Category: Statistics

Int J Pediatr Otorhinolaryngol. 2023 Dec 11;176:111823. doi: 10.1016/j.ijporl.2023.111823. Online ahead of print.

ABSTRACT

OBJECTIVE: About 8.6 % of children in the United States undergo tympanostomy tube (TT) placement every year. Of these, 24.1 % require a second set of tubes. Adjuvant adenoidectomy in children over 4 years is thought to improve the efficacy of TT. The goal of this study is to characterize the efficacy of adjuvant adenoidectomy at the time of TT placement in children under 4 years, to further improve middle ear function.

METHODS: All patients undergoing TT placement alone or TT placement with adenoidectomy from 2014 to 2016 were reviewed. The primary outcome was need for subsequent tube placement.

RESULTS: A total of 409 patients were included in the study (60.6 % male, 39.4 % female). Median age at initial TT placement was 18 months (range 5-48 months); extreme outliers for age were removed from further analysis. Patients were followed for 1-8 years. 250 patients received TT alone while 159 received TT with adenoidectomy. 120 required a second set of tubes. There was a statistically significant benefit to those undergoing adjuvant adenoidectomy with TT placement: 33.6 % of those receiving TT alone required subsequent tubes, whereas only 22.6 % of patients who underwent TT with adjuvant adenoidectomy required reinsertion (X² = 5.630, p = 0.018). Adjuvant adenoidectomy in patients 0-48 months was associated with decreased likelihood of requiring subsequent tube placement (OR = 0.578, p = 0.018). There was an increased likelihood of experiencing otorrhea in those receiving TT alone compared to the TT with adenoidectomy group (X² = 4.353, df = 1, p = 0.0369).

CONCLUSION: Adjuvant adenoidectomy at the time of initial TT placement may have a role in the management of chronic middle ear disease in patients younger than 4 years. However, further studies and prospective randomized studies are needed to explore if this benefit can also be seen in children without chronic rhinosinusitis or nasal obstruction. The benefit-risk ratio from adenoidectomy and modifications in anesthesia technique in the case of adjuvant adenoidectomy should also be further explored.

PMID:38134590 | DOI:10.1016/j.ijporl.2023.111823

Int J Pediatr Otorhinolaryngol. 2023 Dec 16;176:111824. doi: 10.1016/j.ijporl.2023.111824. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the visual outcomes and sequelae of endonasal intervention for orbital infections.

INTRODUCTION: Orbital infections pose a serious threat to vision in the pediatric population and can result in complications such as blindness, diplopia, intracranial involvement, and death. [1] Orbital decompression by endonasal intervention is a common treatment to address a variety of orbital infections including orbital cellulitis, orbital abscesses, and subperiosteal abscesses. [2] The outcomes of visual sequelae such as loss or limitation of visual acuity, extraocular movements, and increased intraocular pressure following orbital decompression via endonasal intervention have not been sufficiently investigated in the current literature.

METHODS: This retrospective cohort study was performed at our tertiary care pediatric hospital using data from 69 patients aged 0-18 years who were admitted between 2008 and 2018. Data was extracted from the electronic medical record system.

RESULTS: Following endoscopic sinus surgery, symptoms of orbital infection improved throughout the cohort. Improvement in visual acuity is demonstrated by a statistically significant decrease in the average logMAR value in both the right and left eye (P = 0.002 and P = 0.028 respectively). There was also a significant improvement to normal values postoperatively for patients who initially presented with abnormal tonometry, extraocular movement, and the appearance of eyelids and eyelashes.

CONCLUSION: There is no decline or loss of vision with otolaryngology surgical intervention for orbital cellulitis in our cohort. This retrospective chart review demonstrates the efficacy of surgical intervention on overall visual outcomes following endonasal intervention for orbital infections such as orbital cellulitis, orbital abscesses, and subperiosteal abscesses.

PMID:38134589 | DOI:10.1016/j.ijporl.2023.111824

J Mech Behav Biomed Mater. 2023 Dec 11;150:106312. doi: 10.1016/j.jmbbm.2023.106312. Online ahead of print.

ABSTRACT

This study aimed to compare the fatigue performance of a lithium disilicate ceramic cemented on different substrates (human dentin and glass fiber-reinforced epoxy resin – GFRER), treated with different types of conditioning (CTR – without surface conditioning; HF5 – 5% hydrofluoric acid; HF10 – 10% hydrofluoric acid; H3PO4 – phosphoric acid 37%; SAND – sandblasting with aluminum oxide). The occlusal surface of human molars (DENT group) (n = 15) was ground for dentin exposure and the root portion was cut, then the dentin slice (2.0 mm thick) was conditioned with 37% phosphoric acid and a dual-curing dental adhesive was applied. The GFRER in a round-rod format was cut into discs (Ø = 10 mm, 2.0 mm thick). Lithium disilicate glass ceramic blocks (IPS e.max CAD, Ivoclar, Schaan, Liechtenstein) were shaped into a cylinder format and cut, resulting in 90 discs (Ø = 10 mm, 1.5 mm thick). The substrate materials of each group were etched according to the groups and the ceramic was etched with 5% hydrofluoric acid for 30 s. A silane coupling agent was applied over the cementation surface in ceramic and GFRER surfaces and a dual cement was used for cementation (ceramic/GFRER or dentin). The disc/disc sets were submitted to thermocycling (25,000 cycles + storage for 6 months), and then tested in step-wise accelerated cyclic fatigue test. The failure pattern and topography were analyzed and the roughness and contact angle were measured before and after surface treatment. The DENT group presented the lowest load to failure values and number of cycles to failure in fatigue (637.33 N; 118.333), showing no statistical similarity with any of the other tested groups (p < 0.05). The topographic analysis showed that all proposed surface treatments modified the substrate surface when compared to the CTR group. All of the fractographical inspections demonstrated failure by radial crack. Considering the roughness analysis, the post-etched DENT group showed similar roughness to all groups of GFRER materials with their surface treated, except for SAND, which showed greater roughness and statistically different from the other groups. The DENT group (49.5) showed statistically different post-conditioning contact angle values from the HF10 group (96.5) and similar to the other groups. The glass fiber-reinforced epoxy resin was not able to simulate the results presented by the human dentin substrate when cemented to lithium disilicate regarding fatigue failure load and number of cycles for failure, regardless of the surface treatment. Lithium disilicate cemented on dentin analogue overestimates the load values for fatigue failure.

PMID:38134583 | DOI:10.1016/j.jmbbm.2023.106312

Public Health. 2023 Dec 21;227:78-85. doi: 10.1016/j.puhe.2023.11.027. Online ahead of print.

ABSTRACT

OBJECTIVES: There is uncertainty about which factors mediate the association between adverse childhood experiences (ACEs) and cardiovascular disease (CVD). This could inform secondary prevention targets.

STUDY DESIGN: Mediation analysis of a prospective cohort study.

METHODS: English Longitudinal Study of Ageing (ELSA) wave 3 data (2006/7) were used to measure retrospective exposure to 12 individual ACEs and waves 2 to 4 (2004/5 to 2008/9) data to measure current exposure to potential mediators [smoking, physical activity, alcohol consumption, body mass index, depression, and C-reactive protein (CRP)]. Waves 4 to 9 ELSA data (2008/9 to 2018/19) were used to measure incident CVD. Cumulative ACE exposure was categorised into experiencing 0, 1 to 3, or ≥4 individual ACEs. Associations were tested between ACE categories, potential mediators, and incident CVD, to inform which variables were analysed in causal mediation models.

RESULTS: The analytical cohort consisted of 4547 participants (56% women), with a mean age of 64 years (standard deviation = 9 years). At least one ACE had been experienced by 45% of the cohort, and 24% developed incident CVD over a median follow-up period of 9.7 years (interquartile range: 5.3-11.4 years). After adjusting for potential confounders, experiencing ≥4 ACEs compared with none was associated with incident CVD [odds ratio (OR): 1.55; 95% confidence interval (CI): 1.10, 2.17], and the association of one to three ACEs compared with none was non-significant (OR: 1.08; 95% CI: 0.93, 1.24). There were two statistically significant mediators of the association between ≥4 ACEs and incident CVD: CRP and depression, which accounted for 10.7% and 10.8% of the association, respectively.

CONCLUSIONS: Inflammation and depression partially mediated the association between ACEs and CVD. Targeting these factors may reduce the future incidence of CVD.

PMID:38134567 | DOI:10.1016/j.puhe.2023.11.027

Waste Manag. 2023 Dec 21;174:539-548. doi: 10.1016/j.wasman.2023.12.030. Online ahead of print.

ABSTRACT

Municipal solid waste incineration bottom ash has emerged as a secondary source of valuable metals, including aluminum and copper. Specifically, the fine fraction, with a particle size less than two millimeters, exhibits average grades of 2.5 g/kg for copper and 10.0 g/kg for elemental aluminum. Gravimetric concentration equipment, such as wet shaking tables, is widely used in the mining and recycling industries to concentrate materials based on density. However, the optimization of these devices typically relies on a trial-and-error approach. This paper presents a statistical model that optimizes the crucial working parameters of the wet shaking table for recovering elemental aluminum in a light product mineral matrix and copper in a high-density product. The statistical analysis highlights that upper values of shaking amplitude are beneficial for both the recovery and grade of copper and aluminum in the obtained products. Conversely, variations in other parameters, such as wash water or desk tilt, yield contrasting effects on grade and recovery. By precisely adjusting the working parameters of the device, the analyses demonstrate that copper enrichment of up to 45 times can be achieved in the product smaller than 500 µm and up to 15 times in the 500-2000 µm product, resulting in the recovery of approximately 65 % of the total copper.

PMID:38134541 | DOI:10.1016/j.wasman.2023.12.030

Eur J Oncol Nurs. 2023 Dec 15;68:102492. doi: 10.1016/j.ejon.2023.102492. Online ahead of print.

ABSTRACT

PURPOSE: The aim of the present study was to explore potential differences in the sociodemographic (with a special focus on gender differences) and psychological predictors of quality of life in individuals diagnosed with cancer.

METHODS: A cross-sectional, observational study was carried out involving individuals struggling with different forms of cancer (N = 430). Linear regression was used to investigate the concurrent predictive role of the independent variables, stratified by gender, for each of the five cancer-specific quality of life domains and overall quality of life.

RESULTS: Sociodemographic characteristics had only a negligible to small role in predicting quality of life in both men and women. In contrast, the psychological variables explained a significantly larger portion of the variance in both genders. There were no statistically significant gender differences regarding the raw quality of life domain scores; however, their predictors were markedly different in the two groups.

CONCLUSION: The results of the present study indicate that it is imperative to take gender differences into consideration when planning psychosocial interventions also focusing on strengths, resources, and coping strategies. Considering the consistently emerging importance of family support in patients’ quality of life, offering psychological interventions to caregivers/family members seems warranted to empower them to provide support to patients throughout the illness trajectory.

PMID:38134495 | DOI:10.1016/j.ejon.2023.102492

Pregnancy Hypertens. 2023 Dec 21;35:32-36. doi: 10.1016/j.preghy.2023.12.003. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the association between body mass index (BMI) and chronic hypertension (CHTN) one-year postpartum following pregnancies complicated by hypertensive disorders of pregnancy (HDP).

STUDY DESIGN: A retrospective cohort study of patients with HDP (gestational hypertension or preeclampsia) in a single Midwestern academic center from 2014 to 2018. The primary outcome was CHTN at one-year postpartum, defined as systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg or taking antihypertensive medication at one-year postpartum. The primary exposure variable was BMI at one-year postpartum, categorized as underweight (<18.5 kg/m²), normal (18.5-24.9 kg/m²), overweight (25-<30 kg/m²), and obese (≥30 kg/m²) and as continuous BMI variable. Descriptive statistics and adjusted logistic regression analysis were performed.

RESULTS: Out of 596 patients with HDP included in this analysis, 275 (46.1 %) had CHTN one-year postpartum. Mean one-year postpartum BMI was 27.9 ± 5.2 kg/m². Prevalence of CHTN at one-year postpartum was higher in obese (38.1 %) and overweight (30.0 %) groups compared to the normal weight group (29.9 %), p < 0.001. In multivariate logistic regression, obesity at one-year postpartum, compared to normal, was associated with 73 % higher likelihood of CHTN following HDP (adjusted OR 1.73, 95 % CI 1.06-2.84). With BMI as a continuous variable, each unit increase in BMI one-year postpartum was associated with 6 % higher likelihood of CHTN (adjusted OR 1.06, 95 % CI 1.02-1.15).

CONCLUSIONS: Obesity at one-year postpartum following HDP was associated with a higher risk of CHTN compared with normal BMI. Weight is a modifiable risk factor that should be targeted in postpartum interventions to reduce cardiovascular disease following HDP.

PMID:38134483 | DOI:10.1016/j.preghy.2023.12.003

J Am Vet Med Assoc. 2023 Dec 22:1-6. doi: 10.2460/javma.23.08.0433. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine quality-of-life changes in owners of dogs undergoing mitral valve repair for myxomatous mitral valve disease, up to 12 months postoperatively.

SAMPLE: Owners of 26 dogs undergoing mitral valve repair at a single UK veterinary referral hospital.

METHODS: Dogs underwent mitral valve repair under cardiopulmonary bypass as previously described. Owner quality of life was assessed by self-completion of a previously validated questionnaire preoperatively and at 1, 3, 6, and 12 months postoperatively.

RESULTS: There was a statistically significant improvement in quality-of-life scores from preoperatively up to 3 months postoperatively and a statistically significant improvement in individual question scores up to 6 months postoperatively.

CLINICAL RELEVANCE: Results suggested that owner quality of life is significantly improved following surgical repair of their pet’s myxomatous mitral valve disease, and this improvement continues beyond the immediate postoperative period. These results may be useful when counseling owners of surgical candidates and is another useful outcome measure.

PMID:38134456 | DOI:10.2460/javma.23.08.0433

J Am Vet Med Assoc. 2023 Dec 22:1-5. doi: 10.2460/javma.23.09.0493. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effects of oral pregabalin versus gabapentin on sedation quality and anesthesia recovery times in cats in a typical perioperative setting.

ANIMALS: 50 healthy cats with > 1 kg body weight presenting for elective surgery.

METHODS: In this randomized, prospective clinical trial, cats presenting to the University of California-Davis Veterinary Medical Teaching Hospital were assigned to receive buprenorphine 0.02 mg/kg IM followed by 1 of 2 oral sedation treatments: pregabalin 4 mg/kg or gabapentin 10 mg/kg. Cats were then anesthetized using a standardized protocol. Physical examination parameters and behavioral scores were measured by 2 treatment-blinded veterinarians to compare sedation levels before and after drug administration. Inadequate sedation for handling or IV catheter placement was addressed by dexmedetomidine administration. After surgery was completed, anesthesia recovery times and quality were assessed by the same veterinarians. The effects of pregabalin versus gabapentin on body temperature, respiratory rate, and heart rate were analyzed using Student t tests; behavioral assessments were analyzed using Wilcoxon signed-rank tests; and drug treatment effects on dexmedetomidine sedation rescue and frequency of delirium during anesthetic recovery were analyzed using Fisher exact tests. A P < .05 indicated statistical significance.

RESULTS: There was no significant difference in change of physiologic parameters or sedation scores before and after sedation between groups. The need for rescue sedation for IV catheter placement and the incidence of emergence delirium were infrequent and similar for both treatments.

CLINICAL RELEVANCE: At the doses studied, oral pregabalin and gabapentin produced indistinguishable effects as adjunctive perioperative sedation agents in cats.

PMID:38134455 | DOI:10.2460/javma.23.09.0493

JMIR Res Protoc. 2023 Dec 22;12:e50677. doi: 10.2196/50677.

ABSTRACT

BACKGROUND: The effects of reinforcement are still controversial in bariatric surgery, and variations may exist in using this technique.

OBJECTIVE: This protocol describes a study that aims to survey the views of bariatric surgeons on reinforcement techniques and evaluate the effects of applying reinforcement techniques in sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).

METHODS: This study is composed of 2 parts. Part 1 will investigate the differences of using reinforcement techniques among surgeons worldwide who perform SG or RYGB through a survey. The survey will be conducted by email and social media. Part 2 will evaluate the safety and effectiveness of using omentopexy or staple line reinforcement in SG and RYGB by systematic review and meta-analysis. In this part, literature searches will be performed in English databases, including CENTRAL, EMBASE CINAHL, Web of Science, and PubMed, and Chinese databases, including Wanfang, China National Knowledge Infrastructure, Database of Chinese Technical Periodicals, and Chinese Biological Medicine, from their establishment to November 2023. Randomized controlled trials and case-control studies will be included. The primary outcomes are rates of postoperative bleeding and gastric leakage. The secondary outcomes include anastomotic stenosis, surgical site infection, reoperation, estimated intraoperative blood loss, operative time (minutes), length of hospital stay (days), overall complications, and 30-day mortality. The meta-analysis will be conducted using RevMan 5.4 under the random-effects model, as well as through extensive subgroup and sensitivity analyses. P values <0.05 will be considered statistically significant. This study was registered with PROSPERO (Prospective Register of Systematic Reviews) in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols).

RESULTS: The results of this study will be published in a peer-reviewed journal. The web-based survey and initial title or abstract review of papers identified by the search strategy will be completed in November 2023. The second round of title or abstract review and downloading of the papers for full-text inclusion will be completed in January 2024. We aim to complete data extraction and meta-analysis by February 2024 and expect to publish the findings by the end of March 2024.

CONCLUSIONS: This study aims to investigate the impact of reinforcement techniques on reducing the incidence of postoperative complications in SG and RYGB procedures and provide assistance for standardizing the procedures of SG and RYGB operations for bariatric surgeons.

TRIAL REGISTRATION: PROSPERO CRD42022376438; https://tinyurl.com/2d53uf8n.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/50677.

PMID:38133924 | DOI:10.2196/50677