Tag: statistics

J Am Heart Assoc. 2025 Dec 10:e042785. doi: 10.1161/JAHA.125.042785. Online ahead of print.

ABSTRACT

BACKGROUND: Transcatheter edge-to-edge repair of the mitral valve (M-TEER) has demonstrated promising outcomes for patients with mitral regurgitation who are unsuitable for surgical intervention. However, the clinical implications of M-TEER in patients requiring mechanical circulatory support (MCS) for unstable hemodynamics remains unclear. This study aimed to evaluate the outcomes of MCS-assisted M-TEER in critically ill patients.

METHODS: Consecutive patients who underwent M-TEER for significant mitral regurgitation were identified from the Japanese multicenter OCEAN-Mitral (Optimized Catheter Valvular Intervention-Mitral) registry. All-cause death was compared between the cohort undergoing MCS-assisted M-TEER and a virtual control group receiving MCS alone without undergoing M-TEER, estimated using the Seattle Heart Failure Model. Additionally, logistic regression analysis was conducted to identify factors associated with in-hospital death following MCS-assisted M-TEER.

RESULTS: A total of 3764 patients were included in the analysis (mean age, 81 years; 54.9% men; 70.1% with secondary mitral regurgitation), of whom 105 underwent MCS-assisted M-TEER. Procedure success exceeded 95%, irrespective of MCS use. The 1-year mortality rate in the MCS-assisted M-TEER group was lower than the estimated mortality rate in the virtual control group (43.2% versus 69.5%). Factors associated with in-hospital death included frailty, inflammation, and hypoalbuminemia. In a landmark analysis starting from discharge date, there was no statistically significant difference in cardiovascular death or heart failure hospitalization between the groups with or without the use of MCS (hazard ratio, 1.45 [95% CI, 0.93-2.26]; P=0.10).

CONCLUSIONS: MCS-assisted M-TEER appears to be a viable and effective therapeutic strategy for carefully selected patients with significant mitral regurgitation and unstable hemodynamics.

REGISTRATION: URL: https://www.umin.ac.jp/ctr/; Unique identifier: UMIN-ID: UMIN000023653.

PMID:41368845 | DOI:10.1161/JAHA.125.042785

Food Addit Contam Part B Surveill. 2025 Dec 9:1-7. doi: 10.1080/19393210.2025.2576912. Online ahead of print.

ABSTRACT

Animal feedstuffs are prone to fungal contamination due to their protein content and high moisture levels at harvest and storage, often leading to mycotoxin production. This study investigated the occurrence of aflatoxins in animal feed and the feed ingredients cottonseed cake and maize oil cake, collected from livestock farms in Okara, Punjab, Pakistan (2021-2022). Aflatoxins were extracted with an acetonitrile – water mixture, purified with Mycosep columns, quantified by HPLC with fluorescence detection and confirmed by mass spectrometry. Aflatoxins were detected in 74% of the animal feed samples, in 87% of the cottonseed cake samples and in 63% of the maize oil cake samples. Notably, 33% of animal feed and 70% of oilseed cake samples exceeded the maximum limit of 20 µg/kg. These findings revealed a high level of aflatoxin contamination, particularly in oilseed cakes, with statistically significant results (p < 0.05), highlighting potential animal health risks.

PMID:41368818 | DOI:10.1080/19393210.2025.2576912

Am J Epidemiol. 2025 Dec 10:kwaf274. doi: 10.1093/aje/kwaf274. Online ahead of print.

ABSTRACT

The COVID-19 pandemic highlighted deep-rooted health inequities globally, with marginalized populations showing disproportionate disease burden. We employed Serfling regression models and multivariable analyses to estimate excess mortality across geographic, demographic, and poverty groups from 2020-2022 in Chile. Elderly populations (80+ years) experienced the highest excess mortality (267.35 per 10,000 population), more than eight times higher than those under 80 years (30.80 per 10,000 population). Multivariable linear regression models showed both Indigenous proportion (coefficient=53.66, p<0.001) and elderly population proportion (coefficient=5.68, p<0.01) as the strong predictors of comuna level excess mortality. Poverty correlated significantly with excess mortality (r=0.23, p<0.001) but this association weakened after adjustment for other covariates in multivariable models. Excess mortality peaked in 2021 rather than in 2020 for most groups, with males initially experiencing higher rates during early pandemic waves. Spatial analyses revealed statistically significant clustering (Moran’s I=0.119, p<0.001) with identifiable hotspots in northern Chile and parts of the south. These findings indicated persistent mortality disparities by age and Indigenous status, independent of poverty, and highlight the urgent need for equity-focused pandemic preparedness. An effective pandemic response should integrate biomedical measures, such as vaccination, with culturally grounded strategies that address structural barriers and the broader social determinants of health.

PMID:41368772 | DOI:10.1093/aje/kwaf274

J Prosthodont. 2025 Dec 10. doi: 10.1111/jopr.70076. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the relevant factors affecting the accuracy of the autonomous dental implant robotic system (ADIR)-assisted implant surgery, providing the foundation for the clinical application of ADIR.

MATERIALS AND METHODS: This retrospective study involved 85 patients with 138 implants who underwent ADIR-assisted implant surgery between March 2022 and May 2024. Drilling plans and virtual preoperative implant placement were designed preoperatively. Cone-beam computed tomography (CBCT) was used immediately after surgery to assess the linear and angular deviations in two-dimensional (2D) and three-dimensional (3D) space between planned and actual implants. Generalized estimation equations (GEE) were applied to analyze the relevant factors affecting the accuracy of ADIR-assisted implant surgery.

RESULTS: The GEE showed a significant correlation between relevant factors (implant position and length) and the linear deviations at both the 2D platform and apex in ADIR-assisted implant surgery (p < 0.05). The platform and apex are more deviated linearly in the anterior region than in the posterior region. Compared to 8 mm implants, 12 and 16 mm implants exhibited larger linear deviation. Sex and age were relevant factors influencing implant 3D positional deviation. Females and patients over 40 years of age showed increased 3D linear deviation of the platform (p < 0.05), but there was no statistical difference in angular deviation. Implant shape, diameter, bone classification, side of arch, guided bone regeneration (GBR), and flap procedure had statistically nonsignificant effects on ADIR-assisted implant surgical accuracy.

CONCLUSIONS: The relevant factors (implant length, implant position, age, and sex of the patient) may affect the accuracy of ADIR-assisted implant surgery. This study is of clinical interest and helps surgeons make clinical decisions to improve the precision of implant surgery.

PMID:41368769 | DOI:10.1111/jopr.70076

Nurs Adm Q. 2025 Dec 10. doi: 10.1097/CIN.0000000000001397. Online ahead of print.

ABSTRACT

Although the significance of big data and data science in predicting health outcomes and identifying causal factors is widely recognized, their application in health disparities research remains limited. Understanding health disparities in the visually impaired population requires examining their health behavior patterns and health literacy levels, which can longitudinally impact their health and well-being. In prior research, one of the authors of the study conducted an online survey with 2718 participants using 5 validated self-reported questionnaires, such as Health Promoting Lifestyle Profile II, Health Literacy Questionnaire, eHealth Literacy Questionnaire, General Self-Efficacy, and Center for Epidemiological Studies Depression. Analysis of the online survey data demonstrated that individuals with blindness exhibited significantly higher levels of health-promoting behaviors, health literacy, and eHealth literacy compared to those with moderate and severe low vision. In this study, the research team developed an R Shiny web application as a follow-up to the online survey to disseminate its findings reproducibly and interactively. The R Shiny web application is expected to facilitate reproducible as well as interactive data analysis and sharing more efficiently than traditional methods, such as appendices or Supplementary Materials, Supplemental Digital Content 2, http://links.lww.com/CIN/A463 in academic journals. Extending the research cycle with open datasets and reproducible data analysis can deepen our understanding of health disparities and foster greater collaboration among researchers with similar interests.

PMID:41368760 | DOI:10.1097/CIN.0000000000001397

J Contemp Dent Pract. 2025 Nov 1;26(11):1092-1095. doi: 10.5005/jp-journals-10024-3962.

ABSTRACT

AIM: The current study aimed to evaluate the penetration depth and sealing ability of three different endodontic sealers.

MATERIALS AND METHODS: A total of 60 extracted human mandibular premolars for orthodontic reasons with a single canal were divided randomly into three groups of 20 samples-Group I: Tubli-Seal [zinc oxide-eugenol (ZOE)-based sealer], group II: Endosequence [bioceramic (BC) sealer], group III: AH Plus (epoxy resin-based sealer). At the coronal, middle, and apical thirds, three transversal segments of 1 mm thickness were created using a low-speed precision IsoMet cutter running at 200 rpm while being continuously cooled by water. Following a gold-palladium sputtered coating, these slices were seen at ×1000 magnification using a scanning electron microscope (SEM). The gaps in between the sealer and the canal wall were measured by analyzing images. Data was recorded and statistically analyzed.

RESULTS: The maximum sealing ability was found in Endosequence BC sealer i.e., 3.96 ± 0.16 followed by AH Plus sealer i.e., 2.32 ± 0.08 and Tubli-Seal sealer i.e., 1.04 ± 0.10. On intergroup comparison at coronal third; a statistically significant difference was obtained between Tubli-Seal sealer vs Endosequence BC sealer and Endosequence BC sealer vs AH Plus sealer. At middle and apical third, significant difference was obtained between Tubli-Seal sealer vs Endosequence BC sealer, Tubli-Seal sealer vs AH Plus sealer and Endosequence BC sealer vs AH Plus sealer (p < 0.001).

CONCLUSION: On conclusion, according to the current investigation, Endosequence BC sealer had the best sealing ability, followed by AH Plus sealer and Tubli-Seal sealer.

CLINICAL SIGNIFICANCE: The effectiveness of endodontic therapy depends on proper root canal closure. There are many endodontic sealers available; finding easy-to-use and effective items is crucial to providing quality patient care. When a root canal system is fully sealed, oral pathogens cannot colonize and re-infect the root and periapical tissues. How to cite this article: Mohan D, Lahiri B, Sreenivasalu PKP, et al. Assessment of the Sealing Ability and Penetration Depth of Different Endodontic Sealers: A Scanning Electron Microscope Study. J Contemp Dent Pract 2025;26(11):1092-1095.

PMID:41368750 | DOI:10.5005/jp-journals-10024-3962

J Contemp Dent Pract. 2025 Nov 1;26(11):1087-1091. doi: 10.5005/jp-journals-10024-3955.

ABSTRACT

OBJECTIVE: Orthodontic treatments often involve the use of metal or ceramic brackets bonded to the enamel surface of teeth, which can increase the risk of developing white spot lesions (WSLs) (demineralization) due to prolonged exposure to plaque and bacterial acids. This study aimed to investigate the potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in promoting remineralization and minimizing enamel loss without compromising the bond strength of metal and ceramic brackets.

MATERIALS AND METHODS: This in vitro experimental study involves a total of 44 therapeutically extracted first premolars immersed in artificial saliva and subjected to periodic demineralization cycles. Among these, 11 premolars were treated with a CPP-ACP remineralizing agent bonded with metal brackets, while another 11 premolars were treated with a CPP-ACP remineralizing agent and bonded with ceramic brackets. The remaining premolars were bonded with metal brackets (n = 11) or ceramic brackets (n = 11) without CPP-ACP treatment. Scanning electron microscope (SEM) analysis was conducted after debonding the brackets.

RESULTS: One-way ANOVA revealed a statistically significant difference among groups (p < 0.0001). Group IV (ceramic brackets with CPP-ACP) had the highest number of samples with score 0 (90.9%), indicating complete surface remineralization. Group III (metal brackets with CPP-ACP) followed with a 72.72% score 0. In contrast, both control groups (I and II) had 81.81% score 3, indicating severe surface damage. Scanning electron microscope analysis corroborated these findings, with group IV showing a smoother, more uniform enamel surface.

CONCLUSION: The premolars treated with CPP-ACP and bonded with ceramic brackets exhibited significantly higher remineralization potential compared to those treated with CPP-ACP and bonded with metal brackets. How to cite this article: Anbarasu P, Bhattacharyya A, Dinesh S, et al. Evaluation of the Preventive Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on White Spot Lesions during Fixed Orthodontic Treatment Using Scanning Electron Microscopy. J Contemp Dent Pract 2025;26(11):1087-1091.

PMID:41368749 | DOI:10.5005/jp-journals-10024-3955

J Contemp Dent Pract. 2025 Nov 1;26(11):1079-1086. doi: 10.5005/jp-journals-10024-3897.

ABSTRACT

AIM: The study aims to evaluate the effect of fluoridated and non-fluoridated mouthwash on the rate of tooth movement and surface topography changes of nickel-titanium (NiTi) and multistranded stainless steel arch wires.

MATERIALS AND METHODS: Twenty patients aged 18-30 years with moderate mandibular anterior crowding [Little’s Irregularity Index (LII): 4-6 mm] were selected and randomly divided into two groups (n = 10) and were assigned by archwire type: Group I (NiTi) and group II (multistranded SS). Each group was subdivided into fluoridated (Colgate MaxFresh Mouthwash; groups IA and IIA) and non-fluoridated (Listerine; groups IB and IIB) mouthwash subgroups (n = 5). The rate of tooth movement was assessed monthly for 3 months using LII, and the surface topography of the retrieved wires was evaluated using scanning electron microscopy (SEM). Data were recorded and statistically analyzed.

RESULTS: Both group I and group II demonstrated a reduction in LII over the 3 months. The non-fluoridated subgroup of group I had the greatest reduction (from 5.58 ± 0.12 mm at T0 to 0.76 ± 0.03 mm at T3) compared to the fluoridated subgroup (from 4.80 ± 0.11 to 0.50 ± 0.07 mm). For group II, the non-fluoridated subgroup reduced from 5.26 ± 0.12 mm to 0.73 ± 0.04 mm, and the fluoridated subgroup reduced from 4.27 ± 0.15 mm to 0.43 ± 0.07 mm. Intragroup comparisons were statistically significant over time (p < 0.001; Friedman test), and intergroup differences at each time point also proved statistically significant (p < 0.05; Kruskal-Wallis test). The SEM showed more significant surface damage (pitting, corrosion, and inclusions) in wires exposed to the fluoridated mouthwash group than the non-fluoridated rinse.

CONCLUSION: Non-fluoridated mouth rinses seem to aid in orthodontic tooth movement rates, especially with NiTi arch wire, while fluoridated mouth rinses can inhibit arch wire efficacy.

CLINICAL SIGNIFICANCE: This study addresses the lack of in vivo evidence regarding the impact of frequently used mouth rinses on orthodontic treatment efficiency. These findings will assist in selecting adjunctive mouth rinses to maintain the integrity of the arch wire and improve the rate of movement during the alignment phase. How to cite this article: Gadde H, Kumar S, Bhattu BK, et al. Effect of Fluoridated and Non-fluoridated Mouthwash on Tooth Movement and Surface Topography Changes of Arch Wires: An In Vivo Study. J Contemp Dent Pract 2025;26(11):1079-1086.

PMID:41368748 | DOI:10.5005/jp-journals-10024-3897

J Contemp Dent Pract. 2025 Nov 1;26(11):1073-1078. doi: 10.5005/jp-journals-10024-3875.

ABSTRACT

AIM: This study aims to evaluate the antimicrobial effectiveness and smear layer removal of Piper longum extract as a natural irrigant in root canal therapy compared to ethylenediaminetetraacetic acid (EDTA), a commonly used irrigant.

MATERIALS AND METHODS: A total of 0.5 gm of powdered P. longum fruit was extracted using distilled water and heat. Eighteen freshly extracted human maxillary central incisors were selected and decoronated to a length of 16 mm. Root canals were prepared and divided into two groups (n = 9 each): Group I was treated with 17% EDTA (control), and group II was treated with P. longum extract (test). Irrigants were activated using gutta-percha cones. Samples were sectioned for SEM evaluation at coronal, middle, and apical regions. SEM imaging was performed at ×200 (debris) and ×1,000 (smear layer). The antimicrobial analysis was done by incubating a fresh suspension of microorganisms, and the sterile wells bored were filled with varying concentrations of P. longum, and inhibition zones were measured using a vernier caliper for positive, negative, and experimental groups. Data were recorded and statistically analyzed using SPSS software.

RESULTS: Mean smear layer scores were 2.11 ± 0.60 EDTA and 1.66 ± 0.70 (P. longum). Mean debris scores were 2.22 ± 0.44 EDTA and 2.11 ± 0.33 (P. longum). Piper longum demonstrated enhanced smear layer removal and comparable debris clearance. Antimicrobial zones of inhibition for P. longum at 150 µL ranged from 12 mm (Streptococcus mutans) to 11 mm (Candida albicans), comparable to the positive control, ampicillin (bacteria) and fluconazole (fungi). The differences in inhibition zones between P. longum and the positive control were statistically significant (p < 0.05). No zones were observed for negative controls (distilled water).

CONCLUSION: Piper longum extract demonstrated substantial efficacy in removing the smear layer and reducing microbial load within the root canal system, comparable to conventional EDTA.

CLINICAL SIGNIFICANCE: There is a growing need for biocompatible and sustainable alternatives to synthetic irrigants, which may cause adverse effects such as tissue toxicity or dentin erosion. This study explores the potential of P. longum, a natural herbal extract with known antimicrobial and anti-inflammatory properties, as an adjunctive irrigant in root canal therapy. How to cite this article: Varshasree S, Sinduja P, Manjesh D, et al. Effectiveness of Piper longum Extract as Natural Irrigant on Antimicrobial Properties and Smear Layer Removal: A Scanning Electron Microscope Study. J Contemp Dent Pract 2025;26(11):1073-1078.

PMID:41368747 | DOI:10.5005/jp-journals-10024-3875

J Contemp Dent Pract. 2025 Nov 1;26(11):1067-1072. doi: 10.5005/jp-journals-10024-3974.

ABSTRACT

AIM: This study aimed to evaluate the prevalence, patterns, and severity of iatrogenic damage to adjacent teeth during fixed prosthodontic tooth preparation.

METHODOLOGY: A total of 126 teeth were assessed following fixed prosthodontic preparation procedures. The adjacent tooth surfaces were examined clinically to determine the level (degree), location, and type of damage on both mesial and distal surfaces. Damage severity was graded as normal, mild, or severe; locations were recorded according to the specific third of the surface involved, and damage type was categorized as abrasion, nick, or both. A Chi-square test was performed to explore differences based on tooth position (maxillary vs mandibular) and operator experience (clinicians, interns, and students).

RESULTS: Normal surfaces were the most frequently recorded finding, accounting for 155 (61.5%) of all assessed surfaces. Mild damage was observed in 77 (30.5%) of cases, while severe damage was less common in 19 (7.5%). The middle third of the proximal surface was the most affected site among damaged teeth. Nicks were the predominant damage type 66 (26.2%), followed by abrasion 21 (8.3%). Maxillary teeth exhibited more severe damage, particularly on mesial surfaces, whereas mandibular teeth more often remain undamaged. A statistically significant difference was observed based on operator experience; students recorded a higher frequency of both mild and severe damage compared to interns and clinicians.

CONCLUSION: Iatrogenic damage to adjacent teeth during fixed prosthodontic preparation was commonly observed, with mild damage and nicks affecting the middle third of the proximal surface being the most frequent. Severe damage occurred more on the maxillary mesial surfaces.

CLINICAL SIGNIFICANCE: Iatrogenic damage was more pronounced on maxillary mesial surfaces and occurred predominantly in preparations performed by less experienced operators. How to cite this article: Alharbi MF, Agwan MAS, Alrethia RA. Prevalence and Patterns of Iatrogenic Damage to Adjacent Teeth during Fixed Prosthodontic Preparation. J Contemp Dent Pract 2025;26(11):1067-1072.

PMID:41368746 | DOI:10.5005/jp-journals-10024-3974