Category: Statistics

J Burn Care Res. 2023 Jun 9:irad088. doi: 10.1093/jbcr/irad088. Online ahead of print.

ABSTRACT

Burns represent a large portion of injuries attending emergency departments each year, with children accounting for the biggest proportion. Appropriate first aid has been shown to help improve the outcome of burns and decrease the need for surgical intervention. Several studies outside of Indonesia demonstrate inadequate parental knowledge of burns first aid, but few evaluated interventions to improve knowledge. A period of data gathering from June to September 2022 was include the parents who have offspring aged between 18 and 12. This questionnaire was developed to achieve the objectives of this study and was based on others of a similar nature. A total of 102 participants were included in this study. 102 parents (79.4% female (n=81), 20.6% male (n=21)) were questioned. Baseline knowledge was found to be poor overall; it was found that nearly 91% of parents did not know the first-aid procedures for treating pediatric burns. However, educational initiatives were effective in advancing this knowledge. When a child got burned, nearly 68% of parents knew to use cold running water, and about 70% knew to get help from a doctor. Cold running water being applied is an extremely positive sign, which can have the most beneficial effect on the healing of the injury. No other variables analysed were shown to be statistically significant predictors of pre- or post-test scores (all p > 0.05). This study concluded that educational knowledge was effective to improve the parents’ ability in performing first aid for burn care.

PMID:37294898 | DOI:10.1093/jbcr/irad088

J Oral Rehabil. 2023 Jun 9. doi: 10.1111/joor.13533. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the morphological analyses of the bone components of temporomandibular joint (TMJ), and dentofacial morphology in myotonic dystrophy type 1 (DM1) patients by cone-beam computed tomography (CBCT).

METHODS: Sixty-six individuals (33 DM1, and 33 healthy subjects) age ranging from 20 to 69 were included in the study. Clinical examinations of the patients’ TMJ regions and evaluation of dentofacial morphology (maxillary deficiency, open-bite, deep palate, and cross-bite) were performed. Dental occlusion was determined based on Angle’s classification. CBCT images were evaluated regarding mandibular condyle morphology (convex, angled, flat, and round) and osseous changes observed in the condyle (normal, osteophyte, erosion, flattening, sclerosis). DM1-specific morphological and bony TMJ alterations were determined.

RESULTS: DM1 patients showed a high prevalence of morphological and osseous TMJ changes, and statistically significant skeletal alterations. The analysis of CBCT scans indicated the prevalent condylar shape among patients with DM1 was flat, the main osseous abnormality was flattening, there was a tendency towards skeletal Class II, and a posterior cross-bite was frequently detected in DM1 patients. There was no statistically significant difference between the genders on the parameters evaluated in both groups.

CONCLUSION: Adult patients with DM1 presented a high frequency of crossbite, tendency to skeletal Class II and morphological osseous alterations of TMJ. The analysis of the morphological condylar alterations in patients with DM1 may be beneficial in the diagnosis of TMJ disorders. This study reveals DM1-specific morphological and osseous TMJ alterations to provide an appropriate orthodontic /orthognathic treatment planning to patients.

PMID:37294889 | DOI:10.1111/joor.13533

J Am Soc Mass Spectrom. 2023 Jun 9. doi: 10.1021/jasms.3c00043. Online ahead of print.

ABSTRACT

Rehmannia glutinosa (Gaert.) Libosch. ex Fisch. et Mey. is a perennial herb of the Scrophulariaceae family, which has long enjoyed a good reputation in China, and has a wide range of pharmacological effects and clinical applications. The place of origin is an important factor affecting the chemical composition of R. glutinosa, resulting in different pharmacological effects. Herein, internal extractive electrospray ionization mass spectrometry (iEESI-MS) combined with statistical techniques was established for high-throughput molecular differentiation of different R. glutinosa samples. Dried and processed R. glutinosa samples from four different places of origin were analyzed by iEESI-MS with high throughput (>200 peaks) and rapidness (<2 min/sample) without sample pretreatment. Clear separation models created by OPLS-DA were then established for distinguishing the places of origin of dried and processed R. glutinosa by using the obtained MS data. In addition, the molecular differences between the pharmacological effects of dried and processed R. glutinosa were also investigated by OPLS-DA, and 31 different components were screened out. This work provides a promising method for evaluating the quality of traditional Chinese medicines and studying the biochemical mechanism of processing.

PMID:37294877 | DOI:10.1021/jasms.3c00043

Cochrane Database Syst Rev. 2023 Jun 8;6:CD013737. doi: 10.1002/14651858.CD013737.pub2.

ABSTRACT

BACKGROUND: Following hip fracture, people sustain an acute blood loss caused by the injury and subsequent surgery. Because the majority of hip fractures occur in older adults, blood loss may be compounded by pre-existing anaemia. Allogenic blood transfusions (ABT) may be given before, during, and after surgery to correct chronic anaemia or acute blood loss. However, there is uncertainty about the benefit-risk ratio for ABT. This is a potentially scarce resource, with availability of blood products sometimes uncertain. Other strategies from Patient Blood Management may prevent or minimise blood loss and avoid administration of ABT.

OBJECTIVES: To summarise the evidence from Cochrane Reviews and other systematic reviews of randomised or quasi-randomised trials evaluating the effects of pharmacological and non-pharmacological interventions, administered perioperatively, on reducing blood loss, anaemia, and the need for ABT in adults undergoing hip fracture surgery.

METHODS: In January 2022, we searched the Cochrane Library, MEDLINE, Embase, and five other databases for systematic reviews of randomised controlled trials (RCTs) of interventions given to prevent or minimise blood loss, treat the effects of anaemia, and reduce the need for ABT, in adults undergoing hip fracture surgery. We searched for pharmacological interventions (fibrinogen, factor VIIa and factor XIII, desmopressin, antifibrinolytics, fibrin and non-fibrin sealants and glue, agents to reverse the effects of anticoagulants, erythropoiesis agents, iron, vitamin B12, and folate replacement therapy) and non-pharmacological interventions (surgical approaches to reduce or manage blood loss, intraoperative cell salvage and autologous blood transfusion, temperature management, and oxygen therapy). We used Cochrane methodology, and assessed the methodological quality of included reviews using AMSTAR 2. We assessed the degree of overlap of RCTs between reviews. Because overlap was very high, we used a hierarchical approach to select reviews from which to report data; we compared the findings of selected reviews with findings from the other reviews. Outcomes were: number of people requiring ABT, volume of transfused blood (measured as units of packed red blood cells (PRC)), postoperative delirium, adverse events, activities of daily living (ADL), health-related quality of life (HRQoL), and mortality.

MAIN RESULTS: We found 26 systematic reviews including 36 RCTs (3923 participants), which only evaluated tranexamic acid and iron. We found no reviews of other pharmacological interventions or any non-pharmacological interventions. Tranexamic acid (17 reviews, 29 eligible RCTs) We selected reviews with the most recent search date, and which included data for the most outcomes. The methodological quality of these reviews was low. However, the findings were largely consistent across reviews. One review included 24 RCTs, with participants who had internal fixation or arthroplasty for different types of hip fracture. Tranexamic acid was given intravenously or topically during the perioperative period. In this review, based on a control group risk of 451 people per 1000, 194 fewer people per 1000 probably require ABT after receiving tranexamic acid (risk ratio (RR) 0.56, 95% confidence interval (CI) 0.46 to 0.68; 21 studies, 2148 participants; moderate-certainty evidence). We downgraded the certainty for possible publication bias. Review authors found that there was probably little or no difference in the risks of adverse events, reported as deep vein thrombosis (RR 1.16, 95% CI 0.74 to 1.81; 22 studies), pulmonary embolism (RR 1.01, 95% CI 0.36 to 2.86; 9 studies), myocardial infarction (RR 1.00, 95% CI 0.23 to 4.33; 8 studies), cerebrovascular accident (RR 1.45, 95% CI 0.56 to 3.70; 8 studies), or death (RR 1.01, 95% CI 0.70 to 1.46; 10 studies). We judged evidence from these outcomes to be moderate certainty, downgraded for imprecision. Another review, with a similarly broad inclusion criteria, included 10 studies, and found that tranexamic acid probably reduces the volume of transfused PRC (0.53 fewer units, 95% CI 0.27 to 0.80; 7 studies, 813 participants; moderate-certainty evidence). We downgraded the certainty because of unexplained high levels of statistical heterogeneity. No reviews reported outcomes of postoperative delirium, ADL, or HRQoL. Iron (9 reviews, 7 eligible RCTs) Whilst all reviews included studies in hip fracture populations, most also included other surgical populations. The most current, direct evidence was reported in two RCTs, with 403 participants with hip fracture; iron was given intravenously, starting preoperatively. This review did not include evidence for iron with erythropoietin. The methodological quality of this review was low. In this review, there was low-certainty evidence from two studies (403 participants) that there may be little or no difference according to whether intravenous iron was given in: the number of people who required ABT (RR 0.90, 95% CI 0.73 to 1.11), the volume of transfused blood (MD -0.07 units of PRC, 95% CI -0.31 to 0.17), infection (RR 0.99, 95% CI 0.55 to 1.80), or mortality within 30 days (RR 1.06, 95% CI 0.53 to 2.13). There may be little or no difference in delirium (25 events in the iron group compared to 26 events in control group; 1 study, 303 participants; low-certainty evidence). We are very unsure whether there was any difference in HRQoL, since it was reported without an effect estimate. The findings were largely consistent across reviews. We downgraded the evidence for imprecision, because studies included few participants, and the wide CIs indicated possible benefit and harm. No reviews reported outcomes of cognitive dysfunction, ADL, or HRQoL.

AUTHORS’ CONCLUSIONS: Tranexamic acid probably reduces the need for ABT in adults undergoing hip fracture surgery, and there is probably little or no difference in adverse events. For iron, there may be little or no difference in overall clinical effects, but this finding is limited by evidence from only a few small studies. Reviews of these treatments did not adequately include patient-reported outcome measures (PROMS), and evidence for their effectiveness remains incomplete. We were unable to effectively explore the impact of timing and route of administration between reviews. A lack of systematic reviews for other types of pharmacological or any non-pharmacological interventions to reduce the need for ABT indicates a need for further evidence syntheses to explore this. Methodologically sound evidence syntheses should include PROMS within four months of surgery.

PMID:37294864 | DOI:10.1002/14651858.CD013737.pub2

J Chem Theory Comput. 2023 Jun 9. doi: 10.1021/acs.jctc.3c00252. Online ahead of print.

ABSTRACT

Generalized expressions for thermodynamic properties in terms of ensemble averages are discussed for adiabatic and isothermal ensembles. They are implemented in the simulation code ms2 and validated by Monte Carlo simulations for the Lennard-Jones fluid. A comparison of the eight statistical ensembles regarding size scaling behavior, convergence, and stability is provided for state points throughout the homogeneous fluid region. The resulting data are in good agreement but differ in their statistical distributions. In closed systems, the statistical quality of the data is better than in open systems. Overall, the microcanonical ensemble performs best.

PMID:37294862 | DOI:10.1021/acs.jctc.3c00252

Int J Periodontics Restorative Dent. 2023 Jun 9. doi: 10.11607/prd.8466. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed at evaluating marginal leakage of 3 different types of bonding agent and 2 posterior composites and a giomer available commercially.

MATERIAL AND METHODS: Class II box only cavities were prepared on 90 mandibular first molars with margins extending 1mm beyond cement enamel junction. The samples were divided into 9 groups on the basis of three different bonding agents and 2 different composites and giomer. Cavities were restored as per the manufacturer’s description. Teeth were subjected to thermocycling regime (500×, 5-55°C) and dye penetration by immersing in 2% methylene blue for 24 hours. The marginal adaptation was evaluated as a continuous margin at gingival level under stereomicroscope. The results were analyzed using Kruskal Wallis and Mann Whitney U test.

RESULTS: The results of the groups with total etch technique showed no statistical difference between Nanohybrid Filtek Z250XT and Hybrid SwissTec. The groups with self etch technique showed no statistical difference when used with either of the 2 composites. The acid etch technique when used showed better marginal adaptation compared to self etch technique. The giomer when used in total etch technique showed better adaptation than when used with self etch technique but over all showed more marginal leakage in comparison to the composites.

CONCLUSION: Total etch technique in comparison to self etch technique gave better marginal adaptations for composites and giomers. Int J Periodontics Restorative Dent. doi: 10.11607/prd.4866.

PMID:37294860 | DOI:10.11607/prd.8466

Eur J Appl Physiol. 2023 Jun 9. doi: 10.1007/s00421-023-05245-w. Online ahead of print.

ABSTRACT

PURPOSE: Excessive intensity exercises can bring irreversible damage to the heart. We explore whether heart sounds can evaluate cardiac function after high-intensity exercise and hope to prevent overtraining through the changes of heart sound in future training.

METHODS: The study population consisted of 25 male athletes and 24 female athletes. All subjects were healthy and had no history of cardiovascular disease or family history of cardiovascular disease. The subjects were required to do high-intensity exercise for 3 days, with their blood sample and heart sound (HS) signals being collected and analysed before and after exercise. We then developed a Kernel extreme learning machine (KELM) model that can distinguish the state of heart by using the pre- and post-exercise data.

RESULTS: There was no significant change in serum cardiac troponin I after 3 days of load cross-country running, which indicates that there was no myocardial injury after the race. The statistical analysis of time-domain characteristics and multi-fractal characteristic parameters of HS showed that the cardiac reserve capacity of the subjects was enhanced after the cross-country running, and the KELM is an effective classifier to recognize HS and the state of the heart after exercise.

CONCLUSION: Through the results, we can draw the conclusion that this intensity of exercise will not cause profound damage to the athlete’s heart. The findings of this study are of great significance for evaluating the condition of the heart with the proposed index of heart sound and prevention of excessive training that causes damage to the heart.

PMID:37294516 | DOI:10.1007/s00421-023-05245-w

Curr Diab Rep. 2023 Jun 9. doi: 10.1007/s11892-023-01516-0. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Despite the crucial role that prediction models play in guiding early risk stratification and timely intervention to prevent type 2 diabetes after gestational diabetes mellitus (GDM), their use is not widespread in clinical practice. The purpose of this review is to examine the methodological characteristics and quality of existing prognostic models predicting postpartum glucose intolerance following GDM.

RECENT FINDINGS: A systematic review was conducted on relevant risk prediction models, resulting in 15 eligible publications from research groups in various countries. Our review found that traditional statistical models were more common than machine learning models, and only two were assessed to have a low risk of bias. Seven were internally validated, but none were externally validated. Model discrimination and calibration were done in 13 and four studies, respectively. Various predictors were identified, including body mass index, fasting glucose concentration during pregnancy, maternal age, family history of diabetes, biochemical variables, oral glucose tolerance test, use of insulin in pregnancy, postnatal fasting glucose level, genetic risk factors, hemoglobin A1c, and weight. The existing prognostic models for glucose intolerance following GDM have various methodological shortcomings, with only a few models being assessed to have low risk of bias and validated internally. Future research should prioritize the development of robust, high-quality risk prediction models that follow appropriate guidelines, in order to advance this area and improve early risk stratification and intervention for glucose intolerance and type 2 diabetes among women who have had GDM.

PMID:37294513 | DOI:10.1007/s11892-023-01516-0

Mycopathologia. 2023 Jun 9. doi: 10.1007/s11046-023-00758-6. Online ahead of print.

ABSTRACT

Candidemia is a serious infection associated with increased mortality. It is unclear whether a high concentration of Candida in stool in patients with hematologic malignancies is associated with a higher risk for developing candidemia. In this observational historical study in patients hospitalized in hemato-oncology departments, we describe the association between gastrointestinal Candida colonization and the risk for candidemia and other severe outcomes. Data from 166 patients with heavy burden of Candida in stool were collected and compared to a control group of 309 patients with minimal or no Candida in stool, from 2005 to 2020. Severe immunosuppression and recent use of antibiotics were more common in heavily colonized patients. Outcomes of heavily colonized patients were worse as compared to the control group with statistical significance in 1-year mortality (53% vs. 37.5%, p = 0.001) and borderline statistical significance in candidemia rate (12.6% vs. 7.1%, p = 0.07). Risk factors for 1-year mortality were significant colonization of Candida in stool, older age and recent use of antibiotics. In conclusion, significant stool burden of Candida among hospitalized hemato-oncology patients may pose a risk for 1-year mortality and increased candidemia rate.

PMID:37294507 | DOI:10.1007/s11046-023-00758-6

J Behav Med. 2023 Jun 9. doi: 10.1007/s10865-023-00420-y. Online ahead of print.

ABSTRACT

To evaluate the effect of yoga on the frequency of MetS and its impact on cardiovascular risk markers in climacteric women. We recruited 84 sedentary women between 40 and 65 years diagnosed with MetS. Participants were randomly assigned to a 24-week yoga intervention or control group. We evaluated the frequency of MetS and changes in the individual components of MetS at baseline and after 24 weeks. We also assessed the impact of yoga practices on cardiovascular risk through the following markers: High-sensitivity C-reactive Protein (hs-CRP), Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI), and Atherogenic Index of Plasma (AIP). The frequency of MetS reduced significantly after 24 weeks of yoga practice (- 34.1%; p < 0.001). Statistical analysis showed that the frequency of MetS was significantly lower in the yoga group (65.9%; n = 27) than in the control group (93.0%; n = 40) after 24 weeks (p = 0.002). Regarding the individual components of MetS, yoga practitioners had statistically lower waist circumference, systolic blood pressure, triglycerides, HDLc, and glucose serum concentrations than the control group after 24 weeks. Yoga practitioners also had a significant decrease in hs-CRP serum concentrations (3.27 ± 2.95 mg/L vs. 2.52 ± 2.14 mg/L; p = 0.040) and a lower frequency of moderate or high cardiovascular risk (48.8% vs. 34.1%; p = 0.001) after 24 weeks of practice. The yoga group had LAP values significantly lower than the control group after the intervention period (55.8 ± 38.04 vs. 73.9 ± 40.7; p = 0.039). Yoga practice demonstrated to be an effective therapeutic to manage MetS and reduce cardiovascular risk in climacteric women.

PMID:37294473 | DOI:10.1007/s10865-023-00420-y