Category: Statistics

Eur J Dent. 2022 Jan 11. doi: 10.1055/s-0041-1735931. Online ahead of print.

ABSTRACT

OBJECTIVE: Antibiotics misuse and a high level of antibiotics resistance is observed worldwide, but particularly in developing countries. Kosovo in the last decade is facing challenges regarding antimicrobial resistance. The purpose of the present study was to investigate patterns of antibiotics prescriptions of dentists in Kosovo’s major dental clinics.

MATERIALS AND METHODS: For Kosovo’s prescribing pattern, data collection was obtained from 10 Regional Dental Clinics and a Tertiary Health Center regarding patients who were prescribed antibiotics in the years 2015 to 2019. Data analysis was performed by using descriptive statistics and was processed by using MS Excel.

RESULTS: Most prescribed antibiotic during the observed period from 2015 to 2019 in Kosovo was amoxicillin, although a drastic increase of amoxicillin with clavulanic acid-as a broad-spectrum antibiotic-is observed. The trend of antibiotics use in tertiary health institutions is in an overall decrease in Kosovo with an exception in the year 2017. Despite this overall decrease, inconsistency in prescribing is observed when the pattern is analyzed for each region separately. The highest number of patients in health care dental clinics received antibiotics for maxilla-related health conditions and the lowest number of them for oncologic ones.

CONCLUSION: The patterns of antibiotics prescriptions by dental practitioners in Kosovo during the years 2015 to 2019 are fluctuating. Compared with the global health care standards, the irrational use of antibiotics in dental health care clinics in Kosovo still exist and this issue should be further addressed by respective actors.

PMID:35016236 | DOI:10.1055/s-0041-1735931

Eur J Dent. 2022 Jan 11. doi: 10.1055/s-0041-1735937. Online ahead of print.

ABSTRACT

OBJECTIVE: Different post-sintering processes are expected to be a reason for alteration in the strength of zirconia. This study evaluated the effect of post-sintering processes on the flexural strength of different types of monolithic zirconia.

MATERIALS AND METHODS: A total of 120 classical- (Cz) and high-translucent (Hz) monolithic zirconia discs (1.2 mm thickness and 14 mm in Ø) were prepared, sintered, and randomly divided into four groups to be surface-treated with (1) as-glazed (AG); (2) finished and polished (FP); (3) finished, polished, and overglazed (FPOG); and (4) finished, polished, and heat-treated (FPHT) technique (n = 15). Biaxial flexural strength (σ) was determined on a piston-on-three ball in a universal testing machine at a speed of 0.5 mm/min.

STATISTICAL ANALYSIS: Analysis of variance, and post hoc Bonferroni multiple comparisons were determined for significant differences (α = 0.05). Weibull analysis was applied for survival probability, Weibull modulus (m), and characteristic strength (σ₀). The microstructures were examined with a scanning electron microscope and X-ray diffraction.

RESULTS: The mean ± standard deviation value of σ (MPa), m, and σ₀ were 1,626.43 ± 184.38, 9.51, and 1,709.79 for CzAG; 1,734.98 ± 136.15, 12.83, and 1,799.17 for CzFP; 1,636.92 ± 130.11, 14.66, and 1,697.63 for CzFPOG; and 1,590.78 ± 161.74, 10.13, and 1,663.82 for CzFPHT; 643.30 ± 118.59, 5.59, and 695.55 for HzAG; 671.52 ± 96.77, 3.28, and 782.61 for HzFP; 556.33 ± 122.85, 4.76, and 607.01 for HzFPOG; and 598.36 ± 57.96, 11.22, and 624.89 for HzFPHT. The σ was significantly affected by the post-sintering process and type of zirconia (p < 0.05), but not by their interactions (p > 0.05). The Cz indicated a significantly higher σ than Hz. The FP process significantly enhanced σ more than other treatment procedures.

CONCLUSION: Post-sintering processes enabled an alteration in σ of zirconia. FP enhanced σ, while FPOG and FPHT resulted in a reduction of σ. Glazing tends to induce defects at the glazing interface, while heat treatment induces a phase change to tetragonal, both resulted in reducing σ. Finishing and polishing for both Cz and Hz monolithic zirconia is recommended, while overglazed or heat-treated is not suggested.

PMID:35016234 | DOI:10.1055/s-0041-1735937

Eur J Dent. 2022 Jan 11. doi: 10.1055/s-0041-1739447. Online ahead of print.

ABSTRACT

OBJECTIVE: Canine impaction is a difficult condition to treat, and it usually necessitates a combination of surgical exposure and orthodontic traction or surgical extraction. An accurate assessment of the maxillary canine’s position can help determine the severity of the impaction, the difficulty of therapy, and the treatment’s prognosis.

MATERIALS AND METHODS: A total of 55 impacted canines were studied and selected retrospectively. Difficulty indexes were used to measure the severity of impaction with pretreatment panoramic radiographs.

STATISTICAL ANALYSIS: Pearson correlation was used to test the validity of the difficulty index modification score. Regression statistical analysis was used to evaluate any correlation between total scoring from each index with surgical treatment.

RESULTS: The validity test on the variable modification index score showed a valid value (p = 0.000). According to both treatment difficulty and modification index, odontectomy group showed higher mean of total scoring than surgical exposure group. Treatment difficulty and modification index showed a significant correlation with surgical treatment (p = 0.003 and p = 0.001).

CONCLUSIONS: The higher the severity of canine impaction, the greater is the possibility of odontectomy than surgical exposure. Both indexes can consider to be used in determining surgical treatment planning.

PMID:35016233 | DOI:10.1055/s-0041-1739447

Eur J Dent. 2022 Jan 11. doi: 10.1055/s-0041-1739438. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate and compare the first tooth contact region, occlusion time, time to generate total force, and force distribution between open bite (OB) and non-OB (NOB) patients at the maximum intercuspation position using the T-Scan III system.

MATERIALS AND METHODS: Sixteen patients were divided into the OB and NOB groups (n = 8 for each group). The T-Scan III system was used to evaluate the first tooth contact region, occlusion time, time to generate total force, and force distribution.

STATISTICAL ANALYSIS: The mean patient age, overjet, overbite, occlusion time, and time to generate total force were compared between the groups by independent samples t-test. Relative force distributions between groups and among regions were compared by the Mann-Whitney U- and Kruskal-Wallis H-tests, respectively. A probability value of less than 5% (p < 0.05) was considered significant.

RESULTS: Differences in the first tooth contact region between groups were observed. The molar region was the first tooth contact region in the OB group, while first tooth contact was observed in all regions in the NOB group. Neither the occlusion time nor the time to generate total force was significantly different between the groups (p > 0.05). The highest force distributions were observed in the molar regions in both groups. Significant intragroup differences were found among all regions (p < 0.05), except between the anterior and premolar regions in the NOB group (p = 0.317). Intergroup differences in the force distributions in the anterior (p = 0.000), premolar (p = 0.038), and molar (p = 0.007) regions were significant.

CONCLUSION: Unlike in the NOB group, in which first tooth contact occurred in every region, in the OB group, first tooth contact occurred only in the molar region. Compared with those in the NOB group, the force distributions in the OB group were approximately 1.5 times higher in the molar region but were significantly lower in the anterior and premolar regions.

PMID:35016230 | DOI:10.1055/s-0041-1739438

Eur J Dent. 2022 Jan 11. doi: 10.1055/s-0041-1736418. Online ahead of print.

ABSTRACT

OBJECTIVES: The use of herbal dentifrices has grown exponentially over the years. They are categorically referred to as ethnomedicines. Various agents have been tried with contradicting findings based on phytopharmacological analysis. Miswak is one agent which has been used over the years. A novel Moringa oleifera-based dentifrice has shown promising results in terms of its cytotoxicity, biocompatibility, and as a potent anti-inflammatory agent. Therefore, the present study aims to compare the efficacy of two commercially available miswak- and moringa-based herbal dentifrices on the reduction of plaque and gingivitis scores.

MATERIALS AND METHODS: This randomized clinical crossover study included 20 subjects with mild to moderate gingivitis. The study was conducted over a total examination period of 20 days with a wash-out period of 2 weeks between the use of both the toothpastes. The plaque index and gingival index of the study subjects were recorded at the designated time intervals throughout the study period.

STATISTICAL ANALYSIS: The data collected were entered on Microsoft Excel, and statistical analysis using SPSS software (SPSS version 28, IBM Corp, Armonk, New York, United States) was done. The statistical test used was the Wilcoxon signed-rank test. Moreover, p ≤0.05 was considered significant.

RESULTS: The results showed that the reduction in mean gingival index scores from baseline to day 3 was more statistically significant in the moringa-based dentifrice. Similarly, the plaque index scores showed statistically significant reduction following the use of the moringa-based dentifrice when compared with the miswak dentifrice. This study reveals that the moringa dentifrice is a safe and effective agent in reducing plaque accumulation and treating gingival inflammation.

CONCLUSION: The current study aims to provide an insight into the possible role of moringa dentifrice as a possible adjunctive oral hygiene aid.

PMID:35016231 | DOI:10.1055/s-0041-1736418

Clin Infect Dis. 2022 Jan 7:ciab1029. doi: 10.1093/cid/ciab1029. Online ahead of print.

ABSTRACT

BACKGROUND: The degree to which the 2019 novel coronavirus disease (COVID-19) pandemic will affect the US human immunodeficiency virus (HIV) epidemic is unclear.

METHODS: We used the Johns Hopkins Epidemiologic and Economic Model to project HIV infections from 2020 to 2025 in 32 US metropolitan statistical areas (MSAs). We sampled a range of effects of the pandemic on sexual transmission (0-50% reduction), viral suppression among people with HIV (0-40% reduction), HIV testing (0-50% reduction), and pre-exposure prophylaxis use (0-30% reduction), and indexed reductions over time to Google Community Mobility Reports.

RESULTS: Simulations projected reported diagnoses would drop in 2020 and rebound in 2021 or 2022, regardless of underlying incidence. If sexual transmission normalized by July 2021 and HIV care normalized by January 2022, we projected 1,161 (1%) more infections from 2020 to 2025 across all 32 cities than if COVID had not occurred. Among “optimistic” simulations in which sexual transmission was sharply reduced and viral suppression was maintained we projected 8% lower incidence (95% credible interval: 14% lower to no change). Among “pessimistic” simulations where sexual transmission was largely unchanged but viral suppression fell, we projected 11% higher incidence (1% to 21% higher). MSA-specific projections are available at jheem.org?covid.

CONCLUSIONS: The effects of COVID-19 on HIV transmission remain uncertain and differ between cities. Reported diagnoses of HIV in 2020-2021 are likely to correlate poorly with underlying incidence. Minimizing disruptions to HIV care is critical to mitigating negative effects of the COVID-19 pandemic on HIV transmission.

PMID:35016216 | DOI:10.1093/cid/ciab1029

Eur J Dent. 2022 Jan 11. doi: 10.1055/s-0041-1739442. Online ahead of print.

ABSTRACT

OBJECTIVES: Diabetes mellitus (DM) is a major risk factor for periodontitis. Susceptibility to periodontitis increases approximately three times in people with DM. There is a clear relationship between the degree of hyperglycemia and the severity of periodontitis. This study aimed to analyze the reduction of tumor necrosis factor-α (TNF-α) in diabetics who came for periodontitis examination to prevent exacerbations.

MATERIALS AND METHODS: This was an analytic observational study using a cross-sectional approach at health centers in Surabaya, Indonesia. Measurement of periodontal status used the community periodontal index of treatment needs by measuring bleeding at probing and pocket depth. TNF-α was measured using enzyme-linked immunosorbent assay, and behavior and lifestyle using a questionnaire.

STATISTICAL ANALYSIS: The Kolmogorov-Smirnov test was performed to identify data normality (p < 0.05). A nonparametric test was used to measure the degree of association between different characteristics and the incidence of periodontitis in type 2 DM patients with and without periodontitis. Spearman’s test was done to examine the correlation between TNF-α level and severity of periodontitis in diabetics. The significant level was at p <0.05.

RESULTS: There was a correlation between age, predisposing factors, reinforcing factors, drug consumption, and TNF-α levels in patients with type 2 DM and the incidence of periodontitis.

CONCLUSIONS: Poor glycemic control can induce oxidative stress on the gingiva, thereby aggravating damage to periodontal tissue. An important factor in preventing periodontitis for type 2 DM patients is controlling blood sugar levels through regular consumption of drugs and regular maintenance of oral cavity health. Knowledge is a predisposing factor that affects adherence of people with type 2 DM to consuming drugs regularly, which can be strengthened by family support. These will ultimately play a role in reducing TNF-α levels.

PMID:35016229 | DOI:10.1055/s-0041-1739442

Adv Nutr. 2021 Nov 23:nmab140. doi: 10.1093/advances/nmab140. Online ahead of print.

ABSTRACT

Whether older adults need more protein than younger adults is debated. The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert committee of the Health Council of the Netherlands conducted a systematic review (SR) of randomized controlled trials (RCTs) examining the effect of increased protein intake on health outcomes in older adults from the general population with an average habitual protein intake ≥0.8 g/(kg BW · d). Exposures were the following: 1) extra protein compared with no protein and 2) extra protein and physical exercise compared with physical exercise. Outcomes included lean body mass, muscle strength, physical performance, bone health, blood pressure, serum glucose and insulin, serum lipids, kidney function, and cognition. Data of >1300 subjects from 18 RCTs were used. Risk of bias was judged as high (n = 9) or “some concerns” (n = 9). In 7 of 18 RCTs, increased protein intake beneficially affected ≥1 of the tested outcome measures of lean body mass. For muscle strength, this applied to 3 of 8 RCTs in the context of physical exercise and in 1 of 7 RCTs without physical exercise. For the other outcomes, <30% (0-29%) of RCTs showed a statistically significant effect. The committee concluded that increased protein intake has a possible beneficial effect on lean body mass and, when combined with physical exercise, muscle strength; likely no effect on muscle strength when not combined with physical exercise, or on physical performance and bone health; an ambiguous effect on serum lipids; and that too few RCTs were available to allow for conclusions on the other outcomes. This SR provides insufficiently convincing data that increasing protein in older adults with a protein intake ≥0.8 g/(kg BW · d) elicits health benefits.

PMID:35016214 | DOI:10.1093/advances/nmab140

Eur Heart J. 2022 Jan 7:ehab892. doi: 10.1093/eurheartj/ehab892. Online ahead of print.

ABSTRACT

AIMS: This report from the European Society of Cardiology (ESC) Atlas Project updates and expands upon the widely cited 2019 report in presenting cardiovascular disease (CVD) statistics for the 57 ESC member countries.

METHODS AND RESULTS: Statistics pertaining to 2019, or the latest available year, are presented. Data sources include the World Health Organization, the Institute for Health Metrics and Evaluation, the World Bank, and novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery. New material in this report includes sociodemographic and environmental determinants of CVD, rheumatic heart disease, out-of-hospital cardiac arrest, left-sided valvular heart disease, the advocacy potential of these CVD statistics, and progress towards World Health Organization (WHO) 2025 targets for non-communicable diseases. Salient observations in this report: (i) Females born in ESC member countries in 2018 are expected to live 80.8 years and males 74.8 years. Life expectancy is longer in high income (81.6 years) compared with middle-income (74.2 years) countries. (ii) In 2018, high-income countries spent, on average, four times more on healthcare than middle-income countries. (iii) The median PM2.5 concentrations in 2019 were over twice as high in middle-income ESC member countries compared with high-income countries and exceeded the EU air quality standard in 14 countries, all middle-income. (iv) In 2016, more than one in five adults across the ESC member countries were obese with similar prevalence in high and low-income countries. The prevalence of obesity has more than doubled over the past 35 years. (v) The burden of CVD falls hardest on middle-income ESC member countries where estimated incidence rates are ∼30% higher compared with high-income countries. This is reflected in disability-adjusted life years due to CVD which are nearly four times as high in middle-income compared with high-income countries. (vi) The incidence of calcific aortic valve disease has increased seven-fold during the last 30 years, with age-standardized rates four times as high in high-income compared with middle-income countries. (vii) Although the total number of CVD deaths across all countries far exceeds the number of cancer deaths for both sexes, there are 15 ESC member countries in which cancer accounts for more deaths than CVD in males and five-member countries in which cancer accounts for more deaths than CVD in females. (viii) The under-resourced status of middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, ablation procedures, device implantation, and cardiac surgical procedures.

CONCLUSION: Risk factors and unhealthy behaviours are potentially reversible, and this provides a huge opportunity to address the health inequalities across ESC member countries that are highlighted in this report. It seems clear, however, that efforts to seize this opportunity are falling short and present evidence suggests that most of the WHO NCD targets for 2025 are unlikely to be met across ESC member countries.

PMID:35016208 | DOI:10.1093/eurheartj/ehab892

Neural Comput. 2022 Jan 11:1-38. doi: 10.1162/neco_a_01468. Online ahead of print.

ABSTRACT

We propose a novel method for enforcing AI fairness with respect to protected or sensitive factors. This method uses a dual strategy performing training and representation alteration (TARA) for the mitigation of prominent causes of AI bias. It includes the use of representation learning alteration via adversarial independence to suppress the bias-inducing dependence of the data representation from protected factors and training set alteration via intelligent augmentation to address bias-causing data imbalance by using generative models that allow the fine control of sensitive factors related to underrepresented populations via domain adaptation and latent space manipulation. When testing our methods on image analytics, experiments demonstrate that TARA significantly or fully debiases baseline models while outperforming competing debiasing methods that have the same amount of information-for example, with (% overall accuracy, % accuracy gap) = (78.8, 0.5) versus the baseline method’s score of (71.8, 10.5) for Eye-PACS, and (73.7, 11.8) versus (69.1, 21.7) for CelebA. Furthermore, recognizing certain limitations in current metrics used for assessing debiasing performance, we propose novel conjunctive debiasing metrics. Our experiments also demonstrate the ability of these novel metrics in assessing the Pareto efficiency of the proposed methods.

PMID:35016212 | DOI:10.1162/neco_a_01468