Category: Statistics

Int J Paediatr Dent. 2021 Sep 27. doi: 10.1111/ipd.12930. Online ahead of print.

ABSTRACT

BACKGROUND: The association of breastmilk feeding and dental caries risk in children remains controversial. Moreover, it is unclear whether caries risk factors differ between breastmilk-fed and formula-milk-fed infants.

AIM: To investigate dental caries in 13-18-month-old infants receiving breastmilk or formula milk feeding and associated risk factors.

DESIGN: One hundred and sixty-six 13-18-month-old infants were recruited from a tertiary hospital in xxx, xxx. Information on feeding practices, demography and potential risk factors was collected using a caregiver questionnaire. Carious lesions were identified by visual and tactile examination. Chi-square, Mann-Whitney-U tests and Logistic regression were used for statistical analyses.

RESULTS: Caries prevalence in breastmilk- and formula-milk-fed infants was 31.8% and 36.0%, respectively, with no statistically significant difference (p=0.579). Among all children, having dental plaque deposition on more than 1/3 of the crown (adjusted OR(aOR)15.11, 95%CI 6.11-37.35) and sleeping while milk feeding (aOR2.20, 95%CI 1.01-4.77) were associated with dental caries. However, in subgroup analysis, sleeping while milk feeding increased caries risk in formula-milk-fed group only (aOR2.95, 95%CI 1.07-8.12).

CONCLUSIONS: Type of milk feeding was not associated with dental caries, while dental plaque and sleeping while milk feeding increased the odds of having dental caries in this population.

PMID:34570950 | DOI:10.1111/ipd.12930

Acta Anaesthesiol Scand. 2021 Sep 27. doi: 10.1111/aas.13983. Online ahead of print.

ABSTRACT

BACKGROUND: We sought to provide a description of surge response strategies and characteristics, clinical management and outcomes of patients with severe COVID-19 in the intensive care unit (ICU) during the first wave of the pandemic in Denmark, Finland, Iceland, Norway and Sweden.

METHODS: Representatives from the national ICU registries for each of the five countries provided clinical data and a description of the strategies to allocate ICU resources and increase the ICU capacity during the pandemic. All adult patients admitted to the ICU for COVID-19 disease during the first wave of COVID-19 were included. The clinical characteristics, ICU management and outcomes of individual countries were described with descriptive statistics.

RESULTS: Most countries more than doubled their ICU capacity during the pandemic. For patients positive for SARS-CoV-2, the ratio of requiring ICU admission for COVID-19 varied substantially (1.6-6.7%). Apart from age (proportion of patients aged 65 years or over between 29-62%), baseline characteristics, chronic comorbidity burden and acute presentations of COVID-19 disease were similar among the five countries. While utilization of invasive mechanical ventilation was high (59-85%) in all countries, the proportion of patients receiving renal replacement therapy (7-26%) and various experimental therapies for COVID-19 disease varied substantially (e.g. use of hydroxychloroquine 0-85%). Crude ICU mortality ranged from 11% to 33%.

CONCLUSION: There was substantial variability in the critical care response in Nordic ICUs to the first wave of COVID-19 pandemic, including usage of experimental medications. While ICU mortality was low in all countries, the observed variability warrants further attention.

PMID:34570897 | DOI:10.1111/aas.13983

Int Endod J. 2021 Sep 27. doi: 10.1111/iej.13636. Online ahead of print.

ABSTRACT

AIM: To explore the presence of the cGAS-STING inflammatory pathway in human pulp tissue and human dental pulp cells (HDPCs).

METHODOLOGY: Pulp tissue was collected from freshly extracted human healthy third molars or third molars with irreversible pulpitis. Quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunoassay (ELISA) was performed to assess IFN-β, TNF, and IL-6. HDPCs prepared from healthy human pulp tissues were transfected with interferon stimulatory DNA (ISD), bacterial genomic DNA, bacterial cyclic dinucleotides c-di-AMP, c-di-GMP, or host cyclic dinucleotide cGAMP. SiRNA was used to knockdown the endogenous cGAS or STING. G140 and H-151 were used to inhibit cGAS and STING, respectively. Amlexanox and BAY 11-7082 were used to inhibit TBK1 and NF-κB, respectively. qRT-PCR and ELISA was performed to detect the level of IFN-β, TNF, and IL-6. Western blot was performed to evaluate the TBK1, IRF3, and p65 phosphorylation. The Student’s t-test and one-way ANOVA were used for statistical analysis RESULTS: IFN-β, TNF, and IL-6 were upregulated in the inflamed human dental pulp tissue. CGAS and STING mRNA were increased in the inflamed human dental pulp tissue and detected in HDPCs prepared from healthy human pulp tissues. ISD transfection induced TBK1, IRF3, and p65 phosphorylation as well as IFN-β, TNF, and IL-6 production. IFN-β, TNF, and IL-6 production were also induced by transfection of bacterial and host cyclic dinucleotides or bacteria DNA. ISD or bacteria DNA transfection elevated the intracellular levels of cGAMP. Knockdown of cGAS or STING, as well as using cGAS inhibitor G140 or STING inhibitor H-151 abolished the IFN-β, TNF, and IL-6 production induced by ISD transfection. Knockdown of STING or using STING inhibitor H-151 abolished the IFN-β, TNF, and IL-6 induction by transfection of bacterial and host cyclic dinucleotides. Both Amlexanox and BAY 11-7082 inhibited IFN-β, TNF, and IL-6 production triggered by ISD and cyclic dinucleotides transfection.

CONCLUSIONS: HDPCs expressed an intact cGAS-STING signaling axis. The cGAS-STING signaling axis may play an important role in pulp inflammation and immune defense.

PMID:34570917 | DOI:10.1111/iej.13636

Rev Esc Enferm USP. 2021 Sep 24;55:e20210195. doi: 10.1590/1980-220X-REEUSP-2021-0195. eCollection 2021.

ABSTRACT

OBJECTIVE: To evaluate the effect of training on intravenous medication administration in pediatric patients on nursing staff ‘s learning and response.

METHOD: This is a quasi-experimental study (pre- and post-test), with 38 nursing professionals who participated in training on administration of intravenous (IV) medication in pediatric patients with heart disease. For data collection, a questionnaire with 19 items was applied to evaluate participants’ learning before (pre-test) and after (post-test) training. Data were analyzed by descriptive and analytical statistics (binomial and Friedman tests).

RESULTS: Nurses predominated (52.6%), mean age 41.2 years and 9.8 years of professional experience in pediatrics. For learning evaluation, there was an increase in the rate of hits from the pre-test to the post-test in 13 items, with a significant difference (p < 0.05) in the items: removing adornments to sanitize hands; wearing gloves when administering medication; administering medication with gloves, mask and goggles; and checking patient name by asking their companion.

CONCLUSION: Training had positive effects on nursing professionals’ learning and reaction.

PMID:34570871 | DOI:10.1590/1980-220X-REEUSP-2021-0195

Eur J Public Health. 2021 Sep 27:ckab162. doi: 10.1093/eurpub/ckab162. Online ahead of print.

ABSTRACT

BACKGROUND: Studies have found an association between problem gambling and poverty. However, there is relatively little research on social inequalities and problem gambling using population representative data.

METHODS: A population-representative self-report web-based and postal survey with register-based linkage was conducted in the three geographical areas of Finland. Participants (n = 7186, aged 18 or older) were randomly selected from the population register. Sociodemographic factors and social welfare benefits were studied among gambling groups and their statistical difference were examined by χ2 test. Seven logistic regression models were calculated, where unemployment, social security benefits and low income were treated as dependent variables and where sex, age, family structure and education were controlled as covariates. The results were presented as odds ratios (OR) with 95% confidence intervals (CIs).

RESULTS: Problem and at-risk gambling (ARG) was more common among people who were unemployed [PG: χ2=6.4 (1), P < 0.01, ARG: χ2=12.4 (1), P < 0.001] or had received social security benefits [PG: χ2=41.6 (1), P < 0.001, ARG: χ2=22.9 (1), P < 0.001]. The OR for problem gambling was high as 5.6 (CI: 3.22-9.61) among respondents who had received social assistance even when covariates were taking into count. Almost a third of those experiencing problem or at-risk gambling received at least one form of social security benefit.

CONCLUSIONS: The most important task of gambling policy should be reducing gambling-related harms and diminishing social inequality. However, even in government organized system where gambling profits are used for common good, profits come from the most socially disadvantaged people thereby exacerbating inequality.

PMID:34570872 | DOI:10.1093/eurpub/ckab162

Acta Odontol Latinoam. 2021 Aug 1;34(2):166-172.

ABSTRACT

Adhesively cemented fiber-reinforced composite posts are commonly used to reconstruct endodontically treated teeth. Adhesion to intraradicular dentin is complex, and close contact between the resin cements and the dentin is essential. The removal of the smear layer following post space preparation (secondary smear layer) can improve this integration. Different mechanical systems have been used to activate the irrigant inside the root canal. The purpose of this study was to compare, ex-vivo, the removal of the smear layer from the walls of the immediate post space preparation by the action of three mechanized instruments. Forty premolar specimens with a single root canal were selected, endodontically treated, and shaped for glass fiber post cementation with Peeso reamer #1 (Dentsply Sirona, Switzerland) and Macrolock finishing drill #3 (RTD, France). The specimens were randomly divided into 4 groups (n=10): Group C (control); Group PUI (passive ultrasonic irrigation); Group CEP (Rotoprox brush, Hager Werken, Germany) and Group XP (XP-endo Finisher, FKG Dentaire, Switzerland). Post space surfaces were cleaned with 3mL of distilled water; each specimen root split longitudinally to expose the root canals, and prepared for examination in a scanning electron microscope at magnification 350X. The results were analyzed using the Kruskal-Wallis and Friedman tests (p>0.05). RESULTS: Statistically significant differences (p<0.05) were found between Groups C and XP in all three root regions, but not between Groups C, CEP and PIU. Of these, Group CEP showed a better trend in the results of the coronary and middle thirds, without significant difference with Group XP. Although it was difficult to achieve a clean dentin surface after preparation for the fiberglass post, the XP-endo Finisher was the most efficient in removing secondary smear layer, followed by the Rotoprox conical brush.

PMID:34570865

Acta Odontol Latinoam. 2021 Aug 1;34(2):143-148.

ABSTRACT

The aim of this study was to evaluate the amount of radiating energy transmitted through lithium disilicate discs of different thicknesses and opacities with different curing units (CU). Discshaped specimens 8 mm in diameter and 1.5 mm or 0.7 mm thick were designed with Zbrush® and Cura 3D® software, milled from HT and MO IPS e-maxCAD blocks (Ivoclar Vivadent) with Ceramill Mikro 4 (Amann Girrbach, Austria) and processed according to manufacturer instructions. Thickness was checked with a Mitutoyo (México) caliper. Four groups (n=4) were formed: G1(HT/1.5 mm), G2(MO/1.5 mm), G3(HT/0.7 mm) y G4(MO/0.7 mm), and the effect of three CUs: Coltolux (Coltene- Whaledent), LED.C, (Woodpecker Medical Instrument Co.Ltd) and Deepcure L(3M-ESPE) was tested Measurements were taken with a halogen and LED radiometer (Woodpecker® LM-1-Guilin Woodpecker Medical Instrument Co.Ltd) after applying the guide of each CU directly on the reading window (d) and after interposing each of the specimens. The ratio of transmitted energy was determined in each case and data was analyzed with repeated measures ANOVA and Tukey test for multiple comparisons. LED.C: d:1600 mW/cm2, G1: 0.31(0.00), G2: 0.14(0.00) G3: 0.54(0.01), G4: 0.38(0.01); Deepcure L: d:1500 mW/cm2, G1: 0.34(0.01), G2: 0.20(0,00), G3: 0.56(0.01), G4: 0.41(0.02); Coltolux: d:1275 mW/cm2, G1: 0.44(0.01), G2: 0.24(0,00), G3: 0.65(0.01), G4: 0.47(0,00). Statistically significant differences were found among the curing units (P<0.001) and for the interaction CU-thickness (P<0.001) and CU-opacity (P=0.023). Within the conditions of this study, the ratio of light transmitted through lithium disilicate structures is related to their thickness and opacity, and to the curing unit employed.

PMID:34570862

Acta Odontol Latinoam. 2021 Aug 1;34(2):149-155.

ABSTRACT

The aim of this study was to determine prevalence and describe the clinical and radiographic findings of three-rooted primary mandibular first and second molars in a Mexican population. Intraoral periapical radiograph, orthopantomogram or cone beam computed tomography (CBCT) were obtained. A total 2284 children from the state of Puebla, Mexico were examined, of whom 20 presented an anatomic variant in tooth crown shape. Of the total teeth with crown alterations, 10 first and 5 second primary mandibular molars were found to have supernumerary roots. In one case, it was possible to obtain micro-CT images. The study recorded prevalence, unilateral or bilateral occurrence, and ratio between sexes. Data were analyzed using descriptive statistics. Clinical findings were presence of an anatomical variation (tuberculum paramolare / right and/or left cervical convexity) in primary mandibular first molars. Second molars presented conventional crown morphology. Prevalence of three-rooted primary mandibular first and second molars was 0.44% and 0.22%, respectively. Male: female ratio for presence of threerooted primary mandibular first molars was 4:1, showing genetic predisposition in males, and for second molars it was 1.5:1, with no predisposition according to sex. The clinical and radiographic anatomical variants in primary molars should be considered by pediatric dentists during routine care because they may cause difficulties in restorations.

PMID:34570863

PLoS Negl Trop Dis. 2021 Sep 27;15(9):e0009679. doi: 10.1371/journal.pntd.0009679. eCollection 2021 Sep.

ABSTRACT

Dengue is recognized as a major health issue in large urban tropical cities but is also observed in rural areas. In these environments, physical characteristics of the landscape and sociodemographic factors may influence vector populations at small geographic scales, while prior immunity to the four dengue virus serotypes affects incidence. In 2019, a rural northwestern Ecuadorian community, only accessible by river, experienced a dengue outbreak. The village is 2-3 hours by boat away from the nearest population center and comprises both Afro-Ecuadorian and Indigenous Chachi households. We used multiple data streams to examine spatial risk factors associated with this outbreak, combining maps collected with an unmanned aerial vehicle (UAV), an entomological survey, a community census, and active surveillance of febrile cases. We mapped visible water containers seen in UAV images and calculated both the green-red vegetation index (GRVI) and household proximity to public spaces like schools and meeting areas. To identify risk factors for symptomatic dengue infection, we used mixed-effect logistic regression models to account for the clustering of symptomatic cases within households. We identified 55 dengue cases (9.5% of the population) from 37 households. Cases peaked in June and continued through October. Rural spatial organization helped to explain disease risk. Afro-Ecuadorian (versus Indigenous) households experience more symptomatic dengue (OR = 3.0, 95%CI: 1.3, 6.9). This association was explained by differences in vegetation (measured by GRVI) near the household (OR: 11.3 95% 0.38, 38.0) and proximity to the football field (OR: 13.9, 95% 4.0, 48.4). The integration of UAV mapping with other data streams adds to our understanding of these dynamics.

PMID:34570788 | DOI:10.1371/journal.pntd.0009679

PLoS One. 2021 Sep 27;16(9):e0257653. doi: 10.1371/journal.pone.0257653. eCollection 2021.

ABSTRACT

The use of renal biopsy through laparoscopy is increasingly present both in human and veterinary medicine. However, both techniques require skill and training to make the operator capable to do it. The learning curve allows the quantitative and qualitative assessment of the number of attempts and minimum time for the surgical procedure. The objective included establish the learning curve for laparoscopy-guided kidney biopsy procedures in dog and pig corpses. Six dogs and six pigs corpses weighing less than 10 kg were used for this study. All corpses underwent kidney biopsy performed through laparoscopy. Twenty-four operators, two per animal, performed 20 renal biopsies each (10 for each kidney), with 480 collection-procedures in total. Duration and difficulty of the procedure and the biopsy sample quality were evaluated and statistical analysis was performed using a mixed regression model with a random effect of individuals and multivariate analysis of data. There were 91.5% of the samples that were adequate for evaluation. There was no significant difference in the number of glomeruli or cortex percentage considering the attempts in either species, demonstrating the operator’s ability since first collection. Swine samples showed higher amounts of renal cortex than canine samples. The procedure duration was shorter as more attempts were performed in dogs and pigs. From the fourth repetition, the professional reached a plateau for the variable related to ‘collection’, and from the second, the professional presented uniform duration for ‘sample storage’. Operators of the swine model acquired more agility than the dog ones. The variable ‘difficulty’ decreased as more repetitions were performed, reaching a plateau in the sixth attempt. Seven renal biopsies laparoscopy-guided are required for an operator to be considered ‘capable’ to perform the procedure in the referred species included. The learning curve for image-guided kidney biopsy procedures improves the implementation of this technique and benefits patients that undergo this procedure.

PMID:34570802 | DOI:10.1371/journal.pone.0257653