Observed and Perceived Pain: Findings of a Cross-Sectional Study in Hospitalized Subjects.

BACKGROUND: Pain constitutes a serious problem of a health, economic, ethical, and social equity nature affecting negatively quality of life. Its assessment is often subjected to overestimation or underestimation. AIM: The aim of this study is threefold: (1) to estimate the prevalence of pain in hospitalized patients; (2) to assess the grade of correlation between the level of pain observed by the nurses and the pain perceived by the patients; and (3) to examine the level of scientific knowledge among the healthcare professionals. DESIGN: Cross-sectional study. METHODS: The intensity level of observed and perceived pain has been evaluated in 401 patients with validated scales. Analyzed data have been extracted from the electronic medical record and integrated into the data-collection sheet. A questionnaire has been submitted to nurses to investigate their level of knowledge on pain assessment and management. RESULTS: The study included 350 patients out of 401; for 51 patients the "pain" data was missing. Prevalence of perceived pain was 40.15%. Nurses overestimated pain in 7.43% of cases and underestimated it in 24.9%. The majority of the nursing staff claimed to be aware of the pain topic, however, they showed some uncertainties in clinical practice. CONCLUSIONS: The differential variation between the observed pain and the perceived one resulted in 43.71% of cases, highlighting the dependence on the two variables: "area of hospitalization" and "intensity level". The observation and monitoring of pain did not appear to be a consolidated practice, thus representing an important area for investments in the nursing profession.

Probabilistic graphical modelling of early childhood caries development.

In order to develop a statistical model for complex interactions among factors affecting early childhood caries development (ECC), 234 children from the "XXXX oral growth longitudinal study" were analysed at ages 3, 4 and 5. A questionnaire for children's parents (clinical history, nutritional and oral hygiene habits) and clinical oral examinations were recorded each year. The probabilistic dependence structure on the most significant factors was modelled with an Undirected Graphical Model (UGM or Markov random fields) which provides a probabilistic reasoning approach for the establishment of multi-way associations. The best fitting UGM was estimated through the maximum likelihood principle and two-way factor associations were verified through Fisher's exact statistical hypothesis tests for count data. The effect of sugar intake on caries incidence is mediated by oral hygiene; for caries incidence, oral hygiene quality is more relevant than toothbrushing time; the effect of pacifier on caries incidence is statistically significant only when considered in combination with breastfeeding time. Among behavioural ECC risk factors, the quality of oral hygiene, and not the toothbrushing frequency, is a primary factor that modulates the sugar intake in his primary role of the ECC developer. School-based oral health programs for ECC prevention should be improved with supervised toothbrushing program. UGM analysis could improve the school-based oral health programs with more effective and efficient prevention strategies based on the hierarchical interactions among the ECC risk factors. Oral hygiene plays a pivotal role in early childhood caries and can modulate positively or negatively their development. Supervised toothbrushing is a crucial intervention to be included in the daily educational and clinical practice and in the school-based oral health promotion programs. Trial registration: Clinical trial registration number: NCT02798809.

Generation of all randomizations using circuits.

After a rich history in medicine, randomized control trials (RCTs), both simple and complex, are in increasing use in other areas, such as web-based A/B testing and planning and design of decisions. A main objective of RCTs is to be able to measure parameters, and contrasts in particular, while guarding against biases from hidden confounders. After careful definitions of classical entities such as contrasts, an algebraic method based on circuits is introduced which gives a wide choice of randomization schemes.

Long-range dependence in earthquake-moment release and implications for earthquake occurrence probability.

Since the beginning of the 1980s, when Mandelbrot observed that earthquakes occur on 'fractal' self-similar sets, many studies have investigated the dynamical mechanisms that lead to self-similarities in the earthquake process. Interpreting seismicity as a self-similar process is undoubtedly convenient to bypass the physical complexities related to the actual process. Self-similar processes are indeed invariant under suitable scaling of space and time. In this study, we show that long-range dependence is an inherent feature of the seismic process, and is universal. Examination of series of cumulative seismic moment both in Italy and worldwide through Hurst's rescaled range analysis shows that seismicity is a memory process with a Hurst exponent H ≈ 0.87. We observe that H is substantially space- and time-invariant, except in cases of catalog incompleteness. This has implications for earthquake forecasting. Hence, we have developed a probability model for earthquake occurrence that allows for long-range dependence in the seismic process. Unlike the Poisson model, dependent events are allowed. This model can be easily transferred to other disciplines that deal with self-similar processes.

Optimization of Anodic Porous Alumina Fabricated from Commercial Aluminum Food Foils: A Statistical Approach.

Anodic porous alumina is a known material based on an old industry, yet with emerging applications in nanoscience and nanotechnology. This is promising, but the nanostructured alumina should be fabricated from inexpensive raw material. We fabricated porous alumina from commercial aluminum food plate in 0.4 M aqueous phosphoric acid, aiming to design an effective manufacturing protocol for the material used as nanoporous filler in dental restorative composites, an application demonstrated previously by our group. We identified the critical input parameters of anodization voltage, bath temperature and anodization time, and the main output parameters of pore diameter, pore spacing and oxide thickness. Scanning electron microscopy and grain analysis allowed us to assess the nanostructured material, and the statistical design of experiments was used to optimize its fabrication. We analyzed a preliminary dataset, designed a second dataset aimed at clarifying the correlations between input and output parameters, and ran a confirmation dataset. Anodization conditions close to 125 V, 20°C, and 7 h were identified as the best for obtaining, in the shortest possible time, pore diameters and spacing of 100-150 nm and 150-275 nm respectively, and thickness of 6-8 µm, which are desirable for the selected application according to previously published results. Our analysis confirmed the linear dependence of pore size on anodization voltage and of thickness on anodization time. The importance of proper control on the experiment was highlighted, since batch effects emerge when the experimental conditions are not exactly reproduced.

A topological study of repetitive co-activation networks in in vitro cortical assemblies.

To address the issue of extracting useful information from large data-set of large scale networks of neurons, we propose an algorithm that involves both algebraic-statistical and topological tools. We investigate the electrical behavior of in vitro cortical assemblies both during spontaneous and stimulus-evoked activity coupled to Micro-Electrode Arrays (MEAs). Our goal is to identify core sub-networks of repetitive and synchronous patterns of activity and to characterize them. The analysis is performed at different resolution levels using a clustering algorithm that reduces the network dimensionality. To better visualize the results, we provide a graphical representation of the detected sub-networks and characterize them with a topological invariant, i.e. the sequence of Betti numbers computed on the associated simplicial complexes. The results show that the extracted sub-populations of neurons have a more heterogeneous firing rate with respect to the entire network. Furthermore, the comparison of spontaneous and stimulus-evoked behavior reveals similarities in the identified clusters of neurons, indicating that in both conditions similar activation patterns drive the global network activity.

Structural identifiability analysis of some highly structured families of statespace models using differential algebra.

In this paper we identify biologically relevant families of models whose structural identifiability analysis could not be performed with available techniques directly. The models considered come from both the immunological and epidemiological literature.

Parallel synthesis and study of fluorous biphasic partition coefficients of 1H,1H,2H,2H-perfluoroalkylsilyl derivatives of triphenylphosphine: a statistical approach.

A library of fluorous, (1H,1H,2H,2H-perfluoroalkyl)silyl-substituted derivatives of triphenylphosphine, Ph(3-a)P[C(6)H(5-y)[SiMe(3-b)(CH(2)CH(2)C(x)F(2x+1))(b)](y)-pos](a) [a = 1-3; b = 1-3; x = 4, 6, 8, or 10; pos = 3, 4 (y = 1) or 3,5 (y = 2)], was prepared using parallel synthetic techniques. Upon variation of these four parameters, a total of 108 different fluorous phosphines can be synthesized. Using factorial design, 37 phosphines were selected and their partition coefficients in the typical fluorous biphasic solvent system PFMCH/toluene (PFMCH = perfluoromethylcyclohexane) determined. By fitting of the partition coefficient data to linear functions of the parameters a, b, and x, the partition coefficients of the remaining 71 fluorous phosphines, which were not prepared, could be predicted. Using this approach, some unexpected trends in the dependence of the partition coefficient on variations of the four parameters became clear, resulting in a better understanding of the optimum fluorous substitution pattern for obtaining the highest partition coefficient (P). In this way, the partition coefficient was increased by 2 orders of magnitude, i.e., from the initial value P = 7.8 for 1(3, 2, 6, C4) to P > 238 for 1(2, 3, 6, C3C5). Para- and 3,5-substituted phosphines showed irregular behavior in the sense that elongation or increase of the number of perfluoroalkyl tails did not necessarily lead to higher partition coefficients. Particularly high values were found for phosphines containing a total of 72 fluorinated carbon atoms on the meta position(s) of the aryl rings. Linear relationships were found between the predicted log P of 1(a, b, x, C4) and the experimentally determined log P values of fluorous diphosphines [CH(2)P[C(6)H(4)(SiMe(3-b)(CH(2)CH(2)C(6)F(13))(b))-4](2)](2) and monophosphines Ph(3-a)P(C(6)H(4)(CH(2)CH(2)C(6)F(13))-4)(a). One of the most fluorophilic phosphines, i.e., 1(3, 1, 8, C3C5), was applied and efficiently recycled in rhodium-catalyzed, fluorous hydrosilylation of 1-hexene by HSiMe(2)Ph using PFMCH as the fluorous phase and the substrates as the organic phase. It was demonstrated that a higher partition coefficient of the ligand in PFMCH/toluene at 0 degrees C indeed resulted in less leaching of both the catalyst and the free ligand during phase separation.