Quality of life among family caregivers of cancer patients: an investigation of SF-36 domains.

BACKGROUND: With improving survival rates, cancer has become more of a chronic disease with long-term palliative care requirements. Thus, it is even more than ever necessary to pay careful attention to the well-being of family caregivers of cancer patients, as cancer trajectory is a challenging path for both patients and their caregivers. This study focusses on ascertaining the level of quality of life (QoL) domains and their attributable significant factors among a population of cancer family caregivers. METHODS: This was a cross-sectional study. The study population consist of caregivers of adult cancer patients in Zanjan, Iran between 2019 and 2020. Medical Outcomes General Health Survey Short Form 36 (SF-36) was the instrument to measure outcome variables. Clinical and basic characteristics of the caregivers and their patients were also collected using a questionnaire designed for this purpose. Data were analyzed using Independent samples t-test, Analysis of Variance, and stepwise linear regression in SPSS v.26. RESULTS: Of the caregivers 167 were male and 133 were female. The mean age of the participants was 40.77 ± 12.56, most of whom were offspring of the patients (148, 49.3%), married (239, 79.7%), and self-employed (81, 27.0%). both domains of bodily pain (76.50 ± 16.67) and physical functioning (74.88 ± 20.27) showed the highest scores among caregivers. Age and gender of caregivers, duration of caregiving, Eastern Cooperative Oncology Group (ECOG) performance status scale as well as type and stage of cancer, and type of treatment were among the significant predictors of QoL domains (All, p < 0.001). CONCLUSION: Findings of the present study substantiated various significant predictors for QoL along with low levels of QoL domains among the caregivers of cancer patients. Securing such findings proves the magnitude of probable unmet needs and psychological challenges in this population and provides the health policy makers with some valuable clues to draw effective strategies to address such issues.

Shear Bond Strength of Colored and Sandblasted Zirconia to Ceramic Veneers Fabricated by the Pressing and Layering Techniques: An In Vitro Study.

Introduction: Porcelain-veneered zirconia (PVZ) restorations are increasingly used due to their optimal esthetics and high strength. However, chipping of porcelain limits the application of PVZ restorations. The aim of this study was to assess the shear bond strength (SBS) of colored and sandblasted zirconia to ceramic veneers fabricated by the pressing and layering techniques. Materials and Methods: Sixty cubic zirconia specimens (10 × 10 × 2 mm) were assigned to three groups according to their surface treatment: (I) control, (II) sandblasting with 50 µm alumina particles (S), and (III) coloring (C). Each group was subsequently divided into two subgroups according to the porcelain-veneering technique: (I) layering (L) and (II) pressing (P). The specimens underwent 10,000 thermal cycles between 5 and 55°C, and their biaxial SBS was measured in an electromechanical universal test machine (0.5 mm/min with 2.5 kN load cell). The failure mode was also assessed under a stereomicroscope. Three samples were randomly selected from each subgroup (n = 18) for examination of zirconia-phase transformation by X-ray diffraction (XRD). Two-way and one-way ANOVA followed by the post hoc Tukey test were used to analyze statistical differences among the groups and subgroups (α = 0.05). Results: The sandblasted zirconia with press porcelain (SP) subgroup showed the highest (24.40 ± 8.16 MPa) and the colored zirconia with press porcelain (CP) subgroup showed the lowest (13.76 ±3.62 MPa) SBS. All failures were cohesive. Rate of phase transformation in layered porcelain was significantly lower than that in pressed porcelain (P < 0.01). Conclusion: The sandblasted group showed the highest and the colored group showed the lowest SBS; the layered group showed higher SBS than the pressed group.

Expression, purification and investigation of antibacterial activity of a novel hybrid peptide LL37/hBD-129 by applied comprehensive computational and experimental approaches.

Antibiotic-resistant pathogens have become a great universal health concern. Antimicrobial peptides (AMPs) are small amphipathic and cationic polypeptides with high therapeutic potential against various microorganisms containing drug-resistant strains. Two major groups of these peptides, which have antibacterial activity against Gram-positive and Gram-negative bacteria, antiviral activity, and even antifungal activity, are defensins and cathelicidins. Hybridization of various AMPs is an appropriate approach to achieving new fusion AMPs with high antibacterial activity but low cellular toxicity. In the current research, the amino-acid sequence of human cathelicidin LL-37 (2-31) and Human beta-defensin (hBD)-129 were combined, and the fusion protein was evaluated by bioinformatics tool. The designed AMP gene sequence was commercially synthesized and cloned in the pET-28a expression vector. The LL-37/hBD-129 fusion protein was expressed in E.coli BL21-gold (DE3). The expression of the recombinant protein was evaluated using the SDS-PAGE method. The LL37/hBD-129 was successfully expressed as a recombinant hybrid AMP in E.coli BL21-gold (DE3) strain. Purification of the expressed AMP was performed by Ni-NTA column affinity chromatography, and the purified AMP was validated using the Western blot technic. Finally, the antimicrobial activity of the fusion AMP against Staphylococcus aureus and Escherichia coli bacteria was assessed. Based on the in silico analysis and experimental evaluations, the fusion AMP showed a significant antimicrobial effect on E. coli and Staphylococcus aureus bacteria.

The relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine patients: the mediating role of pain self-efficacy.

BACKGROUND: Migraine is a neurological disease that has several physical and psychological complications, which is characterized by disability and impaired quality of life. AIMS: The aim of this study was to explore the mediating role of pain self-efficacy in the relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine sufferers. The relationship between these factors with quality of life (QOL) was not fully explored in migraine patients. METHOD: This study was a correlational study of structural equations. Therefore, 300 patients with migraine who referred to one of the specialized neurological treatment centers in Zanjan in 2021 were recruited based on the inclusion criteria. Patients also completed the World Health Organization Quality of Life Scale (WHOQOL-BREF), Meaning in Life Questionnaire, Multidimensional Scale of Perceived Social Support, Spiritual Well-Being Scale, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire. Finally, the hypotheses were then analyzed with correlation coefficient and path analysis method by using SPSS-26 and LISREL-10.2 programs. RESULTS: The results of the present study showed that pain self-efficacy has a mediating role in the relationship between meaning of life and quality of life (B = 0.015), perceived social support with quality of life (B = 0.022), spiritual well-being with quality of life (B = 0.021), as well as pain catastrophizing with quality of life (B = - 0.015). CONCLUSION: According to the results of this study, by considering the role of self-efficacy of pain, it is possible to develop the programs to strengthen and improve the meaning of life, perceived social support, spiritual well-being and also reduce pain catastrophizing, in order to improve the quality of life of patients with migraine.

The Effect of Abutment Angulation and Crown Material Compositions on Stress Distribution in 3-Unit Fixed Implant-Supported Prostheses: A Finite Element Analysis.

Objective: The aim of this study was to evaluate influence of abutment angulation and restoration material compositions on the stress pattern in dental implants and their surrounding bone. Materials and Methods: In this finite element study, the six different solid 3D models of "mandibular 3-unit fixed implant-supported prostheses" were analyzed. In all of these models, a straight abutment was used for anterior implants at the second premolar site, and in order to posterior implant at the second molar site, abutments with three different angles (straight, 15, and 20°) were used. Also, two different restoration material compositions (porcelain fused to base metal (PFBM) and porcelain fused to noble metal (PFNM)) were considered for fixed implant supported restorations. A 450 N static force was exerted in a straight manner along the longitudinal axis of the anterior implant in a tripod, and the stress distribution was measured based on the restoration materials and abutment angulations of the models in the 3 sites of cortical, cancellous bone, and fixtures. The simulation was performed with ABAQUS 6.13 Software. Results: In all models, stress values in surrounding cortical bone were more than in spongy bone. Maximum stress levels in an anterior abutment-implant complex were seen in models with angled implants. In models with parallel implants, the stress level of a molar straight abutment-implant complex was less than that of premolar straight ones. In an angled posterior abutment-implant complex, less stress level was detected compared to straight ones. In all PFNB models, stress values were slightly more and distributed in a wider area of premolar straight abutments. Conclusion: Increasing an abutment angle, increases stress in surrounding bone and straight implant-abutment combination. It seems that the crown material composition affects stress distribution of the implant-abutment combination but does not affect stress distribution of surrounding bone.

Principal of environmental life cycle assessment for medical waste during COVID-19 outbreak to support sustainable development goals.

Disposal of medical waste (MW) must be considered as a vital need to prevent the spread of pandemics during Coronavirus disease of the pandemic in 2019 (COVID-19) outbreak in the globe. In addition, many concerns have been raised due to the significant increase in the generation of MW in recent years. A structured evaluation is required as a framework for the quantifying of potential environmental impacts of the disposal of MW which ultimately leads to the realization of sustainable development goals (SDG). Life cycle assessment (LCA) is considered as a practical approach to examine environmental impacts of any potential processes during all stages of a product's life, including material mining, manufacturing, and delivery. As a result, LCA is known as a suitable method for evaluating environmental impacts for the disposal of MW. In this research, existing scenarios for MW with a unique approach to emergency scenarios for the management of COVID-19 medical waste (CMW) are investigated. In the next step, LCA and its stages are defined comprehensively with the CMW management approach. Moreover, ReCiPe2016 is the most up-to-date method for computing environmental damages in LCA. Then the application of this method for defined scenarios of CMW is examined, and interpretation of results is explained regarding some examples. In the last step, the process of selecting the best environmental-friendly scenario is illustrated by applying weighting analysis. Finally, it can be concluded that LCA can be considered as an effective method to evaluate the environmental burden of CMW management scenarios in present critical conditions of the world to support SDG.

Frequency distribution of temporomandibular disorders according to occlusal factors: A cross-sectional study.

BACKGROUND: Temporomandibular disorder (TMD) is a common condition affecting the temporomandibular joint and causes pain and discomfort. However, the role of factors contributing to this problem is still controversial. The purpose of this cross-sectional study was to determine the correlation of occlusal factors and parafunctional habits with TMD and The determination of TMD prevalence among patients referring to Isfahan Dental School in 2017. MATERIALS AND METHODS: In this cross-sectional study, A total of 200 patients between 20 and 50 years were examined and questioned based on the Research Diagnostic Criteria for Temporomandibular Disorders assessment instrument. The association of occlusal factors (dental relationship, lateral occlusal scheme, horizontal differences between centric occlusion and Maximum intercuspation (MI), difference between MI and mandibular resting position) and parafunctional habits (bruxism/clenching and habits) with TMD was analyzed using Chi-square tests and independent sample t-test (α = 0.05). Binomial logistic regression analysis was performed with respect to confounding variables. RESULTS: The prevalence of TMD in the studied sample was 58.9%. Only bruxism showed a significant difference between TMD and non-TMD groups (P < 0.05). Other parafunctional and occlusal factors did not act as influential factors for TMD. CONCLUSION: Parafunction may play an important role in the initiation of TMD, although other habits and occlusal factors are considered as noninfluential factors. However, larger sample size and multicenter sampling are recommended for the future studies.

Five year clinical outcomes of metal ceramic and zirconia-based implant-supported dental prostheses: A retrospective study.

OBJECTIVES: The implant-supported restorations can be made of all-ceramic materials. The purpose of this study was to compare five year clinical outcomes of zirconia-based and metal ceramic implant-supported fixed dental prostheses (FDPs). METHODS: In this study, 114 posterior implant-supported FDPs including zirconia-based (52) or metal ceramic (62) restorations were made for 114 patients with a mean age of 59 ±â€¯8.4 years and evaluated in a 5 year follow up. The modified California Dental Association (CDA) guidelines were used to assess the quality of the restorations. The soft tissue status was evaluated using gingival and plaque indices, probing depth and bleeding on probing. Additionally, the bone loss around implants was assessed by parallel priapical radiographs. The visual analogue scale was used regarding patients' satisfaction. The data analysis were performed by Kaplan-Meier, log rank test, Cox regression, Mann-Whitney U and Student's t-test. (α = 0.05). RESULTS: Five year Kaplan-Meier survival rate of the zirconia-based and metal ceramic FDPs were 98.1 % and 100 % respectively with no significant difference (P = 0.12). The success rates were 81.6 % for zirconia-based and 81.0 % for metal ceramic restorations (P = 0.85). The CDA rating of both studied groups was not significantly different except the marginal gap which was better in zirconia-based FDPs (P < 0.001). Fracture of veneering ceramics occurred in 2.7 % of metal ceramic and 6.4 % of zirconia-based FDPs, which were not considered as failure. Soft tissue status was not affected by the type of restorations except for plaque index which was more favorable for zirconia-based FDPs (P < 0.001). No significant difference was found between marginal bone loss of the two groups (P = 0.30 mesial, P = 0.46 distal). CONCLUSIONS: Zirconia-based and metal ceramic FDPs showed similar promising clinical performance in the 5-year follow-up. CLINICAL SIGNIFICANCE: Zirconia-based implant-supported FDPs might be a successful restorative method with acceptable survival rate and patient's satisfaction.

Five year clinical outcomes and survival of chairside CAD/CAM ceramic laminate veneers - a retrospective study.

PURPOSE: The aim of this clinical study was to compare the survival, modified California Dental Association (CDA) criteria, and periodontal parameters of laminate veneers made with Empress CAD and emax CAD over 60 months. METHODS: One hundred and ninety seven ceramic laminate veneers were placed in 71 patients in a private practice. The restorations were made using CEREC AC Bluecam with Empress CAD and emax CAD blocks. Modified CDA guidelines were used to evaluate clinical performance of the restorations. Gingival and plaque indices, probing pocket depth, and bleeding on probing were also recorded. Patient's satisfaction was assessed using visual analogue scale. Kaplan-Meier and Log rank test were used to analyze survival probability and success rate of the restorations. CDA rating of Empress CAD and emax CAD was compared with Log rank test (α=0.05). RESULTS: The survival rates of ceramic Empress CAD and emax CAD laminate veneers were 97.8 % and 100 % respectively (p=0.13). The success rate of these veneers was 92.4 % for Empress CAD and 100 % for emax CAD (p<0.05). Two Empress CAD laminate veneer failed because of fracture. Other restorations had very good or good CDA scores after 5 years. The periodontal parameters were not significantly different between first and fifth years except plaque index. The mean score of patients' satisfaction was 95.5±8.4. CONCLUSIONS: Chair-side computer-aided design/computer-aided manufacturing ceramic laminate veneers were clinically successful restorations with mean survival rate of 99.0 % and success rate of 96.4 % after 5 years.

Effect of ceramic cooling protocols and zirconia coloring on fracture load of zirconia-based restorations.

BACKGROUND: Residual thermal stresses in dental porcelains can cause clinical failure. Porcelain cooling protocols may affect the amount of residual stresses within porcelain and also porcelain-zirconia bond strength. The objective of this study was to assess the effect of cooling protocols on the fracture load of porcelain veneered zirconia restorations. MATERIALS AND METHODS: Forty zirconia bars (31 mm × 6.5 mm × 1.35 mm ± 0.1 mm) were fabricated by computer-aided design and computer-aided manufacturing technology. Half of the specimens were immersed in the coloring agent for 2 min before sintering (yellow group). Thus, the specimens were divided into two groups of white (W) and yellow (Y) samples (n = 20). Heat-pressed ceramic was applied to all bars. After pressing, half of the samples in each group were immediately removed from the oven (fast cooling) while the other specimens remained in the partially open door (30%) oven until the temperature reached to 500°C. Samples were thermocycled for 5000 cycles and subjected to modified four-point flexural strength test by a universal testing machine at a crosshead speed of 0.5 mm/min. Two-way ANOVA, One-way ANOVA followed by post hoc Tukey honest significant difference tests were used for data analysis (α = 0.05). RESULTS: Fractures were cohesive in all samples (within the porcelain adjacent to the interface). Two-way ANOVA showed that the effect of cooling protocol on the fracture load of samples was statistically significant (P < 0.001). In addition, the fracture load of W and Y groups was significantly different (P < 0.001). The white slow group showed the highest fracture load (179.88 ± 23.43 N). CONCLUSION: Slow cooling protocol should be preferably applied for zirconia restorations. Coloring agent used in this study had a significant negative effect on fracture load.

Effect of Denture Tooth Material on Load Transmission Under Denture Bases.

OBJECTIVES: Pressure transmission under denture bases can vary depending on the denture tooth material. The aim of the present study was to evaluate pressure transmission under denture bases using denture teeth of different materials in direct and indirect tooth contacts. MATERIALS AND METHODS: In this in-vitro study, the pressure transmission generated by five types of denture teeth, including ceramic, nanocomposite, composite-acrylic resin, cross-linked acrylic resin, and polymethyl methacrylate (PMMA), under direct and indirect pressures was evaluated (n=10). The maximum pressure (MPa) was measured using a strain gauge. Data were statistically analyzed with one-way analysis of variance (ANOVA; α=0.05). RESULTS: The denture tooth material had a significant effect on pressure transmission under denture bases (P<0.001). Under direct load, ceramic and PMMA teeth exhibited the maximum and minimum pressures, respectively, contrary to indirect load (P<0.001). CONCLUSIONS: Pressure transmission under denture bases significantly varies with the use of different denture tooth materials. Acrylic teeth could be the most favorable choice to reduce the pressure beneath denture bases. Nanocomposite and acrylic resin-composite teeth may be used as alternatives.