Category: Statistics

Gac Med Mex. 2024;160(4):420-428. doi: 10.24875/GMM.M24000919.

ABSTRACT

BACKGROUND: The underreporting of vital statistics poses a problem for the quality of information. To address underreporting, Mexico implemented the “Intentional Search for Children Deaths” in 2002.

OBJECTIVE: To analyze trends in the underreporting of deaths in neonates and children under 5 years of age (U5) from 1992 to 2022 at the national level and by state.

MATERIAL AND METHODS: A comparative analysis was conducted between the records of the National Institute of Statistics and Geography (INEGI) and the Institute for Health Metrics and Evaluation (IHME) chosen as the gold standard after comparison with five other independent data sources. The analysis considers marginalization to describe the magnitude of underreporting.

RESULTS: From 2001 to 2022, at the national level, the underreporting gap decreased from 38.2% to 9.0% among children U5 and from 30.7% to 5.5% in the neonatal age, with heterogeneous results across states.

CONCLUSIONS: The registration of deaths has improved; however, it is crucial to identify states needing further investigation and intervention to reduce the underreporting gap in infant mortality.

PMID:39832330 | DOI:10.24875/GMM.M24000919

Gac Med Mex. 2024;160(4):399-403. doi: 10.24875/GMM.24000149.

ABSTRACT

BACKGROUND: In developed countries, most of the neurologists use pericranial nerve blocks to treat headache patients, nevertheless, the knowledge and use patterns of this technique in developing countries are unknown.

OBJECTIVE: Evaluate the knowledge and use patterns of pericranial nerve blocks in headache treatment by Mexican neurologists.

MATERIAL AND METHODS: We did a cross-sectional study, 90 Mexican neurologists completed a 26-question survey including data about sociodemographics, knowledge and patterns of use of pericranial nerve blocks. All statistical analyses were performed with R (version 4.2.0).

RESULTS: The mean age was 43.2 + 9.9 years, 55(61.1%) were men. In terms of knowledge, migraine was correctly identified by 74 participants (82.2%), while cluster headache by 65 participants (72.2%) as indications for pericranial nerve blocks. Regarding the use patterns of pericranial nerve blocks, 87(96.7%) of the neurologists had heard about the technique, but only 12(13.3%) use it in their clinical practice. In terms of education, 19(21.1%) received training during the residency and 27(30%) during the post-residency period.

CONCLUSIONS: The knowledge and use of pericranial nerve blocks for the treatment of headaches in Mexico is low. Stakeholders should develop strategies to improve the field of headache disorders in Mexico.

PMID:39832328 | DOI:10.24875/GMM.24000149

Gac Med Mex. 2024;160(4):384-392. doi: 10.24875/GMM.M24000933.

ABSTRACT

INTRODUCTION: Twin pregnancy through assisted reproduction techniques is increasing, as are the associated complications.

OBJECTIVE: Compare maternal and perinatal complications associated with spontaneous twin pregnancy and through assisted reproduction techniques (ART).

MATERIAL AND METHODS: Retrospective comparative and controlled study. It included 208 patients treated at the UMAE HGO 4 of the IMSS, divided into two groups according to the method of conception (spontaneous vs ART), comparing maternal and perinatal complications. Quantitative variables were compared with the student’s T or Mann Whitney U test and qualitative variables with the chi-square test. The probability ratio was calculated with a 95 % confidence interval, with statistical significance p < 0.05.

RESULTS: 208 patients with twin pregnancies were included; 104 (50%) conceived spontaneously and 104 (50%) by assisted reproductive techniques (ART). Maternal complications were higher in the ART group: preterm delivery (84.6 vs 60.5%), hypertensive disease (43.2 vs 19.2%), gestational diabetes (38.1 vs 24.8%), and obstetric hemorrhage (41.9 vs 25.7%). Prematurity and respiratory distress syndrome were significantly higher in the ART group.

CONCLUSIONS: Twin pregnancy due to ART increases the risk of maternal and perinatal complications, which forces us to improve prenatal control with a risk approach.

PMID:39832326 | DOI:10.24875/GMM.M24000933

J Clin Psychiatry. 2025 Jan 2;86(1):24m15339. doi: 10.4088/JCP.24m15339.

ABSTRACT

Objective: We compared substance use disorder (SUD) prevalence among adult inflammatory bowel disease (IBD) hospitalizations with non-IBD controls from the 2016-2018 National Inpatient Sample, assessing correlations with demographics, socioeconomic status, geographic regions, depression, and anxiety.

Methods: The primary aim focused on SUD, defined as substance abuse or dependence (International Statistical Classification of Diseases, Tenth Revision [ICD-10]: F10-F19) excluding unspecified use or remission, among hospitalizations documenting IBD (Crohn’s disease or ulcerative colitis; ICD-10: K50-51) as one admitting diagnosis (IBD-D). The prevalence of SUD among hospitalizations with and without IBD was compared. The secondary aim further characterized factors influencing SUD among hospitalizations with IBD as the primary diagnosis (IBD-PD). Multivariable logistic regression was performed to estimate the adjusted odds ratios (ORs) for SUD including associated covariates.

Results: SUD prevalence was 20.9% for IBD-D and 20.8% for non-IBD controls (P = .38). After adjustments, there was less SUD (OR 0.92, 95% CI, 0.90-0.93) but more opioid use disorder (OUD) (OR 1.20, 95% CI, 1.15-1.24) among IBD-D; other substances were less likely among IBD-D. Among IBD-PD hospitalizations, SUD significantly associated with Crohn’s disease (75.1% vs 58.8%, P < .001), Medicaid (30.4% vs 15.8%, P < .001), lowest-income quartile (32.8% vs 23.8%, P < .001), depression (19.1% vs. 12.5%), and anxiety (24.7% vs. 14.9%). These factors were also associated with OUD. Notably, certain geographic regions and urbanization levels correlated with both elevated SUD and OUD among IBD-PD hospitalizations.

Conclusions: We comprehensively characterized SUD prevalence among adult IBD hospitalizations, identifying demographic, socioeconomic, geographic, and mental health risk factors for SUD and OUD in IBD. These findings inform efforts to decrease SUD among IBD patients by improving health care delivery through reducing health care disparities and improving psychiatric care.

PMID:39832310 | DOI:10.4088/JCP.24m15339

Acta Orthop. 2025 Jan 20;96:94-101. doi: 10.2340/17453674.2024.42704.

ABSTRACT

BACKGROUND AND PURPOSE: Evidence for long-term outcomes following acetabular fractures in older adults is limited. We aimed to evaluate mortality, complications, and need for subsequent surgical procedures in operatively and nonoperatively treated older patients with acetabular fractures.

METHODS: Patients aged ≥ 70 years with acetabular fractures treated at Uppsala University Hospital between 2010 and 2020 were included. Fractures were classified according to Letournel. Local medical records were analyzed and cross-referenced with the Swedish Arthroplasty Register to identify reoperations and delayed arthroplasty procedures. Follow-up time ranged from 2-12 years. Primary outcome was mortality 1 year after injury. Descriptive statistics, survival analysis using the Kaplan-Meier method, and logistic regression models were used.

RESULTS: 247 patients (67% men) with a median age of 80 years (range 70-102) were included. Most patients were ASA class 3 (67%). 148 (60%) patients were treated operatively. The 1-year mortality was 15% (95% confidence interval [CI] 9-21) in the operatively and 29% (CI 19-37) in the nonoperatively treated group. Difference in adjusted mortality rates between treatments did not reach statistical significance. 20% of patients treated with open reduction internal fixation (ORIF) underwent some form of reoperation. In the nonoperatively treated group, 1% had a delayed THA.

CONCLUSION: The 1-year mortality following acetabular fractures in older people was 21% (CI 15-26), underscoring the frailty of this patient group. ORIF alone was associated with a 20% reoperation rate while the rate of delayed surgical treatment in patients selected for nonoperative treatment was 1%.

PMID:39832287 | DOI:10.2340/17453674.2024.42704

Dentomaxillofac Radiol. 2025 Jan 20:twaf002. doi: 10.1093/dmfr/twaf002. Online ahead of print.

ABSTRACT

OBJECTIVES: This meta-research assessed methodologies used for evaluating peri-implant marginal bone levels on digital periapical radiographs in randomised clinical trials published between 2019 and 2023.

METHODS: Articles were searched in four databases. Data on methods for assessing peri-implant marginal bone levels were extracted. Risk of bias assessment was performed.

RESULTS: During full-text reading, 108 out of 162 articles were excluded. Methodological issues accounted for these exclusions, including the absence of radiograph-type information, the lack of radiographic positioners, the missing anatomical references, and the use of panoramic radiographs or tomography. Fifty-four articles were included, most from Europe (70%) and university-based (74%). Radiographic positioners were specified in 54% of articles. Examiner calibration was unreported in 54%, with 69% lacking details. In 59%, no statistical measure assessed examiner agreement. Blinding was unreported or unused in 50%. Marginal bone level changes were the primary outcome of 61%. Most articles (59.3%) raised “some concerns” regarding bias, while 37% showed a high risk of bias, and only two articles (3.7%) demonstrated a low risk of bias.

CONCLUSIONS: Several limitations and areas for improvement were identified. Future studies should prioritize protocol registration, standardize radiographic acquisitions, specify examiner details, implement calibration and statistical measures for agreement, introduce blinding protocols, and maintain geometric calibration standards.

PMID:39832279 | DOI:10.1093/dmfr/twaf002

Rheumatology (Oxford). 2025 Jan 20:keaf027. doi: 10.1093/rheumatology/keaf027. Online ahead of print.

ABSTRACT

OBJECTIVE: Systemic lupus erythematosus (SLE) is a heterogeneous disease which manifests as different subphenotypes. Distinct subphenotypes, such as lupus nephritis (LN), have been associated with increased genetic risk, but prior studies have been limited by cross-sectional and imprecisely subphenotyped cohorts. This study investigated the genetic basis for LN using a longitudinal cohort of distinctly subphenotyped patients.

METHODS: SLE patients with biopsy-proven LN or never developed LN (NLN) were recruited from 8 tertiary referral centres. All patients had longitudinal clinical data for at least 10-years, or died during the study period. NLN patients had no renal involvement for at least 10-years. Subjects were genotyped and polygenic risk scores (PRS) were calculated using 230 SLE-associated SNPs. Genome-wide association analyses were also conducted for LN-vs-control, NLN-vs-control, and LN-vs-NLN comparisons, along with heterogeneity tests to assess differences in effect size.

RESULTS: Among 1462 patients, 824 (56%) and 638 (43%) had LN and NLN, respectively. PRS was significantly higher in the LN cohort. Genome-wide significant variants were identified in HLA, TNFAIP3, BLK, and STAT4 loci specifically for LN patients, while STAT4 also remained significant for NLN patients. Direct LN-vs-NLN associations showed no statistically significant variants but heterogeneity tests revealed other genetic loci, including ELF1, OX40, DUSP22, and TPCN2.

CONCLUSION: Different subphenotypes of SLE are predisposed by distinct genetic risk loci, which can only be identified in clearly subphenotyped cohorts with sufficient longitudinal data. We identified unique genetic risk loci enriched among patients with biopsy-proven LN, and postulate that individual subphenotypes may have varying genetic predisposition.

PMID:39832277 | DOI:10.1093/rheumatology/keaf027

Environ Toxicol Chem. 2025 Jan 20:vgaf021. doi: 10.1093/etojnl/vgaf021. Online ahead of print.

ABSTRACT

Polymer-coated fertilizers, widely used in rice cultivation in Japan, contribute to reactive nitrogen management and agricultural productivity but are a source of microplastics in the environment. Here, we investigated microplastics derived from polymer-coated fertilizer (microcapsule) runoff in Japanese paddy fields at 38 sites to quantitatively assess the behavior of microcapsules in paddy fields, and to estimate the total amount of runoff and accumulation in Japan. We also examined the factors causing variations in the amount of runoff among paddy fields. Between 61 and 100% of microcapsule runoff during the irrigation period occurred between puddling and rice transplanting, with concentrations ranging from 2 to 482 mg/m2 in paddy fields. Water management practices and wind direction and speed explained the difference in runoff between plots. The total amount of microcapsules discharged from Japanese paddy fields during the irrigation season was estimated to be between 17 and 6,291 t (median 1,157 t) from the loads obtained in this study. According to fertilizer statistics and our results, total microcapsule accumulation on agricultural land in Japan was estimated to be 75,623 t. These results suggest that paddy fields in Japan will remain a long-term source of marine microplastics.

PMID:39832270 | DOI:10.1093/etojnl/vgaf021

Dentomaxillofac Radiol. 2025 Jan 20:twaf004. doi: 10.1093/dmfr/twaf004. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this technical report was to assess whether the “Radiological Report” tool within the Artificial Intelligence (AI) software Diagnocat can achieve a satisfactory level of performance comparable to that of experienced dentomaxillofacial radiologists in interpreting cone-beam CT scans.

METHODS: Ten cone-beam CT scans were carefully selected and analyzed using the AI tool, and they were also evaluated by two dentomaxillofacial radiologists. Observations related to tooth numeration, alterations in dental crowns, roots, and periodontal tissues were documented and subsequently compared to the AI findings. Kappa statistics, along with their corresponding 95% confidence intervals, were calculated to ascertain the degree of agreement.

RESULTS: The agreement between the AI tool and the radiologists ranged from substantial to nearly perfect for identifying teeth, determining the number of roots and canals, assessing crown conditions, and detecting endodontic treatments. However, for tasks such as classifying bone loss, identifying posts, evaluating the quality of fillings, and appraising the situation of periodontal spaces, the agreement was deemed slight.

CONCLUSIONS: The “radiological report” tool of the Diagnocat demonstrates satisfactory performance in reliably identifying teeth, roots, canals, assessing crown conditions, and detecting endodontic treatment. However, further investigations are needed to evaluate the tool’s effectiveness in diagnosing posts, assessing the condition and quality of fillings, and determining the status of periodontal spaces.

PMID:39832268 | DOI:10.1093/dmfr/twaf004

Dentomaxillofac Radiol. 2025 Jan 20:twaf006. doi: 10.1093/dmfr/twaf006. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to develop an automated method for generating clearer, well-aligned panoramic views by creating an optimized three-dimensional (3D) reconstruction zone centered on the teeth. The approach focused on achieving high contrast and clarity in key dental features, including tooth roots, morphology, and periapical lesions, by applying a 3D U-Net deep learning model to generate an arch surface and align the panoramic view.

METHODS: This retrospective study analyzed anonymized cone-beam CT (CBCT) scans from 312 patients (mean age 40 years; range 10-78; 41.3% male, 58.7% female). A 3D U-Net deep learning model segmented the jaw and dentition, facilitating panoramic view generation. During preprocessing, CBCT scans were binarized, and a cylindrical reconstruction method aligned the arch along a straight coordinate system, reducing data size for efficient processing. The 3D U-Net segmented the jaw and dentition in two steps, after which the panoramic view was reconstructed using 3D spline curves fitted to the arch, defining the optimal 3D reconstruction zone. This ensured the panoramic view captured essential anatomical details with high contrast and clarity. To evaluate performance, we compared contrast between tooth roots and alveolar bone and assessed intersection over union (IoU) values for tooth shapes and periapical lesions (#42, #44, #46) relative to the conventional method, demonstrating enhanced clarity and improved visualization of critical dental structures.

RESULTS: The proposed method outperformed the conventional approach, showing significant improvements in the contrast between tooth roots and alveolar bone, particularly for tooth #42. It also demonstrated higher IoU values in tooth morphology comparisons, indicating superior shape alignment. Additionally, when evaluating periapical lesions, our method achieved higher performance with thinner layers, resulting in several statistically significant outcomes. Specifically, average pixel values within lesions were higher for certain layer thicknesses, demonstrating enhanced visibility of lesion boundaries and better visualization.

CONCLUSIONS: The fully automated AI-based panoramic view generation method successfully created a 3D reconstruction zone centered on the teeth, enabling consistent observation of dental and surrounding tissue structures with high contrast across reconstruction widths. By accurately segmenting the dental arch and defining the optimal reconstruction zone, this method shows significant advantages in detecting pathological changes, potentially reducing clinician fatigue during interpretation while enhancing clinical decision-making accuracy. Future research will focus on further developing and testing this approach to ensure robust performance across diverse patient cases with varied dental and maxillofacial structures, thereby increasing the model’s utility in clinical settings.

ADVANCES IN KNOWLEDGE: This study introduces a novel method for achieving clearer, well-aligned panoramic views focused on the dentition, providing significant improvements over conventional methods.

PMID:39832267 | DOI:10.1093/dmfr/twaf006