Tag: statistics

J Prosthet Dent. 2025 Mar 20:S0022-3913(25)00208-2. doi: 10.1016/j.prosdent.2025.02.059. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: While dual-polymerizing self-adhesive resin cements have been widely used because of their bonding capabilities and ease of use, there is a lack of comprehensive data on their biocompatibility, particularly concerning the cytotoxic effects of different polymerization methods on cell viability.

PURPOSE: The purpose of this in vitro study was to investigate the potential cytotoxic effects of 3 different dual-polymerizing self-adhesive resin cements polymerized by light polymerization or autopolymerization on L929 cells in vitro using by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium-bromide (MTT) test.

MATERIAL AND METHODS: Three different dual-polymerizing self-adhesive resin cements (Calibra Universal; Dentsply Sirona Inc, SpeedCEM Plus; Ivoclar AG, and TheraCem Ca; Bisco Inc) were light or autopolymerized in polytetrafluoroethylene (PTFE) molds containing Ø5-mm and 2-mm-thick cells in accordance to the manufacturer’s instructions. The specimens were incubated in Dulbecco Modified Eagle Medium (DMEM-High; Capricorn Scientific GmbH) for 48 hours and the extracts were obtained. The 100% concentration of the extract was diluted and extracts at 66.7%, 44.4%, 29.6%, and 19.8% concentrations were obtained. Specimen extracts at 5 different concentrations were incubated with L929 (NCTC clone 929: CCL 1; American Type Culture Collection) mouse fibroblast cells in 96-well tissue culture plates at 37 °C and 5% CO₂ for 24, 48, and 72 hours. At the end of the incubation period, the effects of the materials on cell viability were evaluated with the MTT test. The data were analyzed using a statistical software program (IBM SPSS Statistics, v25.0; IBM Corp) (α=.05), employing ANOVA and the Tukey’s HSD test.

RESULTS: All tested cement specimens significantly reduced cell viability (P<.05). Cell viability decreased with increasing concentration and incubation time in all specimens tested. The light-polymerized SpeedCem Plus showed the least cytotoxicity regardless of concentration and incubation time, followed by TheraCem Ca. However, the autopolymerized Calibra Universal significantly reduced cell viability. Cell viability rate of all light polymerized cements was considerably higher than autopolymerized cements (P<.05).

CONCLUSIONS: All the tested self-adhesive resin cements caused a significant reduction in viability of L929 cells. The composition of the self-adhesive resin cement and the activation type of polymerization affected cytotoxicity.

PMID:40118683 | DOI:10.1016/j.prosdent.2025.02.059

J Prosthet Dent. 2025 Mar 20:S0022-3913(25)00189-1. doi: 10.1016/j.prosdent.2025.02.041. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Removable partial dentures (RPDs) provide an important treatment option for replacing missing teeth, particularly for vulnerable populations. However, RPDs have been associated with damage to the remaining dentition, which can lead to treatment failure.

PURPOSE: The purpose of this retrospective clinical study was to investigate the failure rates of RPD treatments among patients at a state-sponsored dental school and identify factors contributing to these failures.

MATERIAL AND METHODS: A retrospective analysis was conducted using electronic health records (EHRs) from 4941 individuals for a total of 7529 patient-arches. The outcome of RPD treatment was defined as failure when any major procedure was performed on any tooth adjacent to a treated edentulous span. The time to event was measured from the date of RPD placement to the first recorded failure or the last follow-up visit (censored). A multivariable Cox proportional hazards model was employed to assess the hazard ratios for the variables of interest (α=.05).

RESULTS: The average age of the cohort was 59 years, 52% female, and the mean follow-up period was 35 months. Among the arches that experienced failure (24.2%), the average time to failure was 33 months. In the multivariable model, statistically significant associations with RPD failure were found for several variables: Kennedy classification without distal extension (HR=1.23, P<.001), older age (HR=1.01, P<.001), male sex (HR=1.17, P=.008), maxillary arch (HR=1.60, P<.001), lack of insurance (HR=0.78, P<.001), cast metal framework (HR=0.55, P<.001), tobacco use (HR=1.21, P=.002), and dental fear (HR=1.26, P=.003).

CONCLUSIONS: While the associations were not particularly strong, dental school patients who smoked, experienced dental anxiety, or received maxillary RPDs or RPDs without a cast metal framework demonstrated an elevated risk of requiring major treatment to the abutment teeth, leading to the failure of the RPD treatment.

PMID:40118681 | DOI:10.1016/j.prosdent.2025.02.041

An Bras Dermatol. 2025 Mar 20:S0365-0596(25)00025-X. doi: 10.1016/j.abd.2024.05.011. Online ahead of print.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) burden increases with disease severity.

OBJECTIVE: Characterize the real-world burden of AD in Brazil, Mexico, and Argentina.

METHODS: MEASURE-AD enrolled patients (≥12-years old) with moderate to severe AD receiving or candidates for systemic therapy between December 2019-December 2020. Patient characteristics, treatments, and outcomes were recorded during one office visit. Primary outcome measures included worst itch/past 24hours (Worst Pruritus Numerical Rating Scale [WP-NRS]), quality of life (QoL, Dermatology Life Quality Index [DLQI] and Children’s DLQI [CDLQI]).

RESULTS: Of 180 patients (adults, n=157; adolescents, n=23), 52.2% were male, the mean (SD) age was 33.8 (17.0) years, and all were receiving AD treatment (65.6% systemic therapy). Severe pruritus (WP-NRS ≥ 7) was reported by 54.4% (adults, 57.3%; adolescents, 34.8%). A very/extremely large effect on QoL (DLQI/CDLQI≥11) was reported among 50.0% of patients ≥ 16 years old and 42.9% of patients 12-15 years old. The mean Eczema Area Severity Index (EASI) was 17.0 (adults, 17.7; adolescents, 12.4); 3.9% of patients had clear skin (EASI 0) and 26.7% had severe AD (EASI 23-72). Over the previous 6 months, 0, 1-2, 3-4, 5-6, and > 6 flares were reported by 8.3%, 27.2%, 31.1%, 11.7%, and 15.6% of patients, respectively. On average, flares lasted 15.2 days (adults, 15.9 days; adolescents, 11.1 days).

STUDY LIMITATIONS: Patient self-reported information and recall during one office visit.

CONCLUSIONS: Despite treatment, disease severity and impact on QoL were high, suggesting that AD is not adequately controlled in all patients, highlighting a considerable unmet need for effective treatments to reduce AD burden.

PMID:40118674 | DOI:10.1016/j.abd.2024.05.011

J Voice. 2025 Mar 20:S0892-1997(25)00089-X. doi: 10.1016/j.jvoice.2025.02.040. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the behavior of vocal nodules from childhood to postpuberty.

METHODS: Adolescents aged 15 years or older who presented vocal nodules in childhood were included and underwent the same evaluations performed in childhood. They answered a questionnaire about vocal symptoms, treatments, habits, and vocal abuse. They were submitted to videolaryngoscopy, auditory-perceptual, and acoustic vocal assessments.

RESULTS: In total, 31 adolescents (15-18 years), 23 boys, eight girls, mean age in childhood and postpuberty: girls (10.25 ± 1.85, 16.75 ± 1.3); boys (10.08 ± 1.34, 15.95 ± 1.87), without statistical difference between childhood and postpuberty (P > 0.05).

SYMPTOMS: four boys (12.9%) and three girls (9.67%) maintained dysphonia postpuberty. Videolaryngoscopy: nodules were not detected after puberty. Minor alterations: hyperemia (n-2), edema (n-1), posterior glottic cleft (n-1), and microweb (n-1).

TREATMENTS: vocal therapy (n-18), microsurgery (n-8), and no treatment (n-5). There was a significant difference in the acoustic (maximum phonation time, f₀, jitter, pitch perturbation quotient, shimmer, amplitude perturbation quotient, and Student t test) and acoustic perceptive parameters (Mann-Whitney rank sum test) between the moments (childhood and postpuberty). In the comparison between the treatments (Shapiro-Wilk and Kolmogorov-Smirnov tests) just for shimmer parameter, there was a statistical difference, being more significant in surgery and speech therapy.

CONCLUSIONS: After puberty, we observed a reduction in vocal symptoms, as well as an improvement in videolaryngoscopic findings and in auditory and acoustic perceptive vocal parameters. In the comparison between the treatments just for shimmer parameter, there was a statistical difference, being more significant in surgery and speech therapy.

PMID:40118659 | DOI:10.1016/j.jvoice.2025.02.040

Int J Geriatr Psychiatry. 2025 Mar;40(3):e70064. doi: 10.1002/gps.70064.

ABSTRACT

INTRODUCTION: The rise of mobile health interventions offers significant potential to improve the well-being of the aging global population, particularly individuals at an increased risk of dementia. To fully leverage this potential, it is crucial to evaluate the mobile health applications across different demographic and socio-economic landscapes. This study investigated the relationship between a country’s development status and the quality of dementia-focused mobile health applications, as well as the influence of developers’ medical expertise on app quality and perceived impact.

METHODS: This cross-sectional observational design study utilized the uMARS tool to evaluate the objective and subjective quality of dementia-related mobile health applications. Objective quality was assessed across engagement, functionality, aesthetics, and information domains, while subjective quality included user recommendations, anticipated usage, and perceived impact. A stratified random sampling method selected 17 apps for evaluation, and inter-reviewer reliability was confirmed (Kendall’s W = 0.143, p = 0.045). Data analysis involved descriptive statistics, independent sample t-tests, and Pearson’s correlation coefficients, with statistical significance set at p < 0.05.

RESULTS: Among the 51 dementia-related mobile health app analyzed, only one was developed in a low-income country. Additionally, this study found a linear correlation between the perceived impact of a mobile health app for dementia and the medical background of the development team, with a Pearson correlation coefficient of t = 3.708 (p < 0.001). Engagement was highly correlated with subjective quality (Pearson correlation coefficient r = 0.955, p < 0.001), and there was a strong correlation between the information provided by the apps and the perceived impact (Pearson correlation coefficient r = 0.884, p < 0.001).

CONCLUSION: The adoption of mobile health apps must be prioritized to assist individuals with dementia and their caregivers in low income countries. Future apps should focus on improving engagement and involving medical experts in development to increase credibility and utilization across socioeconomic levels and healthcare systems.

PMID:40118652 | DOI:10.1002/gps.70064

Kidney Int. 2025 Apr;107(4):602-605. doi: 10.1016/j.kint.2025.01.012.

ABSTRACT

In this issue, Schouten et al. report findings from a cost-effectiveness analysis of hemodiafiltration versus conventional high-flux hemodialysis using data from the Comparison of High-Dose Hemodiafiltration with High-Flux Hemodialysis (CONVINCE) trial. They found that the overall cost-effectiveness of hemodiafiltration is within the range of accepted willingness-to-pay thresholds in some countries, while near (but outside) the lower-bound thresholds of other countries. How decision-makers value treatment costs for additional years on dialysis and country-specific costs and willingness-to-pay thresholds influence the cost-effectiveness of hemodiafiltration.

PMID:40118588 | DOI:10.1016/j.kint.2025.01.012

J Am Board Fam Med. 2024 Nov-Dec;37(6):1014-1026. doi: 10.3122/jabfm.2023.230469R1.

ABSTRACT

BACKGROUND: At least 26 different fecal immunochemical tests (FITs) are available for use in the US. Liquid vial and card collection devices are available.

OBJECTIVES: 1) assess participant’s difficulties with and preferences for types of FITs; 2) assess whether errors in FIT collection were associated with FIT collection difficulty; 3) identify factors associated with difficulty with FIT stool collection.

METHODS: Prospective individuals scheduled for a colonoscopy were invited to participate in a study comparing test characteristics of 5 FITs. A product questionnaire asked participants about ease of collection and difficulties.

RESULTS: 2,148 participants; mean age 63 years; 63% females, 83% Whites, and 19% Hispanics. 1265 (61%) preferred use of a liquid vial versus 181 (9%) the card. 49% had no difficulty with Hemoccult ICT, and 66 to 70% had no difficulty with the liquid vials. Difficulties with Hemoccult ICT included: being messy (21%), collection window too small (19%), and getting sample on stick (8%). Difficulties with the liquid vials included difficulty probing or scraping the stool (5% to 8%) and unclear directions (3%). In a multivariable model, the perceived difficulty in FIT collection was significantly higher for Hemoccult ICT compared with OC-Auto Micro (adjusted odds ratio [AOR], 4.05), and it was significantly high for those with a FIT error (AOR, 3.90).

CONCLUSION: Participants strongly preferred a liquid vial compared with a card. Perceived difficulty was significantly associated with FIT errors and with FIT brand. Medical offices providing FITs should ensure that patients understand the task of FIT collection, so that errors are minimized.

PMID:40118555 | DOI:10.3122/jabfm.2023.230469R1

J Am Board Fam Med. 2024 Nov-Dec;37(6):1047-1054. doi: 10.3122/jabfm.2024.240059R1.

ABSTRACT

BACKGROUND: With the goals of improving health care delivery, patient outcomes, and creating a more engaged workforce, there have been consistent calls over the past 2 decades for increasing research capacity within the field of family medicine. Since 2014, the University of Minnesota Department of Family Medicine and Community Health (UMN DFMCH) has implemented strategies to enhance clinical faculty research capabilities while maintaining high-quality clinical care and medical education. This study reports changes in clinical faculty publications.

METHODS: Peer-reviewed publication data from 2013, 2016, 2019, and 2022 were analyzed for clinical faculty employed by the UMN DFMCH during those years. An annual research culture survey was administered via e-mail to clinical faculty in 2021, 2022, and 2023. The survey asked questions regarding Research Leadership, Culture, Training, Infrastructure, and Capacity.

RESULTS: While 2019 had the highest total number of publications with 99, 2022 had the highest proportion of faculty with at least 1 publication (50%). In 2023, 63.6% of survey respondents thought there were opportunities for them to participate in research, up from 41.0% in 2021. When asked about their research capacity and goals, 43.5% in 2023 responded positively, compared with 19.4% in 2021.

CONCLUSIONS: The efforts in our department to increase research capacity through investing in research infrastructure, faculty training and mentoring, and funding have led to notable increases in clinical faculty publications and positive perceptions of our research culture. These results provide additional evidence of the value of a model that harmonizes clinical care, education and research missions.

PMID:40118553 | DOI:10.3122/jabfm.2024.240059R1

J Neurosurg Pediatr. 2025 Mar 21:1-8. doi: 10.3171/2024.12.PEDS24542. Online ahead of print.

ABSTRACT

OBJECTIVE: Patients with advanced moyamoya disease have chronic cerebrovascular insufficiency with superimposed acute ischemic insults, leading to brain atrophy and cognitive decline. The outcomes of revascularization procedures in moyamoya patients with marked brain atrophy are not yet clearly known.

METHODS: This retrospective study used an approach based on the global cerebral atrophy scale to identify patients with severe brain atrophy from a single-surgeon series of patients with moyamoya disease undergoing revascularization from January 2015 to January 2024. Clinical outcomes (modified Rankin Scale [mRS] score, improvement in symptoms and cognitive function) and radiological outcomes (arterial spin labeling [ASL] perfusion) were studied and compared between direct and indirect revascularization groups.

RESULTS: Of 153 patients in the series, 16 (mean age 8.9 years) had severe brain atrophy (cortical atrophy score ≥ 8). The presenting symptoms were recurrent transient ischemic attack in 6 patients (37.5%), major stroke in 7 patients (43.75%), and seizure in 3 patients (18.75%). Fourteen patients underwent surgeries for both hemispheres and 2 patients underwent surgery for 1 hemisphere. Of the 30 hemispheres, 17 (56.7%) were treated with direct revascularization and 13 (43.3%) with indirect revascularization. The mean follow-up duration was 38.8 months. The median mRS score improved from 3 (preoperative) to 1.5 (last follow-up), with 11 patients (68.75%) showing improvement in mRS score. Thirteen patients (81.25%) showed improvement in presenting symptoms. Overall, 12 of 16 patients (75%) showed improvement in cognitive function at the last follow-up. The mean preoperative and follow-up ASL scores improved for the lower-perfusion hemispheres from 7.9 to 8.9 and for the higher-perfusion hemispheres from 9.6 to 10.45, respectively. Differences between preoperative and postoperative ASL scores for both groups were statistically significant. There was no significant difference in clinical and radiological outcomes between the direct and indirect revascularization groups. Clinical outcomes were comparable across patient groups based on the distribution of brain atrophy (unilateral/bilateral, predominant left/right side, predominant vascular territory involved).

CONCLUSIONS: Moyamoya patients with severe brain atrophy showed improvement in paroxysmal symptoms, cognitive function, and overall clinical functioning status, as well as radiological perfusion, after undergoing either direct or indirect revascularization. Comparative efficacy of direct and indirect revascularization in these patients needs further investigation.

PMID:40117668 | DOI:10.3171/2024.12.PEDS24542

J Neurosurg Pediatr. 2025 Mar 21:1-6. doi: 10.3171/2024.12.PEDS24418. Online ahead of print.

ABSTRACT

OBJECTIVE: Intrathecal baclofen (ITB) is commonly used to treat secondary generalized dystonia. Intraventricular baclofen (IVB) has been shown to be a safe alternative treatment with low complications. The objective of this study was to report the long-term effects of IVB.

METHODS: This retrospective analysis included patients who underwent IVB therapy from April 2005 to June 2024. The decision to use IVB and the surgical technique have been previously described. Data collection included sex, race, etiology of dystonia, Gross Motor Functional Classification System scores, Barry-Albright Dystonia Scale (BADS) scores, Ashworth Scale scores, medical and surgical management of dystonia, follow-up duration, and complications. Patients whose IVB pump was removed within 1 year and those with less than 1 year of follow-up were excluded.

RESULTS: Thirty-six patients with IVB were identified, and 27 patients (median age 12.9 years) were ultimately included. The most common cause of secondary dystonia was cerebral palsy in 21 patients (78%), followed by metabolic and neurodegenerative disorders in 4 (14%), infection in 1 (4%), and severe traumatic brain injury (TBI) in 1 (4%). The follow-up duration ranged from 1.2 to 16.7 years, with a median of 7.7 years and mean of 8.4 years. The baclofen dosage was twice as high in patients with metabolic and neurodegenerative disorders compared with those with cerebral palsy, TBI, and infection, with median dosages of 1455 μg/day and 725 μg/day, respectively. Both posttreatment BADS and Ashworth Scale scores showed statistically significant improvement. Complications included infection that necessitated pump removal in 1 patient (4%), wound dehiscence that was treated with wound revision and antibiotics in 1 patient (4%), and hydrocephalus that required CSF diversion in 4 patients (15%). In 2 patients, IVB therapy was ineffective at controlling dystonia and, thus, was discontinued after 1.3 and 2.7 years. One patient asked for the pump to be removed after 1.2 years due to “does not like the physical pump itself.” Four patients (15%) developed hydrocephalus, which required CSF diversion via a ventriculoperitoneal shunt in 3 patients and a lumboperitoneal shunt in 1 patient, with no further shunt or IVB complications.

CONCLUSIONS: IVB is well tolerated in patients with generalized secondary dystonia refractory to conventional medical therapy, ITB, and deep brain stimulation. Positive long-term outcomes were reported in this cohort, with significant improvement in dystonia and overall complication rates similar to those reported with ITB.

PMID:40117664 | DOI:10.3171/2024.12.PEDS24418