Associations among gastroesophageal reflux disease, mental disorders, sleep and chronic temporomandibular disorder: a case–control study
Bibliographic record
Abstract
BACKGROUND: Temporomandibular disorders (TMDs) are a family of pain-related disorders associated with impaired function in the jaw, temporomandibular joint and muscles of mastication. Our objectives were to evaluate the association between chronic TMD and gastresophageal reflux disease (GERD) and to determine whether mental disorders or undermined sleep mediates this association. METHODS: We conducted a case-control study involving 1522 consecutive adult patients with chronic TMD and 1522 matched controls from 2 hospitals in China. All participants were aged between 18 and 70 years and were recruited from July 2017 to April 2018 Chronic TMD was diagnosed by trained dentists using the criteria in the Orofacial Pain Prospective Evaluation and Risk Assessment Study. Trained gastroenterologists made blinded diagnoses of GERD according to the Montreal definition and classification (at least 2 d of mild symptoms, or 1 d of moderate or severe symptoms per week). We used validated questionnaires to evaluate psychological status and sleep quality. RESULTS: Of the study participants, we identified 132 patients and 61 controls with GERD. Using conditional logistic regression analysis, we identified GERD as a risk factor for TMD (odds ratio 2.74, 95% confidence interval 1.88 to 3.98). Mediation analyses identified that somatization, anxiety and undermined sleep moderately mediated the relation between TMD and GERD. INTERPRETATION: Our study suggests that symptomatic GERD is associated with chronic, painful TMD, and somatization, anxiety and undermined sleep mediate this association to a certain extent. Due consideration should be given to the evaluation and management of gastrointestinal symptoms and mental disorders in the combined therapy for painful TMD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".