Category: Statistics

J Dent Educ. 2023 May 16. doi: 10.1002/jdd.13240. Online ahead of print.

ABSTRACT

PURPOSE: This work aimed to utilize virtual reality (VR) in dental radiographic anatomical interpretation in junior dental students and test if it can enhance student learning, engagement, and performance.

METHODS: VR software for panoramic anatomy was developed. Sixty-nine first-year dental students were divided into a control group (lecture-based) and an experimental group (VR) to learn panoramic radiographic anatomy. Both groups were then tested on knowledge via a 20-question quiz. Student feedback on VR experience was collected via an online survey.

RESULTS: There was a statistically significant difference between lecture-based and VR students in the correct identification of anatomical landmarks. Lecture-based students scored higher in identifying the ear lobe, hyoid bone, condylar neck, and external oblique ridge, whereas VR students scored higher in identifying zygoma (Chi-squared test, p < 0.005). The VR group reported high evaluation on all perception items of the online feedback survey on their experience (Student t-test, p < 0.005).

CONCLUSIONS: Lecture-based students generally showed better performance in panoramic radiographic anatomy. Several structures were not correctly identified in both groups of novice students. The positive feedback of VR experience encourages future implementation in education to augment conventional methods of radiographic anatomy in dentistry with considerations to repeated exposures throughout undergraduate dental education.

PMID:37191982 | DOI:10.1002/jdd.13240

JAMA Netw Open. 2023 May 1;6(5):e2313220. doi: 10.1001/jamanetworkopen.2023.13220.

ABSTRACT

IMPORTANCE: The neural retina is considered a unique window to systemic health, but its biological link with systemic health remains unknown.

OBJECTIVE: To investigate the independent associations of retinal ganglion cell-inner plexiform layer thickness (GCIPLT) metabolic profiles with rates of mortality and morbidity of common diseases.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study evaluated UK Biobank participants enrolled between 2006 and 2010, and prospectively followed them up for multidisease diagnosis and mortality. Additional participants from the Guangzhou Diabetes Eye Study (GDES) underwent optical coherence tomography scanning and metabolomic profiling and were included for validation.

MAIN OUTCOMES AND MEASURES: Systematic analysis of circulating plasma metabolites to identify GCIPLT metabolic profiles; prospective associations of these profiles with mortality and morbidity of 6 common diseases with their incremental discriminative value and clinical utility.

RESULTS: Among 93 838 community-based participants (51 182 [54.5%] women), the mean (SD) age was 56.7 (8.1) years and mean (SD) follow-up was 12.3 (0.8) years. Of 249 metabolic metrics, 37 were independently associated with GCIPLT, including 8 positive and 29 negative associations, and most were associated with the rates of future mortality and common diseases. These metabolic profiles significantly improved the models for discriminating type 2 diabetes over clinical indicators (C statistic: 0.862; 95% CI, 0.852-0.872 vs clinical indicators only, 0.803; 95% CI, 0.792-0.814; P < .001), myocardial infarction (0.792; 95% CI, 0.775-0.808 vs 0.768; 95% CI, 0.751-0.786; P < .001), heart failure (0.803; 95% CI, 0.786-0.820 vs 0.790; 95% CI, 0.773-0.807; P < .001), stroke (0.739; 95% CI, 0.714-0.764 vs 0.719; 95% CI, 0.693-0.745; P < .001), all-cause mortality (0.747; 95% CI, 0.734-0.760 vs 0.724; 95% CI, 0.711-0.738; P < .001), and cardiovascular disease mortality (0.790; 95% CI, 0.767-0.812 vs 0.763; 95% CI, 0.739-0.788; P < .001). Additionally, the potential of GCIPLT metabolic profiles for risk stratification of cardiovascular diseases were further confirmed in the GDES cohort using a different metabolomic approach.

CONCLUSIONS AND RELEVANCE: In this prospective study of multinational participants, GCIPLT-associated metabolites demonstrated the potential to inform mortality and morbidity risks. Incorporating information on these profiles may facilitate individualized risk stratification for these health outcomes.

PMID:37191963 | DOI:10.1001/jamanetworkopen.2023.13220

JMIR Res Protoc. 2023 Mar 12. doi: 10.2196/41811. Online ahead of print.

ABSTRACT

BACKGROUND: The epidemiology, morbidity, and burden of the disease related to airway sequelae associated with invasive mechanical ventilation (IMV) in the context of the COVID-19 pandemic remain unclear.

OBJECTIVE: This scoping review aims to summarize the current knowledge regarding airway sequelae after severe SARS-CoV2 infection. This knowledge will help guide research endeavors and decision-making in clinical practice.

METHODS: This scoping review will include participants of all genders and no particular age group who developed post-COVID airway related complication will be excluded. No exclusion criteria will be applied from country, language or document type. The information source will include analytical observational, observational studies. Unpublished data will not be completely covered as grey literature will be covered. A total of 2 independent reviewers will participate in the process of screening, selection, and data extraction, and the whole process will be performed blindly. Conflict between reviewers will be solve through discussion and additional reviewer. Results will be reported by using descriptive statistics and information will be displayed on RedCap.

RESULTS: The literature search was conducted in May 2022 in in the following databases; PubMed, EMBASE, SCOPUS, Cochrane Library, LILACS and Grey literature to identify observational studies; a total of 738 results were retrieved. The scoping review will be finished by March-2023.

CONCLUSIONS: This scoping review will describe current knowledge on the most frequently encountered laryngeal and/or tracheal sequelae in patients exposed to mechanical ventilation due to SARS-CoV-2 infection. This scoping review will find the incidence of airway sequelae post-COVID19 and the most common sequelae such as; airway granuloma, vocal fold paralysis, and airway stenoses. Future studies should evaluate the incidence of these disorders.

INTERNATIONAL REGISTERED REPORT: PRR1-10.2196/41811.

PMID:37191952 | DOI:10.2196/41811

Int Ophthalmol. 2023 May 16. doi: 10.1007/s10792-023-02734-x. Online ahead of print.

ABSTRACT

PURPOSE: The use of video-based social media platforms is increasing among trainee residents, fellows, and practicing ophthalmologists. In this study, we objectively evaluate the quality of Ahmed glaucoma valve (AGV) implantation videos on open access, video-based internet platforms.

DESIGN: Internet-based cross-sectional study.

PARTICIPANTS: Not applicable.

METHODS: In this cross-sectional study, 23 websites publishing medical surgery training video content were queried using the keyword “Ahmed glaucoma valve implantation”.

MAIN OUTCOME MEASURES: The descriptive statistics of video parameters were noted, and the videos were assessed using established scoring systems-Sandvik, Health on the Net Foundation Code of Conduct (HON code), mDISCERN, and Global Quality Score (GQS) scores. Video Quality Score (VQS) was determined based on the 14 steps per the AGV implantation rubric.

RESULTS: One hundred and nineteen videos were evaluated, and 35 were excluded. The total quality of all 84 videos according to their Sandvik, HON Code, GQS, DISCERN, and VQS scores was 11.79 ± 1.70 (excellent quality), 6.86 ± 0.75 (excellent quality), 3.97 ± 0.93 (good quality), 3.26 ± 0.66 (fair quality) and 11.45 ± 2.67 (good quality), respectively. No significant correlation was found between the descriptive parameters and video quality score. However, no significant correlation was found between the descriptive parameters and video quality score.

CONCLUSIONS: The objective analysis showed that the video quality ranged from good to excellent. AGV implantation videos were sparse on exclusive ophthalmology surgical video portals. Therefore, more peer-reviewed videos following standardized rubric are needed on open-access surgical video platforms.

PMID:37191927 | DOI:10.1007/s10792-023-02734-x

Eur Arch Otorhinolaryngol. 2023 May 16. doi: 10.1007/s00405-023-07977-z. Online ahead of print.

ABSTRACT

PURPOSE: Bilateral cochlear implantation is an effective treatment for patients with bilateral profound hearing loss. In contrast to children, adults mostly choose a sequential surgery. This study addresses whether simultaneous bilateral CI is associated with higher rates of complications compared to sequential implantation.

METHODS: 169 bilateral CI surgeries were analyzed retrospectively. 34 of the patients were implanted simultaneously (group 1), whereas 135 patients were implanted sequentially (group 2). The duration of surgery, the incidence of minor and major complications and the duration of hospitalization of both groups were compared.

RESULTS: In group 1, the total operating room time was significantly shorter. The incidences of minor and major surgical complications showed no statistically significant differences. A fatal non-surgical complication in group 1 was particularly extensively reappraised without evidence of a causal relationship to the chosen mode of care. The duration of hospitalization was 0.7 days longer than in unilateral implantation but 2.8 days shorter than the combined two hospital stays in group 2.

CONCLUSION: In the synopsis of all considered complications and complication-relevant factors, equivalence of simultaneous and sequential cochlear implantation in adults in terms of safety was found. However, potential side effects related to longer surgical time in simultaneous surgery must be considered individually. Careful patient selection with special consideration to existing comorbidities and preoperative anesthesiologic evaluation is essential.

PMID:37191916 | DOI:10.1007/s00405-023-07977-z

Eur Arch Otorhinolaryngol. 2023 May 16. doi: 10.1007/s00405-023-08010-z. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to use a new biological active fat enhanced leukocyte-platelet-rich fibrin membrane (L-PRF) for skull base defect reconstruction and compare its validity and reliability with the time-honored fascia lata.

METHODS: This prospective study was conducted on 48 patients with spontaneous CSF leaks who were divided into 2 matched groups by stratified randomization, 24 patients in each group. In group A we performed multilayer repair using fat enhanced L-PRF membrane. In group B we used fascia lata for the multilayer repair. In both groups we enforced the repair with mucosal grafts/flaps.

RESULTS: The two groups were statistically matched for age, sex, intracranial pressure, and site and size of the skull base defect. There was no statistically significant difference between the two groups regarding the outcome of the repair or recurrence of CSF leak during the first postoperative year. Meningitis occurred in one patient in group B and was successfully treated. Another patient in group B developed thigh hematoma which resolved spontaneously.

CONCLUSION: The fat enhanced L-PRF membrane is a valid reliable option in repair of CSF leaks. The membrane is autologous, readily available, easily prepared, and has the advange of including stromal fat, stromal vascular fraction (SVF), and leukocyte-platelet-rich fibrin (L-PRF). The present study showed that fat enhanced L-PRF membrane is stable, non-absorbable, not liable to shrink or become necrotic, and can establish good seal of the skull base defect and further enhance the healing process. The use of the membrane also has the advantage of avoiding thigh incision and possible hematoma formation.

PMID:37191915 | DOI:10.1007/s00405-023-08010-z

Unfallchirurgie (Heidelb). 2023 May 16. doi: 10.1007/s00113-023-01323-y. Online ahead of print.

ABSTRACT

The comparison of different age groups both with respect to the number of traffic accident victims and in relation to the risk of causing an accident is the prerequisite for a differentiated assessment of persons likely to be a threat and the risk. For this purpose, selected accident statistics were analyzed and evaluated in the context of general population developments. It turns out that the accident risk for older drivers over 75 years of age is not exceptionally high; however, the risk of dying in a road traffic accident is more pronounced for the group of over 75-year-olds. The result varies depending on the means of transport. The findings are intended to stimulate further discussion and give indications for areas of action to increase road safety, especially for older road users.

PMID:37191894 | DOI:10.1007/s00113-023-01323-y

Odontology. 2023 May 16. doi: 10.1007/s10266-023-00816-x. Online ahead of print.

ABSTRACT

Sirtuins (SIRTs) are a family of proteins involved in the metabolic process responsible for extending the lifespan. The role of SIRT1, 6, and 7 in oral squamous cell carcinoma (OSCC) and oral leukoplakia (OLP), one of its precursors, is still elusive. In this study, 82 OLP and 77 OSCC were immunohistochemically examined for SIRT1, 6, and 7. Stained sections were thoroughly scanned and evaluated using a digital image analysis program. The SIRT1, 6, and 7 expressions were detected in the nuclei of epithelial and carcinoma cells in various degrees. Afterward, any correlations among SIRTs, including associations with clinicopathological features and the Kaplan-Meier curves were analyzed. OSCC demonstrated significantly higher SIRT1 expression than OLP, while non-dysplastic lesions showed significantly higher SIRT6 expression than other lesions. A strong correlation was observed between SIRT6 and 7 in OLP, SIRT1 and 6 in in OSCC and in SIRT6 and 7 when all lesion types were considered. There were no significant differences between SIRTs reactivity and the clinical features in OLP. For OSCC, SIRT1 and 6 was found to be directly associated with site of the lesion, while SIRT7 showed a direct relationship between gender, stromal lymphocytic infiltration, and depth of the invasion. OSCC with high SIRT7 expression revealed a slightly lower survival probability, although not statistically significant (p = 0.1019). Our findings suggest that SIRT1, 6, and 7 may play correlated and diverse roles in the development and advancement of OSCC.

PMID:37191889 | DOI:10.1007/s10266-023-00816-x

Int Urogynecol J. 2023 May 16. doi: 10.1007/s00192-023-05545-x. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: During the COVID-19 pandemic, many surgical societies released guidelines that included cancellation of elective cases. The aim of this study was to better understand our patients’ perceptions of the severity of their pelvic floor disorders (PFDs) and to determine what factors influenced this perception. We also aimed to better understand who might be amenable to telemedicine visits and what factors influenced this decision.

METHODS: This is a cross-sectional quality improvement study that included women at least 18 years of age diagnosed with a pelvic floor disorder being evaluated within a university Female Pelvic Medicine and Reconstructive Surgery clinic during the COVID-19 pandemic. Patients whose appointments and procedures were being cancelled were queried on whether they would be willing to answer a telephone questionnaire developed by the clinical and research teams. We gathered descriptive data from 97 female patients with PFDs using a primary phone questionnaire. The data were analyzed using proportions and descriptive statistics.

RESULTS: Of the 97 patients, the majority (79%) viewed their conditions as non-urgent. Factors that influenced patients’ perception of urgency included race (p=0.037), health status (p≤0.001), a history of diabetes (p=0.011), and willingness to attend an in-person appointment (p=0.010). Further, 52% of respondents were willing to attend a tele-health appointment. Statistically significant factors influencing this decision were ethnicity (p=0.019), marital status (p=0.019), and willingness to attend an in-person appointment (p=0.011).

CONCLUSION: The majority of women did not view their conditions as urgent during the COVID-19 pandemic and were amenable to a telehealth appointment.

PMID:37191888 | DOI:10.1007/s00192-023-05545-x

J Cardiovasc Transl Res. 2023 May 16. doi: 10.1007/s12265-023-10397-3. Online ahead of print.

ABSTRACT

BACKGROUND: Recent advances in multi-marker platforms offer faster data generation, but the fidelity of these methods compared to the ELISA is not established. We tested the correlation and predictive performance of SOMAscan vs. ELISA methods for NTproBNP and ST2.

METHODS: Patients ≥ 18 years with heart failure and ejection fraction < 50% were enrolled. We tested the correlation between SOMA and ELISA for each biomarker and their association with outcomes.

RESULTS: There was good correlation of SOMA vs. ELISA for ST2 (ρ = 0.71) and excellent correlation for NTproBNP (ρ = 0.94). The two versions of both markers were not significantly different regarding survival association. The two ST2 assays and NTproBNP assays were similarly associated with all-cause mortality and cardiovascular mortality. These associations remained statistically significant when adjusted for MAGGIC risk score (all p < 0.05).

CONCLUSION: SOMAscan quantifications of ST2 and NTproBNP correlate to ELISA versions and carry similar prognosis.

PMID:37191882 | DOI:10.1007/s12265-023-10397-3