Category: Statistics

J Voice. 2021 Oct 23:S0892-1997(21)00309-X. doi: 10.1016/j.jvoice.2021.09.009. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effects of auditory training with synthesized voices on intra- and inter-rater agreement of the auditory-perceptual voice analysis of roughness and breathiness.

METHODS: This was an experimental study consisting of four auditory training sessions. The sample consisted of twenty raters, students from a Speech-Language Pathology course, who had previous experience with auditory-perceptual assessment. The raters participated in the four training sessions with a seven-day break in between sessions. Each training consisted of three tasks: 1) Pre-training activity: Participants were asked to rate 20 natural voices, normal and dysphonic, from zero to three, according to the parameters of roughness and breathiness; 2) Training activity: Synthesized voice anchor stimuli were presented, and participants were asked to rate them from zero to three. Four stimuli were related to roughness and four to breathiness. Participants heard 20 voice stimuli and were instructed to pair the natural voice with the synthesized anchor stimulus that most resembled it; and 3) Post-training activity: the 20 voices from the pre-training activity were randomized and participants rated the same voices, without prior knowledge that these were repeated. Statistical analysis of data was performed using the AC₂ test, to assess the extent of agreement between raters, and the Friedman test to compare the training sessions. A 5% significance level was considered.

RESULTS: For the auditory-perceptual voice analysis of roughness, intra-rater agreement results ranged from 79% to 86% between the first and fourth auditory training session, with improvement in intra-rater agreement from the fourth session forward (P = 0.005). For the analysis of breathiness, results ranged from 88% to 92% between the first and fourth auditory training sessions, with improvement from the fourth session forward (P = 0.036). Inter-rater agreement results for the auditory-perceptual analysis of roughness ranged from 23% to 34%, and from 48% to 61% for breathiness, with no differences regarding training (P = 0.855).

CONCLUSION: The auditory-perceptual breathiness parameter had a higher AC₂ indicator compared to the roughness parameter, suggesting better agreement. The intra-rater agreement showed improvement starting from the fourth auditory training session for the assessment of roughness and breathiness. The auditory training program did not show a positive inter-rater agreement impact.

PMID:34702611 | DOI:10.1016/j.jvoice.2021.09.009

J Voice. 2021 Oct 24:S0892-1997(21)00291-5. doi: 10.1016/j.jvoice.2021.08.012. Online ahead of print.

ABSTRACT

OBJECTIVES: This study examined the efficacy of the NHS waterpipe as a superficial hydration treatment in voice production in healthy young women.

STUDY DESIGN: This is a prospective, single-blind, within- and between-subject experimental design.

METHODS: Thirty six female university students (mean age 24.6 years, range 19-45 years) were recruited to the study. Participants were randomized to two experimental groups (E1 and E2) and a control group. E1 underwent hydration treatment with the NHS waterpipe filled with 0.9% saline that was immersed in a cup of heated water. E2 underwent a similar treatment but without heated immersion. The control group received no treatment. Acoustic Voice Quality Index (AVQI v03.01) and its subparameters, phonation threshold pressure, self-perceived phonatory effort and sensation of throat dryness was measured at three time points (before the intervention and immediately and 15 minutes after it).

RESULTS: The Tilt of the AVQI’s subparameters increased significantly in the E1 (P = 0.027) and E2 groups (P = 0.027) after the intervention. Furthermore, the E1 group had significantly lower harmonics-to-noise-ratio values at the third measurement point compared to the E2 group (P = 0.023). These findings may result from fluid transported to the vocal fold level. The sensations of throat dryness decreased in the E1 (P = 0.001) and E2 groups (P < 0.0005) after the intervention. Perceived phonatory effort decreased statistically significantly at the final measurement point in the E1 (P = 0.002) and E2 (P = 0.031) groups. No variables changed in the control group.

CONCLUSIONS: The waterpipe seems to be efficient in hydrating vocal folds on single use. It seems to be more efficient when employed with a hot water bath, albeit slightly impairing some acoustic values in the short term. Without the heated fluid, it still seems to decrease sensations of throat dryness and affect acoustic voice quality. The waterpipe does not seem to have an effect on phonation threshold pressure, and it seems to lower self-perceived effort just as efficiently whether the waterpipe is employed using a hot water bath or not. Further research is needed to prove the efficacy of long-term usage and usage with voice patients.

PMID:34702612 | DOI:10.1016/j.jvoice.2021.08.012

J Pediatr Nurs. 2021 Oct 23:S0882-5963(21)00300-6. doi: 10.1016/j.pedn.2021.10.003. Online ahead of print.

ABSTRACT

BACKGROUND: Creating a womb-like environment for the preterm infant is vital to reduce the stress caused by stimuli and facilitate optimal neurological-behavioral development.

PURPOSE: This randomized-controlled study aimed to determine the effect of simulative heartbeat nest use on vital signs, pain level, and comfort in preterms.

METHODS: The study population consisted of 52 (experiment: 25, control: 27) preterms hospitalized in a university hospital’s neonatal intensive care unit between May-November 2018. Before the application, preterms in both groups were evaluated with PIPP and Comfort scales. The experiment group was monitored in the nest with a heart beating device for 15 min. The control group was observed in the nest without the device for 15 min. Their heartbeats and oxygen saturation were recorded. After the application, preterms in both groups were re-evaluated with PIPP and Comfort scale.

RESULTS: There was no statistically significant difference between the groups in terms of gestation week, age, birth weight and height, HB, SaO2, PIPP, and Comfort Scale total scores before and after the application (p > .05). However, the mean SaO2 increased significantly during the application (p < .003) in the experiment group; and that the PIPP total score decreased statistically significantly (p: 0.001) after the application. The comfort scale total score averages of the preterms in both groups decreased statistically significantly after the application (experiment:p < .01; control:p < .05).

IMPLICATIONS FOR PRACTICE AND RESEARCH: Preterms in both groups had similar indicators. The nests that create heartbeat provide positive outcomes, such as the standard nests’.

PMID:34702595 | DOI:10.1016/j.pedn.2021.10.003

Br J Oral Maxillofac Surg. 2021 Jan 19:S0266-4356(21)00015-2. doi: 10.1016/j.bjoms.2021.01.001. Online ahead of print.

ABSTRACT

The aim of this study was to assess the impact, if any, of L-PRF application in an implant bed prior to implant placement, focusing on stability by means of implant stability quotient (ISQ) values. The literature was searched in a systematic way by means of the main databases and hand searching of the most relevant journals. The inclusion and exclusion criteria were used to determine the eligible studies included in this review. Only randomised controlled trials (RCT) and controlled clinical trials (CCT) were included. A total of four RCTs were included for data extraction. The risk of bias was deemed moderate to unclear. Meta-analysis was performed to assess the effect of L-PRF, on implant stability, immediately post-insertion in three studies, after one week from the implant placement in three studies and after four weeks for all the included studies. The fixed effects model has shown Hedges g statistic for the one week varying from 0.380 to 1.401 with a pooled figure of 0.764 (95% CI 0.443 to 1.085) and for four weeks varying between 0.74 and 1.1 with a combined effect of 0.888 (95% CI 0.598 to 1.177). The results for both intervals were in favour of the use of L-PRF while the statistical difference immediately post-insertion was not statistically significant. The present systematic review, though acknowledging its limitations, suggests that L-PRF has a positive effect on secondary implant stability and that needs to be correlated to the clinical practice to measure the actual clinical effect by means of reducing treatment times.

PMID:34702597 | DOI:10.1016/j.bjoms.2021.01.001

J Prosthet Dent. 2021 Sep 21:S0022-3913(21)00490-X. doi: 10.1016/j.prosdent.2021.09.002. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Although psychological disorders have been established as one of the etiological factors for temporomandibular disorders, anxiety levels in individuals with masticatory muscle pain before and during the coronavirus 2019 (COVID-19) pandemic have not previously been compared.

PURPOSE: The purpose of this clinical study was to evaluate anxiety levels in patients with masticatory muscle pain at times before and during the COVID-19 pandemic.

MATERIAL AND METHODS: Eighty patients (18 to 68 years) with masticatory muscle pain were included in the study. All participants had completed the Generalized Anxiety Disorder 7 questionnaire (GAD-7) before the first COVID-19 infection had been reported in Turkey. After the onset of the COVID-19 pandemic, all participants were contacted by telephone to repeat the GAD-7 to evaluate changes in their psychology during the first lockdown. However, 18 of the 80 patients were unreachable. A statistical analysis was performed by using the Mann-Whitney U test. Proportion comparisons between sociodemographic characteristics and GAD-7 levels were performed by using the Fisher exact test (α=.05).

RESULTS: Forty-eight (60%) of the study population were women, and 32 (40%) were men, with a mean age ±standard deviation of 36.63 ±13.85 years. Both before and during the pandemic, GAD-7 scores were statistically similar as was each demographic parameter, including sex, educational status, and occupational status (P>.05). Also, no significant correlation was recorded between age and GAD-7 global scores obtained before and during the pandemic (r=-0.098 and r=-0.052, respectively, P>.05). However, during-pandemic GAD-7 scores were statistically higher than before-pandemic GAD-7 scores (P<.001).

CONCLUSIONS: Demographic parameters had no connection with anxiety levels in patients with masticatory muscle pain before and during the COVID-19 pandemic. However, the COVID-19 pandemic anxiety levels in the participants were higher than the levels before the pandemic.

PMID:34702584 | DOI:10.1016/j.prosdent.2021.09.002

Injury. 2021 Oct 17:S0020-1383(21)00881-0. doi: 10.1016/j.injury.2021.10.013. Online ahead of print.

ABSTRACT

BACKGROUND: Routinely collected health data (RCHD) offers many opportunities for traumatic brain injury (TBI) research, in which injury severity is an important factor.

OBJECTIVE: The use of clinical injury severity indices in a context of RCHD is explored, as are alternative measures created for this specific purpose. To identify useful scales for full body injury severity and TBI severity this study focuses on their performance in predicting these currently used indices, while accounting for age and comorbidities.

DATA: This study utilized an extensive population-based RCHD dataset consisting of all patients with TBI admitted to any Belgian hospital in 2016.

METHODS: Full body injury severity is scored based on the (New) Injury Severity Score ((N)ISS) and the ICD-based Injury Severity Score (ICISS). For TBI specifically, the Abbreviated Injury Scale (AIS) Head, Loss of Consciousness and the ICD-based Injury Severity Score for TBI injuries (ICISS) were used in the analysis. These scales were used to predict three outcome variables strongly related to injury severity: in-hospital death, admission to intensive care and length of hospital stay. For the prediction logistic regressions of the different injury severity scales and TBI severity indices were used, and error rates and the area under the receiver operating curve were evaluated visually.

RESULTS: In general, the ICISS had the best predictive performance (error rate between 0.06 and 0.23; AUC between 0.82 [0.81;0.83] and 0.86 [0.85;0.86]). A clearly increasing error rate can be noticed with advancing age and accumulating comorbidity.

CONCLUSION: Both for full body injury severity and TBI severity, the ICISS tends to outperform other scales. It is therefore the preferred scale for use in research on TBI in the context of RCHD. In their current form, the severity scales are not suitable for use in older populations.

PMID:34702594 | DOI:10.1016/j.injury.2021.10.013

Mater Sci Eng C Mater Biol Appl. 2021 Nov;130:112435. doi: 10.1016/j.msec.2021.112435. Epub 2021 Sep 16.

ABSTRACT

In this work, we investigate differences in the mechanical and structural properties of tendon fascicle bundles dissected from different areas of bovine tendons. The properties of tendon fascicle bundles were investigated by means of uniaxial tests with relaxation periods and hysteresis, dynamic mechanical analysis (DMA), as well as magnetic resonance imaging (MRI). Uniaxial tests with relaxation periods revealed greater elastic modulus, hysteresis, as well as stress drop during the relaxation of samples dissected from the posterior side of the tendon. However, the normalized stress relaxation curves did not show a statistically significant difference in the stress drop between specimens cut from different zones or between different strain levels. Using dynamic mechanical analysis, we found that fascicle bundles dissected from the anterior side of the tendon had lower storage and loss moduli, which could result from altered fluid flow within the interfascicular matrix (IFM). The lower water content, diffusivity, and higher fractional anisotropy of the posterior part of the tendon, as observed using MRI, indicates a different structure of the IFM, which controls the flow of fluids within the tendon. Our results show that the viscoelastic response to dynamic loading is correlated with fluid flow within the IFM, which was confirmed during analysis of the MRI results. In contrast to this, the long-term relaxation of tendon fascicle bundles is controlled by viscoplasticity of the IFM and depends on the spatial distribution of the matrix within the tendon. Comparison of results from tensile tests, DMA, and MRI gives new insight into tendon mechanics and the role of the IFM. These findings may be useful in improving the diagnosis of tendon injury and effectiveness of medical treatments for tendinopathies.

PMID:34702520 | DOI:10.1016/j.msec.2021.112435

Dent Mater. 2021 Oct 23:S0109-5641(21)00281-5. doi: 10.1016/j.dental.2021.10.003. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the volume loss after air abrasion with alumina particles with different morphology on bovine enamel and luting composite resin.

METHODS: Air abrasion was performed on 12 unscathed bovine teeth and 72 luting composite resin discs with 85 μm round-shaped and 50 μm sharp-edged alumina particles applied for 20 s, 40 s and 60 s (n = 12). Air abrasion was standardized by uniform areas of 2 mm diameter, a pressure of 0.25 MPa and a distance of 3 mm. The volume loss was determined by using a laboratory scanner.

RESULTS: Air abrasion with round-shaped alumina particles was mostly not measurable with the laboratory scanner, while sharp-edged alumina air abrasion resulted in significant loss of enamel. The median of volume loss by sharp-edged alumina particles ranged from 0.78 mm³ (20 s) to 2.52 mm³ (60 s). In contrast to round-shaped alumina the removal caused by sharp-edged alumina increased significantly with increasing application times (p ≤ 0.05). For air abrasion on luting composite resin the median of the removed volume ranged from 2.25 mm³ (20 s) to 6.18 mm³ (60 s), while round-shaped alumina showed a range from 0.45 mm³ (20 s) to 1.40mm³ (60 s). The round-shaped alumina produced a statistically significant lower volume loss than sharp-edged alumina for all three air abrasion times.

SIGNIFICANCE: The 85 μm round-shaped alumina particles removed less composite resin than 50 μm sharp-edged alumina particles but barely any enamel, making it an option for removing composite resin residues from enamel.

PMID:34702558 | DOI:10.1016/j.dental.2021.10.003

Am J Health Behav. 2021 Sep 30;45(5):924-932. doi: 10.5993/AJHB.45.5.12.

ABSTRACT

Objective: In this study, we examined physical activity (PA) engagement outside of college physical education (PE) classes using the Transtheoretical Model (TTM). Methods: Overall, 414 university students enrolled in PE classes voluntarily participated in this study. Participants were asked to complete a survey packet to measure 4 core constructs of TTM and their PA level performed outside of PE classes. Among the participants, 150 randomly selected students were asked to wear a triaxial accelerometer for 7 consecutive days to identify their PA level. Descriptive statistics and multivariate analyses of variance were used to determine the association between stages of motivational readiness and other strategic core constructions. Results: We categorized 77% of respondents into either the “action” stage or the “maintenance” stage for engaging in additional PA outside of the classes. Behavioral processes of change showed a graded and significant association with the stages. Both self-efficacy and decisional balance were significantly higher in students at higher stages. Conclusion: Our findings showed that most students enrolled in college PE classes had additional PA outside of the class participation. In addition, behavioral processes may be effective strategies for this specific target group to promote PA.

PMID:34702439 | DOI:10.5993/AJHB.45.5.12

Am J Health Behav. 2021 Sep 30;45(5):879-894. doi: 10.5993/AJHB.45.5.8.

ABSTRACT

Objectives: We established baseline prevalence rates of HIV testing among adult, sexual minorities and identified the correlates of never being HIV tested. Methods: We used a 20-state sample of the 2017-2019 Behavioral Risk Factor Surveillance System to identify sexual minorities who responded to the HIV testing question (N=433,042). Using weighted multivariate logistic regression analysis, we identified the characteristics associated with never being HIV tested and the impact of state health departments’ HIV testing messages on testing status. Results: Overall, 41.6% of sexual minorities reported never being HIV tested with statistically significant state-level variation. Being younger (18-24 years) or older (65+ years), not black, married, and in good health significantly increased the odds of never being HIV tested as did lacking regular healthcare access and reporting no high-risk HIV behaviors. States’ HIV testing messages had no statistically significant effect on HIV testing status. Conclusions: Although sexual minorities were less likely than straight respondents to report never being HIV tested, a sizable population remained untested. Specific characteristics associated with sexual minorities’ HIV testing status can be used to tailor public health messages and optimize testing rates.

PMID:34702435 | DOI:10.5993/AJHB.45.5.8