Dental extraction, intensity-modulated radiotherapy of head and neck cancer, and osteoradionecrosis

Objective To seek evidence for osteoradionecrosis (ORN) after dental extractions before or after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC). Methods Medline/PubMed, Embase, and Cochrane Library were searched from 2000 until 2020. Articles on HNC patients treated with IMRT and dental extractions were analyzed by two independent reviewers. The risk ratios (RR) and odds ratios (OR) for ORN related to extractions were calculated using Fisher’s exact test. A one-sample proportion test was used to assess the proportion of pre- versus post-IMRT extractions. Forest plots were used for the pooled RR and OR using a random-effects model. Results Seven of 630 publications with 875 patients were eligible. A total of 437 (49.9%) patients were treated with extractions before and 92 (10.5%) after IMRT. 28 (3.2%) suffered from ORN after IMRT. ORN was associated with extractions in 15 (53.6%) patients, eight related to extractions prior to and seven cases related to extractions after IMRT. The risk and odds for ORN favored pre-IMRT extractions (RR = 0.18, 95% CI: 0.04–0.74, p = 0.031, I2 = 0%, OR = 0.16, 95% CI: 0.03–0.99, p = 0.049, I2 = 0%). However, the prediction interval of the expected range of 95% of true effects included 1 for RR and OR. Conclusion Tooth extraction before IMRT is more common than after IMRT, but dental extractions before compared to extractions after IMRT have not been proven to reduce the incidence of ORN. Extractions of teeth before IMRT have to be balanced with any potential delay in initiating cancer therapy.

Association of minimum dietary diversity and minimum meal frequency with anthropometric parameters among children of 6 to 23 months of age attending immunization clinic of a tertiary care hospitals

Background: The age of 6–23 months is the golden period in the first 1000 days of life. Insufficient quantities, frequencies, and inadequate quality of complementary feedings have a negative effect on child health and growth, especially in the first two years of life.Methods: A hospital based descriptive type of observational study was carried out in the immunization clinic. The source population were the mothers who had children in age group of 6-23 months brought to the clinic in the month of January 2021 comprise the “target population”. The sample size of 102 was calculated with 80% of power, confidence level of 95% and considering prevalence of MDD as 15.2%. Purposive sampling technique was employed for selection of study sample. Proportion of Minimum Meal Diversity and Minimum Meal Frequency was calculated and their association was assessed with anthropometric characteristics.Results: Proportion of MDD was found to be 72.5% (Figure 1) whereas Proportion of MMF was found to be 87.3 %. The proportion of MDD was significantly high among the children who had minimum meal frequency. MDD and MMF were protective against the acute malnutrition among the children.Conclusions: This study shows that consumption of a diverse diet and MMF is associated with a reduction in undernutrition among children of 6 to 23 months of age. Measures to improve the type of complementary foods given to children to meet their needs for energy and nutrients should be considered.

Epidemiology and approach in Carpal Tunnel Syndrom: An analysis of the impact on return on labor

Background: Carpal Tunnel Syndrome (CTS) is defined as a focal, chronic and symptomatic compressive neuropathy of the median nerve at the wrist. It is the most prevalent neuropathy in the population. The objective of the study to describe the epidemiological, clinical and occupational profile of patients with CTS who underwent median nerve neurolysis in the carpus and the Occupational Therapy intervention attended by the Sistema Único de Saúde (SUS). Methods: This is a descriptive study, carried out from january 2014 to december 2017 at Centro Estadual de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), in the city of Goiânia, located in the Center-West region of Brazil. The Reference population covered the medical records of patients submitted to the surgical procedure and rehabilitation. During this period, 698 patients underwent surgery and rehabilitation, and the sample of 249 charts analyzed was defined by means of a sample calculation using the finite sample proportion test. A margin of error of 5% was considered in the calculation. Out-of-time-range patients and those with other associated hand injuries were excluded. Our study was approved by the Research Ethics Committee registered under number 97279.121. The data were analyzed with the aid of the SPSS 23 statistical package. In all analyzes, thes ignificancel evel adopted was 5% (p <0.05).Results: The demographic profile was composed of 223 women, representing 89.6% of the sample, in the age group between 40 and 59 years, being 74.7% of right-handed patients. Comorbidities were present in 63.1% of the patients and the main ones are Systemic Arterial Hypertension (SAH), Diabetes Mellitus (DM) and Fibromyalgia. The vast majority of cases were classified as severe or very severe staging. The labor distribution was categorized into 12 distinct groups, with workers doing domestic work prevailing. Conclusion: A greater bilateral involvement was observed in the studied sample, classified in the severe or very severe stages, which resulted in the surgical treatment and early intervention and systematization of occupational therapy, which favored the patient to be replaced in work activities in about 84, 7% of the cases surveyed.

WAYS IN WHICH HIGH-SCHOOL STUDENTS UNDERSTAND THE SAMPLING DISTRIBUTION FOR PROPORTIONS

In Spain, curricular guidelines as well as the university-entrance tests for social-science high-school students (17–18 years old) include sampling distributions. To analyse the understanding of this concept we investigated a sample of 234 students. We administered a questionnaire to them and ask half for justifications of their answers. The questionnaire consisted of four sampling tasks with two sample sizes (n = 100 and 10) and population proportions (equal or different to 0.5)systematically varied. The experiment gathered twofold data from the students simultaneously, namely about their perception of the mean and about their understanding of variation of the sampling distribution. The analysis of students’ responses indicates a good understanding of the relationship between the theoretical proportion in the population and the sample proportion. Sampling variability, however, was overestimated in bigger samples. We also observed various types of biased thinking in the students: the equiprobability and recency biases, as well as deterministic pre-conceptions. The effect of the task variables on the students’ responses is also discussed here. First published December 2020 at Statistics Education Research Journal: Archives

Proximal Interphalangeal Joint Arthrodesis Techniques: A Systematic Review

Proximal interphalangeal joint (PIPJ) arthrodesis is a salvage option in the management of end-stage PIPJ arthropathy. Numerous techniques have been described, including screws, Kirschner wires, tension band wiring, intramedullary devices, and plate fixation. There remains no consensus as to the optimum method, and no recent summary of the literature exists. A literature search was conducted using the MEDLINE, EMBASE, and PubMed databases. English-language articles reporting PIPJ arthrodesis outcomes were included and presented in a systematic review. Pearson χ2 and 2-sample proportion tests were used to compare fusion time, nonunion rate, and complication rate between arthrodesis techniques. The mean fusion time ranged from 5.1 to 12.9 weeks. There were no statistically significant differences in fusion time between arthrodesis techniques. Nonunion rates ranged from 0.0% to 33.3%. Screw arthrodesis demonstrated a lower nonunion rate than wire fusion (3.0% and 8.5% respectively; P = .01). Complication rates ranged from 0.0% to 22.1%. Aside from nonunions, there were no statistically significant differences in complication rates between arthrodesis techniques. The available PIPJ arthrodesis techniques have similar fusion time, nonunion rate, and complication rate outcomes. The existing data have significant limitations, and further research would be beneficial to elucidate any differences between techniques.

WAYS IN WHICH HIGH-SCHOOL STUDENTS UNDERSTAND THE SAMPLING DISTRIBUTION FOR PROPORTIONS

In Spain, curricular guidelines as well as the university-entrance tests for social-science high-school students (17–18 years old) include sampling distributions. To analyse the understanding of this concept we investigated a sample of 234 students. We administered a questionnaire to them and ask half for justifications of their answers. The questionnaire consisted of four sampling tasks with two sample sizes (n = 100 and 10) and population proportions (equal or different to 0.5)systematically varied. The experiment gathered twofold data from the students simultaneously, namely about their perception of the mean and about their understanding of variation of the sampling distribution. The analysis of students’ responses indicates a good understanding of the relationship between the theoretical proportion in the population and the sample proportion. Sampling variability, however, was overestimated in bigger samples. We also observed various types of biased thinking in the students: the equiprobability and recency biases, as well as deterministic pre-conceptions. The effect of the task variables on the students’ responses is also discussed here. First published December 2020 at Statistics Education Research Journal: Archives

Assessing MSMEs Growth Through Rosca Involvement Using Paired t-Test and One Sample Proportion Test

In this research work, rotating savings and credit association (ROSCA) effect on the growth of micro, small and medium enterprises (MSMEs) and identification of a factor supporting the continuity of ROSCAs is studied. A well-designed questionnaire with a reliability value of 0.957 was distributed to 400 entrepreneurs in Wukari through snowball sampling technique. After validity check, 368 valid questionnaires were used for the research. Firstly, a paired t-test was applied to know if entrepreneurs achieve significant positive growth in their business before and after 5 years of joining ROSCAs. At 5% level of significance, entrepreneurs achieved significant positive growth in their businesses 5 years and above of joining ROSCAs. Secondly, a one sample proportion Z-score test was used to identify the major factor responsible for ROSCAs continuity. At 5% significance level, flexibility was identified as the major factor responsible for ROSCAs. It was concluded based on the results obtained that ROSCAs has a significant positive effect on the growth of MSMEs and ROSCAs continuity towards MSMEs growth is due to its flexibility factor in terms of operations, disbursement, seeking loans and interest rate.

Testing of Auditory Clinical Alarms in ICU/CCU

Almost all medical devices in ICU/CCU have a built-in clinical alarm system to alert when there are changes in a patient’s condition. The objective of this study is to investigate the effectiveness of the existing alarm system in ICU/CCU. Two summative usability tests were conducted to test the effectiveness of existing and new alarm signals based on IEC 60601-1-8:2006 standard. Further formative test is conducted to study the perception of urgency associated with a number of tones in the alarm signals. The findings indicate that the existing auditory alarm signal in ICU/CCU does not indicate the urgency of the alarm conditions. The simulation test indicates that the respondents preferred 282Hz, 500Hz and 800Hz for low, medium and high-risk alarm respectively. The one-sample proportion z test on urgency mapping indicates that the proportion of responses for the highest risk is more than 50% for a single tone test signal. These results show that a single tone test signal being perceived as the highest risk is regardless of frequency. It can be concluded the auditory alarm designed based on this IEC 60608-1-8:2006 standard is not effective. As such it is proposed that the incorporation of the new alarm frequencies and tones will improve the effectiveness of the alarm signal

Consumer Preference of Products for the Prevention and Treatment of Stretch Marks: Systematic Product Search

Background Striae distensae, or stretch marks, are a common and distressing condition affecting females two-and-a-half times more frequently than males. Despite the numerous products available for stretch mark prevention and treatment, there have been few studies that consider consumer product preference. Objective The aim of this study was to determine which products were preferred by consumers for the prevention and treatment of stretch marks based on product vehicle and product ingredients. Methods In January 2020, a search was conducted on internet retailer Amazon for products related to stretch marks. The top products were identified as those with 100 reviews or greater and a rating of 4 or higher. The products were classified as either stretch mark–specific or non stretch mark–specific. Price, rating, type of vehicle, and specific ingredients of both product groups were compared. Vehicle-type and ingredients in both product groups were compared with two-tailed two-sample proportion tests to determine if certain vehicles or ingredients were more likely to be found in stretch mark–specific products. P<.05 indicated statistical significance. Results Out of over 10,000 products, 184 were selected as the top products according to the review and rating criteria of which 117 (63.6%) were stretch mark–specific and 67 (36.4%) were non stretch mark–specific. Oil was the most common vehicle (131/184, 71.2%) while vitamin E was the most common ingredient (58/184, 31.5%). Oil, as a vehicle, was more likely to be found in stretch mark–specific products than in non stretch mark–specific products (P=.001). Olive oil (P=.02) and cocoa butter (P=.08), Centella asiatica (P=.01), and shea butter (P=.003) were the ingredients more likely to be found in stretch mark–specific products than in non stretch mark–specific products. Conclusions This study demonstrated that there are many products available for the prevention and treatment of stretch marks and identified specific ingredients in the products preferred by customers. There are few studies investigating the effectiveness of the major ingredients in the stretch mark products that are preferred by consumers. Future studies can focus on the effectiveness of the ingredients found in the products that are preferred by consumers.