Category: Statistics

Adv Exp Med Biol. 2023;1425:171-181. doi: 10.1007/978-3-031-31986-0_16.

ABSTRACT

The purpose of the present study was to explore the duration between the onset of psychopathology and the first contact either with a sectorized Community Mental Health Centre (CMHC) of Athens area or other mental health services, identify the pathways to the CMHC as well as possible sociodemographic and clinical factors affecting help-seeking behavior. The sample consisted of 355 individuals who visited the CMHC, but had sought help from another mental health care source prior to their visit to the Centre (group A), and was compared with 398 individuals who had no previous contact with any other psychiatric service (group B). The average duration of untreated mental disorders was found to be 19.85 (SD 23.113) for males of group A and 26.26 (SD 41.158) for males of group B. Among females the mean duration was found to be 18.11 (SD 27.293) for group A and 22.21 (SD 29.440) for group B, a statistically significant difference. In group A, the intervening services referred the clients at an earlier stage. The striking difference is that only eight individuals (2%) of group B (first timers) were diagnosed as suffering from schizophrenia contrasting to the 61 (17.4%) counterparts of group A. Individuals in our study diagnosed with psychosis seemed to have sought help first from other mental health services and delay to visit a CMHC. People who face problems resulting from their interpersonal or professional relationships often choose to have a first contact with a CMHC. Reduction of the delay in treatment will require clearer understanding of the contributing factors. Liaison activities with public and mental health sector services and outreach interventions to increase awareness on the early recognition of psychopathologic symptoms and the need for early referral could reduce the duration of untreated mental disorders.

PMID:37581791 | DOI:10.1007/978-3-031-31986-0_16

Adv Exp Med Biol. 2023;1425:131-139. doi: 10.1007/978-3-031-31986-0_12.

ABSTRACT

INTRODUCTION: Cardiovascular disease remains a major cause of morbidity and premature mortality worldwide. The aim of the present study was to investigate the association of atherosclerotic cardiovascular disease (ASCVD) risk estimator with depression in women undergoing cardiological evaluation.

MATERIAL AND METHOD: Three hundred women undergoing cardiological evaluation completed the Zung Self-Rating Depression Scale (ZSDS) questionnaire which included women’s characteristics.

RESULTS: A percentage of 57.4% of our participants exhibited ASCVD risk <5%; while the 18.3% had ASCVD risk between 5% and 7.4%, the 18.3% between 7.5% and 20%, and the remaining 6% > 20%. In terms of depression, 50% of the women had a score of less than 38 (median), according to Zung scale and mean score was 38.4. In addition, 25% of women had a score below 32. These scores indicate low levels of depression in women. Statistically significant higher rates of depression were found in women who were not involved with physical activities (p = 0.030).

CONCLUSIONS: The negative impact of depression on the ASCVD risk could potentially be prevented by modifying individuals’ behavior with regard to their engagement in physical activity.

PMID:37581787 | DOI:10.1007/978-3-031-31986-0_12

Adv Exp Med Biol. 2023;1425:69-77. doi: 10.1007/978-3-031-31986-0_7.

ABSTRACT

INTRODUCTION: Childhood cancer is a life-threatening, chronic condition and treatment may extent for several years. The diagnosis of cancer in children could stress intensely their parents.

AIM: To explore coping strategies utilized by Greek parents who have children with cancer.

MATERIAL AND METHODS: Eighty-five parents of children with cancer, admitted for treatment at the in-patient unit of a Paediatric Hospital in Athens completed a questionnaire with demographic and their children’s disease related characteristics and the Family Crisis Oriented Personal Evaluation Scale.

RESULTS: Sixty mothers (70.6%) and 25 fathers (29.4%) completed the questionnaire. A percentage of 29.4% of the parents included in this study considered themselves anxious. Elementary or secondary school graduates scored higher in Seeking Spiritual Support (p = 0.013). Stay-at-home or unemployed parents scored lower in the subscale of Passive Appraisal (p = 0.012). Parents who were very well informed tended to exhibit more frequently passive appraisal behavior (p = 0.004). Parents whose child had Hodgkin’s lymphoma scored higher in the subscale of Acquiring Social Support (p = 0.034). Statistical significance was found between parent’s strategies of Seeking Spiritual Support and the gender (girls) (p = 0.036), as well as the treatment problems (p = 0.008) of hospitalized children.

CONCLUSIONS: This study may help health professionals understand Greek families’ coping strategies when they have a child with cancer. Appropriate knowledge could significantly help them in the field of planning and implementation of personalized care in order to achieve optimal therapeutic outcomes.

PMID:37581782 | DOI:10.1007/978-3-031-31986-0_7

Int J Rehabil Res. 2023 Aug 15. doi: 10.1097/MRR.0000000000000598. Online ahead of print.

ABSTRACT

The objective was to examine the effects of backward walking training for improving walking speed and balance in children with cerebral palsy. A systematic review of randomized trials was conducted. Trials had to include children with cerebral palsy, with a Gross Motor Function Classification System, between I and III, that delivered backward walking training as a solo intervention or in combination with forward walking training. The outcomes of interest were walking speed and balance. The methodological quality of included trials was assessed by the PEDro scale, and the quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation. Eight papers, involving 156 participants, were included. Using random-effects meta-analysis, we estimated that backward walking training improved walking speed by 0.10 m/s [95% confidence interval (CI) 0.05-0.16] and by 2 points on the Pediatric Balance Scale (0-56) (95% CI 1.5-2.2) more than forward walking training. We also estimated that the addition of backward walking training increased walking speed by 0.20 m/s (95% CI 0.07-0.34) and reduced the angular excursion of the center of gravity by 0.5 degrees (95% CI -0.7 to -0.3). The quality of the evidence was classified as low to moderate. In conclusion, overall, backward walking training appears to be as effective or slightly superior to forward walking training for improving walking speed in children with CP. The addition of backward walking training statistically significantly and clinically important enhanced benefits on walking speed.

PMID:37581293 | DOI:10.1097/MRR.0000000000000598

J Prosthodont. 2023 Aug 15. doi: 10.1111/jopr.13745. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the accuracy of three torque-control devices used on healing abutments in implant prosthodontics.

MATERIALS AND METHODS: In this in vitro experiment, three torque controllers, Ankylos^® friction-based, Straumann^® spring-based, and Anthogyr^® pre-calibrated torque control devices were used to tighten the healing abutments of Ankylos^® and Straumann^® dental implants to a pre-determined value of 15 Ncm. A digital torque meter (DT), Cedar DID-4A, was used to assess removal torque as a surrogate for the accuracy of the torque controllers to apply a tightening force of 15Ncm on healing abutments. One-way analysis of variance (ANOVA) was used to identify differences between each torque controller and the digital torquemeter, a p<0.05 was considered significant.

RESULTS: The torque required to remove the healing abutments was 16.05± 0.66 Ncm for the Ankylos^® ratchet, 12.61± 0.90 Ncm for the Straumann^® ratchet, and 14.37±1.08 Ncm for the Anthogyr^® torque-control device. Significant statistical differences were observed between Ankylos^Ò and the control digital torquemeter (p = 1.84E^-8 ; F = 50.3); Anthogyr^® and control digital torquemeter (p = 0.01; F = 6.79); and Straumann^® and control digital torquemeter (p = 0.01; F = 141.15).

CONCLUSION: Friction-based (Ankylos^® ), spring-based (Straumann^® ), and pre-calibrated (Anthogyr^® ) torque control devices present over-torque and under-torque values when used over healing abutments of Ankylos^® and Straumann^® implant systems. This article is protected by copyright. All rights reserved.

PMID:37581292 | DOI:10.1111/jopr.13745

Ann Surg. 2023 Aug 15. doi: 10.1097/SLA.0000000000006032. Online ahead of print.

ABSTRACT

OBJECTIVE: In this study, we sought to assess how liver allografts preserved using portable normothermic machine perfusion (NMP) compare against those that underwent ischemic cold storage (ICS) in the setting of donation after brain death (DBD) and donation after circulatory death (DCD) liver transplantation.

BACKGROUND: Compared to conventional ICS, NMP may offer a more homeostatic preservation, permit physiologic assessment of organ function, and provide opportunities for graft improvement/modification. We report a single center US experience of liver NMP.

METHODS: A single center, retrospective analysis of collected data on 541 adult whole liver transplants from 469 DBD donors (NMP[n=58] vs ICS[n=411]) and 72 DCD donors (NMP[n=52] vs ICS[n=20]) between January 2016 and December 2022.

RESULTS: In DBD LT, male gender (OR [95% CI]: 1.83 [1.08-3.09]) and greater than 10% macrosteatosis of the donor liver (1.85 [1.10-3.10]) were statistically significant independent risk factors of early allograft dysfunction (EAD). Donor age >40yo and cold ischemia time (CIT) >7h were independent risk factors of reperfusion syndrome (RPS). 1-year, 3-year, and 5-year incidences of ischemic cholangiopathy (IC) did not differ significantly in DBD cases between the NMP and ICS cohorts. In DCD LT, NMP was an independent protective factor against EAD (0.11 [0.03-0.46]) and RPS (0.04 [0.01-0.25]). Incidence of IC in the DCD cases at 1-year and 3-year timepoints was significantly lower in the NMP cohort (1.9% compared to 20% in the ICS group).

CONCLUSIONS: Compared to conventional ICS, NMP can significantly reduce the incidence of EAD, RPS, and IC after DCD liver transplantation.

PMID:37581260 | DOI:10.1097/SLA.0000000000006032

Curr Opin Obstet Gynecol. 2023 Aug 15. doi: 10.1097/GCO.0000000000000900. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: This review introduces the recognized body of evidence on social determinants of health, which continue to show that a person’s health is determined by their broader environmental and social context and that societal inequities harm health and healthcare outcomes. An area of inequity is race, which, although a social construct, has a significant impact on a person’s morbidity and mortality as well as their access and experience of healthcare. Racial disparities in maternal and perinatal outcomes are widely recognized. Therefore, this review focuses on the less commonly addressed early pregnancy setting.

RECENT FINDINGS: Health inequities are present in the early pregnancy setting, as racial disparities exist in early pregnancy presentations and outcomes. Black women have a higher incidence of miscarriage, ectopic pregnancy and poorer survival rates from gestational trophoblastic neoplasms. Asian women have a statistically significantly higher incidence of gestational trophoblastic disease.

SUMMARY: The findings support the need for more consistent and detailed research on the impact of race on early pregnancy outcomes and increasing ethnic diversity among study populations for trials to ensure meaningful and applicable data. Raising awareness of this racial health inequity in early pregnancy is the first step clinicians can take to tackle this issue.

PMID:37581257 | DOI:10.1097/GCO.0000000000000900

Extremes (Boston). 2023;26(3):573-594. doi: 10.1007/s10687-022-00456-4. Epub 2022 Dec 17.

ABSTRACT

Confounding variables are a recurrent challenge for causal discovery and inference. In many situations, complex causal mechanisms only manifest themselves in extreme events, or take simpler forms in the extremes. Stimulated by data on extreme river flows and precipitation, we introduce a new causal discovery methodology for heavy-tailed variables that allows the effect of a known potential confounder to be almost entirely removed when the variables have comparable tails, and also decreases it sufficiently to enable correct causal inference when the confounder has a heavier tail. We also introduce a new parametric estimator for the existing causal tail coefficient and a permutation test. Simulations show that the methods work well and the ideas are applied to the motivating dataset.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10687-022-00456-4.

PMID:37581203 | PMC:PMC10423152 | DOI:10.1007/s10687-022-00456-4

Cureus. 2023 Aug 13;15(8):e43405. doi: 10.7759/cureus.43405. eCollection 2023 Aug.

ABSTRACT

Introduction A common dental problem is the fear of pain during needle prick for giving local anesthesia (LA). The needle prick pain during dental procedures often varies with sex and age. Perception of pain depends on various factors, which can be psychological and biological. This perception of pain may change the behavior of patients toward dental treatments. Traditionally, lidocaine gel formulation was utilized before the parenteral dosage form. The lidocaine gel formulation is considered the drug of choice for LA in dental surgery. Currently, amitriptyline has been utilized in dental practice because of its beneficial pharmacology. Hence, the present study has been undertaken to compare the anesthetic ability of amitriptyline as an intraoral topical anesthetic agent with lidocaine gel. Methods This study was a comparative clinical study between two medications’ anesthetic properties. This study included 120 patients indicated for bilateral orthodontics (the subdivision of dentistry that emphasizes identifying necessary interventions for the malocclusion of teeth) procedures. All the subjects were divided into amitriptyline and lidocaine groups. Both anesthetic gels were applied at separate sites before the injection of LA. The time of the onset of anesthesia was noted and analyzed. Patients were selected on the basis of inclusion and exclusion criteria. Individuals aged 18 to 30 years who were systemically healthy and orthodontically indicated for bilateral premolar extraction were included in this study. Again, patients with a history of neurological disorders and allergies to amitriptyline and lidocaine were excluded from the current study. Results Significant differences emerged between groups at five and 10 minutes, with amitriptyline-induced partial numbness (36.7% and 6.7%). At 40 and 45 minutes, both groups showed varied partial and complete numbness, with amitriptyline leading to partial recovery (23.3% and 73.3% complete numbness, 23.3% partial recovery) and lidocaine resulting in partial recovery (81.7%). When comparing the visual analog scale (VAS) scores, both groups exhibited a similar simultaneous effect at 15 minutes. Nonetheless, amitriptyline displayed significantly lower scores at 25 and 35 minutes (p < 0.001) in comparison to lidocaine. Similar observations were made when controlling for pain intensity. Conclusion It was concluded that amitriptyline holds both anesthetic and analgesic properties. Nevertheless, this study was unable to generalize the study findings because of the small sample size and being a single-center study. However, the VAS scores of anesthetic and analgesic pharmacodynamics properties of amitriptyline were statistically significantly lower than lidocaine, particularly at 25 and 35 minutes. Additionally, amitriptyline-induced anesthetic and analgesic pharmacology, especially pharmacokinetics properties, depends on the location and pattern of pain.

PMID:37581201 | PMC:PMC10423460 | DOI:10.7759/cureus.43405

Cureus. 2023 Aug 12;15(8):e43396. doi: 10.7759/cureus.43396. eCollection 2023 Aug.

ABSTRACT

The menisci are essential components in the pathophysiology of knee osteoarthritis. Patients with meniscal lesions and an intact anterior cruciate ligament (ACL) undergoing meniscectomy exhibit a significantly increased prevalence of radiographic osteoarthritis. ACL reconstruction surgery enhances knee stability and mitigates the advancement of minor meniscal tears. The purpose of this study was to show the influence of meniscal repair as compared to meniscectomy on anterior cruciate ligament reconstruction in terms of knee stability and radiological imaging. This was a retrospective study performed in Dr. D.Y. Patil Hospital, Pimpri, Pune, on a sample size of 30 patients between December 2021 and January 2023. Patients were followed up clinically and radiologically post-operatively at six months and one year. ACL reconstruction with meniscectomy was performed on 16 patients (group 2), while ACL reconstruction with meniscus repair was performed on 14 patients (group 1). At the end of six months in group 1, one patient out of 14 had a grade 2 Lachman test positive, while seven patients out of 16 had a grade 2 Lachman test positive in group 2. It was a statistically insignificant value (p>0.05). Further, at the end of 12 months, X-ray evaluation of the femoral tunnel shows an average increment of 0.5 mm in Group 1, while an average femoral tunnel widening of 3 mm was observed in Group 2. It was statistically insignificant (p>0.05). The study concluded that meniscus repair significantly increases anteromedial knee stability. It has been shown that meniscectomy, when done along with ACL reconstruction, increases the chances of femoral tunnel widening, resulting in less graft bone integration.

PMID:37581197 | PMC:PMC10423315 | DOI:10.7759/cureus.43396