with when making a judgment. In this case, preceptors make a judgment of students' clinical performance during clinical practicum. There is scant literature examining the impact of noise on nursing student assessment. Purpose: This article explores the noise that influences nursing preceptors' assessment of students in clinical practice. Method: A qualitative descriptive design was used, and interviews were conducted with preceptors from the clinical setting. Results: Three themes were identified, describing the tensions faced by preceptors when assessing students and the noise that impacted those assessments. Conclusion: Both system noise and individual noise impacted the process and outcome of nursing student assessment during clinical practicum. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the clinical performance of dual- and light-cure bulk-fill resin composites (BFRCs) in Class ӀӀ restorations after 2 years. Materials and methods: A double-blinded, prospective, randomized clinical trial (RCT) was conducted following the CONSORT (Consolidated Standard of Reporting Trials) guidelines. Forty patients were enrolled in the study. Each patient received three compound Class ӀӀ restorations. One dual-cure (Fill-Up; Coltene Waledent AG) and two light-cure (QuiXfil; Dentsply, and Tetric N-Ceram Bulk Fill; Ivoclar Vivadent) BFRCs were used for 120 Class ӀӀ restorations. A universal adhesive (ONE COAT 7 UNIVERSAL; Coltene Waledent AG) was used with all restorations. Restorations were clinically evaluated after 1 week (baseline), 6 months, 12 months, 18 months, and finally after 24 months using the FDI World Dental Federation (FDI) criteria. The Kruskal–Wallis test was used for comparison between BFRCs groups at baseline and at each recall period, and the Wilcoxon signed-rank test was used for comparing different follow-up times of each BFRC to baseline. The level of significance was set at p < 0.05. Results: All BFRCs restorations showed only minor changes and revealed no statistically significant differences between their clinical performance for all evaluated parameters at all recall periods; also, there was no statistically significant difference between all recall periods and baseline for all evaluated parameters. Conclusion: The two-year clinical performance of dual-cure BFRC was comparable to light-cure BFRCs in Class ӀӀ restorations. Clinical relevance: Dual- and light-cure BFRCs showed excellent clinical performance in Class ӀӀ restorations after a 2-year clinical follow-up. [ABSTRACT FROM AUTHOR]

Background: An accurate status determination of breast cancer biomarkers (ER, PR, HER2, Ki67) is crucial for guiding patient management. The "gold standard" for assessing these biomarkers in FFPE tissue is IHC, which faces challenges in standardization and exhibits substantial variability. In this study, we compare the concordance of a new commercial RT-qPCR kit with IHC in determining BC biomarker status. Methods: The performance was evaluated using 634 FFPE specimens, which underwent histological analysis in accordance with standard of care methods. HER2 2+ tumors were referred to ISH testing. An immunoreactive score of ≥2/12 was considered positive for ER/PR and 20% staining was used as a cut-off for Ki67 high/low score. RT-qPCR and results calling were performed according to the manufacturer's instructions. Results: High concordance with IHC was seen for all markers (93.2% for ER, 87.1% for PR, 93.9% for HER2, 77.9% for Ki67 and 80.1% for proliferative signature (assessed against Ki67 IHC)). Conclusions: By assessing the concordance with the results obtained through IHC, we sought to demonstrate the reliability and utility of the kit for precise BC subtyping. Our findings suggest that the kit provides a highly precise and accurate quantitative assessment of BC biomarkers. [ABSTRACT FROM AUTHOR]

To synthesize evidence relevant for informed decisions concerning cognitive testing of older physicians. Relevant literature was systematically searched in Medline, EMBASE, PsycInfo, and ERIC, with key findings abstracted and synthesized. Cognitive abilities of physicians may decline in an age range where they are still practicing. Physician competence and clinical performance may also decline with age. Cognitive scores are lower in physicians referred for assessment because of competency or performance concerns. Many physicians do not accurately self-assess and continue to practice despite declining quality of care; however, perceived cognitive decline, although not an accurate indicator of ability, may accelerate physicians' decision to retire. Physicians are reluctant to report colleagues' cognitive problems. Several issues should be considered in implementing cognitive screening. Most cognitive assessment tools lack normative data for physicians. Scientific evidence linking cognitive test results with physician performance is limited. There is no known level of cognitive decline at which a doctor is no longer fit to practice. Finally, relevant domains of cognitive ability vary across medical specialties. Physician cognitive decline may impact clinical performance. If cognitive assessment of older physicians is to be implemented, it should consider challenges of cognitive test result interpretation. [ABSTRACT FROM AUTHOR]