Ambient air pollutants are known risk factors for cardiovascular disease (CVD) morbidity and mortality with significant racial disparities. However, few studies have explored racial differences among highly susceptible subpopulations, such as renal transplant recipients (RTRs). Despite improvements in quality of life after transplantation, CVD remains the major cause of mortality, especially among Black recipients. This study aimed to evaluate potential racial differences in the association between long-term levels of PM_2.5 and the risk of all-cause, total CVD, and coronary heart disease (CHD) mortality among RTRs. This retrospective study consists of 93,857 non-smoking adults who received a renal transplant between 2001 and 2015. Time-dependent Cox regression was used to assess the association between annual concentrations of PM_2.5 and mortality risk. In the multivariable-adjusted models, a 10 μg/m³ increase in ambient PM_2.5 levels found increased risk of all-cause (HR = 3.45, 95% CI: 3.08–3.78), CVD (HR = 2.38, 95% CI: 1.94–2.92), and CHD mortality (HR = 3.10, 95% CI: 1.96–4.90). Black recipients had higher risks of all-cause (HR = 4.09, 95% CI: 3.43–4.88) and CHD mortality (HR = 6.73, 95% CI: 2.96–15.32). High levels of ambient PM_2.5 were associated with all-cause, CVD, and CHD mortality. The association tended to be higher among Black recipients than non-Blacks.

This study aimed to evaluate the differences in the retention of custom-cast non-precious post and cores (CCNPPCs) (control group), custom-milled titanium post and cores (CMTPCs), custom-printed titanium post and cores (CPTPCs), and custom-milled zirconia post and cores (CMZPCs), and to evaluate their mode of failure. The tested null hypothesis was that there were no differences in the retention of the various custom post and cores tested. A total of 80 post-and-core patterns were made using pattern resin and were divided into four groups: Group 1—fabricated via conventional casting using a non-precious casting alloy; Group 2—fabricated using a computer-aided design/computer-aided manufacturing (CAD/CAM) subtractive technique using titanium; Group 3—fabricated using a CAD/CAM additive (3D printing) technique using titanium; and Group 4—fabricated using a CAD/CAM subtractive technique using zirconia. The post and cores were cemented with resin cement and a universal pull-out test was used to check the retention. The data were statistically analyzed using one-way ANOVA tests, post hoc tests, and Tukey’s adjustment for multiple comparisons. The pull-out test revealed higher retention values for CPTPCs and CMTPCs. When compared with CMZPCs, the conventional CCNPPCs revealed significantly better retention values (p < 0.05). Cohesive failure was observed in Groups 1, 2, and 4. However, Group 3 revealed a mixed type of failure. The CCNPPCs revealed clinically acceptable values, while the CPTPC and CMTPC groups revealed better overall values of retention and time to failure. The titanium alloy was assessed to be a promising choice for fabricating dental post-and-core restorations.

Background: Substantial evidence has established links between air pollution and increased risks of overall morbidity and mortality, especially for respiratory and cardiovascular diseases. However, little research has explored these relationships among highly sensitive populations, such as renal transplant recipients. Despite the improvement in quality of life after renal transplantation, cardiovascular diseases (CVD) are major causes of graft loss and mortality. The present study was designed to assess the association between long-term ambient fine particulate matter (PM2.5) and risk of CVD-related mortality, including CHD, stroke, sudden cardiac arrest, and CHF, among renal transplant recipients. Methods: This retrospective cohort study consists of transplant data from 2001 to 2015, and includes 93,857 non-smoking, adult renal transplant recipients who have lived in the contiguous United States at the same location throughout the study period. Annual-average concentrations for the three ambient air pollutants (PM2.5, O3, and NO2) were assigned to subjects' residential ZIP codes. Cox proportional hazard models were used to assess the association between PM2.5 and CVD mortality risk. Results: In the multivariable-adjusted models, a 10 ug/m3 increase in ambient PM2.5 levels was associated with increased risk of total CVD (HR=1.85, 95 % CI: 1.57 - 2.17), CHD (HR=2.20, 95 % CI: 1.53 - 3.17), stroke (HR=1.82, 95%CI: 1.15 - 2.89), and cardiac arrest (HR=1.77, 95% CI: 1.42 - 2.19). There was no clear association between PM2.5 and risk of CHF mortality. Conclusions: The findings of this study provide strong evidence supporting an adverse effect of ambient PM2.5 in this vulnerable group. Positive associations were found between PM2.5 and all CVD mortality outcomes, except CHF mortality. Our findings raise the question of whether increased emphasis should be placed on implementing preventive strategies to lessen the impact of air pollution on CVD risk.

Objective: To characterize presentation, disease course, and treatment of idiopathic subglottic stenosis (iSGS) in non‐Caucasian women and compare this cohort to the predominantly female, Caucasian patient cohorts identified in the literature.Study Design: Retrospective review. Results are compared to systematic review of demographics.Setting: Multiple California institutions from 2008 to 2021.Methods: Patients with intubation within 2 years of disease or who met exclusion criteria listed in prior publications were excluded. A systematic review of iSGS patient demographics was also completed for comparison.Results: Of 421 patients with iSGS, 58 self‐identified as non‐Caucasian women, with 50 ultimately included. Mean age of onset was 45.1 years old (95% confidence interval [CI], 41.5‐48.8), and mean age at diagnosis was 47.2 years (95% CI, 43.6‐50.7). Mean Charlson comorbidity index was 1.06 (n = 49, 95% CI, 0.69‐1.44). At diagnosis, Cotton‐Meyer severity scores (documented in n = 45) were Cotton‐Myer (CM) I (28.9%), CM II (40%), and CM III (31.1%). Mean age at first endoscopic surgery was 47.7 (95% CI, 44.2‐51.3) years. 64% experienced disease recurrence with a median of 11 months between their first and second surgery. Our systematic review identified 60 studies that reported demographic features in patients with iSGS. 95% of pooled patients were Caucasian, while other demographic features were similar to the current cohort.Conclusion: The non‐Caucasian population, almost 14% of this Californian cohort, does not differ from the majority Caucasian population detailed in contemporary literature. This cohort supports the presence of some racial and ethnic heterogeneity in this disease population.

Nurse anesthesiology programs continue to search for the best student traits and/or qualities to determine success in transitioning through a program of study and passing the National Certification Examination. These traits are not always quantitative in nature, but qualitative. Students face many stressors in transitioning through a nurse anesthesiology training program, and how students cope with those stressors may clue in the nurse anesthesia educators as to what determines success. This pilot study aimed to determine whether grit, or perseverance toward meeting a long-term goal, was a trait worth considering in determining student success. To that end, this cross-sectional quantitative correlational pilot study conducted in two nurse anesthesiology programs found that one grit subscale--Perseverance of Effort--was statistically significant in determining student success as defined herein.