Category: Statistics

J Prosthodont. 2022 Mar 8. doi: 10.1111/jopr.13504. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate, in a minipig model, the soft tissue integration of four different transmucosal materials, as well as the peri-implant bone remodeling.

MATERIALS AND METHODS: A total of 40 implants were placed in five minipigs in a single stage surgery, and two of each of the following abutment materials were used in each animal: (1) titanium (Ti; control), (2) polymethylmethacrylate (PMMA), (3) zirconia (Zi), and (4) veneering ceramic (VC). After a healing period of 3 months, the samples were collected and subjected to non-decalcified histology. The soft tissue dimensions (sulcus, junctional epithelium, and connective tissue attachment) were assessed on each abutment and the distance from the implant margin to first bone-to-implant contact (BIC) was measured.

RESULTS: The mean biological width-characterized by the sum of junctional epithelium and connective tissue measurements-was 3.8 (0.6) mm and no statistically significant difference was found between the four groups (P = 0.41). However, a long junctional epithelium (3.3-3.8 mm) and a very short connective tissue attachment (0.1-0.2 mm) were observed with all abutments. The measured peri-implant bone remodeling was similar in all four groups (P = 0.88).

CONCLUSIONS: Within its limitations, the present study showed that all tested materials allowed soft tissue integration, consisting of a long junctional epithelium, extending close to the bone level, and a rather short portion of connective tissue. This article is protected by copyright. All rights reserved.

PMID:35258144 | DOI:10.1111/jopr.13504

Ultrasound Obstet Gynecol. 2022 Mar 8. doi: 10.1002/uog.24896. Online ahead of print.

ABSTRACT

OBJECTIVE: Monochorionic diamniotic (MCDA) twin complicated by type III selective fetal growth restriction (sFGR) are at high risk of fetal death. Our aim was to identify predictors of fetal death.

METHODS: We performed an international multicenter retrospective cohort study. Type III sFGR was defined as fetal growth of one twin below the 10th percentile and intertwin growth difference of 25% or more, in combination with intermittent absent or reversed end-diastolic flow in the umbilical artery of the smaller fetus. Predictors of fetal death were longitudinally recorded throughout gestation and assessed in uni- and multivariable using logistic regression models. The classification and regression trees (CART) method was used to construct a prediction model of fetal death using significant predictors derived from the univariable analysis.

RESULTS: Three-hundred and eight twin pregnancies (616 fetuses) were included in the analysis. In 273 pregnancies (88.6%) both twins were liveborn, whereas in 35 pregnancies there was either a single (n=19; 6.2%) or a double fetal death (n=16; 5.2%). Earlier gestational age at diagnosis of type III sFGR, oligohydramnios of the smaller twin and deterioration of umbilical artery Doppler flow were associated with an increased risk of fetal death. Neither parameter identified in the univariable analysis maintained statistical significance in multivariable analysis. The CART model allowed to identify three risk groups: a low risk group (risk of fetal death 6.8%) where the umbilical artery Doppler did not deteriorate, an intermediate risk group (risk of fetal death 16.3%) where the umbilical artery Doppler deteriorated but the diagnosis of sIUGR was first made after 16+5 weeks’ gestation and a high-risk group (risk of fetal death 79%) where the umbilical artery Doppler deteriorated and gestational age at diagnosis was less than 16+5 weeks’ gestation.

CONCLUSIONS: Type III sFGR is associated with a high risk of fetal death. A prediction algorithm can help identifying the highest risk group (Doppler deterioration and early presentation). Further studies should investigate the potential benefit of fetal surveillance and intervention in this cohort. This article is protected by copyright. All rights reserved.

PMID:35258125 | DOI:10.1002/uog.24896

J Nurs Manag. 2022 Mar 8. doi: 10.1111/jonm.13578. Online ahead of print.

ABSTRACT

AIM(S): To analyse whether patient verbal aggression would be related to emotional exhaustion and whether this relationship would be mediated by work-family conflict and moderated by dehumanization and resilience.

BACKGROUND: Although patient verbal aggression has been identified as one of the most experienced forms of aggression, its effects on Italian healthcare providers during the pandemic are still poorly known.

METHOD(S): A total of 197 Italian healthcare professionals completed paper-and-pencil questionnaires. Descriptive statistics and moderated mediation analyses were performed.

RESULTS: Patient verbal aggression was positively related to healthcare professionals’ emotional exhaustion, both directly and indirectly, as mediated by work-family conflict. Healthcare providers were more likely to become emotionally exhausted when they had low resilience and, simultaneously, tended to ascribe patients non-uniquely human traits.

CONCLUSION(S): Patient verbal aggression may spill over onto healthcare professionals’ family lives. Dehumanization represents an ineffective coping strategy that exacerbate the effects of aggression on work-family conflict, while resilience represents a protective resource against emotional exhaustion.

IMPLICATIONS FOR NURSING MANAGEMENT: Hospital organizations could benefit from providing their staff with stress management interventions, aggression management, psychological support, and psychological resilience training programs. These programs should incorporate coping skills on establishing work-home boundaries and balancing empathy with cognitive problem-solving abilities.

PMID:35258120 | DOI:10.1111/jonm.13578

J Bone Miner Res. 2022 Mar 8. doi: 10.1002/jbmr.4541. Online ahead of print.

ABSTRACT

Repositioning error in longitudinal high-resolution peripheral-quantitative computed tomography (HR-pQCT) imaging can lead to different bone volumes being assessed over time. To identify the same bone volumes at each time point, image registration is used. While cross-sectional area image registration corrects axial misalignment, 3D-registration additionally corrects rotations. Other registration methods involving matched angle analysis (MA) or boundary transformations (3D-TB) can be used to limit interpolation error in 3D-registering micro finite-element data. We investigated the effect of different image registration methods on short-term in vivo precision in adults with osteogenesis imperfecta, a collagen-related genetic disorder resulting in low bone mass, impaired quality, and increased fragility. The radii and tibiae of 29 participants were imaged twice on the same day with full repositioning. We compared the precision error of different image registration methods for density, microstructural and micro finite-element outcomes with data stratified based on anatomical site, motion status, and scanner generation. Regardless of the stratification, we found that image registration improved precision for total and trabecular bone mineral densities, trabecular and cortical bone mineral contents, area measurements, trabecular bone volume fraction, separation, and heterogeneity, as well as cortical thickness and perimeter. 3D-registration marginally outperformed cross-sectional area registration for some outcomes, such as trabecular bone volume fraction and separation. Similarly, precision of micro finite-element outcomes was improved after image registration, with 3D-TB and MA methods providing greatest improvements. Our regression model confirmed the beneficial effect of image registration on HR-pQCT precision errors, while motion had a detrimental effect on precision even after image registration. Collectively, our results indicate that 3D-registration is recommended for longitudinal HR-pQCT imaging in adults with osteogenesis imperfecta. Since our precision errors are similar to those of healthy adults, these results can likely be extended to other populations, although future studies are needed to confirm this. This article is protected by copyright. All rights reserved.

PMID:35258112 | DOI:10.1002/jbmr.4541

J Bras Nefrol. 2022 Feb 28:S0101-28002022005018401. doi: 10.1590/2175-8239-JBN-2021-0161. Online ahead of print.

ABSTRACT

INTRODUCTION: This article describes the main differences between COVID-19-induced acute kidney injury (AKI-COVID19) in patients with previous normal renal function (AKI-NRF) and those with chronic kidney disease (AKI-CKD) treated in a high complexity clinic in Barranquilla (Colombia).

MATERIAL AND METHODS: The patients included in this study (n: 572) were those with a positive diagnosis of COVID-19 confirmed by detection of a positive PCR for SARS-CoV-2. Of these patients, 188 developed AKI during their hospital stay. Patients’ epidemiological data, serum parameters, and clinical frailty status were recorded. Statistical analysis and comparison among AKI-NRF, AKI-CKD, and non-AKI patients were performed.

RESULTS: The incidence of COVID-19-induced AKI was 33%, with the majority classified as AKIN 1, 16% requiring renal replacement therapy, and AKI-COVID19 mortality of 68%. A significantly higher prevalence of hypertension, cardiac disease, and serum reactive C-protein and lower albumin values in AKI-CKD patients was recorded. Mortality rate, invasive ventilation requirement, and D-dimer levels were significantly higher in AKI-NRF patients.

CONCLUSION: Different clinical patterns between AKI-NRF and AKI-CKD were documented.

PMID:35258071 | DOI:10.1590/2175-8239-JBN-2021-0161

Biosci Rep. 2022 Mar 8:BSR20212084. doi: 10.1042/BSR20212084. Online ahead of print.

ABSTRACT

Bacterial virulence factors are often located in their genomic islands (GIs). Helicobacter pylori, a highly diverse organism is reported to be associated with several gastrointestinal diseases like, gastritis, gastric cancer, peptic ulcer, duodenal ulcer etc. A novel similarity score-based comparative analysis with GIs of fifty H. pylori strains revealed clear idea of the various factors which promote disease progression. Two putative pathogenic GIs in some of the H. pylori strains were identified. One GI, having a putative labile enterotoxin and other dynamin-like proteins (DLPs), is predicted to increase the release of toxin by membrane vesicular formation. Another island contains a virulence-associated protein D (vapD) which is a component of a type-II toxin-antitoxin system (TAs), leads to enhance the severity of the H. pylori infection. Besides the well-known virulence factors like CagA, and VacA, several GIs have been identified which showed to have direct or indirect impact on H. pylori clinical outcomes. One such GI, containing lipopolysaccharide (LPS) biosynthesis genes was revealed to be directly connected with disease development by inhibiting the immune response. Another collagenase-containing GI worsens ulcers by slowing down the healing process. GI consisted of fliD operon was found to be connected to flagellar assembly and biofilm production. By residing in biofilms, bacteria can avoid antibiotic therapy, resulting in chronic infection. Along with well-studied CagA and VacA virulent genes, it is equally important to study these identified virulence factors for better understanding H. pylori induced disease prognosis.

PMID:35258077 | DOI:10.1042/BSR20212084

Lab Chip. 2022 Mar 8. doi: 10.1039/d1lc01175h. Online ahead of print.

ABSTRACT

The digital polymerase chain reaction (dPCR) is an irreplaceable variant of PCR techniques due to its capacity for absolute quantification and detection of rare deoxyribonucleic acid (DNA) sequences in clinical samples. Image processing methods, including micro-chamber positioning and fluorescence analysis, determine the reliability of the dPCR results. However, typical methods demand high requirements for the chip structure, chip filling, and light intensity uniformity. This research developed an image-to-answer algorithm with single fluorescence image capture and known image-related error removal. We applied the Hough transform to identify partitions in the images of dPCR chips, the 2D Fourier transform to rotate the image, and the 3D projection transformation to locate and correct the positions of all partitions. We then calculated each partition’s average fluorescence amplitudes and generated a 3D fluorescence intensity distribution map of the image. We subsequently corrected the fluorescence non-uniformity between partitions based on the map and achieved statistical results of partition fluorescence intensities. We validated the proposed algorithms using different contents of the target DNA. The proposed algorithm is independent of the dPCR chip structure damage and light intensity non-uniformity. It also provides a reliable alternative to analyze the results of chip-based dPCR systems.

PMID:35258048 | DOI:10.1039/d1lc01175h

Blood Press Monit. 2022 Mar 7. doi: 10.1097/MBP.0000000000000589. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to evaluate the effects of blood pressure (BP) values obtained by 24-h ambulatory BP monitoring (ABPM) of hypertensive children and adolescents on left ventricular mass index (LVMI).

METHODS: Patients diagnosed with HT with BP measurements confirmed with ABPM and evaluated with echocardiography for LVMI were included. The patients were divided into two groups according to their BMI as obese and nonobese. SDSs of ABPM parameters were compared between the groups.

RESULTS: A total of 158 children with HT were included in the study. Ninety of these patients were obese. In obese and nonobese cases, mean SDS levels were similar in ABPM parameters, whereas LVMI was significantly higher in obese patients (P = 0.049). There was a significant correlation between LVMI and 24-h SBP SDS, daytime SBP SDS, 24-h SBP load and daytime BP load. In obese cases, there was a statistically significant correlation between LVMI and 24-h SBP SDS, daytime SBP SDS, 24-h SBP load, daytime SBP load as well as nighttime SBP SDS and nighttime SBP load. When the whole group was evaluated, 24-h SBP SDS was the most effective parameter influencing LVMI (P = 0.001). Similarly, the most effective ABPM parameter on LVMI in obese patients was 24-h SBP SDS (P = 0.001).

CONCLUSION: A significantly higher rate of LVMI in obese patients suggests that obesity itself is an effective factor on LVMI. In addition, systolic hypertension is more effective on cardiac functions compared with DBP measurements and systolic-DBP dipping ratios.

PMID:35258018 | DOI:10.1097/MBP.0000000000000589

Blood Press Monit. 2022 Mar 7. doi: 10.1097/MBP.0000000000000595. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is to determine the accuracy of the G.LAB MD41A0 upper-arm oscillometric blood pressure (BP) monitor for self/home BP measurement in patients with diabetes according to the Association for the Advancement of Medical Instrumentation /European Society of Hypertension /International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018).

METHODS: Patients with diabetes were recruited according to AAMI/ESH/ISO Universal Standard using the same arm sequential BP measurement method. The standard cuff of the test device was used for arm circumference 22-44 cm.

RESULTS: A total of 92 patients with diabetes were recruited and 85 were analyzed with an average age of 55.1 ± 17.7 years, 48 men, and arm circumference of 32.0 ± 6.0 cm. For the validation Criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 0.89 ± 6.04/-0.84 ± 5.11 mmHg (systolic/diastolic). For Criterion 2, the SD of the averaged BP differences between the test device and reference BP per subject was 4.23/4.19 mmHg (systolic/diastolic).

CONCLUSION: The G.LAB MD41A0 upper arm BP monitor fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) in patients with diabetes and can be recommended for self/home use.

PMID:35258022 | DOI:10.1097/MBP.0000000000000595

ESC Heart Fail. 2022 Mar 8. doi: 10.1002/ehf2.13872. Online ahead of print.

ABSTRACT

AIMS: This study aimed to profile the changes in non-invasive clinical, biochemical, and imaging markers during withdrawal of therapy in patients with recovered dilated cardiomyopathy, providing insights into the pathophysiology of relapse.

METHODS AND RESULTS: Clinical, biochemical, and imaging data from patients during phased withdrawal of therapy in the randomized or single-arm cross-over phases of TRED-HF were profiled. Clinical variables were measured at each study visit and imaging variables were measured at baseline, 16 weeks, and 6 months. Amongst the 49 patients [35% women, mean age 53.6 years (standard deviation 11.6)] who withdrew therapy, 20 relapsed. Increases in mean heart rate [7.6 beats per minute (95% confidence interval, CI, 4.5, 10.7)], systolic blood pressure [6.6 mmHg (95% CI 2.7, 10.5)], and diastolic blood pressure [5.8 mmHg (95% CI 3.1, 8.5)] were observed within 4-8 weeks of starting to withdraw therapy. A rise in mean left ventricular (LV) mass [5.1 g/m² (95% CI 2.8, 7.3)] and LV end-diastolic volume [3.9 mL/m² (95% CI 1.1, 6.7)] and a reduction in mean LV ejection fraction [-4.2 (95% CI -6.6, -1.8)] were seen by 16 weeks, the earliest imaging follow-up. Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) fell immediately after withdrawing beta-blockers and only tended to increase 6 months after beginning therapy withdrawal [mean change in log NT-proBNP at 6 months: 0.2 (95% CI -0.1, 0.4)].

CONCLUSIONS: Changes in plasma NT-proBNP are a late feature of relapse, often months after a reduction in LV function. A rise in heart rate and blood pressure is observed soon after withdrawing therapy in recovered dilated cardiomyopathy, typically accompanied or closely followed by early changes in LV structure and function.

PMID:35257498 | DOI:10.1002/ehf2.13872