Category: Statistics

Cereb Cortex. 2023 Dec 2:bhad457. doi: 10.1093/cercor/bhad457. Online ahead of print.

ABSTRACT

Current theories of attention differentiate exogenous from endogenous orienting of visuospatial attention. While both forms of attention orienting engage different functional systems, endogenous and exogenous attention are thought to share resources, as shown by empirical evidence of their functional interactions. The present study aims to uncover the neurobiological basis of how salient events that drive exogenous attention disrupts endogenous attention processes. We hypothesize that interference from exogenous attention over endogenous attention involves alpha-band activity, a neural marker of visuospatial attention. To test this hypothesis, we contrast the effects of endogenous attention across two experimental tasks while we recorded electroencephalography (n = 32, both sexes): a single cueing task where endogenous attention is engaged in isolation, and a double cueing task where endogenous attention is concurrently engaged with exogenous attention. Our results confirm that the concurrent engagement of exogenous attention interferes with endogenous attention processes. We also found that changes in alpha-band activity mediate the relationship between endogenous attention and its effect on task performance, and that the interference of exogenous attention on endogenous attention occurs via the moderation of this indirect effect. Altogether, our results substantiate a model of attention, whereby endogenous and exogenous attentional processes involve the same neurophysiological resources.

SIGNIFICANCE STATEMENT: Scientists differentiate top-down from bottom-up visuospatial attention processes. While bottom-up attention is rapidly engaged by emerging demands from the environment, top-down attention in contrast reflects slow voluntary shifts of spatial attention. Several lines of research substantiate the idea that top-down and bottom-up attentional processes involve distinct functional systems. An increasing number of studies, however, argue that both attention systems share brain processing resources. The current study examines how salient visual events that engage bottom-up processes interfere with top-down attentional processes. Using neurophysiological recordings and multivariate pattern classification techniques, the authors show that these patterns of interference occur within the alpha-band of neural activity (8-12 Hz), which implies that bottom-up and top-down attention processes share this narrow-band frequency brain resource. The results further demonstrate that patterns of alpha-band activity explains, in part, the interference between top-down and bottom-up attention at the behavioral level.

PMID:38044466 | DOI:10.1093/cercor/bhad457

J Dent Educ. 2023 Dec 3. doi: 10.1002/jdd.13431. Online ahead of print.

ABSTRACT

PURPOSE: The desirability of Orthodontic Residency remains high today relative to the past 30 years. This investigation seeks to re-assess factors influencing Orthodontic Residency program selection amidst contemporary challenges and changes, including increasing student debt, reduced residency stipends, and shifting practice models.

METHODS: This mixed-methods study consisted of interviews (qualitative) and surveys (quantitative). Fifteen final-year dental students and first-year orthodontic residents were interviewed one-on-one following a topic guide and then transcripts were analyzed using MAXQDA2022 to identify values, factors, and influences related to program selection and ranking. Qualitative findings and previous studies provided the basis for a survey distributed to residency applicants in 2020-22. Data were analyzed with bivariate and descriptive statistics with stratification by debt group.

RESULTS: Interviews (N = 15) elevated the importance of location, interview experience, program cost, and clinical education. Surveys (N = 239) identified the most desirable factors for program selection: satisfied residents, strong clinical training with multiple techniques, good interview impressions, low cost, high patient numbers, a strong reputation, and good clinical facilities with new technology. Less desirable factors include programs that are hospital-based, certificate-only, research-intensive, and require considerable after-hours work.

CONCLUSIONS: Clinical education and interview experiences are key for residency selection, consistent with prior studies, though program cost has grown in importance. Findings can help guide orthodontic programs in recruiting applicants and suggest a need to limit educational costs.

PMID:38044465 | DOI:10.1002/jdd.13431

BMC Oral Health. 2023 Dec 3;23(1):962. doi: 10.1186/s12903-023-03674-9.

ABSTRACT

BACKGROUND: Gingival recession and post-operation discomfort are still a problem for patients receiving the periodontal regeneration surgery for intra-bony defects. To further reduce the trauma and the post-operation gingival recession, a novel periodontal endoscopy-aided non-incisional regeneration technique (NIT) was proposed in the treatment of intra-bony defects.

METHODS: Retrospective analysis of 21 subjects treated with NIT and 21 subjects with periodontal endoscopy-aided scaling and root planing (PSRP) at baseline and 1-year evaluation was conducted. After removing the subgingival calculus and granulation tissue, bone grafting materials were placed into intrabony defects with the assistance of a gingival retractor in the NIT group. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), as well as the distance between bone crest (BC) level and base of the defect (BD) (intrabony defect depth, IBD) were evaluated at baseline and 1 year after treatment.

RESULTS: At 1-year follow-up, the value of CAL, PD and IBD were statistically significant different compared with baseline in both two groups (p<0.001). CAL gain (p = 0.012) and PD reduction (p = 0.004) was greater in the NIT than PSRP. However, no difference in the IBD reduction was found between the NIT group and PSRP. Better CAL gain and PD reduction was achieved in the 1-year term in the NIT when compared with PSRP.

CONCLUSION: NIT have resulted in significant gains in both clinical and radiographic parameters. NIT might be utilized as an alternative of the surgical treatment for periodontal intrabony defects.

TRIAL REGISTRATION: This clinical trial registration was registered retrospectively (August 3, 2023) and the number is ChiCTR2300074317.

PMID:38044459 | DOI:10.1186/s12903-023-03674-9

World J Surg Oncol. 2023 Dec 4;21(1):379. doi: 10.1186/s12957-023-03254-9.

ABSTRACT

BACKGROUND: Abdominally based free flaps are commonly used in breast reconstruction. A frequent complication is venous congestion, which might contribute to around 40% of flap failures. One way to deal with it is venous supercharging. The primary aim of this study was to investigate the scientific evidence for the effects of venous supercharging.

METHODS: A systematic literature search was conducted in PubMed, CINAHL, Embase, and Cochrane library. The included articles were critically appraised, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

RESULTS: Thirty-six studies were included. Most studies had serious study limitations and problems with directness. Three studies report ‘routine’ use of venous supercharging and performed it prophylactically in patients who did not have clinical signs of venous congestion. Seventeen studies report on flap complications, of which one is a randomised controlled trial demonstrating statistically significant lower complication rates in the intervention group. The overall certainty of evidence for the effect of a venous supercharging on flap complications, length of hospital stay and operative time, in patients without clinical signs of venous congestion, is very low (GRADE ⊕ ⊕ ⊝ ⊝), and low on and surgical takebacks (GRADE ⊕ ⊕ ⊝ ⊝). Twenty-one studies presented data on strategies and overall certainty of evidence for using radiological findings, preoperative measurements, and clinical risk factors to make decisions on venous supercharging is very low (GRADE ⊕ ⊝ ⊝ ⊝).

CONCLUSION: There is little scientific evidence for how to predict in which cases, without clinical signs of venous congestion, venous supercharging should be performed. The complication rate might be lower in patients in which a prophylactic venous anastomosis has been performed.

TRIAL REGISTRATION: PROSPERO (CRD42022353591).

PMID:38044454 | DOI:10.1186/s12957-023-03254-9

J Orthop Surg Res. 2023 Dec 4;18(1):924. doi: 10.1186/s13018-023-04394-0.

ABSTRACT

BACKGROUND: Intraoperative 3D imaging using cone-beam CT (CBCT) provides improved assessment of implant position and reduction in spine surgery, is used for navigated surgical techniques, and therefore leads to improved quality of care. However, in some cases the image quality is not sufficient to correctly assess pedicle screw position and reduction, especially due to metal artifacts. The aim of this study was to investigate whether changing the acquisition trajectory of the CBCT in relation to the pedicle screw position during dorsal instrumentation of the spine can reduce metal artifacts and consequently improve image quality as well as clinical assessability on the artificial bone model.

METHODS: An artificial bone model was instrumented with pedicle screws in the thoracic and lumbar spine region (Th10 to L5). Then, the acquisition trajectory of the CBCT (Cios Spin, Siemens, Germany) to the pedicle screws was systematically changed in 5° steps in angulation (- 30° to + 30°) and swivel (- 30° to + 30°). Subsequently, radiological evaluation was performed by three blinded, qualified raters on image quality using 9 questions (including anatomical structures, implant position, appearance of artifacts) with a score (1-5 points). For statistical evaluation, the image quality of the different acquisition trajectories was compared to the standard acquisition trajectory and checked for significant differences.

RESULTS: The angulated acquisition trajectory increased the score for subjective image quality (p < 0.001) as well as the clinical assessability of pedicle screw position (p < 0.001) highly significant with particularly strong effects on subjective image quality in the vertebral pedicle region (d = 1.06). Swivel of the acquisition trajectory significantly improved all queried domains of subjective image quality (p < 0.001) as well as clinical assessability of pedicle screw position (p < 0.001). The data show that maximizing the angulation or swivel angle toward 30° provides the best tested subjective image quality. Angulation and swivel of the acquisition trajectory result in a clinically relevant improvement in image quality in intraoperative 3D imaging (CBCT) during dorsal instrumentation of the spine.

PMID:38044441 | DOI:10.1186/s13018-023-04394-0

Brain Imaging Behav. 2023 Dec 4. doi: 10.1007/s11682-023-00832-z. Online ahead of print.

ABSTRACT

Traumatic axonal injury (TAI) may result in the disruption of brain functional networks and is strongly associated with cognitive impairment. However, the neural mechanisms affecting the neurocognitive function after TAI remain to be elucidated. We collected the resting-state functional magnetic resonance imaging data from 28 patients with TAI and 28 matched healthy controls. An automated anatomical labeling atlas was used to construct a functional brain connectome. We utilized a graph theoretical approach to investigate the alterations in global and regional network topologies, and network-based statistics analysis was utilized to localize the connected networks more precisely. The current study revealed that patients with TAI and healthy controls both showed a typical small-world topology of the functional brain networks. However, patients with TAI exhibited a significantly lower local efficiency compared to healthy controls, whereas no significant difference emerged in other small-world properties (Cp, Lp, γ, λ, and σ) and global efficiency. Moreover, patients with TAI exhibited aberrant nodal centralities in some regions, including the frontal lobes, parietal lobes, caudate nucleus, and cerebellum bilaterally, and right olfactory cortex. The network-based statistics results showed alterations in the long-distance functional connections in the subnetwork in patients with TAI, involving these brain regions with significantly altered nodal centralities. These alterations suggest that brain networks of individuals with TAI present aberrant topological attributes that are associated with cognitive impairment, which could be potential biomarkers for predicting cognitive dysfunction and help understanding the neuropathological mechanisms in patients with TAI.

PMID:38044412 | DOI:10.1007/s11682-023-00832-z

Drug Deliv Transl Res. 2023 Dec 4. doi: 10.1007/s13346-023-01488-4. Online ahead of print.

ABSTRACT

Chronic and allergic rhinosinusitis impacts approximately 12% of the global population. Challenges in rhinosinusitis treatment include paranasal sinus inaccessibility and variability in delivery efficiency among individuals. This study addresses these challenges of drug delivery by developing a high-efficiency, low-variability protocol for nasal drop delivery to the ostiomeatal complex (OMC) and maxillary sinus. Patient-specific nasal casts were dissected to reveal the configurations of conchae and meatus, providing insights into anatomical features amendable for sinus delivery. Fluorescent dye-enhanced videos visualized the dynamic liquid translocation in transparent nasal casts, allowing real-time assessment and quick adjustment to delivery parameters. Dosimetry to the OMC and maxillary sinus were quantified as drop count and mass using a precision scale. Key delivery factors, including the device type, formulation, and head-chin orientation, were systematically investigated in a cohort of ten nasal casts. Results show that both the squeeze bottle and soft-mist nasal pump yielded notably low doses to the OMC with high variability, and no dose from these two devices was detected within the maxillary sinuses. In contrast, the proposed approach, which included a curved nozzle surpassing the nasal valve and leveraged gravity-driven liquid translocation along the lateral nasal wall, delivered significant doses to the OMC and maxillary sinus. Iterative experimentations identified the optimal head tilt to be 40° and chin tilt to be° from the lateral recumbent position. Statistical analyses established the drop count required for effective OMC/sinus delivery. The proposed delivery protocol holds the potential to enhance chronic rhinosinusitis treatment outcomes with low variability. The dual role of nasal anatomy in posing challenges and offering opportunities highlights the need for future investigations using diverse formulations in a larger cohort of nasal models. Optimized gravity-driven intranasal drop administration delivers significant doses to the ostiomeatal complex and maxillary sinus.

PMID:38044376 | DOI:10.1007/s13346-023-01488-4

Acta Neurochir (Wien). 2023 Dec 4. doi: 10.1007/s00701-023-05867-1. Online ahead of print.

ABSTRACT

BACKGROUND: Tumor consistency is considered to be a critical factor for the surgical removal of meningiomas and its preoperative assessment is intensively studied. A significant drawback in the research of predictive methods is the lack of a clear shared definition of tumor consistency, with most authors resorting to subjective binary classification labeling the samples as “soft” and “hard.” This classification is highly observer-dependent and its discrete nature fails to capture the fine nuances in tumor consistency. To compensate for these shortcomings, we examined the utility of texture analysis to provide an objective observer-independent continuous measure of meningioma consistency.

METHODS: A total of 169 texturometric measurements were conducted using the Brookfield CT3 Texture Analyzer on meningioma samples from five patients immediately after the removal and on the first, second, and seventh postoperative day. The relationship between measured stiffness and time from sample extraction, subjectively assessed consistency grade and histopathological features (amount of collagen and reticulin fibers, presence of psammoma bodies, predominant microscopic morphology) was analyzed.

RESULTS: The stiffness measurements exhibited significantly lower variance within a sample than among samples (p = 0.0225) and significant increase with a higher objectively assessed consistency grade (p = 0.0161, p = 0.0055). A significant negative correlation was found between the measured stiffness and the time from sample extraction (p < 0.01). A significant monotonic relationship was revealed between stiffness values and amount of collagen I and reticulin fibers; there were no statistically significant differences between histological phenotypes in regard to presence of psammoma bodies and predominant microscopic morphology.

CONCLUSIONS: We conclude that the values yielded by texture analysis are highly representative of an intrinsic consistency-related quality of the sample despite the influence of intra-sample heterogeneity and that our proposed method can be used to conduct quantitative studies on the role of meningioma consistency.

PMID:38044374 | DOI:10.1007/s00701-023-05867-1

Environ Monit Assess. 2023 Dec 4;196(1):4. doi: 10.1007/s10661-023-12175-9.

ABSTRACT

This paper is an effort of geo-statistical analysis of rainfall variability and trend detection in the eastern Hindu Kush region located in the north-west of Pakistan. The eastern section of the HK region lies in the western part of Pakistan. Exploring rainfall variability and quantifying its trend and magnitude is one of the key indicators among all climatic parameters. In the study area, Pakistan Meteorology Department (PMD) has established seven meteorological stations: Drosh, Chitral, Dir, Timergara, Saidu Sharif, Malam Jabba, and Kalam. Daily, mean monthly, and mean annual rainfall time series data for all the met stations were geo-statistically analyzed in the GIS environment for detecting monthly and annual variability in rainfall, variability, and trend detection. Mann-Kendall (MK) and Theil-Sen’s slope (TSS) statistical tests were applied to rainfall data. Initially, the MK test was applied for detection of trends and TSS test was used to quantify the change in magnitude. The results indicate that the rainfall variability in intensity and trend pattern detection. The analysis confirms that an extremely significant rainfall trend in the case of mean annual rainfall was predicted at Dir and Malam Jabba meteorological stations. Opposite to this, at Kalam and Chitral stations, a less significant rainfall trend was noted. In a similar context, no prominent rainfall trend has been found at Drosh, Timergara, and Saidu Sharif meteorological stations. Likewise, using TSS, an extremely negative variation in the magnitude of rainfall was verified at Kalam and Malam Jabba. However, a noteworthy positive change in rainfall magnitude has been noted at Dir and Saidu Sharif meteorological stations. The findings of this research have the potential to assist the decision and policy makers and academicians to think truly and conduct more scientific research studies to mitigate climate change.

PMID:38044361 | DOI:10.1007/s10661-023-12175-9

J Dent Educ. 2023 Dec 3. doi: 10.1002/jdd.13426. Online ahead of print.

ABSTRACT

BACKGROUND: Haptic technologies have opened a new avenue in preclinical dental education, with evidence that they can be used to improve student performance. The aim of this systematic review was to (1) determine the effect of haptic simulators on motor skill acquisition during preclinical dental training, (2) explore students’ perception, and (3) explore the ability of haptic systems to distinguish users based on their initial level of manual dexterity.

METHODS: A comprehensive search of articles published up to February 2023 was performed using five databases (i.e., PubMed/Medline, ScienceDirect, Web of Sciences, Scopus, and Cochrane Library) and specialized journals. The Preferred Reporting Items for Systematic Review and Meta-Analysis 2020 guidelines were followed, and the risk of bias was assessed. Only studies on the application of haptic simulators in dentistry preclinical training were included. Qualitative synthesis of data was performed, and the protocol was registered in PROSPERO (ID = CRD42022337177).

RESULTS: Twenty-three clinical studies, including 1303 participants, were included. The authors observed a statistically significant improvement in dental students’ motor skills in various dental specialties, such as restorative dentistry, pediatric, prosthodontics, periodontics, implantology, and dental surgery, after haptic training. Haptic technologies were perceived well by all participants, with encouraging data regarding their ability to differentiate users according to their initial level of manual dexterity.

CONCLUSIONS: Our work suggests that haptic simulators can significantly improve motor skill acquisition in preclinical dental training. This new digital technology, which was well perceived by the participants, also showed encouraging results in discriminating users according to their level of experience.

PMID:38044266 | DOI:10.1002/jdd.13426