Category: Statistics

Int Endod J. 2023 May 20. doi: 10.1111/iej.13935. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to compare the cardiovascular effects (heart rate, oxygen saturation (SpO₂ )_, systolic and diastolic blood pressure) and the anaesthetic efficacy of intraosseous computerized anaesthesia (ICA) versus inferior alveolar nerve block (IANB) in Symptomatic irreversible pulpitis (SIP).

METHODOLOGY: The study protocol was registered with ClinicalTrials.gov (NCT03802305). In a randomized, prospective clinical trial, 72 mandibular molar teeth with SIP were randomly allocated to conventional IANB injection (n = 36) or ICA injection (n = 36), both with 1.8 mL of 4% articaine with 1:100,000 epinephrine. The primary objective was to assess the cardiovascular parameters (heart rate, oxygen saturation, blood pressure) before, during, and after the anaesthesia. The secondary objectives were to compare ICA with IANB for success and postoperative outcomes for up to 3 days.

RESULTS: The maximum increase in heart rate in the ICA group was greater than in the IANB. Other cardiovascular parameters did not show differences throughout the clinical procedure. There were no statistically significant differences (P > .05) between groups for sex, age, or anxiety. The total success rate of ICA (91.43%) was significantly higher (P = 0.0034) than that of IANB (69.44%).

CONCLUSIONS: This study establishes that ICA is safe and efficient in the first intention for the treatment of SIP of the mandibular molar.

PMID:37209243 | DOI:10.1111/iej.13935

Environ Monit Assess. 2023 May 20;195(6):701. doi: 10.1007/s10661-023-11311-9.

ABSTRACT

Water bodies are constantly being degraded by leachates from waste disposal sites, particularly in the Nigeria cities. This paper investigates the effect of waste disposal sites on physicochemical properties of water in selected states of Southeast Nigeria. To achieve the main aim of the study, three waste disposal sites were selected from three cities based on their proximity to streams. Wet and dry seasonal effects were also noted. The experiment was laid out in a Randomized Complete Block Design, with four replications for 3 years, and data collected was analyzed statistically. The result indicated that biological oxygen demand (BOD) values of 29.31 ± 1.60 mg/L, 23.87 ± 2.32 mg/L, and 32.73 ± 1.30 mg/L at Abakaliki, Enugu, and Awka in the wet period decreased by 2%, 17%, and 10% respectively, relative to the dry season values, and were significantly (p < 0.05) higher relative to the respective controls. The result also proved that values of chemical oxygen demand (COD), nitrate (NO₃^–), and turbidity in water presented similar results. However, more findings from this study showed an evidence of more pollution loads from the waste disposal sites in the wet period relative to the dry season due possibly to increased leachate and run-off coming out of the sites to the surface water bodies. Based on the findings, the study strongly recommends proper awareness to avoid contamination/pollution of surface water bodies within the vicinity of the waste dump sites among the immediate settlement that make use of the environment in order to safe-guard their lives.

PMID:37209226 | DOI:10.1007/s10661-023-11311-9

Gastric Cancer. 2023 May 20. doi: 10.1007/s10120-023-01397-y. Online ahead of print.

ABSTRACT

PURPOSES: Previous studies have suggested that there is an increased risk of osteoporotic fracture in gastric cancer survivors. However, the data was not classified according to surgery type. This study investigated the cumulative incidence osteoporotic fracture (OF) in gastric cancer survivors according to treatment modality.

METHODS: A total of 85,124 gastric cancer survivors during 2008-2016 were included. The type of surgery was classified as total gastrectomy (TG, n = 14,428)/subtotal gastrectomy (SG, n = 52,572)/endoscopic mucosal dissection and endoscopic mucosal resection (ESD/EMR, n = 18,125). The site of osteoporotic fractures included the spine, hip, wrist, and humerus. We examined cumulative incidence using Kaplan-Meier survivor analysis and cox proportional hazards regression analysis to determine the risk factor of OF.

RESULTS: The incidence of OF per 100,000 patient year was 2.6, 2.1, 1.8 in TG, SG, ESD/EMR group. The cumulative incidence rate was 2.3% at 3 years, 4.0% at 5 years, and 5.8% at 7 years in gastrectomy group, and 1.8% at 3 years, 3.3% at 5 years in the SG group, and 4.9% at 7 years postoperatively in ESD/EMR group. TG increased the risk of OF compared to patients who underwent SG (HR 1.75, 95% confidence interval [CI] 1.57-1.94), and ESD/EMR (hazard ratio [HR] 2.23, 95% CI 2.14-2.32).

CONCLUSION: Gastric cancer survivors who underwent TG had an increased osteoporotic fracture risk than did SG or ESD/EMR in these patients. The amount of gastric resection and accompanying metabolic changes seemed to mediate such risk. Additional research is needed to establish an optimal strategy for each type of surgery.

PMID:37209225 | DOI:10.1007/s10120-023-01397-y

Int Ophthalmol. 2023 May 20. doi: 10.1007/s10792-023-02742-x. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the systemic inflammation in moderate-to-severe Graves’ ophthalmopathy patients with abnormal thyroid function by using complete blood cell count-derived inflammatory biomarkers and compare to moderate-to-severe GO patients with regulated thyroid function and healthy controls. The second aim is to evaluate the relationship of complete blood cell count-derived inflammatory biomarkers with clinical findings in moderate-to-severe GO.

METHODS: In this retrospective study, 90 GO patients with abnormal thyroid function composed Group 1, 58 patients who had normal thyroid function for at least 3 months composed Group 2, and 50 healthy individuals composed Group 3. Demographic data, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and systemic immune-inflammatory index (SII) were evaluated.

RESULTS: There was no statistically significant difference between groups in terms of age, sex, and smoking habits (p > 0.05). There was a statistically significant difference in NLR (p = 0.011), MLR (p = 0.013), MPV (p < 0.001), and SII (p < 0.001) values among 3 groups. For NLR, MLR, and SII the highest values were detected in Group 1. MPV levels were higher in Group 3 than Groups 1 and 2 (p < 0.001). None of the hematological parameters were found to be a risk factor for any clinical severity findings of GO.

CONCLUSION: The higher levels of NLR, MLR, and SII levels may show systemic inflammation in GO patients with abnormal thyroid function, and this may have an impact on the clinical course of ophthalmopathy. These findings may suggest that cautious control of thyroid hormone levels is important in the management of GO.

PMID:37209204 | DOI:10.1007/s10792-023-02742-x

Foot Ankle Int. 2023 May 20:10711007231167364. doi: 10.1177/10711007231167364. Online ahead of print.

ABSTRACT

BACKGROUND: Posterior tibial tendon (PTT) tendoscopy and medializing calcaneal osteotomy (MCO) are among the available techniques for patients presenting with symptomatic flexible hindfoot valgus (stage IA) progressive collapsing foot deformity (PCFD). The aim of this study was to determine clinical and radiographic outcomes of combined PTT tendoscopy and MCO for patients presenting with symptomatic stage IA PCFD.

METHODS: A retrospective cohort study was performed in order to determine clinical and radiographic outcomes of 30 combined PTT tendoscopies and MCO on 27 patients presenting with symptomatic stage IA PCFD, with a minimum follow-up of 24 months. Patient satisfaction was assessed at last available follow-up as very satisfied, satisfied, and unsatisfied. Clinical assessment was performed evaluating preoperative and last available follow-up visual analog scale for pain (VAS-P), Foot and Ankle Outcome Score (FAOS), and the 36-Item Short Form Health Survey (SF-36). Magnetic resonance imaging (MRI) was performed preoperatively on all patients. Standard weightbearing anteroposterior, lateral, and long axial view radiographs of the foot and ankle were taken preoperatively, immediate postoperatively, at 6 weeks, 3 months, 6 months, 1 year postoperatively, and last follow-up evaluation available for each patient.

RESULTS: The mean follow-up was 38.6 (range, 26-62) months. We registered 27 very satisfied, 1 satisfied, and 2 unsatisfied patients. There was statistically significant improvement on all clinical scores (VAS-P, FAOS and SF-36), as well as on lateral talo-first metatarsal and hindfoot alignment angles. We found low-grade PTT tears in 5 patients (16.67%) in whom preoperative MRI documented PTT tenosynovitis alone.

CONCLUSION: We found that combined PTT tendoscopy and MCO provide significant clinical and radiographic improvement for patients presenting with symptomatic stage IAB PCFD. PTT tendoscopy should be considered in the treatment of all surgically addressed flexible valgus feet as it detects tendon tears which are frequently missed on an MRI.

LEVEL OF EVIDENCE: Level IV, retrospective case series.

PMID:37209035 | DOI:10.1177/10711007231167364

J Esthet Restor Dent. 2023 May 20. doi: 10.1111/jerd.13066. Online ahead of print.

ABSTRACT

OBJECTIVE: the aim of this study was to evaluate the effect of resin composite layering on discolored substrates to obtain masking ability with monolithic ceramics.

MATERIALS AND METHODS: Four groups (n = 8) of computer-aided design/computer aided manufacturing (CAD/CAM) monolithic ceramics, shade A1, with thicknesses of 1.0 and 1.5 mm, were tested: feldspathic (FC), leucite-reinforced (LC), lithium disilicate-reinforced (LD), and translucent zirconia (5YSZ). Five substrates were used: A1 (used as reference), A3.5, C4, and coppery and silvery metals. The substrates were separated as non-layered or layered (with flowable opaque resin composite (FL), white opaque restorative resin composite (WD), and A1-shaded opaque restorative resin composite (A1D)). Resin composite layers of 0.5 and 1.0 mm were tested. The try-in paste, shade A1, was used as a luting agent. Translucency parameter (TP₀₀ ) was assessed for the ceramics. Color differences (∆E₀₀ ) were assessed for the restorative ceramics and resin composite layers over discolored substrates with the CIEDE2000 formula. The results were compared statistically, and descriptively with acceptability (AT, 1.77) and perceptibility (PT, 0.81) thresholds.

RESULTS: Feldspathic showed the highest TP₀₀ (for both ceramic thicknesses) and LD the lowest (for 1.5 mm of ceramic thickness) (P < 0.001). For substrate A3.5, layering with 1.0 mm of A1D or WD ensured ∆E₀₀ below PT for all ceramics tested (P < 0.001). The use of 0.5 mm of FL or 1.0 mm of A1D associated with ceramics LC, LD, and 5YSZ ensured ∆E₀₀ below AT for substrates C4 and coppery metal (P < 0.001). Silvery background layered with 0.5 mm of FL presented ∆E₀₀ below AT for all ceramics and ∆E₀₀ below PT for lithium disilicate of 1.0 mm of thickness (∆E₀₀ = 0.72).

CONCLUSIONS: Layering severely discolored substrates with selected opaque resin composites ensures masking ability for restoration with CAD/CAM monolithic ceramics.

CLINICAL SIGNIFICANCE: Severely discolored substrates are predictably restored with monolithic CAD/CAM ceramics by performing a previous layering of the substrate with opaque resin composite.

PMID:37209028 | DOI:10.1111/jerd.13066

Int Endod J. 2023 May 20. doi: 10.1111/iej.13934. Online ahead of print.

ABSTRACT

AIM: To analyze and compare the root canal microbiome present in root-filled teeth of two different geographical populations, and to study their functional potential using next-a generation sequencing approach.

METHODOLOGY: Sequencing data obtained from surgical specimens from previously treated teeth with periapical bone loss from Spain and USA were included in the study. Taxa were classified using SILVA v.138 database. Differences in genera abundances among the 10 most abundant genera were evaluated using a Kruskal-Wallis test. Alpha diversity indices were calculated in mothur. The Shannon and Chao1 indices were used. Analyses of similarity (ANOSIM) to determine differences in community composition were done in mothur, with Bonferroni correction for multiple comparisons. P values < 0.05 were considered statistically significant. Identification of enriched bacteria function prediction in the study groups (Kegg pathways) was carried out by Linear discriminant analysis Effect Size (LEfSe) via Python 3.7.6.

RESULTS: A greater alpha-diversity (Shannon and Chao1 indices) was observed from samples obtained in Spain (P = 0.002). Geography showed no significant effects on community composition via an ANOSIM using Bray-Curtis dissimilarities (R = 0.03, P = 0.21). Bacterial functional analysis prediction obtained by PICRUSt showed that 5.7% KEGG pathways differed between the Spain and USA samples.

CONCLUSIONS: The taxonomic assessment alone does not fully capture the microbiome’s differences from two different geographical locations. Carbohydrate and amino acid metabolism were enriched in samples from Spain, while samples from the USA had a higher representation of pathways related to nitrogen, propanoate metabolism, and secretion systems.

PMID:37209012 | DOI:10.1111/iej.13934

Scand J Public Health. 2023 May 20:14034948231173473. doi: 10.1177/14034948231173473. Online ahead of print.

ABSTRACT

AIMS: In Denmark, all residents regardless of nationality are ‘de jure’ entitled to a wide range of free-of-charge healthcare services. There is, however, only scarce quantitative knowledge on immigrants’ experiences of their ‘de facto’ access to healthcare and on how access relates to immigrants’ types of residence permits. The study aims to address these gaps.

METHODS: Survey data on access to healthcare, employment and housing were collected among adult, newly arrived immigrants in Denmark (n=1711) at 26 publicly contracted Danish language schools in September-December 2021 by national cluster-random sampling stratified by region. Data were analysed using descriptive statistics and multivariate logistic regression.

RESULTS: In total, 21% reported general difficulties obtaining good healthcare. Commonly experienced barriers related to financial constraints (39%), communication (37%) and lack of knowledge about the healthcare system (37%). Refugees and their families had higher odds of reporting barriers related to finances (odds ratio (OR) 2.58; confidence interval (CI) 1.77-3.76), communication (OR 3.15; CI 2.39-4.14) and knowledge (OR 1.84; CI 1.16-2.90), while other family reunified immigrants had lower odds of reporting knowledge barriers (OR 0.71; CI 0.54-0.93) compared with immigrants with EU/EEA residence permits, adjusted for gender and residential region. These results remained significant when further adjusted for age, length of stay, education, income, rural/urban residence and household size.

CONCLUSIONS: Difficulties accessing healthcare are experienced by a large share of newly arrived immigrants in Denmark and are dependent on residence permit type. The findings suggest strengthened efforts to reduce barriers related to finances, communication and knowledge, while focusing on the most vulnerable immigrants.

PMID:37209005 | DOI:10.1177/14034948231173473

Int J Dermatol. 2023 May 20. doi: 10.1111/ijd.16710. Online ahead of print.

ABSTRACT

BACKGROUND: Incidence of cutaneous melanoma is steadily growing, and its early recognition is of paramount importance. Small, pigmented lesions often represent a challenge for the clinician, as predictors of melanoma have not yet been uniquely identified in this setting.

OBJECTIVES: To identify dermoscopic features that aid in distinguishing small diameter melanomas (≤5 mm) from equivocal melanocytic nevi measuring ≤5 mm.

METHODS: A retrospective multicenter study was conducted to collect demographics, clinical and dermoscopic pictures of (i) histology-proven flat melanomas, measuring ≤5 mm, (ii) histology-proven but clinically/dermoscopically equivocal melanocytic nevi measuring ≤5 mm, and (iii) histology-proven flat melanomas, measuring >5 mm. An independent dermoscopic evaluation was performed. Differences in predefined dermoscopic features were assessed across the three groups.

RESULTS: A total of 103 melanomas measuring ≤5 mm were collected; 166 control lesions, comprising 85 large (>5 mm) melanomas and 81 dubious, clinically equivocal melanocytic nevi measuring ≤5 mm were included. Of the 103 mini-melanomas, only 44 were melanoma in situ. Five dermoscopic predictors of melanoma were identified for the assessment of flat, non-facial melanocytic lesions measuring ≤5 mm, namely: atypical pigment network, blue-white veil, pseudopods, peripheral radial streaks, and presence of more than one color. The latter were combined into a predictive model capable of identifying melanoma with 65% sensitivity and 86.4% specificity, at a cut-off score of 3. Among melanomas measuring ≤5 mm, presence of a blue-white veil (P = 0.0027) or negative pigment network (P = 0.0063) was associated with invasiveness.

CONCLUSION: A set of five dermoscopic predictors of melanoma, atypical pigment network, blue-white veil, pseudopods, peripheral radial streaks, and presence of more than one color is proposed for the assessment of flat, non-facial melanocytic lesions measuring ≤5 mm.

PMID:37208996 | DOI:10.1111/ijd.16710

J Prosthodont. 2023 May 19. doi: 10.1111/jopr.13716. Online ahead of print.

ABSTRACT

PURPOSE: To compare screw surface characteristics between hemi-engaging and non-engaging implant-supported fixed partial denture (FPD) designs after cyclic loading.

MATERIALS AND METHODS: Twenty-four implants measuring 4.3 × 10mm were mounted on acrylic resin blocks. Specimens were divided into 2 groups. An experimental group included twelve 3-unit FPD with a hemi-engaging design; a control group included twelve 3-unit FPD with the conventional design of two non-engaging abutments. Both groups were subjected to two types of cycling loading (CL), first axial loading, and then lateral loading at 30°. Load was applied to the units one million times (1.0×10⁶ cycles) for each loading axis. Data on screw surface roughness in three locations and screw thread depth were collected before (BL) and after (AL) each loading type. Screw surface roughness was measured in μm using a mechanical digital surface profilometer and optical profiler. To evaluate screw thread depth in μm, an upright optical microscope Axio-imager 2 was used. To confirm readings made from the optical microscope, four random samples were selected from each group for scanning electron microscopy (SEM) analysis. The effect of cyclic loading was evaluated by averaging values across the two screws within each specimen, then calculating difference scores (DL) between BL and AL (DL = AL – BL). Additional difference scores were computed between the non-engaging screws in each experimental group specimen, and one randomly selected non-engaging screw in each control specimen. This difference was referred to as the non-engaging DL. Statistical significance was assessed using Mann-Whitney U tests (α = .05).

RESULTS: Comparisons of DL and non-engaging DL by loading type revealed one significant difference regarding surface roughness at the screw thread. Significantly greater mean changes were observed after axial loading compared to lateral loading regarding both DL (axial M = -0.36 ± 0.08; lateral M = -0.21 ± 0.09; U = 20; p = .003) and non-engaging DL (axial M = -0.40 ± 0.22; lateral M = -0.21 ± 0.11; U = 29; p = .013). No significant differences in screw surface roughness in other sites or thread depth were found between the experimental and control abutment designs in DL or in non-engaging DL. No significant differences were found for DL (axial U = 13, P = .423; lateral U = 9, P = .150;) or non-engaging DL (axial U = 13, P = .423; lateral U = 18, P = 1.00).

CONCLUSIONS: Results suggest that overall, changes in screw surface physical characteristics did not differ between hemi-engaging and non-engaging designs after evaluating screw surface roughness and thread depth before and after axial and lateral cyclic loading. This article is protected by copyright. All rights reserved.

PMID:37208973 | DOI:10.1111/jopr.13716