Tag: statistics

Retin Cases Brief Rep. 2025 Apr 16. doi: 10.1097/ICB.0000000000001765. Online ahead of print.

ABSTRACT

PURPOSE: Evaluate the safety and efficacy of membrane rich in growth factors (mPRGF) and its effects on retinal vasculature and anatomy in refractory and poor-prognosis macular holes.

METHODS: Retrospective, interventional, longitudinal, case series and single-center study conducted at Dr. Elías Santana Hospital, Dominican Republic. Patients with macular hole larger than 400 microns, refractory or with poor prognosis were treated with posterior pars plana vitrectomy (PPV) plus adjuvant therapy mPRGF. A total of seven eyes were included: refractory MH (n=6) and traumatic MH (n=1). The anatomical closure was evaluated by optical coherence tomography (OCT) and foveal avascular zone (FAZ), and foveal density (FD) was measured with optical coherence tomography angiography (OCT-A) pre- and post-surgery. Also, the corrected visual acuity (CVA) was compared pre- and post-intervention.

RESULTS: A total of seven eyes were intervened with a surgical-anatomic closure rate was 85.7%. The average CVA resulted in an improvement of over six lines in Snellen notation which was statistically significant (p=0.036). FAZ and FD showed a decrease (p=0.002) and increase (p=0.043), respectively after surgery.

CONCLUSIONS: In conclusion, this clinical research provides compelling evidence supporting the efficacy and safety of mPRGF in achieving the anatomical closure of refractory or traumatic macular holes larger than 400 microns. Notably, mPRGF treatment demonstrated significant improvements in patients’ visual acuity and contributed to the restoration of normal retinal vasculature. These exciting results pave the way for the potential utilization of mPRGF as a reproducible and cost-effective adjuvant therapy in the surgical management of macular holes.

PMID:40258274 | DOI:10.1097/ICB.0000000000001765

J Med Internet Res. 2025 Apr 21;27:e60681. doi: 10.2196/60681.

ABSTRACT

BACKGROUND: Identifying patients with inherited colorectal cancer (CRC) syndromes offers many potential benefits. However, individuals often experience decisional conflict regarding genetic testing for CRC, and the uptake rate remains low. Given the growing popularity of genetic testing and the increasing demands on genetic service providers, strategies are needed to promote informed decision-making, increase genetic testing uptake among at-risk individuals, and ensure the rational use of genetic service resources.

OBJECTIVE: This study aims to determine whether a decision aid (DA) tool could promote informed decision-making among family members regarding the genetic testing of a patient with CRC.

METHODS: A single-center, parallel-group, randomized controlled trial was conducted. We randomized 82 family members of patients with CRC, who were involved in major medical decision-making for the patient, to either a DA intervention or usual care. The primary outcome was informed decision-making, assessed through measures of knowledge, decisional conflict, decision self-efficacy, and preparation for decision-making. Secondary outcomes included patients’ uptake of genetic counseling and testing, participants’ CRC screening behavior, healthy lifestyle scores, anxiety and depression levels, quality of life, and satisfaction with the intervention. Data were collected at baseline (T0), after the intervention (T1), and 3 months after the baseline survey (T2). The DA intervention and outcome assessments at T1 and T2 were delivered via WeChat. The effects of the intervention were analyzed using generalized estimating equation models.

RESULTS: Statistically significant improvements were observed in knowledge (T1: β=2.049, P<.001; T2: β=3.317, P<.001), decisional conflict (T1: β=-11.660, P<.001; T2: β=-17.587, P<.001), and decision self-efficacy (T1: β=15.353, P<.001; T2: β=22.337, P<.001) in the DA group compared with the usual care group at both T1 and T2. Additionally, the DA group showed significantly greater improvement in processed and red meat intake (β=-1.494, P<.001) at T1 and in healthy lifestyle scores (β=1.073, P=.03) at T2. No differences were found between the groups for other outcomes.

CONCLUSIONS: A DA tool may be a safe, effective, and resource-efficient approach to facilitate informed decision-making about genetic testing. However, the current DA tool requires optimization and further evaluation-for example, by leveraging more advanced technology than WeChat to develop a simpler and more intelligent DA system.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100048051; https://www.chictr.org.cn/showproj.html?proj=129054.

PMID:40258273 | DOI:10.2196/60681

J Med Internet Res. 2025 Apr 21;27:e71684. doi: 10.2196/71684.

ABSTRACT

BACKGROUND: Breast cancer is one of the most prevalent cancers among women and significantly impacts psychological well-being and health-related quality of life (HR-QoL) during the perioperative period. Mobile health interventions offer a promising approach to providing education and psychosocial support, yet their effectiveness in this context remains underexplored.

OBJECTIVE: This study aimed to develop and evaluate the effectiveness of an innovative, mobile-based, perioperative care program for women undergoing breast cancer surgery (iCareBreast). The assessment focused on perioperative self-efficacy, anxiety, depression, fatigue, HR-QoL, and perioperative care satisfaction.

METHODS: A two-group randomized control trial was conducted at a tertiary hospital in Singapore. The intervention group used the iCareBreast app, offering four main resources: perioperative care guidance, breast cancer and surgery education, psychological support, and social support. The control group received standard hospital care. Participants in the intervention group engaged with the fully automated app daily for 29 days (two weeks before surgery, on the day of surgery, and two weeks after surgery). Data were collected face-to-face or on the web at three time points: baseline, immediately after the intervention (T1; two weeks after surgery), and at a 2.5-month follow-up (T2; three months after surgery). The primary outcome was perioperative care self-efficacy, while secondary outcomes included anxiety, depression, fatigue, HR-QoL, and perioperative care satisfaction.

RESULTS: A total of 123 patients with early-stage breast cancer scheduled for breast surgery were enrolled in the study, with 62 patients assigned to the iCareBreast group and 61 patients to the control group. The results showed no significant differences between the groups in the primary outcome-perioperative self-efficacy-at any time point. Baseline scores were similar (P=.80), and while the iCareBreast group showed slightly lower scores at T1 (mean difference [MD] -1.63, 95% CI -3.43 to 0.18; P=.08) and T2 (MD -1.90, 95% CI -4.06 to 0.26; P=.09), the differences were not statistically significant. Similarly, secondary outcomes, including anxiety, depression, fatigue, HR-QoL, and perioperative care satisfaction, showed no significant changes between groups (all P>.05). However, the iCareBreast group reported higher perioperative care satisfaction during the postintervention assessment. Satisfaction scores were comparable at T1 (P=.68), while at T2, the iCareBreast group showed a slight increase compared to the control group (MD 0.35, 95% CI 0.04-0.73; P=.08), though the difference was not statistically significant.

CONCLUSIONS: The mobile-based psychosocial intervention, although satisfied by users, did not demonstrate significant benefits compared to standard care. This highlights the need to refine the iCareBreast app in future iterations to enhance its effectiveness in addressing the targeted health outcomes. Future mobile health research should prioritize optimizing user engagement strategies and incorporating personalized approaches to better address the perioperative care needs of patients with breast cancer.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04172350; https://clinicaltrials.gov/study/NCT04172350.

PMID:40258266 | DOI:10.2196/71684

JMIR Res Protoc. 2025 Apr 21;14:e59511. doi: 10.2196/59511.

ABSTRACT

BACKGROUND: The evolving global health landscape highlights the importance of travel medicine, making it necessary for health care professionals to understand the epidemiologic profiles among varied traveler populations and keep themselves updated in this rapidly changing field. However, in Italy, travel medicine clinics have significant gaps in resource allocation, staff training, and infrastructure.

OBJECTIVE: This protocol of a cross-sectional study aims to create and validate a questionnaire to assess the knowledge, attitudes, and practices of health care professionals in travel medicine in Italy. The final goal is to provide a tool to evaluate the state of travel medicine, guide training initiatives, and be able to monitor trends over time.

METHODS: The study population consists of health care professionals who practice travel medicine in Italy. The questionnaire will be developed by adapting an existing English survey and conducting a scoping review to align the questionnaire with contemporary scientific discourse. The validation process includes face validity, content validity, and expert evaluation. The sample size, determined through power analysis, ranges from 218 to 278 participants. The questionnaire will undergo a pilot test on a smaller sample size (10% of the total) to identify and address any issues. Statistical analysis will include central tendency and dispersion measures, categorical summaries, group comparisons, and regressions. This research received ethical approval, and informed consent will be obtained from all participants.

RESULTS: As of July 2024, we completed the questionnaire validation involving 9 experts. The validated version of the questionnaire includes 86 items. Furthermore, we conducted a pilot test on 53 individuals during the SIMVIM (Italian Society of Travel Medicine and Migrations) course on travel medicine held in Lucca, Italy, on June 14, 2024.

CONCLUSIONS: This cross-sectional study will guide strategic planning and targeting training and awareness activities in areas deemed most critical or lacking. The study’s structured approach and periodic assessments will facilitate the identification of educational gaps, the dissemination of best practices, and the overall improvement of health care services for travelers in Italy.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/59511.

PMID:40258265 | DOI:10.2196/59511

Gen Dent. 2025 May-Jun;73(3):73-77.

ABSTRACT

The use of mouthwash is a practical approach to decreasing bacteria during orthodontic treatment. This study aimed to investigate the antibacterial effect of 0.2% curcumin mouthwash on Streptococcus mutans in individuals undergoing fixed orthodontic treatment. For this double-blinded clinical study, 22 orthodontic patients aged 15 years or older with no systemic or periodontal diseases were selected and randomly divided into 2 groups of 11 individuals. One group received 0.2% curcumin mouthwash (intervention), while the other group received 0.2% chlorhexidine mouthwash (control) to use twice daily. Orthodontic elastics were collected from the patients’ mouth immediately before the first use of the mouthwash, immediately after the first use, and after 20 days of mouthwash use. The elastics were stored in normal saline, and the samples were transferred to a microbiology laboratory for serial dilution, plating, and incubation. After 48 hours, the number of colony-forming units (CFUs) of S mutans were counted and compared. The Friedman and Wilcoxon tests were used for statistical analysis of intragroup data, while the Mann-Whitney U test was used for intergroup comparisons. A difference of P < 0.05 was considered statistically significant. Both the curcumin and chlorhexidine groups demonstrated a statistically significant decrease in CFUs of S mutans immediately after the initial use as well as after 20 days’ use (P < 0.05). After the first use, there was no statistically significant difference between the groups in the reduction of CFUs (P = 0.071). However, after 20 consecutive days of mouthwash use, the curcumin group had a significantly greater decrease in CFUs of S mutans than the chlorhexidine group (P < 0.001). Both chlorhexidine and curcumin mouthwashes significantly reduced the number of S mutans colonies when used regularly. The results of the present study suggest that curcumin herbal mouthwash is a superior choice to chlorhexidine for orthodontic patients due to its long-term antibacterial properties.

PMID:40258261

Gen Dent. 2025 May-Jun;73(3):68-72.

ABSTRACT

The objective of this study was to compare the clinical performance of 2 types of pit and fissure sealants–containing either fluoride or amorphous calcium phosphate (ACP)–over a period of 24 months. In this retrospective split-mouth study, 36 fluoride-containing sealants (Clinpro) and 36 ACP-containing sealants (Aegis) were evaluated 24 months after placement in the permanent first molars of 30 children aged 6 to 7 years. The sealants were inspected for retention based on the criteria of Oulis and Berdouses, with scores of 0, 1, and 2 representing total retention, partial loss, and total loss, respectively. In addition, the sealants were assigned scores for marginal integrity, marginal discoloration, and anatomical form based on the criteria of Feigal et al. Differences between groups in the occurrences of each evaluation variable were compared using relative risk with its 95% CI as well as the chi-square or Fisher exact test. The level of significance was set at P = 0.05. The retention success rates of the fluoride and ACP sealants after 24 months were 66.6% and 61.1%, respectively, but the difference was not statistically significant (P > 0.05). The overall clinical success of the fluoride-containing sealant was slightly greater than that of the ACP-containing sealant in terms of marginal discoloration and anatomical form; however, these differences were not statistically significant (P > 0.05). The marginal integrity of the sealant with ACP nanofillers was greater than that of the fluoride-containing sealant, but the difference did not reach statistical significance (P > 0.05). After a 24-month follow-up period, no significant disparities in clinical performance were observed between fluoride- and ACP-containing sealants in terms of retention rates, marginal integrity, marginal discoloration, or anatomical form. The clinical performance of both sealant types was found to be acceptable.

PMID:40258260

Gen Dent. 2025 May-Jun;73(3):35-41.

ABSTRACT

Pulp stones result from the calcification of dental pulp tissue. There is limited research on pulp stones in unerupted teeth, but they are more suitable for investigating the influence of systemic factors on pulp stone formation because they are not exposed to the conditions of the oral cavity. The objectives of this cross-sectional descriptive-analytical study were to use cone beam computed tomography (CBCT) to evaluate pulp stones in unerupted teeth and to be the first investigation to assess the correlation between pulp stones and blood levels of principal biochemical factors. The CBCT records of 90 patients were evaluated, and 3 groups were defined based on the size of pulp stones: small pulp stone (including total absence as well as minute particles with maximum diameter < 0.05 mm); moderate-sized pulp stone (maximum diameter 0.05-1.59 mm); or large pulp stone (maximum diameter ≥ 1.60 mm). This was followed by assessment of the patients’ blood levels of 5 principal biochemical factors: fasting blood glucose (FBG), total cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL). The data were analyzed by chi-square test, 1-way analysis of variance, and Kruskal-Wallis test, and values of P < 0.05 were considered statistically significant. Individuals with a large pulp stone were significantly older than individuals with a small pulp stone (P = 0.024). No statistically significant difference was found in the distribution of the sexes in the 3 pulp stone groups, nor was there any association between pulp stones in unerupted teeth and FBG, total cholesterol, triglycerides, HDL, or LDL level (P > 0.05). The prevalence of tooth types followed a consistent pattern across all 3 groups, with canines being the most commonly affected, followed by premolars. In the present study, confounding variables were minimized by using unerupted teeth. CBCT was found to be an accurate 3-dimensional imaging modality for evaluation of pulp stones. As people age, the likelihood of pulp stone formation increases. No statistically significant association was observed between the prevalence of pulp stones and patients’ sex or biochemical factor levels.

PMID:40258254

Gen Dent. 2025 May-Jun;73(3):28-33.

ABSTRACT

The purpose of this study was to compare the tensile strength, modulus of elasticity, porosity, and waste reduction of extra-light-body polyvinyl siloxane (PVS) impression material mixed with a helical impression tip or a new cartridge integrated system (NCIS) from the same manufacturer (Dentsply Sirona). The legacy teal tip (TT group) was compared with the NCIS red (RT group) and blue (BT group) mixing tips. Dumbbell-shaped specimens (TT, n = 17; RT, n = 15; and BT, n = 16) were prepared in accordance with German Institute for Standardization’s rubber testing standard (DIN 53504.2017) and tested in a universal testing machine for tensile strength and modulus of elasticity. Porosity was evaluated via microcomputed tomography of cylindrical specimens (TT, n = 7; RT, n = 6; and BT, n = 7). Waste reduction was evaluated by comparing the mass of the mixing tips before use and after polymerization of the PVS to determine the difference in weight, which represented the amount of retained material (n = 11 per group). Tensile strength was analyzed using 1-way analysis of variance (ANOVA). Modulus of elasticity was analyzed using 1-way ANOVA with Tukey HSD. Porosity and waste reduction were analyzed using Shapiro-Wilk, Kruskal-Wallis, and Steel-Dwass tests. The analyses revealed no differences in tensile strength between groups (P = 0.493). The TT group had a significantly higher modulus of elasticity than the RT and BT groups (P < 0.001). The BT group had the highest mean porosity, and the difference between BT and RT was statistically significant (P = 0.048). The RT group showed the least material waste. Supporting the claims of the manufacturer, the NCIS tips generated tensile strengths comparable to that of the legacy tip and produced less waste, achieving waste reductions of 62% (RT) and 21% (BT) compared with the legacy tip. However, the RT and BT groups had a lower modulus of elasticity than the TT group, and porosity was increased in the BT group.

PMID:40258253

PLoS Comput Biol. 2025 Apr 21;21(4):e1011909. doi: 10.1371/journal.pcbi.1011909. Online ahead of print.

ABSTRACT

Cell sorting by differential adhesion is one of the basic mechanisms explaining spatial organization of neurons in early stage brain development of fruit flies. The columnar arrangements of neurons determine the large-scale patterns in the fly visual center. Experimental studies indicate that hexagonal configurations regularly appear in the fly compound eye, which is connected to the visual center by photoreceptor axons, while tetragonal configurations can be induced in mutants. We need a mathematical framework to study the mechanisms of such a transition between hexagonal and tetragonal arrangements. Here, we propose a new mathematical model based on macroscopic approximations of agent-based models that produces a similar behavior changing from hexagonal to tetragonal steady configurations when medium-range repulsion and longer-range attraction between individuals are incorporated in previous successful models for cell sorting based on adhesion and volume constraints. We analyze the angular configurations of these patterns based on angle summary statistics and compare between experimental data and parameter fitted ARA (Adhesion-Repulsion-Attraction) models showing that intermediate patterns between hexagonal and tetragonal configuration are common in experimental data as well as in our ARA mathematical model. Our studies indicate an overall qualitative agreement of ARA models in tile patterning and pave the way for their quantitative studies. Our study opens up a new avenue to explore tile pattern transitions, found not only in the column arrangement in the brain, but also in the other related biological processes.

PMID:40258228 | DOI:10.1371/journal.pcbi.1011909

PLoS Comput Biol. 2025 Apr 21;21(4):e1012949. doi: 10.1371/journal.pcbi.1012949. Online ahead of print.

ABSTRACT

Nosocomial, or hospital-acquired, infections are a key determinant of patient health in healthcare facilities, leading to longer stays and increased mortality. In addition to the direct effects on infected patients, the burden imposed by nosocomial infections impacts both staff and other patients by increasing the load on the healthcare system. The appropriate infection control response may differ depending on whether the infection was acquired in the hospital or the community. For example, nosocomial outbreaks may require ward closures to reduce the risk of onward transmission, whilst this may not be an appropriate response to repeated importations of infections from outside the facility. Unfortunately, it is often unclear whether an infection detected in a healthcare facility is nosocomial, as the time of infection is unobserved. Given this, there is a strong case for the development of models that can integrate multiple datasets available in hospitals to assess whether an infection detected in a hospital is nosocomial. When assessing nosocomiality, it is beneficial to take into account both whether the timing of infection is consistent with hospital acquisition and whether there are any likely candidates within the hospital who could have been the source of the infection. In this work, we developed a Bayesian model which jointly estimates whether a given infection detected in hospital is nosocomial and whether it came from a set of individuals identified as candidates by hospital staff. The model coherently integrates pathogen genetic information, the timings of epidemiological events, such as symptom onset, and location data on the infected patient and candidate infectors. We illustrated this model on a real hospital dataset showing both its output and how the impact of the different data sources on the assessed probabilities are contingent on what other data has been included in the model, and validated the calibration of the predictions against simulated data.

PMID:40258227 | DOI:10.1371/journal.pcbi.1012949