Category: Statistics

Eur J Oncol Nurs. 2023 Dec 12;68:102490. doi: 10.1016/j.ejon.2023.102490. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effectiveness of auricular acupuncture combined with pelvic floor muscle training to manage urinary incontinence following radical prostatectomy.

METHODS: This is a randomized clinical trial that was conducted between April 2019 and April 2020 with 60 participants allocated into two groups, namely: control (pelvic muscle training) and intervention (auricular acupuncture + pelvic muscle training). Interventions were carried out during eight weekly sessions. Generalized estimating equations and proportion difference tests were applied in the statistical analysis with a significance level of 0.05.

RESULTS: Urinary incontinence severity decreased between pre-test and post-test in both groups. There was a statistically significant difference of the impact of urinary incontinence on quality of life between the groups at post-test in the domain “severity measures” (p = 0.013), and only in the intervention group between pre-test and post-test in the domains “emotions” (p < 0.001) and “sleep and mood” (p = 0.008). The intervention group was 20.8% (p = 0.007) and 25.3% (p = 0.002) less likely to present nocturia and urinary urgency, respectively.

CONCLUSIONS: Auricular acupuncture combined with pelvic floor muscle training was more effective, compared to pelvic floor muscle training alone, in reducing the impact of urinary incontinence on quality of life and reducing the odds of nocturia and urinary urgency.

PMID:38113770 | DOI:10.1016/j.ejon.2023.102490

Reprod Biomed Online. 2023 Oct 6;48(2):103586. doi: 10.1016/j.rbmo.2023.103586. Online ahead of print.

ABSTRACT

RESEARCH QUESTION: Does positive Chlamydia trachomatis serology have an impact on the cumulative live birth rate from IVF?

DESIGN: A retrospective matched cohort study compared women with positive Chlamydia trachomatis serology (group A) who underwent IVF treatment between January 2016 and December 2021 with a control group of women with negative Chlamydia trachomatis serology (group B). The main outcome measures were the cumulative live birth rate per IVF cycle and the live birth rate per embryo transfer. Secondary outcomes were the cumulative rates of clinical pregnancy, ectopic pregnancy and pregnancy loss calculated per IVF cycle and per embryo transfer.

RESULTS: A total of 151 women in group A were matched 1:2 to 302 women in group B, representing 220 and 440 IVF cycles, respectively. Women with a history of Chlamydia trachomatis infection had a significantly higher rate of tubal obstruction (P < 0.001), excluded or operated hydrosalpinx (P = 0.002) and/or history of chronic endometritis (P < 0.001). There were no statistically significant differences between the two groups in the mean number of mature oocytes retrieved, fertilization rate or implantation rate. The IVF cumulative live birth rate per cycle was similar in the two groups (36.7% in group A versus 34.9% in group B, P = 0.692). The cumulative rates of clinical pregnancy, pregnancy loss, biochemical pregnancy and ectopic pregnancy were comparable between the two groups.

CONCLUSION: Positive Chlamydia trachomatis serology has no impact on IVF pregnancy outcomes.

PMID:38113763 | DOI:10.1016/j.rbmo.2023.103586

Braz J Otorhinolaryngol. 2023 Dec 2;90(2):101373. doi: 10.1016/j.bjorl.2023.101373. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to investigate the effect of bilateral sphenopalatine ganglion blockade (SPGB) on the main postoperative complications in septorhinoplasty operations.

METHODS: In this randomized, controlled, prospective study, 80 cases planned for Septorhinoplasty operations under general anesthesia were included in the study. The cases were divided into two groups; SPGB was performed with 2 mL of 0.25% bupivacaine bilaterally 15 min before the end of the operation in the SPGB group (Group S, n = 40). In the control group (Group C, n = 40), 2 mL of 0.9% NaCl solution was applied into both SPG areas. In the recovery unit after the operation; the pain and analgesic needs of the patients at 0, 2, 6 and 24 h were evaluated.

RESULTS: There was no statistically significant difference between the groups in terms of hemodynamic parameters (ASA, MBP, HR) (p > 0.05) All VAS values were statistically lower in Group S than in Group C (p < 0.05). In Group S, the need for analgesic medication was found in 5 cases between 0-2 h, whereas in Group C, this rate was found in 17 cases, and it was statistically significant (p < 0.05).

CONCLUSION: Bilateral SPGB application was determined to provide better analgesia in the early postoperative period compared to the control group, it was concluded that further studies are needed to say that there are significant effects on laryngospasm and nausea-vomiting.

LEVEL OF EVIDENCE: 2, degree of recommendation B.

PMID:38113753 | DOI:10.1016/j.bjorl.2023.101373

Accid Anal Prev. 2023 Dec 18;195:107398. doi: 10.1016/j.aap.2023.107398. Online ahead of print.

ABSTRACT

The increasing number of bicycle crashes leading to injuries in the Netherlands is frequently related (e.g., in the media) to increased use of the electric bicycle. For this reason, policy makers face the challenge of selecting and implementing the most promising countermeasures including those focused on electric bicycles. It may be questioned, however, to what extent the electric bicycle itself is a (direct) cause of crashes leading to injuries or whether other factors are important for explaining the increased number of bicycle injury crashes. On the basis of an abbreviated list of criteria by Elvik (2011), this paper illustrates the potential influence of factor inclusions, analysis selections, and data presentations on the general impression about crash causation with the electric bicycle as an example. The aim is to provide a ‘best practice guide’ by taking into account (1) a theoretical explanation of causal mechanisms, (2) control for confounders, and (3) a statistical association of sufficient strength and consistency in the expected direction. We conclude that an apparent increased risk of electric bicycles may be explained by factors such as age, exposure, health factors, and gender of the cyclist. A relatively simple analysis, by comparing fatality numbers of conventional and electric bicycles, showed that including or excluding these factors may lead to vastly different interpretations of fatality causes and the relative risk of electric bicycles compared to conventional bicycles.

PMID:38113728 | DOI:10.1016/j.aap.2023.107398

J Plast Reconstr Aesthet Surg. 2023 Nov 28;88:524-534. doi: 10.1016/j.bjps.2023.11.036. Online ahead of print.

ABSTRACT

INTRODUCTION: Oncological treatments, such as radiotherapy and surgery, are high-risk factors for the development of secondary lymphedema in the upper and lower limbs, as well as the genitalia. Prophylactic lymphedema surgery (PLS) has previously demonstrated promising results in reducing secondary lymphedema in breast cancer and urogenital cancer patients. We conducted a study to adapt this principle for patients with lower-extremity sarcomas.

MATERIAL AND METHODS: Inclusion criteria included patients with tumors on the medial aspect of the thigh and leg and tumor size larger than 5 cm. Group A (19 patients) comprised a prospective cohort (2020-2023) in which a PLS protocol was executed. Lymphaticovenous anastomosis (LVA) was performed when lymphatic channels were interrupted due to tumor resection, intraoperatively verified by indocyanine green. Lymph node transfer was employed exclusively in cases involving preoperative radiotherapy and inguinal lymph node resection. Measurements were collected both preoperatively and at 1, 3, 6, and 12 months postoperatively. Group B (26 patients) constituted a retrospective cohort (2017-2020) without PLS reconstruction, where the prevalence of lymphedema was determined.

RESULTS: In total, we enrolled 45 patients with soft tissue sarcomas located on the inner aspect of the thigh and leg (26 in the control group vs. 19 in the prophylactic group). In the control group, lymphedema was observed in 10 out of 27 patients (37.04%). In the prophylactic group, two patients exhibited signs of lower-extremity lymphedema (2/19, 10.52%) with a median follow-up of 14.15 months (6 months-33months), demonstrating statistically significant differences between the two groups (p = 0.02931).

CONCLUSIONS: PLS for lower limb soft tissue sarcomas shows promising results, although it is premature to reach solid conclusions. Multicentre studies, standardization of criteria, larger sample sizes and longer-term follow-up are imperative for further validation.

PMID:38113721 | DOI:10.1016/j.bjps.2023.11.036

Proc Inst Mech Eng H. 2023 Dec 19:9544119231214651. doi: 10.1177/09544119231214651. Online ahead of print.

ABSTRACT

The diagnosis of osteoporosis using Dual-energy X-ray Absorptiometry (DXA) relies on accurate hip scans, whereby variability in measurements may be introduced by altered patient positioning, as could occur with repeated scans over time. The goal herein was to test how altered postures affect diagnostic metrics (i.e., standard clinical metrics and a newer image processing tool) for femur positioning. A device was built to support cadaveric femurs and adjust their orientation in 3° increments in flexion and internal/external rotation. Seven isolated femurs were scanned in six flexion postures (0° (neutral) to 15° of flexion) and eleven rotational postures (15° external to 15° internal rotation) while collecting standard clinical DXA-based measures for each scan. The fracture risk tool was applied to each scan to calculate fracture risk. Two separate one-way repeated measures ANOVAs (α = 0.05) were performed on the DXA-based measures and fracture risk prediction output. Flexion had a significant effect on T-score, Bone Mineral Density (BMD), and Bone Mineral Content (BMC), but not area, at angles greater than 12°. Internal and external rotation did not have a significant effect on any clinical metric. Fracture risk (as assessed by the image processing tool) was not affected by either rotation mode. Overall, this suggests clinicians can adjust patient posture to accommodate discomfort if deviations are less than 12 degrees, and the greatest care should be taken in flexion. Furthermore, the tool is relatively insensitive to postural adjustments, and as such may be a good option for tracking risk over repeated patient scans.

PMID:38112093 | DOI:10.1177/09544119231214651

J Phys Condens Matter. 2023 Dec 18. doi: 10.1088/1361-648X/ad16ac. Online ahead of print.

ABSTRACT

We systematically investigate the long- and short-range chemical order, lattice volume, and spontaneous magnetization in single-crystalline Fe_0.6Al_0.4compound thin films. The vapor-quenching method based on a molecular beam epitaxy technique is utilized to fabricate the single-crystalline Fe_0.6Al_0.4compound with the differentB2 long-range order parameterS.Swas varied by the deposition temperatureT_d, and it increases with increasingT_d. The lattice volumeVdecreased with increasingT_d, while the tetragonal distortion, ~4%, due to epitaxial strain were observed. The changes inSandVwere accompanied with the change in the magnetic moment per Fe,μ_Fe.μ_Feshowed the monotonic decrease as a function ofSwhereasμ_Femonotonically increases withV. With considering tetragonal distortion,μ_Fe–Vrelationship has a good agreement with the previous reports. Theμ_Fe–Srelationship showed the steep decrease ofμ_FearoundS~0.6. In contrast toμ_Fe–Vrelationship,μ_Fe–Srelationship does not match only from ours to previous studies but also among other reports. It implies the statistical number of the nearest-neighbor Fe-Fe bonds,i.e.S, cannot be an enough explanatory parameter. To clarify the structural origin of change inμ_Fe, the short-range order parameter inferred from the analysis of superlattice diffractions were introduced. They showed the clear difference for the films with high and lowμ_Fe. The results suggest that the transition from the long- to the short-range order state plays the significant role onμ_Fe.

PMID:38112082 | DOI:10.1088/1361-648X/ad16ac

Transpl Infect Dis. 2023 Dec 19:e14213. doi: 10.1111/tid.14213. Online ahead of print.

ABSTRACT

INTRODUCTION: Utilization of hepatitis C viremic (HCV+) deceased donor kidneys (DDKT) for aviremic recipients increases opportunities for transplantation with excellent short-term outcomes. Our primary aim was to understand longer-term outcomes, specifically assessing kidney and liver function in the first year posttransplant.

METHODS: This was a retrospective single-center study of adult DDKT recipients of HCV+ kidneys (cases) matched 1:1 to recipients of HCV- kidneys (comparators). Between-group outcomes were analyzed using comparisons of means and proportions, survival analysis methods, and multivariable mixed effects models.

RESULTS: Sixty-five cases and 65 comparators had statistically comparable demographic and clinical characteristics. There were no between-group differences in serum creatinine or estimated glomerular filtration rate at month 12 (p = .662) or in their trajectories over months 1-12 (p > .292). Within the first 60 days, rates of liver function values >3 times upper limit of normal among cases were comparable to comparators for aspartate aminotransferase (AST) (14% vs. 6%, p = .242) and higher for alanine transaminase (ALT) (23% vs. 6%, p = .011). AST declined during the first 8 weeks (p = .005) and stabilized for both groups (p = .406) during the following 10 months. ALT declined during the first 8 weeks (p < .001), continued to decline over months 3-12 (p = .016), and the trajectory was unrelated to antiviral therapy initiation among cases.

CONCLUSIONS: Aviremic recipients of HCV+ kidneys had comparable kidney outcomes to matched recipients of HCV- kidneys. Despite more HCV+ recipients having an elevation in ALT within the first 60 days, ALT values normalized with no identified liver complications attributed to HCV.

PMID:38112078 | DOI:10.1111/tid.14213

J Periodontol. 2023 Dec 19. doi: 10.1002/JPER.23-0125. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to evaluate the effect of active oxygen-releasing gel as an adjuvant, with and without antimicrobial photodynamic therapy (aPDT), in the treatment of residual pockets in periodontal patients with type 2 diabetes mellitus (DM2).

METHODS: Patients with residual pockets with probing depth (PD) ≥4 mm and bleeding on probing (BOP) were divided into the following groups: SI (n = 17)-subgingival instrumentation in a single session; BM (n = 17)-SI followed by local application of active oxygen-releasing gel inside the periodontal pocket for 3 min; BM + aPDT (n = 17)-SI followed by application of BM for 3 min and pocket irrigation with methylene blue, and 660-nm diode laser irradiation at 100 mW for 50 s. The periodontal clinical parameters, serum levels of glycated hemoglobin, and immunological analysis of crevicular fluid were evaluated. All data were submitted to statistical analysis (α = 5%).

RESULTS: A significant reduction in BOP was verified at 90 and 180 days in the BM + aPDT group. The percentage of sites with PD ≥ 4 mm was significantly reduced at 90 days in BM + aPDT and BM, whereas after 180 days only BM showed a significant reduction. In the BM + aPDT group, there was a significant reduction in tumor necrosis factor α levels at 90 days. There were no differences between the treatments.

CONCLUSION: The use of adjuvant active oxygen-releasing gel, with or without aPDT, resulted in the same clinical benefits as SI in the treatment of residual pockets in poorly controlled DM2 patients.

PMID:38112075 | DOI:10.1002/JPER.23-0125

J Periodontol. 2023 Dec 19. doi: 10.1002/JPER.23-0448. Online ahead of print.

ABSTRACT

BACKGROUND: Individuals enrolled in supportive periodontal therapy (SPT) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined “threshold” at which a patient’s profile is set to be at high risk for TLP in the literature. Therefore, this study aimed to assess the influence of RPc on TLP and determine the prognostic performance of RPc compared to the staging and grading of periodontitis on TLP risk.

METHODS: Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving SPT for at least 10 years were evaluated in this retrospective study. TLP and the percentage of sites with RPc ≥ 5 mm or ≥6 mm per patient were collected. The prognostic performance of RPc was compared to the staging and grading of the disease on TLP using a multilevel Cox proportional hazard regression model.

RESULTS: Over a median follow-up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with TLP had ≥1 site with RPc ≥5 mm (90.8%) or ≥6 mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with RPc ≥5 mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for TLP compared to RPc ≤4 mm/grade A. Grading exhibited the best discrimination and model fit.

CONCLUSION: Patients with RPc ≥5 mm at >15% of the sites are at risk for tooth loss. Grading and RPc ≥5 mm displayed very good predictive capability of TLP.

PMID:38112067 | DOI:10.1002/JPER.23-0448