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Nevin Manimala Statistics

Tooth-Implant-Supported Prosthetic Structures Versus Implant-Supported Restorations

Acta Stomatol Croat. 2023 Jun;57(2):177-189. doi: 10.15644/asc57/2/8.

ABSTRACT

OBJECTIVES: The primary aim was to compare the amount of bone height change that occurs around the tooth and the implant when having tooth-implant-supported prosthetic restorations versus bone height change that appears around implants in only implant-supported prosthetic restorations. The secondary aim was to examine the influence of various factors such as the number of teeth involved in the construction, their endodontic treatment, number of implants, the type of implantology construction, the jaw in which the construction is located, the condition of the opposite jaw, gender, age, and working time, as well as to examine whether the initial bone level influenced the amount of change in bone height itself.

MATERIALS AND METHODS: With a total of 50 respondents, 25 X-ray panoramic images were representing tooth-implant-supported prosthetic restorations, while the other 25 were representing implant-supported prosthetic restorations. Bone measures were taken (from enamel-cement junction/implant neck to the most apical bone point) from 2 panoramic radiographs. The first one is immediately after the implant placement and the second and the last one again in half a year up to seven years after, depending on the time when the photo was taken for each patient. The obtained difference represented the bone resorption, the bone formation, or a state without change. Influence of different factors, such as sex, age of the patient, working time, the number of teeth involved in the construction, endodontic treatment, number of implants, the type of implant construction, the jaw where the construction is located, the condition of the opposite jaw, as well as the initial bone condition, was examined. During the statistical analysis, frequency tables, basic statistical parameters, the Mann-Whitney U test, the Kruskal-Wallis Anova, Wilcoxon test, and regression analysis were used, and the results were presented in tabular form and the form of the Pareto diagram of t-values.

RESULTS: No statistically significant difference in bone change (whether we are talking about the place of the implant (-0.359±1.009 and median value 0.000), the place of a tooth (-0.428±0.746 and median value -0,150) in tooth-implant supported restorations, or the place of the implant in case of implant-supported structures (-0,059±0,200 and median value -0,120)) was proven. When talking about the influence of other factors, by regression analysis, the number of implants was shown to be the only factor with a statistically significant influence (β=0.54; P=0.019) in a change of bone level, but only when talking about implant-supported restorations.

CONCLUSION: No significant difference was proven between bone height change, neither around the tooth nor the implant in tooth-implant-supported prosthetic restorations compared to the bone height changes around the implant in only implant-supported prosthetic restorations. Among all the examined factors, the number of implants has shown to have statistically significant contribution to the amount of bone height change in implant-supported prosthetic restorations.

PMID:37427363 | PMC:PMC10323935 | DOI:10.15644/asc57/2/8

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Nevin Manimala Statistics

Psychometric Properties of the 14 Items Oral Health Impact Profile Questionnaire Translated into the Macedonian language

Acta Stomatol Croat. 2023 Jun;57(2):145-154. doi: 10.15644/asc57/2/5.

ABSTRACT

OBJECTIVE: Due to the consideration that oral/dental health is an important part of general health, well-being, and an individual’s quality of life, the need for appropriate instruments assessing oral health-related quality of life is emphasized. This study aimed to evaluate the psychometric properties of the Oral health-related quality of life questionnaire consisting of 14 questions among the Macedonian language-speaking adults (OHIP-MAC 14).

MATERIAL AND METHODS: A total of 270 adults participated in the study. The reliability of the questionnaire was examined by testing the internal consistency and reproducibility (test-retest). The responsiveness of the instrument was tested by computing the pre-intervention and post-intervention OHIP-14 scores using the paired t-test followed by the determination of the effect-size. The two aspects of the construct validity were evaluated: concurrent validity and discriminative validity.

RESULTS: A concurrent validity analysis confirmed that the instrument performed well. Discriminative validity also confirmed good psychometric properties (P<0.01). The ICC statistics and the Cronbach alpha coefficients indicated the appropriate reliability of the instrument for the included groups of participants. The responsiveness of the questionnaire was also acceptable (P<0.01) demonstrating the large effect-size of 1.43.

CONCLUSION: The OHIP 14 MAC showed acceptable psychometric properties and can be recommended as a valuable instrument in assessments of the Oral health-related quality of life in the Republic of North Macedonia.

PMID:37427359 | PMC:PMC10323931 | DOI:10.15644/asc57/2/5

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Nevin Manimala Statistics

The Asymmetry of the Mandible in Patients with Unilateral Temporomandibular Joint Disc Displacement Confirmed by Magnetic Resonance Imaging

Acta Stomatol Croat. 2023 Jun;57(2):167-176. doi: 10.15644/asc57/2/7.

ABSTRACT

OBJECTIVES: The study aimed to determine the relationship between the mandibular asymmetry index according to Kjellberg between patients with painful unilateral anterior disc displacement (DD) and asymptomatic volunteers without disc displacement. Vertical measurements were performed on a panoramic single-image radiograph, and the disc status was confirmed by magnetic resonance imaging (MRI).

MATERIAL AND METHODS: Two groups of subjects were retrospectively selected, 40 patients (the overall mean age was 35.5 years; 75% female) with temporomandibular disorder symptoms confirmed by RDC/TMD axis I and manual functional analysis. Unilateral DD was determined by MRI. A comparative group of asymptomatic volunteers (20 dental students with a mean age of 23.4 years; 72% female) had the physiological position of the disc determined by MRI. The vertical asymmetry of the condyle was determined by the method of Kjellberg et al. The symmetry of the gonial angle of the mandible was also measured.

RESULTS: A comparison of the mean of the asymmetry index between patients (average 90.89±7.08%) and asymptomatic volunteers (mean 95.86±4.44%) showed a statistically significant difference (p=0.0029). There was no difference (p=0.088) in gonial angle symmetry between the patients (mean 96.48±2.96°) and the asymptomatic volunteers (mean 97.52±2.31°). The distribution of the presence of individual DD diagnoses (partial and total displacement with reduction, displacement without reduction) in patients diagnosed with asymmetry of the mandible was without statistical significance (p>0.05).

CONCLUSION: This study actually points to the asymmetry of the mandible as a potential morphological risk of anterior DD.

PMID:37427358 | PMC:PMC10323934 | DOI:10.15644/asc57/2/7

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Nevin Manimala Statistics

Comparison of phenprocoumon with direct oral anticoagulants in catheter ablation of atrial fibrillation

Eur Heart J Open. 2023 Jun 20;3(4):oead065. doi: 10.1093/ehjopen/oead065. eCollection 2023 Jul.

ABSTRACT

AIMS: In patients undergoing catheter ablation for atrial fibrillation (AF), direct oral anticoagulants (DOACs) are as effective and safe as the vitamin K antagonist (VKA) warfarin. Phenprocoumon has a different pharmacokinetic profile compared with warfarin and is the most used VKA in Germany. The aim of the study was to compare DOAC with phenprocoumon.

METHODS AND RESULTS: In this retrospective single-centre cohort study, 1735 patients who underwent 2219 consecutive catheter ablations for AF between January 2011 and May 2017 were included. All patients were in-hospital for at least 48 h after catheter ablation. The primary outcome was defined as peri-procedural thrombo-embolic events. The secondary outcome was any bleeding according to the International Society on Thrombosis and Haemostasis (ISTH). The mean age of the patients was 63.3 years. Phenprocoumon was prescribed in 929 (42%) of the cases, and in 697 (31%) dabigatran, 399 (18%) rivaroxaban, and 194 (9%) apixaban. During hospitalization, 37 (1.6%) thrombo-embolic events occurred, including 23 transient ischaemic attacks (TIAs). Compared with the use of phenoprocoumon, the use of DOAC was significantly associated with a lower thrombo-embolic risk [16 (1.2%) vs. 21 (2.2%), odds ratio (OR)], 0.5 [95% confidence interval (CI) 0.2-0.9], P = 0.04. No statistically significant association with bleeding risk was observed [phenprocomoun: 122 (13%); DOAC: 163 (12.6%); OR 0.9 (95% CI 0.7-1.2); P = 0.70]. Interruption of oral anticoagulation (OAC) was associated with an increased risk for thrombo-embolic complications [OR 2.2 (1.1-4.3); P = 0.031], and bleeding [OR 2.5 (95% CI 1.8-3.2), P = 0.001].

CONCLUSION: In patients undergoing catheter ablation for AF, the use of DOAC was associated with a reduced risk of thrombo-embolic events compared with phenprocoumon. Non-interrupted oral anticoagulation (OAC) therapy was associated with a reduced risk of peri-procedural thrombo-embolic and any bleeding complications.

PMID:37427356 | PMC:PMC10329261 | DOI:10.1093/ehjopen/oead065

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Nevin Manimala Statistics

CRISPR/Cas9‑mediated EZH2 knockout suppresses the proliferation and migration of triple‑negative breast cancer cells

Oncol Lett. 2023 Jun 22;26(2):343. doi: 10.3892/ol.2023.13929. eCollection 2023 Aug.

ABSTRACT

Triple-negative breast cancer (TNBC) is an aggressive subtype of BC characterized by extensive intratumoral heterogeneity. Compared with other types of BC, TNBC is more prone to invasion and metastasis. The aim of the present study was to determine whether adenovirus-mediated clustered regulatory interspaced short palindromic repeats (CRISPR)/Cas9 system is capable of effectively targeting enhancer of zeste homolog 2 (EZH2) in TNBC cells and lay an experimental basis for the investigation of the CRISPR/Cas9 system as a gene therapy for BC. In the present study, EZH2 was knocked out in MDA-MB-231 cells using the CRISPR/Cas9 gene editing tool to create EZH2-knockout (KO) group (EZH2-KO group). Moreover, the GFP knockout group (control group), and a blank group (Blank group), were employed. The success of vector construction and EZH2-KO were verified by T7 endonuclease I (T7EI) restriction enzyme digestion, mRNA detection and western blotting. Changes in proliferation and migration ability of MDA-MB-231 cells following gene editing were detected by MTT, wound healing, Transwell and in vivo tumor biology assays. As indicated by the results of mRNA and protein detection, the mRNA and protein expression of EZH2 were significantly downregulated in the EZH2-KO group. The difference in EZH2 mRNA and protein between the EZH2-KO and the two control groups was statistically significant. MTT, wound healing and transwell assay suggested that the proliferation and migration ability of MDA-MB-231 cells in the EZH2-KO group were significantly decreased after EZH2 knockout. In vivo, the tumor growth rate in the EZH2-KO group was significantly lower than that in the control groups. In brief, the present study revealed that the biological functions of tumor cells were inhibited after EZH2 knockout in MDA-MB-231 cells. The aforementioned findings suggested that EZH2 can have a key role in the development of TNBC.

PMID:37427349 | PMC:PMC10326815 | DOI:10.3892/ol.2023.13929

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Nevin Manimala Statistics

Are there reliable multiparametric MRI criteria for differential diagnosis between intracranial meningiomas and solitary intracranial dural metastases?

Oncol Lett. 2023 Jun 28;26(2):350. doi: 10.3892/ol.2023.13936. eCollection 2023 Aug.

ABSTRACT

Intracranial meningiomas are the most common tumors of the central nervous system (CNS). Meningiomas account for up to 36% of all brain tumors. The incidence of metastatic brain lesions has not been determined. Up to 30% of adult patients with cancer of one localization or another suffer from a secondary tumor lesion of the brain. The vast majority of meningiomas have meningeal localization; >90% are solitary. The incidence of intracranial dural metastases (IDM) is 8-9% of cases, while in 10% of cases, the brain is the only localization, and in 50% of cases the metastases are solitary. Typically, the task of distinguishing between meningioma and dural metastasis does not involve difficulties. Periodically, there is a situation when the differential diagnosis between these tumors is ambiguous, since meningiomas and solitary IDM may have similar characteristics, in particular, a cavity-less solid structure, limited diffusion of water molecules, the presence of extensive peritumoral edema, and an identical contrast pattern. The present study included 100 patients with newly diagnosed tumors of the CNS, who subsequently underwent examination and neurosurgical treatment at the Federal Center for Neurosurgery with histological verification between May 2019 and October 2022. Depending on the histological conclusion, two study groups of patients were distinguished: The first group consisted of patients diagnosed with intracranial meningiomas (n=50) and the second group of patients were diagnosed with IDM (n=50). The study was performed using a magnetic resonance imaging (MRI) General Electric Discovery W750 3T before and after contrast enhancement. The diagnostic value of this study was estimated using Receiver Operating Characteristic curve and area under the curve analysis. Based on the results of the study, it was found that the use of multiparametric MRI (mpMRI) in the differential diagnosis of intracranial meningiomas and IDM was limited by the similarity of the values of the measured diffusion coefficient. The assumption, previously put forward in the literature, regarding the presence of a statistically significant difference in the apparent diffusion coefficient values, which make it possible to differentiate tumors, was not confirmed. When analyzing perfusion data, IDM showed higher cerebral blood flow (CBF) values compared with intracranial meningiomas (P≤0.001). A threshold value of the CBF index was revealed, which was 217.9 ml/100 g/min, above which it is possible to predict IDM with a sensitivity and specificity of 80.0 and 86.0%, respectively. Diffusion-weighted images are not reliable criteria for differentiating intracranial meningiomas from IDM and should not influence the diagnosis suggested by imaging. The technique for assessing the perfusion of a meningeal lesion makes it possible to predict metastases with a sensitivity and specificity close to 80-90% and deserves attention when making a diagnosis. In the future, in order to reduce the number of false negative and false positive results, mpMRI would require additional criteria to be included in the protocol. Since IDM differs from intracranial meningiomas in the severity of neoangiogenesis and, accordingly, in greater vascular permeability, the technique for assessing vascular permeability (wash-in parameter with dynamic contrast enhancement) may serve as a refining criterion for distinguishing between dural lesions.

PMID:37427340 | PMC:PMC10326821 | DOI:10.3892/ol.2023.13936

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Nevin Manimala Statistics

The Prevalence of Comorbidities and Associated Factors among Patients with Dementia in the Indian Setting: Meta-analysis of Observational Studies

Indian J Psychol Med. 2023 Jul;45(4):338-344. doi: 10.1177/02537176221130252. Epub 2022 Oct 27.

ABSTRACT

BACKGROUND: Patients with dementia usually have multiple comorbidities. The presence of comorbidities may exacerbate the progression of dementia and decreases the patient’s ability to participate in health maintenance activities. However, there is hardly any meta-analysis estimating the magnitude of comorbidities among patients with dementia in the Indian context.

METHODS: We searched PubMed, Scopus, and Google Scholar, and relevant studies conducted in India were included. The risk of bias was assessed and a random-effects meta-analysis model was used in which I2 statistics were calculated to measure heterogeneity among studies.

RESULTS: Fourteen studies were included in the meta-analysis based on the inclusion and exclusion criteria. Altogether, we found the coexistence of comorbid conditions such as hypertension (51.10%), diabetes (27.58%), stroke (15.99%), and factors like tobacco use (26.81 %) and alcohol use (9.19%) among patients with dementia in this setting. The level of heterogeneity was high due to differences in the methodologies in the included studies.

CONCLUSIONS: Our study found hypertension as the most common comorbid condition among patients with dementia in India. The observed lacuna of methodological limitations in the studies included in the current meta-analysis provides the urgent need for good quality research to successfully meet the challenges ahead while devising appropriate strategies to treat the comorbidities among patients with dementia.

PMID:37427307 | PMC:PMC7614734 | DOI:10.1177/02537176221130252

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Nevin Manimala Statistics

Machine Learning and the Conundrum of Stroke Risk Prediction

Arrhythm Electrophysiol Rev. 2023 Apr 12;12:e07. doi: 10.15420/aer.2022.34. eCollection 2023.

ABSTRACT

Stroke is a leading cause of death worldwide. With escalating healthcare costs, early non-invasive stroke risk stratification is vital. The current paradigm of stroke risk assessment and mitigation is focused on clinical risk factors and comorbidities. Standard algorithms predict risk using regression-based statistical associations, which, while useful and easy to use, have moderate predictive accuracy. This review summarises recent efforts to deploy machine learning (ML) to predict stroke risk and enrich the understanding of the mechanisms underlying stroke. The surveyed body of literature includes studies comparing ML algorithms with conventional statistical models for predicting cardiovascular disease and, in particular, different stroke subtypes. Another avenue of research explored is ML as a means of enriching multiscale computational modelling, which holds great promise for revealing thrombogenesis mechanisms. Overall, ML offers a new approach to stroke risk stratification that accounts for subtle physiologic variants between patients, potentially leading to more reliable and personalised predictions than standard regression-based statistical associations.

PMID:37427297 | PMC:PMC10326666 | DOI:10.15420/aer.2022.34

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Nevin Manimala Statistics

Prevalence of smoking cigarettes and beliefs regarding smoking habits among medical students: a cross-sectional study in Sudan

Front Public Health. 2023 Jun 20;11:1193475. doi: 10.3389/fpubh.2023.1193475. eCollection 2023.

ABSTRACT

BACKGROUND: Smoking is a common problem in university students worldwide. Smoking is one of the most dangerous social phenomena and has a significant impact on public health. This study investigated the beliefs and attitudes of medical students toward smoking in Sudan.

METHODS: A cross-sectional study was conducted among medical students at Al Neelain University, Sudan, from March to June 2022 using a web-based questionnaire. The questionnaire consisted of eight items on demographic characteristics and 13 on the beliefs and attitudes toward smoking. Other data included smoking status, smoking habits, the number of cigarettes smoked per day, and smoking duration. Data analysis was performed descriptively, and chi-square test and logistic regression were conducted using SPSS version 24. Statistical significance was set at 0.05.

RESULTS: A total of 336 students participated in this study, and the smoking prevalence was 48.8% (41.1% in men and 7.7% in women). In total, 76.8% reported smoking daily at a rate of 5-10 cigarettes per day. In terms of students’ beliefs about smoking, 86.8% disagreed with selling cigarettes at the university. Of the respondents, 68.4% did not approve smoking on campus. There was a relationship between smoking habits and the age group of 22-25 years, which was the highest smoking category among students (p-value = 0.01).

CONCLUSION: The prevalence of cigarette smoking among medical students is disturbing, particularly as they are future doctors. There is a need to include plans to reduce smoking among students that can be incorporated into courses and special programs.

PMID:37427282 | PMC:PMC10325783 | DOI:10.3389/fpubh.2023.1193475

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Nevin Manimala Statistics

State-space prior distribution for parameter of nonhomogeneous Poisson spatiotemporal models

Biom J. 2023 Jul 9:e2200125. doi: 10.1002/bimj.202200125. Online ahead of print.

ABSTRACT

This article proposes a new class of nonhomogeneous Poisson spatiotemporal model. In this approach, we use a state-space model-based prior distribution to handle the scale and shape parameters of the Weibull intensity function. The proposed prior distribution enables the inclusion of changes in the behavior of the intensity function over time. In defining the spatial correlation function of the model, we include anisotropy via spatial deformation. We estimate the model parameters from a Bayesian perspective, employ the Markov chain Monte Carlo approach, and validate this estimation procedure through a simulation exercise. Finally, the extreme rainfall in the southern semiarid region in northeastern Brazil is analyzed using the R10mm index. The proposed model showed better fit and prediction ability than did other nonhomogeneous Poisson spatiotemporal models available in the literature. This improvement in performance is mainly due to the flexibility of the intensity function that is achieved by allowing the incorporation, in time, of the climatic characteristics of this region.

PMID:37424029 | DOI:10.1002/bimj.202200125