Tag: statistics

BMC Oral Health. 2023 Nov 27;23(1):929. doi: 10.1186/s12903-023-03661-0.

ABSTRACT

BACKGROUND: The injury of the inferior alveolar nerve (IAN) is one of the most serious complications of impacted mandibular third molars (IMTMs) extraction. The influence of the root orientation of IMTMs on IAN injury is still controversial. A deeper understanding of the risk factors of IAN injury conduces to better prevention of IAN injury. This study aims to explore whether root orientation is an independent risk factor of IAN injury during IMTMs extraction using the statistical strategy of propensity score matching (PSM).

METHODS: This retrospective cohort study included 379 patients with 539 cases of high-risk IMTMs screened by panoramic radiography and cone beam computed tomography. The IAN injury incidence after extraction of different groups of IMTMs was analyzed using the chi-square test or Fisher’s exact test. The correlation between third molar root orientation and impaction depth/contact degree with IAN was evaluated by the Lambda coefficient. Based on PSM for balancing confounding factors including age, sex, impaction depth, and contact degree, the effect of root orientation on the incidence of IAN injury was further analyzed using Fisher’s exact test.

RESULTS: There were significant group differences in IAN injury incidence in impaction depth, root orientation, and contact degree of root-IAC before PSM. Root orientation was correlated with impaction depth and contact degree of root-IAC. After PSM, there were 9 cases with IAN injury and 257 cases without IAN injury. There were significant group differences between the buccal and non-buccal groups after PSM, and the risk of IAN injury was higher when the root was located on the buccal side of IAC (OR = 8.448, RR = 8).

CONCLUSIONS: Root orientation is an independent risk factor of IAN injury, and the risk is higher when the root is located on the buccal side of IAC. These findings could help better evaluate the risk of inferior alveolar nerve injury before the extraction of IMTMs.

PMID:38008723 | DOI:10.1186/s12903-023-03661-0

BMC Ophthalmol. 2023 Nov 27;23(1):485. doi: 10.1186/s12886-023-03230-7.

ABSTRACT

BACKGROUND: This study aimed to identify an initial screening tool for congenital ectopia lentis (CEL) by comparing ocular biological parameters in children with myopia.

METHODS: A retrospective case-control study was conducted at one tertiary referral centre, from October 2020 to June 2022. Axial length (AL), corneal curvature (CC), refractive astigmatism (RA), corneal astigmatism (CA), internal astigmatism (IA), the difference between the axis of RA and CA [AXIS(RA-CA)], white-to-white corneal diameter (WTW), and axial length-corneal radius ratio (AL/CR) were compared in 28 eyes of CEL patients, and 60 eyes of myopic patients matched for age and refraction. The spherical equivalent of each eye was < -3.00 D. Area under the curve (AUC) of the receiver operating characteristic curves were calculated.

RESULTS: The differences in RA, AL, mean keratometry (Kmed), maximum keratometry (Kmax), minimum keratometry (Kmin), CA, IA, AXIS(RA-CA), WTW, and AL/CR between the CEL and myopic groups were statistically significant (p < 0.05; p < 0.001; p < 0.001; p < 0.001; p < 0.001; p < 0.05; p < 0.001; p < 0.001; p < 0.001; p < 0.001, respectively). In logistic regression analysis RA, IA, AXIS(RA-CA), and AL/CR were significantly associated with CEL (p < 0.05). AUCs for RA, IA, AXIS(RA-CA), and AL/CR were 0.694, 0.853, 0.814, and 0.960, respectively. AUCs for AL/CR in SE< -6.00 D subgroup was 0.970, and 0.990 in -6.00 D ≤ SE < -3.00 D group. An AL/CR < 3.024 was the optimal cut-off point differentiating the CEL and control groups (sensitivity, 92.9%; specificity, 88.30%).

CONCLUSIONS: A smaller AL/CR could identify CEL in children with myopia. An AL/CR cut-off value of 3.024 may be the most sensitive and specific parameter for the differential diagnosis of CEL in patients with mild to high myopia.

PMID:38008718 | DOI:10.1186/s12886-023-03230-7

Burns. 2023 Nov 2:S0305-4179(23)00216-4. doi: 10.1016/j.burns.2023.10.016. Online ahead of print.

ABSTRACT

The split-thickness skin graft (STSG) donor site is the commonest used during burn surgery which has its own complications and as such the focus should be on minimizing it. Modifications to practice in our unit which we believe aid this include limiting the amount of STSG taken and the harvest of super-thin STSGs, with 0.003-0.005 in. (0.08-0.13 mm) being the commonest dermatome settings used. A patient-reported survey via a mobile phone link to a questionnaire was sent to 250 patients who had a STSG for an acute burn between 1st August 2020 and 31st July 2021. Patient demographics were collected from electronic records including the thickness of the FTSG taken when recorded. Patient responses were statistically analyzed and logistic regression with backwards elimination was performed to explore which contributing factors led to an improved experience of the donor site. Questionnaire responses were obtained from 107 patients (43%). These were between one and two and a half years after the injury. Concerning early donor site issues, itch was a problem for 52% of patients, pain was a problem for 48% of patients. Less common problems (fewer than 25% of patients) were leaking donor sites, wound breakdown, and over-granulation. Regarding long-term outcomes, increased, decreased or mixed pigmentation at the donor site was reported by 32% patients at the time of the survey. Hyper-vascular donor sites were reported by 24% patients. Raised or uneven feeling donor sites were reported by 19% patients, firm or stiff donor sites by 13% patients, and altered sensation by 10% patients. At the time of the survey, 70% responders reported their donor site looked “the same or about the same as my normal skin”. Of these, 62 reported how long it took for this to happen, and it equates to a third looking normal at 6 months and half looking normal at a year. For the 32 patients who reported their donor site looking abnormal, 72% were “not bothered” by it. Patients with super-thin grafts (0.003-0.005 in.) were significantly more likely to have normal sensation, normal stiffness, and be less raised at their donor sites than those who had thin grafts (0.006-0.008 in.). This survey gives important information on patients’ experiences of donor site morbidity that may form part of an informed consent process and allow tailored advice. Furthermore, it suggests that super-thin grafts may provide a superior donor site experience for patients.

PMID:38008702 | DOI:10.1016/j.burns.2023.10.016

Burns. 2023 Nov 3:S0305-4179(23)00226-7. doi: 10.1016/j.burns.2023.10.019. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the prognostic value of the Ryan score, Belgian Outcome of Burn Injury (BOBI) score,revised Baux (rBaux) score, and a new model (a Logit(P)-based scoring method created in 2020) for predicting mortality risk in patients with extremely severe burns and to conduct a comparative analysis.

METHODS: A retrospective analysis was conducted on 599 burn patients who met the inclusion criteria and were admitted to the burn unit of the First Affiliated Hospital of Nanchang University from 2017 to 2022. Relevant information was collected, and receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were plotted for each of the four models in assessing mortality in these burn patients using both age-stratified and unstratified forms. The ROC curve section was further compared with the area under the curve (AUC), optimal cutoff value, as well as its sensitivity and specificity. Additionally, the quality of the AUC was assessed using the Delong test.

RESULT: Among the patients who met the inclusion criteria, 532 were in the survival group and 67 in the death group. Irrespective of age stratification, the novel model exhibited superior performance with an AUC of 0.868 (95% CI: 0.838-0.894) among all four models predicting mortality risk in included patients, and also demonstrated better AUC quality than other models; the calibration curves showed that the accuracy of all four models was good; the DCA curves showed that the clinical utility of the novel model and rBuax score were better. In the comparison of four scoring models across different age groups, the new model demonstrated the largest AUC in both 0-19 years (0.954, 95% CI 0.914-0.979) and 20-59 years groups (0.838, 95% CI 0.793-0.877), while rBuax score exhibited the highest AUC in ≥ 60 years group (0.708, 95% CI of 0.602-0.800). The calibration curves showed that the four models exhibited greater accuracy within the age range of 20-59 years, while the DCA curves indicated that both the novel model and rBuax score scale displayed better prediction in both the 20-59 and ≥ 60 years groups.

CONCLUSIONS: All four models demonstrate accurate and effective prognostication for patients with severe burns. Both the novel model and rBaux score exhibit enhanced prediction utility. In terms of the model itself alone, the new model is not simpler than, for example, the rBaux score, and whether it can be applied clinicallyinvolves further study.

PMID:38008701 | DOI:10.1016/j.burns.2023.10.019

Drugs Real World Outcomes. 2023 Nov 26. doi: 10.1007/s40801-023-00403-0. Online ahead of print.

ABSTRACT

BACKGROUND: Adverse drug events among older adults result in significant mortality, morbidity and cost. This harm may be mitigated with appropriate prescribing and deprescribing. We sought to understand the prescribing outcomes of an interdisciplinary geriatric virtual consultation service.

METHODS: We conducted a retrospective, before-and-after feasibility study to measure prescribing outcomes for a medication optimization virtual interdisciplinary geriatric specialist (MOVING) programme comprised of expertise from geriatric clinical pharmacology, pharmacy and psychiatry for older adults (aged ≥ 65 years) between June and December 2018, Ontario, Canada. The primary outcome was the number of distinct prescriptions and the presence of polypharmacy (defined as ≥ 4 medications) before and after the service. Secondary outcomes included the number of as needed and regularly administered prescriptions, number of potentially inappropriate prescriptions as defined by the Beers and STOPP criteria, and number of prescriptions for psychotropics, long-acting opioids and diabetic medications.

RESULTS: We studied 40 patients with a mean age of 80.6 [standard deviation (SD) 8.8] years who received a MOVING consult. We found no significant change in the mean total number of prescriptions per patient before (12.02, SD 5.83) and after the intervention (11.58, SD 5.28), with a mean difference of -0.45 [95% confidence interval (CI) -0.94 to 0.04; p = 0.07]. We found statistically significant decreases in as needed prescriptions (mean difference – 0.30, 95% CI – 0.45 to – 0.15; p<0.001), and potentially harmful medications as identified by the Beers (mean difference -1.25, 95% CI -2.00 to -0.50; p = 0.002) and STOPP (mean difference -1.65, 95% CI -2.33 to -0.97; p < 0.001) scores. Without including the cost savings from hospital diversion by a MOVING consult, the costs of a MOVING consult were $545.80-$629.80 per person, compared with the costs associated with traditional in-person consults involving similar specialist clinical services ($904.89-$1270.69 per person).

CONCLUSION: A MOVING model of care is associated with decreases in prescriptions for potentially inappropriate medications in older adults. These findings support further evaluation to ascertain health system impacts.

PMID:38007818 | DOI:10.1007/s40801-023-00403-0

Stud Health Technol Inform. 2023 Nov 23;308:669-679. doi: 10.3233/SHTI230899.

ABSTRACT

OBJECTIVE: To analyze the regularity of modern Chinese herbal compound in the treatment of salivation based on data mining technology, and to study the potential mechanism of core Chinese herbal medicine in the treatment of salivation using network pharmacology and molecular docking.

METHODS: CNKI, VIP and Wanfang literature databases were searched.Choose a prescription for salivation.Excel2019 was used to establish a database of formulas for the treatment of salivation.The included TCM compounds were analyzed by frequency statistics and association rules using the ancient and modern medical record cloud platform to obtain the core drug pairs.TCMSP and Uniprot were used to search the components and targets of the core drug pairs, and intersected with the disease targets obtained from Genecards, OMIM, TTD, PharmgKb, and DrugBank platforms.Complex networks were constructed by cytoscape3.9.1; PPI networks were completed by STRING platform; GO and KEEG pathway enrichment analysis was performed by R language; finally molecular docking validation was performed using AutoDockTools software; and the results were visualized by Pymol software.

RESULTS: 122 prescriptions were obtained, 194 herbs were used, the total frequency was 1047, and the top ten drugs used were Atractylodes macrocephala Koidz, Poria cocos, Glycyrrhiza uralensis, Yizhiren, Citrus sinensis, Codonopsis pilosula, Yam, Pinellia ternate, Zingiber officinale, and Coptis chinensis.After association rule analysis, the core drug pair Codonopsis pilosula – Atractylodes macrocephala Koidz was obtained.Twenty-seven effective active components of core drug pairs were screened, corresponding to 62 targets for the treatment of salivation, and four core targets were MAPK1, TP53, MAPK14, and ESR1.GO enrichment analysis yielded 1789 biological process entries, 81 cellular component entries and 111 molecular function entries.KEGG enrichment analysis resulted in 157 pathways, and the first 30 were selected for visualization.Molecular docking of luteolin, 7-Methoxy-2-methyl isoflavone, Stigmasterol, 3β-acetoxyatractylone, Frutinone A, 3betaHydroxymethyllenetanshiquinone, glycitein to the core target showed that the key active components had good binding activity to the core target.

CONCLUSION: The key active components of Codonopsis pilosula and Atractylodes macrocephala Koidz in the treatment of salivation act on MAPK1, TP53, MAPK14 and ESR1 through Calcium, PI3K Akt and IL-17 signaling pathways to regulate the physiological processes of nerve, muscle, endocrine and reproductive systems and the physiological functions of nerve cells, providing a theoretical reference for the later study of integrated traditional Chinese and western medicine in the treatment of salivation.

PMID:38007798 | DOI:10.3233/SHTI230899

Stud Health Technol Inform. 2023 Nov 23;308:662-668. doi: 10.3233/SHTI230898.

ABSTRACT

With the development of the times, spinal problems are not only one of the diseases that older people pay close attention to, but also gradually spread among teenagers. Therefore, it is very important to predict the possibility of wound infection in patients after spinal fusion and internal fixation. The method is to statistically analyze the clinical data of patients with clinical spinal disease, and to propose individualized treatment and recovery plan for each patient’s pathological characteristics and postoperative recovery, so as to realize humanized service and minimize the possibility of wound infection. In this paper, Logistic logistic regression, SMOTE algorithm and confusion matrix are used to model the probability of infection after spinal fusion and internal fixation. In the positive confirmation analysis part, the information data of 449 clinical cases were selected for analysis, and 14 variables such as gender, age, number of internal fusion fixation segments, past medical history, intraoperative blood transfusion and bleeding volume were selected as research indicators to explore the related factors of postoperative infection. The classification method adopts two classifications. The two types of data are ‘postoperative infection’ and ‘postoperative non-infection’. In the statistical description of the data, it is found that age, selection of internal fusion fixation segments, preoperative hospitalization days, cerebrospinal fluid leakage, and preoperative ASA score are all important factors affecting the incidence of postoperative infection.

PMID:38007797 | DOI:10.3233/SHTI230898

Stud Health Technol Inform. 2023 Nov 23;308:583-589. doi: 10.3233/SHTI230888.

ABSTRACT

This study focuses on the analysis of the effects of potential factors on the Death Rate of Covid-19. The factors, in both demographic and economic aspects, have been discussed in the study through the extensive application of statistical inference, such as the Analysis of Variance (ANOVA), Univariate Linear Regression, and Multivariate Linear Regression. In the result section, the significance of the effects of these factors on Covid-19 has been carefully discussed.

PMID:38007787 | DOI:10.3233/SHTI230888

Stud Health Technol Inform. 2023 Nov 23;308:359-364. doi: 10.3233/SHTI230860.

ABSTRACT

In this study, screening, confirmation and validation of mismatch allele-specific (AS) forward (F)-primers are executed to establish a quadruplex amplification analysis (real-time PCR) for discrimination of CYP2D6*10, ADRB1, NPPA and CYP3A5*3 genotypes associated with hypertensive pharmacogenomics. To significantly distinguish heterozygote and homozygote, ΔCq (differences in threshold cycles between the wild-type F-primer amplification assay and the mutant-type F-primer amplification assay) was utilized to determine outcomes. Detection of plasmid by uniplex real-time PCR was used to screen the mismatch AS F-primers. Robustness assessment and agreement analysis were employed to confirm and validate initially selected F-primers, respectively. Robustness assessment confirmed that except of ADRB1 (0.7-0.9), amplification efficiency ranged from 0.9 to 1.1. No statistically significant difference was found between the analysis and NGS. Therefore, the optimized F-primer as polymorphism recognition molecules can benefit the genotyping guiding drug delivery in anti-hypertension treatment.

PMID:38007760 | DOI:10.3233/SHTI230860

Stud Health Technol Inform. 2023 Nov 23;308:253-260. doi: 10.3233/SHTI230847.

ABSTRACT

Gram-negative bacteria had been regarded as several important sources of lethal infection. Rapid identification of pathogenic bacteria is extremely important for the diagnosis and clinical treatment of diseases. In current study, three gram-negative bacteria, including Klebsiella aerogenes, Enterobacter cloacae and Escherichia coli, were used to access the feasibility of characterizing Gram-negative bacteria by surface-enhanced Raman Spectroscopy (SERS). Bacterial samples were from Escherichia coli isolates (n=1000), Klebsiella aerogenes isolates (n=1000) and Enterobacter cloacaeand isolates (n=1000). The differences of three Gram-negative bacteria were characterized by SERS spectra. Furthermore, four multivariate statistical algorithms based on the combination of principal component analysis (or partial least squares) and linear discriminant analysis (or support vector machine) were used to discriminate the spectra of three gram-negative bacteria.

PMID:38007748 | DOI:10.3233/SHTI230847