Category: Statistics

Interact Cardiovasc Thorac Surg. 2021 Apr 28:ivab030. doi: 10.1093/icvts/ivab030. Online ahead of print.

ABSTRACT

OBJECTIVES: Technology has the potential to assist healthcare professionals in improving patient-doctor communication during the surgical journey. Our aims were to assess the acceptability of a quality of life (QoL) application (App) in a cohort of cancer patients undergoing lung resections and to depict the early perioperative trajectory of QoL.

METHODS: This multicentre (Italy, UK, Spain, Canada and Switzerland) prospective longitudinal study with repeated measures used 12 lung surgery-related validated questions from the European Organisation for Research and Treatment of Cancer Item Bank. Patients filled out the questionnaire preoperatively and 1, 7, 14, 21 and 28 days after surgery using an App preinstalled in a tablet. A one-way repeated measures analysis of variance was run to determine if there were differences in QoL over time.

RESULTS: A total of 103 patients consented to participate in the study (83 who had lobectomies, 17 who had segmentectomies and 3 who had pneumonectomies). Eighty-three operations were performed by video-assisted thoracoscopic surgery (VATS). Compliance rates were 88%, 90%, 88%, 82%, 71% and 56% at each time point, respectively. The results showed that the operation elicited statistically significant worsening in the following symptoms: shortness of breath (SOB) rest (P = 0.018), SOB walk (P < 0.001), SOB stairs (P = 0.015), worry (P = 0.003), wound sensitivity (P < 0.001), use of arm and shoulder (P < 0.001), pain in the chest (P < 0.001), decrease in physical capability (P < 0.001) and scar interference on daily activity (P < 0.001) during the first postoperative month. SOB worsened immediately after the operation and remained low at the different time points. Worry improved following surgery. Surgical access and forced expiratory volume in 1 s (FEV1) are the factors that most strongly affected the evolution of the symptoms in the perioperative period.

CONCLUSIONS: We observed good early compliance of patients operated on for lung cancer with the European Society of Thoracic Surgeons QoL App. We determined the evolution of surgery-related QoL in the immediate postoperative period. Monitoring these symptoms remotely may reduce hospital appointments and help to establish early patient-support programmes.

PMID:33909903 | DOI:10.1093/icvts/ivab030

J Periodontol. 2021 Apr 28. doi: 10.1002/JPER.20-0871. Online ahead of print.

ABSTRACT

BACKGROUND: It is well known that following root surface debridement (RSD) residual deposits remain. Periodontal endoscopy has provided a method of directly visualizing root surfaces during periodontal debridement in an intact pocket without the need for surgical incision. The aim of this study was to determine if periodontal debridement utilizing endoscopic visualization was more effective in improving clinical and radiographic parameters as compared to root surface debridement (RSD).

METHODS: Thirty-eight subjects were randomised into RSD with perioscope (n = 19) or RSD only (n = 19) groups. A full mouth evaluation included probing pocket depths (PPD), clinical attachment levels (CAL), bleeding upon probing (BOP) and plaque scores (PI) recorded at baseline, three and twelve months and compared between groups. Radiographs were taken at sites with deepest pockets at baseline and 12-months and the change in radiographic bone levels (RBL) compared. An independent samples T-test was used to assess statistical significance.

RESULTS: Both groups had significant improvements in clinical outcomes. The test (T) group had a significantly lower percentage of PPDs 7-9 mm at three (0.72±1.2%) and twelve months (0.5±1.0%) as compared to the control (C) group (2.25±2.9%; 1.84±2.3%). At twelve months, the test group recorded a significantly lower mean PPD (T: 2.70+0.2 mm; C: 2.98±0.4 mm), BOP% (T: 4.3±3.2%; C: 11.95±7.1%), PI% (T: 25.61±3.9%; C: 30.11±6.3%) and less change in gingival recession (T: -0.13±0.2 mm; C: -0.50±0.6 mm) (p<0.05). More radiographic bone gain was observed in the test group (0.69±0.3 mm) as compared to the control group (0.49±0.2 mm). This was also observed around multi-rooted teeth (T: 0.83±0.45 mm; C: 0.46±0.36 mm).

CONCLUSION: The adjunctive use of the perioscope provided a slight benefit to the outcomes of non-surgical therapy particularly at deeper probing depths. This article is protected by copyright. All rights reserved.

PMID:33909914 | DOI:10.1002/JPER.20-0871

Rev Saude Publica. 2021 Apr 23;55:12. doi: 10.11606/s1518-8787.2021055003417. eCollection 2021.

ABSTRACT

OBJECTIVES: To estimate the prevalence and factors associated with hesitancy in getting the vaccine against SARS-CoV-2 in Maranhão, Brazil.

METHODS: This is a cross-sectional population-based study conducted from October 19 to 30, 2020. The estimates were calculated based on clustering, stratification, and non-response. A three-stage sampling was adopted, considering stratum, census tracts, and domicile. After systematic analysis, thirty sectors were selected in each stratum, totaling 150 sectors. Each sector contained a fixed number of 34 households, thus totaling 5,100 households. One individual within each household (resident for at least six months and aged one year or more) was selected by a simple random sampling. We questioned participants about their vaccination intention. Univariate association between independent variables and the outcome were verified using descriptive analysis (weighted frequencies) and Pearson’s chi-square test (p < 0.05). Robust multivariate analysis was performed using a three-level hierarchical model.

RESULTS: We found 17.5% (95%CI 16.1-19.1%) of the 4,630 individuals interviewed to report hesitancy to be vaccinated against covid-19. After final model adjustment, vaccination hesitancy was statistically higher among residents of the cities of Imperatriz (24.0%; RP = 1.48; IC95% 1.09-2.02) and municipalities of the Grande Ilha de São Luís (20.7%; RP = 1.34; 95%CI 1.02-1.76), female individuals (19.8%; RP = 1.44; 95%CI 1.20-1.75), older adults (22.8%; RP = 1.79; IC95% 1.30-2.46), evangelicals (24.1%; RP = 1.49; 95%CI 1.24-1.79), and those without reported symptoms (18.6%; RP = 1.24; 95%CI 1.02-1.51). We found no statistical differences for other socioeconomic and demographic characteristics, as well as variables related to the labor market, behaviors, and health conditions of the interviewees.

CONCLUSION: The prevalence of vaccine hesitancy in Maranhão and its association with individual, contextual, and clinical factors enable us to identify the groups and contexts of greatest resistance, requiring special attention from public strategies to ensure wide vaccination.

PMID:33909868 | DOI:10.11606/s1518-8787.2021055003417

Angle Orthod. 2021 May 1;91(3):307-312. doi: 10.2319/080220-676.1.

ABSTRACT

OBJECTIVES: To develop a prediction model that combined information derived from chronological age, sex, and the cervical vertebral maturation (CVM) method to predict the pubertal spurt in mandibular growth.

MATERIALS AND METHODS: A total of 50 subjects (29 females, 21 males) were selected from the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection, the University of Michigan Growth Study, and the Denver Child Growth study. A total of 456 lateral cephalograms were analyzed, and a multilevel logistic model was applied. The outcome variable was the presence or absence of the mandibular pubertal growth peak. The predictive variables were chronological age up to the third order, sex, presence or absence of CS 3 interactions between age and sex, age and CS 3, sex and CS 3.

RESULTS: The mean age ± standard deviation (SD) at the first cephalogram was 8.2 ± 0.5 years, whereas the mean age at the last cephalogram was 16.5 ± 1.1 years. The mean interval ± SD between two consecutive cephalograms was 1.0 ± 0.1 years. The mean age ± SD at the lateral cephalogram obtained immediately before the mandibular pubertal growth peak was 12.1 ± 1.1 years for females and 13.2 ± 0.8 years for males. The greatest increase in mandibular length occurred after CS 3 in 78% of the subjects. The presence of CS 3, age, second-order age, sex, and the interaction between age and sex were all statistically significant predictors of the mandibular pubertal growth spurt.

CONCLUSIONS: CS 3, chronological age, and sex can be used jointly to predict the pubertal peak in mandibular growth.

PMID:33909876 | DOI:10.2319/080220-676.1

Phys Ther. 2021 Apr 28:pzab115. doi: 10.1093/ptj/pzab115. Online ahead of print.

ABSTRACT

OBJECTIVE: After amputation, people with lower-limb loss (PLL) face challenges to regain their previous physical activity level. Assessing the scope of evidence regarding physical activity in PLL can identify sources of evidence and gaps within the literature that can influence amputation-related research, outcome assessment choices, and wellness activities. The purpose of this scoping review was to map the evidence regarding steps per day as a physical activity measure for PLL. Specific aims were to 1) identify research designs, 2) catalog population subgroups, 3) document steps per day measurement methods, and 4) provide descriptive data for steps per day in PLL.

METHODS: The Medline, CINAHL, Embase, Web of Science, and AMED databases; and the Journal of Prosthetics and Orthotics archive were searched without language or time limits. Exclusion criteria included: no PLL subjects, not peer-reviewed, and no direct step count measure. Inclusion criteria allowed any sample size, non-prosthetic use, and self-reported step count. As a scoping review, only descriptive statistics were compiled, and no methodologic quality assessment was performed.

RESULTS: 21 articles using crossover (8), cohort (4), cross-section (8), and case-study (1) designs were included that reported accelerometer (19) or pedometer (2) data. Studies often mixed amputation etiologies (15/21) and most (13/21) excluded transfemoral amputations (TFA). Studies primarily examined people with transtibial amputations (TTA = 81.2%) and people at independent community walking levels (K3 = 49.2%, K4 = 36.3%). All 21 studies had N < 100, and overall included 515 combined subjects (343, 66.6% male), aged 53.2 (22.1) years. Pooled steps per day for PLL was 5087 (2998): 5929 (3047) for TTA and 3553 (2030) for TFA.

CONCLUSIONS: Most PLL have low activity levels compared to the 10,000 generally recommended or 6000 common in people with diabetes. Research with larger samples, defined subgroups, and data along the recovery continuum would enhance knowledge of physical activity level in PLL. Impact statement: This scoping review has identified gaps in the research related to steps per day as a measure of physical activity in people with lower-limb loss to guide future research. Lay Summary: People with lower-limb loss take fewer steps per day than suggested for general health. Increasing steps per day may be a useful goal for this population, and this study is a first step in improving knowledge of physical activity levels in people with lower-limb loss.

PMID:33909881 | DOI:10.1093/ptj/pzab115

Braz Oral Res. 2021 Apr 26;35:e043. doi: 10.1590/1807-3107bor-2021.vol35.0043. eCollection 2021.

ABSTRACT

Numerous studies have reported abnormalities in the development of oral structures in congenital infections that also involve microcephaly. In this context, it is necessary to identify possible dental anomalies of shape and/or number in patients with Zika virus syndrome using radiography. The study population consisted of 35 children born with congenital ZIKV who underwent intraoral radiographic examinations for 24 consecutive months. A modified periapical technique was performed in an occlusal position for the maxilla and mandible. Categorical data were expressed as absolute and percentage frequencies and compared using Pearson’s Chi-square test, with a 95% confidence interval. Of the entire sample, eight children (22.8%) had dental anomalies of shape and/or number, and four children (11.4%) presented with both anomalies, with agenesis of the upper and lower deciduous/permanent incisors and dental form modifications, such as microdontia and anomalous cusps. When we considered age and sex, there was no statistically significant difference between patients who presented with agenesis and those who presented with modifications. Children with congenital Zika virus syndrome were more likely to have dental modifications in the number and shape of their teeth, and it is essential to implement medium- to long-term monitoring to diagnose other possible alterations throughout the development of the mixed and permanent dentition, favoring their treatment.

PMID:33909865 | DOI:10.1590/1807-3107bor-2021.vol35.0043

Braz Oral Res. 2021 Apr 26;35:e060. doi: 10.1590/1807-3107bor-2021.vol35.0060. eCollection 2021.

ABSTRACT

This study aimed to describe the morphometric relationship of root canal orifices on the pulp floor in the presence/absence of mesiobuccal second canal (MB2) in the maxillary first molars and other aspects of its internal anatomy. Sixty-two maxillary first molars were scanned by micro-CT. The presence of the MB2 canal was verified. The distance between the center points of the MB1, MB2, distobuccal (DB), and palatal (P) canal orifices on the pulp floor were measured (MB1-MB2, MB1-DB, MB2-DB, MB1-P, and DB-P). The MB1-P to DB-P ratio was calculated. The distances between the anatomic apex and the MB1 and MB2 apical foramina were measured. The length of the band-shaped isthmus was also measured. Student’s t-test was applied to verify the association between the presence of an MB2 canal, the interorifice distances, and the ratio of the MB1-P to DB-P distance (α = 5%). The MB2 canal was present in 43 roots (69.35%). Statistics showed significant differences when MB2 was present for the largest MB1-P distance (p < 0.05) and higher values for the MB1-P to DB-P ratio (p < 0.05). A band-shaped isthmus was detected in 25.8% of MB roots. The mean distance from the apical foramen to the isthmus floor ranged from 1.74 for MB1 canals to 1.42 for MB2 canals. Canal orifice distances on the pulp floor may predict the presence of MB2 canals. There was a high incidence of isthmus, accessory canals, and apical delta in the critical apical zone in MB roots of maxillary first molars.

PMID:33909867 | DOI:10.1590/1807-3107bor-2021.vol35.0060

Braz Oral Res. 2021 Apr 26;35:e042. doi: 10.1590/1807-3107bor-2021.vol35.0042. eCollection 2021.

ABSTRACT

This study aimed to analyze the influence of socioeconomic factors on the frequency of diagnoses of oral mucosal changes and the number of hospitalized patients with oral and oropharyngeal cancer in Brazil. This cross-sectional study analyzed data from all Brazilian cities in the period 2011-2017. The frequency of diagnoses of oral mucosal changes and the number of hospitalized patients of oral and oropharyngeal cancer in Brazil were extracted from the Primary Care Information System (SIAB) and Brazilian National Cancer Institute (INCA) databases. The socioeconomic factors evaluated were the Gini coefficient of inequality, municipal Human Development Index (MHDI), inadequate basic sanitation rate, employment rate, illiteracy rate and expected years of schooling. Associated factors were examined using bivariate Spearman’s correlations and multivariate Poisson regressions, and statistically significant (p < 0.05) correlations between study variables and regression coefficients were obtained. A higher frequency of diagnoses of mucosal changes was observed in cities with a higher Gini coefficient (B = 11.614; p < 0.001), higher MHDI (B = 11.298; p < 0.001), and higher number of hospitalized patients with oral and oropharyngeal cancer (B = 0.001, p < 0.002). Cities with higher Gini coefficients (B = 8.159, p < 0.001), higher inadequate basic sanitation rates (B = 0.09, p = 0.001), lower expected years of schooling (B = -0.718, p < 0.001), and higher illiteracy rates (B = 0.191, p < 0.001) had a higher frequency of hospitalized patients with oral and oropharyngeal cancer. In conclusion, more developed cities showed a higher frequency of diagnoses of mucosal changes. Greater inequality and worse socioeconomic conditions are associated with a higher frequency of hospitalized patients with oral and oropharyngeal cancer in Brazil.

PMID:33909864 | DOI:10.1590/1807-3107bor-2021.vol35.0042

Braz Oral Res. 2021 Apr 26;35:e038. doi: 10.1590/1807-3107bor-2021.vol35.0038. eCollection 2021.

ABSTRACT

A randomized controlled parallel clinical trial was conducted to evaluate the efficacy of the association of 1.23% topical professional acidulated phosphate fluoride (APF) gel with oral hygiene and dietary instructions on the arrest of active non-cavitated lesions in permanent, mixed, and temporary dentition in children between 3 and 12 years of age. Ninety-eight caries-active children were randomly divided into two groups: a fluoride gel group (n = 49) and a non-fluoridated gel group (n = 49). Each group received up to eight weekly applications of gel, weekly professional toothbrushing with oral hygiene instructions and dietary counselling. Caries lesions were assessed qualitatively through visual-tactile criteria performed in three stages: initial, intermediate, and final. Regression models were applied to identify risk indicators for caries control. Between-group comparison regarding the time taken to arrest the lesions was performed using Chi-squared and Fisher’s exact tests. Seventeen children did not receive the allocated intervention, and one was lost to follow-up (n = 80). There was no difference between the control and placebo groups regarding the time to the arrest of the lesion (p >.05). The treatments showed similar results without significant statistical difference (p = 0.33; 95%CI: 0.32-1.48). No adverse effects were observed. It can be concluded that no additional effect of the association of 1.23% APF gel with oral hygiene using fluoride dentifrice and dietary instructions on the arrest of active non-cavitated lesions could be established. We can also confirm the importance of toothbrushing frequency and, consequently, the visible plaque reduction in the control of caries activity. RBR-37V5S3.

PMID:33909860 | DOI:10.1590/1807-3107bor-2021.vol35.0038

Braz Oral Res. 2021 Apr 26;35:e040. doi: 10.1590/1807-3107bor-2021.vol35.0040. eCollection 2021.

ABSTRACT

This study aimed to evaluate the influence of choosing different socioeconomic status indicators in research regarding older adults’ oral health. This is a cross-sectional study that analyzed baseline data from the Brazilian Longitudinal Study on Aging (ELSI-Brazil). The outcomes were edentulism (n = 9,073) and self-reported oral health (n = 9,365). The following socioeconomic indicators were assessed: individual income, per capita household income, and wealth index. Poisson regression analysis with robust variance was performed to estimate prevalence ratios (PR), with their respective 95% confidence intervals (CI), after adjusting for socioeconomic and oral health behavior variables. Absolute inequality measures were also estimated. The individual income indicator was not statistically associated with the results after adjustments. When using per capita household income indicator, individuals in the richest quintile showed a 12% lower prevalence of poor self-reported oral health [PR: 0.88 (CI: 0.78-0.98)], relative to the poorest, and there was no association with edentulism. When the wealth index was chosen, there was a 22% lower prevalence of edentulism [PR: 0.78 (CI: 0.64-0.94)] and 15% lower prevalence of self-reported poor oral health [PR: 0.85 (CI: 0.78-0.93)] in individuals of the richest quintile, both relative to the poorest quintile. Regarding absolute inequality measures, for edentulism, the wealth index showed the highest absolute inequality. When considering self-reported oral health, per capita household income showed the greatest absolute inequality. Despite scientific challenges and the difficulty of socioeconomic indicator metrics, further investments in its development are critical to measure, promote, and improve population oral health.

PMID:33909862 | DOI:10.1590/1807-3107bor-2021.vol35.0040