Tag: statistics

Dent Med Probl. 2025 Mar 12. doi: 10.17219/dmp/187834. Online ahead of print.

ABSTRACT

BACKGROUND: Chlorhexidine digluconate (CHG) is considered the most effective and safe antimicrobial agent in dentistry. Recently, it has often been produced in the form of preparations with additional substances that may modify its effect.

OBJECTIVES: The aim of the present study was to compare the efficacy of various simple and combined CHG rinses against selected bacterial and yeast strains.

MATERIAL AND METHODS: This research followed the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines, using the disk diffusion method. The study was carried out on the following reference strains: Staphylococcus aureus ATCC 43300; Streptococcus pyogenes ATCC 19615; Pseudomonas aeruginosa ATCC 27853; Enterococcus faecalis ATCC 29212; Candida albicans ATCC 10231; C. glabrata ATCC 15126; C. krusei ATCC 14243; and C. parapsilosis ATCC 22019. The disinfection efficacy of 9 commercial mouthwashes with CHG was assessed (4 simple preparations, with different concentrations (0.5%, 0.2%, 0.12%, and 0.05%), and 5 combined preparations (0.2% CHG with adjuvants)) by comparing the size of the growth inhibition zones (GIZs) of microorganisms after 24 h of incubation.

RESULTS: Growth inhibition zones were observed around all tested substances, for all assessed strains. In simple preparations, the greatest reduction in growth was observed for Gram-positive bacteria. Statistically significantly smaller GIZs were recorded for P. aeruginosa and all Candida strains. The size of GIZ also depended on the CHG concentration used. In combined preparations, the greatest reduction in growth was also observed for Gram-positive bacteria (especially large GIZs for S. aureus when using 0.2% CHG with colostrum). Statistically significantly smaller GIZs were observed for P. aeruginosa and all yeasts. None of the evaluated adjuvants impaired the disinfecting effect of CHG.

CONCLUSIONS: The evaluated combined preparations of CHG showed disinfecting efficacy against selected bacterial and fungal strains comparable to that of simple formulations. The combination of 0.2% CHG with colostrum showed the additive synergism of antimicrobial activity against the S. aureus ATCC 43300 strain.

PMID:40072412 | DOI:10.17219/dmp/187834

Int J Radiat Oncol Biol Phys. 2025 Mar 10:S0360-3016(25)00141-5. doi: 10.1016/j.ijrobp.2025.02.003. Online ahead of print.

ABSTRACT

PURPOSE: The FAST-Forward study paved the way for ultrahypofractionation (UHF) in breast cancer. We prospectively registered and analyzed our case series receiving UHF + simultaneous integrated boost (SIB) to further reduce the treatment to a total of 5 days. The study aimed to present the 6-month early side effects results of the first patients treated with this scheme in 16 radiation oncology centers in Spain.

METHODS AND MATERIALS: A total of 242 breast cancer patients received adjuvant radiation therapy between April and December 2020. The median age was 61 years (interquartile range, 53-70). All patients underwent breast-conserving surgery. Chemotherapy (QT) was administered to 27.7%, and endocrine therapy to 85.1%. A SIB of 29 Gy was applied to 60.7% of the patients, while 39.3% did not have a boost indication. Breast radiation therapy (RT) with SIB to the tumor bed and regional node irradiation was done in 5.4 % of patients.

RESULTS: Most patients were treated with Volumetric modulated arc therapy (66.1%) and intensity modulated RT (30.6%). One patient received treatment by 3-dimensional techniques (0.4%) and 7 patients (2.9%) a combined intensity modulated RT-3-dimensional technique. Deep inspiration breath-hold was used in 16.9% of cases. At the end of treatment, erythema grade (G) 0 was presented in 56.1%, G1 in 43.1%, and G2 in 0.8%. G1 edema was observed in 14.6% and less than 1% had G2. After 6 months, 97% had G0 erythema, 3% G1, and 0% G2, while G1 edema was observed in 11.4% and G2 in 2.5%. No statistically significant impact on side effects was found for planning target volume breast and planning target volume boost volumes.

CONCLUSIONS: UHF with SIB of 29 Gy to the tumor bed in patients with early-stage breast cancer is clinically feasible, safe, and free of an excess of early side effects. Further analysis of late toxicity is needed.

PMID:40072398 | DOI:10.1016/j.ijrobp.2025.02.003

Am J Orthod Dentofacial Orthop. 2025 Mar 11:S0889-5406(25)00061-7. doi: 10.1016/j.ajodo.2025.02.006. Online ahead of print.

ABSTRACT

INTRODUCTION: This longitudinal study assessed the intermaxillary and intraarch relationships from mixed to permanent dentitions during a 4-year follow-up.

METHODS: The sample comprised 352 children evaluated for crowding, midline maxillary diastema, anterior spacing, overjet, overbite, and sagittal and transverse relationships in mixed (T1) and permanent (T2) dentition. Data between different time points were compared using McNemar and Bowker symmetry tests, with a significance level of 5%.

RESULTS: Of the 352 children evaluated over a 4-year follow-up period, significant changes were observed in the intraarch and intermaxillary relationships from T1 to T2. The intraarch relationship showed significant decreases in crowding (61.3%), maxillary midline diastema (74.3%), and anterior spacing (82.2%) (P <0.0001). Regarding the intermaxillary relationship, statistically significant changes were observed in the overjet (P = 0.003), overbite (P = 0.004), and anteroposterior (P <0.0001) and transverse relationships (P <0.0001). In addition, 43.1% of children had increased overjet at T1 and normal overjet at T2, 29.3% of children with a Class II relationship at T1 and Class I relationship at T2, 70.5% of children with posterior crossbite and normal transverse relationship at T2, and 73.9% of children with anterior open bite and normal overbite at T1 and average overbite at T2.

CONCLUSIONS: Significant favorable changes in intraarch relationships were observed during the transition from mixed to permanent dentition. Children also show changes in intermaxillary relationships, with a potential improvement in occlusion of the permanent dentition.

PMID:40072391 | DOI:10.1016/j.ajodo.2025.02.006

Crit Rev Food Sci Nutr. 2025 Mar 12:1-10. doi: 10.1080/10408398.2025.2466758. Online ahead of print.

ABSTRACT

This study aims to review the evidence from Mendelian randomization (MR) studies on the causal role of vitamin D in type 2 diabetes (T2D). A systematic search (registered on PROSPERO (CRD42024551731)) was performed in PubMed, Embase and Web of Science for publications up to June 2024. MR studies including vitamin D as the exposure and T2D as the outcome were included. Among the 22 studies included, which were mainly in European populations, half used single nucleotide polymorphisms (SNPs) located on vitamin D synthesis and metabolism genes, while others selected SNPs based on statistical thresholds. Negative associations implying that vitamin D protects against T2D were reported in three one-sample and three two-sample MR studies. The remaining studies reported null associations between genetically predicted circulating 25-hydroxyvitamin D and risk of T2D regardless of MR design, study population, data source or SNP selection. Findings from MR studies on circulating 25-hydroxyvitamin D and risk of T2D do not consistently support the causal role of vitamin D in T2D in the general population. Future MR studies to examine the non-linear association of vitamin D with T2D or disease progression from prediabetes are warranted to clarify the use of vitamin D in the prevention of T2D.

PMID:40072362 | DOI:10.1080/10408398.2025.2466758

Int J Surg. 2025 Mar 12. doi: 10.1097/JS9.0000000000002331. Online ahead of print.

ABSTRACT

OBJECTIVE: Persistent postoperative sensory loss significantly limits breast reconstruction following mastectomy. In addition, the absence of sensation profoundly impacts patients’ physical well-being and overall quality of life. New surgical techniques involving nerve autograft intercostal nerve elongation have been introduced to neurotize reconstructed breasts. However, patient quality of life after neurotization has not been well evaluated. This study aimed to investigate improvements in patient quality of life in association with breast neurotization.

METHODS: A prospective cohort study of 132 patients treated at (blinded for review) between January 2018 and December 2022 was conducted. Two groups of patients who underwent nipple-sparing mastectomy (NSM) and breast reconstruction were compared: those with (n = 67) and without (n = 65) breast neurotization. Patient-reported outcomes were assessed via the BREAST-Q reconstruction module questionnaire and an additional questionnaire measuring sensation, nipple satisfaction, and breast symptoms. Objective measurements were conducted via the Semmes-Weinstein monofilaments test.

RESULTS: With respect to patient-reported outcomes, the innervated group had significantly higher scores for nipple sensation and on the BREAST-Q domains of psychosocial well-being (71.6 ± 18.1 vs. 62.8 ± 18.6, P = 0.006), sexual well-being (56.9 ± 22.1 vs. 47.3 ± 20.7, P = 0.015), satisfaction with the medical team, as well as less frequent post-operative breast symptoms. In the subgroup analysis, the innervated group demonstrated higher scores in both autologous flap and implant-based reconstruction. Linear regression revealed a statistically significant relationship between objectively measured monofilament value and subjectively examined patient-reported outcomes: nipple sensation, breast sensation, and BREAST-Q score for the psychosocial well-being domain (coefficient: – 4.922, P = 0.033).

CONCLUSION: Breast reconstruction with autologous nerve graft neurotization yields improved sensory outcomes and has a statistically significant positive impact on the quality of life of breast reconstruction patients.

PMID:40072353 | DOI:10.1097/JS9.0000000000002331

Epilepsia. 2025 Mar 12. doi: 10.1111/epi.18345. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was undertaken to prospectively assess the frequency and type of psychiatric disorders (PDs) in pediatric surgical candidates and evaluate the effects of epilepsy surgery on their psychopathological profile.

METHODS: This is a prospective controlled study. Psychopathology was assessed using both diagnostic interviews and questionnaires completed by clinicians, parents, and whenever possible, patients, at baseline (T0) and 1 year after surgery in operated patients (T1) and 1 year after the first evaluation in a control group of nonoperated patients (T1). A “global assessment measure” was developed to integrate the results of the interviews, and the questionnaires were administered to multiple informants, at both T0 and T1. Descriptive statistics and multivariable analyses were performed for all outcomes. An ordinal logistic regression model was estimated to analyze the correlation between surgical treatment and possible changes in psychopathology at T1.

RESULTS: At T0, 103 children (42 females, mean age at first evaluation = 9.5 ± 3.92 years) with lesional epilepsy were included in the study. Thirty-two patients (31.07%) had at least one PD, and 17 (16.5%) had more than one PD of any type. Sixty-two (60.2%) of 103 patients were enrolled for the T1 phase of the study, of whom 39 underwent epilepsy surgery. The ordinal logistic model revealed that patients who underwent surgery and achieved Engel class I outcome were 17.57 times (p = .047) more likely to experience improvement in their psychopathological profile than those who were not operated on and continued to experience seizures.

SIGNIFICANCE: This prospective controlled study demonstrates a high prevalence of PD in pediatric surgical candidates and a correlation between successful surgery and reduced PD burden. An integrated approach encompassing diagnostic interviews and questionnaires, and accounting for potential disagreement between multiple informants, is essential for carefully assessing psychiatric comorbidities in children with drug-resistant seizures.

PMID:40072310 | DOI:10.1111/epi.18345

Acta Odontol Scand. 2025 Mar 12;84:119-127. doi: 10.2340/aos.v84.43276.

ABSTRACT

The aim was to assess the correlation between periodontal status, whole salivary interleukin-1 beta (IL-1β) levels and oral yeasts carriage (OYC) among individuals with varying ranges of body mass index (BMI). Material and method: The weight, waist circumference (WC), and height of individuals were assessed. Participants were categorized into three groups: Group-1 – normal weight (18.5-24.9 Kg/m2); Group-2 – overweight (25-29.9 Kg/m2); and Group-3 – obese (≥ 30 Kg/m2). Plaque and gingival indices (PI and GI, respectively), probing depth (PD), clinical-attachment-loss (CAL), missing teeth (MT) and marginal-bone-loss (MBL) were assessed. Whole salivary IL-1β levels and OYC were assessed. Group-comparisons were done. P < 0.05 was considered statistically significant. Findings: Twenty-two, 22 and 22 individuals with comparable mean ages were included in groups 1, 2 and 3, respectively. The mean WC and BMI were higher in Group 3 than Groups 1 (P < 0.05) and 2 (P < 0.05). The mean PI, CAL, PD, GI, MT and MBL were higher in Group-3 than groups 1 (P < 0.05) and 2 (P < 0.05). There was no difference in mean PI, CAL, PD, GI, MT and MBL in groups 1 and 2. The salivary flow rate was higher in groups 1 (P < 0.05) and 2 (P < 0.05) than Group-3. The OYC and IL-1β were higher in Group-3 than groups 1 (P < 0.05) and 2 (P < 0.05). There was a correlation between PD and OYC in Group-3 (P < 0.05). Conclusion: Periodontal inflammation is worse, and whole salivary IL-1β levels are elevated in obese than overweight individuals and subjects with normal BMI. There seems to be no association between BMI and OYC.

PMID:40072290 | DOI:10.2340/aos.v84.43276

Nurs Ethics. 2025 Mar 12:9697330251324319. doi: 10.1177/09697330251324319. Online ahead of print.

ABSTRACT

BackgroundNurses working in a clinic must be morally sensitive to identify unethical circumstances and act morally. Educational strategies that can effectively gain this sensitivity are a matter of curiosity.ObjectiveThis study aimed to examine if an interactive ethics training program would benefit (a) moral sensitivity and (b) knowledge.Research DesignThe present study was quasi-experimental based on a control group pretest/posttest.Participants and Research ContextThe study involved 53 nurses from 10 hospitals in Istanbul, Türkiye. The intervention group received the 5-week Interactive Ethics Training Program. Data were collected through the Personal Characteristics Form, Moral Sensitivity Questionnaire, and Nursing Ethics Knowledge Test.Ethical ConsiderationsThe study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Non-Invasive Research Ethics Committee (No. 78/2022) from Istanbul Medipol University.ResultsThere was a statistically significant difference between the two groups in the posttest for moral sensitivity (MD: -10.247; p = .010) and knowledge level (MD: 4178; p = .009).ConclusionAn interactive ethics training program in nursing ethics education positively impacts nurses’ moral sense and knowledge. Improving nurses’ moral awareness can facilitate ethical decision-making. Therefore, it is advised that nurse educators design their curricula based on these results.

PMID:40072238 | DOI:10.1177/09697330251324319

Liver Int. 2025 Apr;45(4):e70059. doi: 10.1111/liv.70059.

ABSTRACT

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most common chronic liver disease globally. MASLD is a multisystem disease where metabolic dysfunction plays a key role in the development of MASLD and its most relevant liver-related morbidities and extrahepatic complications, such as cardiovascular disease, chronic kidney disease and certain types of extrahepatic cancers. Among the least examined MASLD-related extrahepatic complications, an ever-increasing number of observational studies have reported a positive association between MASLD and the risk of serious bacterial infections (SBI) requiring hospital admission. This risk remained significant in those studies where statistical analysis was adjusted for age, sex, ethnicity, obesity, type 2 diabetes and other common comorbidities. Notably, the incidence rates of SBI were further increased with more advanced MASLD, especially in patients with MASLD-related cirrhosis, and were also observed for some acute viral infections, including SARS-CoV-2 infection, leading to severe COVID-19. In this narrative review article, we provide an overview of the literature on (a) the recent epidemiological data linking MASLD to the risk of serious bacterial and non-bacterial infections requiring hospital admission, (b) the putative underlying mechanisms through which MASLD may increase the susceptibility to serious infections, both directly and through the immune dysfunction associated with cirrhosis and portal hypertension, and (c) the practical and clinical implications of the increased risk of serious bacterial and non-bacterial infections in the growing global population with MASLD.

PMID:40072231 | DOI:10.1111/liv.70059

Ann Noninvasive Electrocardiol. 2025 Mar;30(2):e70062. doi: 10.1111/anec.70062.

ABSTRACT

INTRODUCTION: Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS-T angle, in patients with HFpEF.

METHODS: Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as p < 0.05.

RESULTS: A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT-proBNP, La size, La volume index, Tp-e time, Tp-e/QTc ratio, and fQRS-T angle were statistically significantly higher in the cardiac event group. NT-proBNP level and fQRS-T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS-T angle has a cut-off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan-Meier analysis also found that when the fQRS-T angle was > 58.63, mortality was higher than at narrower angles.

CONCLUSIONS: According to our study, the fQRS-T angle, which can be easily and inexpensively calculated on ECG, predicts long-term ventricular arrhythmias in patients with HFpEF.

PMID:40072228 | DOI:10.1111/anec.70062