Category: Statistics

Minerva Dent Oral Sci. 2023 Nov 30. doi: 10.23736/S2724-6329.23.04791-5. Online ahead of print.

ABSTRACT

BACKGROUND: The treatments with clear aligners (CA) showed an exponential higher percentage in the last years being almost invisible with major patient acceptability and a resulting improvement in quality of life. CA are composed of thermoplastic polyurethane not inert but subjected to changes due to heating and humidity, chewing forces, and prolonged exposure to enzymes in saliva in the oral cavity and external factors. Cigarette smoke (CS) and the aerosol produced by tobacco products with reduced health risks may be considered among the external factors affecting CA. The purpose of this study was the assessment of optical properties (absorbance and transmittance) and roughness of CA after in vitro aging due to exposition to CS and THS2.2, compared to controls. The secondary objective will be the investigation of CS and THS2.2 effects on resin composite inside aligners used for attachments during treatment with CA.

METHODS: A total number of 60 CA units will be used and equally divided in three different groups (20 in each): CS group exposed to reference cigarettes smoking, THS2.2 group exposed to aerosol from 20 heat-not-burn sticks, and control group, CG to pure air only. The aligners will present ten introflection for the attachments on the anterior part. In accordance with ISO standard 3402, 3R4F cigarettes and THS2.2 tobacco sticks must undergo conditioning for a minimum of 48 hours and a maximum of 21 days at a temperature of 22±1 °C and a relative humidity of 60±3%.

RESULTS: Using spectrophotometry, the optical characteristics (absorbance and transmittance) of each aligner will be evaluated after aging (Jasco UV-vis V630PC, Tokyo, Japan). Each aligner will be cut with a rotating saw from canine to canine prior to the measurements in order to lop off the lingual region and displaying the labial barrier. The absorbance and transmittance measurements will be collected and statistically analyzed with a significance of P<0.05.

CONCLUSIONS: Surface roughness of the aligners and attachments inside them will be assessed by 3D scanning microscopy (Infinite Focus G4h). Color of resin composite will be assessed using the (CIE Lab) Commission Internationale de l’Eclairage L*a*b* color space by means of Olympus CrystalEyef dental spectrophotometer. Clinicians should advise patients to refrain from smoking and drinking coffee or tea while wearing aligners for two reasons: first, the color change is unacceptably noticeable when wearing aligners, and second, the material’s chemical composition may be slightly altered, which could affect the intended dental movements.

PMID:38037696 | DOI:10.23736/S2724-6329.23.04791-5

BMC Med Educ. 2023 Nov 30;23(1):909. doi: 10.1186/s12909-023-04887-w.

ABSTRACT

BACKGROUND: Across higher education, student retention, progression, and graduation are considered essential elements of students’ academic success. However, there is scarce literature analyzing these attributes across health professions education. The current study aims to explore rates of student retention, progression, and graduation across five colleges of the Health Cluster at Qatar University, and identify predictive factors.

METHODS: Secondary longitudinal data for students enrolled at the Health Cluster between 2015 and 2021 were subject to descriptive statistics to obtain retention, progression and graduation rates. The importance of student demographic and academic variables in predicting retention, progression, or graduation was determined by a predictive model using XGBoost, after preparation and feature engineering. A predictive model was constructed, in which weak decision tree models were combined to capture the relationships between the initial predictors and student outcomes. A feature importance score for each predictor was estimated; features that had higher scores were indicative of higher influence on student retention, progression, or graduation.

RESULTS: A total of 88% of the studied cohorts were female Qatari students. The rates of retention and progression across the studied period showed variable distribution, and the majority of students graduated from health colleges within a timeframe of 4-7 years. The first academic year performance, followed by high school GPA, were factors that respectively ranked first and second in importance in predicting retention, progression, and graduation of health majors students. The health college ranked third in importance affecting retention and graduation and fifth regarding progression. The remaining factors including nationality, gender, and whether students were enrolled in a common first year experience for all colleges, had lower predictive importance.

CONCLUSIONS: Student retention, progression, and graduation at Qatar University Health Cluster is complex and multifactorial. First year performance and secondary education before college are important in predicting progress in health majors after the first year of university study. Efforts to increase retention, progression, and graduation rates should include academic advising, student support, engagement and communication. Machine learning-based predictive algorithms remain a useful tool that can be precisely leveraged to identify key variables affecting health professions students’ performance.

PMID:38036997 | DOI:10.1186/s12909-023-04887-w

BMC Gastroenterol. 2023 Nov 30;23(1):423. doi: 10.1186/s12876-023-03057-y.

ABSTRACT

BACKGROUND: The present study aims to explore the clinical application of enhanced recovery after surgery (ERAS) in pediatric patients with congenital upper gastrointestinal obstruction (CUGIO).

METHODS: A total of 82 pediatric patients with CUGIO admitted to the neonatal intensive care unit in Kunming Children’s Hospital between June 2017 and June 2021 were enrolled in the present study and divided into two groups: the ERAS group (n = 46) and the control group (n = 36). The ERAS management mode was adopted in the ERAS group, and the conventional perioperative management mode was adopted in the control group.

RESULTS: In the ERAS group and the control group, the time to the first postoperative bowel movement was 49.2 ± 16.6 h and 58.4 ± 18.8 h, respectively, and the time to the first postoperative feeding was 79 ± 7.1 h and 125.2 ± 8.3 h, respectively. The differences in the above two indicators between the two groups were statistically significant (P < 0.05). In the ERAS group, the days of parenteral nutrition and the length of hospital stay were 14.5 ± 2.3 d and 18.8 ± 6.4 d, respectively. In the control group, 17.6 ± 2.2 d and 23.1 ± 8.1 d, respectively. The differences in these two indicators between the two groups were statistically significant (P < 0.05).

CONCLUSION: The ERAS management model had a positive effect on early postoperative recovery in pediatric patients with CUGIO.

PMID:38036993 | DOI:10.1186/s12876-023-03057-y

BMC Oral Health. 2023 Nov 30;23(1):948. doi: 10.1186/s12903-023-03693-6.

ABSTRACT

BACKGROUND: Attachment material is one of the contributing factors to the degree of wear of the attachment components in mandibular implant-retained overdentures. The purpose of this in vitro study was to compare the wear behavior of 2 different attachment systems of dissimilar materials in mandibular implant-retained overdentures by qualitative and quantitative methods.

METHODS: Two attachment systems of different materials were utilized (n = 16); Titach (Dental Evolutions Inc, Beverly Hills, CA, USA) with a titanium-to-titanium interface and Locator R-Tx (Zest Anchors Inc, Escondido, CA, USA) with a titanium-to-nylon interface. One thousand cycles of overdenture insertion and removal simulating 1-year clinical use were performed. All matrices were removed from the overdentures and all patrices were unscrewed from the implants for wear assessment quantitively using a stereomicroscope and qualitatively using a scanning electron microscope. Data were analyzed by using an independent sample t test.

RESULTS: After cyclic loading, stereomicroscopic findings showed that the Titach group had statistically significant higher wear value than the Locator R-Tx group (p < 0.001). Moreover, scanning electron microscopy images showed noticeable abrasion in Titach patrix at the area of highest convexity. However, the Locator R-Tx matrix displayed an apparent tear of rubber inserts.

CONCLUSIONS: Titach attachment with the titanium-to-titanium interface revealed more wear than Locator R-Tx attachment with the titanium-to-nylon interface. Thus, the type of attachment material influences the degree of wear of the attachment components.

PMID:38036982 | DOI:10.1186/s12903-023-03693-6

BMC Med Res Methodol. 2023 Nov 30;23(1):283. doi: 10.1186/s12874-023-02101-5.

ABSTRACT

BACKGROUND AND OBJECTIVE: Clinical practice guidelines (CPGs) are evaluated for quality with the Appraisal of Guidelines for Research and Evaluation (AGREE) tool, and this is increasingly done for different countries and regional groupings. This scoping review aimed to describe, map, and compare these geographical synthesis studies, that assessed CPG quality using the AGREE tool. This allowed a global interpretation of the current landscape of these country-wide or regional synthesis studies, and a closer look at its methodology and results.

STUDY DESIGN AND METHODS: A scoping review was conducted searching databases Medline, Embase, Epistemonikos, and grey literature on 5 October 2021 for synthesis studies using the later versions of AGREE (AGREE II, AGREE-REX and AGREE GRS) to evaluate country-wide or regional CPG quality. Country-wide or regional synthesis studies were the units of analysis, and simple descriptive statistics was used to conduct the analysis. AGREE scores were analysed across subgroups into one of the seven Sustainable Development Goal regions, to allow for meaningful interpretation.

RESULTS: Fifty-seven studies fulfilled our eligibility criteria, which had included a total of 2918 CPGs. Regions of the Global North, and Eastern and South-Eastern Asia were most represented. Studies were consistent in reporting and presenting their AGREE domain and overall results, but only 18% (n = 10) reported development methods, and 19% (n = 11) reported use of Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Overall scores for domains Rigor of development and Editorial independence were low, notably in middle-income countries. Editorial Independence scores, especially, were low across all regions with a maximum domain score of 46%. There were no studies from low-income countries.

CONCLUSION: There is an increasing tendency to appraise country-wide and regionally grouped CPGs, using quality appraisal tools. The AGREE tool, evaluated in this scoping review, was used well and consistently across studies. Findings of low report rates of development of CPGs and of use of GRADE is concerning, as is low domain scores globally for Editorial Independence. Transparent reporting of funding and competing interests, as well as highlighting evidence-to-decision processes, should assist in further improving CPG quality as clinicians are in dire need of high-quality guidelines.

PMID:38036974 | DOI:10.1186/s12874-023-02101-5

Int J Emerg Med. 2023 Nov 30;16(1):87. doi: 10.1186/s12245-023-00563-4.

ABSTRACT

BACKGROUND: The use of intravenous fluid therapy in patients with major trauma in prehospital settings is still controversial. We conducted an umbrella review to evaluate which is the best volume expansion in the resuscitation of a hemorrhagic shock to support the development of major trauma guideline recommendations.

METHODS: We searched PubMed, Embase, and CENTRAL up to September 2022 for systematic reviews (SRs) investigating the use of volume expansion fluid on mortality and/or survival. Quality assessment was performed using AMSTAR 2 and the Certainty of the evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

RESULTS: We included 14 SRs investigating the effects on mortality with the comparisons: use of crystalloids, blood components, and whole blood. Most SRs were judged as critically low with slight overlapping of primary studies and high consistency of results. For crystalloids, inconsistent evidence of effectiveness in 28- to 30-day survival (primary endpoint) was found for the hypertonic saline/dextran group compared with isotonic fluid solutions with moderate certainty of evidence. Pre-hospital blood component infusion seems to reduce mortality, however, as the certainty of evidence ranges from very low to moderate, we are unable to provide evidence to support or reject its use. The blood component ratio was in favor of higher ratios among all comparisons considered with moderate to very low certainty of evidence. Results about the effects of whole blood are very uncertain due to limited and heterogeneous interventions in studies included in SRs.

CONCLUSION: Hypertonic crystalloid use did not result in superior 28- to 30-day survival. Increasing evidence supports the scientific rationale for early use of high-ratio blood components, but their use requires careful consideration. Preliminary evidence is very uncertain about the effects of whole blood and further high-quality studies are required.

PMID:38036955 | DOI:10.1186/s12245-023-00563-4

Langmuir. 2023 Nov 30. doi: 10.1021/acs.langmuir.3c02385. Online ahead of print.

ABSTRACT

Antimicrobial resistance (AMR) is on an upsurge as more and more broad-spectrum antibiotics are being used haphazardly, resulting in imbalances in the ecosystem and disrupting common/systematic clinical protocols. To combat this issue, metal-organic framework embedded zinc-copper-benzenedicarboxylate@calcium alginate composite beads (Zn-Cu-BDC@CA CBs) were synthesized and utilized for the adsorption of tetracycline (TC) from water. The surface morphology, presence of functional groups, surface area, and thermal stability of Zn-Cu-BDC@CA CBs were evaluated by field emission scanning electron microscopy (FESEM), Fourier transform infrared spectroscopy (FTIR), Brunauer-Emmett-Teller (BET), and thermal gravimetric analysis (TGA), respectively. Batch adsorption experiments were also carried out to optimize the adsorption performance of Zn-Cu-BDC@CA CBs for TC by adjusting the key parameters, including pH of the solution, contact time, adsorbent dosage, temperature, and initial concentration of TC. From the RSM model, 96.8% removal of TC takes place under the optimum conditions (pH = 7.3, mass = 17.2 mg, concentration = 21.3 ppm, time = 3.4 h, and temperature = 31.8 °C), which aligns closely with the experimental batch study, where the addition of 20 mg of adsorbent to a 20 mL TC solution (20 mg/L) at a pH of 7 and a temperature of 27 °C yielded an impressive TC removal efficiency of 96.55% within 180 min. Zn-Cu-BDC@CA CBs possess homogeneous adsorption surfaces, and TC is adsorbed via monolayer chemisorption, according to the results derived from the Langmuir isotherm model and pseudo-second-order kinetic model. The thermodynamic analysis indicated that the adsorption process is both endothermic and spontaneous. In their entirety, the synthesized Zn-Cu-BDC@CA CBs exhibit certain operational advantages, such as simple separation, satisfactory adsorption performance, and decent recyclability, indicating their viability for industrial application of elimination of TC residues from aquatic environments.

PMID:38036945 | DOI:10.1021/acs.langmuir.3c02385

Psychooncology. 2023 Nov 30. doi: 10.1002/pon.6258. Online ahead of print.

NO ABSTRACT

PMID:38036931 | DOI:10.1002/pon.6258

Ann Surg Oncol. 2023 Nov 30. doi: 10.1245/s10434-023-14637-3. Online ahead of print.

ABSTRACT

BACKGROUND: The benefit of primary tumor resection in distant metastatic small bowel neuroendocrine tumors (SBNETs) is controversial, with treatment-based morbidity not well-defined. We aimed to determine the impact of primary tumor resection on development of disease-specific complications in patients with metastatic well-differentiated SBNETs.

PATIENTS AND METHODS: A retrospective analysis was performed of patients diagnosed with metastatic well-differentiated jejunal/ileal SBNETs at a single tertiary care cancer center from 1980 to 2016. Outcomes were compared on the basis of treatment selected at diagnosis between patients who underwent initial medical treatment or primary tumor resection.

RESULTS: Among 180 patients, 71 underwent medical management and 109 primary tumor resection. Median follow-up was 116 months. Median event-free survival did not differ between treatment approaches (log-rank p = 0.2). In patients medically managed first, 16/71 (23%) required surgery due to obstruction, perforation, or bleeding. These same complications led to resection at presentation in 31/109 (28%) surgically treated patients. Development of an obstruction from the primary tumor was not associated with disease progression/recurrence (HR 1.14, 95% CI 0.75-1.75) with all patients recovering postoperatively. Ongoing tumor progression requiring secondary laparotomy was associated with worse mortality (HR 7.51, 95% CI 3.3-16.9; p < 0.001) and occurred in 20/109 (18%) primary tumor resection and 7/16 (44%) initially medically treated patients.

CONCLUSIONS: Rates of event-free survival among patients with metastatic SBNETs do not differ on the basis of primary tumor management. The development of an obstruction from the primary tumor was not associated with worse outcomes with all patients salvaged. Regardless of initial treatment selected, patients with metastatic SBNET should be closely followed for early signs of primary tumor complications.

PMID:38036927 | DOI:10.1245/s10434-023-14637-3

Neuroinformatics. 2023 Nov 30. doi: 10.1007/s12021-023-09648-0. Online ahead of print.

ABSTRACT

The international neuroscience community is building the first comprehensive atlases of brain cell types to understand how the brain functions from a higher resolution, and more integrated perspective than ever before. In order to build these atlases, subsets of neurons (e.g. serotonergic neurons, prefrontal cortical neurons etc.) are traced in individual brain samples by placing points along dendrites and axons. Then, the traces are mapped to common coordinate systems by transforming the positions of their points, which neglects how the transformation bends the line segments in between. In this work, we apply the theory of jets to describe how to preserve derivatives of neuron traces up to any order. We provide a framework to compute possible error introduced by standard mapping methods, which involves the Jacobian of the mapping transformation. We show how our first order method improves mapping accuracy in both simulated and real neuron traces under random diffeomorphisms. Our method is freely available in our open-source Python package brainlit.

PMID:38036915 | DOI:10.1007/s12021-023-09648-0