Tag: statistics

Vopr Pitan. 2022;91(3):64-72. doi: 10.33029/0042-8833-2022-91-3-64-72. Epub 2022 May 4.

ABSTRACT

The growing prevalence of overweight and obesity is an urgent problem not only in adults but also in children in both developed and developing countries. The purpose of this study was to analyze the prevalence of overweight and obesity and other forms of nutritional disorders in Russian children. Material and methods. The nutritional status of 17 329 children aged 2-18 years was assessed on the basis of anthropometric data, obtained by the Federal State Statistics Service during the “Sample Survey of the Population’s Diet” in 2018. The prevalence of various forms of malnutrition was assessed by the Z-score categories: underweight, stunted growth (short stature), thinness, overweight, obesity. Results. Population mean and median values of Z-scores in all sex-age groups do not exceed ±0.5 in relation to WHO standards, which indicates the applicability of the standards to assessing the nutritional status of Russian children population. High body weight (WAZ>2) occurs in 7.6% of children, underweight in 2.6%. The incidence of short stature in boys and girls is 7.0 and 6.8%, respectively. The prevalence of overweight and obesity in boys is 20.4 and 10.4%, respectively, while in girls, 15.4 and 7.6%. In general, in the population of children 2-18 years old, the prevalence of overweight is 18%, and obesity is 9.1%. The index of malnutrition, including the sum of the frequency of various combinations of low Z-scores (<-2), characterizing underweight, short stature, thinness, and their combinations was 8.0%. The multilevel logistic regression showed that overweight and obesity inversely depend on age; the risk of developing these conditions is lower in the city, but higher in male children compared to female children. Conclusion. The population of children 2-18 years old in the Russian Federation is characterized by a low incidence of forms of malnutrition, such as underweight and thinness. However, the prevalence of overweight and obesity is higher than in European countries.

PMID:35852979 | DOI:10.33029/0042-8833-2022-91-3-64-72

Aust Endod J. 2022 Jul 19. doi: 10.1111/aej.12660. Online ahead of print.

ABSTRACT

This study aimed to evaluate the removal of 2-hydroxyisocaproic acid (HICA) from the root canal system and its effect on the bond strength of the mineral trioxide aggregate (MTA). 126 single-rooted teeth were divided into 3 experimental groups (n = 36) that were treated with double antibiotic paste (DAP), HICA and calcium hydroxide (CH) and one control group (n = 18). In the first part, 18 teeth from each experimental group (n = 54) were examined to remove HICA from the root canal. In the second part, 72 teeth (3 experimental groups (n = 54) and one control group (n = 18)) were used for the evaluation of the push-out bond strength of MTA. There was no statistically significant difference between HICA, DAP and CH residues (p > 0.05). HICA group showed significantly less push-out bond strength (p < 0.05). DAP, HICA and CH could not be removed entirely from the root canal. HICA significantly reduced the bond strength of the MTA.

PMID:35852919 | DOI:10.1111/aej.12660

Otolaryngol Head Neck Surg. 2022 Jul 19:1945998221113550. doi: 10.1177/01945998221113550. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare billing practices, reimbursement rates, and patient populations of otolaryngology (ORL) physicians practicing in rural and urban settings.

STUDY DESIGN: Retrospective cross-sectional study.

SETTING: Medicare Provider Utilization and Payment Data: Physician and Other Supplier Data.

METHODS: Medicare-allowed payments, number of services, and number of patients were gathered along with patient population comorbidity statistics, including average hierarchical condition category risk scores.

RESULTS: In 2019, 92% of the overall total 8959 ORL physicians practiced in an urban setting. These 8243 urban ORL physicians, on average, billed for 51 (interquartile range [IQR], 31-67) unique Healthcare Common Procedure Coding System (HCPCS) codes, cared for 393 (IQR, 172-535) Medicare patients, performed 1761 (IQR, 502-2070) services, and collected $139,957 (IQR, $55,527-$178,479) per provider. In contrast, the 704 rural ORL physicians, on average, billed for a greater number of unique HCPCS codes (59; IQR, 37-77; P < .001), treated more Medicare patients (445; IQR, 242-614; P < .001), and performed more services (2330; IQR, 694-2748; P < .001) but collected about the same per provider ($141,035; IQR, $56,555-$172,864; P = .426). Older age was associated with rural practice (P = .027). Among both urban and rural ORL physicians, the variety and complexity of procedures and patient comorbidity profiles were comparable.

CONCLUSION: Most ORL physicians practice in large urban settings, a finding potentially related to financial sustainability and career opportunity. With an already small workforce, the aging rural ORL physician population is an identifiable weak point in the otolaryngology specialty that must be addressed with geo-specific recruitment campaigns, rural work incentivization, and the development of career advancement opportunities in rural areas.

PMID:35852873 | DOI:10.1177/01945998221113550

JMIR Form Res. 2022 Jul 19;6(7):e37278. doi: 10.2196/37278.

ABSTRACT

BACKGROUND: University students are susceptible to excessive stress. A web-based stress management intervention holds promise to improve stress but is still at a novel stage in Indonesia.

OBJECTIVE: The aim of this paper was to report the feasibility of the intervention we developed-Rileks-among university students in Indonesia in terms of acceptability and usability, and to propose recommendations for future improvements.

METHODS: A single-group pretest and posttest design was used. Participants with scores of 15 or higher on the stress subscale of the 42-item Depression Anxiety Stress Scales were given access to the intervention (N=68). The main outcome measures were the 8-item Client Satisfaction Questionnaire (CSQ-8) score, the System Usability Scale (SUS) score, and intervention uptake. Participants’ experience in each session was evaluated using closed- and open-ended questions for future improvements. Descriptive statistics were used to examine primary outcome and qualitative session evaluations. Participants’ responses to each topic of the open questions were summarized.

RESULTS: The intervention was evaluated as being satisfactory (CSQ-8 mean score 21.89, SD 8.72; range 8-32). However, the intervention’s usability was still below expectation (SUS mean score 62.8, SD 14.74; range 0-100). The core modules were completed by 10 out of 68 participants (15%), and the study dropout rate was 63% (43/68) at postassessment. In general, the module content was rated positively, with some notes for improvement covering content and technical aspects.

CONCLUSIONS: This study indicates that Rileks is potentially feasible for Indonesian university students. In order to be optimally applied in such a context and before scaling up web-based interventions in Indonesia, in general, further development and refinement are needed.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/11493.

PMID:35852838 | DOI:10.2196/37278

Otolaryngol Head Neck Surg. 2022 Jul 19:1945998221113310. doi: 10.1177/01945998221113310. Online ahead of print.

ABSTRACT

OBJECTIVE: To review the literature on pneumococcal vaccination compliance rates among cochlear implant (CI) patients and to examine the utility of intervention programs on increasing vaccination rates.

DATA SOURCES: PubMed, Scopus, and CINAHL.

REVIEW METHODS: A systematic review was performed following PRISMA guidelines. Studies of pneumococcal vaccination rates at baseline and before and after the implementation of a quality improvement (QI) intervention were included. A total of 641 studies were screened, and 13 studies met inclusion criteria. Meta-analyses of pneumococcal vaccination rates pre- and post-QI intervention in CI patients were performed.

RESULTS: A total of 12,973 children and adults were included. The baseline PCV13 and PPSV23 vaccination rates were 53.45% (95% CI, 37.02%-69.51%) and 42.53% (95% CI, 31.94%-53.48%), respectively. Comparing children and adults, PCV13 and PPSV23 baseline vaccination rates were not statistically significant. The PPSV23 vaccine rate after QI initiatives was significantly higher than the baseline rate at 83.52% (95% CI, 57.36%-98.46%). After these interventions, patients had a 15.71 (95% CI, 4.32-57.20, P < .001) increased odds of receiving PPSV23 vaccination compared to before QI implementation.

CONCLUSIONS: The baseline rates of PCV13 and PPSV23 are highly variable and lower than expected, given current vaccination recommendations for CI patients. QI programs appear successful in increasing compliance rates with the PPSV23 vaccination; however, they are still far from full compliance. Further intervention programs with stricter surveillance, monitoring, and follow-up systems are needed to achieve improved compliance with the PCV13 and PPSV23 vaccination in CI recipients.

PMID:35852861 | DOI:10.1177/01945998221113310

Clin Implant Dent Relat Res. 2022 Jul 19. doi: 10.1111/cid.13123. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of four decontamination protocols on contaminated healing abutments (HAs) and their effects on surface topography.

METHODS: Eighty contaminated single-use HA samples collected from human participants were stained with phloxine B and examined microscopically. The retrieved HAs were randomly divided into four test groups: (1) Autoclaving only (AU), (2) 5.25% sodium hypochlorite (NaOCl) + AU, (3) Electrochemical treatment (EC) + AU, (4) NaOCl + EC + AU, and positive control (contaminated without any treatment). Four new unused HAs served as negative controls (NC). The surface features were analyzed using stereo microscopy (SM), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and optical profilometry.

RESULTS: The lowest decontamination efficacy was observed for the AU group. The NaOCl + AU and EC + AU groups effectively removed residual contamination, whereas EC + AU showed better decontamination results than NaOCl + AU. SM, SEM, and EDS analyses revealed the best decontamination efficacy in the combined NaOCl + EC + AU group compared to the other groups. Surface roughness (Sa), developed surface area ratio (Sdr), and texture-aspect ratio (Str) in AU, NaOCl + AU, EC + AU, and NaOCl + EC + AU groups were not statistically significant compared to the NC group.

CONCLUSIONS: The combination of NaOCl with subsequent EC can remove soft and hard deposits from the surface of HAs compared to NaOCl alone and EC alone, without altering the surface topography of HAs.

PMID:35852825 | DOI:10.1111/cid.13123

JAMA Netw Open. 2022 Jul 1;5(7):e2222425. doi: 10.1001/jamanetworkopen.2022.22425.

ABSTRACT

IMPORTANCE: Few studies have examined the neurodevelopmental consequences of prenatal exposure to opioid analgesics. Therefore, it is necessary to gain knowledge to inform clinical decisions for pregnant women with moderate to severe pain.

OBJECTIVE: To investigate fifth-grade scholastic skills in children with prenatal exposure to opioid analgesics.

DESIGN, SETTING, AND PARTICIPANTS: A cohort study was conducted based on data from the Norwegian Mother, Father, and Child Cohort (1999-2008). These data were linked to the Medical Birth Registry of Norway, and data from Statistics Norway included 64 256 live-born singletons, born to 54 568 mothers who reported pain during pregnancy, were analyzed. The study was conducted from July 1 to December 15, 2021.

EXPOSURES: Self-reported exposure to opioid analgesics during pregnancy, characterized in terms of any exposure, the exposure timing, and the exposure duration.

MAIN OUTCOMES AND MEASURES: Scores from 3 national tests for children in fifth grade. The tests measured scholastic skills in literacy, numeracy, and the English language. Test scores were standardized to z scores. Differences in z scores were compared between children of mothers exposed to opioid analgesics during pregnancy and children of mothers with only prepregnancy opioid exposure.

RESULTS: Of the 64 256 children included, 32 521 were boys (50.6%), and 1483 children (2.3%) were exposed to an opioid analgesic at least once during gestation. All test scores were similar between children with any exposure to opioid analgesics in utero and children with only prepregnancy exposure. Children exposed in the first trimester and those exposed in two or three 4-week intervals during pregnancy scored lower than children of mothers with only prepregnancy exposures on tests in literacy (weighted β [wβ], -0.13; 95% CI, -0.25 to -0.01 and wβ, -0.19; 95% CI, -0.35 to -0.04) and numeracy (wβ, -0.14; 95% CI, -0.25 to -0.04 and wβ, -0.19; 95% CI, -0.34 to -0.05). These differences were small and may not be clinically relevant.

CONCLUSIONS AND RELEVANCE: In this large birth cohort, prenatal exposure to opioid analgesics had no substantial negative association with fifth-grade scholastic skills. However, adequate pain management in pregnancy may be addressed on an individual patient level, bearing in mind the benefits and risks of different analgesic therapies.

PMID:35852803 | DOI:10.1001/jamanetworkopen.2022.22425

JAMA Netw Open. 2022 Jul 1;5(7):e2222537. doi: 10.1001/jamanetworkopen.2022.22537.

ABSTRACT

IMPORTANCE: The existing gestational weight gain (GWG) recommendations for twin pregnancies are lacking for underweight individuals and are not stratified by obesity class.

OBJECTIVE: To identify optimal GWG ranges associated with reduced adverse perinatal outcomes stratified by prepregnancy body mass index (BMI) categories in twin pregnancies.

DESIGN, SETTING AND PARTICIPANTS: This population-based cohort study of twin pregnancies using data from the National Center for Health Statistics was conducted between January 1, 2014, and December 31, 2018. Statistical analysis was performed from October 24, 2021, to May 7, 2022. The study population comprised 262 604 individuals between 18 and 45 years of age with live-born twins without congenital malformation between 24 and 42 weeks of gestation. Two approaches were used to determine the optimal GWG ranges: a statistics-based approach calculating IQRs of GWG in a low-risk population, and an outcome-based approach identifying GWG thresholds below or above which an adverse perinatal outcome increased.

EXPOSURE: Gestational weight gain.

MAIN OUTCOMES AND MEASURES: Preterm birth less than 36 weeks, gestational hypertensive disorders, small for gestational age status, large for gestational age status, and a composite outcome defined as any occurrence of the individual outcomes.

RESULTS: The main sample comprised 200 810 individuals with twin pregnancies (mean [SD] maternal age, 30.4 [5.5] years; 1624 [0.8%] American Indian or Alaska Native, 13 031 [6.5%] Asian or Pacific Islander, 36 423 [18.1%] Black, and 149 732 [74.6%] White; and 137 409 [68.4%] multiparous). In the low-risk subgroup (n = 61 794), the IQRs of the total GWG after 36 weeks of gestation as assessed using a statistics-based approach and based on BMI group were 15.9 to 22.7 kg for underweight, 15.4 to 22.7 kg for normal weight, 12.7 to 22.2 kg for overweight, 10.0 to 20.0 kg for class 1 obesity, 7.7 to 18.1 kg for class 2 obesity, and 5.9 to 16.3 kg for class 3 obesity. The absolute risk of the composite outcome showed U-shaped associations with GWG across BMI categories. The optimal GWG ranges by 36 weeks identified using an outcome-based approach and BMI group were 17.5 to 24.9 kg for underweight, 15.0 to 24.9 kg for normal weight, 15.0 to 24.9 kg for overweight, 10.0 to 19.9 kg for class 1 obesity, 7.5 to 17.4 kg for class 2 obesity, and 5.0 to 9.9 kg for class 3 obesity. The multivariable logistic models assessed using the validation sample (n = 49 275) showed that GWG defined outside those optimal ranges was associated with preterm birth at less than 36 weeks, gestational hypertensive disorders, and small or large for gestational age.

CONCLUSIONS AND RELEVANCE: This population-based cohort study found that optimal GWG ranges were similar for individuals with underweight and normal weight but decreased with increasing severity of obesity. The current US Institute of Medicine GWG recommendations may be too high for individuals with moderate or severe obesity.

PMID:35852802 | DOI:10.1001/jamanetworkopen.2022.22537

Odontology. 2022 Jul 19. doi: 10.1007/s10266-022-00730-8. Online ahead of print.

ABSTRACT

This study aimed at investigating differences in heat generation and bone architecture following four different implant site preparation techniques: compressive osteotomes, conventional drills, osseodensification (OD mode with osseodensification drills), and piezoelectric systems. Porcine rib bones were used as a model for implant surgery. Thermocouples were employed to measure temperature changes, and micro-CT to assess the bone architecture. The primary stability and insertion torque values of the implants placed in the differently prepared sites were assessed. The temperature changes were higher with Piezo. The average primary stability using the ISQ scale was the greatest for drills (76.17 ± 0.90) and the lowest for osteotomes (71.50 ± 11.09). Insertion torque was significantly higher with the osseodensification method (71.67 ± 7.99 Ncm) in comparison to drills, osteotomes, and piezo. Osteotomes showed the highest bone to implant contact percentage (39.83 ± 3.14%) and average trabecular number (2.02 ± 0.21 per mm), while drills exhibited the lowest (30.73 ± 1.65%; 1.37 ± 0.34 per mm). Total implant site bone volume was the highest with osseodensification (37.26 ± 4.13mm³) and the lowest for osteotomes (33.84 ± 3.84mm³). Statistical analysis showed a high primary stability and decrease in temperature during implant site preparation with osseodensification technique. The results support the use of osseodensification technique for implant site preparation.

PMID:35852778 | DOI:10.1007/s10266-022-00730-8

Sports Med. 2022 Jul 19. doi: 10.1007/s40279-022-01726-8. Online ahead of print.

ABSTRACT

BACKGROUND: Recreational football is an intense, versatile form of exercise with multiple high- and odd-impact actions. Recreational football is therefore hypothesized to be suitable for bone modeling and bone health.

OBJECTIVE: The aim of the present systematic review and meta-analysis was to evaluate the effects of recreational football on bone mineral density (BMD), bone mineral content (BMC) and bone turnover markers (BTM).

DESIGN: Systematic review and meta-analysis.

DATA SOURCES: MEDLINE, PubMed, SPORTDiscus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar were searched prior to September 2021. A manual database search was also performed using the following key terms, either singly or in combination: recreational football/soccer, street football/soccer, recreational small-sided games, effect, influence, impact, bone turnover markers, bone mineral density, bone turnover marker, bone health, osteogenesis, CTX, osteocalcin, P1NP.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised and matched controlled trials with participants allocated to a recreational football group or any other type of training intervention or passive control group were included. The primary outcome measures were total BMD, lower limb BMD, total BMC, lower limb BMC, osteocalcin, procollagen type 1N-terminal propeptide (P1NP) and collagen type 1 cross-linked C-telopeptide (CTX). A total of 17 papers met the inclusion criteria and were included.

STATISTICAL ANALYSIS: Comprehensive Meta-analysis V.2 software (Biostat, Englewood, New Jersey, USA) was used for the meta-analyses.

RISK OF BIAS: Agreement between the two reviewers was assessed using RoB2 tool and k statistics for full-text screening and rating of relevance and risk of bias. The k agreement rate between reviewers was k = 0.92.

RESULTS: The football interventions included were based on studies having a duration of 12-64 weeks with one 5-year follow-up study and with a training frequency of 1-3 sessions/wk. Training sessions were 45-60 min sessions of 3v3 – 7v7 small-sided games. The subjects covered an age span from 9 to 73 years. Five studies examined recreational football effects in females, nine studies in males and three studies included both sexes. Recreational football training produced a statistically significant effect (mean difference = 0.02 g/cm², 95% confidence interval: 0.00-0.03, P = 0.02) on lower limb BMD and negligible effects for total BMD compared to no-exercise controls. The recreational football effects on total and lower limb BMC, when compared to both no-exercise controls and exercise controls, were negligible. A moderate to large significant increase in osteocalcin, P1NP and CTX was observed for recreational football compared to both no-exercise controls and exercise controls.

CONCLUSION: In conclusion, recreational football training regimes lasting 12-64 weeks have a large osteogenic impact on bone turnover markers in comparison with no-exercise controls as well as exercise controls, and beneficial effects on lower limb BMD compared to no-exercise controls. Short and medium duration recreational football interventions have negligible effects on whole-body BMD and BMC (total and lower limb), with magnitudes similar to those of other exercise modes.

PMID:35852769 | DOI:10.1007/s40279-022-01726-8