Factors contributing to student satisfaction with dental loupes and headlights.

PURPOSE: Surgical loupes and headlights are becoming standard equipment for dental professionals and students. Students often purchase these relatively expensive instruments with limited knowledge of which features will affect their satisfaction with use. The purpose of this study was to measure levels of satisfaction with loupes and headlights amongst dental and dental hygiene students after 1, 2 and 3 years of use, and use those findings to guide first-year students in making better purchasing decisions. METHODS: An electronic survey was sent to all second, third and fourth year dental students as well as second-year dental hygiene students at the University of Nebraska Medical Center (UNMC) in October 2018. The survey asked students to respond to multiple questions with a 5-level Likert scale measurement of satisfaction and provide open-ended responses to questions about their loupes and headlights. RESULTS: Ninety-three percent of eligible students responded. Overall, 68% of students were very satisfied with their loupes and 56% were very satisfied with their headlights. Sixty-seven percent of dental students chose 3.5× magnification or higher and 96% of dental hygiene students chose 2.5×. CONCLUSIONS: Of all characteristics evaluated for loupes, customer service and sales representatives received the lowest satisfaction ratings. For headlights, battery-related factors (battery life in hours, rate of recharging, size or weight and on/off controls) received the lowest satisfaction scores. Information collected and reported in this way can help future students make better decisions when selecting products, vendors and features that will best meet their needs.

A randomized trial of loading vancomycin in the emergency department.

BACKGROUND: Optimizing vancomycin dosing may help eradicate bacteria while avoiding resistance. The guidelines recommend loading doses; however, there are no data to demonstrate that this may result in a more rapid achievement of therapeutic troughs. OBJECTIVE: To evaluate the percentage of troughs reaching therapeutic levels at 12, 24, and 36 hours following an initial vancomycin dose of 30 mg/kg compared with 15 mg/kg. METHODS: This prospective, randomized study was performed in a community academic medical center. Patients who were to receive vancomycin in the emergency department were randomized to an initial traditional dose of 15 mg/kg or a 30-mg/kg loading dose followed by 15 mg/kg every 12 hours for 3 doses. Patients weighing >120 kg or with creatinine clearances <50 mL/min were excluded. RESULTS: In total, 99 patients were enrolled; 12 hours after the initial dose of vancomycin, there was a significantly greater proportion of patients reaching target trough levels of 15 mg/L among the patients who received a loading dose as compared with a traditional dose (34% vs 3%, P < 0.01). This trend continued at 24 hours but was not statistically significant. At 36 hours, there was no difference in the percentage of patients reaching target levels between the 2 groups. No statistically significant difference in nephrotoxicity or adverse events among the 2 groups was demonstrated. CONCLUSION: A loading dose of 30 mg/kg of vancomycin achieved a higher percentage of therapeutic levels at 12 hours when compared with the traditional dose of 15 mg/kg, without increased nephrotoxicity or adverse events.

Evaluation of an early step-down strategy from intravenous anidulafungin to oral azole therapy for the treatment of candidemia and other forms of invasive candidiasis: results from an open-label trial.

BACKGROUND: Hospitalized patients are at increased risk for candidemia and invasive candidiasis (C/IC). Improved therapeutic regimens with enhanced clinical and pharmacoeconomic outcomes utilizing existing antifungal agents are still needed. METHODS: An open-label, non-comparative study evaluated an intravenous (i.v.) to oral step-down strategy. Patients with C/IC were treated with i.v. anidulafungin and after 5 days of i.v. therapy had the option to step-down to oral azole therapy (fluconazole or voriconazole) if they met prespecified criteria. The primary endpoint was the global response rate (clinical + microbiological) at end of treatment (EOT) in the modified intent-to-treat (MITT) population (at least one dose of anidulafungin plus positive Candida within 96 hours of study entry). Secondary endpoints included efficacy at other time points and in predefined patient subpopulations. Patients who stepped down early (≤ 7 days' anidulafungin) were identified as the "early switch" subpopulation. RESULTS: In total, 282 patients were enrolled, of whom 250 were included in the MITT population. The MITT global response rate at EOT was 83.7% (95% confidence interval, 78.7-88.8). Global response rates at all time points were generally similar in the early switch subpopulation compared with the MITT population. Global response rates were also similar across multiple Candida species, including C. albicans, C. glabrata, and C. parapsilosis. The most common treatment-related adverse events were nausea and vomiting (four patients each). CONCLUSIONS: A short course of i.v. anidulafungin, followed by early step-down to oral azole therapy, is an effective and well-tolerated approach for the treatment of C/IC. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00496197.

Rhinocerebral Mucor circinelloides infection in immunocompromised patient following yogurt ingestion.

The purpose of this case report is to illustrate the cause of this patient's headache and sinus pain in the setting of a unique environmental exposure: the patient ingested yogurt only days before presentation. This particular brand of yogurt caused controversy in early September 2013 when the manufacturer voluntarily recalled all flavors. The yogurt was found to be contaminated with Mucor circinelloides. The recall was triggered by the FDA, after receiving many complaints from consumers affected by temporary gastrointestinal symptoms such as abdominal cramping, diarrhea, and nausea. This patient was diagnosed with Rhinocerebral mucormycosis through fungal culture of the affected area. He was specifically colonized with Mucor circinelloides, a variant that rarely causes disease in humans. According to a literature review, only eight cases of mucormycosis in adults caused by this strain were documented before 2009.

Maintaining a strong rural dental workforce.

AIMS: This study was designed to examine demographics of University of Nebraska Medical Center College of Dentistry graduates over a recent 10-year period and factors related to their choice of rural or urban practice. Findings were compared to similar previous studies to analyze trends. METHODS: Using data from the annual Health Professions Tracking Service 2019 Dentistry Profile survey, we examined the demographic information of 169 graduates from 2009 to 2018 practicing in Nebraska at the end of 2018. We analyzed factors such as rural or urban high school graduation, gender, and other background information to explore associations with their 2018 practice location (urban vs. rural) using chi-square tests and logistic regression. RESULTS: This study found that some demographic variables were associated with future practice location. Specifically, a higher proportion of graduates of rural high schools chose to work in a rural location (60%) relative to those who graduated from an urban high school (18%) (p < 0.0001). A higher proportion of men (50%) selected rural practice compared to women (33%) (p = 0.02). Only 17 graduates who attended high school outside of Nebraska stayed to practice in Nebraska, and there was a lower proportion of these graduates working in rural locations (18%) relative to in-state high school graduates (45%) (p = 0.03). CONCLUSION: We found significant positive associations between dentists who chose rural practice and demographic factors such as being rural high school graduates, male, and in-state predental residents. Our findings differ from descriptive results of similar previous studies.

Malignant acanthosis nigricans in rectal adenocarcinoma.

A case of generalized malignant acanthosis nigricans is reported. The patient was asymptomatic of any gastrointestinal complaints and investigations revealed the presence of adenocarcinoma of the rectum. The association between paraneoplastic acanthosis nigricans and internal malignancy is well established and the most common association is with adenocarcinoma of gastrointestinal origin.

An unusual presentation of invasive squamous cell carcinoma of the upper extremities in a patient with a history of severe electrical burns and chronic thermal and chemical exposure.

This is a case report that depicts an atypical presentation of very aggressive, metachronous invasive squamous cell carcinomas of the upper extremities in a patient with no prior history of precancerous or cancerous skin lesions and no significant solar radiation exposure. Potentially causative factors that played a role in the emergence of this aggressive form of skin cancer in this case study are multifactorial: (1) chronic thermal exposure of 3000 degrees F daily to his hands for an eight to ten-year time period; (2) chronic chemical exposure of DMSO solvent and higher levels of chemical contaminants such and finally; (3) a form of chronic immunosuppression as a result of his severe electrical burns that resulted in widespread second and third burns throughout his body.

Full Stokes polarimeter for characterization of fiber optic gyroscope coils.

We describe the design, construction, calibration, and validation of a Stokes vector polarimeter for investigating the polarization characteristics of fiber optic gyroscope coils. The device measures the complete Stokes vector, and reports conventional polarization properties including the Degree of Polarization (DoP), the orientation and Degree of Linear Polarization (DoLP), and the handedness and Degree of Circular Polarization (DoCP). The sensor operates at 1550 nm and employs a division of aperture optical architecture to acquire full Stokes vectors at 8 kHz while calculating polarization properties at a rate of 200 Hz. Preliminary measurements performed on both traditionally and unconventionally wound gyroscope coils are also presented.

Qualifications and Characteristics North American Dental Deans Seek in Department Chairpersons.

The aim of this study was to determine whether deans of North American dental schools perceived that one category of department chairperson skills (leadership or management) was more important than the other for their chairpersons to be successful. A secondary purpose was to determine the professional qualifications and personal characteristics these deans perceived contributed most to the success of department chairpersons and whether those differed by the research emphasis of the school. An email survey was sent in 2016 to all 75 deans of U.S. and Canadian dental schools with graduating classes. Section one of the survey was an open response section asking deans to list the five most essential characteristics of a successful department chairperson. Section two asked deans to rank the importance of eight listed professional qualifications, and the last section asked deans to rate the importance of four leadership and four management traits that could contribute to the success of their chairpersons. Questions about characteristics of the deans and the schools were also included. A response rate of 46.7% was obtained. The most frequent characteristics listed in the open response section were in the categories of vision, academic expertise, and integrity. The three most highly ranked professional qualifications were previous teaching experience, previous administrative experience, and history of external research funding. Four of the eight professional qualifications were ranked differently by deans of high compared to moderate research-intensive schools (p<0.05). Overall, the respondents rated leadership skills more highly than management skills (p=0.002) as important for departmental chairpersons.