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Nevin Manimala Statistics

Is Periodontal and Peri- Implant Disease Associated with Fixed Partial Denture Use? A 25-year Prospective Case Series

Eur J Prosthodont Restor Dent. 2023 Sep 14. doi: 10.1922/EJPRD_2542Cambiaghi09. Online ahead of print.

ABSTRACT

INTRODUCTION: The association of the periodontium with the fixed prosthesis is the basis of prosthetic rehabilitation. This prospective case series aimed to evaluate periodontal health through the relation between periodontal/peri-implant disease progression and the use of fixed partial dentures (FPDs).

METHODS: Probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) on either teeth or implants were evaluated at up to 25-year follow-up and compared with the baseline. Statistical analysis was performed using the Kaplan-Meier test (p⟨0.05).

RESULTS: The prospective evaluation showed that the patients maintained adequate periodontal health. Failure (severe periodontal stages) occurred in 12.5% of patients. The survival rate for 107 teeth/implants was 80.48%. The comparisons for clinical parameters revealed no statistically significant difference (p⟩ 0.05). At T1, the measurements for anterior and posterior regions, respectively, were PD =2.7mm and 3.1mm; CAL= 3.3mm and 3.6mm; GI=0.5 (both regions); and PI=0.79 and 0.62. Periodontal/peri-implant disease progression did not relate to the use of prostheses.

CONCLUSIONS: Patients with more frequent follow-up appointments and lower GI and PI showed periodontal health for longer periods. Patients with different oral hygiene levels present different periodontal disease progression. Periodic hygiene control and motivation are vital factors for extensive oral rehabilitation success.

PMID:37721553 | DOI:10.1922/EJPRD_2542Cambiaghi09

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Nevin Manimala Statistics

Methodological Issues with Head and Neck Cancer Prognostic Risk Prediction Models

Community Dent Health. 2023 Sep 14. doi: 10.1922/CDH_00015Ghanati09. Online ahead of print.

ABSTRACT

OBJECTIVE: Prognostic risk prediction models estimate the probability of developing head and neck cancer (HNC), providing valuable information for managing the disease. While different prognostic HNC risk prediction models have been developed worldwide, a comprehensive evaluation of their methods is lacking. We conducted a scoping review with a critical assessment aiming to identify the methodological strengths and limitations of HNC risk prediction models.

METHOD: We searched Medline, Embase, Scopus, Web of Science, and CAB Abstracts databases and included full-text-available peer-reviewed published papers on developing or validating a prognostic HNC risk prediction model. Study quality was appraised using the PROBAST tool.

RESULTS: Nine papers were included. Although all had a high risk of bias, mainly in the analysis domain, only two studies had high concerns about clinical applicability.

CONCLUSION: Currently published studies provide insufficient information on methods, making it difficult to judge the models’ quality and applicability. Future investigations should follow the guidelines in reporting the prediction modelling studies.

PMID:37721548 | DOI:10.1922/CDH_00015Ghanati09

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Nevin Manimala Statistics

Multi-Modal Digital Impressions For Palatal Defects

Eur J Prosthodont Restor Dent. 2023 Sep 18. doi: 10.1922/EJPRD_2586AbuBaker08. Online ahead of print.

ABSTRACT

INTRODUCTION: This in-vitro study investigated limitations of intra-oral scanners (IOS) in capturing palatal defects at decreased mouth openings. The trueness and precision of composite 3D-printed models from Cone-Beam Computed Tomography (CBCT) and IOS were measured.

METHODS: A partially dentate palatal defect model was scanned with IOS (3M™TrueDefinition) at various simulated mouth openings. Five silicone impressions were poured in gypsum. Scans were taken using 3M™TrueDefinition; Planmeca Planscan®, n=5 each. Model was scanned on two CBCT (PlanmecaProFace®; Accuitomo170®CBCT, n=5 each). Geomagic®Control2014™ was used to create composite-models merging CBCT with IOS. Thirty composite-models were 3D-printed. Trueness and precision were measured. Pearson Correlation Coefficients measured correlation between mouth opening and data capture. Data analysed using Kruskal-Wallis, Wilcoxon rank-sum, and ANOVA. Statistical significance inferred when p⟨0.05.

RESULTS: Mouth openings ⟨20mm, IOS didn’t capture information of soft tissue. Increased mouth opening positively correlated with increased data capture(r=0.93, p=0.001). AccuitomoCBCT and TrueDefinition IOS composite-models had the highest (trueness) and [precision](median (IQR) 0.172 mm(0.062-0.426)); [mean [SD] 0.080 mm [0.008]]. Casts had the lowest results (median (IQR) 0.289 mm(0.119-1.565));[mean [SD] 0.338 mm [0.089]](p⟨0.001).

CONCLUSION: Mouth opening ⟨20mm resulted in insufficient data capture by IOS for clinical applications. Composite digital models showed promising trueness and precision results.

PMID:37721541 | DOI:10.1922/EJPRD_2586AbuBaker08

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Nevin Manimala Statistics

Bleaching Gels Used After 1 Week of Mixing: Efficacy, Hydrogen Peroxide Penetration, and Physical-chemical Properties

Oper Dent. 2023 Sep 1;48(5):564-574. doi: 10.2341/23-010-L.

ABSTRACT

OBJECTIVES: This in vitro study aimed to evaluate the bleaching efficacy (BE), hydrogen peroxide penetration into the pulp chamber (HPP), and physical-chemical properties (concentration, pH, and viscosity) of in-office bleaching gels immediately and after 1 week of mixing.

METHODS AND MATERIALS: We randomly divided 49 premolars into seven groups: control (no bleaching) and the following in-office bleaching (Opalescence Boost 40%, Total Blanc One Step 35%, and Whiteness HP Blue 35%) applied at two storage times: immediately and after 1 week. We evaluated the BE using a digital spectrophotometer and the HPP through UV-Vis spectroscopy. We measured the initial concentration, pH, and viscosity using titration, a Digital pH meter and Rheometer, respectively. For statistical analysis, we used a twoway analysis of variance and Tukey and Dunnet tests (α=0.05).

RESULTS: We observed higher BE and HPP for Opalescence Boost and Total Blanc One Step after 1 week of mixing than for Whiteness HP Blue (p<0.001). We observed a significantly lower initial concentration for Whiteness HP Blue 1 week after mixing compared to immediately (p=0.00001). All bleaching gels showed a decrease in pH after 1 week of mixing (p=0.00003). However, Total Blanc One Step had a lower pH at both evaluation times (p<0.001). Only Opalescence Boost maintained viscosity 1 week after mixing.

CONCLUSIONS: Opalescence Boost was the only bleaching gel able to keep bleaching efficacy, with the same characteristics of permeability and physical- chemical properties after 1 week of mixing.

PMID:37721110 | DOI:10.2341/23-010-L

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Nevin Manimala Statistics

Mediastinal lymphadenopathies and skin lesions in a 49-year-old Sinhalese man

Monaldi Arch Chest Dis. 2023 Sep 15. doi: 10.4081/monaldi.2023.2736. Online ahead of print.

ABSTRACT

Leprosy is a neglected disease sporadically reported in high-income countries. Skin lesion and peripheral nerve involvement represent most common manifestations. Mediastinal lymphadenopathy in the absence of superficial lymph nodes involvement is very rare. Atypical or rare clinical presentations of disease may delay diagnosis and therapy and cause potential life-threatening manifestations and disabilities. We describe the case of a 49-year-old Sinhalese man who was admitted to our hospital with a one-month history of peripheral neurological symptoms and skin lesions on lower limbs. CT scan showed the presence of mediastinal lymphadenopathies without lung parenchymal and superficial lymph nodes involvement. Endobronchial ultrasound-guided transbronchial needle aspiration showed the presence of granulomas while skin biopsy revealed dermo-hypodermic granulomas with perineural lymphohistiocytic inflammatory reaction. Fite-Faraco staining demonstrated the presence of acid-fast bacilli in both lymph nodal and skin biopsy and polymerase chain reaction was positive for Mycobacterium leprae. Multibacillary leprosy was then diagnosed.

PMID:37721088 | DOI:10.4081/monaldi.2023.2736

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Nevin Manimala Statistics

Sleeping Difficulties, Sleep Duration, and Risk of Hypertension in Women

Hypertension. 2023 Sep 18. doi: 10.1161/HYPERTENSIONAHA.123.21350. Online ahead of print.

ABSTRACT

BACKGROUND: Rates of poor sleep and hypertension are alarming worldwide. In this study, we investigate the association between sleeping difficulties and sleep duration with hypertension risk in women.

METHODS: Sixty-six thousand one hundred twenty-two participants of the NHS2 (Nurses’ Health Study 2), who were free of hypertension at baseline (2001), were followed prospectively for 16 years and incident hypertension assessed every 2 years. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for hypertension incidence associated with sleeping difficulties and sleep duration.

RESULTS: During follow-up, we documented 25 987 incident cases of hypertension. After controlling for demographic and lifestyle risk factors, compared with women who slept 7 to 8 hours, women with shorter sleep duration had a significantly higher risk of hypertension (≤5 hours: HR, 1.10 [95% CI, 1.05-1.16]; 6 hours: HR, 1.07 [95% CI, 1.03-1.10]), whereas the risk for women with longer sleep duration was not statistically significant (9 hours: HR, 1.03 [95% CI, 0.97-1.10]; >9 hours: HR, 1.08 [95% CI, 0.94-1.23]). Compared with women rarely having difficulty falling or staying asleep, women sometimes or usually having these sleep difficulties had significantly higher risk of developing hypertension (HR, 1.14 [95% CI, 1.11-1.17] and 1.28 [95% CI, 1.22-1.35]; Ptrend<0.001). Early morning awakening was not associated with hypertension risk (Ptrend=0.722). There was no effect modification by night work or chronotype.

CONCLUSIONS: Difficulty falling or staying asleep and short sleep duration were associated with higher risk of hypertension among women in our study. Screening for poor sleep could be useful in identifying people at higher risk for hypertension.

PMID:37721046 | DOI:10.1161/HYPERTENSIONAHA.123.21350

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Nevin Manimala Statistics

Long term respiratory morbidity of cesarean-delivered second twin compared to their vaginally-delivered sibling: A retrospective population-based cohort study

Pediatr Pulmonol. 2023 Sep 18. doi: 10.1002/ppul.26688. Online ahead of print.

ABSTRACT

BACKGROUND: Offspring born via cesarean delivery (CD) may be more prone to develope long-term respiratory diseases, compared to those delivered vaginally (VD). In this study, we compared the rates of respiratory diseases between first twins VD and second twins delivered via CD.

METHODS: This was a retrospective database study. All twin deliveries encompassed at the Soroka University Medical Center, a large tertiary hospital in southern Israel, between 1991 and 2020, in which the first twin was VD and the second via CD were included. Respiratory diseases included respiratory tract diseases such as bronchiolitis and bronchial asthma. The cumulative incidence of respiratory diseases was compared between the twins using Kaplan-Meier survival analysis and multivariable Cox models to adjust for confounding variables.

RESULTS: A total of 395,408 deliveries occurred during the study period, with 13,402 (3.4%) of all deliveries being twins. Of these, 184 (1.4%) were first twins VD and second twins delivered via CD. The second CD twin was more likely to have a non-reassuring fetal heart rate pattern and an Apgar score less than 7 at 5 min. No other differences were found between the siblings. The incidence of long-term respiratory diseases was not statistically different between the CD and VD siblings (7.6% vs. 9.4%, respectively; OR = 0.54; 95% CI: 0.23-1.26). Similarly, the cumulative incidence of respiratory diseases was not statistically different (Kaplan-Meier, log-rank, p = .59), and in the multivariable analysis which adjusted for birthweight and fetal distress during delivery (adjusted hazard ratio = 1.06; 95% CI: 0.43-26.25).

CONCLUSIONS: While the immediate outcomes for the CD twin were slightly worse compared to the VD twin, there was no difference in long-term respiratory diseases between the siblings.

PMID:37721028 | DOI:10.1002/ppul.26688

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Nevin Manimala Statistics

Utilization of an Automated Latex Agglutination Turbidity Assay for Assessing Gastric Mucosal Alteration during Helicobacter pylori Infection

Gut Liver. 2023 Sep 18. doi: 10.5009/gnl220464. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: : A latex agglutination turbidity (LA) assay to test for serum antibodies has been approved in Japan and Korea for mass screening of Helicobacter pylori infection. In this study, we evaluated the LA assay for diagnosing H. pylori infection and predicting gastric mucosal changes in a Mongolian population.

METHODS: : In total, 484 individuals were classified into H. pylori-positive (n=356) and H. pylori-negative (n=128) groups, as determined by histology and H. pylori culture.

RESULTS: : The best cutoff, sensitivity, and specificity values for the LA assay were 18.35 U/mL, 74.2%, and 65.6%, respectively. The LA values in the atrophic gastritis group were statistically higher than those in the other groups (healthy, chronic gastritis, intestinal metaplasia, and gastric cancer, p<0.0001). The cutoff value to distinguish the atrophic gastritis group from the other four groups was 32.0 U/mL, and its area under the curve was 0.673, which was the highest among the E-plate, pepsinogen (PG) I, PG II, and PG I/II ratio tests in our data. The odds ratios for atrophic gastritis determined by the LA assay and PG I test in multiple logistic regression were 2.5 and 1.9, respectively, which were significantly higher than for the other tests.

CONCLUSIONS: : The LA assay can determine the risk of atrophic gastritis, which in turn is a considerable risk factor for gastric cancer. We propose using this assay in combination with the PG I/II ratio to avoid missing gastric cancer patients who have a low LA value (less than 32.0 U/mL).

PMID:37720994 | DOI:10.5009/gnl220464

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Nevin Manimala Statistics

Clayton copula for survival data with dependent censoring: An application to a tuberculosis treatment adherence data

Stat Med. 2023 Oct 15;42(23):4057-4081. doi: 10.1002/sim.9858. Epub 2023 Aug 1.

ABSTRACT

Ignoring the presence of dependent censoring in data analysis can lead to biased estimates, for example, not considering the effect of abandonment of the tuberculosis treatment may influence inferences about the cure probability. In order to assess the relationship between cure and abandonment outcomes, we propose a copula Bayesian approach. Therefore, the main objective of this work is to introduce a Bayesian survival regression model, capable of taking into account the dependent censoring in the adjustment. So, this proposed approach is based on Clayton’s copula, to provide the relation between survival and dependent censoring times. In addition, the Weibull and the piecewise exponential marginal distributions are considered in order to fit the times. A simulation study is carried out to perform comparisons between different scenarios of dependence, different specifications of prior distributions, and comparisons with the maximum likelihood inference. Finally, we apply the proposed approach to a tuberculosis treatment adherence dataset of an HIV cohort from Alvorada-RS, Brazil. Results show that cure and abandonment outcomes are negatively correlated, that is, as long as the chance of abandoning the treatment increases, the chance of tuberculosis cure decreases.

PMID:37720988 | DOI:10.1002/sim.9858

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Nevin Manimala Statistics

Inference for covariate-adjusted time-dependent prognostic accuracy measures

Stat Med. 2023 Oct 15;42(23):4082-4110. doi: 10.1002/sim.9848. Epub 2023 Jul 14.

ABSTRACT

Evaluating the prognostic performance of candidate markers for future disease onset or progression is one of the major goals in medical research. A marker’s prognostic performance refers to how well it separates patients at the high or low risk of a future disease state. Often the discriminative performance of a marker is affected by the patient characteristics (covariates). Time-dependent receiver operating characteristic (ROC) curves that ignore the informativeness of the covariates will lead to biased estimates of the accuracy parameters. We propose a time-dependent ROC curve that accounts for the informativeness of the covariates in the case of censored data. We propose inverse probability weighted (IPW) estimators for estimating the proposed accuracy parameters. We investigate the performance of the IPW estimators through simulation studies and real-life data analysis.

PMID:37720987 | DOI:10.1002/sim.9848