Category: Statistics

Cost Eff Resour Alloc. 2022 Dec 23;20(1):72. doi: 10.1186/s12962-022-00398-5.

ABSTRACT

OBJECTIVES: Surgical lung resection involves a critical task of stapled ligation and transection of major vascular structures and tissue, which may lead to bleeding and complications. A newer powered stapling system with Gripping Surface Technology (GST) was introduced to account for tissue movements. This study aimed to examine the real-world effectiveness of GST system on intraoperative and postoperative outcomes of pulmonary resection.

METHODS: A retrospective analysis was conducted using the electronic medical records of Sichuan Provincial People’s Hospital between July 2020 and March 2021 in China. Patients who underwent their first procedures of single-port lobectomy or multi-port segmentectomy by video-assisted thoracoscopic surgery were identified and grouped as GST group or manual stapler group (manual group) by the stapler types. The intraoperative outcomes such as bleeding rate, blood loss volume, and intervention rate at the staple line (including intraoperative pressure, suture, and electrocoagulation) were documented by trained nurses during the surgery. Propensity score matching was performed between the two groups, controlling forage, BMI, smoking history, history of surgery, complications, and level of complexity of pneumonectomy.

RESULTS: A total of 108 matched patients were included in the analysis (54 in the GST group and 54 in the manual group). GST group had lower risks for intraoperative bleeding (22.8% vs 51.9%; p = 0.003) and intraoperative interventions (31.5% vs 55.6%; p = 0.02), compared to the manual group. A decrease in the intraoperative blood loss was observed in the GST group, but not statistically significant (134.39 ± 52.82 ml vs 158.11 ± 73.14 ml, p = 0.102). The use of NEOVEIL (reinforcement material to prevent air leakage from the staple line) intraoperatively during surgery was significantly lower in the GST group (24.1%) than in the manual group (50%, p = 0.01).

CONCLUSION: The GST system was associated with better intraoperative outcomes in clinical practice in China.

PMID:36564821 | DOI:10.1186/s12962-022-00398-5

Gut Pathog. 2022 Dec 23;14(1):49. doi: 10.1186/s13099-022-00525-w.

ABSTRACT

BACKGROUND: Microbial dysbiosis has been closely linked with colorectal cancer development. However, data is limited regarding the relationship of the mucosal microbiome, adenomatous polyps and dietary habits. Understanding these associations may elucidate pathways for risk stratification according to diet.

RESULTS: Patients undergoing screening colonoscopy were included in our prospective, single center study and divided into adenoma or no adenoma cohorts. Oral, fecal, and mucosal samples were obtained. Microbial DNA was extracted, and amplicon libraries generated using primers for the 16S rRNA gene V4 region. Patient and dietary information was collected. Of 104 participants, 44% presented with polyps, which were predominantly tubular adenomas (87%). Adenoma formation and multiple patient dietary and lifestyle characteristics were associated with mucosal microbiome diversity. Lifestyle factors included age, body mass index, adenoma number, and dietary consumption of red meats, processed meats, vegetables, fruit, grain, fermented foods and alcohol.

CONCLUSION: In this study we showed associations between dietary habits, adenoma formation and the mucosal microbiome. These early findings suggest that ongoing research into diet modification may help reduce adenoma formation and subsequently the development of CRC.

PMID:36564812 | DOI:10.1186/s13099-022-00525-w

J Ovarian Res. 2022 Dec 23;15(1):135. doi: 10.1186/s13048-022-01082-1.

ABSTRACT

OBJECTIVE: The aim of the present study is to evaluate the long-term outcomes in patients with early stage ovarian cancer undergoing fertility-sparing surgery.

METHODS: The present study performed a retrospective analysis of recurrence, pregnancy and survival of a total of 66 patients who were diagnosed with early stage ovarian cancer (stage I) in XXX Faculty of Medicine Hospital between 2004 and 2019. Of these patients, 16 had undergone fertility-sparing surgery, and the remaining 50 patients had undergone radical surgery.

RESULTS: Of 66 eligible patients, 16 had undergone fertility-sparing surgery, and the remaining 50 patients had undergone radical complete surgery. When demographic and descriptive data are taken into consideration, the mean age was 32.6 ± 6.76 years in patients undergoing fertility-sparing surgery and 54.05 ± 10.8 years in patients undergoing complete surgery, and the difference between the groups was statistically significant (p = 0.001). Of patients undergoing fertility-sparing surgery, 11 (16.7%) had stage Ia disease (most common), 5 (7.5%) had stage Ic disease, whereas no patient with stage Ib disease was detected. Of patients undergoing complete radical surgery, 32 (48.5%) had stage Ia disease (most common), 1 (1.5%) had stage Ib disease with bilateral ovarian involvement, and stage Ic was the second most common disease stage. Also, stage Ic3 was the most common disease stage (8 patients, 12.1%) among those with stage Ic disease. The rate of recurrence was 4.5% (3 patients) in patients undergoing fertility-sparing surgery, and recurrences occurred at 37 months, 69 months, and 76 months, respectively. A patient with stage Ic3 disease and endometrioid type tumor who developed recurrence at 37 months died at 130 months. Of patients undergoing complete surgery, ten patients (15.2%) developed recurrence, and there was no significant difference between the two groups in terms of recurrence (p = 1.00). At the end of 15-year follow-up period, there was no significant difference between patients undergoing fertility-preserving surgery and those undergoing complete surgery in terms of mortality (p = 0.668).

CONCLUSION: The observation of significant findings in terms of the rate of recurrence and disease-free survival following fertility-sparing surgery in patients with low-risk early stage ovarian cancer suggests that survival is positively affected in early stage ovarian cancer.

PMID:36564811 | DOI:10.1186/s13048-022-01082-1

J Orthop Surg Res. 2022 Dec 23;17(1):563. doi: 10.1186/s13018-022-03462-1.

ABSTRACT

BACKGROUND: The shortening length of the lower extremity after the proximal femoral osteotomy is an important issue to be considered in preoperative planning of developmental dysplasia of the hip (DDH) in children. There is still a lack of research on shortening the length of the lower extremities in different proximal femoral osteotomy varus styles. We aimed to verify the relationship between the shortening length after “point-to-face” and “face-to-face” varus osteotomy and proposed a formula for calculating the difference in shortening length and verified its feasibility.

METHODS: Fifty-five children with unilateral DDH were enrolled. The preoperative hip CT data were imported into mimics 21, 3-Matic 10 (Materialise, Leuven, Belgium) for femoral reconstruction and simulated osteotomy, and the difference (t) was calculated by directly measuring the length of the proximal femur after osteotomy. d* sinθ was measured in a three-dimensional environment to calculate the difference in femoral shortening length between the two osteotomy methods (t’).

RESULTS: The results of the direct measurement method and the formula measurement method are shown in the table; the differences in the results of the femoral shortening length difference were not statistically significant (P > 0.05). The limits of agreement (95%) of the difference values using Bland-Altman analysis were between – 0.50 and 0.46 mm, with a mean of – 0.02 mm, indicating a high agreement between the two methods. r = 0.99 (P < 0.05) for the Pearson correlation analysis between the direct measurement method and the calculated method showed that the two methods were significantly correlated.

CONCLUSIONS: The derived formula can accurately calculate the difference in the shortening length of the proximal femur after “point-to-face” and “face-to-face” varus osteotomy in children with DDH, which is suitable for clinical application.

PMID:36564807 | DOI:10.1186/s13018-022-03462-1

BMC Oral Health. 2022 Dec 23;22(1):636. doi: 10.1186/s12903-022-02671-8.

ABSTRACT

BACKGROUND/OBJECTIVES: Disinfection of surgical guides is mandatory for intraoperative use. Virgin Coconut Oil may be a potent alternative disinfectant; however, its effect has not been fully discussed in dentistry. The objectives of this study were to compare the morphological and the volumetric dimensional changes of 3D printed surgical guides after immersion in three disinfectants: 100%Virgin Coconut Oil, 2% Glutaraldehyde, and 70% Ethyl Alcohol and to assess the antimicrobial effectiveness of the tested disinfectants.

MATERIALS AND METHODS: A surgical guide was designed using open platform software to print thirty guides and then cut them into two halves (N = 60). Pre-disinfection scans of the first half of the three study groups (n = 30) were performed using Cone-beam Computed Tomography, then immersed for 20 min in three disinfectants as follows: group VCO was immersed in 100% Virgin Coconut Oil, group GA was immersed in 2% Glutaraldehyde, and group EA was immersed in 70% Ethyl Alcohol. Post-disinfection scans of the first half of the three study groups (n = 30) were performed and then compared morphologically and volumetrically using an analyzing software program The second half of the three control groups (n* = 30) were soaked for 20 min in sterile distilled water as follows: group VCO*, group GA*, and group EA* for the assessment of the antimicrobial effectiveness of the three tested disinfectants.

RESULTS: At the morphological assessment of the dimensional changes, group VCO were the most accurate with the lowest mean deviation value of 0.12 ± 0.02 mm and root mean square value of 0.12 mm, group GA and group EA were less accurate with mean deviation value of = 0.22 ± 0.05 mm and = 0.19 ± 0.03 mm and root mean square value of 0.22 and 0.20 respectively (p < 0.001). At the volumetric assessment, group VCO showed lower volumetric changes with a mean deviation value of 0.17 ± 0.10 mm, root mean square value of 0.19 mm, than group GA with mean deviation value of 0.23 ± 0.10 mm, root mean square value of 0.25 mm and group EA with mean deviation value of 0.27 ± 0.11 mm, root mean square value of 0.29 mm, however, no statistically significant differences were found between the three study groups (p = 0.10). The antimicrobial effectiveness of the three tested disinfectants showed a hundred percent (100%) reduction in the total microbial count in the first half of the three study groups treated with the three disinfectants revealing no bacterial growth, however, statistically significant differences were found between the second half of the three control and the first half of the three study groups. (p < 0.001).

CONCLUSIONS: Virgin Coconut Oil showed higher morphological dimensional accuracy of the tested surgical guides than Glutaraldehyde and Ethyl Alcohol without causing any volumetric dimensional changes in the 3D printed surgical guides after disinfection for 20 min and the antimicrobial effectiveness was the same between the three tested disinfectants without showing any microbial growth.

PMID:36564796 | DOI:10.1186/s12903-022-02671-8

BMC Oral Health. 2022 Dec 23;22(1):633. doi: 10.1186/s12903-022-02660-x.

ABSTRACT

BACKGROUND: Prescribing medicine is integral to clinical dentistry. Infective endocarditis may be rare but fatal if left untreated. As a result, judicious prescribing of antibiotics should be implemented due to potential. To our knowledge, no Australian study has examined dental students’ knowledge and perceptions about antibiotic prophylaxis for dental procedures.

METHODS: Australian dental students were invited to undertake the survey comprising case vignettes to investigate their medication knowledge. A total of 117 responses were received. The questions were 12 clinically relevant questions and three perception-based questions. Results were analysed using descriptive statistics as well as the chi-squared test.

RESULTS: The 117 respondents had a mean correct response of 7.34 ± 2.64 (range 3-12 out of 12). Out of 117 students, 89 (76%) answered more than half of the questions correctly. Only three students (3%) answered all the questions correctly. Nearly two-thirds felt that they knew about antibiotic prophylaxis used for dental procedures.

CONCLUSION: Most respondents answered more than half, but not all, of the clinical questions correctly. It is crucial to highlight that dental student may never receive any more training on antimicrobial stewardship (AMS) at any point in their future careers. It may be ideal that this issue is addressed at the dental school. One way to target this is to potentially nationalised teaching delivery of dental AMS across Australia.

PMID:36564792 | DOI:10.1186/s12903-022-02660-x

Cardiovasc Diabetol. 2022 Dec 23;21(1):289. doi: 10.1186/s12933-022-01729-9.

ABSTRACT

BACKGROUND: The mechanisms linking obesity to cardiovascular disease (CVD) are still not clearly defined. Individuals who are overweight or obese often develop insulin resistance, mediation of the association between obesity and CVD through the insulin resistance seems plausible and has not been investigated. This study aimed to evaluate whether and to what extend the effect of general and central obesity on cardiovascular disease (CVD) is mediated by insulin resistance.

METHODS: A total of 94,136 participants without CVD at baseline were recruited from the Kailuan study. Insulin resistance was evaluated by the triglyceride-glucose (TyG) index, calculating as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Mediation analysis using a new 2-stage regression method for survival data proposed by Valeri and VanderWeele was to explore the mediating effects of the TyG index on the association between obesity and CVD.

RESULTS: During a median follow-up of 13.01 years, we identified 7327 cases of CVD. Mediation analyses showed that 47.81% of the total association (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.12-1.24) between overweight and CVD was mediated through the TyG index (HR [indirect association], 1.07; 95% CI, 1.07-1.09), and the proportion mediated was 37.94% for general obesity. For central obesity, analysis by waist circumference, waist/hip, and waist/height categories yielded an attenuated proportion mediated of 32.01, 35.02, and 31.06% for obesity, taken normal weight as reference.

CONCLUSIONS: The association between obesity and CVD was mediated by TyG index, suggesting proper control of insulin resistance can be effective to reduce the effects of obesity on CVD.

PMID:36564775 | DOI:10.1186/s12933-022-01729-9

BMC Vet Res. 2022 Dec 23;18(1):445. doi: 10.1186/s12917-022-03552-6.

ABSTRACT

BACKGROUND: Equine intestinal epithelial stem cells (ISCs) serve as potential targets to treat horses with severe intestinal injury. The ability to isolate and store ISCs from intestinal biopsies creates an opportunity for both in vitro experiments to study ISC dynamics in a variety of intestinal diseases, and, in the future, utilize these cells as a possible therapy. If biopsies could be successfully stored prior to processing for ISCs, this would increase the availability of sample repositories for future experimental and therapeutic use. However, delayed culture of equine ISCs following prolonged sample storage has not been described. The objective of this study was to describe the isolation and culture of equine ISCs following delayed tissue storage. Small intestinal full thickness biopsies were collected post euthanasia. Fresh tissue was immediately processed or stored at 4 °C for 24, 48 and 72 h (H) before processing. Intestinal stem cells (crypts) were dissociated and cultured. Size, growth efficiency and proliferation potential were compared between resultant enteroids (“mini-guts”) derived from each storage timepoint. In a separate study, growth efficiency of cryopreserved crypts was compared to cryopreserved enteroid fragments to investigate prolonged storage techniques.

RESULTS: Intestinal crypts were successfully isolated and cultured from all timepoints. At 72H post initial collection, the intestine was friable with epithelial sloughing; resultant dissociation yielded more partial crypts. Enteroids grown from crypts isolated at 72H were smaller with less proliferative potential (bud units, (median 6.5, 3.75-14.25)) than control (median 25, 15-28, p < 0.0001). No statistical differences were noted from tissues stored for 24H compared to control. Following cryopreservation, growth efficiency improved when cells were stored as enteroid fragments (median 81.6%, 66.2-109) compared to crypts (median 21.2%, 20-21.5, p = 0.01). The main limitations included a small sample size and lack of additional functional assays on enteroids.

CONCLUSIONS: Equine ISCs can be isolated and cultured after prolonged tissue storage. Resultant enteroids had minimal differences even after 24-48H of whole tissue storage. This suggests that ISCs could be isolated for several days from samples properly stored after procedures, including surgery or necropsy, and used to create ISC repositories for study or therapy of equine intestinal diseases.

PMID:36564773 | DOI:10.1186/s12917-022-03552-6

BMC Med Educ. 2022 Dec 23;22(1):891. doi: 10.1186/s12909-022-03969-5.

ABSTRACT

BACKGROUND: Supervisors play a key part as role models and supporting the learning during residents’ post-graduate medical education, but sometimes lack sufficient pedagogic training and are challenged by high demands in today’s healthcare. The aim of this study was to describe the strengths and areas for improvement identified in the supervision process by residents and supervisors in post-graduate medical education.

METHODS: This study included supervisors and residents working at departments and health centres who have used a web-based questionnaire, as a part of the Evaluation and Feedback For Effective Clinical Teaching (EFFECT) model, during the period 2016-2019. Descriptive statistics and content analysis were used to analyse ratings and comments to describe strengths and areas for improvement in the supervision process.

RESULTS: The study included 287 resident evaluations of supervisors and 78 self-evaluations by supervisors. The supervisor as a role model, being available, and, giving personal support, were the three most important strengths identified by the residents and supervisors. Residents in primary care also identified the role modelling of general practice competence as a strength, whereas residents and supervisors in hospital departments addressed supervisors as energetic and showing work was fun. The area with the need of most improvement was, Giving and receiving feedback.

CONCLUSIONS: To be able to give feedback, residents and supervisors, needed to see each other in work, and the learning environment had to offer time and space to pedagogical processes, like feedback, to improve the learning environment.

PMID:36564770 | DOI:10.1186/s12909-022-03969-5

BMC Oral Health. 2022 Dec 23;22(1):635. doi: 10.1186/s12903-022-02674-5.

ABSTRACT

BACKGROUND: Evaluating the effect of different surface treatment methods on the micro-tensile bond strength (µTBS) of two different resin-matrix computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics (RMCs).

METHODS: A standardized inlay preparations were performed on 100 intact maxillary premolars. According to the type of the restorative material, the teeth were randomly divided into two equally sized groups (n = 50): (polymer-infiltrated ceramic (Vita Enamic) and resin-based composites (Lava Ultimate)). The inlays were fabricated using CAD/CAM technology. In each group, the specimens were randomly assigned to five subgroups (n = 10) according to the surface treatment method: group 1 used was the control group (no surface treatment); group 2, was treated with air abrasion with 50 μm Al₂O₃ (A) and universal adhesive (UA); group 3, was treated with air abrasion with 50 μm Al₂O₃ (A) and silane coupling agent (S); group 4, was treated with hydrofluoric acid (HF) and universal adhesive (UA) and group 5, was treated with Hydrofluoric acid (HF) + silane coupling agent (S). The inlays were then cemented to their respective preparations using dual-cure self-adhesive resin cement (RelyX U200, 3 M ESPE) according to the manufacturer’s instructions. The µTBS test was conducted in all groups, and stereomicroscope and scanning electron microscope were used to inspect the failure mode. The data were statistically analyzed using a two-way analysis of variance (ANOVA) and Tukey’s post-hoc multiple comparison tests at a significance level of p < 0.05.

RESULTS: Surface treatments significantly increased the µTBS of the materials compared to the control group (p < 0.05). For CAD/CAM RBCs, the µTBS value highest in group 2 whereas, for PICN, the µTBS value was highest in group 3. Cohesive failure of CAD/CAM restorative material was the most predominant mode of failure in all treated groups, whereas adhesive failure at restoration-cement interface was the most predominant failure mode in the control group.

CONCLUSION: Surface treatments increase the µTBS of resin-matrix CAD/CAM ceramics to tooth structure. Air abrasion followed by universal adhesive and hydrofluoric acid followed by silane application appears to be the best strategies for optimizing the bond strength of CAD/CAM RBCs and PICN respectively.

PMID:36564766 | DOI:10.1186/s12903-022-02674-5