Category: Statistics

Environ Sci Pollut Res Int. 2021 Nov 26. doi: 10.1007/s11356-021-17434-1. Online ahead of print.

ABSTRACT

Study was conducted utilizing a confirmed medication adherence scale to measure the socio-demographic profile, self-care, and medication adherence among Type-2 Diabetes Mellitus (T2DM) patients. The Fisher exact test was used to calculate the level of significance (P) using SPSS (Statistical Package for Social Sciences) Version 21.0. The research presented in this paper uses statistical evidence to assess the numerous aspects that may be linked to medication adherence. A prospective observational study was undertaken on participants visiting the outpatient department for 6 months at a North Indian tertiary care hospital to investigate the pattern and quality of life associated with T2DM. The study examined those who had T2DM for more than 2 years. At the time of the visit, subjects were interviewed using socio demographic information and a structured verified questionnaire. Fisher exact test was used to identify the parameters that were linked to medication adherence, with P0.05 being regarded statistically significant. A total of 350 T2DM outpatients were followed up on, with a male-to-female ratio of 1:0.95. A 13-item medication adherence scale was created and tested, revealing that approximately 32% of participants demonstrated high adherence to anti-diabetic drugs (score = 13). The P value was obtained using Fisher exact test for educational status, occupation, marital status, and the quantity and kind of anti-diabetic drugs was found to be 0.05. Only 32% of the respondents took their diabetes medication as prescribed, indicating the need to improve adherence among T2DM patients. The quantity and kind of anti-diabetic drugs, as well as the patients’ educational status, occupation, and marital status, all demonstrated a statistically significant relationship with medication adherence.

PMID:34826085 | DOI:10.1007/s11356-021-17434-1

Eur Geriatr Med. 2021 Nov 26. doi: 10.1007/s41999-021-00592-3. Online ahead of print.

ABSTRACT

INTRODUCTION: In 2019, The EWGSOP2 group made updates on the definition and diagnosis of sarcopenia. The aim of this study is to determine the possible risk factors for chemotherapy dose-limiting toxicity (DLT).

METHODS: Newly diagnosed gastrointestinal (GI) cancer patients were included in this prospective observational study. Chemotherapy DLTs were recorded in patients receiving platinum-based therapy. The patients were divided into two groups according to the current sarcopenia criteria.

RESULTS: 75 patients were included in the final analysis. Chemotherapy DLT occurred in 52% (n = 39) of all patients who received platinum-based chemotherapy. DLT rates were 78.9% and 42.9% in sarcopenic and non-sarcopenic patients, respectively (p = 0.007). According to the results of the multivariate analysis, the only sarcopenia was found as a statistically significant risk factor for DLT.

CONCLUSION: Assessment of sarcopenia evaluated with the current EWGSOP2 diagnostic criteria is useful in predicting chemotherapy DLT development in patients with a diagnosis of GI cancer. In the future, current EWGSOP2 recommendations should be considered while designing a study investigating the correlation between sarcopenia and chemotoxicity.

PMID:34826111 | DOI:10.1007/s41999-021-00592-3

Environ Sci Pollut Res Int. 2021 Nov 26. doi: 10.1007/s11356-021-17623-y. Online ahead of print.

ABSTRACT

Climate change and increased greenhouse gas emissions boost the global average temperature to less than 2°C, which is the estimated breakeven point. The globe is moving into blue pollution economies as the environmental sustainability objective becomes more distorted. The study looked at three United Nations Sustainable Development Goals, namely (i) affordable and clean energy; (ii) industry, innovation, and infrastructure; and (iii) climate change, to see how far the Chinese economy has progressed toward green and clean development strategy. In the context of China, the “pollution damage function” was intended to refer to carbon damages related to carbon pricing, technological variables, sustained economic growth, incoming foreign investment, and green energy. The data was collected between 1975 and 2019 and analyzed using various statistical approaches. The results of the autoregressive distributed lag model suggest that carbon taxes on industrial emissions reduce carbon damages in the short and long run. Furthermore, a rise in inbound foreign investment and renewable energy demand reduces carbon damages in the short term, proving the “pollution halo” and “green energy” hypotheses; nonetheless, the results are insufficient to explain the stated results in the long run. In the long run, technology transfers and continued economic growth are beneficial in reducing carbon damages and confirming the potential of cleaner solutions in pollution mitigation. The causal inferences show the one-way relationship running from carbon pricing and technology transfer to carbon damages, and green energy to high-technology exports in a country. The impulse response estimates suggested that carbon tax, inbound foreign investment, and technology transfers likely decrease carbon damages for the next 10 years. On the other hand, continued economic growth and inadequate green energy sources are likely to increase carbon pollution in a country. The variance decomposition analysis suggested that carbon pricing and information and communication technology exports would likely significantly influence carbon damages over time. To keep the earth’s temperature within the set threshold, the true motivation to shift from a blue to a green economy required strict environmental legislation, the use of green energy sources, and the export of cleaner technologies. Source: Authors’ self-extract.

PMID:34826072 | DOI:10.1007/s11356-021-17623-y

Clin Oral Investig. 2021 Nov 26. doi: 10.1007/s00784-021-04253-4. Online ahead of print.

ABSTRACT

OBJECTIVES: To explore microbial communities associated with health and disease status around teeth and dental implants.

MATERIALS AND METHODS: A total of 10 healthy, 24 periodontitis, and 24 peri-implant sites from 24 patients were sequenced by next-generation sequencing. Microbial DNA was extracted and 16S rRNA gene was amplified. Bioinformatic analyses were performed using quantitative insights into microbial ecology (QIIME), linear discriminant analysis effect size (LEfSE), and STAMP.

RESULTS: Differences in microbial diversity across three types of sites were not statistically significant. Several genera and species were more prevalent in healthy compared with diseased sites, including Lautropia, Rothia and Capnocytophaga and Kingella. Among diseased sites, Peptostreptococcaceae, Dialister, Mongibacterium, Atopobium, and Filifactor were over-represented in peri-implantitis sites, while Bacteroidales was more abundant in periodontitis sites.

CONCLUSIONS: Diseased periodontal and peri-implant sites and corresponding healthy sites have distinct microbiological profiles. These findings suggest that microbial analyses could identify biomarkers for periodontal health and disease and lead to the development of new strategies to improve periodontal health and treat peri-implant and periodontal diseases.

CLINICAL RELEVANCE: The study contributes to improving our understanding of healthy, periodontally affected, and peri-implantitis sites which can improve our ability to diagnose, monitor, and manage these oral conditions.

PMID:34826030 | DOI:10.1007/s00784-021-04253-4

Oral Radiol. 2021 Nov 26. doi: 10.1007/s11282-021-00578-8. Online ahead of print.

ABSTRACT

OBJECTIVES: The current study aimed to investigate the influence of the periapical lesion size on healing outcome following Regenerative Endodontic Procedures (REPs) in mature teeth using cone-beam computed tomography (CBCT) and Mimics software.

METHODS: The study included ten mature necrotic maxillary anterior teeth with periapical lesions ≥ 3 CBCT Periapical index score (CBCTPAI). REPs via blood clots were performed for all the teeth. CBCT scans were taken pre and postoperatively after 12 months follow-up periods and transferred to Mimics for volume measurements and comparison. Statistical analysis was performed using the Wilcoxon signed-rank test.

RESULT: All teeth were symptom-free with a statistically significant decrease in the volume of the periapical lesion (P < 0.05) after 12 months except for one case.

CONCLUSION: The study concluded that REPs could be a successful treatment modality for mature necrotic teeth with periapical lesions however the size of the preoperative periapical lesion could affect the outcome of the periapical healing.

TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov (ID: NCT04646538).

PMID:34826060 | DOI:10.1007/s11282-021-00578-8

Clin Oral Investig. 2021 Nov 26. doi: 10.1007/s00784-021-04248-1. Online ahead of print.

ABSTRACT

OBJECTIVES: This systematic review and network meta-analysis aimed to answer to the following questions: (a) In patients undergoing alveolar ridge preservation after tooth extraction, which grafting material best attenuates horizontal and vertical ridge resorption, as compared to spontaneous healing?, and (b) which material(s) promotes bone formation in the extraction socket?

MATERIALS AND METHODS: The MEDLINE, SCOPUS, CENTRAL, and EMBASE databases were screened in duplicate for RCTs up to March 2021. Two independent authors extracted the data and assessed the risk of bias of the included studies. Primary outcomes were ridge horizontal and vertical dimension changes and new bone formation into the socket. Both pairwise and network meta-analysis (NMA) were undertaken to obtain estimates for primary outcomes and compare different grafting materials.

RESULTS: Eighty-eight RCTs were included, with a total of 2805 patients and 3073 sockets. Overall, a total of 1740 sockets underwent alveolar ridge preservation with different materials (1432 were covered by a membrane). Pairwise meta-analysis showed that, as compared to spontaneous healing, all materials statistically significantly reduced horizontal and vertical shrinkage. According to the multidimensional scale ranking of the NMA, xenografts (XG) and allografts (AG), alone or combined with bioactive agents (Bio + AG), were the most predictable materials for horizontal and vertical ridge dimension preservation, while platelet concentrates performed best in the percentage of new bone formation.

CONCLUSIONS: Alveolar ridge preservation is effective in reducing both horizontal and vertical shrinkage, as compared to untreated sockets. NMA confirmed the consistency of XG for ridge dimension preservation, but several other materials and combinations like AG, Bio + AG, and AG + alloplasts, produced even better results than XG in clinical comparisons. Further evidence is needed to confirm the value of such alternatives to XG for alveolar ridge preservation. Bio + AG performed better than the other materials in preserving ridge dimension and platelet concentrates in new bone formation. However, alloplasts, xenografts, and AG + AP performed consistently good in majority of the clinical comparisons.

CLINICAL RELEVANCE: XG and Bio + AG demonstrated significantly better performance in minimizing post-extraction horizontal and vertical ridge dimension changes as compared with other grafting materials or with spontaneous healing, even if they presented the worst histological outcomes. Allografts and other materials or combinations (AG + AP) presented similar performances while spontaneous healing ranked last.

PMID:34826029 | DOI:10.1007/s00784-021-04248-1

Minerva Obstet Gynecol. 2021 Nov 26. doi: 10.23736/S2724-606X.21.04983-6. Online ahead of print.

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) is a low-grade inflammatory disease characterized by anovulation and hyperandrogenism, associated with insulin-resistance. The aim of our study was to investigate the effects of a treatment with alpha-lipoic acid on clinical, endocrine and metabolic features of women affected by PCOS.

METHODS: In this pilot cohort study, 60 women (30 hyperinsulinemic and 30 normoinsulinemic patients; age 15-34 years) were enrolled and clinical, hormonal and metabolic parameters were evaluated before and after a six-months treatment with alpha-lipoic acid 800 mg/daily. Investigations were performed during the early follicular phase of the menstrual cycles (spontaneous or progestin-induced cycles): after fasting overnight for 10-12 h, blood samples were collected for hormonal and metabolic assays and oral glucose tolerance test and pelvic ultrasound were performed. Total Antioxidant Capacity was expressed as LAG time.

RESULTS: The treatment was able to increase the number of menstrual cycles during the 6 months considered in all patients and to reduce BMI in the normoinsulinemic population. In hyperinsulinemic patients we observed a statistically significant reduction in AUC-I as well as an increase of total antioxidant capacity.

CONCLUSIONS: The relevant results in restoring menstrual cyclicity in both groups, in addition to the antioxidant effect, confirm that hyperinsulinemia influences only the metabolic response to the treatment, without predict the ovarian function. Even if alpha-lipoic acid mechanisms of action is not clear and further studies are needed to confirm these results, it could be considered a valid therapeutic alternative to traditional drugs, without side effects as reported.

PMID:34825791 | DOI:10.23736/S2724-606X.21.04983-6

Int Angiol. 2021 Nov 26. doi: 10.23736/S0392-9590.21.04771-4. Online ahead of print.

ABSTRACT

BACKGROUND: The death due to stroke is caused by embolism of the arteries which is due to the rupture of the atherosclerotic lesions in carotid arteries. The lesion formation is over time, and thus, early screening is recommended for asymptomatic and moderate-risk patients. The previous techniques adopted conventional methods or semi-automated and, more recently, machine learning solutions. A handful of studies have emerged based on solo deep learning (SDL) models such as UNet architecture.

METHODS: The proposed research is the first to adopt hybrid deep learning (HDL) artificial intelligence models such as SegNet-UNet. This model is benchmarked against UNet and advanced conventional models using scale-space such as AtheroEdge 2.0 (AtheroPoint, CA, USA). All our resultant statistics of the three systems were in the order of UNet, SegNet-UNet, and AtheroEdge 2.0.

RESULTS: Using the database of 379 ultrasound scans from a Japanese cohort of 190 patients having moderate risk and implementing the cross-validation deep learning framework, our system performance using area-under-the-curve (AUC) for UNet, SegNet-UNet, and AtheroEdge 2.0 were 0.93, 0.94, and 0.95 (p<0.001), respectively. The coefficient of correlation between the three systems and ground truth (GT) were: 0.82, 0.89, and 0.85 (p<0.001 for all three), respectively. The mean absolute area error for the three systems against manual GT was 4.07±4.70 mm2, 3.11±3.92 mm2, 3.72±4.76 mm2, respectively, proving the superior performance SegNet-UNet against UNet and AtheroEdge 2.0, respectively. Statistical tests were also conducted for their reliability and stability.

CONCLUSIONS: The proposed study demonstrates a fast, accurate, and reliable solution for early detection and quantification of plaque lesions in common carotid artery ultrasound scans. The system runs on a test US image in < 1 second, proving overall performance to be clinically reliable.

PMID:34825801 | DOI:10.23736/S0392-9590.21.04771-4

Jpn J Nurs Sci. 2021 Nov 25:e12461. doi: 10.1111/jjns.12461. Online ahead of print.

ABSTRACT

AIMS: This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan.

METHODS: The study implemented a cross-sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K-clustering and structural equation modeling were used for data analysis.

RESULTS: Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p < 0.001). Higher mentoring competence (mean >3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean <2.49) was observed among Japanese and Italian mentors with diplomas in nursing, younger ages, less work experience, and no previous education in mentoring.

CONCLUSION: Mentoring requires motivated, highly competent mentors since mentoring is a critical aspect of nursing education. Mentoring roles should be given to nurses with higher education and mentoring training. Younger, less experienced nurses without formal mentoring training may need support from senior nurses when performing mentoring roles and could also facilitate a more balanced workload between patient care and mentoring for senior nurses.

PMID:34825767 | DOI:10.1111/jjns.12461

J Cosmet Dermatol. 2021 Nov 26. doi: 10.1111/jocd.14594. Online ahead of print.

ABSTRACT

OBJECTIVES: There is a lack of clinical research in the Chinese market concerning dissolving microarray (DMA) patches in cosmetic applications. In this study, the clinical efficacy and safety tests of DMA patch technology were performed on Chinese consumers.

METHODS: A 4-week clinical efficacy and safety evaluation was conducted on 30 Chinese female subjects with crow’s feet and eye bags. DMA patches loaded with hyaluronic acid (HA-DMA) were applied under the eyes and corners of the eyes of the subjects three times a week over four consecutive weeks. Skin firmness and dermal layer strength were measured using ultrasound, and changes in skin wrinkles were detected using VISIA-CR and Primos Lite. Eye bag ratings were evaluated by professional dermatologists based on the 0-6 grades of eye bags in the “Skin Aging Atlas Volume 2: Asian Type.”

RESULTS: HA-DMA patches produced good clinical improvements on both crow’s feet and eye bags in the study participants. HA-DMA effectively increased skin firmness while reducing the number, area, and volume of crow’s feet, along with reducing eye bag ratings. The reductions in all metrics were statistically significant with positive effects evident in as little as 1 week of treatment. There were no adverse effects related to the treatments observed during the test period.

CONCLUSIONS: In a clinical efficacy trial of 30 Chinese female subjects, HA-DMA showed excellent therapeutic benefits without adverse effects while reducing crow’s feet and eye bags. HA-DMA is expected to be a safe, effective, and novel cosmetic for improving the appearance of aging skin.

PMID:34825760 | DOI:10.1111/jocd.14594