Construction of an evaluation index system of core competencies for critical care blood purification nurses in China: A Delphi study.

AIM: The purpose of this study was to construct a core competencies evaluation index system for critical care blood purification nurses in China. BACKGROUND: While nursing is an integral part of critical care blood purification treatment, there are no established indicators to evaluate the core competencies of critical care blood purification nurses. DESIGN: A Delphi study. METHODS: An initial draft of the competencies evaluation index system for critical care blood purification nurses was developed through a literature review and semi-structured interviews. From February 2023 to March 2023, a two-round Delphi survey was conducted to consult with 18 experts in the field of critical care blood purification from eight provinces in China to rate the importance of each item and propose modifications to the evaluation index system. RESULTS: The effective questionnaire recovery rates in two rounds of expert consultation were 94.4 % and 94.1 % and the average expert authority coefficients were 0.88 in both rounds. The core competencies evaluation index system of critical care blood purification nurses consisted of 39 items in five domains, namely theoretical knowledge, practical skills, professional development capability, critical thinking ability and personal qualities and attributes. The Kendall's W coefficients for the first- and second-level indicators were.21 and.20 in the first round and.23 and.25, respectively, in the second round of consultations (p < .01). CONCLUSION: The core competencies evaluation index system of critical care blood purification nurses is scientific and reliable and can provide references for the recruitment, training and management of critical care blood purification nurses.

Long-Term Effects of Bone Morphogenetic Protein-2-Loaded Calcium Phosphate on Maxillary Sinus Lift Surgery for Delayed and Simultaneous Dental Implantation.

Maxillary sinus lift surgery (MSLS) is considered to be a useful treatment method for patients with atrophic alveolar bone. Choosing a suitable surgical procedure to simultaneously decrease graft absorption and obtain long-term survival of dental implants is still a challenge. In this study, 20 patients received MSLS with graft of bone morphogenetic protein 2 (BMP2)-loaded calcium phosphate. Dental implants were placed simultaneously in 10 patients receiving MSLS (1-stage group), and in 10 patients receiving dental implants with a 3 to 6 months delay (2-stage group). The effects were evaluated based on clinical and radiographic examination during a 4 to 5 years follow-up. The results showed that only 1 perforation of the maxillary sinus mucosa was observed in 1-stage group, and was patched with a collagen membrane. An average bone gain of 6.8 mm was observed, and all implants exhibited no looseness, peri-implantitis, or fracture, all of which were stable during the follow-up and exhibited nice dental function during a 4 to 5 years follow-up. The loss of peri-implant bone height was 1.12 ±â€Š0.47 and 1.10 ±â€Š0.39 mm, the probing depth of periodontal pocket was 1.79 ±â€Š0.62 and 1.81 ±â€Š0.71 mm, the sulcular bleeding index was 1.63 ±â€Š0.47 and 1.72 ±â€Š0.54 in 1-stage group and 2-stage group, respectively, and no significant differences existed between these 2 groups. These findings implied that BMP2-loaded calcium phosphate may be a suitable material for MSLS, especially for patients with minimal bone height. Clinicians can use the 1- or 2-stage technique based on clinical condition, patients' choice and clinicians' experience. In patients where implants cannot be stabilized for patients with minimal bone height, 2-stage surgery may be more suitable.

Root canal morphology of permanent three-rooted mandibular first molars: Part III--An odontometric analysis.

INTRODUCTION: The purpose of this study was to quantitatively analyze the root canal morphology of three-rooted mandibular first molars by micro-computed tomography (micro-CT) scans. METHODS: Twenty three-rooted mandibular first molars were scanned by micro-CT scans. The teeth were reconstructed three-dimensionally by software Mimics 10.01 (Materialise, Leuven, Belgium). The levels of the root apexes and furcations; the diameters; wall thicknesses; and tapers of the mesiobuccal (MB), mesiodistal (ML), distobuccal (DB) and distolingual (DL) canals were determined. The buccolingual/mesiodiatal (BL/MD) diameter ratios (ΔC) and the prevalence of long oval canals (ΔC > 2) at different levels were calculated. RESULTS: The level of distal furcations was significantly (P < .01) lower than that of MD furcations with an average of 1.09 mm. The buccal and lingual walls were significantly (P < .05) thicker than the mesial and distal for the MB, ML, and DB canals. Among four canals, the DL canal had the smallest mean value of ΔC at each level. The average BL taper was greater than the MD for each canal except the middle portion of the DL canal. CONCLUSION: The vertical length, width, BL/MD diameter ratio, wall thickness, and BL taper of the DB canals are on average greater than the DL canals. The MB, ML, and DB canals are more oval, whereas the DL canals are relatively rounder. The geometric data of root canals are useful for endodontic treatment on three-rooted mandibular first molars.

Root canal morphology of permanent three-rooted mandibular first molars--part I: pulp floor and root canal system.

INTRODUCTION: Racial variations in root form and canal anatomy present endodontic challenges for clinicians. This study examined root canal morphology of three-rooted mandibular first molars by micro-computed tomography scans. METHODS: A total of 122 extracted mandibular first molars were collected from a native Chinese population. After calculating the frequency of occurrence, 20 three-rooted (experimental group) and 25 two-rooted first molars (control group) were scanned and reconstructed three-dimensionally. RESULTS: The frequency of three-rooted mandibular first molars was 31.97% (39/122). The mean interorifice distances from the distolingual (DL) canal to the distobuccal (DB) and mesiolingual canal were 2.93 mm and 2.86 mm, respectively. The mesial root predominately contained a type 2-2 root canal, with an incidence of 65% in the experimental group and 64% in the control group. Type 1-1 canals were seen more frequently in the DL and DB roots of the three-rooted first molars as well as in the distal roots of the two-rooted first molars. The incidences were 100% (20/20), 95% (19/20), and 72% (18/25), respectively. Accessory and lateral canals rarely occurred in the extra DL roots. The incidence was only 10% (2/20). A furcation canal extending from the floor to the furcation region was not observed. CONCLUSION: Three-rooted mandibular first molars commonly have 4 separate canals with high incidences of accessory canals in the mesial and DB root. The geometric data of pulp floors are useful for locating the extra DL canal.

[Experimental study of preparation errors during instrumentation of artificial curved root canals with stainless steel K files].

PURPOSE: To investigate the features and rules of preparation errors developed from instrumentation of curved root canals. METHODS: 8 curved artificial root canals were prepared with stainless steel K files by the step-back technique,the root canals were digitally photographed,the images were analysed by the software Image-Pro Plus,the shapes and positions of the root canals were measured and analysed.SPSS 10.0 software package was used for statistical analysis, paired-samples t test was used to compare the difference of the means among sample groups. RESULTS: After root canal preparation,the mean value of the angles of canal curvature decreased from 36.21 degrees to 21.98 degrees , while the mean value of the radius of the canal curvature increased from 6.25mm to 11.35mm; the canal axes transported and intercrossed with the original axes at 2 points and created 3 intersection zones.The taper of the root canals was destroyed and a series of instrumentation defaults were created. CONCLUSION: The cause of preparation errors was the transportation of the root canal instruments leaded by the elastic force and cutting effects.

[Curve analysis and geometric measurement of root canal curvatures].

PURPOSE: To study the anatomical features of curved root canals. METHODS: According to Nagy's classification,the root canals were divided into 4 types:type I (straight), type C (continuously curved), type J (apically curved) and type S (multicurved). Each type had a sample selected from extracted permanent teeth. Digital radiographs were taken at buccolingual and mesiodistal directions with a K-file inserted into the root canal. The images were treated by Photoshop7.0 and CorelTRACE10 softwares, after that a CAD/CAM software UG NX V1.0 was applied to extract the 2D curves of the root canal axis from the images,then the 3D curves of the root canal axis were built up accordingly. The curvature of the curves was analysed and the geometric parameters were measured by UG. RESULTS: The curvature values of type I root canal were very low; the curvature of type C root canal reached a peak on the middle part,it decreased slowly towards the two ends; type J root canal had a curvature peak near the root apex, and the middle 1/3 and neck 1/3 parts of the root canal were "curvature flat zones". Type S root canal had a curvature inflection,and beside it were 2 curvature peaks at opposite directions. The geometric parameter values of the same root canal's 2D and 3D axis were different. CONCLUSION: Each point on the root canal axis had a curvature value and a vector of tangent, different root canal forms had different rules of curvature distribution, just 1 or 2 parameters couldn't describe a curved root canal completely.