Tag: statistics

Pain Manag Nurs. 2025 Mar 11:S1524-9042(24)00328-X. doi: 10.1016/j.pmn.2024.12.015. Online ahead of print.

ABSTRACT

Up to 90% of amputee patients have phantom limb pain (PLP), which is difficult to treat. The aim of this study was to assess the medium and long-term efficacy of mirror therapy (MT) in unilateral amputee adults with PLP.

METHODS: We carried out an uncontrolled prospective longitudinal study. Twelve consecutive adult subjects with upper or lower limb amputation and PLP were selected. Weekly sessions of nurse-guided, in-person MT training lasting 1.5 h were implemented for six months. In parallel, self-administered home sessions were added 20 min per day, five days per week for 12 months. At baseline, and at three, six, and 12 months the following variables were analyzed: subjects’ clinical characteristics, pain intensity (visual analog scale), disability (Oswestry Disability Index), Quality of Life (QoL SF-36), impression of patient’s global improvement (Patient Global Impression scale, PGI-I), and hours of MT in consultation and at home.

RESULTS: Statistically significant differences in mean pain intensity scores were found (p < .001) between baseline, and measurements at three, six, and 12 months. Mean disability scores showed statistically significant improvement (p < .001) at at three months. QoL, and mean baseline scores in Physical Function (p < .002) and Body Pain (p < .001) dimensions improved significantly. Patient global impression scores were statistically significant.

CONCLUSIONS: These findings support the efficacy the medium and long term, of MT, in unilateral amputee adults, with PLP, through 12-month follow-up.

PMID:40074638 | DOI:10.1016/j.pmn.2024.12.015

J Prosthet Dent. 2025 Mar 11:S0022-3913(25)00187-8. doi: 10.1016/j.prosdent.2025.02.040. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Early childhood caries is one the world’s most common problems in infants and treatment of posterior teeth with esthetic crowns in a low rate of wear on opposite dentition is a challenge for pediatric dentists.

PURPOSE: The purpose of this in vitro study was to evaluate the wear behavior of the tooth colored crown materials and the opposing teeth in using different esthetic crown materials in the mixed dentition period.

MATERIAL AND METHODS: The following tooth type and crown materials were considered in the experiment. Primary molars consist of first and second molars that were close to exfoliation or needed to be extracted because of orthodontic treatment and were caries free and with no restorations. Permanent teeth consisted of third molars that were caries free and with no restorations. Three different types of crown materials were used: nano-hybrid resin (VarseoSmile Crown ^plus; Bego GmbH), tetragonal zirconia polycrystalline stabilized with 3 mol% yttria (G-CERAM; Atlas Enta), and lithium disilicate glass-ceramic (IPS e.max CAD; Ivoclar AG). The wear test was performed in an artificial saliva environment (pH=6.7), based on the pin-on-plate technique, for a 2-mm stroke, under a compressive force of 30-N, at a frequency of 2-Hz and with 10 000, 20 000, and 30 000 cycles. A multi-way ANOVA statistical method was used (α=.05).

RESULTS: Wear of the opposing teeth by the glass-ceramic was greater than by the nano-hybrid resin or zirconia materials (P<.05). All 3 crown materials wore primary teeth more than permanent teeth (P<.05). Compared with nano-hybrid resin, zirconia led to more wear of the opposing tooth (P<.05). The wear behavior of the nano-hybrid resin was more predictable compared with the other 2 materials.

CONCLUSIONS: Zirconia and lithium disilicate-based glass-ceramic materials caused more wear on both primary and permanent teeth compared with nano-hybrid materials, yet exhibited less wear themselves when opposed by primary or permanent teeth.

PMID:40074629 | DOI:10.1016/j.prosdent.2025.02.040

J Prosthet Dent. 2025 Mar 11:S0022-3913(25)00118-0. doi: 10.1016/j.prosdent.2025.02.024. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Extraoral photogrammetry (PG) systems can record implant positions in 1 scan or in 2 scans that are then merged. However, the accuracy of implant positions recorded in 2 partial photogrammetry scans is unknown.

PURPOSE: The purpose of this in vitro study was to compare the accuracy of complete arch implant scans recorded in 1 or 2 scans by using 3 extraoral PG systems.

MATERIAL AND METHODS: An edentulous cast with 6 implant abutment analogs (MultiUnit Abutment Plus Replica) was digitized (T710). Two groups were developed depending on the number of scans recorded to capture the 6 implant positions: 1 or 2 scans (n=30). Additionally, 3 subgroups were created based on the PG used: Icam4D, Grammee, OxoFit. In the 1-scan group, the corresponding markers of each system were placed on the implant abutment analogs of the cast. On each specimen, a scan was recorded to capture the 6 implant positions. In the 2-scan group, the corresponding markers of each system were hand tightened on the implant abutment analogs located on the right and left first molars and right and left lateral incisors. The first PG scan was obtained to capture these 4 implant positions. Afterwards, the markers of the right and left lateral incisors were removed and hand tightened on the implant abutment analogs positioned on the right and left first premolars. Lastly, the second PG scan was obtained to capture these 4 implant positions. In the ICam4D and Grammee subgroups, the partial scans were merged by the PG software program. In the OxoFit subgroup, the partial PG scans were merged by using a program (DentalCAD). Linear and angular measurements among the implants were completed on the digitized cast and used to compare the discrepancies with the same measurements acquired on each specimen. Two-way ANOVA and Tukey tests were used to analyze the trueness data. The Levene test was used to analyze the precision values (α=.05).

RESULTS: Linear trueness differences were found among the groups (P=.048) and subgroups (P<.001). The 1-scan group achieved the best linear trueness (P=.048). The Icam4D obtained the best linear trueness. Linear precision differences were found among subgroups (P=.018). Icam4D had the best linear precision. Angular trueness differences were found among the groups (P=.022) and subgroups (P<.001) with a significant group×subgroup interaction (P<.001). The 1-scan group obtained better angular trueness than the 2-scan group. The Icam4D and OxoFit obtained the best angular trueness. Angular precision discrepancies were found among the groups (P<.001) and subgroups (P<.001) tested. The 1-scan group had the best angular precision. The Icam4D and OxoFit obtained the best angular precision.

CONCLUSIONS: The number of scans and extraoral PG system impacted the implant position’s accuracy of complete arch implant scans. The discrepancies measured involved 13 µm of mean linear trueness, 9 µm of mean linear precision, 0.145 degrees of mean angular trueness, and 0.053 degrees of mean angular precision among the subgroups tested. The impact of these statistically significant differences may not be clinically relevant.

PMID:40074628 | DOI:10.1016/j.prosdent.2025.02.024

Br J Anaesth. 2025 Mar 11:S0007-0912(25)00099-6. doi: 10.1016/j.bja.2025.02.007. Online ahead of print.

ABSTRACT

BACKGROUND: In the UK, total intravenous anaesthesia (TIVA) is used in 25% of general anaesthetics and is gaining traction because of its lower environmental impact and effectiveness in reducing postoperative nausea and vomiting (PONV). Although meta-analyses have compared TIVA and inhalational anaesthesia (IA), the optimal delivery method-manual infusion or target-controlled infusion (TCI)-remains underexplored. This review addresses this gap, leveraging the rapidly growing body of evidence to guide optimal anaesthetic practice.

METHODS: We searched PubMed, Embase, Cochrane CENTRAL and Web of Science from inception to October 10, 2024. Studies comparing TIVA and IA across several patient-related and efficiency outcomes were included. Meta-analyses were performed for all outcomes. Subgroup analyses were performed to assess the contribution of different factors including a comparison of TCI with manual infusion in TIVA.

RESULTS: In total, 385 RCTs were included. No significant difference in ClassIntra grade 3-4 adverse events was observed between TIVA and IA (risk ratio [RR]: 1.00, 95% confidence interval [CI]: 0.88-1.12; P=0.97). Subgroup analysis also showed no significant difference for TCI (RR: 0.89, 95% CI: 0.66-1.21; P=0.46) or manual infusion (RR: 1.03, 95% CI: 0.90-1.17; P=0.70) groups. IA was favoured in recovery times and costs, whereas the incidence of PONV and agitation on emergence favoured TIVA. No statistical difference was observed in our other outcomes.

CONCLUSIONS: TIVA and IA are comparably safe, with TIVA reducing PONV and agitation, whereas IA offers faster recovery and lower costs. The use of TCI in TIVA might decrease postoperative cognitive dysfunction and increase recovery time, highlighting the need for a systematic review directly comparing TCI and manual infusion.

SYSTEMATIC REVIEW PROTOCOL: This review was registered prospectively with PROSPERO (CRD42024413368) on October 10, 2024. A single amendment to the title and order of outcomes was performed on November 21, 2024.

PMID:40074622 | DOI:10.1016/j.bja.2025.02.007

Sleep Health. 2025 Mar 11:S2352-7218(25)00030-0. doi: 10.1016/j.sleh.2025.01.010. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify associations between perceived neighborhood walkability and sleep across racial and ethnic groups of US adults.

METHODS: Data from the 2020 National Health Interview Survey (N=27,521) were used to assess self-reported measures of walkability (pedestrian access, accessible amenities, unsafe walking conditions) and sleep (short and long duration; frequency of waking up unrested, trouble falling and staying asleep, sleep medication use). Stratified by racial and ethnic group, we calculated the age-adjusted prevalence of neighborhood walkability features and sleep measures and estimated prevalence ratios assessing associations between neighborhood walkability and sleep while adjusting for sociodemographic and health covariates.

RESULTS: The prevalence of unsafe walking conditions due to crime was lowest among non-Hispanic White adults (6.9%), and access to places to relax was lowest among non-Hispanic Black adults (72.5%). The prevalence of short sleep duration was highest among non-Hispanic Black adults (37.9%). Neighborhood environment features had differential associations with sleep when stratified by race and ethnicity. For example, walking path access was related to lower sleep medication use among non-Hispanic Asian adults (adjusted prevalence ratio (aPR): 0.42, 95% CI: 0.19-0.91) but greater use among non-Hispanic White adults (aPR: 1.24, 95% CI: 1.05-1.46). More associations were observed among non-Hispanic White adults than other groups; and the strongest magnitude of association was observed among non-Hispanic Asian adults (traffic and sleep medication aPR: 0.31, 95% CI: 0.12-0.84).

CONCLUSIONS: Associations between the neighborhood environment and sleep vary and may be inconsistent by race and ethnicity. Future research may help identify determinants.

PMID:40074608 | DOI:10.1016/j.sleh.2025.01.010

J World Fed Orthod. 2025 Mar 11:S2212-4438(25)00001-3. doi: 10.1016/j.ejwf.2025.01.001. Online ahead of print.

ABSTRACT

OBJECTIVES: This randomized two-arm parallel trial aimed to compare the effectiveness of standard anterior bracket positioning with the smile arc protection (SAP) method in terms of occlusal and smile morphometric indices, and perceived post-treatment smile aesthetics.

METHODS: Patients needing nonextraction orthodontic treatment were randomly assigned to either the SAP or standard bracket placement group. Inclusion criteria were ages 11 to 25 years, nonextraction treatment, and good oral hygiene, all treated using the Roth 0.018 system. Primary outcomes assessed occlusal and smile morphometric changes using cephalograms, study models, and photographs. Perceived smile aesthetics was evaluated with the Visual Analogue Scale (VAS). Statistical analyses included independent t-tests, paired t-tests, Mann-Whitney U test, Wilcoxon signed rank test, and analysis of covariance.

RESULTS: Forty-two patients (mean age, 19.5 ± 5.5) were randomized evenly between the SAP and standard groups. Baseline characteristics were similar, and one patient from the SAP group was excluded. No significant differences were found between the groups for occlusal and smile morphometric variables before and after treatment (P > 0.05). Post-treatment, the smile arc significantly improved in the SAP group compared to both the standard method (P = 0.005) and its pretreatment state (P = 0.005). VAS scores from orthodontists and laypersons showed no significant differences (P > 0.05), but general dentists rated the SAP group’s smiles as more attractive (P = 0.002).

CONCLUSIONS: The SAP method was more effective in achieving a consonant smile arc than conventional bracket positioning. While other occlusal and morphometric changes showed no significant differences, general dentists found the SAP group’s smiles more attractive. Further research is needed to confirm these results.

REGISTRATION: The research was registered in the Iranian Registry of Clinical Trials (IRCT) database with the identification code IRCT20220108053669N3.

PMID:40074606 | DOI:10.1016/j.ejwf.2025.01.001

ESC Heart Fail. 2025 Mar 12. doi: 10.1002/ehf2.15264. Online ahead of print.

ABSTRACT

AIMS: Atrial fibrillation (AF) is a frequent comorbidity in heart failure (HF). We analysed factors associated with new-onset atrial fibrillation in patients with heart failure using linked real-world UK data from primary and secondary care, along with findings from genome-wide association studies.

METHODS AND RESULTS: Among 163 174 participants with a diagnosis of HF (January 1998 to May 2016) from Clinical Practice Research Datalink (CPRD) and Hospital Episodes Statistics (HES), 111 595 participants had no previous history of AF (mean age 76.3 ± 12.6; 50.3% women; 95.8% white ethnicity). Multivariate weighted Cox regression was used to identify predictors for new-onset AF. Linkage disequilibrium score regression was performed to assess the strength of the genetic correlation between AF and identified predictors. During follow-up (median 1.33 years, IQR 0.15-4.18), the incidence rate for AF was 2.8% at 30 days, 9.9% at 1 year, 18.0% at 3 years, and 24.9% at 5 years after HF diagnosis after HF diagnosis. Female sex (HR = 0.79, 95% CI 0.71-0.88), age (HR = 1.04, 95% CI 1.04-1.04), white ethnicity (HR = 1.30, 95% CI 1.06-1.59), social deprivation (HR = 1.20, 95% CI 1.01-1.42), BMI (HR = 1.01, 95% CI 1.00-1.02), gentle physical activity (HR = 0.84, 95% CI 0.72-0.97), hypertension (HR = 1.15, 95% CI 1.03-1.29), chronic kidney disease (HR = 1.15, 95% CI 1.06-1.24), chronic obstructive pulmonary disease (COPD) (HR = 1.10, 95% CI 1.01-1.19) and valvular heart disease (HR = 1.17, 95% CI 1.06-1.29) were associated with new-onset AF. Angiotensin-converting enzyme inhibitors were associated with lower AF incidence (HR = 0.88, 95% CI 0.80-0.96), and the magnitude of effect was dependent on the duration of administration. Linkage disequilibrium score regression showed important genetic correlation between AF and HF (rg = 0.57, P = 2.30 × 10^-59) and reduced, but still significant, overlap between AF and BMI (rg = 0.19, P = 6.18 × 10^-20), systolic and diastolic blood pressure, smoking, and COPD (P values ranging from <10^-4 to <0.05).

CONCLUSIONS: Incident AF in the HF population is high, with good genetic correlation for the two conditions. Identified predictors for new-onset AF might be helpful to improve management of HF patients and AF prevention.

PMID:40074560 | DOI:10.1002/ehf2.15264

Nurs Crit Care. 2025 Mar;30(2):e70000. doi: 10.1111/nicc.70000.

ABSTRACT

BACKGROUND: Ventilator-associated pneumonia (VAP) is a frequent and severe complication among newborns in neonatal intensive care units (NICUs). It is associated with elevated morbidity and mortality rates, more extended hospital stays and increased health care costs. Implementing preventive care bundles and structured sets of evidence-based practices reduces VAP incidence. As primary caregivers, nurses are critical in consistently applying these preventive measures in NICU settings.

AIM: To evaluate the impact of a structured training programme on nurses’ practices in the prevention of VAP among ventilated newborns in NICUs.

STUDY DESIGN: This prospective, pre- and post-intervention study was conducted with 27 nurses caring for mechanically ventilated newborns. All newborns admitted to the NICU who met inclusion criteria were included in the study (34 newborns pre-intervention, 38 newborns post-intervention and 41 newborns 3 months after the intervention).

RESULTS: The results indicate significantly improved nurses’ practices for VAP prevention across the core, equipment-related general measures, with total mean scores increasing from 50.67% (95% CI: 44.30-56.92) pre-programme to 89.26% (95% CI: 85.68-92.84) immediately post-programme and 73.33% (95% CI: 67.79-78.88) after 3 months (p < .001). Before the programme, 85.3% of newborns developed VAP. However, this dropped dramatically to just 10.5% immediately after the programme, with a relative risk of 0.123 (95% CI: 0.046-0.328, p < .001). Even 3 months later, the rates remained much lower at 19.5% than before the programme, with a relative risk of 0.228 (95% CI: 0.117-0.445, p < .001). Multivariate logistic regression showed that only overall nurses’ practices remained statistically significant in reducing VAP risk (OR = 0.819, 95% CI: 0.728-0.920, p = .001) after adjusting for confounders. Prolonged ventilation and individual components of nursing practices were not significant in the multivariate model.

CONCLUSIONS: This study demonstrates that a structured educational programme can significantly enhance nurses’ adherence to VAP preventive practices and reduce VAP incidence. Regular training initiatives are crucial for sustaining high care standards, thereby improving neonatal patient health care outcomes.

RELEVANCE TO CLINICAL PRACTICE: Newborns in the neonatal intensive care unit (NICU) are at a higher risk of developing ventilator-associated pneumonia (VAP) because of their fragile immune systems, the need for mechanical ventilation and prolonged hospital stays. VAP can lead to severe complications, including increased morbidity, mortality and long-term health issues. Training NICU nurses on VAP prevention care bundles is crucial for improving neonatal care, reducing preventable infections and optimizing clinical outcomes in a highly vulnerable neonatal population. It supports evidence-based practice, enhances nurse competence and contributes to the overall quality of care in neonatal intensive care settings. As a result, implementing such a training programme should be a top priority in NICU clinical practice.

PMID:40074557 | DOI:10.1111/nicc.70000

J Genet Eng Biotechnol. 2025 Mar;23(1):100475. doi: 10.1016/j.jgeb.2025.100475. Epub 2025 Mar 5.

ABSTRACT

Leprosy remains a significant health concern, particularly in India, Brazil, and Indonesia. Early diagnosis is essential to prevent complications, highlighting the need for improved diagnostic tools. This study aimed to identify novel Mycobacterium leprae antigens and assess their effectiveness against human sera through immunotools for antibody response evaluation. Using bioinformatics, we predicted B-cell epitopes in M. leprae, which were chemically synthesized and tested via dot blotting with sera from leprosy patients, tuberculosis patients, and healthy controls. Promising peptides underwent further analysis through ELISA using 465 serum samples from leprosy patients, household contacts, and healthy controls across Brazil. The samples were also tested against known antigens HSA-NDO, LID-1, and NDO-LID. A total of 102 epitope sequences were generated, of which eight (PEP1 to PEP8) demonstrated the ability to differentiate between individuals with and without exposure to M. leprae. The results of the ELISA test exhibited statistically significant differences in absorbance responses between the experimental groups for the novel synthetic peptides (p < 0.05). PEP3, PEP4, and PEP5 demonstrated the most favorable outcomes, with values of the area under the receiver operating characteristic curve (AUC) of 0.9759, 0.9796 and 0.9551 respectively in the comparison of healthy controls with household contacts, and 0.8257, 0.7945, and 0.7961 comparing the same controls with patients. Furthermore, the synthetic peptides demonstrated superior sensitivity, specificity, and AUC compared to HSA-NDO, LID-1, and NDO-LID. The identified peptides showed significant responses in samples from patients and household contacts (HHC), indicating their potential for tracing exposure to M. leprae bacilli. These novel synthetic peptides could enhance the sensitivity of rapid diagnostic tests for leprosy, facilitating early detection of the infection. This could help prevent disease progression and interrupt transmission.

PMID:40074449 | DOI:10.1016/j.jgeb.2025.100475

J Genet Eng Biotechnol. 2025 Mar;23(1):100462. doi: 10.1016/j.jgeb.2025.100462. Epub 2025 Feb 1.

ABSTRACT

The study aims to evaluate the significant role of interleukin 15 (IL-15), IL-22, IL-37, and Caspase 9 gene expression in polycystic ovary syndrome (PCOS), focusing on the underlying mechanisms and potential diagnostic or therapeutic implications. Peripheral blood has been collected, and serum was separated for the evaluation of the serum IL-15, IL-22, and IL-37. The ELISA technique has been carried out to determine the serum levels of understudied factors mentioned above in Iraqi women patients diagnosed with PCOS (No. = 90) via a specialized gynecologist and healthy fertile women (No. = 48) as a control group. In addition, a genetic study on the expression of the caspase 9 gene in these patients had been performed. The data reveals statistically significant differences in interleukin levels in PCOS patients versus the control group. Specifically, the PCOS group exhibits significantly higher levels of IL-15 and IL-22 as compared to the control group. Conversely, the PCOS group shows significantly lower levels of IL-37 compared to the control group. The results showed no statistically significant difference in the mean expression of the Caspase 9 gene when comparing these fold graduations. However, it’s worth noting that a higher fold frequency was observed in both the PCOS and control groups, with 57.1 % and 60 %, respectively, having folds less than 1. The distribution of folds varied across other categories was also addressed. Additionally, there was a notable difference in the frequency of 11.4 % in the PCOS group compared to 2 % in the control group for folds greater than 9. The findings suggest that interleukins, particularly IL-22 and IL-37, hold promise as diagnostic markers for distinguishing PCOS from healthy conditions. However, the potential diagnostic utility of the Caspase 9 gene expression was not confirmed in this study.

PMID:40074436 | DOI:10.1016/j.jgeb.2025.100462