Tag: statistics

J Dent Educ. 2025 May 19:e13940. doi: 10.1002/jdd.13940. Online ahead of print.

ABSTRACT

PURPOSES: This study compared a chatbot with an expository interactive lecture as a tool for teaching pulpal and periapical diagnosis in undergraduate dental education.

METHODS: A chatbot and an expository interactive lecture were used to deliver the topic of pulpal and periapical diagnosis based on the American Association of Endodontics guidelines. A total of 24 second-year students in a 4-year undergraduate program were enrolled. An initial test (Test A) with 10 multiple-choice questions was applied to all students. Then, the students were randomly assigned to two different groups: Lecture (control) and Chatbot (experimental). The Lecture group attended an expository interactive lecture delivered by an endodontist. Simultaneously, in the Chatbot group, the chatbot was delivered to the students through the Telegram Messenger application. After 50 min, both groups were submitted to the same test (Test B). Subsequently, the Control group used the chatbot, while the Experimental group attended a lecture by the same faculty. After the split activity, all the students replied to a questionnaire with their perceptions regarding both activities. Statistical analysis was performed with the significance level set at 5%.

RESULTS: Twenty-two students replied to the questions. Both Lecture and Chatbot groups showed significant grade improvement (Lecture: from 6.18 ± 2.08 to 8.45 ± 1.28; Chatbot: from 5.55 ± 1.63 to 7.91 ± 1.58). No difference in the initial and final average grades was detected between the groups. Overall, the chatbot was considered more fun and simpler while the lecture was preferred for understanding (p < 0.05). Chatbot was rated 4.95/5 for ease of use.

CONCLUSIONS: The chatbot was as effective as an interactive lecture in delivering the basic content of pulpal and periapical diagnosis. The students’ perception was that the chatbot was simpler and more fun than the lecture; however, the interactive lecture is a better tool to fully understand the topic. The professor is irreplaceable when discussing the content.

PMID:40384501 | DOI:10.1002/jdd.13940

JPEN J Parenter Enteral Nutr. 2025 May 19. doi: 10.1002/jpen.2771. Online ahead of print.

ABSTRACT

BACKGROUND: In response to coronavirus disease 19, healthcare organizations made dramatic and immediate shifts from in-person office to telehealth visits to provide care to patients while adhering to social distancing restrictions. The objective of this study was to test the efficacy of virtual visits compared with “brick and mortar” (in-person visits) for patients receiving home parenteral nutrition for clinical outcomes of the incidence of catheter complications and 30-day readmissions.

METHODS: A retrospective cohort study was conducted between January 2020 and December 2020 on eligible patients managed by the Cleveland Clinic Home Nutrition Support and the Center Gut Rehabilitation and Transplant teams. Those receiving home parenteral nutrition who were seen in a follow-up clinic appointment were included.

RESULTS: Of 189 patients studied, 103 had in-person visits and 86 had virtual visits. A total of 7.9% (n = 15) of patients had catheter complications. Virtual visits demonstrated statistical noninferiority of the incidence of catheter-related complications when compared with in-person visits (90% CI, -0.051 to 0.106; margin <0.1). Readmission incidence for in-person visits was 8.5% (n = 16) and 6.3% (n = 12) for virtual visits. Virtual visits demonstrated statistical noninferiority to in-person visits for incidence of readmissions after the visit (90% CI, -0.094 to 0.106; margin <0.1).

CONCLUSION: Virtual visits demonstrate noninferiority to in-person visits based on the incidence of catheter complications and readmission rates. New evaluation techniques need to be developed for this high-risk populations in virtual visits to establish effective and safe patient management.

PMID:40384499 | DOI:10.1002/jpen.2771

Emerg Med Australas. 2025 Jun;37(3):e70057. doi: 10.1111/1742-6723.70057.

ABSTRACT

OBJECTIVE: We evaluated guideline adherence and healthcare utilisation in an emergency department (ED) pre- and post-implementation of a physiotherapy-led low back pain (LBP) guideline and rapid outpatient follow-up service (collectively termed PLEDGE model).

METHODS: The PLEDGE model was implemented in a metropolitan tertiary hospital. Data from LBP ED presentations were extracted from electronic medical records for 1 year pre- and post-PLEDGE model implementation. To evaluate guideline-adherent care, the primary outcome was the incidence of any opioid analgesia use. Requests for imaging and pathology were secondary outcomes. To evaluate healthcare utilisation, the primary outcome was the ED National Emergency Access Target (NEAT). Secondary outcomes included ED re-presentations within 28 days, short stay unit (SSU) admissions and ED length of stay (LOS).

RESULTS: Overall, 2732 patients were included (1384 post-implementation). For guideline-adherent care, opioid analgesia (χ² (1, N = 2732) = 17.406, p < 0.001) and pathology ordering (χ² (1, N = 2732) = 6.363, p = 0.012) significantly reduced post-implementation; however, there was no reduction in imaging requests (χ² (1, N = 2732) = 1.859, p = 0.173). With respect to healthcare utilisation, measures of ED NEAT and ED LOS worsened. Patients were significantly less likely to be admitted to SSU (χ² (1, N = 2732) = 6.356, p = 0.012) or re-present to ED (χ² (1, N = 2732) = 4.098, p = 0.043).

CONCLUSION: Implementation of the PLEDGE model reduced opioid analgesia use, pathology ordering, SSU admissions and ED re-presentations and provided a valuable safety net. ED NEAT worsened, ED LOS increased and imaging requests remained unchanged.

PMID:40384488 | DOI:10.1111/1742-6723.70057

J Esthet Restor Dent. 2025 May 19. doi: 10.1111/jerd.13489. Online ahead of print.

ABSTRACT

OBJECTIVE: Lithia-based glass ceramics lead the indirect single-unit restoration market, but the underlying evidence is dominated by a single material. New materials have been introduced. The purpose was to investigate the elemental composition, elemental oxide composition, as-fabricated surface morphology, as-fabricated flexural strength, color, contrast ratio, and absolute light transmission for a variety of lithia-based glass ceramics.

MATERIALS AND METHODS: Test and control materials included: Amber Direct, Amber Mill, Cerec Tessera, IPS Emax CAD, Enamic, IPS Empress CAD, Initial Lisi, Supriniy PC, and TriLuxe Forte. Inductively coupled plasma-optical emission spectrometry, X-ray fluorescence, scanning electron microscopy, mechanical testing (n = 10), visible light spectroscopy (n = 4), and transmission testing (n = 4) were used to evaluate the above parameters. Where appropriate, ANOVA and multiple comparisons testing were used to determine which of the materials differed from one another (α = 0.05).

RESULTS: A range of lithia-based glass ceramics exhibited substantial differences in the above parameters. Differences were of sufficient magnitude to have statistical significance (p < 0.05) and clinical importance. Milling partly crystallized blocks, followed by additional crystallization, almost doubled flexural strength values in comparison to milling fully sintered blocks. Differences in a wide range of color parameters, more than sufficient to be obvious to the eye, were measured even though the materials were all the same nominal shade.

CONCLUSIONS: A variety of lithia-based glass-ceramic materials differed substantially across a range of chemical and physical properties.

CLINICAL SIGNIFICANCE: A range of dental lithia-based glass-ceramic materials exhibited substantial differences in chemical composition, strength, and optical properties of a magnitude expected to influence their clinical performance. The milling of partly crystallized blocks, followed by additional crystallization, almost doubled flexural strength values in comparison to the milling of fully sintered blocks or control materials. At high magnification, machining damage was evident for all materials except for one partially crystallized lithia-based material, which had also exhibited the highest strength.

PMID:40384480 | DOI:10.1111/jerd.13489

Cancer Control. 2025 Jan-Dec;32:10732748251344469. doi: 10.1177/10732748251344469. Epub 2025 May 19.

ABSTRACT

IntroductionCancer-related financial hardship is pervasive, impacting both patients and caregivers, making it crucial to address financial hardship at the household level. The CREDIT (S1912CD) study was designed to enroll and randomize cancer patients and spousal caregivers as dyads to proactive financial navigation compared to usual care. The study faced several challenges to recruitment. This paper discusses the changes made to successfully complete the study.MethodsThe study took place among NCI Community Oncology Research Program (NCORP) sites and allowed several venues for protocol feedback, including SWOG group meetings, NCORP administrator meetings, and individual calls with recruiting sites. A patient advocate worked with the study team to review and update documents to ensure the study was relevant and accessible to potential participants.ResultsSeveral barriers were identified including sites facing challenges in enrolling patient-spouse dyads, multiple financial navigation partners causing confusion and delays in delivery of the intervention, eligibility criteria concerns, and participant discomfort with providing social security numbers. Several modifications were made to address these obstacles during a study restructure, including making caregiver participation optional, streamlining intervention delivery, and modifying eligibility criteria to allow more time between diagnosis and enrollment. Changes from the restructure resulted, on average, in a 9.5 patient per month increase in accrual (4.1 to 13.6) and has enabled the study to reach overall accrual within the study timeline. Importantly, the study maintained diverse accrual and continued to accrue willing caregivers to enable exploratory analysis of caregiver outcomes.ConclusionInterventions examining how to mitigate financial hardship for cancer patients and those affected by cancer, must be pragmatic in order to be translated into sustainable programs in real world settings. Providing recruiting sites an avenue for feedback ensured that the study team could adjust the protocol to meet site needs and successfully complete this financial navigation study.

PMID:40384469 | DOI:10.1177/10732748251344469

Emerg Med Australas. 2025 Jun;37(3):e70060. doi: 10.1111/1742-6723.70060.

ABSTRACT

OBJECTIVES: To explore and describe patients’ expectations, perceptions and experiences of having a pelvic examination (PV) in the emergency department (ED) and to describe ED clinicians’ attitudes and perceptions regarding PVs.

METHODS: A mixed methods study using questionnaires and semi-structured interviews with patients and clinicians at two EDs in the same health service (tertiary ED and urban district ED) between May 2023 and February 2024. Quantitative data are reported descriptively using means and proportions. A qualitative descriptive approach and thematic analysis were used to develop themes from interviews and gather granular insights from participants’ first-hand experiences.

RESULTS: Clinicians completed 84 questionnaires and nine interviews. Patients completed 63 questionnaires and eight interviews. Quantitative and qualitative data were merged to form four themes: (1) the variable clinical utility of the PV in ED, (2) lack of ED clinician confidence and training, (3) bedside manner as primary influence on patient experience, and (4) the inadequate ED setting for performing intimate exams.

CONCLUSIONS: The utility of PVs in ED remains ambiguous and it is vital to avoid unnecessary invasive exams. However, urgent PVs will sometimes be needed and participants have made actionable suggestions to improve the clinical care delivered when performing PVs in ED. The four themes can inform future strategies to advance clinicians’ training, confidence and skill level when performing PVs. This will lead to overall enhanced patient experience and satisfaction and reduce downstream negative consequences of having an inadequate PV experience in ED.

PMID:40384467 | DOI:10.1111/1742-6723.70060

Ying Yong Sheng Tai Xue Bao. 2024 Dec 18;35(12):3497-3506. doi: 10.13287/j.1001-9332.202411.032.

ABSTRACT

Soil biological health assessment is an integral component of soil health evaluation, providing crucial insights into soil processes from a biological perspective. However, current soil health assessments primarily rely on soil physical and chemical indicators, lacking standardized methods and framework for incorporating soil biological indicators. We reviewed the development of soil health assessment and proposed a method, which incorporates the ‘dimension reduction’ of soil health index evaluation system using exploratory factor analysis and the ‘scoring’ based on cumulative normal distribution function into the soil biological health assessment. We further used this method to analyze soil biological health status of upland in black soil region at field and regional scales. The results showed that the use of exploratory factors could reflect soil biological health status in multiple dimensions, which was more conducive to formulating soil health conservation policies or measures according to local conditions. Our results highlighted the critical role of soil biota and their interaction networks in soil health assessment, which would provide necessary technical support for soil health assessment using soil biological indicators.

PMID:40383902 | DOI:10.13287/j.1001-9332.202411.032

Cancer Causes Control. 2025 May 19. doi: 10.1007/s10552-025-02010-6. Online ahead of print.

ABSTRACT

PURPOSE: Accumulating evidence suggested long-term exposure to air pollution as a risk factor of lung cancer. Recent efforts confirmed the association based on extended population and individual exposure by leveraging administrative databases and complete address information. However, few studies achieved simultaneous improvements. Using the 2 million cohort along with their individual residential exposures, this study aimed to investigate the association of four criteria pollutants and incident lung cancer in the Seoul Metropolitan Area, South Korea.

METHODS: Our study population included 2,035,278 people aged ≥ 30 years and without cancer for 2002-2006 from the National Health Insurance System database. We identified lung cancer incidence for 2007-2016 and assessed individual long-term exposure to particulate matter ≤ 10 µm and 2.5 µm in diameter (PM₁₀ and PM_2.5), nitrogen dioxide (NO₂), and ozone at participants’ home addresses by using previously validated exposure prediction models. Using time-varying Cox proportional hazard models, we estimated hazard ratios (HRs) per interquartile range increase in each pollutant concentration adjusting for individual and area-level characteristics.

RESULTS: There were 18,229 lung cancer new cases over 10 years. We did not find the association for all four pollutants (PM₁₀: HR = 0.99 [95% Confidence Interval = 0.93-1.04]; PM_2.5: 0.97 [0.92-1.02]; NO₂: 1.00 [0.96-1.05]; and ozone: 1.01 [0.98-1.04]). The extended stratified and sensitivity analyses mostly showed null associations.

CONCLUSION: Our findings of no association contradictory to existing evidence, despite the considerable improvement in exposure assessment and population size, suggest further examination by integrating histological variation and indoor and/or personal exposure.

PMID:40383829 | DOI:10.1007/s10552-025-02010-6

Sci Rep. 2025 May 18;15(1):17256. doi: 10.1038/s41598-025-99848-2.

ABSTRACT

Systemic volume changes during acute lung injury (ALI) are closely related to lung injury severity, disease progression, and treatment methods. Twenty-one goats were divided into control, mild injury, and severe injury groups via oleic acid injection. Carotid ultrasound measured carotid diameter and corrected flow time (FTc), while cardiac ultrasound assessed aortic and pulmonary artery velocity-time integral (VTI). Post-euthanasia at 6 h, lung wet-to-dry (W/D) ratio and pathological scores were analyzed. Statistical trends, correlations between ultrasound parameters and lung injury markers, and diagnostic performance via ROC analysis were evaluated. The severe injury group had significantly higher lung W/D ratios and pathological scores than the mild injury group. Carotid ultrasound showed a progressive decrease in carotid diameter and FTc post-injury, with FTc significantly lower in the severe injury group at 6-h. FTc was negatively correlated with lung W/D ratio and pathological scores. Cardiac ultrasound indicated a decreasing trend in aortic and pulmonary artery VTI post-injury, with pulmonary artery VTI significantly lower in the severe injury group at all times and negatively correlated with lung W/D ratio and pathological scores. ROC analysis showed that pulmonary artery VTI had the highest area under the curve (AUC), with values greater than 0.8 at all time points. The combined use of pulmonary artery VTI and carotid FTc had AUC values greater than 0.85 at all time points, peaking at 6-h (AUC = 0.951). In conclusion, pulmonary artery VTI is an excellent indicator for evaluating ALI severity post-injury, and the combination of pulmonary artery VTI and carotid FTc shows strong diagnostic performance for assessing ALI severity.

PMID:40383807 | DOI:10.1038/s41598-025-99848-2

Sci Rep. 2025 May 19;15(1):17266. doi: 10.1038/s41598-025-02137-1.

ABSTRACT

The primary treatment for breast cancer patients is surgery which often impacts physical activity (PA). This study aimed to investigate factors associated with the PA level of Thai women with breast cancer after surgical mastectomy at Siriraj Hospital, Thailand. Ninety-three participants completed the questionnaires which included personal information, the Global Physical Activity Questionnaire, perceived benefits, perceived barriers, perceived self-efficacy, interpersonal influence and situational influence, the Thai Body Image Index score, and the Thai Hospital Anxiety and Depression Scale. Data was analysed using descriptive statistics, Chi-square statistics (Odds-Ratio and 95% Confidence Interval) and multiple logistic regression analysis. The study found that post-mastectomy Thai women participated in sufficient PA (2.8 metabolic equivalent of tasks (METs)). It was also found that PA at work was associated with occupation, higher incomes, moderate satisfaction as assessed by the Thai Body Image Index score, and higher levels of anxiety and depression. Participation in recreational activities was associated with older age, higher perceived self-efficacy, and greater interpersonal influence. However, statistically significant associations from the chi-square test did not remain significant after analysis with the multiple logistic regression. By exploring these associations, we can tailor supportive care strategies to address the PA needs of individuals affected by breast cancer which is essential for the development of comprehensive interventions that optimize patient health and well-being throughout the cancer journey.

PMID:40383805 | DOI:10.1038/s41598-025-02137-1