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Nevin Manimala Statistics

The Effect of Preoperative Pain, Fear, and Anxiety on Postoperative Pain in Urological Surgery Patients: A Descriptive and Correlational Study

J Perianesth Nurs. 2023 Nov 3:S1089-9472(23)00886-9. doi: 10.1016/j.jopan.2023.07.013. Online ahead of print.

ABSTRACT

PURPOSE: The study was conducted to determine the effect of preoperative pain, fear, and anxiety on postoperative pain and analgesia use in urology patients.

DESIGN: A descriptive and correlational design was used.

METHODS: The population of the study consisted of patients who were hospitalized in the Urology clinic of a university hospital and were planning surgery. The sample consisted of 106 patients who met the inclusion criteria and agreed to participate in the study. The study’s data was collected using the Personal Information Form, Analgesia Follow-up Form, Surgical Fear Questionnaire, Surgical Anxiety Questionnaire, and Visual Analog Scale prepared in line with the literature. Descriptive statistics, Pearson correlation coefficient, and linear regression analysis were used to evaluate the data.

FINDINGS: A positive linear relationship was found between postoperative pain and surgical anxiety, surgical fear, and preoperative pain (P < .05). Regression analysis revealed that preoperative pain (P = .006) affected the level of postoperative pain. In addition, fear of surgery (P = .035) and postoperative pain (P = .000) were found to affect the use of postoperative 24-hour analgesia.

CONCLUSIONS: The study revealed a relationship between the postoperative pain experienced by the patients and preoperative pain, fear, and anxiety.

PMID:37921714 | DOI:10.1016/j.jopan.2023.07.013

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Nevin Manimala Statistics

Hepatic steatosis and skeletal muscle alterations during the COVID-19 lockdown in a cohort of patients with chronic liver disease in Japan

Hepatol Res. 2023 Nov 3. doi: 10.1111/hepr.13981. Online ahead of print.

ABSTRACT

AIM: Following the coronavirus outbreak, a state of public emergency was declared worldwide, which enforced lifestyle changes. This study therefore aimed to investigate the changes in lifestyle, body composition, hepatic steatosis and fibrosis in patients with chronic liver disease (CLD) under lockdown.

METHODS: During the lockdown period, 1344 patients with CLD answered a lifestyle questionnaire. In 298 patients, body composition and liver stiffness measure (LSM) / controlled attenuation parameter (CAP) were analyzed by InBody® and FibroScan®, respectively, and serial data were obtained in 137 patients.

RESULTS: Above half of the CLD patients answered decreases in physical activity and frequency of outings during lockdown, while diet was less affected. Overall, 58% of patients showed elevations in CAP values, which were not different statistically over times. Women, but not men, were more likely to increase CAP values during lockdown. LSM, nor serum fibrosis markers, were not elevated chronologically during lockdown. In men, body mass index (BMI), body fat percentage, and visceral fat area (VFA) were significantly increased, whereas in women, lower-limb muscle mass was significantly decreased. Patients with decreased SMI showed elevations in CAP and VFA values, and patients who exercised less showed increases in BMI.

CONCLUSION: In response to lockdown, men tended to increase body fat but the degree of hepatic steatosis was less affected, while women were more likely to exacerbate hepatic steatosis with skeletal muscle loss among CLD patients. Gender-specific approaches need to be established for management of CLD patients to avoid exacerbation or comorbidity of steatotic liver disease. This article is protected by copyright. All rights reserved.

PMID:37921697 | DOI:10.1111/hepr.13981

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Nevin Manimala Statistics

Cie L*A*B* Values in VITA Classical and VITA 3D Master by Two Dental Spectrophotometers

Int J Prosthodont. 2023 Nov 1;36(5):649. doi: 10.11607/ijp.7235.

ABSTRACT

PURPOSE: To compare the CIE L*a*b* values of two different dental shade guides using two shade-matching spectrophotometers.

MATERIALS AND METHODS: SpectroShade Micro (SS) and Easyshade (ES) (VITA Zahnfabrik) were tested. One calibrated operator performed 30 measurements of each tab from three batches of the two guides, VITA Classical (VC) and VITA 3D Shade Master (VM). Receiver operating characteristic (ROC) curves and intraclass coefficients (ICC) between the different batches were calculated. Results were given as mean and SD of the L*a*b* values and the respective color differences according to the CIEDE 2000 formula (ΔE00) for each of the shade tabs in the two spectrophotometers and then analyzed with independent student t test (α = .05).

RESULTS: A total of 1,440 and 2,610 measurements for VC and VM, respectively, were performed per spectrophotometer. There were statistically significant differences between the two devices for all L*a*b* values, with the exception of: L* for 3R1.5; a* for 2R1.5, 3L1.5, 2L2.5, 3M2, 3L2.5, 4L1.5, and 4L2.5; and b* for D3, 1M2, and 3M2. When assessing the same shade guide, differences in ΔE00 were detected between devices above the acceptability threshold (AT) (ΔE00 ≥ 1.8) for all shade tabs except for VC (C1, C2, D3, A3.5, C3, and A4) and VM (4M1, 3R2.5, 4L2.5, and 4M3). The overall mean of the interdevice ΔE00 was 2.2 ± 1.0 for VC and 2.5 ± 1.0 for VM.

CONCLUSIONS: The two dental spectrophotometers presented high ICC and ROC values, which validates their indication as auxiliary tools. However, there are discrepancies in the hues D (VC) and R (VM) with interdevice variability when evaluated for the L*a*b* component. Int J Prosthodont 2023;36:e38-e52.

PMID:37921676 | DOI:10.11607/ijp.7235

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Nevin Manimala Statistics

Benford’s Law and distributions for better drug design

Expert Opin Drug Discov. 2023 Nov 3:1-7. doi: 10.1080/17460441.2023.2277342. Online ahead of print.

ABSTRACT

INTRODUCTION: Modern drug discovery incorporates various tools and data, heralding the beginning of the data-driven drug design (DD) era. The distributions of chemical and physical data used for Artificial Intelligence (AI)/Machine Learning (ML) and to drive DD have thus become highly important to be understood and used effectively.

AREAS COVERED: The authors perform a comprehensive exploration of the statistical distributions driving the data-intensive era of drug discovery, including Benford’s Law in AI/ML-based DD.

EXPERT OPINION: As the relevance of data-driven discovery escalates, we anticipate meticulous scrutiny of datasets utilizing principles like Benford’s Law to enhance data integrity and guide efficient resource allocation and experimental planning. In this data-driven era of the pharmaceutical and medical industries, addressing critical aspects such as bias mitigation, algorithm effectiveness, data stewardship, effects, and fraud prevention are essential. Harnessing Benford’s Law and other distributions and statistical tests in DD provides a potent strategy to detect data anomalies, fill data gaps, and enhance dataset quality. Benford’s Law is a fast method for data integrity and quality of datasets, the backbone of AI/ML and other modeling approaches, proving very useful in the design process.

PMID:37921672 | DOI:10.1080/17460441.2023.2277342

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Nevin Manimala Statistics

Clinical characteristics and prognosis of early-onset cholangiocarcinoma: a population-based study

Scand J Gastroenterol. 2023 Nov 3:1-9. doi: 10.1080/00365521.2023.2277663. Online ahead of print.

ABSTRACT

BACKGROUND: Little is known about the disease of early-onset cholangiocarcinoma (EOC). The primary objective of this study was to compare EOC with later-onset cholangiocarcinoma (LOC) concerning clinical features and survival prognosis.

METHODS: 19325 cholangiocarcinoma patients were extracted from 1975 to 2020 in the SEER database. Cox regression analysis and Kaplan-Meier survival curves were used for the evaluation of cause-specific survival (CSS) and overall survival (OS). To reduce confounding, we compared survival differences between the EOC and LOC groups using propensity score matching (PSM).

RESULTS: 4037 cholangiocarcinoma patients were included in the study, of which 274 were EOC and 3763 were LOC. Early-onset patients were more likely to be non-white, and intrahepatic cholangiocarcinoma. At diagnosis, patients had advanced AJCC stage, lymph node metastase and distant metastase. The EOC patients were more likely to receive surgery, radiotherapy, and chemotherapy than later-onset patients. Multifactorial COX analysis indicated that EOC patients had lower mortality risk than later-onset patients, and similar results were obtained after PSM; Kaplan-Meier survival curves corroborated that early-onset patients exhibited better OS than later-onset patients, and this survival advantage persisted after PSM. Further subgroup analysis following matching demonstrated that early-onset patients had better OS than later-onset patients in the surgical subgroup, while there were no statistically significant differences in the radiotherapy and chemotherapy subgroups.

CONCLUSION: The EOC patients typically exhibit an intrahepatic presentation and generally experience a more favorable prognosis. Surgery emerged as a critical treatment modality significantly influencing the overall prognosis of EOC.

PMID:37921657 | DOI:10.1080/00365521.2023.2277663

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Influence of formaldehyde exposure on the molecules of the NO/cGMP-cAMP signaling pathway in different brain regions of Balb/c mice

Toxicol Ind Health. 2023 Nov 3:7482337231210942. doi: 10.1177/07482337231210942. Online ahead of print.

ABSTRACT

This toxicology study was conducted to assess the impact of formaldehyde, a common air pollutant found in Chinese gymnasiums, on the brain function of athletes. In this research, a total of 24 Balb/c male mice of SPF-grade were divided into four groups, each consisting of six mice. The mice were exposed to formaldehyde at different concentrations, including 0 mg/m3, 0.5 mg/m3, 3.0 mg/m3, and 3.0 mg/m3 in combination with an injection of L-NMMA (NG-monomethyl-L-arginine), which is a nitric oxide synthase antagonist. Following a one-week test period (8 h per day, over 7 days), measurements of biomarkers related to the nitric oxide (NO)/cGMP-cAMP signaling pathway were carried out on the experimental animals post-treatment. The study found that: (1) Exposure to formaldehyde can lead to brain cell apoptosis and neurotoxicity; (2) Additionally, formaldehyde exposure was found to alter the biomarkers of the NO/cGMP-cAMP signaling pathway, with some changes being statistically significant (p < 0.05 or p < 0.01); (3) The use of L-NMMA, an antagonist of the NO/cGMP-cAMP signaling pathway, was found to prevent these biomarker changes and had a protective effect on brain cells. The study suggests that the negative impact of formaldehyde on the brain function of mice is linked to the regulation of the NO/cGMP-cAMP signaling pathway.

PMID:37921628 | DOI:10.1177/07482337231210942

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Nevin Manimala Statistics

Effectiveness of distraction-based interventions for relieving anxiety, fear and pain in hospitalized children during venous blood sampling: a systematic review protocol

JBI Evid Synth. 2023 Nov 6. doi: 10.11124/JBIES-22-00057. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this review is to evaluate the effectiveness of active compared with passive distraction-based interventions in relieving anxiety, fear, and pain in hospitalized preschool and school-age children during venous blood sampling.

INTRODUCTION: Venous blood sampling remains the most common procedure that causes anxiety, fear, and pain among the pediatric population. It is important that health care professionals relieve a child’s pain and the related emotions because untreated pain may have long-term effects on children’s growth and development. It is necessary to determine which interventions are effective in relieving these outcomes in preschool and school-age children during blood sampling.

INCLUSION CRITERIA: This review will include randomized controlled trials and quasi-experimental studies that include active and passive distraction-based interventions for relieving hospitalized preschool and school-age children’s anxiety, fear, and pain during venous blood sampling.

METHODS: CINAHL, PubMed, Scopus, and Cochrane Library databases will be searched for published studies. MedNar, Google Scholar, and PsycEXTRA databases will be searched for in-progress and unpublished studies. Two independent researchers will perform critical appraisal and data extraction using JBI methodology. Data describing randomized controlled trials and quasi-experimental studies will be pooled in a statistical meta-analysis. If statistical analysis is not possible, the findings will be reported narratively. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach will be used to assess certainty in the quality of evidence.

REVIEW REGISTRATION: PROSPERO CRD42023455617.

PMID:37921627 | DOI:10.11124/JBIES-22-00057

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Nevin Manimala Statistics

The Impact of Body Mass Index on Adverse Outcomes Associated with Panniculectomy: A Multimodal Analysis

Plast Reconstr Surg. 2023 Nov 3. doi: 10.1097/PRS.0000000000011179. Online ahead of print.

ABSTRACT

BACKGROUND: Overhanging pannus may be detrimental to ambulation, urination, sexual function, and social well-being. Massive weight loss patients often have high residual body mass index (BMI) and comorbidities presenting a unique challenge in panniculectomy patient selection. This study aims to better characterize the role of BMI in post-operative complications following panniculectomy.

METHODS: A meta-analysis attempted to assess the impact of BMI on complications following panniculectomy. Cochrane Q and I 2 test statistics measured study heterogeneity, with subsequent random effects meta-regression investigating these results. After this, all panniculectomy patients in the National Surgical Quality Improvement Program (NSQIP) years 2007-2019, were analyzed. Univariate and multivariable tests assessed the relative role of BMI on 30-day postoperative complications.

RESULTS: Thirty-four studies satisfied inclusion criteria, revealing very high heterogeneity (Cochrane Q = 2453.3; I 2 = 99.1%), precluding further meta-analysis results. Receiver operator curves demonstrated BMI was a significant predictor of both all causes (area under the curve (AUC): 0.64, 95%CI:0.62-0.66) and wound complications (AUC:0.66, 95%CI:0.63-0.69). BMI remained significant following multivariable regression analyses. Restricted cubic spines demonstrated marginal increases in complication incidence above 33.2 and 35 for all-cause and wound complications respectively.

CONCLUSION: Reported literature regarding postoperative complications in panniculectomy patients is highly heterogeneous, and may limit evidence-based care. Complication incidence positively correlated with BMI, though ROC demonstrated its limitations as the sole predictive variable. Further, RSC demonstrated diminishing marginal predictive capacity of BMI for incremental increases in BMIs above 33.2-35 kg/m 2. These findings support a re-evaluation of the role of BMI cut-offs in panniculectomy patient selection.

PMID:37921622 | DOI:10.1097/PRS.0000000000011179

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Nevin Manimala Statistics

Decontamination and Repair Protocol Promotes Positive Outcomes in Implants Affected by Peri-implantitis: A Human Case Series

Int J Periodontics Restorative Dent. 2023 Nov 3;43(6):699-705. doi: 10.11607/prd.5534.

ABSTRACT

This study assessed the effectiveness and predictability of a readily available protocol to treat peri-implantitis utilizing mechanical debridement, chemical antiseptic surface detoxification, and osseous grafting. Nine patients (7 women, 2 men; mean age: 56.5 years) with 15 implants with peri-implantitis were included. Pocket probing depth (PPD), bleeding on probing (BOP), and standardized digital periapical radiographic measurements were taken. Surgical flaps were elevated, and the implant threads were cleaned with a plastic curette. Chemical decontamination was performed by scrubbing solutions of 0.25% sodium hypochlorite (NaClO) and 1.5% hydrogen peroxide (H2O2) around the exposed implant using cotton pellets. Bony defects were filled with a 50/50 mixture of bovine hydroxyapatite and nanocrystalline calcium sulfate (CaSO4). A porcine collagen membrane was placed over the grafted bony defect. Follow-up appointments were scheduled 1 week, 2 weeks, 3 months, 6 months, 9 months, and 1 year posttreatment. Clinical and radiographic parameters were assessed and compared. At baseline, PPD ranged from 5 to 7.5 mm (mean: 6 ± 0.7 mm). At 12 months, PPD ranged from 1.5 to 4.2 mm (mean: 2.5 ± 0.8 mm). The mean PPD reduction of 3.6 mm (59.2%) was statistically significant (P < .001). The number of bleeding sites around each test implant decreased significantly from 4 to 0.4 sites between baseline and 12 months (P < .001). Mean radiographic bone loss decreased from 4.8 ± 1.3 mm to 2.7 ± 1.2 mm (P < .001). The proposed method of mechanical decontamination, chemical detoxification, and bone regeneration is clinically effective and reproducible. Clinical peri-implant parameters and radiographic bone levels were improved and maintained their stability for 1 year using this peri-implantitis treatment protocol.

PMID:37921607 | DOI:10.11607/prd.5534

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Nevin Manimala Statistics

Diagnostic significance of blood lymphocyte activation markers in pre-eclampsia

Clin Exp Immunol. 2023 Oct 31:uxad121. doi: 10.1093/cei/uxad121. Online ahead of print.

ABSTRACT

The adaptive and innate immune system is important in both initiating and preventing functional disorders during pregnancy, one of which is pre-eclampsia. The research aims to conduct the comparative quantification of selected subpopulations of peripheral blood immunoregulatory cells in pregnant women with pre-eclampsia in the third trimester. The marker receptors CD4, CD8, CD95, CD25, CD27, and the marker antigen HLA-DR were considered. The screening was performed by flow cytometry with dual phenotyping using phycoerythrin- and fluorescein-isothiocyanate-labeled monoclonal antibodies. Data processing consisted in calculating a likelihood value to assess the statistical significance of the difference between the samples. A statistically significant decrease in the subpopulation titer of T- and B-lymphocytes with marker receptors CD4, CD8, and CD19 was found in pre-eclampsia patients. In the CD4 carrier T-lymphocyte population, there was an increased expression of the CD25/CD95 activation and apoptosis markers. In the CD8 T-killer population, a decreased representation of the CD27/CD25/CD95 markers of differentiation, activation, and apoptosis was deterministic. The expression pattern of the major histocompatibility complex antigen HLA-DR did not change significantly in normality and pathology. The titer of peripheral natural killer cells carrying the CD56 marker increased in patients with various degrees of disease severity, while the number of CD16 natural killer remained at the level of the control group. The research results suggest that a change in the ratio of the above receptors is a diagnostic indicator for pre-eclampsia.

PMID:37921073 | DOI:10.1093/cei/uxad121