Tag: statistics

BMC Med. 2023 Jan 16;21(1):21. doi: 10.1186/s12916-022-02722-5.

ABSTRACT

BACKGROUND: The number of medications prescribed during pregnancy has increased over the past few decades. Few studies have described the prevalence of multiple medication use among pregnant women. This study aims to describe the overall prevalence over the last two decades among all pregnant women and those with multimorbidity and to identify risk factors for polypharmacy in pregnancy.

METHODS: A retrospective cohort study was conducted between 2000 and 2019 using the Clinical Practice Research Datalink (CPRD) pregnancy register. Prescription records for 577 medication categories were obtained. Prevalence estimates for polypharmacy (ranging from 2+ to 11+ medications) were presented along with the medications commonly prescribed individually and in pairs during the first trimester and the entire pregnancy period. Logistic regression models were performed to identify risk factors for polypharmacy.

RESULTS: During the first trimester (812,354 pregnancies), the prevalence of polypharmacy ranged from 24.6% (2+ medications) to 0.1% (11+ medications). During the entire pregnancy period (774,247 pregnancies), the prevalence ranged from 58.7 to 1.4%. Broad-spectrum penicillin (6.6%), compound analgesics (4.5%) and treatment of candidiasis (4.3%) were commonly prescribed. Pairs of medication prescribed to manage different long-term conditions commonly included selective beta 2 agonists or selective serotonin re-uptake inhibitors (SSRIs). Risk factors for being prescribed 2+ medications during the first trimester of pregnancy include being overweight or obese [aOR: 1.16 (1.14-1.18) and 1.55 (1.53-1.57)], belonging to an ethnic minority group [aOR: 2.40 (2.33-2.47), 1.71 (1.65-1.76), 1.41 (1.35-1.47) and 1.39 (1.30-1.49) among women from South Asian, Black, other and mixed ethnicities compared to white women] and smoking or previously smoking [aOR: 1.19 (1.18-1.20) and 1.05 (1.03-1.06)]. Higher and lower age, higher gravidity, increasing number of comorbidities and increasing level of deprivation were also associated with increased odds of polypharmacy.

CONCLUSIONS: The prevalence of polypharmacy during pregnancy has increased over the past two decades and is particularly high in younger and older women; women with high BMI, smokers and ex-smokers; and women with multimorbidity, higher gravidity and higher levels of deprivation. Well-conducted pharmaco-epidemiological research is needed to understand the effects of multiple medication use on the developing foetus.

PMID:36647047 | DOI:10.1186/s12916-022-02722-5

BMC Public Health. 2023 Jan 16;23(1):113. doi: 10.1186/s12889-022-14759-5.

ABSTRACT

BACKGROUND: Parental work stress and impaired mental health seem to have intensified during the current COVID-19 pandemic. Both can have a negative impact on parent-child bonding: psychosocial work stress in the course of a spillover effect from work to family and symptoms of impaired mental health as part of a crossover effect from parent to child. This potentially affects the child’s development in the long term.

METHOD: This cross-sectional study examined the relationship between psychosocial work stress and parent-child bonding during the early COVID-19 pandemic (May-June 2020). Symptoms of depression and aggressiveness were considered as mediators of this relationship. The sample consisted of employees in Eastern Germany (n = 380; 42.9% mothers, 57.1% fathers), aged 24-55 years, with children aged 0-36 months.

RESULTS: In the total sample, an association was only found after adjusting for potential confounders, indicating that higher psychosocial work stress is associated with weaker bonding between the parent and child (β = 0.148, p = .017, 95% CI [0.566, 5.614]). The separate analyses for mothers and fathers did not reveal a statistically significant relationship between psychosocial work stress and parent-child bonding. In the total sample, the higher the psychosocial work stress was, the higher were the parental symptoms of depression (β = 0.372, p < .001, 95% CI [3.417, 5.696]) and aggressiveness β = 0.254, p < .001, 95% CI [1.008, 3.208]). The mental health symptoms in turn were related to weaker parent-child bonding (symptoms of depression β = 0.320, p < .001, 95% CI [0.345, 0.749]; symptoms of aggressiveness β = 0.394, p < .001, 95% CI [0.697, 1.287]). The results furthermore suggested that parental mental health symptoms mediate the association between psychosocial work stress and parent-child bonding (symptoms of depression, ab = 2.491, 95% CI [1.472, 3.577] and of aggressiveness, ab = 2.091, 95% CI [1.147, 3.279]). The mediation effect was also found in the separate analyses for the mothers and fathers.

DISCUSSION: The results of this study during the early COVID-19 pandemic in Germany highlight the importance of prevention as well as intervention measures in relation to psychosocial work stress that may play a debilitating role in the context of family relationships. In addition, the results suggest that both employers and employees should be made aware of the importance of psychosocial work stress, as it can have a negative impact on mental health, which in turn may have a major influence on family relationships.

PMID:36647046 | DOI:10.1186/s12889-022-14759-5

J Neuroeng Rehabil. 2023 Jan 16;20(1):6. doi: 10.1186/s12984-023-01132-9.

ABSTRACT

BACKGROUND: Stroke remains a major public health concern in the United States and a leading cause of long-term disability in adults. Dynamic body weight support (DBWS) systems are popular technology available for use in clinical settings such inpatient rehabilitation. However, there remains limited studies in such inpatient settings that compare DBWS to standard of care (SOC) using real world outcome measures. For survivors of acute ischemic stroke, we determine if incorporating a dynamic body weight support (DBWS) system into inpatient therapy offers greater improvement than standard of care (SOC).

METHODS: A retrospective chart review included 52 individuals with an acute ischemic stroke admitted to an inpatient rehabilitation facility. Functional Independence Measure (FIM) data, specifically changes in FIM at discharge, served as the primary outcome measure. Patient cohorts received either therapies per SOC or therapies incorporating DBWS. Regardless of cohort group, all patients underwent therapies for 3 h per day for 5 days a week.

RESULTS: For both groups, a statistically and clinically significant increase in total FIM (P < 0.0001) was observed at discharge compared to at admission. Improvements for the DBWS group were significantly greater than the SOC group as evidenced by higher gains in total FIM (p = 0.04) and this corresponded to a medium effect size (Cohen’s d = 0.58). Among FIM subscores, the DBWS group achieved a significant increase in sphincter control while all other subscore changes remained non-significant.

CONCLUSIONS: This preliminary evidence supports the benefit of using DBWS during inpatient rehabilitation in individuals who have experienced an acute ischemic stroke. This may be due to the greater intensity and repetitions of tasks allowed by DBWS. These preliminary findings warrant further investigations on the use of DBWS in inpatient settings.

PMID:36647043 | DOI:10.1186/s12984-023-01132-9

Rep Prog Phys. 2023 Jan 16. doi: 10.1088/1361-6633/acb36e. Online ahead of print.

ABSTRACT

Many experimentally relevant quantum spin chains are approximately integrable, and support long-lived quasiparticle excitations. A canonical example of integrable model of quantum magnetism is the XXZ spin chain, for which energy spreads ballistically, but, surprisingly, high-temperature spin transport can be diffusive or superdiffusive. We review the transport properties of this model using an intuitive quasiparticle picture that relies on the recently introduced framework of generalized hydrodynamics. We discuss how anomalous linear response properties emerge from hierarchies of quasiparticles both in integrable and near-integrable limits, with an emphasis on the role of hydrodynamic fluctuations. We also comment on recent developments including non-linear response, full-counting statistics and far-fromequilibrium transport. We provide an overview of recent numerical and experimental results on transport in XXZ spin chains.

PMID:36645909 | DOI:10.1088/1361-6633/acb36e

Biomed Phys Eng Express. 2023 Jan 16. doi: 10.1088/2057-1976/acb357. Online ahead of print.

ABSTRACT

We propose a technique for metal artefact reduction in digital tomosynthesis reconstruction. Although the problem was addressed earlier in the literature, we suggest another approach, which is, in our opinion, simpler, and easier to implement. It is a two-stage algorithm. At the first stage, attenuation images are segmented by decomposing their intensity distributions into gaussian-like components. Statistical information contained in each component is used for pixel classification. Components corresponding to metallic objects are identified, and a pixel threshold value separating regions occupied by metal objects from the rest of the image is found. Based on this value, at the second stage, a smooth mapping of image intensity is applied. This makes dense regions transparent, resulting in the artefact reduction in reconstruction. The methodology is demonstrated by several examples.

PMID:36645907 | DOI:10.1088/2057-1976/acb357

Ann Intern Med. 2023 Jan 17. doi: 10.7326/M22-0364. Online ahead of print.

ABSTRACT

BACKGROUND: Primary infection with or reactivation of Epstein-Barr virus (EBV) can occur after liver transplant (LT) and can lead to posttransplant lymphoproliferative disease (PTLD). In pediatric LT, an EBV-DNA viral load (EBV VL) monitoring strategy, including the reduction of immunosuppression, has led to a lower incidence of PTLD. For adult LT recipients with less primary infection and more EBV reactivation, it is unknown whether this strategy is effective.

OBJECTIVE: To examine the effect of an EBV VL monitoring strategy on the incidence of PTLD after LT in adults.

DESIGN: Cohort study.

SETTING: Two university medical centers in the Netherlands.

PATIENTS: Adult recipients of first LT in Leiden between September 2003 and January 2017 with an EBV VL monitoring strategy formed the monitoring group (M1), recipients of first LT in Rotterdam between January 2003 and January 2017 without such a strategy formed the contemporary control group (C1), and those who had transplants in Leiden between September 1992 and September 2003 or Rotterdam between 1986 and January 2003 formed the historical control groups (M0 and C0, respectively).

MEASUREMENTS: Influence of EBV VL monitoring on incidence of PTLD.

RESULTS: After inverse probability of treatment weighting of the 4 groups to achieve a balance among the groups for important patient characteristics, differences within hospitals between the historical and recent era in cumulative incidences-expressed as the number of events per 1000 patients measured at 5-, 10-, and 15-year follow-up-showed fewer events in the contemporary era in both centers. This difference was considerably larger in the monitoring center, whereas the 95% CI included the null value of 0 for point estimates.

LIMITATION: Retrospective, low statistical power, and incompletely balanced groups, and non-EBV PTLD cannot be prevented.

CONCLUSION: Monitoring EBV VL may reduce PTLD incidence after LT in adults; larger studies are warranted.

PRIMARY FUNDING SOURCE: None.

PMID:36645888 | DOI:10.7326/M22-0364

Am J Speech Lang Pathol. 2023 Jan 16:1-24. doi: 10.1044/2022_AJSLP-22-00101. Online ahead of print.

ABSTRACT

PURPOSE: A mixed-method approach was used to investigate the lived experiences of adults with mild traumatic brain injury (mTBI). The study aimed to understand the perceived relationship between cognitive-communication problems, thinking and communication concerns, and neurobehavioral symptoms. We hypothesized that individuals with cognitive-communication problems would attribute their problems with communication to their mTBI history and their self-perceived problems would be correlated with symptomatology.

METHOD: The Neurobehavioral Symptom Inventory (NSI) and an online cognitive-communication survey was used to conduct a study of 30 adults with mTBI history. Quantitative survey and NSI scores were analyzed with content analysis and correlational statistics.

RESULTS: The average NSI Total score was 17 with the following subscale scores: somatic (5), affective (8), and cognitive (3.9). Participants reported problems with expressive communication (56%), comprehension (80%), thinking (63%), and social skills (60%). Content analysis revealed problems in the following areas: expression (e.g., verbal, and written language), comprehension (reading and verbal comprehension), cognition (e.g., attention, memory and speed of processing, error regulation), and functional consequences (e.g., academic work, social problems, and anxiety and stress). A Pearson correlation indicated a statistically significant relationship (p < .01) between the Communication Survey Total and the Total, Somatic, Affective, and Cognitive subscales.

CONCLUSIONS: This study highlights a multifactorial basis of cognitive-communication impairment in adults with mTBI. We show that those with mTBI history perceive difficulties with cognitive-communication skills: conversations, writing, and short-term memory/attention. Furthermore, those with mTBI perceive their cognitive-communication problems after injury have impacted their vocational, social, and academic success.

PMID:36645876 | DOI:10.1044/2022_AJSLP-22-00101

Aggress Behav. 2023 Jan 16. doi: 10.1002/ab.22070. Online ahead of print.

ABSTRACT

We conducted an observational study of a collection of interactive processes known as “demand-withdraw” in relation to adolescent dating aggression. Couples (N = 209) aged 14-18 years participated in a challenging observational laboratory assessment to measure demands (i.e., pressures for a change), as well as demand → partner withdraw and demand → partner avoid sequences. Actor and partner effects were disentangled via dyadic data analyses. The results indicated a fairly consistent pattern in which demand → withdraw and demand → avoid sequences led by either partner were positively associated with both partners’ physical and psychological aggression (measured via a dual informant questionnaire method). Further, higher quality demands (i.e., pressures for change that were specific and encouraged both members of the dyad to increase a given behavior) were inversely associated with aggression. Yet, all of the above associations were attenuated to the point of statistical nonsignificance after controlling for hostility. These results suggest two primary possibilities. The associations of demand → withdraw and demand → avoid sequences with dating aggression may be spurious, with the sequences merely markers for hostility, a known correlate of dating aggression. Alternatively, hostility may mediate the relations of demand → withdraw and demand → avoid sequences with dating aggression. Further research is required to test these competing explanations. Implications for preventive intervention are discussed.

PMID:36645870 | DOI:10.1002/ab.22070

Int J Prosthodont. 2022 Nov-Dec;35(6):815-823. doi: 10.11607/ijp.7986.

ABSTRACT

PURPOSE: To evaluate the long-term survival of IPS Empress 2 and IPS e.max (Ivoclar Vivadent) restorations in a non-university setting.

MATERIALS AND METHODS: A retrospective study design was used to evaluate the survival rate of 1,132 Empress 2 and IPS e.max restorations placed in 251 patients with regard to patient age, gender, tooth type, tooth vitality, material, restoration form (inlay vs partial crown vs crown), cementation mode (self-adhesive vs non-self-adhesive), and bruxism activity. Kaplan-Meier and regression analyses were used for statistical analyses.

RESULTS: Of the 1,132 restorations, a total of 15 (IPS e.max = 3, Empress 2 = 12) failed. The overall survival rate for all restorations was 98.7% after 15.4 years. A significantly reduced survival rate was found for nonvital teeth (P = .002), patient age > 60 years (P = .002), crowns (vs inlays and partial crowns; P = .002), and self-adhesive resin materials (P = .018).

CONCLUSION: Within the limitations of this study, glass-ceramic single-tooth restorations made of Empress 2 and IPS e.max show good survival rates up to a period of 15 years.

PMID:36645866 | DOI:10.11607/ijp.7986

Int J Prosthodont. 2022 Nov-Dec;35(6):752-760. doi: 10.11607/ijp.7302.

ABSTRACT

PURPOSE: To evaluate the effects of nonthermal atmospheric plasma (NTAP) treatment, alone or combined with sandblasting and/or primer application, on the bonding of zirconia ceramics to resin cement. Materıals and Methods: A total of 420 discs of Y-TZP (2 x 15 x 12 mm) were prepared and randomly divided into 10 groups according to surface treatment, as follows: Z (control), SB (sandblasting), Pr (primer), SBPr (sandblasting + primer), P (NTAP), SBP (sandblasting + NTAP), PrP (primer + NTAP), SBPrP (sandblasting + primer + NTAP), PPr (NTAP + primer), and SBPPr (sandblasting + NTAP + primer). After surface treatments, the surface roughness values were evaluated using a profilometer, and the contact angle measurements were performed using a goniometer. Surface characterizations of the groups were analyzed using scanning electron microscopy and x-ray photoelectron spectroscopy analyses. Shear bond strength tests were performed after adhesive cementation in 20 specimens per group, with half (n = 10) subjected to thermocycling (5,000 cycles, 5°C to 55°C). The failure mode was recorded by examining each specimen using a stereomicroscope. One-way and two-way ANOVA followed by Student-Newman-Keuls test (α = .05) were used to analyze the data statistically.

RESULTS: Untreated zirconia surfaces (without sandblasting) were found to have a higher wettability and oxygen ratio after NTAP treatment. The clinical application order of NTAP is an important factor, and the best combination for bonding quality was NTAP treatment followed by primer application on untreated zirconia (group PPr), rather than on a sandblasted surface. Conclusıon: NTAP application may be a promising surface treatment method for adhesive cementation of zirconia ceramics as an alternative to sandblasting. To achieve strong adhesion, NTAP should be applied before primer aplication.

PMID:36645863 | DOI:10.11607/ijp.7302