Category: Statistics

J Dent. 2024 Oct 25:105431. doi: 10.1016/j.jdent.2024.105431. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective was to investigate the dimensional stability of different types of 3D printed dental models, and to measure the dimensional changes over time.

METHODS: Four dental casts with different constructions were printed. The four types of models were as follows: hollow casts with 2.5 mm wall thickness (2,5mm.H), hollow casts with 2 mm wall thickness (2mm.H), hollow casts with 2 mm wall thickness with stabilization bars (2mm.B) and hollow casts with 2 mm wall thickness with gypsum base (2mm.G). The casts were digitized with a laboratory scanner (3Shape E3 Red E Scanner) to obtain the reference Standard Tessellation Language (STL) files. All models were stored at room temperature and scanned again after 1 day and after 1, 2 and 10 weeks. This data was compared to the reference STL file and was analysed by comparing the deformation using surface fitting software (Geomagic Control X, 3D Systems). The results were statistically evaluated using paired Student’s t-tests, with the significance level set at p<0.05.

RESULTS: There were significant differences in dimensional stability after 10 weeks between the four different dental casts. According to our results, the 2mm.B casts showed the least deformation which was followed by the 2mm.H casts. However, both the 2,5mm.H and the 2mm.G casts showed significant deformation compared to the 2mm.B casts.

CONCLUSIONS: Within the limitations of this study – using only one printer and one type of resin – we found that the deformation of all investigated casts remained within the clinically acceptable range. However, there were significant differences between the various construction types printed with the Bego Varseo Printer and Bego Varseo Wax Model Gray material.

CLINICAL SIGNIFICANCE: It is crucial to determine how long 3D printed models can maintain their accuracy to prevent potential adverse effects, especially given the extended storage periods required for the time-consuming procedures in prosthodontic and orthodontic treatments.

PMID:39490627 | DOI:10.1016/j.jdent.2024.105431

J Dent. 2024 Oct 26:105433. doi: 10.1016/j.jdent.2024.105433. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effects of three different scanning strategies on the trueness and precision of optical impressions obtained with four intraoral scanners (IOSs).

METHODS: The reference maxillary dental arch model was fabricated using Telio CAD, and the relative reference digital reference cast was obtained using a computer numerical control machine and an optical scanner (E4, 3Shape, Copenhagen, Denmark). Test scans were performed with four different IOSs (TRIOS3, MEDIT i700, CS 3600, and iTero Element 5D) by an experienced operator and three different scanning strategies (S1: manufacturer-recommended, S2: optimal per previous literature, and S3: experimental). The scan duration was recorded for each scan. All scans were converted to standard tessellation language format and imported into Geomagic Control X. The accuracy was measured by absolute deviation/distance between aligned surfaces. for comparison with the reference cast using Initial Alignment and Best Fit Alignment functions. Data of trueness and precision of each IOS and scan duration were statistically compared using analysis of variance for repeated measures and Bonferroni post-hoc test (p<.05).

RESULTS: Scans obtained with MEDIT i700 and CS 3600 showed higher trueness with S3 (p<.05). Scans obtained with TRIOS 3, MEDIT i700, and CS 3600 were more precise with S3, whereas those with iTero Element 5D were more precise with S2 (p<.05). Statistically significant differences were found in scan duration between different scan strategies for all IOSs.

RESULTS: No significant differences in trueness were found among strategies (S1: 9.98 µm, S2: 11.93 µm, S3: 8.84 µm; p=0.388) in Trios 3 and iTero Element 5D (S1: 12.24µm, S2: 11.53µm, S3: 10.71µm; p= p=0.279). Scanning strategy S3 with MEDIT i700 achieved greater trueness (7.33 µm) than S2 (16.33 µm, p<.05), while no significant difference was noted between S1 (10.44 µm) and S3 (p=0.291). S3 showed the highest trueness (16.28 µm) compared to S2 (24.05 µm) and S1 (24.78 µm, p<.001) for CS 3600, with no difference between S1 and S2 (p=0.457). Trios 3 had higher precision with S2 (22.46 µm) than S3 (31.69 µm, p<.05), and no significant differences between S1 (25.67 µm) and S2/S3 (p>.05). MEDIT i700 with S3 (29.52 µm) was more precise than both S1 (39.52 µm) and S2 (46.24 µm) (p<.001) with no difference between the last two (p=0.302). S2 yielded the highest precision (44.93 µm) compared to S3 (61.81 µm) and S1 (76.53 µm) (p<.001) for CS 3600, with S3 more precise than S1 (p<.001). Similarly, iTero Element 5D showed S2 as the most precise (30.19 µm) compared to S3 (42.80 µm) and S1 (44.45 µm) (p<.05), with no difference between S1 and S3 (p=0.472). Scan durations were shorter for S3 and S1 compared to S2 in Trios 3 (p<.001), and S3 was faster than S1 and S2 for MEDIT i700 (p<.001). CS 3600 scans with S1 were quicker than S2 and S3 (p<.001). For iTero Element 5D, no significant differences were found between S1 and S3 (p=0.511), but S2 was slower than both (p<.001).

CONCLUSIONS: Scanning strategies significantly affect the accuracy and scan duration of optical impressions. Overall, scans obtained with S3 showed the best combination of trueness, precision, and scan duration with MEDIT i700. Specifically, S3 provided the best trueness with both the MEDIT i700 and the CS 3600 while the S2 strategy demonstrated the highest precision for most scanners. Overall, the S1 and S3 strategies resulted faster than S2 among the devices evaluated.

CLINICAL SIGNIFICANCE: The study’s results suggest that the experimental scan strategy may optimize the use of intraoral scanners in clinical practice, potentially leading to more accurate and time-efficient dental impressions.

PMID:39490607 | DOI:10.1016/j.jdent.2024.105433

Reprod Toxicol. 2024 Oct 26:108737. doi: 10.1016/j.reprotox.2024.108737. Online ahead of print.

ABSTRACT

Studies provide notable evidence that oxidative stress (OS) mediated reactive oxygen species (ROS) disturb reproductive health. We have shown in our previous publication that exposure of Di-(2-ethylhexyl) phthalate (DEHP), induces OS mediated ROS generation which inhibits steroid synthesis. In the present study, we demonstrated the ameliorative/protective effects of one of the steroidal saponins, i.e., Shatavarin-IV, isolated from the roots of Asparagus racemosus against DEHP induced OS in rat granulosa cells. Granulosa cells were exposed with DEHP alone (400μM), Shatavarin-IV alone (8μg/ml), and a combination of DEHP + Shatavarin-IV (400μM + 8μg/ml) in vitro for 24 hrs. Intracellular ROS, OS/hypoxia, mitochondrial membrane potential, steroid-responsive genes expression were analyzed. The results revealed that the effective dose of DEHP (400µg) significantly increased OS compared to the control by increasing ROS levels, mitochondrial membrane potential, and β-galactosidase activity with a higher level of apoptotic genes (Bax, Caspase-3) expression at mRNA level. Further, DEHP significantly (p<0.05) reduced mRNA expression of steroidogenic responsive genes (StAR, CYP17A1 and CYP19A1) in granulosa cells treated with above combination compared to control. Interestingly, co-treatment of DEHP + Shatavarin-IV significantly suppressed the DEHP induced OS, ROS, β-galactosidase levels and enhanced steroidogeneic and apoptotic gene expression activities, which suggests that Shatavarin-IV rescued DEHP-induced changes that may useful for the prevention of DEHP- induced reproductive toxicity.

PMID:39490591 | DOI:10.1016/j.reprotox.2024.108737

J Hosp Infect. 2024 Oct 25:S0195-6701(24)00356-6. doi: 10.1016/j.jhin.2024.10.008. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to evaluate whether subcutaneous tunneling in peripherally inserted central catheters (PICC) placement could reduce the occurrence of central-line associated blood stream infection (CLABSI).

METHODS: We conducted an open-label, multicentre, randomized, controlled trial in five tertiary hospitals. Adult hospitalized patients requiring a PICC were randomized in a one-to-one ratio to conventional (cPICC) or tunneled PICC (tPICC) arms using a centralized web-based computer-generated stratified randomization. CLABSI rates between groups were compared in a modified intention-to-treat population. Safety including the incidence of exit-site infection or hemorrhage-associated catheter removal were also compared. This trial was registered with Clinical Research Information Service of Republic of Korea (KCT0005521).

RESULTS: From November 2020 to March 2023, 1,324 participants were enrolled and randomly assigned to tPICC (n=662) and cPICC (n=662). This study was terminated early due to the cohort CLABSI rate being lower than estimated, therefore, the original sample size of 1,694 would render the study underpowered to detect a difference in CLABSI rates. In the tPICC, CLABSI occurred in 13 of 651 participants over 11,071 catheter-days (1.2/1,000 catheter-days), compared with 20 among 650 patients with cPICC over 11,141 catheter-days (1.8/1,000 catheter-days, rate ratio 0.65, 95% CI 0.30-1.38, p=0.30). The incidence of exit-site infection (29 tPICC, 36 cPICC, p=0.5) and hemorrhage-associated catheter removal (11 tPICC, 11 cPICC, p=0.99) was not different between both groups.

CONCLUSION: Due to insufficient sample size, this study could not demonstrate a statistically significant CLABSI risk reduction in the tPICC group compared to the cPICC group. Both groups had similar rates of exit site infection and bleeding.

PMID:39490586 | DOI:10.1016/j.jhin.2024.10.008

World Neurosurg. 2024 Oct 25:S1878-8750(24)01781-9. doi: 10.1016/j.wneu.2024.10.077. Online ahead of print.

ABSTRACT

BACKGROUND: This study explores the vital elements of patient satisfaction in hospital settings, with an emphasis on the aspects of service quality and patient-hospital interaction. It looks at how patients perceive several aspects of service quality, such as assurance, tangibility, empathy, responsiveness, and consistency.

METHODOLOGY: A descriptive cross-sectional study was conducted among 80 Neurosurgery in-patients at the Pakistan Institute of Medical Sciences (PIMS), using convenience sampling. Data collection was done after obtaining consent from each patient. A self-administered questionnaire was used to collect demographic data, and patient satisfaction with the outpatient clinic experience. Data were entered and analyzed in Statistical Package for the Social Sciences, version 25. A chi-square test was used to examine associations between outcome variables and factors related to patient satisfaction.

RESULTS: The majority of the patients were males, 46 (57.5%). The mean age of the patients was 48.73 ± 18.428 years. The waiting time at the hospital also varies, with 77.5% of patients experiencing 0-hour wait time, and the mean waiting time being 38.44 minutes. A positive correlation was found between the following variables: travel time in minutes (χ2 = 0.012, p > 0.05) ; gender (χ2 = 0.037, p < 0.05) ; and the number of hospital visits per month (χ2 = 0.016, p > 0.05) and patient interaction in a health care setting.

CONCLUSION: The study emphasizes the value of excellent patient-hospital interactions and the importance of communication, empathy, and trust-building in promoting these outcomes.

PMID:39490577 | DOI:10.1016/j.wneu.2024.10.077

J Am Coll Radiol. 2024 Oct 26:S1546-1440(24)00852-4. doi: 10.1016/j.jacr.2024.10.011. Online ahead of print.

ABSTRACT

PURPOSE: Routine imaging of soft tissue infection is not recommended and represents a potential area of computed tomography (CT) overuse. The utility of CT in patients with superficial soft tissue infection of the extremities is unknown. The purpose of this study is to evaluate the utilization and clinical impact of CT ordered in the setting of extremity cellulitis.

METHODS: We retrospectively analyzed patients with extremity cellulitis examined with CT between 2012-2021 at a single center. We collected patient history, diagnostic imaging characteristics, and subsequent surgery decision. We hypothesized that yield of CT for deep infection was significantly lower than 10% and that yield was decreasing over time. These hypotheses were evaluated with Rao-Scott Chi-Square tests and repeated measures logistic regression.

RESULTS: There were 496 eligible encounters among 463 patients. Yield of positive CT among lower extremity patients was 5.5% (95%CI 3.33-7.75), significantly less than our hypothesis of 10% (p=0.003). In 71.8% of encounters, patients underwent diagnostic imaging studies in addition to CT. Utilization rose from 0.08% per hospital visit in 2012-2013 to 0.14% in 2020-2021, with differences in yield between time periods not reaching statistical significance (p=0.059). Among 496 encounters, 62 received surgery (12.1%), with 21 of these cases preceded by a positive CT for deep infection.

CONCLUSIONS: Our 10-year single-center analysis of CT use for extremity cellulitis demonstrated a low yield of positive CT findings for deep infection and limited impact of CT on surgical management. A high incidence of patients undergoing multiple radiologic exams suggests uncertainty in selecting appropriate imaging modalities in this clinical scenario.

PMID:39490568 | DOI:10.1016/j.jacr.2024.10.011

Updates Surg. 2024 Nov 3. doi: 10.1007/s13304-024-02000-4. Online ahead of print.

ABSTRACT

Adenocarcinomas, a common subtype of lung cancer, exhibit diverse histological patterns. In 2020, The International Association for the Study of Lung Cancer (IASLC) introduced a grading system emphasizing high-grade components, which has shown prognostic value. Spread through air spaces (STAS) is recognized as a prognostic feature increasing the risk of recurrence in lung cancer. This study evaluates the combination of STAS status and the IASLC-grading system in surgically resected Stage I lung adenocarcinomas. This study is a retrospective analysis of 123 patients with Stage I lung adenocarcinoma who underwent lobectomy between 2011 and 2019. Histological patterns were assessed according to the IASLC criteria, and STAS status was documented. Patients were categorized based on their IASLC Grade and STAS status. Statistical analyses included Kaplan-Meier survival estimates, Cox proportional hazards models, and comparisons using Chi-square and t-tests. The cohort comprised 43 females and 80 males with a mean age of 61.8 ± 7.6 years. STAS positivity was noted in 52.8% of patients. STAS positivity correlated significantly with Grade 3 tumors (p < 0.001). The 5-year recurrence-free survival was significantly lower in STAS-positive patients (70.7% vs. 88.7%, p = 0.026). Patients with Grade 3 and STAS positivity had significantly lower recurrence-free survival compared to other groups (p = 0.002). Grade 3 and STAS positivity were independent predictors of poor recurrence-free survival in multivariate analysis. IASLC Grade 3 tumors and STAS positivity are independent prognostic factors for poor recurrence-free survival in Stage I lung adenocarcinomas. Adjuvant treatment strategies should be considered for patients with these characteristics to improve outcomes.

PMID:39488820 | DOI:10.1007/s13304-024-02000-4

Tissue Eng Regen Med. 2024 Nov 3. doi: 10.1007/s13770-024-00671-z. Online ahead of print.

ABSTRACT

BACKGROUND: Periodontitis is a severe chronic inflammatory disease, whose traditional systemic antimicrobial therapy faces great limitations. In-situ gels provide an effective solution as an emerging local drug delivery system.

METHODS: In this study, the novel thermosensitive poloxamer/carbopol in-situ gels loaded with 20 μmol/L quercetin for the treatment of periodontitis were prepared by cold method. Thirteen batches of in-situ gels based on two independent factors (X₁: poloxamer 407 and X₂: carbopol 934P) were designed and optimized by the statistical method of central composite design (CCD). The transparency, pH, injectability, viscosity, gelation temperature, gelation time, elasticity modulus, degradation rate and in-vitro drug release studies of the batches were evaluated, and the percentage of drug release in the first hour, the time required for 90% drug release, gelation temperature, and gelation time were selected as dependent variables.

RESULTS: These two independent factors significantly affected the four dependent variables (p < 0.05). The optimization result displayed that the optimized concentration of poloxamer 407 was 20.84% (w/v), and carbopol 934P was 0.5% (w/v). The optimized formulation showed a clear appearance (++), acceptable injectability (Pass), viscosity(151,798 mPa s), gelation temperature (36 °C), gelation time (213 s), preferable cell viability and cell proliferation, conformed to first-order release kinetics, and had a significant antibacterial effect.

CONCLUSIONS: The article demonstrates the great potential of the quercetin in-situ gel as an effective treatment for periodontitis.

PMID:39488811 | DOI:10.1007/s13770-024-00671-z

Neuromodulation. 2024 Nov 2:S1094-7159(24)00707-4. doi: 10.1016/j.neurom.2024.09.002. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the analgesic effects of H-coil repetitive transcranial magnetic stimulation (rTMS) primarily targeting the hand area of the primary motor cortex (M1) in patients with peripheral neuropathic pain. Given that the H-coil has a wider reach than conventional coils, there is a possibility that targeting the hand motor cortex also may stimulate prefrontal areas. Thus, we also aimed to examine whether rTMS with an M1 target could produce effects on psychologic outcomes.

MATERIALS AND METHODS: In total, 17 patients were randomly assigned to receive active or sham H-coil rTMS in a counterbalanced order. After a nine-week washout period, they crossed over to either active or sham rTMS, according to a double-blind crossover design. Each treatment period consisted of five daily rTMS sessions and a one- and three-week follow-up visit. The primary outcome was average usual pain intensity. Secondary outcomes included pain unpleasantness, dynamic and static mechanical allodynia, anxiety and depression, sleep, pain catastrophizing, function, and patients’ impression of change. Effects of rTMS were investigated using linear mixed model analyses.

RESULTS: We found two significant interactions between treatment and time, indicating that active H-coil rTMS induced significant analgesic effects (t [134] = -2.18; p = .03; d = -0.10) and significant reductions in anxiety and depression compared with sham stimulation over the treatment course (t [73] = -2.14; p = .04; d = -0.09). The analgesic effect occurred two weeks after the treatment, and the effect on anxiety and depression occurred three weeks after treatment. No other significant interactions were found for the secondary variables.

CONCLUSIONS: Five days of H-coil rTMS targeting the hand area of M1 induced statistically significant effects on pain intensity. Moreover, rTMS improved symptoms of anxiety and depression, possibly because of the wide and deep reach of the H-coil.

CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number for the study is NCT05488808.

PMID:39488777 | DOI:10.1016/j.neurom.2024.09.002

J Inj Violence Res. 2024 Nov 3;16(2). doi: 10.5249/jivr.v16i2.1842. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to investigate the effects of CPT on PTSD, depression, and anxiety symptoms in female victims of domestic violence.

METHODS: A two-arm randomized clinical trial was conducted in Bandar-Abbas involving 62 female victims of domestic violence referred from private gynecology and obstetrics clinics. Initial screening for domestic violence was based on the World Health Organization violence questionnaire. Participants were randomly assigned to either a control group (n=32) or an intervention group (n=28) for a study duration of six months in 2022. Twelve group CPT sessions were conducted. The domestic violence questionnaire, Beck’s Depression Inventory, Beck’s Anxiety Inventory, and the Impact of Event Scale-Revised were completed in three time points: pre-test, post-test, and follow-up.

RESULTS: There was a statistically significant difference in the mean scores of depression, PTSD, and domestic violence (P less than .001) between the two groups; however, no significant difference was found in anxiety scores (P greater than .050).

CONCLUSIONS: CPT is recommended for female victims of domestic violence to reduce symptoms of depression, PTSD, and domestic violence.

PMID:39488744 | DOI:10.5249/jivr.v16i2.1842