Tag: statistics

JAMA Netw Open. 2024 Dec 2;7(12):e2451837. doi: 10.1001/jamanetworkopen.2024.51837.

ABSTRACT

IMPORTANCE: It remains unclear how socioeconomic status (SES) is related to the association between diet and health, as well as the role of behavioral factors, in explaining socioeconomic disparities in health outcomes.

OBJECTIVE: To investigate the associations of neighborhood and individual SES factors, as well as behavioral factors, particularly dietary pattern, with health outcomes.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included US health professionals without chronic diseases at baseline who were enrolled in the Health Professionals Follow-Up Study (calendar years 1988-2018), the Nurses’ Health Study (calendar years 1992-2018), and the Nurses’ Health Study II (calendar years 2001-2019). Data analysis was performed in September 2023.

EXPOSURES: Repeated questionnaires were used to assess neighborhood and individual SES factors and behavioral factors, including dietary pattern (assessed using the Alternative Healthy Eating Index 2010), alcohol intake, body mass index, cigarette smoking, physical activity, sedentary television-viewing time, and sleep duration.

MAIN OUTCOMES AND MEASURES: The main outcomes were incident major cardiovascular disease (CVD), type 2 diabetes (T2D), and total mortality. The associations of SES and behavioral factors with outcomes were analyzed using multivariable Cox proportional hazards regression models with hazard ratios (HRs) per 10th- to 90th-percentile increments.

RESULTS: The study analyzed 152 192 participants for major CVD (mean [SD] age, 52.0 [8.7] years; 125 959 female [82.8%]), 151 217 participants for T2D (mean [SD] age, 52.0 [8.6] years; 125 231 female [82.8%]), and 141 145 participants for mortality (mean [SD] age, 51.6 [8.5] years; 117 627 female [83.3%]). A healthy dietary pattern was inversely associated with risk for major CVD (HR, 0.87 [95% CI, 0.82-0.93]), T2D (HR, 0.79 [95% CI, 0.75-0.84]), and total mortality (HR, 0.84 [95% CI, 0.81-0.88]). Without adjusting for neighborhood and individual SES factors, the HRs were 0.85 (95% CI, 0.80-0.91) for risk for major CVD, 0.78 (95% CI, 0.74-0.82) for T2D, and 0.82 (95% CI, 0.79-0.85) for total mortality. Neighborhood SES was inversely associated with risk for major CVD (HR, 0.90 [95% CI, 0.85-0.95]), T2D (HR, 0.92 [95% CI, 0.88-0.97]), and total mortality (HR, 0.91 [95% CI, 0.88-0.94]). Behavioral factors accounted for a large proportion of the associations with risk for major CVD (46.3% [95% CI, 32.5%-60.6%]), T2D (77.4% [95% CI, 64.5%-86.6%]), and total mortality (42.8% [95% CI, 32.9%-53.3%]).

CONCLUSIONS AND RELEVANCE: In this prospective cohort study of health professionals, associations between diet and health outcomes remained similar without adjusting for SES factors, while health behaviors, including diet, accounted for a large proportion of the associations between neighborhood SES and health. These findings highlight the importance of health behaviors, particularly high-quality diets, in promoting individual health and possibly reducing health disparities associated with SES.

PMID:39705030 | DOI:10.1001/jamanetworkopen.2024.51837

JAMA Netw Open. 2024 Dec 2;7(12):e2453976. doi: 10.1001/jamanetworkopen.2024.53976.

ABSTRACT

IMPORTANCE: Poor medication adherence is associated with high morbidity and mortality among patients with chronic heart failure (CHF), which is particularly concerning in China.

OBJECTIVE: To assess the effect of a pharmacist-led management model incorporating a social media platform vs usual care on medication adherence in patients with CHF.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, multicenter randomized clinical trial was conducted from March 2021 to May 2023, with a follow-up duration of 52 weeks. The trial was conducted in the cardiology wards of 5 hospitals in China. Participants were 18 years or older, had a CHF diagnosis, and were receiving stable medication. They were randomly assigned to either the intervention group (pharmacist-led management) or the control group (usual care) in a 1:1 ratio using a computer-generated random number table with concealed allocation via opaque envelopes. Intention-to-treat data analysis was performed from June 2023 to July 2024.

INTERVENTION: The intervention group received a multimodal pharmaceutical intervention, including WeChat application-based communication and education, and a standardized follow-up visit from a pharmacist every month. The control group received the standardized follow-up visit from nurses every month.

MAIN OUTCOMES AND MEASURES: The primary outcome was the proportion of days covered (PDC) by heart failure medication at 52 weeks.

RESULTS: Among the 445 participants analyzed, 223 were assigned to the intervention group and 222 to the control group. These patients had a mean (SD) age of 63.2 (13.3) years and included 263 males (59.1%). A total of 333 patients (74.8%) had a New York Heart Association class III or IV heart failure, indicating severe limitations in physical activity. At 52 weeks, the intervention group had a significantly higher PDC for heart failure medication (8.1%; 95% CI, 5.5%-10.7%; P < .001) and a greater proportion of patients with PDC of 80% or greater (odds ratio, 0.34; 95% CI, 0.21-0.54; P < .001) compared with the control group.

CONCLUSIONS AND RELEVANCE: This randomized clinical trial found a modest improvement in medication adherence among patients with CHF who received the pharmacist-led management intervention vs usual care.

TRIAL REGISTRATION: Chinese Clinical Trial Registry Identifier: ChiCTR2000040232.

PMID:39705029 | DOI:10.1001/jamanetworkopen.2024.53976

Ann Med. 2025 Dec;57(1):2443256. doi: 10.1080/07853890.2024.2443256. Epub 2024 Dec 20.

ABSTRACT

BACKGROUND: Malnutrition is prevalent in patients with inflammatory bowel disease (IBD); however, its ability to predict the disease activity in IBD remains unexplored. Therefore, this study aimed to explore the association between malnutrition and disease activity in IBD.

METHODS: In this retrospective study, we enrolled 1006 patients diagnosed with IBD from the First Affiliated Hospital of Wenzhou Medical University from 2011 to 2022. Malnutrition was assessed based on the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) scores. Logistic regression analyses were performed to identify predictors for disease activity. Restricted cubic spline analysis was performed to evaluate the possible nonlinear relations, and subgroup analysis was performed to explore potential interactions. Additionally, prediction performances were compared through receiver operating characteristic curves, net reclassification improvement, and integrated discrimination improvement.

RESULTS: The prevalence of malnutrition calculated by the PNI, GNRI, and CONUT scores in IBD was 16.9%, 72.1%, and 75.6%, respectively and significant correlations were observed among them. Multivariate logistic regression analysis showed that PNI, GNRI, and CONUT were independent risk factors for disease activity, and no significant nonlinear relationship was observed between disease activity and all three indexes. No statistically significant interactive effect was found in nearly all the subgroups. GNRI showed the highest predictive value compared with PNI and CONUT. Additionally, combining any of the three indexes improved the ability of C-reactive protein to predict IBD activity.

CONCLUSIONS: All three nutritional indexes evaluated malnutrition to be an independent risk factor for IBD activity.

PMID:39705015 | DOI:10.1080/07853890.2024.2443256

Stomatologiia (Mosk). 2024;103(6):66-72. doi: 10.17116/stomat202410306166.

ABSTRACT

OBJECTIVE: The aim of the study is to perform a systematic search, qualitative synthesis, and a meta-analysis of scientific publications on the prevalence and experience of dental caries among 15-year-old adolescents in the Arctic zone of the Russian Federation.

MATERIALS AND METHODS: A systematic review based on PRISMA guidelines. The review includes sources that describe the prevalence and intensity of caries in 15-year-old adolescents within the Arctic zone of the Russian Federation. Publications from 1998-2023 in English and Russian were searched for using the PubMed and eLIBRARY platforms. In total, 208 publications identified, but only 4 were included in meta-analysis.

RESULTS: The total number of adolescents in the studies included in the review was 1567 with a significant proportion being residents of the Arkhangelsk region. The weighted prevalence of caries was 87.9% (95% CI: 83.7-91.7%). The statistically significant increase was registered only in the city of Norilsk. In Arkhangelsk, the increase in the prevalence of caries was accompanied by a decrease in the activity of the carious process, which was due to a significant decrease in the K component in the structure of the DMFT index.

CONCLUSION: The review provides the evidence on a high prevalence of caries among 15-year-old adolescents in Arctic Russia. Further research of the dental status of adolescents is warranted as well as the development of effective preventive measures on individual and population levels.

PMID:39705001 | DOI:10.17116/stomat202410306166

Stomatologiia (Mosk). 2024;103(6):55-59. doi: 10.17116/stomat202410306155.

ABSTRACT

THE AIM: The of study was to assess the prevalence and features of acute dental trauma in children living in educational institutions.

MATERIALS AND METHODS: 131 medical records of children from orphanages who suffered dental injuries in the period from 2017 to 2021 were studied. The analysis of the relationship of the type of acute dental injury (ADI) with the gender, age of patients, history, and the timing of medical care access was carried out. A dental examination was also performed on 52 healthy pupils of the Center for the Promotion of Family Education in Moscow (study group) with ADI. The control group consisted of healthy children living in families (n=52). The dental aesthetic index DAI was determined in patients of both groups.

RESULTS: Based on a retrospective analysis of the medical histories of children in educational institutions, 38.2% had a tooth luxation, 61.8% had a tooth fracture. The timing for medical care provision was characterized by a large range of values, an asymmetry of distribution (Me=4.5 days). The prevalence of ADI was higher in children from orphanages compared with children of the control group. In the case of a history of tooth injury, the DAI index was on average 5.2 points higher (p=0.016).

CONCLUSION: Dental examination of children in orphanages revealed a higher prevalence of OTD compared to children living in families. The DAI b index in patients of both groups is on average 5.2 points higher (p=0.016) in the case of a history of ADI. The study highlights the need to improve dental care and prevent dental injuries among children in educational institutions.

PMID:39704999 | DOI:10.17116/stomat202410306155

Stomatologiia (Mosk). 2024;103(6):48-54. doi: 10.17116/stomat202410306148.

ABSTRACT

OBJECTIVE: To study the associations between salivary minerals concentrations and caries experience among adolescents in the conditions of one of the industrial centers of the Far North.

MATERIAL AND METHODS: In total, 146 adolescents aged 15-17 years took part in a cross-sectional study in Syktyvkar, Komi Republic. Caries experience was assessed as DMFT index and its components. Salivary concentrations of sodium, potassium, magnesium, phosphorus, total- and ionized calcium as well as salivary pH were determined. Poisson regression models were used for all calculations using Stata 18 statistical software.

RESULTS: Positive associations were observed between the number of decayed teeth and concentrations of sodium (p<0.001) and ionized calcium (p=0.003). Sodium (p=0.017), potassium p=0.005), magnesium (p=0.006) and phosphorus (p<0.001) concentrations were inversely associated with the number of filled teeth. Inverse relationships were identified between saliva pH and the number of decayed (p<0.001) and missing (p=0.009) teeth.

CONCLUSION: We observed significant associations between salivary minerals concentrations and caries experience among adolescents in Syktyvkar. When replicated in other populations, the results can be used to develop predictive models for caries progression in adolescents of the Russian North.

PMID:39704998 | DOI:10.17116/stomat202410306148

Stomatologiia (Mosk). 2024;103(6):25-29. doi: 10.17116/stomat202410306125.

ABSTRACT

OBJECTIVE: To determine the prevalence of dentition defects and the need for orthopedic treatment among the population of the regions of Mongolia.

MATERIALS AND METHODS: The study involved 444 residents over the age of 18 living in the Khangai region of Mongolia. After a written agreement to participate in the study, an oral examination was performed and the examination data were marked on the map. When determining the topography of dentition defects, the classifications of E. Kennedy and E.I. Gavrilov were used, the presence and type of dentures were noted. Statistical processing of the results was carried out using the SPSS Statistics 25.0 program.

RESULTS: Dentition defects were found in 91.3% of the subjects, complete absence of teeth in 0.4%, and 7.7% of the subjects had complete dentition. With an increase in the age of the subjects, there was a tendency to a predominance of terminal defects (80.8% aged 45 to 74 years). Regardless of age, defects in the anterior parts of the dentition were less common. Of the study participants, 209 (51.0%) had dentures, 97.1% wore removable structures. Acrylic and nylon prostheses prevailed among removable structures (97.0%), only 6 participants had clasp structures. Of the 410 examined with dentition defects, 201 (49.0%) did not have dentures and needed prosthetics after rehabilitation and special preparation of the oral cavity for prosthetics.

CONCLUSION: The reasons leading to early tooth loss and the most commonly used prosthetics methods are related to the economic level of the country’s development, the lifestyle of the population, the state of sanitary and educational work and the low level of prevention of oral diseases. Comprehensive budgetary preventive measures in a particular region of the country are important for reducing oral diseases, aimed not only at reducing the incidence rate, but also at raising public awareness about oral health.

PMID:39704995 | DOI:10.17116/stomat202410306125

Stomatologiia (Mosk). 2024;103(6):20-24. doi: 10.17116/stomat202410306120.

ABSTRACT

The aim of this work is to study the mechanical properties of temporary composite crowns and temporary composite orthopedic structures manufactured by 3D printing.

MATERIALS AND METHODS: For the two studied groups of samples: the original 3D-printed samples and the poured samples from a composite material of a certain shape, 8 samples were made and visually checked for the absence of porosity. The strength and elasticity were measured using the three-point bending method and the hardness was measured using the indentation method.

RESULTS: For both materials, the hardness, flexural strength and flexural elasticity show consistently high values required by GOST 24621-2015 (ISO 868:2003) [Plastics and ebonite] and GOST 4648-2014 (ISO 178:2010) [Plastics]. However, the statistical data on bending are higher for the composite material, with a larger spread of the elastic modulus value, in contrast to the 3D-printed samples.

CONCLUSION: Both materials are suitable for the manufacture of temporary orthopedic structures. For a more accurate assessment, it is necessary to continue studying the 3D-printed material for cytotoxicity, water absorption, and microstructure.

PMID:39704994 | DOI:10.17116/stomat202410306120

Stomatologiia (Mosk). 2024;103(6):14-19. doi: 10.17116/stomat202410306114.

ABSTRACT

OBJECTIVE: The aim of the study is to study the degree of adhesion of reference strains of microorganisms to the surface of modern polymer materials for the manufacture of removable prostheses.

MATERIALS AND METHODS: The primary and residual microbial adhesion of 4 types of polymers was studied: acrylic polymer (Villacryl H Plus), monomerless polymer (Vertex ThermoSens), photopolymers for additive manufacturing (Harz Labs Dental Denture Base, Harz Labs Dental Sand). C. albicans, S. aureus, E. faecalis, and S. mutans were used as reference strains.

RESULTS: The analysis of the primary adhesion of C. albicans, S. aureus, E. faecalis, and S. mutans revealed statistically significant differences between the adhesion indices to the studied material samples. The minimal indices of primary and residual adhesion were noted for the photopolymers for additive manufacturing samples while monomerless polymer samples showed the highest adhesion index in all cases. The indicators of residual adhesion of the reference strains were extremely low.

CONCLUSION: Photopolymers for additive manufacturing have a lower index of primary and residual microbial adhesion in comparison with acrylic and non-monomeric polymers. These materials are potentially inert from a microbiological point of view and can be recommended for the manufacture of removable prostheses.

PMID:39704993 | DOI:10.17116/stomat202410306114

Stomatologiia (Mosk). 2024;103(6):5-9. doi: 10.17116/stomat20241030615.

ABSTRACT

THE AIM OF THE STUDY: Was a comparative analysis of the structural features of the endodontic system and the thickness of hard dental tissues over the past ten centuries.

MATERIALS AND METHODS: 180 teeth of people who lived from the X to XX centuries AD were studied using cone-beam computed tomography in endodontic mode: the volume of the endodontic system and the thickness of hard dental tissues were calculated using the algorithm developed by us. The Pearson correlation coefficient and Student’s t-test were calculated in Excel program, and the data was analyzed with GraphPad Prism 8 Statistics Guide statistical program.

RESULTS: The most significant Pearson correlation coefficient was found between the volume of the endodontic system and the thickness of the enamel in the area of the support cusp (r=0.723) and had a linear relationship for ten centuries. The dynamics of changes in other parameters has a non-linear dependence. Changes in parameters occur in a wave-like way.

CONCLUSION: The article assesses variability of structure of endodontic system and variation of features of internal structure of teeth.

PMID:39704991 | DOI:10.17116/stomat20241030615