Category: Statistics

Brain Netw Modul. 2024 Apr-Jun;3(2):52-60. doi: 10.4103/bnm.bnm_17_24. Epub 2024 Jun 27.

ABSTRACT

Chronic neuropathic pain (CNP) remains a significant clinical challenge, with complex neurophysiological underpinnings that are not fully understood. Identifying specific neural oscillatory patterns related to pain perception and interference can enhance our understanding and management of CNP. To analyze resting electroencephalography data from individuals with chronic neuropathic pain to explore the possible neural signatures associated with pain intensity, pain interference, and specific neuropathic pain characteristics. We conducted a secondary analysis from a cross-sectional study using electroencephalography data from a previous study, and Brief Pain Inventory from 36 patients with chronic neuropathic pain. For statistical analysis, we modeled a linear or logistic regression by dependent variable for each model. As independent variables, we used electroencephalography data with such brain oscillations: as delta, theta, alpha, and beta, as well as the oscillations low alpha, high alpha, low beta, and high beta, for the central, frontal, and parietal regions. All models tested for confounding factors such as age and medication. There were no significant models for Pain interference in general activity, walking, work, relationships, sleep, and enjoyment of life. However, the model for pain intensity during the past four weeks showed decreased alpha oscillations, and increased delta and theta oscillations were associated with decreased levels of pain, especially in the central area. In terms of pain interference in mood, the model showed high oscillatory Alpha signals in the frontal and central regions correlated with mood impairment due to pain. Our models confirm recent findings proposing that lower oscillatory frequencies, likely related to subcortical pain sources, may be associated with brain compensatory mechanisms and thus may be associated with decreased pain levels. On the other hand, higher frequencies, including alpha oscillations, may disrupt top-down compensatory mechanisms.

PMID:39119588 | PMC:PMC11309019 | DOI:10.4103/bnm.bnm_17_24

BJOG. 2024 Aug 8. doi: 10.1111/1471-0528.17922. Online ahead of print.

ABSTRACT

OBJECTIVES: Accurate assessment of gestational age (GA) is important at both individual and population levels. The most accurate way to estimate GA in women who book late in pregnancy is unknown. The aim of this study was to externally validate the accuracy of equations for GA estimation in late pregnancy and to identify the best equation for estimating GA in women who do not receive an ultrasound scan until the second or third trimester.

DESIGN: This was a prospective, observational cross-sectional study.

SETTING: 57 prenatal care centres, France.

PARTICIPANTS: Women with a singleton pregnancy and a previous 11-14-week dating scan that gave the observed GA were recruited over an 8-week period. They underwent a standardised ultrasound examination at one time point during the pregnancy (15-43 weeks), measuring 12 foetal biometric parameters that have previously been identified as useful for GA estimation.

MAIN OUTCOME MEASURES: A total of 189 equations that estimate GA based on foetal biometry were examined and compared with GA estimation based on foetal CRL. Comparisons between the observed GA and the estimated GA were made using R², calibration slope and intercept. RMSE, mean difference and 95% range of error were also calculated.

RESULTS: A total of 2741 pregnant women were examined. After exclusions, 2339 participants were included. In the 20 best performing equations, the intercept ranged from -0.22 to 0.30, the calibration slope from 0.96 to 1.03 and the RSME from 0.67 to 0.87. Overall, multiparameter models outperformed single-parameter models. Both the 95% range of error and mean difference increased with gestation. Commonly used models based on measurement of the head circumference alone were not amongst the best performing models and were associated with higher 95% error and mean difference.

CONCLUSIONS: We provide strong evidence that GA-specific equations based on multiparameter models should be used to estimate GA in late pregnancy. However, as all methods of GA assessment in late pregnancy are associated with large prediction intervals, efforts to improve access to early antenatal ultrasound must remain a priority.

TRIAL REGISTRATION: The proposal for this study and the corresponding methodological review was registered on PROSPERO international register of systematic reviews (registration number: CRD4201913776).

PMID:39118202 | DOI:10.1111/1471-0528.17922

J Orthop Surg Res. 2024 Aug 8;19(1):468. doi: 10.1186/s13018-024-04972-w.

ABSTRACT

OBJECTIVE: This study aims to investigate the anatomical structure of the C6 pedicle and lateral mass in children aged 0-14 years using CT imaging, providing detailed insights into their growth and development.

METHODS: We conducted a comprehensive measurement of C6. Measurements included width, length, and height of the pedicles, as well as the length, width, and thickness of the lateral masses, and several angular metrics. Regression analysis was performed to understand the growth trends, and statistical analyses were carried out to identify differences between age groups, genders, and sides.

RESULTS: In children younger than four years, the pedicle width exceeds its height, influencing the diameter of the pedicle screws. By age two to three, the pedicle height and lateral mass thickness reaches 3.0 mm, allowing for the use of 3.0 mm diameter screws. The pedicle transverse angle remains stable. Most parameters showed no significant differences between the left and right sides. Size parameters exhibited significant larger in males than females at ages 0-1, 3-7, and 10-12 years. Regression analysis revealed that the growth trends of size parameters follow cubic or polynomial curves. Most angular metrics follow cubic fitting curves without a clear trend of change with age.

CONCLUSION: This study provides a detailed analysis of the anatomical development of the C6 pedicle and lateral masses in children, offering valuable insights for pediatric cervical spine surgeries. The findings highlight the importance of considering age-specific anatomical variations when planning posterior surgical fixation, specifically at C6. It is necessary for us to perform thin-layer CT scans on children and carefully measure various indicators before surgery.

PMID:39118178 | DOI:10.1186/s13018-024-04972-w

Mol Cancer. 2024 Aug 8;23(1):161. doi: 10.1186/s12943-024-02077-w.

ABSTRACT

This commentary offers a thoughtful discussion of the study by Wei et al. published in the journal on the role of Olfactomedin 4 (OLFM4) in incomplete intestinal metaplasia, a gastric precancerous condition. The original paper introduces OLFM4 as a novel biomarker with potential enhanced diagnostic efficacy compared to established markers. However, several methodological and interpretive considerations are noted. The histopathological findings could be refined by using higher magnification to better elucidate the cellular localization of OLFM4. Including high-resolution images for key stainings would enhance the study’s robustness in expression profiling. The statistical approach could be strengthened by employing more rigorous, quantitative methodologies. Additionally, integrating immunofluorescence double-staining may improve the reliability of the results. Discrepancies in immunohistochemical signals across datasets suggest a need for further investigation into tissue section representativeness. Clarifying the term “precancerous lesions of gastric carcinoma cells” to align with widely accepted definitions would enhance clarity. The choice of the GES-1 cell model treated with MNNG could be reconsidered in favor of more established models such as organoids, air-liquid interface models, and gastric cancer-specific cell lines. The in vivo MNNG-alcohol combination model might require additional empirical support, given the limited and conflicting literature on this approach, to ensure an accurate portrayal of IM pathogenesis. The commentary concludes with a call for stringent and standardized methodologies in biomarker research to ensure the clinical applicability and reliability of biomarker studies, particularly in the context of gastric cancer detection and intervention.

PMID:39118167 | DOI:10.1186/s12943-024-02077-w

Malar J. 2024 Aug 8;23(1):237. doi: 10.1186/s12936-024-05060-4.

ABSTRACT

BACKGROUND: The Republic of Guinea, where malaria represents the leading cause of morbidity and mortality among children, the seasonal malaria chemoprevention (SMC) is deployed only in areas with very seasonal modes of transmission. It should target children at the highest risk of serious illness. The objective of the study was to prevent uncomplicated and serious cases of malaria in the target population. This study aimed to analyse the monthly trends in malaria-related morbidity among children under the age of 5 in Guinea.

METHODS: This was a quasi-experimental study with routine data from the National Health Information System (SNIS). The two districts Mamou (the SMC intervention site) and Kindia (the control site) were selected to compare the monthly trends in malaria cases among children under the age of 5, from July to October, covering the years from 2015 to 2020. The statistical analysis used interrupted time series to estimate the effects of the SMC.

RESULTS: The SMC programme contributed to a significant average reduction in the number of malaria cases of 225 cases per month in the intervention district (95% CI – 362 to – 88; p = 0.002), compared to the control district. However, the study also revealed that the effect of SMC varied between cycles, presenting different monthly malaria cases.

CONCLUSION: The SMC contributed to a significant reduction in malaria cases among children under the age of 5 in the health district of Mamou from 2018 to 2020. However, this reduction varied by monthly SMC cycle. This study suggests extending the SMC in other areas with high perennial seasonal transmission respecting the World Health Organization SMC eligibility criteria, as a strategy in the dynamic of reducing malaria cases in children under the age of 5 in Guinea.

PMID:39118160 | DOI:10.1186/s12936-024-05060-4

BMC Health Serv Res. 2024 Aug 8;24(1):912. doi: 10.1186/s12913-024-11301-8.

ABSTRACT

BACKGROUND: E-pharmacy has gained popularity as an increasingly utilized platform for accessing healthcare services online. However, its adoption exhibits regional variations and necessitates improvement in certain aspects. Guided by the Theory of Reasoned Action (TRA) and Trust theory, this research explores the pivotal role of information literacy in influencing attitudes, perceived control, word of mouth, and trust. The overarching aim is to understand how these factors collectively impact the adoption of E-pharmacy services.

METHODS: The study employed Structural Equation Modeling to assess data collected from 473 participants in Nigeria. This methodology allowed for a comprehensive evaluation of the intricate relationships between information literacy, attitudes, perceived control, word of mouth, trust, and E-pharmacy adoption. By utilizing statistical tests within this framework, the research sought to provide a robust analysis of the data and derive meaningful insights.

RESULTS: The findings of the research underscore the significance of information literacy in shaping individuals’ attitudes towards E-pharmacy. Higher information literacy levels were associated with more positive attitudes, an enhanced sense of perceived control, and increased positive word-of-mouth regarding the use of E-pharmacy services. Additionally, the study revealed that trust plays a crucial intermediary role between word-of-mouth communication and the actual adoption of E-pharmacy.

CONCLUSIONS: In summary, this research offers a novel and comprehensive explanation of the relationship between information literacy and the adoption of E-pharmacy services. The study’s outcomes contribute valuable insights to the ongoing discourse on E-pharmacy adoption, emphasizing its potential to enhance healthcare accessibility and efficiency within the evolving landscape of digital healthcare. The implications of the findings extend to policymakers, healthcare providers, and other stakeholders interested in optimizing the adoption and integration of E-pharmacy services.

PMID:39118124 | DOI:10.1186/s12913-024-11301-8

BMC Cancer. 2024 Aug 8;24(1):982. doi: 10.1186/s12885-024-12734-4.

ABSTRACT

BACKGROUND: Prompt and accurate diagnosis of prostate cancer (PCa) is of paramount importance for effective treatment planning. While Gallium-68 labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) has proven efficacy in detecting PCa, limited availability poses challenges. As a potential alternative, [^99mTc]Tc-PSMA single photon emission computed tomography (SPECT)/computed tomography (CT) holds promise. This systematic review and meta-analysis aimed to evaluate the diagnostic value of [^99mTc]Tc-PSMA SPECT/CT for prostate cancer.

METHODS: A comprehensive search of PubMed, Cochrane, EMBASE, Scopus, Ovid, and Web of Science databases was conducted until July 2024. Sensitivity and specificity data were extracted to assess the diagnostic accuracy of [^99mTc]Tc-PSMA SPECT/CT, while the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to evaluate study quality. Statistical analyses were performed using STATA 18, with MetaDisc 1.4 employed to detect threshold effects. Diagnostic accuracy indicators, including sensitivity, specificity, diagnostic odds ratio (DOR), negative likelihood ratio (LR-), and positive likelihood ratio (LR+), were pooled. The area under the curve (AUC) of the combined model was calculated using summary receiver-operating characteristic (SROC) curves.

RESULTS: Seven studies meeting the inclusion criteria were identified from an initial pool of 1467 articles, with no publication bias observed. The pooled sensitivity, specificity, and AUC of [^99mTc]Tc-PSMA SPECT/CT were found to be 0.89 (95% CI, 0.84-0.93), 0.92 (95% CI, 0.67-0.99), and 0.93 (95% CI, 0.90-0.95), respectively. Additionally, the comprehensive diagnostic odds ratio, diagnostic score, positive likelihood ratio, and negative likelihood ratio were calculated as 95.24 (95% CI, 17.30-524.41), 4.56 (95% CI, 2.85-6.26), 11.35 (95% CI, 2.31-55.71), and 0.12 (95% CI, 0.08-0.18), respectively.

CONCLUSIONS: In conclusion, our findings demonstrate that [^99mTc]Tc-PSMA SPECT/CT exhibits favorable diagnostic performance for prostate cancer and can provide valuable supplementary information, particularly in regions and settings where [⁶⁸Ga]Ga-PSMA PET/CT availability is limited, such as remote areas. These results highlight the potential of [^99mTc]Tc-PSMA SPECT/CT as a valuable tool in the diagnosis and management of prostate cancer, warranting further investigation and validation in larger patient cohorts.

PMID:39118101 | DOI:10.1186/s12885-024-12734-4

BMC Oral Health. 2024 Aug 8;24(1):915. doi: 10.1186/s12903-024-04703-x.

ABSTRACT

BACKGROUND: Dental caries is a common disease in the oral cavity, and the microorganisms in the cavity are colonized in the form of dental plaque biofilm. Streptococcus mutans is the main pathogen causing dental caries. Using probiotics to inhibit the growth and colonization of pathogenic bacteria, regulate mucosal immunity and improve oral microecological balance is an effective way to prevent or treat dental caries. The aim of this study was to evaluate the caries-prevention of probiotics in vitro and in rat caries models.

METHODS: The probiotics used in this study are a combination of 4 strains of bacteria. After the fermentation of 4 strains (L. plantarum, L. salivarius, L. rhamnosus, and L. paracasei) was completed, they were mixed in equal volume proportions and used as samples to be tested. The mixture was then assessed the ability to inhibit the growth of S. mutans in vitro and in vivo. SPSS Statistics 22.0 (SPSS, Inc., Chicago, IL, USA) was used for analysis.

RESULTS: In vitro the probiotics mixture could inhibit the growth of S. mutans and was able to remove biofilms formed by S. mutans. In a 42-day in vivo experiment, the probiotics group significantly reduced the level of S. mutans on the tooth surface of rats, reducing more than half the bacterial quantities compared with the caries model group (P < 0.05). The amount of S. mutans in the antagonist group was low and highly significant compared with the caries model group. Moreover, the mixture of 4 strains significantly reduced the caries scores (modified Keyes scoring method) in both the probiotic and antagonist groups (p < 0.05).

CONCLUSIONS: The study showed that the combination of the four strains can reduce the cavity scores, and the four strains can be used as products in oral care products. At the same time, the study also suggests that probiotic therapy can be an effective way to prevent dental caries.

PMID:39118098 | DOI:10.1186/s12903-024-04703-x

BMC Oral Health. 2024 Aug 8;24(1):916. doi: 10.1186/s12903-024-04609-8.

ABSTRACT

BACKGROUND: The posterior maxilla presents challenges for implant insertion because of the poor bone quality as well as the loss of vertical bone height. Indirect transcrestal sinus lift techniques are advised when a few millimeters of additional height are needed. This study aimed to evaluate the clinical and radiographic outcomes of antral membrane balloon technique versus Densah burs for transcrestal maxillary sinus lifting with simultaneous implant placement.

MATERIALS AND METHODS: This randomized clinical trial was conducted on 22 patients received 32 dental implants for replacement of missed maxillary posterior teeth after crestal maxillary sinus lifting. The patients were randomly divided into two groups. Group 1, patients underwent crestal sinus floor elevation with simultaneous implant placement using antral membrane balloon technique. Group 2, patients underwent crestal sinus floor elevation with simultaneous implant placement using Densah burs. Patients were evaluated clinically and radiographically using cone beam computed tomography (CBCT) at regular time intervals immediately, 6 months and 12 months after surgery. All clinical and radiographic parameters were statistically analyzed.

RESULTS: All dental implants were successful for 12 months of follow up. Regarding implant primary stability, there was a statistical significant difference between the study groups in favor of Densah group (P = 0.004), while there was no significant difference after 6 months (P = 0.07). Radiographically, balloon group showed a statistically significant immediate postoperative vertical bone height (P < 0.0001), and significant reduction in vertical bone height after 6 months (P < 0.0001). Densah group showed significant increase in bone density (P ≤ 0.05).

CONCLUSION: Both techniques demonstrated successful clinical and radiographic outcomes for crestal sinus lift. The antral membrane balloon group demonstrated better immediate postoperative vertical bone gain, while Densah burs had higher implant primary stability and bone density.

TRIAL REGISTRATION: This study was registered in Clinical-Trials.gov PRS ( https://register.

CLINICALTRIALS: gov ) under identification number NCT05922592 on 28/06/2023.

PMID:39118095 | DOI:10.1186/s12903-024-04609-8

BMC Surg. 2024 Aug 8;24(1):226. doi: 10.1186/s12893-024-02519-8.

ABSTRACT

BACKGROUND: The purpose of this study was to evaluate the predictability of utilizing the backward upward rightward pressure (BURP) maneuver and the efficacy of related tests in patients with a challenging airway and a Mallampati score of 2 or higher who underwent scheduled elective thyroid surgery.

METHODS: Patient files were scanned for 300 adult patients who had undergone thyroid surgery under general anesthesia. The information included their medical history of thyroid disease, previous thyroid surgery, and evaluation tests for difficult intubation such as Mallampati score, maximum mouth opening, ease of intubation, thyroid goitre grade, and whether the BURP maneuver was performed. Patients who had a history of difficult intubation or a Cormack Lehane score less than 2 were excluded. Additionally, the patients were divided into two groups: one group underwent the BURP maneuver (n = 78) and the other did not (n = 56).

RESULTS: Statistically significant differences in the maximum mouth openings and thyroid goitre grade were observed between the groups according to the preoperative evaluation. Furthermore, significant differences were noted between the groups in terms of the ease of intubation, intubation time, Cormack-Lehane score, and number of intubation attempts.

CONCLUSION: There may be a correlation between the maximum mouth opening and thyroid goitre grade in predicting the use of the BURP maneuver. It is important to keep in mind, however, that difficult intubation may occur in some uncommon types of goiter, such as retrosternal goiter, even if the thyroid gland size is small. Therefore, it may be useful to consider performing the BURP maneuver.

PMID:39118091 | DOI:10.1186/s12893-024-02519-8