Category: Statistics

Dent Mater. 2025 Mar 20:S0109-5641(25)00289-1. doi: 10.1016/j.dental.2025.03.005. Online ahead of print.

ABSTRACT

OBJECTIVES: To formulate crosslinker-modified etchants with phosphoric acid (PA) and an organic acid for effective dentin demineralization while addressing solubility issues, and to evaluate their impact on bond strength, nanoleakage, and matrix metalloproteinases (MMP) activity in sound dentin (SD) and caries-affected dentin (CAD) before and after thermocycling.

METHODS: Crosslinker-modified etchants were prepared by mixing 35 % tartaric acid (TA) and 10 % PA and adding 1 % of theaflavins (TF), cranberry extract (CR), or EDC/NHS (EDC). The etchants without crosslinker were used as controls. Dentin surfaces of 74 human molars were exposed, and 35 of them were submitted to a microbiological cariogenic challenge to create CAD. Specimens from SD and CAD were randomly allocated into 10 groups according to the different etchants. Resin-dentin interfacial bonding properties were evaluated after 24 h and after 10,000 thermocycling through microtensile bond strength (μTBS), nanoleakage and MMPs activity via in situ zymography. Statistical analysis was performed using ANOVA followed by Games-Howell or Tukey’s tests.

RESULTS: Compared to the control and EDC-modified groups, TF- and CR-modified etchants maintained stable bond strength and significantly reduced MMP activity, preserving this protection even after thermocycling, which simulates one year of clinical aging, regardless of dentin type (both SD and CAD). While their impact on nanoleakage in CAD was less pronounced after thermocycling, it remained below 50 % of the levels observed in the control and EDC-modified groups.

SIGNIFICANCE: Crosslinker-modified etchants, particularly TF and CR, provide a promising approach for simultaneous etching and biomodification of clinically relevant dentin substrates, enhancing bonding durability.

PMID:40118707 | DOI:10.1016/j.dental.2025.03.005

Transplant Proc. 2025 Mar 20:S0041-1345(25)00156-3. doi: 10.1016/j.transproceed.2025.02.045. Online ahead of print.

ABSTRACT

AIM: We aimed to investigate the effects of Empagliflozin on cardiac arrhythmias and heart rate variability in kidney transplant recipients (KTRs).

METHODS: Twenty-seven diabetic patients who underwent kidney transplantation between August 2020 and August 2023 were included. Patients with HbA1c >8% were received Empagliflozin treatment. A 24-hour Holter ECG monitoring was performed before and one year after beginning Empagliflozin. Holter ECGs were evaluated by a single cardiologist, comparing ventricular ectopic beats (VEB) and supraventricular ectopic beats (SEB) arrhythmias and heart rate variability parameters before and after one year of Empagliflozin treatment.

RESULTS: Twenty-seven patients completed the study, and the mean patient age was 56.1 ± 10 years. Fifteen of the patients (55.6%) were male. The mean duration since transplant before starting Empagliflozin was 62.8 ± 46.2 months. In follow-up, HbA1c decreased from 8.2% to 7.7%(P = .075), urine protein/creatinine ratio reduced from 0.437 ± 0.428 to 0.267 ± 0.146 gr/g (P = .056), and platelet count increased significantly (P = .004). After one year of treatment, the number of VEBs and SEBs in the patients decreased compared to pretreatment. They decreased from 173.5 ± 460.8 and 514.8 ± 265 beats before treatment to 125.1 ± 231.7 and 125.1 ± 231.7 beats after treatment, respectively, but did not reach statistical significance (P > .05). No significant changes were found in heart rate variability parameters (P > .05). No significant correlation was found between VEBs and SEBs and cardiac inflammation indicators (P > .05).

CONCLUSION: This study, for the first time, investigated the effect of Empagliflozin on cardiac arrhythmias and heart rate variability in diabetic KTRs. Empagliflozin did not significantly affect cardiac arrhythmias and heart rate variability in KTRs.

PMID:40118705 | DOI:10.1016/j.transproceed.2025.02.045

Res Social Adm Pharm. 2025 Mar 15:S1551-7411(25)00087-7. doi: 10.1016/j.sapharm.2025.03.008. Online ahead of print.

ABSTRACT

INTRODUCTION: Infographics may be more effective at communicating scientific research compared to text-based abstracts. Using well-designed infographics may expand target audiences beyond the traditional scholarly circles.

AIMS: This study aims to compare the effectiveness and viewer experience of infographics vs. text-based abstracts as research communication tools.

METHODS: A posttest-only, between-participants, digital pilot study was conducted in early 2024. Participants from the field of pharmacy or pharmaceutical sciences were randomized to view either infographics or text-based abstracts for the same research articles. Articles and infographics chosen were sourced from peer-reviewed journals. Survey items, designed from previously published research and by authors, assessed understanding, recall, effectiveness, cognition (cognitive load), and attention. Chi-square tests were used to analyze categorical and ordinal data. Unpaired two-sided t-tests were used to analyze continuous data. Internal reliabilities were calculated for each Likert scale. Exclusion criteria included responses recorded in less than 300 seconds and responses that did not complete all questions for at least one article.

RESULTS: Final analysis included data from 30 infographics viewers and 16 text-based abstracts viewers. Most participants were white, female students from the United States without any reported learning disabilities. Overall, there were no statistically significant differences observed between any measure type. Some infographics had significantly better scores on attention and effectiveness items.

DISCUSSION: Some infographics may perform better than text-based abstracts on measures of attention and effectiveness. The study lacks sufficient power, potentially resulting in failure to detect true differences. Results may differ in populations including non-experts, neurodivergent readers, and individuals whose first language is not English.

CONCLUSION: Infographics may be no better than abstracts at communicating research findings within an audience of scientific readers. Further investigation is warranted to understand how to best leverage infographics as a communication tool.

PMID:40118685 | DOI:10.1016/j.sapharm.2025.03.008

J Prosthet Dent. 2025 Mar 20:S0022-3913(25)00208-2. doi: 10.1016/j.prosdent.2025.02.059. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: While dual-polymerizing self-adhesive resin cements have been widely used because of their bonding capabilities and ease of use, there is a lack of comprehensive data on their biocompatibility, particularly concerning the cytotoxic effects of different polymerization methods on cell viability.

PURPOSE: The purpose of this in vitro study was to investigate the potential cytotoxic effects of 3 different dual-polymerizing self-adhesive resin cements polymerized by light polymerization or autopolymerization on L929 cells in vitro using by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium-bromide (MTT) test.

MATERIAL AND METHODS: Three different dual-polymerizing self-adhesive resin cements (Calibra Universal; Dentsply Sirona Inc, SpeedCEM Plus; Ivoclar AG, and TheraCem Ca; Bisco Inc) were light or autopolymerized in polytetrafluoroethylene (PTFE) molds containing Ø5-mm and 2-mm-thick cells in accordance to the manufacturer’s instructions. The specimens were incubated in Dulbecco Modified Eagle Medium (DMEM-High; Capricorn Scientific GmbH) for 48 hours and the extracts were obtained. The 100% concentration of the extract was diluted and extracts at 66.7%, 44.4%, 29.6%, and 19.8% concentrations were obtained. Specimen extracts at 5 different concentrations were incubated with L929 (NCTC clone 929: CCL 1; American Type Culture Collection) mouse fibroblast cells in 96-well tissue culture plates at 37 °C and 5% CO₂ for 24, 48, and 72 hours. At the end of the incubation period, the effects of the materials on cell viability were evaluated with the MTT test. The data were analyzed using a statistical software program (IBM SPSS Statistics, v25.0; IBM Corp) (α=.05), employing ANOVA and the Tukey’s HSD test.

RESULTS: All tested cement specimens significantly reduced cell viability (P<.05). Cell viability decreased with increasing concentration and incubation time in all specimens tested. The light-polymerized SpeedCem Plus showed the least cytotoxicity regardless of concentration and incubation time, followed by TheraCem Ca. However, the autopolymerized Calibra Universal significantly reduced cell viability. Cell viability rate of all light polymerized cements was considerably higher than autopolymerized cements (P<.05).

CONCLUSIONS: All the tested self-adhesive resin cements caused a significant reduction in viability of L929 cells. The composition of the self-adhesive resin cement and the activation type of polymerization affected cytotoxicity.

PMID:40118683 | DOI:10.1016/j.prosdent.2025.02.059

J Prosthet Dent. 2025 Mar 20:S0022-3913(25)00189-1. doi: 10.1016/j.prosdent.2025.02.041. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Removable partial dentures (RPDs) provide an important treatment option for replacing missing teeth, particularly for vulnerable populations. However, RPDs have been associated with damage to the remaining dentition, which can lead to treatment failure.

PURPOSE: The purpose of this retrospective clinical study was to investigate the failure rates of RPD treatments among patients at a state-sponsored dental school and identify factors contributing to these failures.

MATERIAL AND METHODS: A retrospective analysis was conducted using electronic health records (EHRs) from 4941 individuals for a total of 7529 patient-arches. The outcome of RPD treatment was defined as failure when any major procedure was performed on any tooth adjacent to a treated edentulous span. The time to event was measured from the date of RPD placement to the first recorded failure or the last follow-up visit (censored). A multivariable Cox proportional hazards model was employed to assess the hazard ratios for the variables of interest (α=.05).

RESULTS: The average age of the cohort was 59 years, 52% female, and the mean follow-up period was 35 months. Among the arches that experienced failure (24.2%), the average time to failure was 33 months. In the multivariable model, statistically significant associations with RPD failure were found for several variables: Kennedy classification without distal extension (HR=1.23, P<.001), older age (HR=1.01, P<.001), male sex (HR=1.17, P=.008), maxillary arch (HR=1.60, P<.001), lack of insurance (HR=0.78, P<.001), cast metal framework (HR=0.55, P<.001), tobacco use (HR=1.21, P=.002), and dental fear (HR=1.26, P=.003).

CONCLUSIONS: While the associations were not particularly strong, dental school patients who smoked, experienced dental anxiety, or received maxillary RPDs or RPDs without a cast metal framework demonstrated an elevated risk of requiring major treatment to the abutment teeth, leading to the failure of the RPD treatment.

PMID:40118681 | DOI:10.1016/j.prosdent.2025.02.041

An Bras Dermatol. 2025 Mar 20:S0365-0596(25)00025-X. doi: 10.1016/j.abd.2024.05.011. Online ahead of print.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) burden increases with disease severity.

OBJECTIVE: Characterize the real-world burden of AD in Brazil, Mexico, and Argentina.

METHODS: MEASURE-AD enrolled patients (≥12-years old) with moderate to severe AD receiving or candidates for systemic therapy between December 2019-December 2020. Patient characteristics, treatments, and outcomes were recorded during one office visit. Primary outcome measures included worst itch/past 24hours (Worst Pruritus Numerical Rating Scale [WP-NRS]), quality of life (QoL, Dermatology Life Quality Index [DLQI] and Children’s DLQI [CDLQI]).

RESULTS: Of 180 patients (adults, n=157; adolescents, n=23), 52.2% were male, the mean (SD) age was 33.8 (17.0) years, and all were receiving AD treatment (65.6% systemic therapy). Severe pruritus (WP-NRS ≥ 7) was reported by 54.4% (adults, 57.3%; adolescents, 34.8%). A very/extremely large effect on QoL (DLQI/CDLQI≥11) was reported among 50.0% of patients ≥ 16 years old and 42.9% of patients 12-15 years old. The mean Eczema Area Severity Index (EASI) was 17.0 (adults, 17.7; adolescents, 12.4); 3.9% of patients had clear skin (EASI 0) and 26.7% had severe AD (EASI 23-72). Over the previous 6 months, 0, 1-2, 3-4, 5-6, and > 6 flares were reported by 8.3%, 27.2%, 31.1%, 11.7%, and 15.6% of patients, respectively. On average, flares lasted 15.2 days (adults, 15.9 days; adolescents, 11.1 days).

STUDY LIMITATIONS: Patient self-reported information and recall during one office visit.

CONCLUSIONS: Despite treatment, disease severity and impact on QoL were high, suggesting that AD is not adequately controlled in all patients, highlighting a considerable unmet need for effective treatments to reduce AD burden.

PMID:40118674 | DOI:10.1016/j.abd.2024.05.011

J Voice. 2025 Mar 20:S0892-1997(25)00089-X. doi: 10.1016/j.jvoice.2025.02.040. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the behavior of vocal nodules from childhood to postpuberty.

METHODS: Adolescents aged 15 years or older who presented vocal nodules in childhood were included and underwent the same evaluations performed in childhood. They answered a questionnaire about vocal symptoms, treatments, habits, and vocal abuse. They were submitted to videolaryngoscopy, auditory-perceptual, and acoustic vocal assessments.

RESULTS: In total, 31 adolescents (15-18 years), 23 boys, eight girls, mean age in childhood and postpuberty: girls (10.25 ± 1.85, 16.75 ± 1.3); boys (10.08 ± 1.34, 15.95 ± 1.87), without statistical difference between childhood and postpuberty (P > 0.05).

SYMPTOMS: four boys (12.9%) and three girls (9.67%) maintained dysphonia postpuberty. Videolaryngoscopy: nodules were not detected after puberty. Minor alterations: hyperemia (n-2), edema (n-1), posterior glottic cleft (n-1), and microweb (n-1).

TREATMENTS: vocal therapy (n-18), microsurgery (n-8), and no treatment (n-5). There was a significant difference in the acoustic (maximum phonation time, f₀, jitter, pitch perturbation quotient, shimmer, amplitude perturbation quotient, and Student t test) and acoustic perceptive parameters (Mann-Whitney rank sum test) between the moments (childhood and postpuberty). In the comparison between the treatments (Shapiro-Wilk and Kolmogorov-Smirnov tests) just for shimmer parameter, there was a statistical difference, being more significant in surgery and speech therapy.

CONCLUSIONS: After puberty, we observed a reduction in vocal symptoms, as well as an improvement in videolaryngoscopic findings and in auditory and acoustic perceptive vocal parameters. In the comparison between the treatments just for shimmer parameter, there was a statistical difference, being more significant in surgery and speech therapy.

PMID:40118659 | DOI:10.1016/j.jvoice.2025.02.040

Int J Geriatr Psychiatry. 2025 Mar;40(3):e70064. doi: 10.1002/gps.70064.

ABSTRACT

INTRODUCTION: The rise of mobile health interventions offers significant potential to improve the well-being of the aging global population, particularly individuals at an increased risk of dementia. To fully leverage this potential, it is crucial to evaluate the mobile health applications across different demographic and socio-economic landscapes. This study investigated the relationship between a country’s development status and the quality of dementia-focused mobile health applications, as well as the influence of developers’ medical expertise on app quality and perceived impact.

METHODS: This cross-sectional observational design study utilized the uMARS tool to evaluate the objective and subjective quality of dementia-related mobile health applications. Objective quality was assessed across engagement, functionality, aesthetics, and information domains, while subjective quality included user recommendations, anticipated usage, and perceived impact. A stratified random sampling method selected 17 apps for evaluation, and inter-reviewer reliability was confirmed (Kendall’s W = 0.143, p = 0.045). Data analysis involved descriptive statistics, independent sample t-tests, and Pearson’s correlation coefficients, with statistical significance set at p < 0.05.

RESULTS: Among the 51 dementia-related mobile health app analyzed, only one was developed in a low-income country. Additionally, this study found a linear correlation between the perceived impact of a mobile health app for dementia and the medical background of the development team, with a Pearson correlation coefficient of t = 3.708 (p < 0.001). Engagement was highly correlated with subjective quality (Pearson correlation coefficient r = 0.955, p < 0.001), and there was a strong correlation between the information provided by the apps and the perceived impact (Pearson correlation coefficient r = 0.884, p < 0.001).

CONCLUSION: The adoption of mobile health apps must be prioritized to assist individuals with dementia and their caregivers in low income countries. Future apps should focus on improving engagement and involving medical experts in development to increase credibility and utilization across socioeconomic levels and healthcare systems.

PMID:40118652 | DOI:10.1002/gps.70064

Kidney Int. 2025 Apr;107(4):602-605. doi: 10.1016/j.kint.2025.01.012.

ABSTRACT

In this issue, Schouten et al. report findings from a cost-effectiveness analysis of hemodiafiltration versus conventional high-flux hemodialysis using data from the Comparison of High-Dose Hemodiafiltration with High-Flux Hemodialysis (CONVINCE) trial. They found that the overall cost-effectiveness of hemodiafiltration is within the range of accepted willingness-to-pay thresholds in some countries, while near (but outside) the lower-bound thresholds of other countries. How decision-makers value treatment costs for additional years on dialysis and country-specific costs and willingness-to-pay thresholds influence the cost-effectiveness of hemodiafiltration.

PMID:40118588 | DOI:10.1016/j.kint.2025.01.012

J Am Board Fam Med. 2024 Nov-Dec;37(6):1014-1026. doi: 10.3122/jabfm.2023.230469R1.

ABSTRACT

BACKGROUND: At least 26 different fecal immunochemical tests (FITs) are available for use in the US. Liquid vial and card collection devices are available.

OBJECTIVES: 1) assess participant’s difficulties with and preferences for types of FITs; 2) assess whether errors in FIT collection were associated with FIT collection difficulty; 3) identify factors associated with difficulty with FIT stool collection.

METHODS: Prospective individuals scheduled for a colonoscopy were invited to participate in a study comparing test characteristics of 5 FITs. A product questionnaire asked participants about ease of collection and difficulties.

RESULTS: 2,148 participants; mean age 63 years; 63% females, 83% Whites, and 19% Hispanics. 1265 (61%) preferred use of a liquid vial versus 181 (9%) the card. 49% had no difficulty with Hemoccult ICT, and 66 to 70% had no difficulty with the liquid vials. Difficulties with Hemoccult ICT included: being messy (21%), collection window too small (19%), and getting sample on stick (8%). Difficulties with the liquid vials included difficulty probing or scraping the stool (5% to 8%) and unclear directions (3%). In a multivariable model, the perceived difficulty in FIT collection was significantly higher for Hemoccult ICT compared with OC-Auto Micro (adjusted odds ratio [AOR], 4.05), and it was significantly high for those with a FIT error (AOR, 3.90).

CONCLUSION: Participants strongly preferred a liquid vial compared with a card. Perceived difficulty was significantly associated with FIT errors and with FIT brand. Medical offices providing FITs should ensure that patients understand the task of FIT collection, so that errors are minimized.

PMID:40118555 | DOI:10.3122/jabfm.2023.230469R1