Category: Statistics

J Glob Health. 2021 Aug 21;11:05020. doi: 10.7189/jogh.11.05020. eCollection 2021.

ABSTRACT

BACKGROUND: Around the globe, various self-quarantine, social distancing, and school-closure policies were implemented during the coronavirus disease-19 (COVID-19) outbreak to reduce disease transmission. Many economies/territories were compelled to consider digital learning modalities. In particular, increased digital learning engagement with digital devices and mounting psychosocial stress due to social isolation are likely to pose adverse risks for youth visual health globally. This study examines the association between increased digital device use, psychosocial stress, and myopia symptoms among Chinese youth during the COVID-19 pandemic.

METHODS: This is a retrospective observational population study consisting of 3918 participants enrolled in primary, secondary, and university in China. Participants are recruited through an online survey, which included self-reported information on daily digital device use, psychosocial stress level, condition of visual acuity, and demographic information. We utilize statistical tools including χ² test, paired sample t test, and multiple multivariate logistic regression.

RESULTS: Each hour increase in digital device use is associated with 1.25 odds ratio OR (95% confidence interval (CI) = 1.21-1.30; P < 0.001) increased risk of developing myopic symptoms, each additional hour of digital device use weighted by near-view and blue-light exposure is associated with OR = 1.04 OR (95% CI = 1.03-1.05; P < 0.001) and OR = 2.25 (95% CI = 1.94-2.60; P < 0.001) increased risk respectively. Subjects reporting under stressful conditions are between OR = 1.98 (95% CI = 1.67-2.36; P < 0.001) and OR = 2.03 (95% CI = 1.71-2.42; P < 0.001) more likely to develop myopic symptoms, relative to those citing less stress.

CONCLUSIONS: The COVID-19 pandemic led to favorable conditions for myopigenic behavioral changes characterized by extended sedentary engagement with digital devices, which are significantly associated with higher risks of myopia incidence. Relatedly, psychosocial stress accompanying prolonged social isolation during the pandemic is a less noticeable, albeit significant risk factor for myopia development.

PMID:34484707 | PMC:PMC8397325 | DOI:10.7189/jogh.11.05020

J Glob Health. 2021 Aug 10;11:13007. doi: 10.7189/jogh.11.13007. eCollection 2021.

ABSTRACT

BACKGROUND: Adolescence is a formative period when an individual acquires physical, cognitive, emotional, and social resources that are the foundation for later life, health, and well-being [1]. However, in West and Central African region, this trajectory is curtailed by early childbearing associated with an increased risk of undernutrition and anemia. Evidence on socio-economic determinants of anemia and undernutrition in adolescent mothers is limited. This paper aims to shed some light on this issue and, more specifically, assess the socio-economic determinants of anemia among childbearing adolescents in the region.

METHODS: For this observational study, we pooled data from all Demographic and Health Surveys (DHS) conducted in countries in West and Central Africa region between 1986 and 2017. Outcomes were undernutrition and anemia in adolescent mothers. Predictors were education, wealth, place of residence (rural/urban), and religion. Descriptive statistics were calculated using survey weights for individual surveys and in the pooled sample each country was additionally weighted with its population share. We estimated multiple regression models with and without primary sampling unit fixed effects for both outcomes. All regressions were linear probability models.

RESULTS: Having no formal education was the strongest predictor for both anemia and undernutrition. Belonging to the richest asset quintile was also associated with lower anemia and undernutrition prevalence in some specifications. While urban location of the mother was positively associated with anemia, there was no association with undernutrition.

CONCLUSIONS: Overall, having any formal education emerged as a sole strong predictor of reduced adolescent maternal undernutrition and anemia. Promotion of female education can potentially serve as a high-impact intervention to improve adolescent girls’ health in the region. However, we cannot make conclusions about its causal impact based on this study alone.

PMID:34484714 | PMC:PMC8397284 | DOI:10.7189/jogh.11.13007

J Healthc Eng. 2021 Aug 26;2021:2146369. doi: 10.1155/2021/2146369. eCollection 2021.

ABSTRACT

In this pandemic situation, importance and awareness about mental health are getting more attention. Stress recognition from multimodal sensor based physiological signals such as electroencephalogram (EEG) and electrocardiography (ECG) signals is a very cost-effective way due to its noninvasive nature. A dataset, recorded during the mental arithmetic task, consisting of EEG + ECG signals of 36 participants is used. It contains two categories of performance, namely, “Good” (nonstressed) and “Bad” (stressed) (Gupta et al. 2018 and Eraldeír et al. 2018). This paper presents an effective approach for the recognition of stress marker at frontal, temporal, central, and occipital lobes. It processes the multimodality physiological signals. The variational mode decomposition (VMD) strategy is used for data preprocessing and for the decomposition of signals into various oscillatory mode functions. Poincare plots (PP) are derived from the first eight variational modes and features from these plots have been extracted such as mean, area, and central tendency measure of the elliptical region. The statistical significance of the extracted features with p < 0.5 has been performed using the Wilcoxson test. The multilayer perceptron (MPLN) and Support Vector Machine (SVM) algorithms are used for the classification of stress and nonstress categories. MLPN has achieved the maximum accuracies of 100% for frontal and temporal lobes. The suggested method can be incorporated in noninvasive EEG signal processing based automated stress identification systems.

PMID:34484651 | PMC:PMC8413068 | DOI:10.1155/2021/2146369

J Healthc Eng. 2021 Aug 24;2021:6421025. doi: 10.1155/2021/6421025. eCollection 2021.

ABSTRACT

The objective of the research study is to investigate the use of three-dimensional ultrasonic measurement technology, to determine the size of gestational sac and embryo volume, and to use the ratio of gestational sac volume to embryo volume in IoT-based prediction of pregnancy outcome. The abnormal and normal pregnancy identifiers are there, which assists in prediction of pregnancy outcomes: whether the pregnancy is normal or may suffer pregnancy loss during first trimester. For the observational study, 500 singleton pregnant women who made an appointment for delivery in Qiqihar Hospital from January 2015 to June 2019 were considered. The 500 pregnant women received transvaginal ultrasound at 6⁺⁰ ∼ 8⁺⁰ weeks of gestational age to measure gestational sac volume (GSV), yolk sac volume (YSV), and germ volume (GV). According to pregnancy outcome, they were divided into fine group (n = 435) and abortion group (n = 65). Among the 500 cases, 435 had normal delivery and 65 had abortions. According to the results of gestational age (GA) analysis, the pregnancy success rates at 6 (n = 268), 7 (n = 184), and 8 weeks (n = 48) were 85.8%, 87.5%, and 91.7%, respectively. Comparison of pregnancy failure rate among the three groups shows statistically significant difference. The morphology of germ, yolk sac, and gestational sac cannot be used as a predictor of pregnancy outcome in various degrees. The results of multivariate Cox proportional regression analysis show the following: the ratio of germ volume (GV) to gestational sac volume (GSV) (P=0.008) has an impact on the prediction of spontaneous abortion prognosis, showing statistically significant difference; yolk sac volume (YSV), germ volume (GV), and gestational sac volume (GSV) have no effect on the prediction of spontaneous abortion prognosis (P > 0.05). The ratio of GSV to germ volume has a strong prognostic value for pregnancy results. To a certain extent, the ratio of gestational sac volume to germ volume can predict spontaneous pregnancy abortion at 6th week of gestation, providing a theoretical basis for clinical ultrasound pregnancy examination indicators.

PMID:34484654 | PMC:PMC8410420 | DOI:10.1155/2021/6421025

Clin Orthop Surg. 2021 Sep;13(3):352-357. doi: 10.4055/cios20168. Epub 2021 Jun 3.

ABSTRACT

BACKGROUD: Femoral internal rotation in total knee arthroplasty (TKA) is well known as one of the main causes of patellar maltracking. Although femoral internal rotation in TKA is considered unacceptable due to the risk of patellar maltracking, it is sometimes required for ligament balancing. We evaluated the influence of femoral internal rotation on patellar tracking in TKA performed using the gap technique.

METHODS: From April 2008 to May 2018, 1,612 cases of TKA were done. Among them, 245 cases of TKA for osteoarthritis were followed up for at least 1 year and included in this study. We compared patellar tracking in two groups; group I consisted of 99 cases whose femoral rotation was less than 0° and group II consisted of 146 cases whose femoral rotation was 3°-5° external rotation. Preoperative femoral rotation was measured with the condylar twist angle (CTA) by using computed tomography. The patella was replaced in all cases. Patellar tracking was evaluated with patellar tilt angle (lateral tilt [+] and medial tilt [-]) in the merchant radiograph. Statistical analysis was done using Mann-Whitney U-test. Clinical assessment was performed using the Knee Society clinical rating system.

RESULTS: The preoperative CTA was 5.3° ± 1.6° in group I and 5.4° ± 1.6° in group II, showing no statistically significant difference between groups (p = 0.455). Intraoperative femoral rotation was -0.5° ± 0.8° in group I and 3.9° ± 0.8° in group II when the gap technique was used (p < 0.001). The postoperative patellar tilt angle was -0.4° ± 3.6° in group I and 0.1° ± 4.1° in group II with no statistically significant difference (p = 0.251).

CONCLUSIONS: Compared with femoral external rotation, femoral internal rotation with ligament balance in TKA was not more associated with patellar maltracking. Therefore, patellar tracking might be related with ligament balance in flexion regardless of the anatomic femoral rotational alignment.

PMID:34484628 | PMC:PMC8380535 | DOI:10.4055/cios20168

Clin Orthop Surg. 2021 Sep;13(3):358-365. doi: 10.4055/cios20226. Epub 2021 Apr 12.

ABSTRACT

BACKGROUD: Optimal placement of the components and achieving a neutral mechanical axis are the main goals of total knee arthroplasty (TKA). Different computerised navigation systems are presently used for these purposes. This aim of this study was to compare the pinless navigation (PNA) TKA performed using iAssist with the conventional instrumented (CIN) TKA in terms of functional and radiological outcomes.

METHODS: A total of 100 knees operated for TKA by a single surgeon were studied retrospectively for a period of 2 years. Weight-bearing postoperative radiographs of the knees along with scanograms of the lower limbs were used for measurements of component positioning, mechanical axis alignment, and number of outliers. Oxford knee scoring was used for functional analysis.

RESULTS: No statistically significant difference was seen in the mean mechanical axis alignment (hip-knee-ankle angle), coronal alignment (α and β angles) and sagittal alignment (γ and δ angles) of the femoral and tibial components between the two groups. Though the percentage of outliers for mechanical axis alignment was lower in the PNA-TKA group than in the CIN-TKA group, the difference was not statistically significant (p = 0.73). The number of outliers for the femoral and tibial component positioning in coronal and sagittal planes was not statistically significantly different between the two groups. No statistically significant difference (p = 0.68) was noted between the two groups with respect to the Oxford Knee Score. The mean surgical time was greater in the PNA-TKA group by 11 minutes, which was statistically significantly longer (p = 0.018). Complications were seen in 6.89% of the cases in the CIN-TKA group, while none in the PNA-TKA group.

CONCLUSIONS: The accurate mechanical axis alignment and component positioning can be achieved with the conventional instrumentation, so the use of PNA system, which adds to the surgical cost, is questionable. Also, equally good short-term functional outcome can be achieved with the conventional instrumentation. The surgeon must be accustomed with the instrumentation of the PNA system, or it adds to the surgical time.

PMID:34484629 | PMC:PMC8380527 | DOI:10.4055/cios20226

J Dent Sci. 2021 Oct;16(4):1154-1161. doi: 10.1016/j.jds.2021.03.009. Epub 2021 Apr 7.

ABSTRACT

BACKGROUND/PURPOSE: Radiological examination is indispensable in the diagnosis and follow-up of cemento-osseous dysplasia (COD). The aim of this retrospective study was to describe a series of COD cases, identify the frequencies of COD subtypes, and investigate the demographic and radiological characteristics in relation to subtypes.

MATERIALS AND METHODS: Cone beam computed tomography (CBCT) images/reports of patients with a diagnosis of COD were included in the study. The data collected included information on the age, sex, subtype of COD, location of COD, and region involved. Information regarding the internal density, effects on surrounding structures, and presence of concomitant lesions was also collected. The data obtained were evaluated statistically.

RESULTS: The study group included CBCT images of 142 patients (130 females (91.5%) and 12 males (8.5%)) with a mean age of 46.97 ± 10.57 years. The mandible was involved in almost all cases (99.3%). The most common subtype was florid COD (51.4%) and lesions with hyperdense internal density (81.7%) were more commonly observed. Cortical thinning (78.2%) was a prominent feature. The frequency of root resorption in periapical COD cases (57.1%) was observed to be significantly higher (p < 0.05). All hypercementosis cases were associated with florid subtype (p < 0.05). In a minority of cases (6.3%), the lesions were associated with bone cysts and osteomyelitis.

CONCLUSION: CBCT images clearly demonstrated the effect of COD lesions on surrounding structures. CBCT is an appropriate imaging modality for the diagnosis and follow-up of COD which is the most common fibro-osseous lesion in clinical practice.

PMID:34484583 | PMC:PMC8403794 | DOI:10.1016/j.jds.2021.03.009

J Dent Sci. 2021 Oct;16(4):1182-1190. doi: 10.1016/j.jds.2021.02.010. Epub 2021 Apr 1.

ABSTRACT

BACKGROUND/PURPOSE: Endodontic treatment is basically dependent on knowledge of the root canal anatomy. This study aimed to analyze the root canal configuration of mandibular anterior teeth in an Iraqi subpopulation using cone-beam computed tomography (CBCT) imaging.

MATERIALS AND METHODS: A total of 305 CBCT scans involving 1794 mandibular permanent anterior teeth were evaluated. The number of roots, root canals, root canal system configuration according to Vertucci classification, and bilateral symmetry in root number and root canal number were recorded and statistically analyzed. The effects of gender and age on the incidence of root canal morphology and root canal number were investigated. Chi-square test was used to determine the level of significance (p < 0.05) and Kappa value was used to check reliability of results of the research.

RESULTS: Among the study patients, double root canals were found in (right 26.1% and left 26.4%) mandibular central incisors, in lateral incisors (right 28% and left 30.4%) and canines (right 11.7% and left 11%). Most teeth (77.8%) had a Type I Vertucci configuration and Type V was the least common and only present in canines (0.8%). All examined incisors presented with only one root and only around 2% of canines had two roots. Gender differences were identified for central incisors, while for lateral incisors and canines there were none. Patients older than 60 years had fewer teeth with double root canals (p < 0.05). Slight bilateral asymmetries appeared in central, lateral incisors, and canines in relation to root and root canal numbers.

CONCLUSION: Single rooted with Type I canal configuration is the most prevalent in mandibular anterior teeth in the Iraqi subpopulation. However, the incidence of more than one root canal with different canal configurations is also detected.

PMID:34484586 | PMC:PMC8403811 | DOI:10.1016/j.jds.2021.02.010

Scanning. 2021 Aug 16;2021:2679012. doi: 10.1155/2021/2679012. eCollection 2021.

ABSTRACT

This study was aimed to evaluate the diagnostic accuracy of cone beam computed tomography (CBCT) in detecting noncavitated approximal caries at different exposure parameters and to assess the impact of artifacts generated by amalgam restorations in an in vitro study. Seventy-eight approximal surfaces of extracted teeth were prepared with intentionally created noncavitated approximal caries of different depths; then, thirteen teeth with class 2 amalgam restorations were replaced with one tooth with normal surfaces in each block. CBCT volumes for all teeth were acquired using a Planmeca Promax 3D Mid imaging unit before and after placement of amalgam teeth, with different exposure parameters at low and high definition, both applying and omitting the Metal Artifact Reduction algorithm. The lesions were classified into four groups with regard to lesion extension. All teeth underwent histological analysis as gold standard. The histological examination showed that the distribution of lesions was as follows: 39.8% sound, enamel lesions of less and more than half the enamel thickness each 17.8%, and 24.6% dentin lesions. The detection sensitivity was found to be 0.972%, and specificity was found to be 0.937% for the detection of noncavitated approximal initial enamel and dentin caries. The highest diagnostic accuracy was found when using operating parameters of 90 kV_p, 8 mA, and high resolution (75 μm) with nonamalgam teeth; all modes showed statistically significant higher AUCs than mode 2 (80 kV_p, 7 mA, and 75 μm). However, for teeth with amalgam restorations, the highest accuracy was obtained at low resolution (200 μm) with the other parameters kept the same. It could be concluded that increasing the peak voltage and current improves diagnostic accuracy for the detection of noncavitated approximal caries. Moreover, diagnostic accuracy was found to be higher upon using high spatial resolution when diagnosing caries without adjacent amalgam restorations. There is a statistically significant difference with and without amalgam with respect to all modes.

PMID:34484553 | PMC:PMC8384543 | DOI:10.1155/2021/2679012

J Dent Sci. 2021 Oct;16(4):1117-1124. doi: 10.1016/j.jds.2021.04.020. Epub 2021 Jun 10.

ABSTRACT

BACKGROUND/PURPOSE: Local anesthesia (LA) application is a routine dental work in clinic. The aim of present study was to evaluate the extent of biologic effects of LA on periodontal ligaments (PDL) or bone cells (MG63).

MATERIALS AND METHODS: Local anesthetics (LAs) at different concentrations were added to PDL and MG 63 cells. The viability of the cells was analyzed using an MTT assay. The inflammatory markers, COX-2, IL-1, IL-6 and TNF-A, of PDL and MG63 cells treated with LAs were analyzed with a Western blot assay. The extract medium of the LA-treated PDL cells was added to the MG63 cells for subsequent culture and to examine the RANKL, ALP, and OPG expression. The data were statistically analyzed with p < 0.05 set as an indication of significance.

RESULTS: The viability of the PDL and MG63 cells was less 50% at LAs concentrations above the 10 mM. At high LA concentrations, the PDL and MG63 cells treated with LAs became spherical in shape, or vesicles developed in the cytoplasm. The IL-1, IL-6, and TNF-A expression in the PDL groups showed no statistical differences between Septanest and Scandonest (p > 0.05). The RANKL expression in the MG63 cells increased as the Septanest and Scandonest concentrations were increased in the PDL extract medium (p < 0.05) after 48 h of culturing.

CONCLUSION: The LAs with adrenaline increased inflammation in the PDL and MG63 cells. The LA-treated PDL extract medium increased the RANKL expression in the MG63 cells.

PMID:34484578 | PMC:PMC8403788 | DOI:10.1016/j.jds.2021.04.020