Category: Statistics

Otolaryngol Head Neck Surg. 2023 Aug 18. doi: 10.1002/ohn.503. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether nonopioid analgesic regimens, taken after discharge for thyroid and parathyroid surgery have noninferior pain outcomes in comparison to opioid analgesic regimens. Secondarily, we sought to determine if nonopioid analgesic regimens decrease the number of opioid medications taken after thyroid and parathyroid surgery, and to assess adverse events associated with opioid versus nonopioid regimens.

DATA SOURCES: PubMed, Embase, Cochrane.

REVIEW METHODS: A comprehensive search of the literature was performed according to the PRISMA guidelines, and identified 1299 nonduplicate articles for initial review of which 2 randomized controlled trials (RCTs) were identified as meeting all eligibility criteria. Meta-analysis was not conducted due to heterogeneity in the data and statistical analyses.

RESULTS: Both RCTs included in this systematic review found no significant differences in postoperative pain scores between individuals discharged with a nonopioid only analgesic regimen compared to analgesic regimen that included oral opioid medications. One study reported significantly increased number of postoperative calls related specifically to pain in the nonopioid arm compared to the opioid arm (15.6% vs. 3.2%, P = .045).

CONCLUSION: This systematic review of RCTs revealed a limited number of studies examining nonopioid versus opioid postoperative pain medications among adults who undergo thyroid and parathyroid surgery. Among the 2 RCTs on this topic, there is a shared finding that nonopioid analgesic regimens are noninferior to opioid analgesic regimens in managing postoperative pain after thyroid and parathyroid surgery, supporting the use of nonopioid pain regimens given the risk of opioid dependence associated with prescription opioid medications.

PMID:37595107 | DOI:10.1002/ohn.503

Gen Dent. 2023 Sep-Oct;71(5):58-63.

ABSTRACT

The aim of this study was to evaluate the relationships between the apices of posterior teeth and the maxillary sinus floor, comparing the results of assessments performed with panoramic radiography and cone beam computed tomography (CBCT). This retrospective cross-sectional study consisted of 96 participants with a total of 302 maxillary posterior teeth. On both panoramic radiographs and corresponding CBCT images, 735 roots were classified into 3 categories according to their topographic relationship with the maxillary sinus: class 1, clear, distinct distance between the root tips and the floor of the sinus; class 2, roots adjacent to the floor of the maxillary sinus; or class 3, roots protruding into the maxillary sinus cavity. Panoramic radiographic signs of root protrusion into the sinus (class 3) were categorized as projection, discontinuity, missing lamina dura, darkening, or kinking. The observed data were analyzed using statistical software, and the Cohen κ coefficient was calculated. The level of significance was set at P < 0.05. Multiple logistic regression was performed to identify the predictive radiographic signs of protrusion into the sinus. The overall correlations between panoramic radiography and CBCT classifications were 90.8%, 66.8%, and 47.1% for the class 1, class 2, and class 3 categories, respectively. The radiographic signs of projection and darkening were significant predictors of root protrusion (P < 0.05). Panoramic radiography is reliable for assessing root posi¬tions when there is a clear distance between the roots and the floor of the maxillary sinus. However, when the roots are in contact with or have protruded into the sinus on panoramic images, the results are not definitive, and CBCT should be performed.

PMID:37595085

Gen Dent. 2023 Sep-Oct;71(5):38-44.

ABSTRACT

Demand for direct esthetic restorations is high, but shade matching can be challenging. Some manufacturers claim that a single product is able to match all colors of the human dentition, eliminating shade matching challenges. This in vivo study, which followed the International Commission on Illumination’s (CIE) CIEDE2000 color difference standard (ΔE₀₀), aimed to quantify the shade matching and blending capabilities of a single-shade composite (Omnichroma PLT) used as a direct veneer. A color difference of ΔE₀₀ ≤ 1.8 was set as the acceptability threshold. Ten participants with an unrestored and noncarious maxillary left central incisor were enrolled in the study. Direct spectrophotometric measurements (CIE L*a*b*) were made on the tooth and then on composite cured on the tooth. Consistency in measurements and composite resin placement were attained through the use of a specially designed jig. A digital photograph was then taken with the composite in place, and colorimetric software was used to obtain the L*a*b* values at the most incisal and cervical edges of the restoration. These values were compared to those of the natural tooth structure immediately adjacent to the composite resin. The ΔE₀₀ scores were calculated to determine the composite’s ability to match the tooth shade beneath it (ΔE_m) and to blend with the incisal (ΔE_i) and cervical (ΔE_c) tooth shades. Mean scores for ΔE_m, ΔE_i, and ΔE_c were calculated, and an independent t test (α = 0.05) was used to compare means for ΔE_i and ΔE_c. The mean (SD) ΔE₀₀ values were 6.16 (2.38), 3.90 (2.47), and 6.84 (1.80) for ΔE_m, ΔE_i, and ΔE_c, respectively. A statistically significant difference (P = 0.008) was observed between ΔE_i and ΔE_c. As a direct veneer, the tested composite did not meet the acceptability threshold for any ΔE₀₀ measurement; however, it was better at matching the incisal third of the tooth than it was the other thirds. More in vivo studies are needed to verify and expand on these results.

PMID:37595082

Acta Biochim Pol. 2023 Aug 18. doi: 10.18388/abp.2020_6590. Online ahead of print.

ABSTRACT

Smoking is a main risk factor for bladder cancer (BC). NAT2 is a drug-metabolizing enzyme that catalyses the detoxification of many xenobiotics and carcinogens. Single nucleotide polymorphism (SNP) in NAT2 results in different acetylation phenotypes (fast, intermediate or slow). Certain NAT2 SNPs were associated with BC and/or modified the association of BC with smoking. However, limited evidence is available among BC patients or smokers from Jordan. This study aimed to discover novel SNPs in NAT2 and to assess the association with BC. This was a case-control study among 120 BC patients and 120 controls. Amplification of a 446 bp fragment of NAT2 encoding the N-catalytic domain was conducted using a polymerase chain reaction. Gene sequencing was done using Sanger-based technology. A total of 40 SNPs were detected. Two variants were significantly associated with BC (p<0.05); namely a novel c.87G>A and the reported c.341T>C. Regarding c.87G>A, genotype distribution was significantly associated with BC and subgroup analysis confirmed that this was significant in both smokers (p=0.007) and non-smokers (p=0.001). Regression subgroup analysis suggested GA as a risk factor among smokers (AOR= 2.356). The frequencies of TC and CC genotypes of c.341T>C were significantly higher in BC (p<0.05). This was statistically significant among smokers only (p=0.044), upon subgroup analysis. Multivariate analysis showed that subjects with TC genotype are 6.15 more likely to develop BC and regression subgroup analysis revealed TC as a risk factor among smokers (AOR=5.47). This is the first study from Jordan to report the association of smoking and two NAT2 variants with BC. The data supports the use of GA and TC genotypes of the novel c.87G>A and the reported c.341T>C SNPs, respectively as potential biomarkers of BC, particularly among smokers. Future investigations with a larger population are required to support our findings.

PMID:37595067 | DOI:10.18388/abp.2020_6590

Plant Physiol. 2023 Aug 18:kiad460. doi: 10.1093/plphys/kiad460. Online ahead of print.

ABSTRACT

Source and sink interactions play a critical but mechanistically poorly understood role in the regulation of senescence. To disentangle the genetic and molecular mechanisms underlying source-sink regulated senescence (SSRS), we performed a phenotypic, transcriptomic, and systems genetics analysis of senescence induced by the lack of a strong sink in maize (Zea mays). Comparative analysis of genotypes with contrasting SSRS phenotypes revealed that feedback inhibition of photosynthesis, a surge in reactive oxygen species, and the resulting endoplasmic reticulum (ER) stress were the earliest outcomes of weakened sink demand. Multi-environmental evaluation of a biparental population and a diversity panel identified 12 quantitative trait loci and 24 candidate genes, respectively, underlying SSRS. Combining the natural diversity and coexpression networks analyses identified seven high-confidence candidate genes involved in proteolysis, photosynthesis, stress response, and protein folding. The role of a cathepsin B like protease 4 (ccp4), a candidate gene supported by systems genetic analysis, was validated by analysis of natural alleles in maize and heterologous analyses in Arabidopsis (Arabidopsis thaliana). Analysis of natural alleles suggested that a 700-bp polymorphic promoter region harboring multiple ABA-responsive elements is responsible for differential transcriptional regulation of ccp4 by ABA and the resulting variation in SSRS phenotype. We propose a model for SSRS wherein feedback inhibition of photosynthesis, ABA signaling, and oxidative stress converge to induce ER stress manifested as programmed cell death and senescence. These findings provide a deeper understanding of signals emerging from loss of sink strength and offer opportunities to modify these signals to alter senescence program and enhance crop productivity.

PMID:37595026 | DOI:10.1093/plphys/kiad460

Intern Med J. 2023 Aug 18. doi: 10.1111/imj.16200. Online ahead of print.

ABSTRACT

BACKGROUND: The right internal jugular vein is the preferred approach to tunnelled haemodialysis catheter placement. However, the effect of the insertion site on long-term catheter outcomes remains uncertain.

AIMS: We aimed to analyse a large cohort of tunnelled haemodialysis catheter placements to compare short-term and long-term results according to central venous catheter location.

METHODS: A retrospective cohort study was performed on consecutive tunnelled catheter insertions at two centres over 7 years. The primary outcome was catheter survival, compared according to the central vein site. We used the Kaplan-Meier curve method and Cox proportional hazards modelling to determine the effect of the catheterisation route on primary patency, adjusted for clinical risk factors for catheter failure.

RESULTS: There were 967 tunnelled dialysis catheter placements in 620 patients. The median survival for right internal jugular vein catheters was 569 days. There were no differences in rates of catheter failure between right internal jugular, left internal jugular (adjusted hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.52-1.21), external jugular (HR, 0.79; CI, 0.33-3.13), subclavian (HR, 0.67; CI, 0.58-2.44) and femoral vein (HR, 1.20; CI, 0.36-1.33) catheters following multivariable analysis. There were no major differences in functionality or complications between the groups.

CONCLUSIONS: This study identified no statistically significant relationship between tunnelled haemodialysis catheter insertion site and catheter survival. The contemporary approach to dialysis vascular access should be tailored to specific patient circumstances.

PMID:37595018 | DOI:10.1111/imj.16200

PLoS One. 2023 Aug 18;18(8):e0290239. doi: 10.1371/journal.pone.0290239. eCollection 2023.

ABSTRACT

Although numerous studies have suggested the association between TNF-α-308G/A polymorphism and susceptibility to obstructive sleep apnea (OSA), the results remained controversial and ambiguous. We performed the present meta-analysis to derive a more precise estimation.The PubMed, Embase, Cochrane library, Web of Science, China National Knowledge Infrastructure, Wanfang databases, and Weipu databases (until January 8, 2022) were accessed to retrieve relevant articles. Pooled odds ratios (ORs) with 95% confidence interval (95% CI) were calculated using the STATA statistical software.Totally, fourteen studies involving 2595 cases and 2579 controls were enrolled in this meta-analysis. Pooled results demonstrated significant association between TNF-α-308G/A polymorphism and OSA risk for the overall population(allele model:OR = 1.87 [1.47, 2.38] (n = 14), dominant model: OR = 1.88[1.48, 2.39] (n = 14), recessive model:OR = 2.83 [2.00, 4.00] (n = 11), homozygous model:OR = 3.30 [2.32, 4.68] (n = 11), and heterozygous model:OR = 1.67 [1.36, 2.06] (n = 14); P<0.001, respectively).Subgroup analysis showed that in both Caucasians and Asians, the A allele conferred increased risk to OSA compared to the G allele (Caucasians: OR = 1.40[1.03, 1.90] (n = 5), P = 0.033, Asians: OR = 2.30 [1.62, 3.26] (n = 9), P< 0.001). In subgroup analysis restricted to hospital-based individuals, significant association between TNF-α-308G/A polymorphism and OSA risk was identified under each genetic model. Whereas, in population-based individuals, increased risk of OSA were only found in homozygous model (OR = 2.19[1.23, 3.90] (n = 3), P = 0.008) and recessive model (OR = 1.77 [1.00, 3.13] (n = 3), P = 0.048). There was a substantial between-study heterogeneity (I2 = 69.10%) across studies which was explained by source of control participants (P = 0.036) by meta-regression. The results of leave-one-out meta-analysis and publication bias suggested the reliability and stability of our results.This meta-analysis suggested that TNF-α-308A allele may be a risk factor for the development of OSA. However, large scale,multi-center and well-designed case-control studies are needed in the future.

PMID:37595008 | DOI:10.1371/journal.pone.0290239

PLoS One. 2023 Aug 18;18(8):e0288729. doi: 10.1371/journal.pone.0288729. eCollection 2023.

ABSTRACT

Varieties that tolerate low nitrogen (N) application rates can reduce fertilizer costs, minimize nitrate leaching and runoff losses, and lower overall CO2 emissions associated with fertilizer manufacturing. The goal of our research is to show the usefulness of path models to identify key phenotypic traits for screening plants with a tolerance to low N application rates. We grew tolerant and sensitive cultivars of poinsettia (Euphorbia pulcherrima) using a water-soluble fertilizer (15-5-15 Cal Mag) in both optimal (electrical conductivity of 2.5 dS·m-1) and N-deficient (electrical conductivity of 0.75 dS·m-1) treatments and measured 24 different traits at the cellular, leaf, and whole-plant scales in both cultivars and treatments. The experiment was laid out as a split-plot design with N treatments as main plots and cultivars as sub-plots, with five replications. Path analysis was conducted to develop sequential relationships among these traits. Statistical comparisons between tolerant and sensitive cultivars in the N-deficient treatment indicated an increase in shoot biomass (19.9 vs 14.4 g), leaf area (2775 vs 1824 cm2), leaf dry weight (14.7 vs 10.0 g), lateral root dry weight (3.7 vs 2.4 g), light-saturated photosynthesis (14.5 vs 10.1 μmol∙m-2∙s-1), maximum electron transport rate (119 vs 89 μmol∙m-2∙s-1), chlorophyll content (28.1 vs 12.9 g∙100g-1), leaf N content (27.5 vs 19.9 mg∙g-1), and fine root N content (26.1 vs 20.9 mg∙g-1), and a decrease in anthocyanin content (0.07 vs 0.16 ΔOD∙g-1). The path model indicated that an increase in the lateral root growth and fine root N content can lead to an increase in the leaf N content, in the N-deficient treatment. There were three separate paths that connected higher leaf N content to increased shoot biomass. These paths were mediated by the levels of anthocyanin, chlorophylls, and light-saturated photosynthesis rate (or rubisco capacity). The light-saturated photosynthesis model suggested that the increased uptake of N by fine roots in the tolerant cultivar was likely supported by the photosynthates translocated from the shoot to the root. Leaf N content was associated with multiple plant responses in the N-deficient treatment, and can be a useful screening trait for developing new cultivars, especially in marker-assisted molecular breeding.

PMID:37595003 | DOI:10.1371/journal.pone.0288729

PLoS One. 2023 Aug 18;18(8):e0290102. doi: 10.1371/journal.pone.0290102. eCollection 2023.

ABSTRACT

BACKGROUND: Gestational weight gain (GWG) is a risk factor for adverse pregnancy outcomes, future obesity and chronic diseases among women. However, has not received much attention in many low and middle-income countries such as Nigeria. We investigated the pattern, associated factors and pregnancy outcomes of GWG in Ibadan, Nigeria, using the Ibadan Pregnancy Cohort Study (IbPCS).

METHODOLOGY: The IbPCS is a multicentre prospective cohort study conducted among 1745 pregnant women recruited from four health facilities in Ibadan, Nigeria. GWG, the primary outcome, was categorised according to the Institute of Medicine’s classification into insufficient, adequate and excessive weight gain. Pregnancy outcomes were the secondary outcome variables. Logistic regression analysis (Adjusted odds ratios and 95% confidence interval CI) was used to examine associations, and Poisson regression analyses were used to investigate associations with outcomes.

RESULTS: Only 16.9% of women had optimal GWG, 56.8% had excessive GWG, and 26.9% had insufficient GWG. Excessive GWG was associated with high income ‘> #20,000-‘ (AOR: 1.64, 95% CI: 1.25-2.17), being overweight (AOR: 2.12, 95% CI: 1.52-2.95) and obese (AOR: 1.47, 95% CI: 1.02-2.13) after adjusting for confounders. In contrast, increased odds of insufficient GWG have associated women with depression (AOR: 1.70, 95% CI 1.17-2.47). There was no significant association between inappropriate GWG and pregnancy outcomes However, there was an increased odds for postpartum haemorrhage (AOR: 2.44, 95% CI 1.14-5.22) among women with obesity and excessive GWG.

CONCLUSIONS: Excessive GWG was the most typical form of GWG among our study participants and was associated with high maternal income, and being overweight or obese. GWG needs to be monitored during antenatal care, and interventions that promote appropriate GWG should be implemented among pregnant women in Nigeria.

PMID:37594997 | DOI:10.1371/journal.pone.0290102

PLoS Negl Trop Dis. 2023 Aug 18;17(8):e0011018. doi: 10.1371/journal.pntd.0011018. Online ahead of print.

ABSTRACT

Zoonotic pathogens spread by wildlife continue to spill into human populations and threaten human lives. A potential way to reduce this threat is by vaccinating wildlife species that harbor pathogens that are infectious to humans. Unfortunately, even in cases where vaccines can be distributed en masse as edible baits, achieving levels of vaccine coverage sufficient for pathogen elimination is rare. Developing vaccines that self-disseminate may help solve this problem by magnifying the impact of limited direct vaccination. Although models exist that quantify how well these self-disseminating vaccines will work when introduced into temporally stable wildlife populations, how well they will perform when introduced into populations with pronounced seasonal population dynamics remains unknown. Here we develop and analyze mathematical models of fluctuating wildlife populations that allow us to study how reservoir ecology, vaccine design, and vaccine delivery interact to influence vaccine coverage and opportunities for pathogen elimination. Our results demonstrate that the timing of vaccine delivery can make or break the success of vaccination programs. As a general rule, the effectiveness of self-disseminating vaccines is optimized by introducing after the peak of seasonal reproduction when the number of susceptible animals is near its maximum.

PMID:37594985 | DOI:10.1371/journal.pntd.0011018