Building a workforce of diverse women leaders: Understanding intersectional identities.

BACKGROUND: Women have made significant advancements in the dentist workforce, growing from 20% of dentists in 2005 to 34.5% in 2020. Women have also made inroads in academic dentistry. While much scholarship has documented a growing feminization in dentistry and efforts to promote gender equity in the profession, there has been less exploration of the intersectional identities of these women. This manuscript explores how academic dentistry can support diverse women's leadership focusing on intersectional identities. METHODS: Applying the theoretical framework of intersectionality, we assess publicly available data to explore the percentages of faculty and deans who are women of color. Drawing upon best practices in higher education and our personal experiences, we explore opportunities to increase participation and support the advancement of women of color in academia. RESULTS: In the academic year 2018-2019, of the 5066 full-time faculty members, 40.5% were women. Minoritized women comprised 13.4% of full-time faculty members, compared to White women who were 20.6% of full-time faculty. Minoritized women comprised 7.3% of dental school deans, compared to White women who were 17.6% of deans. CONCLUSION: Intersectionality allows for a deeper examination of women in academic dentistry. Women of color are often erased in discussions about women in academic dentistry, even as the profession celebrates the progress made by women. Embracing the intersectional identities of women and by extension, people who identify as gender non-confirming may help dental schools to become humanistic environments where faculty and leadership represent the growing diversity in the profession and in the world.

Environmental Markers of Plastics and Microplastics.

The slow reaction rates to chemical and photochemical degradation are well-known properties of plastics. However, large plastic surfaces exposed to environmental conditions release particles and compounds that affect ecosystems and human health. The aim of this work was to identify compounds associated with the degradation of polyethylene (PE), polystyrene (PS), and polyvinyl chloride (PVC) microplastics (markers) on silica and sand and evaluate their use to screen microplastics on natural sand. Products were identified by using targeted and untargeted LC-HRMS analysis. All polymers underwent chemical oxidation on silica. PE released dicarboxylic acids (HO2C-(CH2)n-CO2H (n = 4-30), while PS released cis/trans-chalcone, trans-dypnone, 3-phenylpropiophenone, and dibenzoylmethane. PVC released dicarboxylic acids and aromatic compounds. Upon irradiation, PE was stable while PS released the same compounds as under chemical oxidation but at lower yields. Under the above condition, PVC generated HO2C-[CH2-CHCl]n-CH2-CO2H and HO2C-[CH2-CHCl]n-CO2H (n = 2-19) dicarboxylic acids. The same products were detected on sand but at a lower concentration than on silica due to better retention within the pores. Detection of markers of PE and PS on natural sand allowed us to screen microplastics by following a targeted analysis. Markers of PVC were not detected before or after thermal/photo-oxidation due to the low release of compounds and limitations associated with surface exposure/penetration of radiation.

Recruitment strategies and retention rates for five National Dental PBRN studies.

Background: We describe a retrospective assessment of practitioner and patient recruitment strategies, patient retention strategies, and rates for five clinical studies conducted in the National Dental Practice-Based Research Network between 2012 and 2019, and practitioner and patient characteristics associated with retention. Methods: Similar recruitment strategies were adopted in the studies. The characteristics of the practitioners and patients are described. The proportion of patients who either attended a follow-up (FU) assessment or completed an online assessment was calculated. For studies with multiple FU visits or questionnaire assessments, rates for completing each FU were calculated, as were the rates for completing any and for completing all FU assessments. The associations of practitioner and patient characteristics with all clinic FU visits, and with the completion of all assessments for a study were ascertained. Results: Overall, 591 practitioners and 12,159 patients were included. FU rates by patients for any assessment varied from 91% to 96.5%, and rates for participating in all assessments ranged from 68% to 87%. The mean total number of patients each practitioner recruited was 21 (sd = 15); the mean number per study was 13 (sd = 7). For practitioners, practice type and patient enrollment were associated with greater clinic retention, while only race was associated with their patients completing post-visit online assessments. For patients, age was associated with clinic retention, while female gender, age, race, and education were all associated with greater completion of post-visit online assessments. Conclusion: The Network efficiently recruited practitioners and patients and achieved high patient retention rates for the five studies.

Development of a performance-based toolkit of the treatable traits of functioning in hospitalised patients with exacerbation of COPD: a survey-based study protocol.

Background: The management of COPD has been based on the premise of identifying problems that guide personalised treatment based on a multidimensional assessment, known as treatable traits. Exacerbation of COPD (ECOPD) results in physical and functional impairments, limitation of daily activities and negative impact on patients' quality of life and prognosis. In this context, identifying treatable traits in patients with ECOPD is essential to properly guide individualised patient care. There is a need to develop a performance-based toolkit to identify the main treatable traits of functioning in hospitalised patients with ECOPD. Methods and analysis: This is a study protocol of a survey method observational study to develop a performance-based toolkit. The study will include the following steps: 1) definition of treatable traits by both physiotherapists who provide or have provided care to hospitalised patients with ECOPD on a regular basis, and patients who have experienced at least one ECOPD which required hospitalisation; 2) selection of the most appropriate measures (markers) for each treatable trait based on established criteria and a previous systematic review; and 3) implementation of the toolkit in a pilot/feasibility study with hospitalised patients with ECOPD. Conclusion: The development of a feasible performance-based toolkit with the best markers for each key treatable trait of functioning in hospitalised patients with ECOPD will make it possible to create individualised patient care for the specific demands of these patients.

ERS International Congress 2023: highlights from the Allied Respiratory Professionals Assembly.

This article summarises some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2023 European Respiratory Society International Congress. Two sessions from each Assembly group are outlined, covering the following topics: Group 9.01 focuses on respiratory physiology techniques, specifically on predicted values and reference equations, device development and novel applications of cardiopulmonary exercise tests; Group 9.02 presents an overview of the talks given at the mini-symposium on exercise training, physical activity and self-management at home and outlines some of the best abstracts in respiratory physiotherapy; Group 9.03 highlights the nursing role in global respiratory health and presents nursing interventions and outcomes; and Group 9.04 provides an overview of the best abstracts and recent advances in behavioural science and health psychology. This Highlights article provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.

Comparison of Cytokine RANTES/CCL5 Inflammation in Apical Periodontitis and in Jawbone Cavitations - Retrospective Clinical Study.

Background: Apical periodontitis (AP) is one of the most common endodontic diseases associated with osteo destructive cytokine production. The literature also reports cytokine studies in fatty degenerative osteonecrotic bone marrow defects (BMDJ/FDOJ) independent of AP. Objective: We compare the RANTES/CCL5 (R/C) chemokine production between AP and BMDJ/FDOJ. For both pathologies, the R/C expression was also compared to radiographic diagnosis in 2D-OPG, 3D-CBCT/DVT. Material and Methods: Postoperative samples were collected and divided in three different groups: HB (healthy jawbone) (n=19), APs (n=19), and BMDJ/FDOJ (n=7). The R/C expression was evaluated using multiplex analysis. In addition, two clinical cases from AP and BMDJ/FDOJ groups were randomly selected and radiographic diagnosis in 2D-OPG and 3D-CBCT/DVT was compared to TAU measurements and R/C expression in AP and in BMDJ/FDOJ. Results: BMDJ/FDOJ showed the highest R/C expression (2498.71 pg/mL), followed by AP (841.85 pg/mL) and HB (149.85 pg/mL) (AP vs BMDJ/FDOJ = p=0.01; AP vs HB = p=<0.01; BMDJ/FDOJ vs HB = p=<0.01). In both clinical cases, the radiographic findings depict the AP areas in OPG and CBCT/DVT, in contrast to the BMDJ/FDOJ areas. Conversely, the systemic immunological R/C expressions are threefold and fivefold excessive in both cases. Discussion: AP is recognized as a pathology requiring treatment, while the pathogenesis of BMDJ/FDOJ is controversially discussed in the literature, despite stronger potential systemic immunological effects (breast cancer (case 1) and multiple sclerosis (case 2)). The inadequate radiographic representation of reduced bone density in BMDJ/FDOJ areas could be a reason for this contradiction. Conclusion: The data presented provide the first quantitative analysis of R/C expression in AP and BMDJ/FDOJ. BMDJ/FDOJ showed high R/C expression than AP, besides the diagnostic through radiographs being extremely poor. To cover this imprecision, a radiation-free TAU device is available.

Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial.

BACKGROUND: Preoperative exercise training is recommended for improvement of clinical outcomes after lung cancer (LC) surgery. However, its effectiveness in preventing postoperative decline in quality of life (QoL) remains unknown. This study investigated the effect of preoperative home-based exercise training (PHET) on QoL after LC surgery. METHODS: Patients awaiting LC resection were randomized to PHET or a control group (CG). The PHET program combined aerobic and resistance exercise, with weekly telephone supervision. Primary outcome was QoL-assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) at baseline, before surgery, and 1 month after surgery. The secondary outcomes were hospital length of stay and physical performance. The main analysis included a factorial repeated-measures analysis of variance. Additionally, the proportion of patients experiencing clinical deterioration from baseline to post-surgery was assessed. RESULTS: The study included 41 patients (68.1 ± 9.3 years; 68.3% male) in the intention-to-treat analysis (20 PHET patients, 21 CG patients). A significant group × time interaction was observed for global QoL (p = 0.004). Between-group differences in global QoL were statistically and clinically significant before surgery (mean difference [MD], 13.5 points; 95% confidence interval [CI], 2.4-24.6; p = 0.019) and after surgery (MD, 12.4 points; 95% CI, 1.3-23.4; p = 0.029), favoring PHET. Clinical deterioration of global QoL was reported by 71.4% of the CG patients compared with 30 % of the PHET patients (p = 0.003). Between-group differences in favor of PHET were found in pain and appetite loss as well as in physical, emotional and role functions after surgery (p < 0.05). Compared with CG, PHET was superior in improving preoperative five-times sit-to-stand and postoperative exercise capacity (p < 0.05). No between-group differences in other secondary outcomes were observed. CONCLUSION: The study showed that PHET can effectively prevent the decline in QoL after LC surgery.

Sleep and Breathing Conference highlights 2023: a summary by ERS Assembly 4.

This paper presents some of the highlights of the Sleep and Breathing Conference 2023 https://bit.ly/46MxJml.

Lung Science Conference highlights 2023: Post-viral lung diseases - from basic immunology to clinical phenotypes and therapy.

This article provides an overview of some of the highlights of the Lung Science Conference 2023 https://bit.ly/46oWCEX.

[Sperm donation in Switzerland]. / Don de sperme en Suisse.

The acceptance of "marriage for all" in Switzerland has enabled married couples to have access to medically assisted reproduction (MAR) through sperm donation from July 2022. We present the Swiss legal context of sperm donation, the different techniques, the selection of donors and the method of attribution to recipient couples. This article also describes the complexities of managing a sperm bank in Switzerland, presents some of the figures associated and address the fundamental question of access to origins and the secrecy that may be linked to sperm donation.

L'acceptation du « mariage pour tous ¼ en Suisse a permis aux couples de femmes mariées d'avoir accès à la procréation médicalement assistée (PMA) par don de sperme dès juillet 2022. Nous présentons le contexte légal de la pratique du don de sperme en Suisse, les différentes techniques, la sélection des donneurs et le mode d'attribution aux couples receveurs. Cet article décrit également la complexité de la gestion d'une banque de sperme en Suisse, présente quelques chiffres liés à cette activité et aborde également la question fondamentale de l'accès aux origines et du secret qui peut être lié au don de sperme.

Fluorescence of Esthetic Resin Composites: Spectrophotometry and Photography Analysis Techniques.

OBJECTIVES: The aim of this study was to evaluate the fluorescence of nine esthetic resin composite materials using two methods: spectrophotometry and photography analysis. MATERIALS AND METHODS: Three specimens were made for each shade of resin composite (61 shades from 9 resin composites), for a total of 183 specimens. To obtain a control group, the crowns of three sound human incisors were prepared to obtain both enamel and dentin specimens. Fluorescence was measured using two methods: (1) a Spectroshade Micro fluorescence spectrophotometer (MHT Optic Research, Niederhasli, Switzerland) and (2) a photograph analysis using Adobe Photoshop CC software (version 2019.0.0, Adobe Systems, Inc.). STATISTICAL ANALYSIS: The results were statistically analyzed with an analysis of variance (α = 0.05) and with the Tukey-Kramer adjustment. The correlation between two techniques was analyzed by Pearson correlation test (α = 0.05). RESULTS: Fluorescence was highly influenced by the brand of the resin composite and less influenced by the shade (chroma), except for opaquer and incisal shades, and there was almost no difference in opacity, except for incisal shades. There was a weak (r = -0.105) and statistically not significant correlation (p = 0.145) between photography analysis and spectrophotometry techniques. CONCLUSION: The fluorescence of esthetic resin composites is more dependent on the brand than on the shade or opacity.

What to expect of the first ERS/ECFS Adult Cystic Fibrosis Conference.

This article provides a brief overview of the Adult Cystic Fibrosis Conference (#ACFMilan2023) programme, which will be held on 1-2 December 2023, in Milan (Italy) and online. https://bit.ly/3sKpN6p.

From Policies to Practices: Factors Related to the Use of Inclusive Practices in Portugal.

Inclusion is considered a foundation for quality education, and teachers' inclusive practices are essential for success in mainstream classrooms. Portugal has been making progressive improvements in its policies for inclusive education, although there is little consistency in school practices within or between schools. Moreover, data identifying the personal and career variables relevant to teachers' inclusive practices in Portugal are scarce. Therefore, the purpose of this study was to determine the relationship between teachers' inclusive practices and personal and career-based characteristics, including gender, level of teaching, years of experience, roles performed at school, and perception of inclusive resources. The participants were 924 teachers who worked in private and public schools in Portugal. Regression analysis showed that perceived inclusive resources, level of teaching, and gender predicted variance in inclusive practices. Mean difference analyses revealed that teachers at the lower levels of teaching, females, and teachers reporting more inclusive resources had the highest scores for inclusive practices. These findings are discussed in terms of their practical relevance for inclusive school systems.

Cultural adaptation and validation of the Brazilian Portuguese version of the PROactive Physical Activity in COPD-clinical visit instrument for individuals with COPD.

OBJECTIVE: To adapt the PROactive Physical Activity in COPD-clinical visit (C-PPAC) instrument to the cultural setting in Brazil and to determine the criterion validity, test-retest reliability agreement, and internal consistency of this version. METHODS: A protocol for cultural adaptation and validation was provided by the authors of the original instrument and, together with another guideline, was applied in a Portuguese-language version developed by a partner research group from Portugal. The adapted Brazilian Portuguese version was then cross-sectionally administered twice within a seven-day interval to 30 individuals with COPD (57% were men; mean age was 69 ± 6 years; and mean FEV1 was 53 ± 18% of predicted) to evaluate internal consistency and test-retest reliability. Participants also completed the International Physical Activity Questionnaire (IPAQ), the modified Medical Research Council scale, the COPD Assessment Test, and Saint George's Respiratory Questionnaire to evaluate criterion validity. RESULTS: The C-PPAC instrument showed good internal consistency and excellent test-retest reliability: "amount" domain = 0.87 (95% CI, 0.73-0.94) and "difficulty" domain = 0.90 (95% CI, 0.76-0.96). Bland & Altman plots, together with high Lin's concordance correlation coefficients, reinforced that agreement. Criterion validity showed moderate-to-strong correlations of the C-PPAC with all of the other instruments evaluated, especially with the IPAQ (rho = -0.63). CONCLUSIONS: The Brazilian Portuguese version of the C-PPAC is a reliable and valid instrument for evaluating the experience of Brazilian individuals with COPD with their physical activity in daily life.

Characteristics of dentists in the National Dental Practice-Based Research Network.

OBJECTIVES: Our aims are to describe the characteristics of dentists, members of the US National Dental practice-based research network (PBRN) in the United States, and determine how often these dentists provide specific dental procedures. METHODS: Dentists completed a questionnaire when they enrolled in the Network about their demographic and training characteristics and characteristics of their practices and patients. Dentists also reported the frequency of providing specific dental procedures. Data were analyzed using descriptive statistics. RESULTS: Of 4,483 dentists in active clinical practice, 34% identified as females, 70% as white, and 73% as general dentists. Most dentists practiced in large metropolitan areas (87%) and in solo or small practices (72%). On average, they reported about one-half of their patients were children or older adults, a third were from historically underrepresented racial and ethnic groups, and one-quarter were covered by public insurance. Most dentists routinely performed restorations and fixed prosthetics (78%), extractions (59%), removable (44%) and implant (40%) prosthetics, and endodontics on incisor and premolar teeth (44%). CONCLUSIONS: Dentists participating in the National Dental PBRN have much in common with dentists at large. The network has a broad representation of dentists, practice types, patient populations, and treatments offered, including diversity regarding race/ethnicity, gender, insurance, and geography of its practitioners and patients. CLINICAL SIGNIFICANCE: Characteristics of National Dental PBRN dentists suggest that a broad range of dentists is interested in participating in national-level research studies, thereby enabling an array of clinical study settings and topics that can optimize the generalizability of study findings.

Feedback on audit and action planning for dental caries control: a qualitative study to investigate the acceptability among interdisciplinary pediatric dental care teams.

Introduction: American Indian and Alaska Native children suffer from the poorest oral health of all populational groups in the United States. Evidence-based practices (EBP) for caries control are well established, but systematically implementing such practices have proven difficult. Audit and feedback with goal setting, and action planning to implement these EBPs have not been tested or adapted for Alaska Native healthcare settings. The aim of this study was to investigate acceptability and perceived feasibility of an audit and feedback intervention for pediatric dental caries control among dental providers and patient stakeholders. Methods: The pilot program was implemented in two dental clinics from a tribal healthcare consortium in Alaska. Key-informant interviews were conducted to investigate the contextual, organizational, and behavioral facilitators and barriers to the implementation and expansion of the program. Interview transcripts were analyzed by two researchers using thematic analysis. Results: Eight key informants were interviewed twice (during and after the intervention period), and one once, for a total of 17 interviews. Patient stakeholders were not interviewed due to COVID-19 pandemic clinic closures and social isolation mandates. Three principal themes emerged: a positive organizational climate and culture fostered the acceptability of the program, the positive impacts of the program observed in the pediatric dental teams and the organization, and the challenges to implement the program including understanding the data reports, trusting the accuracy of the data, and competing priorities. Conclusions: The intervention of audit and feedback with goal setting and action planning was well accepted and perceived as feasible by the study participants given the financial and human resources provided by the research project. This qualitative study can inform the design and evaluation of process-oriented implementation strategies geared towards decreasing health inequities and improving health outcomes, such as dental caries in American Indian and Alaska Native children and adolescents.

Performance-based outcome measures to assess functionality in hospitalised patients with COPD exacerbations: a systematic review of the measurement properties.

INTRODUCTION: Hospitalised patients with exacerbations of COPD (ECOPD) may have physical and functional impairments that impact morbidity and readmission. Therefore, it is crucial to properly identify reduced functionality in these patients to support a personalised rehabilitation. The objective of this study is to summarise and compare the measurement properties of functionality performance-based outcome measures for hospitalised patients with ECOPD. METHODS: A systematic review based on the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) was performed. The PubMed, Embase, PEDro and Cochrane databases were searched using terms related to functionality, hospitalised patients with ECOPD and measurement properties. Studies were selected and extracted by two researchers. The COSMIN Risk of Bias checklist was applied to assess the methodological quality of the studies and measurement property results were compared with the criteria for good measurement properties. Quality of evidence was graded using a modified Grades of Recommendation, Assessment, Development and Evaluation approach. RESULTS: 13 studies were included with nine outcome measures, namely the 6-min pegboard ring test, the de Morton mobility index, the incremental shuttle walk test (ISWT), the 6-min walk test (6MWT), maximum inspiratory pressure (MIP), the Berg balance scale, 4-m gait speed, handgrip strength and the 6-min stepper test. Construct validity was rated as sufficient, except for the ISWT. Responsiveness, assessed only for MIP, was considered insufficient and measurement errors for the ISWT and 6MWT were insufficient, with a very low quality of evidence for all measurement properties. CONCLUSION: Measurement properties of performance-based outcome measures to assess functionality in patients hospitalised with ECOPD are still scarce, with very low evidence supporting validity and a lack of evidence of responsiveness and reliability. Further studies are needed to address this topic and guide assertive and personalised management.