Still Scholarworks (A.T. Still University)
Not a member yet
2228 research outputs found
Sort by
Influences of Athletic Trainers’ Return-to-Activity Assessments for Patients With an Ankle Sprain
No full textContext: Athletic trainers (ATs) inconsistently apply rehabilitation-oriented assessments (ROASTs) when deciding return-to-activity readiness for patients with an ankle sprain. Facilitators and barriers that are most influential to ATs’ assessment selection remain unknown. Objective: To examine facilitators of and barriers to ATs’ selection of outcome assessments when determining return-to-activity readiness for patients with an ankle sprain. Design: Cross-sectional study. Setting: Online survey. Patients or Other Participants: We sent an online survey to 10 000 clinically practicing ATs. The survey was accessed by 676 individuals, of whom 574 submitted responses (85% completion rate), and 541 respondents met the inclusion criteria. Main Outcome Measure(s): The survey was designed to explore facilitators and barriers influencing ATs’ selection of pain; ankle-joint swelling, range of motion, arthrokinematics, and strength; balance; gait; functional capacity; physical activity level; and patient-reported outcome assessments when making return-to-activity decisions for patients after an ankle sprain. The survey asked for reasons that participants chose to use or not use each measure (eg, previous education, personal comfort, most appropriate, available or feasible, perceived value, and other). The survey contained 12 demographic items that characterized the sample of respondents and were examined as potential influences on the facilitators and barriers. Chi-square analysis was used to identify relationships among participant demographics and facilitators of or barriers to assessment selection. Results: Selection of each ROAST and non-ROAST was most commonly facilitated by previous education, availability or feasibility, or perceived value. Avoidance of each ROAST was most often caused by the lack of previous education, availability or feasibility, or perceived value. The presence of facilitators and barriers was affected by various demographic variables. Conclusions: A variety of facilitators and barriers affected ATs’ implementation of expert-recommended assessments when determining return-to-activity readiness in patients with an ankle sprain. Some subpopulations of ATs experienced more favorable or prohibitive conditions for assessment use
Information literacy skills of health professions students in assessing YouTube medical education content
Get PDFIntroduction: YouTube is a popular social media video platform used by health professions students for medical education. YouTube videos vary in quality, and students need to be able to evaluate and select high-quality videos to supplement their learning. Evaluating the quality of YouTube videos is an essential information literacy skill, and the Association of College and Research Libraries updated the framework of information literacy to include collaborative platforms such as YouTube. Research is needed to understand and explore the information literacy proficiency of students in the health professions who are using YouTube videos as learning resources. Methods: This exploratory expert-novice study investigated the information literacy proficiency of students in evaluating the quality of medical education YouTube videos. Students (n = 89) and experts (n = 23) evaluated three preselected medical education YouTube videos of varying quality using the Medical Quality Video Evaluation Tool (MQ-VET). Results: Results of two-way mixed repeated-measures ANOVA found experts assigned significantly lower ratings to low- and medium-quality videos than students. In other words, students were less information proficient in selecting videos due to overrating source credibility, education quality, and production quality, along with having lower expectations and finding videos more useful. Discussion: The tendency of students to overrate lower-quality videos raises concerns about their selection of educational content outside structured learning environments. If students select videos to watch outside the classroom, they could unintentionally learn medical skills from low-quality videos. These insights suggest a need for teachers to select only high-quality videos for students and for more focused curricular strategies to enhance students’ abilities in critically assessing YouTube resources for medical education
Management of open bite in patients with temporomandibular joint degeneration
No full textOpen bite is a multifactorial problem, which is a challenging type of malocclusion for the orthodontist to treat. A careful and detailed diagnosis is important to ensure the correct treatment approach. With the use of temporary skeletal anchorage devices (TSADs), it is now possible in most cases to treat these malocclusions without surgical intervention. Several etiological factors are involved in the development of this malocclusion, including the patient\u27s facial growth pattern, persistent sucking habits, tongue dysfunction, and mouth breathing due to compromised airways. These factors should always be identified early in a patient\u27s life. Treatment strategies have included habit control, tongue crib, and correction of any airway problems, while in the more severe open bite patients, orthognathic surgery was necessary to correct the problem. Now, it can be treated by the intrusion of the posterior teeth using TSADs. This article presents one type of open bite resulting from condylar degeneration. In the past, this problem could have only been corrected with orthognathic surgery. Here, we demonstrate the result of an acquired open bite treated by intruding the posterior teeth with TSADs. In addition, we provide guidelines for selecting those cases that lend themselves to treatment with TSADs and those where combined orthodontic and orthognathic surgical correction is still needed
Critical-size defects reconstruction with four different bone grafts associated with e-PTFE membrane: A histomorphometric experimental in vivo study
Get PDFObjectives: The goal of this study was to assess the newly formed bone and the remnant biomaterial by comparing four different bone grafts used to treat critical-size defects, associated or not with the non-resorbable membrane.
Materials and methods: Two calvaria critical-size bone defects were created in 50 male Wistar rats. They were divided into blood (G1), autogenous (G2), bioglass (G3), hydroxyapatite (G4), and xenograft (G5) groups, associated or not with e-PTFE. The experimental periods were 15 and 45 days. Sections were prepared for histomorphometric assessment. All data were analyzed by the mixed-effects model with multiple comparisons (significance level, p \u3c .05).
Results: A similar level of new bone was observed for all groups, associated with a high level of vascularization. G1 and G2 ensured sovereignty over the greater quantity of new bone. A non-significant result was reported comparing groups with and without membranes. No significant result was found between the experimental synthetic biomaterials (G3 and G4). G5L achieved 22.0% of new bone after 45 days (p \u3e .05). All groups had a stable volume of biomaterial kept in the short term (p \u3e .05). G2 was the best material for new bone formation and final volume of biomaterial, followed by G4 \u3c G5 \u3c G3. Thus, it is possible that G4 had a better degradation profile among the experimental groups.
Conclusions: The best results were found in the autogenous group, with higher resorption and integration; non-significative new bone was found among the experimental groups; and the regeneration of critical bone defects using an e-PTFE barrier did not present significant results on new bone formation
Crown Lengthening Surgery in the Esthetic Area for Optimized Results: A Review with Surgical Recommendations
No full textBackground: Crown lengthening (CL) in esthetic areas has become a versatile procedure with applications in many clinical situations. Knowledge concerning different periodontal phenotypes, and the supracrestal tissue attachment (STA)—former biological width—has allowed for a better understanding of surgical management, allowing for the individualization of surgical therapy. This review presented an individualized surgical approach to CL in esthetic areas based on evaluating the phenotype and current considerations about the STA, correlating them to suggestive surgical techniques. Methods: For an individualized surgical approach, it is primarily necessary to understand STA, including the relationship and distance between the cementoenamel junction (CEJ) and the bone crest (BC) and the position of the free gingival margin (FGM); secondarily, it is necessary to verify the periodontal phenotype to prepare surgical planning (gingivectomy or osseous resection/contouring). Three periodontal phenotypes are recognized, presenting different biological behaviors due to specific characteristics implicitly correlated to soft tissue management. Results: Then, after assessing the distance from the CEJ to the BC, the position of the FGM, and the periodontal phenotype, it is possible to individualize the treatment according to the phenotype. In cases of a thin and scalloped periodontium with delicate gingiva, there might be the presence of bone dehiscence, fenestration, and instability in the healing of the gingival margin, bringing extra attention to tissue manipulation and suggesting a minimally invasive technique (no flap). A partial-thickness flap is recommended for a thick and scalloped periodontium, keeping the periosteum adhered to the bone. For periodontium B (fibrous and dense gingiva and tissue resistant to injuries), the surgical approach recommended is an open full-thickness flap with osteotomy for horizontal and vertical bone volume removal. Then, observing first the specific parameters, such as the STA, CEJ, BC, FGM, and KTW, and then the characteristics of periodontal phenotypes, it is possible to determine the individualized surgical strategy and a reasonable surgical approach to tissue manipulation in clinical CL surgeries. Conclusions: The surgical approach must be defined according to individualized planning since several variables can influence the dynamics of the periodontal tissues
Correlation between Periodontitis and Gastritis Induced by Helicobacter pylori: A Comprehensive Review
No full textThe goal of this comprehensive review was to verify if the prevalence of Helicobacter pylori (Hp) bacteria in patients with dyspepsia is higher in the oral cavity of periodontal or non-periodontal patients. The bibliographic search was conducted on scientific studies published in PubMed, Cochrane Library, SciELO, and BVS. The focus question was: “In patients with dyspepsia and periodontitis, is the prevalence of Hp bacteria in the oral cavity higher than in patients with only dyspepsia or without any disease?” The inclusion criteria were human studies in English, Portuguese, or Spanish languages, published between 2000 and 2022, that included patients over the age of 18 and aimed to evaluate the presence of Hp bacteria in the oral cavity and in the protective mucosal layer of the gastric lining of patients with the diseases (periodontitis and dyspepsia) or without disease; clinical trials, randomized controlled clinical trials, comparative studies, case-control studies, cross-sectional studies, and cohort studies. The methodological quality evaluation of the included articles was performed using the Joanna Briggs Institute tools. The final scores could be of “Low” quality (at least two “no” [red] or ≥ five “unclear” found), “Moderate” quality (one “no” [red] was found or up to four “unclear” criteria were met), or “High” quality (all green [yes] or at maximum two “unclear”). Of 155 potentially eligible articles, 10 were included in this comprehensive review after the application of the eligibility criteria. The selected studies were scrutinized regarding the relationship between Hp colonization in the oral cavity and stomach, its impact on severity and complications of gastric infection, as well as the effect of the presence of oral and gastric Hp on dental and systemic parameters. Hp can colonize periodontal pockets regardless of its presence in the stomach. There was a higher prevalence of oral biofilm in dyspeptic patients with periodontal disease, and worse control of bleeding and low oral hygiene was observed in periodontal compared to non-periodontal patients. For que quality assessment, the scientific studies included presented low to moderate methodological quality. Conclusions: It is possible to conclude that Hp is a bacterium that can colonize dental plaque independently of the stomach and vice versa; however, when both diseases are found, its presence may be more significant. Supra and subgingival dental plaque may be a reservoir of Hp, suggesting that patients with gastric infections are more likely to have Hp in the oral cavity. The results must be carefully analyzed due to the limitations present in this review
Implant Stability and Histomorphometric Analysis Comparing Two Different Implant Macrogeometries Placed in Fresh Sockets: An Experimental Study in Sheep
No full textPurpose: To examine the impact of two implant designs that promote different insertion torque values on implant stability and to histomorphometrically evaluate the bone healing after immediate implant placement in fresh sockets in a sheep model. Materials and Methods: Twelve female sheep (mean weight: 35.0 ± 5.0 kg) were included in the study. Additionally, 48 conical Morse taper dental implants were included, comprising two groups (n = 24 per group): Group 1, where the implant design can provide high insertion torque values; and Group 2, where the implant design can provide low insertion torque values. Both had the same surface treatment and dimensions (4.0 × 10 mm). The mandibular first and second molars on both sides were extracted carefully. Sequentially, osteotomies were made in the mesial socket of each molar tooth. The final implant position was 2 mm below the buccal bone crest level. On the right side, a Group 1 implant was placed anteriorly, with a Group 2 implant in the posterior position; on the left side, the Group 2 implant was anterior and the Group 1 implant was posterior. A digital torque meter was used to measure the maximum final insertion torque value (f-IT). The initial implant stability quotient (ISQ) was measured immediately after implant insertion (T0) and immediately after the euthanasia and removing the mandibles. The animals were euthanized (n = 6 animals/time) at 21 days (T1) and 35 days (T2). To compare statistical differences for each analyzed intragroup parameter, t-test was used. Pearson’s correlation was used to analyze possible correlations: f-IT and percentage of bone-to-implant contact (%BIC), f-IT and ISQ, and ISQ and %BIC. Results: Group 1 presented higher insertion torque values than Group 2, with a statistically significant difference (P \u3c.0001). The ISQ mean values were higher in the buccolingual direction than those obtained in the mesiodistal direction for both groups. Higher %BIC measurements were seen in Group 2 than Group 1 samples at both times and in both directions. There were statistical differences between groups for new bone, medullary spaces, and collagen matrix at each evaluation time. Conclusions: Using implants with a modified macrogeometry plays a significant role in implant stability and bone tissue healing around the implant. It is important for clinicians to carefully consider implant macrogeometry when planning implant surgery to achieve optimal implant stability and successful osseointegration, mainly in cases of immediate implant placement. Int J Oral Maxillofac Implants 2024;39:857–866. doi: 10.11607/jomi.1082
Conditional Knockouts of Interphotoreceptor Retinoid Binding Protein Suggest Two Independent Mechanisms for Retinal Degeneration and Myopia
No full textAbstract
Purpose: Interphotoreceptor retinoid-binding protein\u27s (IRBP) role in eye growth and its involvement in cell homeostasis remain poorly understood. One hypothesis proposes early conditional deletion of the IRBP gene could lead to a myopic response with retinal degeneration, whereas late conditional deletion (after eye size is determined) could cause retinal degeneration without myopia. Here, we sought to understand if prior myopia was required for subsequent retinal degeneration in the absence of IRBP. This study investigates if any cell type or developmental stage is more important in myopia or retinal degeneration.
Methods: IBRPfl/fl mice were bred with 5 Cre-driver lines: HRGP-Cre, Chx10-Cre, Rho-iCre75, HRGP-Cre Rho-iCre75, and Rx-Cre. Mice were analyzed for IRBP gene expression through digital droplet PCR (ddPCR). Young adult (P30) mice were tested for retinal degeneration and morphology using spectral-domain optical coherence tomography (SD-OCT) and hematoxylin and eosin (H&E) staining. Function was analyzed using electroretinograms (ERGs). Eye sizes and axial lengths were compared through external eye measurements and whole eye biometry.
Results: Across all outcome measures, when bred to IRBPfl/fl, HRGP-Cre and Chx10-Cre lines showed no differences from IRBPfl/fl alone. With the Rho-iCre75 line, small but significant reductions were seen in retinal thickness with SD-OCT imaging and postmortem H&E staining without increased axial length. Both the HRGP-Cre+Rho-iCre75 and the Rx-Cre lines showed significant decreases in retinal thickness and outer nuclear layer cell counts. Using external eye measurements and SD-OCT imaging, both lines showed an increase in eye size. Finally, function in both lines was roughly halved across scotopic, photopic, and flicker ERGs.
Conclusions: Our studies support hypotheses that for both eye size determination and retinal homeostasis, there are two critical timing windows when IRBP must be expressed in rods or cones to prevent myopia (P7-P12) and degeneration (P21 and later). The rod-specific IRBP knockout (Rho-iCre75) showed significant retinal functional losses without myopia, indicating that the two phenotypes are independent. IRBP is needed for early development of photoreceptors and eye size, whereas Rho-iCre75 IRBPfl/fl knockout results in retinal degeneration without myopia
The Crocodylian proatlas functions to redistribute venous blood and cerebrospinal fluid
No full textAbstract
The proatlas, a bone located between the skull and the neural spines of the cervical vertebrae, is best known from reptiles. Most previous studies of the proatlas have centered on its developmental, debating the relationship between the proatlas and the cervical neural arches. The present study was intended as a description of the proatlas in the American alligator (Alligator mississippiensis) and an experimental test of its hypothesized role in venous blood and cerebrospinal fluid (CSF) distribution. In Alligator, the proatlas is chevron-shaped; ventrally it has a loose connection to the dorsal surface of the first cervical vertebrae, dorsally it has a robust elastic tissue tether on the otoccipital and supraoccipital bones. The ventral surface of the proatlas parallels the dorsal margin of the foramen magnum and rests on the dorsal surface of the spinal venous sinus. Experimental manipulation of the proatlas demonstrated that displacement of the proatlas causes pressure changes in both the spinal venous sinus and the enclosed spinal CSF. The results of this study represent the first demonstration of an explicit functional role for the proatlas, the circulation of fluids between the cranial and spinal compartments of the central nervous system
Effect of a new support design on the marginal and internal gap of additively manufactured interim crowns using direct light deposition technology
No full textAbstract
Purpose: To investigate the design and location of supporting structures on the marginal and internal gap of interim restorations.
Materials and methods: A mandibular right first molar resin tooth was prepared for a full coverage crown and scanned using a laboratory scanner (3Shape D900). The scanned data were converted into standard tessellation language (STL) format and an indirect prosthesis was designed using computer-aided design (CAD) software (exocad DentalCAD). The STL file was used to fabricate a total of 60 crowns with a 3D printer (EnvisionTEC Vida HD). The crowns were printed using E-Dent C&B MH resin and divided into 4 groups based on four different support structure designs, including supports on the occlusal (0° group), buccal and occlusal (45° group), buccal (90° group), and a new design consisting of horizontal bars placed on all surfaces and line angles (Bar) (n = 15). The silicone replica technique was used to determine the gap discrepancy. Fifty measurements were obtained for each specimen to examine the marginal and internal gaps by using a digital microscope (Olympus SZX16) at ×70 magnification. Additionally, the marginal discrepancy at different locations of the tested crowns, including buccal (B), lingual (L), mesial (M), and distal (D), as well as the maximum and minimum marginal gap intervals among groups, were analyzed. The collected data were analyzed using factorial ANOVA, followed by the Tukey HSD test for multiple comparisons (a = 0.05).
Results: There was a significant difference in marginal and internal gaps among the groups (p \u3c 0.001). The buccal placement supports (90° group) had the least marginal and internal discrepancies (p \u3c 0.001). The new design group showed the highest marginal and internal gap. The marginal discrepancy in different locations of the tested crowns (B, L, M, D) was found to be significantly different among the groups (p \u3c 0.001). The mesial margin of the Bar group had the largest marginal gap, whereas the buccal margin of the 90° group had the lowest marginal gap. The new design had a significantly smaller difference between the maximum and minimum marginal gap intervals than other groups (p \u3c 0.001).
Conclusion: The location and design of the supporting structures affected the marginal and internal gaps of an interim crown. The buccal placement of supporting bars (90° printing orientation) showed the smallest mean internal and marginal discrepancies