Category: Statistics

Orthod Craniofac Res. 2024 Oct 23. doi: 10.1111/ocr.12867. Online ahead of print.

ABSTRACT

OBJECTIVE: Although the technique of orthodontic aligners has risen in popularity, their mechanical properties have not been thoroughly investigated. The aim of this study was to evaluate the mechanical properties of the orthodontic aligners Clear Aligner after intraoral use for 7, 10 and 14 days, and to compare them with as-received aligners (0 days). It was also sought to examine the properties of the unprocessed raw material (polyethylene glycol terephthalate) used to manufacture these aligners.

MATERIALS/METHODS: Thirty-two aligners by four patients were evaluated and studied at 0, 7, 10, 14 days of use. Each aligner was divided into three segments (two posterior and one anterior), which resulted in 96 samples. Also, 16 samples of unprocessed material were studied. For all samples, elastic modulus, ultimate tensile stress (UTS) and yield stress were calculated by conducting tensile testing. Additionally, material hardness was tested. The two-tailed Mann-Whitney test was performed, having set the level of significance at p = 0.05.

RESULTS: Analysis of the measurements indicated a statistically significant decrease in elastic modulus between days 0 and 14 of use, of UTS between days 0 and 7, 7 and 10, and of yield stress between days 0 and 7. For hardness, in every period, posterior segments demonstrated significantly higher values than anterior segments. All properties of the unprocessed material were statistically significantly higher than the processed samples.

CONCLUSIONS: The unprocessed material presented significant differences in every property tested in comparison to the processed aligners. The processed material showed further deterioration over time during use. The present study provides evidence that thermoforming and ageing affect the mechanical properties of the aligners.

PMID:39441556 | DOI:10.1111/ocr.12867

J Magn Reson Imaging. 2024 Oct 23. doi: 10.1002/jmri.29632. Online ahead of print.

ABSTRACT

BACKGROUND: Women with premenstrual syndrome (PMS) are at increased risk for depression throughout their lives. White matter (WM) microstructure and inflammatory cytokine alterations have been proposed in its etiology.

PURPOSE: To investigate whether WM, assessed using diffusion tensor imaging (DTI), and inflammatory cytokine levels are altered in PMS, and to examine the relationships between WM microstructure, inflammatory cytokines, and symptom severity.

STUDY TYPE: Prospective.

SUBJECTS: Forty-two PMS patients and 58 healthy controls (HCs), categorized according to the daily record of severity of problems (DRSP).

FIELD STRENGTH/SEQUENCE: 3-T, echo planar imaging DTI.

ASSESSMENT: Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured by using tract-based spatial statistics (TBSS). Venous blood was collected to measure cytokines, including interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). Symptoms were assessed by using the DRSP.

STATISTICAL TESTS: Two-sample t test or Mann-Whitney U test were used to compare the DRSP and cytokines. Abnormal DTI metrics in WM were extracted and the differences between groups were analyzed by using two sample t-tests. Spearman’s correlation (r) was used to assess the relationship between DTI metrics, cytokines, and DRSP. A P-value <0.05 with FDR correction was considered statistically significant.

RESULTS: Compared with HCs, PMS patients showed significantly lower FA in the corpus callosum and corona radiata, and significantly higher MD, AD, and RD in the corticospinal tract (CST), and significantly higher MD and RD in the anterior thalamic radiation (ATR). These differential metrics were significantly correlated with DRSP. Patients showed significantly higher IL-1β and TNF-α than HCs. Moreover, TNF-α correlated positively with MD, AD, and RD in both groups (r range, 0.256-0.315).

DATA CONCLUSION: Alterations of WM microstructure and IL-1β and TNF-α may be associated with PMS symptom severity, and TNF-α may correlate with DTI metrics of CST and ATR pathways.

EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.

PMID:39441549 | DOI:10.1002/jmri.29632

Int J Rheum Dis. 2024 Oct;27(10):e15320. doi: 10.1111/1756-185X.15320.

ABSTRACT

AIM: Evaluate the efficacy and safety ® (olokizumab) in patients with rheumatoid arthritis (RA) in real-world clinical practice, with a targeted assessment of patient report outcomes (PRO) and central sensitization.

METHODS: An open-label observational non-interventional study was conducted, enrolling 183 patients with moderate and severe RA activity. All patients received OKZ 64 mg SC as injections every 4 weeks (Q4W) with methotrexate. The patients’ follow-up period was 24 weeks or less. RA activity (DAS28-CRP), pain severity (NRS), patient global assessment (PGA, NRS), functional impairment (NRS), fatigue (FACIT-F), central sensitization (central sensitization inventory, CSI), and symptoms of neuropathic pain (PainDETECT) were evaluated.

RESULTS: The study cohort was comprised of 144 patients. And 39 patients were lost to follow-up, refused OKZ treatment, or were not dosed with OKZ for administrative reasons. In 6 months, DAS28-CRP decreased to 3.3 ± 0.9 (p < .001) and statistically significant reductions in pain intensity, PGA, functional impairment, and fatigue were achieved. Pain intensity decreased as early as 2 days after the first OKZ administration (p < .05). The number of patients with CSI >40 in 24 weeks decreased from 71.0% to 21.0% (p < .001), with PainDETECT >18 – from 21.5% to 13.2%. NSAIDs use decreased from 70.8% to 33.8% (р < .001), steroids – from 54.2% to 32.6%. AEs were reported in 14.2% patients, serious events were observed in three patients.

CONCLUSION: OKZ is effective in reducing RA activity and controlling chronic pain related to dysfunction of the nociceptive system.

PMID:39441547 | DOI:10.1111/1756-185X.15320

Clin Psychol Psychother. 2024 Sep-Oct;31(5):e70001. doi: 10.1002/cpp.70001.

ABSTRACT

BACKGROUND: Personal recovery is valued by people with bipolar disorder (BD), yet its conceptualisation is unclear. Prior work conceptualising personal recovery has focussed on qualitative evidence or clinical factors without considering broader psychosocial factors. This study used a network analysis of Bipolar Recovery Questionnaire (BRQ) responses, aiming to identify (1) independent relationships between items to identify those most “central” to personal recovery and (2) how the relationships between items reflect themes of personal recovery.

METHODS: The model was developed from BRQ responses (36 items) from 394 people diagnosed with bipolar disorder. The undirected network was based on a partial correlation matrix and was weighted. Strength scores were calculated for each node. Community detection analysis identified potential themes. The accuracy of the network was assessed using bootstrapping.

RESULTS: Two consistent communities were identified: “Access to meaningful activity” and “Learning from experiences.” “I feel confident enough to get involved in things in life that interest me” was the strongest item, although the strength stability coefficient (0.36) suggested strength should be interpreted with caution. The average edge weight was 0.02; however, stronger edges were identified.

LIMITATIONS: The network showed low stability, possibly due to sample heterogeneity. Future work could incorporate demographic variables, such as time since BD diagnosis or stage of personal recovery, into network estimation.

CONCLUSIONS: Network analysis can be applied to personal recovery, not only clinical symptoms of BD. Clinical applications could include tailoring recovery-focussed therapies towards encouraging important aspects of recovery, such as feeling confident to get involved with life.

PMID:39441546 | DOI:10.1002/cpp.70001

Anat Histol Embryol. 2024 Nov;53(6):e13113. doi: 10.1111/ahe.13113.

ABSTRACT

Pre-determined anatomical locations in the oral cavity were biopsied, and their histomorphology was characterised using haematoxylin and eosin staining (H&E). The most abundant cell type was of dendritic morphology. Lymphocyte foci were not evident in the palatoglossal folds or the gingiva. Immunohistochemical staining (IHC) for validated leukocyte markers followed, including CD3, CD20, CD79α, CD204, and Iba1. Consistent with H&E findings, CD204 immunoreactivity predominated amongst all niches. With the exception of the alveolar mucosa and palatoglossal folds, we also demonstrate a significant difference in the population of macrophages by region for only the Iba1 antigen (p < 0.0001). B lymphocytes were found, and a significant difference was noted in the sub-epithelium where CD20-positive cells outnumbered those labelled as CD79a positive (p = 0.001), suggesting the possibility that these cells are in an active state in health. A similar significant difference was found in the subepithelial tissue for myeloid cells, as there were more cells labelled as CD204 positive over Iba1, which, along with their distribution pattern, indicates a possible functional and morphological overlap between these cells. No significant difference was found in epithelial tissues for cells of either myeloid or lymphoid origins. The results from this study suggest different regions of the oral cavity exhibit variations in the distribution of immune cells, particularly macrophages and B lymphocytes. Though more studies would be needed to confirm these findings, these differences may have implications for the immune response and overall health of the oral mucosa.

PMID:39441534 | DOI:10.1111/ahe.13113

Environ Sci Pollut Res Int. 2024 Oct 23. doi: 10.1007/s11356-024-35373-5. Online ahead of print.

NO ABSTRACT

PMID:39441514 | DOI:10.1007/s11356-024-35373-5

Environ Sci Pollut Res Int. 2024 Oct 23. doi: 10.1007/s11356-024-35302-6. Online ahead of print.

ABSTRACT

Highway stormwater (HSW) runoff is among the environment’s most important sources of microplastics. This study aimed to characterize via vibrational spectroscopy and quantify SMPs (small microplastics < 100 µm) in HSW runoff from a trafficked highway entering a facility equipped with a filtration system and in those flowing out to the receiving water body near agricultural activities. Samples of the inlet runoff (from the highway) and outlet runoff (the discharge into the environment) were collected in different periods to investigate potential seasonal and spatial differences. The sampling, methodology, and analysis were thoroughly carried out to quantify and simultaneously identify SMPs via Micro-FTIR to obtain a specific novel dataset to assess the environmental quality of highway pollution. A significant difference between inlet and outlet samples was reported; the highest abundance in inlet samples was 39813 ± 277 SMPs L^.1 (SW10 IN; average length of 77 µm), while the highest one in outlet samples was 15173 ± 171 SMPs L^-1 (SW10 OUT; SMPs’ average length of 63 µm). Polyamide 6 (PA 6) and High-Density Polyethylene (HDPE) were predominant. Our results show that these HSW treatment plants, designed for managing regulated pollutants, can intercept SMPs, improving the quality of HSW runoff discharged into the environment.

PMID:39441510 | DOI:10.1007/s11356-024-35302-6

Neurol Ther. 2024 Oct 23. doi: 10.1007/s40120-024-00671-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Real-world data are required to provide a greater understanding of the impact of ofatumumab on the ability to mount an effective immune response following the receipt of approved COVID-19 vaccinations. This retrospective real-world analysis aimed to describe the humoral immune response to COVID-19 vaccination during ofatumumab treatment in patients with multiple sclerosis (MS).

METHODS: Data from patients with MS treated with ofatumumab who were fully vaccinated against COVID-19 infection were abstracted from medical charts at four clinical sites in the USA. Patient characteristics and humoral response were summarized descriptively. Differences in humoral response were documented on the basis of vaccination status during ofatumumab treatment (i.e., after full vaccination and after booster vaccination) and prior disease-modifying treatment (DMT) exposure (i.e., DMT naïve, prior anti-CD20/sphingosine 1-phosphate [S1P] therapy, prior non-anti-CD20/S1P therapy). The sample size precluded formal statistical analysis.

RESULTS: Thirty-eight patients were included. The mean (standard deviation) duration of ofatumumab treatment upon data collection was 20.4 (4.6) months (treatment ongoing for 35 [92%] patients). Definitive humoral response after full vaccination was documented for 34 patients, of whom 20 (60%) were seropositive. Definitive humoral response after booster vaccination was documented among five patients, of whom three (60%) were seropositive. Among patients who were DMT naïve prior to ofatumumab (n = 15), 73% were seropositive; among patients exposed to prior anti-CD20/S1P therapy (n = 14), 33% were seropositive; and among patients exposed to prior non-anti-CD20/S1P therapy (n = 9), 56% were seropositive. Patients naïve to DMT had been living with an MS diagnosis for a shorter duration than those experienced with DMTs.

CONCLUSION: Patients with MS receiving ongoing treatment with ofatumumab can mount a positive humoral response to a COVID-19 vaccination. Prior treatment with anti-CD20 or S1P DMTs may be a risk factor for lower humoral response.

PMID:39441497 | DOI:10.1007/s40120-024-00671-0

J Gen Intern Med. 2024 Oct 23. doi: 10.1007/s11606-024-09117-7. Online ahead of print.

ABSTRACT

BACKGROUND: Black women in academic medicine experience racial and gender discrimination, all while being tasked with improving a flawed system. Representation of Black women in medicine remains low, yet they bear the burden of fostering diversity and mentoring trainees, exacerbating their minority tax and emotional labor, and negatively impacting career progression.

OBJECTIVE: To complement qualitative accounts of Black women authors in the medical education literature with a quantitative account of their representation. We used statistical modeling to estimate the representation of Black women authors in medical education publishing as compared to other groups.

DESIGN: An intersectional methodology employing bibliometric analysis and testimonio reflection.

SUBJECTS: US-based authors of journal articles published in medical education journals between 2000 and 2020.

MAIN MEASURES: Author race was determined using a probability-based algorithm incorporating US Census data, and author gender was ascribed using Social Security Administration records. We conducted two negative binomial generalized linear models by first and last author publications. Metadata for each article was retrieved from Web of Science and PubMed to include author names, country of institutional affiliation, and Medical Subject Headings (MeSH). Results were contextualized via the “testimonio” account of a Black woman author.

KEY RESULTS: Of 21,945 unique authors, Black women (and other racially minoritized groups) published far fewer first and last author papers than white women and men. In addition, major MeSH terms used by Black women authors reveal little overlap with highly ranked medical education topics. The testimonio further narrated struggles with belonging and racial identity.

CONCLUSION: This study revealed that Black women are underrepresented in medical education publishing. We believe that dismantling oppressive structures in the publishing ecosystem and the field is imperative for achieving equity. Additionally, further experiential accounts are needed to contextualize this quantitative account and understand underrepresentation in medical education publishing.

PMID:39441491 | DOI:10.1007/s11606-024-09117-7

Clin Rheumatol. 2024 Oct 23. doi: 10.1007/s10067-024-07190-1. Online ahead of print.

ABSTRACT

The study aims to assess the diagnostic and clinical significance of autoantibodies against aquaporin-1 (anti-AQP1) and aquaporin-5 (anti-AQP5) in primary Sjögren’s syndrome (pSS). A total of 163 participants were categorized into three groups: pSS group, other connective tissue diseases (CTD) group, and healthy control (HC) group. The levels of anti-AQP1 and anti-AQP5 autoantibodies in serum were determined using enzyme-linked immunosorbent assay (ELISA), and clinical data from patients were collected for statistical analysis. Our results showed that the level of anti-AQP1 in the pSS group was higher than in the HC group (P < 0.05), and no significant difference was observed between the pSS group and the CTD group (P > 0.05). ROC showed that the anti-AQP1 had no diagnostic value for pSS (P > 0.05). The anti-AQP5 level of 39 healthy adults was all below the cut-off value (14.10 ng/ml) (P < 0.05). The level of anti-AQP5 in the pSS group was higher than the CTD group (P < 0.05), the AUC was 0.86 (95% CI 0.80-0.93), with a sensitivity of 0.95 (95% CI 0.87-0.99) and a specificity of 0.70 (95% CI 0.58-0.84). No correlation was found between anti-AQP5 levels and the EULAR primary Sjögren’s syndrome disease activity index score, anti-SSA, anti-SSB, antinuclear antibodies, rheumatoid factor, anti-ds-DNA, salivary gland flow rate, complement 3, and lymphocyte count in pSS samples (P > 0.05), respectively. Therefore, the elevated anti-AQP5 may emerge as a novel diagnostic biomarker for pSS patients due to high sensitivity and specificity.

PMID:39441465 | DOI:10.1007/s10067-024-07190-1