Tag: statistics

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):198-202.

ABSTRACT

PURPOSE: To verify the efficacy and safety of calcined cattle bone grafting material in filling alveolar bone defect after tooth extraction.

METHODS: A randomized, bind, parallel, positive-control multicenter clinical trial was conducted. A total of 280 subjects were randomly assigned to either the experimental group (calcined cattle bone group) or control group (Bio-Oss group) equally. The main efficacy indicator was the imaging changes 24 weeks after material implantation. Secondary efficacy indicators were wound healing, rejection, bone metabolism, post-filling symptoms and signs of bone infection. The safety of material was assessed by the incidence of adverse events and serious adverse events. SAS 8.2 software package was used for statistical analysis.

RESULTS: A total of 280 cases were included, of them 267 cases completed the study while 13 cases fell off. The effective rate of FAS(PPS) was 90.58%(97.46%) in the experimental group and 87.05% (95.04%) in the control group. The difference of effective rate between the experimental group and control group (95%CI) was 3.53% (-3.88%, 10.94%) of FAS, 2.42% (-2.38%, 7.22%) of PPS, and there was no significant difference between the two groups. The incision healing of the two groups was good, and the incidence of rejection, bone infection signs, post-filling symptoms and bone metabolic changes was very low. The incidence of adverse events was similar in the two groups, and no serious adverse events related to the study materials occurred.

CONCLUSIONS: The efficacy of calcined cattle bone grafting material in filling alveolar bone defect after tooth extraction is not inferior to that of Bio-Oss, and it is safe and effective for alveolar bone defect repair.

PMID:37154004

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):188-192.

ABSTRACT

PURPOSE: To evaluate the effect of combination of auxiliary irrigation technology and root canal irrigation solution in the treatment of chronic apical periodontitis with fistula, and try to seek a more effective and minimally invasive therapeutic strategy.

METHODS: One hundred and fifty patients with fistulous chronic apical periodontitis who were diagnosed in Hefei Stomatological Hospital from January 2021 to January 2022 were randomly divided into 6 groups, 25 cases in each group. The 6 groups were as follows, group A: 0.5%NaOCl +ultrasonically activated irrigation; Group B: 1.0%NaOCl+ultrasonically activated irrigation; Group C: 2.0%CHX+ultrasonically activated irrigation; Group D: 0.5%NaOCl+sonic activation; Group E: 1.0%NaOCl+sonic activation; Group F: 2.0%CHX+sonic activation. The fistula healing time, treatment effect and postoperative pain were observed in each group. The data were analyzed with SPSS 20.0 software package.

RESULTS: In terms of fistula healing, the 10-day fistula healing rate of group E and group F was higher than that of group A and group D，and the difference was statistically significant(P＜0.05); but there was no significant difference between group E and group F (P＞0.05). The effective rate at 1 month after operation in group A was lower, and the difference was significant (P＜0.05). In terms of postoperative pain, the VAS score of group A was lower than that of group E and group F at all time points, and the difference was statistically significant(P＜0.05).

CONCLUSIONS: In the treatment of chronic apical periodontitis with fistula, 1.0% NaOCl or 2.0% CHX combined with ultrasonically activated irrigation or sonic activation obtain a better short-term effect，of which the sonic activation group can also obtain early healing of the fistula, but the incidence of postoperative pain is higher when sonic activation is used.

PMID:37154002

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):183-187.

ABSTRACT

PURPOSE: To analyze the use status and satisfaction of the follow-up patients, and explore the construction of internet medical service model and platform in stomatology.

METHODS: Patients who visited the internet clinic of stomatology from January to June, 2021 were selected. After diagnosis and treatment, they were followed up by AI intelligent voice with self-designed questionnaire. SPSS 21.0 software was used for statistical analysis.

RESULTS: A total of 372 valid questionnaires were collected. The male-to-female ratio of oral patients was 1.25:1, with an average age of 35.96 years. Most of them had a bachelor’s degree or above, and the patients were mainly from the Yangtze River Delta. 53.76% of patients needed doctors to prescribe drugs. 81.72% of the dental patients believed that the consultation process of internet clinic was convenient, and 79.83% of patients perceived that the system operation of internet clinic was convenient. Binary logistic regression showed that digital literacy, convenience of medical treatment process were significantly related to the satisfaction of internet outpatient service, while gender, education level, online medical treatment duration and convenience of system operation were not related.

CONCLUSIONS: Internet medical treatment in stomatology is feasible, but it is still necessary to break through limitations and further innovate service function. Internet outpatients are mainly young and middle-aged, but it is still necessary to care for the special group of the elderly. It is necessary to further optimize the process, upgrade the system and innovate management, strengthen policy support and incentive mechanism, and promote the transformation of medical service mode in stomatology.

PMID:37154001

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):172-176.

ABSTRACT

PURPOSE: To investigate the changes of serum prealbumin (PA) expression level in patients with oral and maxillofacial space infections and its significance.

METHODS: Patients hospitalized at the Affiliated Hospital of Xuzhou Medical University from January 2020 to September 2021 were selected and divided into infected and non-infected group. One hundred and twenty-one patients with moderate to severe oral and maxillofacial gap infections were in the infected group, and 128 patients without infection were in the non-infected group. In the infected group, PA, high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) levels and related clinical parameters were measured at 1, 3 and 7 d of admission. In the non-infected group, PA, hs-CRP and WBC levels were measured at 1 d of admission. SPSS 23.0 software package was used to statistically analyze the relationship between PA levels and various laboratory and clinical parameters.

RESULTS: PA levels in the infected group were significantly lower than those in the non-infected group at 1 d of admission. PA levels in the infected group showed an overall increasing trend at different time points, and PA was negatively correlated with pain intensity and positively correlated with mouth opening(P＜0.05). The diagnostic sensitivity was 90.91% and the specificity was 92.97% for PA≤19.85 mg/dL, which can be used as the best diagnostic threshold. The diagnostic efficacy can be improved when combined with hs-CRP and WBC. Logistic regression analysis showed that low PA level was an independent risk factor for patients requiring intensive care after surgery (P＜0.05).

CONCLUSIONS: PA is an effective tool for the early diagnosis and evaluation of the efficacy of oral and maxillofacial interstitial infections, and can be used as a reference indicator to assess prognosis.

PMID:37153999

J Matern Fetal Neonatal Med. 2023 Dec;36(1):2208252. doi: 10.1080/14767058.2023.2208252.

ABSTRACT

BACKGROUND: Oxytocin is routinely administered after delivery for prophylaxis and treatment of postpartum hemorrhage, but it is associated with considerable cardiovascular side-effects. Carbetocin, a synthetic oxytocin analogue, has a myometrial contraction effect of 60 min when given IV, compared with 16 min for oxytocin.

OBJECTIVE: To investigate whether there are differences in cardiovascular effects between oxytocin and carbetocin up to 1 h after treatment.

METHODS: Sixty-one healthy pregnant women undergoing elective cesarean section in spinal anesthesia were randomized to receive an IV bolus of either five units (8.3 µg) of oxytocin or 100 µg of carbetocin after delivery of the baby. Heart rate (HR), mean arterial blood pressure, ECG ST index, oxygen saturation (SaO₂), and photoplethysmographic digital pulse wave analysis variables were recorded before and at 1, 5, 20, and 60 min after drug administration. Vasopressor use, uterine tonus, total bleeding, and need for additional uterotonics were also assessed. Repeated measurement ANOVA was used for statistical analyses.

RESULTS: The drugs had equal vasodilatory and hypotensive effects. Oxytocin, but not carbetocin, caused a decrease in HR at 1 min and a sustained decrease in cardiac left ventricular ejection time. Aggregate vasopressor use was higher in the carbetocin group. Neither drug caused any change in ST index, SaO₂, or subjective cardiac symptoms. Uterine tonus, need for additional uterotonics, or total bleeding did not differ significantly between the groups.

CONCLUSION: Single doses of oxytocin and carbetocin had similar dilatory effects on vascular tonus, where the difference in aggregate vasopressor use can be attributed to a more persistent hypotensive effect of carbetocin. A transient negative chronotropic and sustained negative inotropic effect occurred after oxytocin. Neither drug showed any alarmingly adverse effects. Differences in drug effects may be attributed to differences in oxytocin and vasopressin receptor signaling pathways.

PMID:37150593 | DOI:10.1080/14767058.2023.2208252

Air Med J. 2023 May-Jun;42(3):163-168. doi: 10.1016/j.amj.2023.01.009. Epub 2023 Feb 24.

ABSTRACT

OBJECTIVE: In May 2022, the Royal Flying Doctor Service Western Operations in Western Australia pioneered the introduction of the first organizational helicopter emergency service with 2 Eurocopter EC145 helicopters. This article describes the pilot study undertaken, assessing the implementation and flight crew confidence outcomes of the supplementation of video simulation training to standard clinical training for helicopter air medical retrieval.

METHODS: Survey assessments using a 5-point Likert scale provided anonymous demographic data with summarized results of the means and standard deviations. Nonparametric tests were used to compare responses between the control and experimental groups from pretraining to postintervention to postpractical.

RESULTS: The findings showed an increase in confidence rates after a classroom session and further increases after a practical session in the control group. The intervention group showed a small rise in overall confidence levels after being shown video simulations following the completion of their classroom session before commencing their practical session. This study established that regardless of the airframe, clinical staff, often with significant experience in air medical retrieval and critical care medicine, do not automatically have confidence in performing critical care procedures in a new aircraft type to which they have not previously been oriented. The results display a statistically significant increase in confidence levels in procedural performance after the classroom session compared with the pretraining questionnaire, with a subtle further rise when video simulations are included in the classroom session. When a classroom session is subsequently supplemented with a practical simulation session, confidence levels continue to rise.

CONCLUSION: Implementing a comprehensive educational strategy including classroom and practical elements for clinical staff in their orientation to new aircraft improves their confidence in performing critical care procedures if required in flight. The addition of in-flight prerecorded videos demonstrating these critical care procedures is a useful adjunct to simulation training for flight crew in air medical retrieval, and further analytical studies may indeed show a statistically significant improvement in staff confidence.

PMID:37150569 | DOI:10.1016/j.amj.2023.01.009

Air Med J. 2023 May-Jun;42(3):157-162. doi: 10.1016/j.amj.2023.01.004. Epub 2023 Feb 20.

ABSTRACT

OBJECTIVE: The current research was performed to assess professional quality of life; identify factors associated with secondary traumatic stress, burnout, and compassion satisfaction; and evaluate the effectiveness of a peer support pilot intervention among air medical crewmembers.

METHODS: Quantitative research methods were used to assess secondary traumatic stress, compassion satisfaction, and burnout among flight nurses and paramedics. Demographic variables and secondary traumatic stress, burnout, and compassion satisfaction scores using the Professional Quality of Life Scale were assessed. A comparison of survey scores obtained before and 16 months after the implementation of a piloted peer support program was performed.

RESULTS: Crewmembers with less experience within an air medical program and those without a support system are at the highest risk of developing secondary traumatic stress, burnout, and impaired compassion satisfaction. Observed scores for secondary traumatic stress, burnout, and compassion satisfaction suggest that peer support may be an effective intervention among air medical crewmembers. No statistically significant differences in secondary traumatic stress, burnout, or compassion satisfaction were observed by clinical role, marital status, or years in their profession.

CONCLUSION: Peer support after emotionally challenging or stressful transports may combat secondary traumatic stress, compassion fatigue, and burnout. This intervention would be most beneficial for crewmembers who are newer to the transport organization and lack social or familial support.

PMID:37150568 | DOI:10.1016/j.amj.2023.01.004

Am J Clin Nutr. 2023 May 5:S0002-9165(23)48900-9. doi: 10.1016/j.ajcnut.2023.05.007. Online ahead of print.

ABSTRACT

BACKGROUND: At present, the results on the associations between dietary patterns and the risk of dementia are inconsistent, and studies on the associations between dietary patterns and brain structures are limited.

OBJECTIVE: We aimed to investigate the associations of midlife dietary patterns with incident dementia and brain structures.

METHODS: Based on the UK Biobank Study, we investigated the 1) prospective associations of four healthy dietary pattern indices (healthy plant-based diet index [hPDI], Mediterranean diet score [MDS], Recommended food score [RFS], and Mediterranean-Dietary Approaches to Stop Hypertension Intervention [DASH] Intervention for Neurodegenerative Delay Diet [MIND]) with incident dementia (identified using linked hospital data; N = 114,684; mean age, 56.8 years; 55.5% females) using Cox proportional-hazards regressions and the 2) cross-sectional associations of these dietary pattern indices with brain structures (estimated using magnetic resonance imaging; N = 18,214; mean age, 55.9 years; 53.1% females) using linear regressions. A series of covariates were adjusted, and several sensitivity analyses were conducted.

RESULTS: A total of 481 (0.42%) participants developed dementia during the average 9.4-year follow-up. Although the associations were not statistically significant, all dietary patterns exerted protective effects against incident dementia (all hazard ratios < 1). Furthermore, higher dietary pattern indices were significantly associated with larger regional brain volumes, including volumes of gray matter in the parietal and temporal cortices and volumes of the hippocampus and thalamus. The main results were confirmed via sensitivity analyses.

CONCLUSIONS: Greater adherence to hPDI, MDS, RFS, and MIND was individually associated with larger brain volumes in specific regions. This study shows a comprehensive picture of the consistent associations of midlife dietary patterns with the risk of dementia and brain health, underscoring the potential benefits of a healthy diet in the prevention of dementia.

PMID:37150507 | DOI:10.1016/j.ajcnut.2023.05.007

Photodiagnosis Photodyn Ther. 2023 May 5:103598. doi: 10.1016/j.pdpdt.2023.103598. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate the adhesive bond strength and antibacterial efficacy of methylene blue (MB)-mediated antimicrobial photodynamic therapy (aPDT) and curcumin (CUR)-mediated aPDT versus the conventional disinfectants, such as chlorhexidine gluconate (CHX) gel and sodium hypochlorite (NaOCl), for indirect pulp capping (IPC) treatment of permanent molars.

METHODS: One Hundred grossly carious human permanent molars were collected through non-traumatic extraction. All specimens were embedded in polyvinyl cross-sections to the cemento-enamel junction. The cavity preparation was conducted by grinding the samples using silicon carbide discs. After culturing Streptococcus mutans (S. mutans), a 10 µL of S. mutans suspension (10⁶ colony forming units/mL) was transferred in each tooth cavity and anaerobically incubated for 48 hours at 37°C. All specimens were randomly divided into 5 groups: Group-I: samples treated IPC; Group-II: samples treated with 2% CHX gel; Group-III: samples treated with 6% NaOCl; Group-IV: irradiation of prepared cavity with MB-mediated aPDT; and Group-V: irradiation of prepared cavity with CUR-mediated aPDT. After disinfection methods, the universal adhesive was used, and all specimens were restored using giomer. Eventually, confocal laser scanning microscopy, shear bond strength (SBS), micro-tensile bond strength (μTBS), four-point bending strength (4P-BS) analyses were performed, and the data were analyzed statistically.

RESULTS: At baseline, the highest SBS (48.8 ± 6.5 MPa), μTBS (54.3 ± 3.9 MPa), and 4P-BS (123 ± 32 MPa) scores were demonstrated by the samples treated with MB-mediated aPDT. However, after 12 months of storage, the highest SBS (42.3 ± 3.9 MPa) and μTBS (45.2 ± 6.6 MPa) scores were shown by samples treated with MB-mediated aPDT, while CUR-mediated aPDT treated samples demonstrated the highest 4P-BS scores (70 ± 18 MPa). Moreover, the highest antibacterial activity against S. mutans was shown by the samples treated with MB-mediated aPDT.

CONCLUSIONS: The application of aPDT, especially MB-mediated, demonstrated superior SBS, μTBS, and 4P-BS values as well as antibacterial activity against S. mutans as compared to 2% CHX gel and 6% NaOCl as cavity disinfectants for IPC treatment of permanent molars.

PMID:37150490 | DOI:10.1016/j.pdpdt.2023.103598

J Heart Lung Transplant. 2023 May 5:S1053-2498(23)01851-X. doi: 10.1016/j.healun.2023.05.001. Online ahead of print.

ABSTRACT

BACKGROUND: The risk and benefit of desensitization therapy (DST) in highly sensitized mechanical circulatory support (MCS) patients are not well known. We investigated three year post-transplant outcome of desensitized durable MCS patients.

METHODS: Among 689 consecutively enrolled HTx recipients between 2010 and 2016, we categorized them into Group A (desensitized MCS patients, n = 21), Group B (desensitized non-MCS patients, n = 28) and Group C (all non-desensitized patients, n = 640). Post-transplant outcomes included the incidence of primary graft dysfunction (PGD), 3-year survival, freedom from cardiac allograft vasculopathy (CAV), non-fatal major adverse cardiac events (NF-MACE), any treated rejection (ATR), acute cellular rejection (ACR), antibody mediated rejection (AMR) and infectious complications.

RESULTS: The types of DST in Groups A and B were similar and included combinations of rituximab/IVIG and plasmapheresis/bortezomib. Group A, compared with Group B, showed significantly higher pre-DST PRA (92.2 ± 9.8 vs. 83.3 ± 15.6, P = 0.007) and higher PRA reduction after DST (-22.2 ± 26.9 vs. -6.3 ± 7.5, P = 0.015). Groups A and C showed comparable PGD, 3-year survival, freedom from CAV, NF-MACE, ATR, ACR and AMR. Although statistically not significant, Group A showed a numerically higher 3-year freedom from AMR than Group B. Infectious complications were similar in both Groups A and B.

CONCLUSIONS: DST for MCS patients showed significant PRA reduction, resulting in an expansion of the donor pool. Post-transplant outcome of desensitized MCS patients showed comparable clinical outcome to non-desensitized control patients in the same study period, revealing the safety and efficacy of DST.

PMID:37150473 | DOI:10.1016/j.healun.2023.05.001