Category: Statistics

Br Dent J. 2023 Feb 3. doi: 10.1038/s41415-023-5507-4. Online ahead of print.

ABSTRACT

Aim(s) We tested the following hypotheses: would better oral hygiene self-care (OHS) influence cardiovascular (CVD) mortality? Will using mouthwash in addition to OHS affect CVD mortality? How does mouthwash usage impact the oral microbes?Design and methods Among 354 dentate subjects from the Kuopio Oral Health and Heart study, the association of OHS with CVD mortality was assessed using Cox regression analyses, adjusting for age, sex, smoking, dyslipidemia, diabetes, hypertension and education. Additionally, whether using mouthwash would affect this relationship was evaluated.Results In the multivariable-adjusted models, OHS was associated with a 51% reduction in the risk of CVD mortality (hazard ratio [HR] 0.49 [0.28-0.85]; p = 0.01). Even those who had coronary artery disease at baseline showed a marginally significant benefit (0.50 [0.24-1.06]; p = 0.07). However, mouthwash usage did not change OHS effects (HR = 0.49 [0.27-0.87]; p = 0.01), indicating no additional benefits nor detriments. All tested microbes trended to decrease with mouthwash usage in the short term, but none were statistically significant.Conclusion Good OHS significantly lowered the risk of CVD mortality relative to poor OHS. Mouthwash usage did not show any long-term harm or benefit on CVD mortality beyond the benefits rendered by brushing and flossing.

PMID:36737459 | DOI:10.1038/s41415-023-5507-4

Br Dent J. 2023 Feb 3. doi: 10.1038/s41415-023-5506-5. Online ahead of print.

ABSTRACT

Introduction Rental electronic scooters (e-scooters) were legalised in July 2020 in the UK for use on public roads. This has led to higher numbers of emergency department (ED) attendances for head and neck injuries managed by the oral and maxillofacial surgical (OMFS) department.Aim The aim of this research is to assess the increase in e-scooter injuries requiring OMFS input and analyse factors and management associated.Method Data were collected over a 24-month period. A total of 212 e-scooter-related ED presentations were recorded, with 34 patients requiring input from the OMFS department. For the patients referred to OMFS, numerical and categorical factors used independent T-tests and one-way Analysis of Variance tests, respectively, to determine statistical significance at the 5% confidence level (p <0.05).Results The mean age was 32.8 years (SD = 15.9) in a predominately male cohort (79.4%). Alcohol intoxication was observed in 55.8% of accidents. Injuries were most common on Saturdays (41.2%). Soft tissue injuries were present in 64.7% of patients, bony injuries in 38.2% of patients and dental injuries in 11.8% of patients. Imaging was required for 76.5% of patients. In total, 44% of patients required surgical treatment, 5.9% required major surgery and 38.2% required minor surgery.Conclusion This research supports the literature suggesting significant growth in e-scooter-related injuries and their associated burden of conditions managed by the OMFS department.

PMID:36737457 | DOI:10.1038/s41415-023-5506-5

J Sleep Res. 2023 Feb 3:e13829. doi: 10.1111/jsr.13829. Online ahead of print.

ABSTRACT

The purpose of this study was to investigate how the blood pressure increase observed during menopausal transition is affected by sleep-disordered breathing and the menopause itself. Further, we aimed to find new sleep-disordered breathing related markers that would predict the development of hypertension. Sixty-four community-dwelling premenopausal women aged 45-47 years were studied. Polysomnography, serum follicle stimulating hormone, forced expiratory volume in 1 s, and a physical examination were performed at baseline and again after 10 years of follow-up. Indices for sleep apnea/hypopnea and inspiratory flow-limitation were determined. Regression models were used to study the relationships between variables. Changes in the apnea-hypopnea index or serum follicle stimulating hormone were not significant for blood pressure change. An increase in morning blood pressure during the follow-up period was associated with a body mass-index increase. An increase in evening blood pressure was associated with an increase in inspiratory flow-limitation during non-rapid eye movement sleep. Incident hypertension during the follow-up was associated with hypopnea (median hypopnea index 7.6/h, p = 0.048) during rapid eye movement sleep at baseline. Users of menopausal hormone therapy had a lower rapid eye movement sleep apnea-hypopnea index (1.6/h vs. 6.9/h, p = 0.026) at baseline whereas at follow-up users and non-users did not differ in any way. The progression of menopause or the use of menopausal hormone therapy had a minimal effect on blood pressure in our population. The effects of inspiratory flow-limitation on blood pressure profile should be studied further.

PMID:36737407 | DOI:10.1111/jsr.13829

Am J Orthod Dentofacial Orthop. 2023 Feb 1:S0889-5406(22)00711-9. doi: 10.1016/j.ajodo.2022.10.021. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to assess and compare the duration and outcomes of orthodontic treatment with conventional and self-ligating lingual fixed appliances with the American Board of Orthodontics (ABO) Objective Grading System.

METHODS: Thirty consecutive patients with a complete dentition and Angle Class I malocclusion treated with a conventional lingual bracket system (STb; Ormco, Glendora, Calif) or self-ligating lingual bracket system (GC Experience-L; GC Orthodontics, Breckerfeld, Germany) were included. The occlusal outcome was assessed with the ABO instrument. The treatment duration and ABO scores of the 2 groups were recorded. Statistical analyses were evaluated using independent-sample t tests.

RESULTS: The conventional group had a mean treatment time of 2.10 ± 0.69 years, and the self-ligating group had a treatment duration of 1.68 ± 0.48 years (P >0.05). The mean posttreatment ABO scores in the conventional group were 20.23 ± 5.13, and the mean posttreatment ABO scores in the self-ligating group were 21.00 ± 5.66. No difference was found between the groups regarding the criteria of ABO (P >0.05). The highest scores were given in the assessment of buccolingual inclinations in both conventional and self-ligating lingual bracket groups.

CONCLUSIONS: The design of the lingual appliances used in this study did not influence the treatment duration and the total ABO scores in treating patients with a Class I relationship in this sample. Both types of lingual brackets were especially deficient in correcting buccolingual inclinations. The strengths were their ability to close spaces and correct anterior rotations and overjet regardless of the bracket types.

PMID:36737396 | DOI:10.1016/j.ajodo.2022.10.021

Chin J Traumatol. 2022 Dec 13:S1008-1275(22)00134-1. doi: 10.1016/j.cjtee.2022.12.005. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to analyze if any difference exists on the type of immobilisation (above elbow vs. below elbow) in the conservative treatment of distal end radius fractures in adults.

METHODS: The study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses. An electronic literature search was performed up to 1st October 2021 in Medline, Embase, Ovid and Cochrane database using the search terms, “distal end radius fractures OR fracture of distal radius”, “conservative treatment OR non-surgical treatment”, “above elbow immobilisation” and “below elbow immobilisation”. Randomized clinical trials written in English, describing outcome of distal end radius fractures in adults by conservative or non-surgical means using above elbow immobilisation or below elbow immobilisation were included and assessed according to the risk of bias assessment (RoB2) tool by Cochrane collaboration. Non-randomized clinical trials, observational studies, retrospective studies, review articles, commentaries, editorials, conference presentations, operative techniques and articles without availability of full text were excluded from this review. The meta-analysis was performed using Review Manager version 5.4.1 (The Cochrane Collaboration, Copenhagen, Denmark).

RESULTS: Six randomized clinical trials were included for quantitative review. High heterogeneity (I² >75%) was noted among all the studies. The standard mean difference between the disability of the arm, shoulder and hand scores in both the groups was 0.52 (95% CI (-0.28)-1.32) which was statistically non-significant. There was no statistical difference in the radial height (mean difference 0.10, 95% CI (-0.91)-1.12), radial inclination (mean difference 0.5, 95% CI (-1.88)-2.87), palmar tilt (mean difference 1.06, 95% CI (-0.31)-2.43) and ulnar variance (mean difference 0.05, 95% CI (-0.74)-0.64). It was observed that shoulder pain occurred more commonly as a complication in above elbow immobilisation and the values were statistically significant (above elbow: 38/92, 41.3%; below elbow: 19/94, 20.2%).

CONCLUSION: This two-armed systematic review on the above elbow or below elbow immobilisation to be used for conservative treatment of the distal end radius fracture in adults resulted in non-significant differences in terms of functional and radiological scores among the two groups but significant increase in the complication rates in the above elbow group.

PMID:36737394 | DOI:10.1016/j.cjtee.2022.12.005

Foot Ankle Surg. 2023 Jan 18:S1268-7731(23)00010-3. doi: 10.1016/j.fas.2023.01.009. Online ahead of print.

ABSTRACT

BACKGROUND: Various conservative treatment methods can be administered in the early stages of plantar fasciitis (PF). The aim of the treatment is to enable the patient to return to the physical activity as soon as possible.

AIM: In this study it was aimed to compare efficacies of Extracorporeal Shockwave Therapy (ESWT) and Low-Level Laser Therapy (LLLT) on patients with PF.

DESIGN: A local prospective cross-sectional study SETTING: Department of Physical Medicine and Rehabilitation Outpatient Clinic of Sakarya University, Faculty of Medicine POPULATION: Patients aged 18-70 years, having ongoing heel pain for at least 3 months, and not using oral and/or parenteral corticosteroids in the last 6 months.

METHODS: A total of 40 patients with PF included in the current study. Visual Analog Scale (VAS), Roles and Maudsley Score (RMS), American Orthopedic Foot and Ankle Association Score (AOFAS) and Foot Function Index (FFI) questionnaire were performed for all patients. ESWT and LLLT groups comprised of 22 (55%) and 18 (45%) patients, respectively.

RESULTS: We found significant improvements in scores based on the VAS, RMS, AOFAS, FFI in patients with PF and it was sustained for 3 months (p = 0.001, for all scores). While decrease in scores based on the VAS and FFI in LLLT group was statistically more significant compared to ESWT group (p = 0.014, p = 0.013), there was statistically less significant decrease in scores on the AOFAS in LLLT group than that of ESWT group (p = 0.032).

CONCLUSIONS: The results of this study indicated significant improvements in terms of pain, functional status and daily life activities following the administration of either of the treatments. Furthermore, LLLT was found to be significantly more effective for alleviating pain than ESWT in the treatment of PF.

PMID:36737392 | DOI:10.1016/j.fas.2023.01.009

J Craniomaxillofac Surg. 2023 Jan 28:S1010-5182(23)00021-5. doi: 10.1016/j.jcms.2023.01.013. Online ahead of print.

ABSTRACT

The aim of this study was to assess patient satisfaction relating to inpatient stays. In this prospective observational study, adult patients with oncological (oral cancer, medication-related osteonecrosis of the jaw) and non-oncological (mandibular fracture) diagnoses, and who had undergone surgery, were contacted 4 weeks after discharge. Two validated questionnaires were used: EORTC QLQ-C30 for quality of life and IN-PATSAT32 for patient satisfaction. For quality of life, the mandibular fracture group had a lower impairment of physical functioning (M = 83.59, SD = 24.44; p = 0.029) in comparison with both other groups (M = 68.84, SD = 26.24; M = 59.33, SD = 24.43, for oral cancer and osteonecrosis, respectively). Regarding patient satisfaction, patients with oral cancer were slightly more satisfied with doctors’ availability (M = 48.91, SD = 24.11; p = 0.583) compared with the other groups (M = 36.54, SD = 19.11; M = 46.67, SD = 20.86, for mandibular fracture and ostenecrosis, respectively). Patients with an unplanned inpatient stay following an acute event tended to be less satisfied than patients with a planned inpatient stay. Within the limitations of the study it seems that knowledge of these influencing external factors and their effects can support physicians and nursing staff in providing improved patient care.

PMID:36737378 | DOI:10.1016/j.jcms.2023.01.013

Physiol Meas. 2023 Feb 3. doi: 10.1088/1361-6579/acb8fe. Online ahead of print.

ABSTRACT

OBJECTIVE: The quantitative assessment of Parkinsonian tremor, e.g., (0, 1, 2, 3, 4) according to the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale, is crucial for treating Parkinson’s disease. However, the tremor amplitude constantly fluctuates due to environmental and psychological effects on the patient. In clinical practice, clinicians assess the tremor severity over a period of time, whereas manual tremor labeling relies on the clinician’s physician experience. Therefore, automatic tremor quantification based on wearable inertial sensors and machine learning algorithms is affected by the manual labels of clinicians. In this study, an automatic modification method for the labels judged by clinicians is presented to improve Parkinsonian tremor quantitation.

APPROACH: For the severe overlapping of dynamic feature range between different severities, an outlier modification algorithm (PCA-IQR) based on the combination of principal component analysis (PCA) and interquartile range (IQR) statistic rule is proposed to learn the blurred borders between different severity scores, thereby optimizing the labels. Afterward, according to the modified feature vectors, a support vector machine (SVM) with a radial basis function (RBF) kernel is proposed to classify the tremor severity. The classifier models of SVM with RBF kernel, k-nearest neighbors (KNN), and SVM with the linear kernel are compared.

MAIN RESULTS: Experimental results show that the proposed method has high classification performance and excellent model generalization ability for tremor quantitation (accuracy: 97.93%, precision: 97.96%, sensitivity: 97.93%, F1-score: 97.94%).

SIGNIFICANCE: The proposed method may not only provide valuable assistance (digital biomarkers) for clinicians to assess the tremor severity accurately, but also provides self-monitoring for patients at home and improve the assessment skills of clinicians.

PMID:36735971 | DOI:10.1088/1361-6579/acb8fe

Phys Med Biol. 2023 Feb 3. doi: 10.1088/1361-6560/acb8fc. Online ahead of print.

ABSTRACT

OBJECTIVE: Organ deformation models have the potential to improve delivery and reduce toxicity of radiotherapy, but existing data-driven motion models are based on either patient-specific or population data. We propose to combine population and patient-specific data using a Bayesian framework. Our goal is to accurately predict individual motion patterns while using fewer scans than previous models.

APPROACH: We have derived and evaluated two Bayesian deformation models. The models were applied retrospectively to the rectal wall from a cohort of prostate cancer patients. These patients had repeat CT scans evenly acquired throughout radiotherapy. Each model was used to create coverage probability matrices (CPMs). The spatial correlations between these estimated CPMs and the ground truth, derived from independent scans of the same patient, were calculated.\ Main results: Spatial correlation with ground truth were significantly higher for the Bayesian deformation models than both patient-specific and population-derived models with 1, 2 or 3 patient-specific scans as input. Statistical motion simulations indicate that this result will also hold for more than 3 scans. \ Significance: The improvement over previous models means that fewer scans per patient are needed to achieve accurate deformation predictions. The models have applications in robust radiotherapy planning and evaluation, among others.

PMID:36735964 | DOI:10.1088/1361-6560/acb8fc

Int Nurs Rev. 2023 Feb 3. doi: 10.1111/inr.12821. Online ahead of print.

ABSTRACT

AIM: To determine the effect of male nursing students’ voluntary activities on their image in society.

BACKGROUND: The role of voluntary nursing services in enhancing the visibility of nursing in society can also contribute to enhancing the image of male nurses in society.

METHODS: This study employed a one-group, quasi-experimental pre-post analysis design. It was carried out between September 2020 and June 2021 in the pedestrian zone, which is one of the main streets of Bartın in Turkey. Using a convenience sampling approach, tradesmen aged 18 and over operating in commercial enterprises (n = 81) were asked to participate in the study. Information form and Nursing Image Scale were used to collect the research data. Results from the paired sample t test were utilized to analyse the study’s data using the intervention of ‘men nursing students’ voluntary activities’.

RESULTS: The total Nursing Image Scale score of the participants was statistically considerably greater after the intervention than the pre-intervention score. Based on the paired sample t test results, it was observed that the participants obtained higher scores after the intervention than before in the gender sub-dimension as well as all other sub-dimensions of the Nursing Image Scale, and these results were statistically significant.

CONCLUSION: According to the findings of the study, volunteering by male nursing students improved both the profession of nursing and the perception of men in nursing in society.

IMPLICATIONS FOR NURSING/HEALTH POLICY: This study suggested that male nursing students’ voluntary activities could be one of the strategies to overcome the nursing shortage due to its enhancing effect on the profession of nursing and the perception of men in nursing in society.

PMID:36735939 | DOI:10.1111/inr.12821