Designing and validating a questionnaire on oral health care knowledge, attitude, and practice of dental staff

Objectives: This study aimed to design a valid questionnaire to evaluate knowledge, attitude, and practice (KAP) of Mashhad Dental school staff about oral health care and to assess the validity and reliability of this instrument. Methods: The “Dental Staff Awareness of Oral Health Care” (DSAOHC) was divided into three concepts; knowledge, attitude and practice. Ten experts of Mashhad Dental School contributed to design the questionnaire and assessed the face and content validity (I-CVI and S-CVI/AV) in two rounds. The necessity of each item was evaluated according to Lawshe’s Content Validity Ratio (CVR). Construct validity, internal consistency, and reliability were assessed using confirmatory factor analysis, homogeneity coefficients, and test-retest by distributing the instrument among 207 dental staff working in other dental schools and private clinics. Results: Based on the acceptable results of I-CVI, S-CVI/AV (>0.7), and CVR (>0.62), the final version of DSAOHC was approved with 34 questions, including 10 questions about background information, 8 questions for the knowledge, 5 questions for attitude and 11 questions related to practice. Cronbach’s alpha coefficients were acceptable for all domains. The RMSEA criterion was ≤ 0.05 and its upper band confidence interval (CI 90%) was ≤ 0.1. Also, CFI indicated the suitability of the model (the desired value of CFI>0.9). Inter-Class Correlation/ICC revealed the appropriate measure (ICC = 0.998). Conclusion: The measures showed that this instrument is valid and reliable, also culturally adjusted to and acceptable for this community. It may adequately evaluate staffs’ knowledge, attitude, and practice toward oral health

Application of Outlier Robust Nonlinear Mixed Effect Estimation in Examining the Effect of Phenylephrine in Rat Corpus Cavernosum

Abstract Ignoring two main characteristics of the concentration-response data, correlation between observations and presence of outliers, may lead to misleading results. Therefore, the special method should be considered. The present study was designed to apply the outlier robust nonlinear mixed estimation for effects of phenylephrine on rat corpus cavernosum strips. In this study, eight different doses of phenylephrine in eight experimental groups were used. Each group consisted of eight rats. The concentration-response curves to phenylephrine (0.1µM to 300µM) were obtained by the cumulative addition of phenylephrine to the chamber. Because of the existence of an outlier to achieve robust estimations, M-estimation method and Huber function as a dispersion function were used. Cumulative administration of phenylephrine (0.1µM -300µM) caused concentration-dependent contractions in strips of rat corpus cavernosum (-Log EC 50 was 5 ± 0.31, 95% CI= 5.92 to 4.21). The contraction of corpus cavernosum started in the concentration of 0.3 μM and then gradually increased in a dose-dependent manner till it reached a plateau in 100 μM. To consider the clustering feature of concentration-response data, the 4pl regression with a random term has been used. To estimate parameters, because of existence of an outlier in dataset, the robust procedure has been applied. The contraction of corpus cavernosum started in the concentration of 0.3 μM and then gradually increased in a dose-dependent manner till it reached a plateau in 100 μM

Diagnostic accuracy and outcomes of digital breast tomosynthesis (DBT) compared to digital mammography (DM) in identifying breast cancer in women at increased risk of breast cancer due to symptoms and/or family history.

Aims: 1. To examine the diagnostic accuracy and outcomes of DBT, in women with symptoms or signs of breast cancer and/or family history of breast cancer, in comparison with DM. 2. To examine the diagnostic accuracy and outcomes of DBT in the subgroup of women with dense breasts who have symptoms or signs of breast cancer and/or family history of breast cancer, in comparison with DM. 3. To examine the additional diagnostic value of breast ultrasound, used in addition to either DBT or DM in the above-described populations including the subgroup with dense breasts

Impact of the diagnostic label for a low-risk prostate lesion: protocol for two online factorial randomised experiments

INTRODUCTION: Many types of prostate cancer present minimal risk to a man's lifespan or well-being, but existing terminology makes it difficult for men to distinguish these from high-risk prostate cancers. This study aims to explore whether using an alternative label for low-risk prostate cancer influences management choice and anxiety levels among Australian men and their partners.METHODS AND ANALYSIS: We will run two separate studies for Australian men and Australian women with a male partner. Both studies are between-subjects factorial (3×2) randomised online hypothetical experiments. Following consent, eligible participants will be randomised 1:1:1 to three labels: 'low-risk prostate cancer, Gleason Group 1', 'low-risk prostate neoplasm' or 'low-risk prostate lesion'. Participants will then undergo a second randomisation step with 1:1 allocation to the provision of detailed information on the benefits and harms of different management choices versus the provision of less detailed information about management choices. The required sample sizes are 1290 men and 1410 women. The primary outcome is the participant choice of their preferred management strategy: no immediate treatment (prostate-specific antigen (PSA)-based monitoring or active surveillance using PSA, MRI, biopsy with delayed treatment for disease progression) versus immediate treatment (prostatectomy or radiation therapy). Secondary outcomes include preferred management choice (from the four options listed above), diagnosis anxiety, management choice anxiety and management choice at a later time point (for participants who initially choose a monitoring strategy).ETHICS AND DISSEMINATION: Ethics approval has been received from The University of Sydney Human Research Ethics Committee (2023/572). The results of the study will be published in a peer-reviewed medical journal and a plain language summary of the findings will be shared on the Wiser Healthcare publications page http://www.wiserhealthcare.org.au/category/publications/ TRIAL REGISTRATION NUMBERS: Australian New Zealand Clinical Trials Registry (ID 386701 and 386889).</p

Application of Outlier Robust Nonlinear Mixed Effect Estimation in Examining the Effect of Phenylephrine in Rat Corpus Cavernosum: Outlier Robust Nonlinear Mixed Effect Estimation in Examining the Effect of Phenylephrine

Ignoring two main characteristics of the concentration-response data, correlation between observations and presence of outliers, may lead to misleading results. Therefore, the special method should be considered. The present study was designed to apply the outlier robust nonlinear mixed estimation for effects of phenylephrine on rat corpus cavernosum strips. In this study, eight different doses of phenylephrine in eight experimental groups were used. Each group consisted of eight rats. The concentration–response curves to phenylephrine (0.1μM to 300μM) were obtained by the cumulative addition of phenylephrine to the chamber. Because of the existence of an outlier to achieve robust estimations, M-estimation method and Huber function as a dispersion function were used. Cumulative administration of phenylephrine (0.1μM - 300μM) caused concentration-dependent contractions in strips of rat corpus cavernosum (-Log EC50 was 5 ± 0.31, 95% CI= 5.92 to 4.21). The contraction of corpus cavernosum started in the concentration of 0.3 μM and then gradually increased in a dose-dependent manner till it reached a plateau in 100 μM. To consider the clustering feature of concentration-response data, the 4pl regression with a random term has been used. To estimate parameters, because of existence of an outlier in dataset, the robust procedure has been applied. The contraction of corpus cavernosum started in the concentration of 0.3 μM and then gradually increased in a dose-dependent manner till it reached a plateau in 100 μM

An Analysis of the Areas Occupied by Vessels in the Ocular Surface of Diabetic Patients: An Application of a Nonparametric Tilted Additive Model

(1) Background: As diabetes melllitus (DM) can affect the microvasculature, this study evaluates different clinical parameters and the vascular density of ocular surface microvasculature in diabetic patients. (2) Methods: In this cross-sectional study, red-free conjunctival photographs of diabetic individuals aged 30–60 were taken under defined conditions and analyzed using a Radon transform-based algorithm for vascular segmentation. The Areas Occupied by Vessels (AOV) images of different diameters were calculated. To establish the sum of AOV of different sized vessels. We adopt a novel approach to investigate the association between clinical characteristics as the predictors and AOV as the outcome, that is Tilted Additive Model (TAM). We use a tilted nonparametric regression estimator to estimate the nonlinear effect of predictors on the outcome in the additive setting for the first time. (3) Results: The results show Age (p-value = 0.019) and Mean Arterial Pressure (MAP) have a significant linear effect on AOV (p-value = 0.034). We also find a nonlinear association between Body Mass Index (BMI), daily Urinary Protein Excretion (UPE), Hemoglobin A1C, and Blood Urea Nitrogen (BUN) with AOV. (4) Conclusions: As many predictors do not have a linear relationship with the outcome, we conclude that the TAM will help better elucidate the effect of the different predictors. The highest level of AOV can be seen at Hemoglobin A1C of 9% and AOV increases when the daily UPE exceeds 600 mg. These effects need to be considered in future studies of ocular surface vessels of diabetic patients