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028). When subjected to the concurrent use of Papacarie Duo gel and phosphoric acid etching, HE specimens showed a significant increase in µSBS (p < 0.001).

Deproteinising pretreatment using Papacarie Duo gel followed by the application of SU in E&R mode led to increased µSBS of resin composite to HE.

Deproteinising pretreatment using Papacarie Duo gel followed by the application of SU in E&R mode led to increased µSBS of resin composite to HE.

A new two-step self-etch adhesive (2-SEA) free of hydrophilic monomers was evaluated. Its microtensile bond strength (µTBS) to dentin under various aging conditions, interfacial gap formation, water sorption/solubility, and formation of an acid-base resistant zone (ABRZ) were evaluated and compared with a gold-standard 2-SEA.

The new 2-SEA G2-Bond Universal (G2; GC) was compared to Clearfil SE Bond 2 (CSE2, Kuraray Noritake). Their µTBS to sound coronal dentin was tested after 1 week, 10,000 thermal cycles (TC), 20,000 TC, 6 months and 1 year. Failure mode was determined using scanning electron microscopy (SEM). TGF-beta activation Gap formation at the interface of 2-mm deep tapered cavities with an enamel border was observed using swept-source optical coherence tomography after 1 day, 1 week, 10,000 TC, and 20,000 TC. In addition, water sorption and solubility of the bonding agents was measured, and ABRZ formation was evaluated using SEM.

There was no significant difference in µTBS between G2 and CSE2 (p > 0.05), and the aging conditions had no significant effect on µTBS (p > 0.05). In all groups, cohesive failures prevailed (55%-95%). Interfacial gap formation was initially similar for both adhesives (p > 0.05), but G2 exhibited a significantly lower gap formation than CSE2 after TC (p < 0.05). The water sorption of G2 was significantly lower compared to CSE2 (p < 0.05), and their solubility was statistically similar (p > 0.05). ABRZ of similar thickness was observed with both adhesives.

The new 2-SEA exhibited stable dentin bonding and increased hydrophobicity resulting from the absence of hydrophilic monomers.

The new 2-SEA exhibited stable dentin bonding and increased hydrophobicity resulting from the absence of hydrophilic monomers.

The aim of this clinical trial was to compare a self-adhesive flowable resin composite, a highly filled flowable resin composite used in combination with a universal adhesive applied in self-etch mode, and a conventional flowable resin composite used in combination with a universal adhesive applied using two different application modes in occlusal cavities.

Twenty-eight patients received 114 occlusal restorations. Cavities were divided into four groups CS a self-adhering flowable (Constic, DMG); GF a highly filled flowable (G-ænial Universal Flo, GC) in combination with a universal adhesive applied in self-etch mode (G-Premio Bond, GC); TF-SE a conventional flowable (Tetric N-Flow, Ivoclar Vivadent) in combination with a universal adhesive (Tetric N-Bond Universal, Ivoclar Vivadent) applied in self-etch mode; TF-ER a conventional flowable (Tetric N-Flow, Ivoclar Vivadent) in combination with a universal adhesive (Tetric N-Bond Universal, Ivoclar Vivadent) applied in etch&rinse mode. Restorations were scored using modified USPHS criteria. Descriptive statistics were performed using chi-squared tests.

At 24-month evaluations, none of the restorations were lost. The CS group showed significantly higher bravo scores for marginal adaptation than did the other experimental groups (p = 0.024). Significant changes were seen for CS and GF regarding marginal adaptation compared to baseline.

Although the self-adhering flowable resin composite exhibited inferior marginal adaptation compared to the highly filled flowable and conventional flowable resin composites, the restored teeth demonstrated a clinically acceptable performance after 24 months.

Although the self-adhering flowable resin composite exhibited inferior marginal adaptation compared to the highly filled flowable and conventional flowable resin composites, the restored teeth demonstrated a clinically acceptable performance after 24 months.

To compare the clinical performance and treatment times between glass hybrid (GH; EQUIA Forte Fil/EQUIA Forte Coat, GC) and adhesive/nanofilled resin composite restorations (RC; OptiBond FL, Kerr/Filtek Supreme XTE, 3M Oral Care) of sclerotic non-carious cervical lesions (sNCCL).

This is an 18-month interim analysis of a 36-month cluster-randomized trial (ClinicalTrials.gov Identifier NCT02631161). Eighty-eight patients (50-70 years) with 175 sNCCLs were randomized to receive GH or RC restorations. Restorations were placed without mechanical cavity preparation, and treatment time was recorded. After 18 months, restorations were evaluated using FDI criteria. Factors associated with restoration survival were evaluated using multi-level Cox-regression analysis. Generalized linear mixed modelling was used to analyze factors associated with treatment time.

After a mean of 18 months (min/max 8/25), 78 patients (160 restorations) were assessed. Fifteen restorations (18%) failed in GH, and 11 (12%) in the RC, without a significant difference in survival (p = 0.904/Cox). Retention loss was the most common reason for failure in both groups. Restorations placed in older patients showed lower risk of failure [OR (95% CI) 0.90 (0.81-0.99) per year], while mandibular teeth showed higher risks [2.89 (1.00-8.31)]. Treatment time was significantly shorter for GH (mean ± SD 8.6 ± 4.3 min) than RC (11.7 ± 5.7 min; p < 0.001).

GH may be a suitable alternative to RC for restoring sNCCLs, without any significant difference in survival between the two materials at this interim analysis. In addition, placing GH restorations required less chairtime than did placing RC restorations.

GH may be a suitable alternative to RC for restoring sNCCLs, without any significant difference in survival between the two materials at this interim analysis. In addition, placing GH restorations required less chairtime than did placing RC restorations.The Critical Care Resource Nurse Team (CCRNT) evolved from our traditional Rapid Response Team (RRT). The CCRNT is a unique paradigm created using the conceptual framework of the American Association of Critical Care Nursing Synergy Model for Patient Care. The goal of the CCRNT is to help align nurse competencies with patient needs. This team was seen as a much-needed strong clinical support by nursing leadership as large numbers of inexperienced new graduate registered nurses were hired and senior experienced nurses were leaving the workforce. The CCRNT supports 24/7 RRT, Code Blue, Code Stroke, Emergency Airway Response Team, Early Warning System, Medical Emergency Team, simulation team training, and bedside nurse support and mentoring. Coverage expanded from inpatient medical/surgical areas to all areas of the medical center and included hospital-wide initiatives. The focus for the CCRNT changed to a system-wide nursing and patient safety model to improve practice and intervene in near-miss events. This model improved communication between disciplines, provided critical surveillance of at-risk patients, supported patient safety with a significant decrease in patient mortality, and offered a 24/7 expert critical care nurse resource team for staff.

The evidence-based practice (EBP) process was challenged during the early phase of the COVID-19 pandemic by factors such as a novel disease, rapidly changing guidelines, shortage of personal protective equipment, and other health care supplies.

Our aims were to (1) explore sources of evidence sought by critical care nurses during a pandemic and (2) explore nurses' perceptions of EBP.

A qualitative exploratory study was conducted using deidentified data from the American Association of Critical-Care Nurses (ACCN) open-access Facebook page, January 28 to April 30, 2020.

Two major themes were identified (1) "sharing and seeking evidence," that is, nurses used both formal and informal sources to explore evidence supporting evolving clinical practices, and (2) "concerns about evidence," that is, nurses expressed concerns about lack of evidence and mistrust of evolving evidence.

Initially, there was a mismatch in nurses' expectations of the American Association of Critical-Care Nurses Facebook page. A majging evidence.

Delirium-related biochemical derangements lead to electrical changes that can be detected in electroencephalographic (EEG) patterns followed by behavioral signs and symptoms. Studies using limited lead EEG show a large difference between patients with and without delirium while discriminating delirium from other causes. Handheld rapid EEG devices may be capable of detecting delirium before symptom onset, thus providing an objective physiological method to detect delirium when it is most amenable to interventions.

The aim of this study was to explore the potential for rapid EEG to detect waveform pattern changes consistent with delirium status.

This prospective exploratory pilot study used a correlational design and mixed models to explore the relationships between handheld portable EEG data and delirium status.

While being under powered minimized opportunities to detect statistical differences in EEG-derived ratios using spectral density analysis, sleep-to-wake ratios tended to be higher in patients with delirium.

Limited lead EEG may be useful in predicting adverse outcomes and risk for delirium in older critically ill patients. Although this population is at the highest risk for mortality, delirium is not easily identified by current clinical assessments. Therefore, further investigation of limited lead EEG for delirium detection is warranted.

Limited lead EEG may be useful in predicting adverse outcomes and risk for delirium in older critically ill patients. Although this population is at the highest risk for mortality, delirium is not easily identified by current clinical assessments. Therefore, further investigation of limited lead EEG for delirium detection is warranted.Institutional review boards (IRBs) exist to protect the rights and welfare of research participants. Critical care nurses and researchers may interface with IRBs directly or indirectly. Having an understanding of how the IRB process works will help nurses advocate for patients who may also be research participants and will help researchers facilitate approval of their research studies.

Critically ill patients who are mechanically ventilated are at a high risk for malnutrition, which is associated with poor clinical outcomes.

The aim of this study was to determine whether the modified version of Nutrition Risk in the Critically Ill (mNUTRIC) score predicts patients' clinical and functional outcomes in intensive care units (ICUs) in Jordan.

A prospective, observational, quantitative research design was used. A convenience sample of 129 mechanically ventilated patients was recruited from ICUs in 7 hospitals across the different Jordanian health care sectors. Each patient was assessed and scored by the mNUTRIC tool.

Of the total 129 mechanically ventilated patients, the mean (SD) age of critically ill participants was 66.38 (17.46) years, 69.8% of the participants were male (n = 90), and 30.2% were female (n = 39). Approximately 88.4% of mechanical ventilator patients were at a high risk of malnutrition at the time of ICU admission. Overall, high mNUTRIC score (≥5) was significantly associated with MV duration (P = .