Tag: statistics

Shanghai Kou Qiang Yi Xue. 2023 Feb;32(1):23-27.

ABSTRACT

PURPOSE: To explore the effect and molecular mechanism of long non-coding RNA(lncRNA) AWPPH on proliferation and osteogenic differentiation of human periodontal ligament cells by regulating the Notch signaling pathway.

METHODS: Human periodontal ligament cells were cultured in vitro, and osteogenic differentiation was induced. Quantitative real-time polymerase chain reaction (qRT-PCR) experiment were used to detect the AWPPH expression level of cells at 0, 3, 7, and 14 days. Human periodontal ligament cells were divided into blank control group (NC), empty vector group (vector), AWPPH overexpression group (AWPPH), and overexpression AWPPH+ pathway inhibitor group (AWPPH+DAPT). qRT-PCR experiment was used to detect the expression level of AWPPH; thiazole blue (MTT), cloning experiment was used to detect cell proliferation. Western blot was performed to detect the protein expression of alkaline phosphatase (ALP), osteopontin (OPN), osteocalcin (OCN), Notch1 and Hes1. SPSS 21.0 software package was used for statistical analysis.

RESULTS: The AWPPH expression level in periodontal ligament cells decreased after 0, 3, 7, and 14 days of osteogenic differentiation. Overexpression of AWPPH increased the A value of periodontal ligament cells, the number of cloned cells, and up-regulated the protein expression of ALP, OPN, OCN, Notch1, and Hes1. After adding the pathway inhibitor DAPT, the A value and the number of cloned cells decreased, and the protein expression of Notch1, Hes1, ALP, OPN, and OCN decreased.

CONCLUSIONS: Overexpression of AWPPH may inhibit the proliferation and osteogenic differentiation of periodontal ligament cells by reducing the expression of related proteins in the Notch signaling pathway.

PMID:36973839

Shanghai Kou Qiang Yi Xue. 2023 Feb;32(1):17-22.

ABSTRACT

PURPOSE: To study the role of microRNA (miR)-497-5p in the differentiation and mineralization of pre-osteoblasts MC3T3-E1, and to explore the related mechanisms.

METHODS: The third generation MC3T3-E1 cells were transfected into the miR-497-5p overexpression plasmid miR-497-5p mimics, the low expression plasmid miR-497-5p inhibitor, and the negative control plasmid miR-497-5p NC. They were set up as the miR-497-5p mimics group, miR-497-5p inhibitor group, and miR-497-5p NC group. The cells untreated was set up as the blank group. Fourteen days after osteogenic induction, alkaline phosphatase (ALP) activity was detected. The expression of osteocalcin (OCN) and type I collagen (COL-I) proteins related to osteogenic differentiation were detected by Western blotting. Mineralization was observed by alizarin red staining method. The expression of Smad ubiquitination regulatory factor 2 (Smurf2) protein was detected by Western blotting. The targeting relationship between miR-497-5p and Smurf2 was verified by dual luciferase experiment. Statistical analysis was performed by SPSS 25.0 software package.

RESULTS: Compared with the blank group and miR-497-5p NC group, ALP activity of the miR-497-5p mimics group was enhanced, the expression of OCN, COL-I protein and the ratio of the area of mineralized nodules was increased, and the expression of Smurf2 protein was decreased(P＜0.05). ALP activity of the miR-497-5p inhibitor group was weakened, the expression of OCN, COL-I protein and the ratio of the area of mineralized nodules was decreased, and the expression of Smurf2 protein was increased(P＜0.05). Compared with Smurf2 3′-UTR-WT+miR-497-5p NC group, Smurf2 3′-UTR-MT+miR-497-5p mimics group, Smurf2 3′-UTR-MT+miR-497-5p NC group, the activity of dual luciferase in the WT+miR-497-5p mimics group was decreased (P＜0.05).

CONCLUSIONS: Overexpression of miR-497-5p can promote the differentiation and mineralization of pre-osteoblasts MC3T3-E1, and its mechanism may be related to the negatively targeted regulation of Smurf2 protein expression.

PMID:36973838

Shanghai Kou Qiang Yi Xue. 2023 Feb;32(1):1-5.

ABSTRACT

PURPOSE: To compare the incidence of dentinal microcracks after root canal preparation by new generation of nickel-titanium instrument WaveOne Gold, Reciproc Blue with previous WaveOne and Reciproc.

METHODS: Ninety extracted single-rooted mandibular premolars were randomly divided into 6 groups(n=15). The root canals were instrumented by using Hand K files, WaveOne, Reciproc, WaveOne Gold and Reciproc Blue. Fifteen teeth were left unprepared and served as negative controls. The root canals were all prepared to 25#. The roots were then sectioned at 3 mm, 6 mm and 9 mm from the apical orifice using a hard tissue slicer. The slices were observed under stereoscopic microscope at ×25 magnification. SPSS 17.0 software package was used for statistical analysis.

RESULTS: No dentinal microcrack was found in the hand K files group and negative control group. The reciprocating single files WaveOne, WaveOne Gold, Reciproc and Reciproc Blue all produced dentinal microcracks after root canal preparation. The WaveOne generated the most dentinal microcracks than the hand K files(P＜0.05), and the microcracks were mainly concentrated in the middle part of the root. The number of dentinal microcracks caused by Reciproc and Reciproc Blue was the same, with no significant difference(P＞0.05).

CONCLUSIONS: The new generation of reciprocating files of WaveOne Gold and Reciproc Blue may not increase the incidence of dentinal microcracks after root canal preparation.

PMID:36973835

J Eat Disord. 2023 Mar 27;11(1):48. doi: 10.1186/s40337-023-00773-4.

ABSTRACT

INTRODUCTION: We studied whether provisional posttraumatic stress disorder (PTSD) moderated discharge (DC) and 6-month follow-up (FU) outcomes of multi-modal, integrated eating disorder (ED) residential treatment (RT) based upon principles of cognitive processing therapy (CPT).

METHODS: ED patients [N = 609; 96% female; mean age (± SD) = 26.0 ± 8.8 years; 22% LGBTQ +] with and without PTSD completed validated assessments at admission (ADM), DC and 6-month FU to measure severity of ED, PTSD, major depressive disorder (MDD), state-trait anxiety (STA) symptoms, and eating disorder quality of life (EDQOL). We tested whether PTSD moderated the course of symptom change using mixed models analyses and if ED diagnosis, ADM BMI, age of ED onset and LGBTQ + orientation were significant covariates of change. Number of days between ADM and FU was used as a weighting measure.

RESULTS: Despite sustained improvements with RT in the total group, the PTSD group had significantly higher scores on all measures at all time points (p ≤ .001). Patients with (n = 261) and without PTSD (n = 348) showed similar symptom improvements from ADM to DC and outcomes remained statistically improved at 6-month FU compared to ADM. The only significant worsening observed between DC and FU was with MDD symptoms, yet all measures remained significantly lower than ADM at FU (p ≤ .001). There were no significant PTSD by time interactions for any of the measures. Age of ED onset was a significant covariate in the EDI-2, PHQ-9, STAI-T, and EDQOL models such that an earlier age of ED onset was associated with a worse outcome. ADM BMI was also a significant covariate in the EDE-Q, EDI-2, and EDQOL models, such that higher ADM BMI was associated with a worse ED and quality of life outcome.

CONCLUSIONS: Integrated treatment approaches that address PTSD comorbidity can be successfully delivered in RT and are associated with sustained improvements at FU. Improving strategies to prevent post-DC recurrence of MDD symptoms is an important and challenging area of future work.

PMID:36973828 | DOI:10.1186/s40337-023-00773-4

Pilot Feasibility Stud. 2023 Mar 27;9(1):52. doi: 10.1186/s40814-023-01277-3.

ABSTRACT

BACKGROUND: The World Health Organization’s Global Patient Safety Action Plan 2021-2030 call for attention to patient and family involvement to reduce preventable patient harm. Existing evidence indicates that patients’ involvement in their own safety has positive effects on reducing hospitalisation time and readmissions. One intervention reported in the literature is the use of checklists designed for patients’ completion. Studies on such checklists are small scale, but they are linked to reduction in length of hospital stay and readmissions. We have previously developed and validated a two-part surgical patient safety checklist (PASC). This study aims to investigate the feasibility of the PASC usage and implementation prior to its use in a large-scale clinical trial.

METHODS: This is a prospective cross-sectional feasibility study, set up as part of the design of a larger stepped-wedge cluster randomised controlled trial (SW-CRCT). Descriptive statistics were used to investigate patient demographics, reasons for not completing the PASC and percentage of PASC item usage. Qualitative patient interviews were used to identify barriers and drivers for implementation. Interview was analysed through content analysis.

RESULTS: Out of 428 recruited patients, 50.2% (215/428) used both parts of PASC. A total of 24.1% (103/428) of the patients did not use it at all due to surgical or COVID-19-related cancellations. A total of 19.9% (85/428) did not consent to participate, 5.1% (22/428) lost the checklist and 0.7% (3/428) of the patients died during the study. A total of 86.5% (186/215) patients used ≥ 80% of the checklist items. Barriers and drivers for PASC implementation were grouped into the following categories: Time frame for completing the checklist, patient safety checklist design, impetus to communicate with healthcare professionals and support throughout the surgical pathway.

CONCLUSIONS: Elective surgical patients were willing and able to use PASC. The study further revealed a set of barriers and drivers to the implementation. A large-scale definitive clinical-implementation hybrid trial is being launched to ascertain the clinical effectiveness and scalability of PASC in improving surgical patient safety.

TRIAL REGISTRATION: Clinicaltrials.gov: NCT03105713. Registered 10.04.2017.

PMID:36973815 | DOI:10.1186/s40814-023-01277-3

J Foot Ankle Res. 2023 Mar 27;16(1):17. doi: 10.1186/s13047-023-00615-1.

ABSTRACT

BACKGROUND: Diabetic foot assessments detect patients at risk for developing a diabetes-related foot ulceration and can significantly reduce the risk of amputation. In order to organize this assessment effectively, diabetic foot assessment guidelines are required according to the International Working Group of the Diabetic Foot. However, these international guidelines have not been adapted into a national guideline for podiatrists in Flanders, Belgium. This study aims to identify the methods and guidelines currently used to assess the diabetic foot in private podiatry practices in Flanders, Belgium and to explore the podiatrists’ opinions on developing a national diabetic foot assessment guideline.

METHODS: This exploratory mixed method study was composed of an anonymous online survey comprising of open- and closed-ended questions followed by 1:1 online semi-structured interviews. Participants were recruited via e-mail and a closed private Facebook group of podiatry alumni. Data was analyzed using SPSS statistics and thematic analysis described by Braun and Clarke.

RESULTS: This study showed that the vascular assessment of the diabetic foot exists solely of a medical history and palpation of the pedal pulses. Non-invasive tests such as doppler, toe brachial pressure index or ankle brachial pressure index are seldom used. Only 66% reported to use a guideline for the diabetic foot assessment. There was a variety of reported guidelines and risk stratification systems in use in private podiatry practices in Flanders, Belgium.

CONCLUSION: Non-invasive tests such as the doppler, ankle brachial pressure index or toe brachial pressure index are rarely used for the vascular assessment of the diabetic foot. Diabetic foot assessment guidelines and risk stratification systems to identify patients at risk for developing a diabetic foot ulcer were not frequently used. International guidelines of the International Working Group of the Diabetic Foot have not yet been implemented in private podiatry practices in Flanders, Belgium. This exploratory research has provided useful information for future research studies.

PMID:36973800 | DOI:10.1186/s13047-023-00615-1

BMC Nurs. 2023 Mar 27;22(1):84. doi: 10.1186/s12912-023-01234-8.

ABSTRACT

BACKGROUND: Pain is the most disturbing and annoying symptom experienced by children. However, it obtains poor attention in low- and middle-income countries particularly. The objective of this study was to assess knowledge, attitude and factors associated with pediatric pain management among nurses in tertiary hospitals in Northwest Ethiopia.

METHODOLOGY: A multi-center cross-sectional study was conducted from March 1 to April 30, 2021. The knowledge and attitude of nurses were measured by using Nurses’ Knowledge and Attitudes Survey regarding Pain (P-NKAS). Descriptive and binary logistic regression analyses were performed to determine factors associated with knowledge and attitude. The strength of the association was presented by using adjusted odds ratio with 95% confidence interval and p-value < 0.05 was considered as statistically significant.

RESULT: A total of 234 (86.03% response rate) nurses were included and 67.1% of nurses had good knowledge and 89.3% had favorable attitudes towards pediatric pain management. The factors associated with good knowledge were having Bachelor’s Degree and above [AOR = 2.1, P = 0.015], having in-service training [AOR = 2.4, P = 0.008] and favorable attitude [AOR = 3.3, CI = 0.008]. The nurses who demonstrated good knowledge [AOR = 3.3, P = 0.003] and those who had Bachelor’s Degree and above [AOR = 2.8, P = 0.03] were found to have favorable attitude.

CONCLUSION: The nurses who were working in pediatrics care areas had good knowledge and favorable attitude towards pediatrics pain management. However, improvements are needed to eradicate misconceptions; particularly, on pediatrics pain perception, opioid analgesia, multimodal analgesia, and non-pharmacologic pain therapies. Nurses who had higher level of education, in-service training, favorable attitude were found to be knowledgeable. Furthermore, nurses who had higher levels of education and knowledge were found to have favorable attitude.

PMID:36973798 | DOI:10.1186/s12912-023-01234-8

BMC Pregnancy Childbirth. 2023 Mar 27;23(1):207. doi: 10.1186/s12884-023-05478-9.

ABSTRACT

BACKGROUND: Group B Streptococcus (GBS), also referred as Streptococcus agalactiae, is one of the leading causes of life-threatening invasive diseases such as bacteremia, meningitis, pneumonia and urinary tract infection in pregnant women and neonates. Rates of GBS colonization vary by regions, but large-sample studies on maternal GBS status are limited in southern China. As a result, the prevalence of GBS among pregnant women and its associated risk factors and the efficacy of intrapartum antibiotic prophylaxis (IAP) intervention in preventing adverse pregnancy and neonatal outcomes remain poorly understood in southern China.

METHODS: To fill this gap, we retrospectively analyzed demographic and obstetrical data of pregnant women who have undergone GBS screening and delivered between 2016 and 2018 in Xiamen, China. A total of 43,822 pregnant women were enrolled and only a few GBS-positive women did not receive IAP administration. Possible risk factors for GBS colonization were assayed by univariate and multivariate logistic regression analysis. Generalized linear regression model was applicated to analyze whether IAP is one of the impact factors of the hospital length of stay of the target women.

RESULTS: The overall GBS colonization rate was 13.47% (5902/43,822). Although women > 35 years old (P = 0.0363) and women with diabetes mellitus (DM, P = 0.001) had a higher prevalence of GBS colonization, the interaction between ages and GBS colonization was not statistically significant in Logistic Regression analysis (adjusted OR = 1.0014; 95% CI, 0.9950, 1.0077). The rate of multiple births was significantly dropped in GBS-positive group than that of GBS-negative group (P = 0.0145), with no significant difference in the rate of fetal reduction (P = 0.3304). Additionally, the modes of delivery and the incidences of abortion, premature delivery, premature rupture of membranes, abnormal amniotic fluid and puerperal infection were not significantly different between the two groups. The hospitalization stays of the subjects were not influenced by GBS infection. As for neonatal outcomes, the cases of fetal death in maternal GBS-positive group did not statistically differ from that in maternal GBS-negative group.

CONCLUSION: Our data identified that pregnant women with DM are at high risk of GBS infection and IAP is highly effective in prevention of adverse pregnancy and neonatal outcomes. This stressed the necessity of universal screening of maternal GBS status and IAP administration to the target population in China, and women with DM should be considered as priorities.

PMID:36973793 | DOI:10.1186/s12884-023-05478-9

BMC Womens Health. 2023 Mar 27;23(1):137. doi: 10.1186/s12905-023-02268-5.

ABSTRACT

BACKGROUND: Adolescents and young adults (AYAs) in Haiti experience a high unintended pregnancy rate, in part due to unmet contraception needs. Little is known about AYA opinions of and experiences with contraception that may explain remaining gaps in coverage. We aimed to describe barriers and facilitators to contraception use among AYAs in Haiti.

METHODS: We conducted a cross-sectional survey and semi-structured qualitative interviews with a convenience sample of AYA females aged 14-24 in two rural communities in Haiti. The survey and semi-structured interviews assessed demographics, sexual health and pregnancy prevention behaviors and explored contraception opinions and experiences according to Theory of Planned Behavior constructs: attitudes, subjective norms, and perceived behavioral control. We used descriptive statistics to report means and responses to Likert scale and multiple-choice questions. Guided by content analysis, we analyzed interview transcripts through inductive coding and team debriefing.

RESULTS: Among 200 survey respondents, 94% reported any past vaginal sexual activity, and 43% reported ever being pregnant. A large majority were trying to avoid pregnancy (75%). At last sexual activity, 127 (64%) reported use of any contraceptive method; Among them, condoms were the most common method (80%). Among those with previous condom use, most reported use less than half the time (55%). AYAs were concerned about parental approval of birth control use (42%) and that their friends might think they are looking for sex (29%). About one-third felt uncomfortable going to a clinic to ask for birth control. In interviews, AYAs desired pregnancy prevention but frequently noted concerns about privacy and parental, community and healthcare provider judgement for seeking care for reproductive health needs. AYAs also noted a lack of contraception knowledge, evident by frequent misconceptions and associated fears.

CONCLUSION: Among AYAs in rural Haiti, a large majority were sexually active and desire pregnancy avoidance, but few were using effective contraception due to numerous concerns, including privacy and fear of judgement. Future efforts should address these identified concerns to prevent unintended pregnancy and improve maternal and reproductive health outcomes in this population.

PMID:36973773 | DOI:10.1186/s12905-023-02268-5

Acta Med Port. 2023 Mar 27. doi: 10.20344/amp.19021. Online ahead of print.

ABSTRACT

INTRODUCTION: Recently, simulation as an educational method has gained increasing importance in Medicine. However, medical education has favored the acquisition of individual knowledge and skills, while overlooking the development of teamwork skills. Since most errors in clinical practice are due to human factors, i.e., non-technical skills, the aim of this study was to assess the impact that training in a simulation environment has on teamwork in an undergraduate setting.

MATERIAL AND METHODS: This study took place in a simulation center, with a study population of 23 participants, fifth year undergraduate students, randomly divided into teams of four elements. Twenty simulated scenarios of teamwork in the initial assessment and resuscitation of critically ill trauma patients were recorded. Video recordings were made at three distinct learning moments (before training, end of the semester, and six months after the last training), and a blinded evaluation was performed by two independent observers, who applied the Trauma Team Performance Observation Tool (TPOT). Additionally, the Team STEPPS Teamwork Attitudes Questionnaire (T-TAQ) was applied to the study population before and after the training to assess any change in individual attitudes towards non-technical skills. A 5% (or 0.05) significance level was considered for statistical analysis.

RESULTS: With a moderate level of inter-observer agreement (Kappa = 0.52, p = 0.002), there was a statistically significant improvement in the team’s overall approach, evidenced by the TPOT scores (median of 4.23, 4.35 and 4.50, in the three time-points assessed, respectively, p = 0.003). In the T-TAQ, there was an improvement in non-technical skills, that was statistically significant for “Mutual Support” (median from 2.50 to 3.00, p = 0.010).

CONCLUSION: In this study, incorporating non-technical skills education and training in undergraduate medical education was associated with sustained improvement in team performance in the approach to the simulated trauma patient. Consideration should be given to introducing non-technical skills training and teamwork in the emergency setting during undergraduate training.

PMID:36972551 | DOI:10.20344/amp.19021