Category: Statistics

J Orthop Surg Res. 2025 Feb 15;20(1):166. doi: 10.1186/s13018-025-05518-4.

ABSTRACT

PURPOSE: This study aims to systematically assess the surgical outcomes and postoperative recovery discrepancies between Robotic-Assisted Total Knee Arthroplasty (RA-TKA) and Conventional Total Knee Arthroplasty (C-TKA) using machine learning algorithms. The objective is to analyze the advantages and disadvantages of both techniques across various parameters and propose optimization recommendations.

METHODS: Data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) clinical database were collected and underwent thorough cleaning and standardization. Key variables such as operative time, Length of Stay (LOS), and postoperative functional status were extracted for analysis. A predictive model was developed and trained using the random forest machine learning algorithm based on postoperative recovery data. The model’s performance was validated using a test dataset, and statistical analyses were conducted to compare the surgical outcomes and postoperative recovery between RA-TKA and C-TKA.

RESULTS: The machine learning model’s predictions indicate that RA-TKA surpasses C-TKA in all surgical outcome metrics, exhibiting superior means and variances. Furthermore, RA-TKA demonstrates better postoperative functional status, lower Complication Rate (CR), and a higher modified frailty index (mFI), suggesting enhanced and quicker recovery for RA-TKA patients.

CONCLUSION: The evaluation results derived from machine learning algorithms suggest that RA-TKA may offer advantages over C-TKA in several crucial metrics. These findings provide valuable insights that could inform future efforts to optimize surgical procedures and postoperative care in clinical practice.

PMID:39955539 | DOI:10.1186/s13018-025-05518-4

World J Surg Oncol. 2025 Feb 15;23(1):55. doi: 10.1186/s12957-025-03705-5.

ABSTRACT

BACKGROUND: To explore the risk factors of post pancreatectomy diabetes mellitus (PPTDM)in pancreatic ductal carcinoma (PDAC) patients and the value of perioperative fasting blood glucose (FBG) level expression on the long-term survival after surgery.

MATERIALS AND METHODS: Between December 2015 and December 2019, a cohort of 509 patients diagnosed with PDAC and undergoing resection at our hospital was analyzed. They were stratified into two groups, Control group (Control) and study group (PPTDM), depending on the onset of postoperative diabetes mellitus. We analyzed the survival rates at 6 months, 12 months and 24 months post-operation in the two groups. We use univariate and logostic multivariate regressions to analyze the risk factors for PPTDM. ROC curve analysis was conducted to assess the diagnostic significance of perioperative FBG levels regarding patients’ long-term survival rates. The Kaplan-Meier method was employed to assess the impact of both preoperative and postoperative FBG levels on the survival rates within 24 months for each patient group.

RESULTS: The comparison of general clinical data between the two groups shows marginal differences without statistical significance(P > 0.05); Patients in PPTDM group had significantly higher BMI, preoperative jaundice proportion, larger tumor diameter, higher TNM stage and higher proportion of distal pancreatectomy (DP), with P values of 0.023, 0.010, 0.040, 0.012 and 0.005, respectively. The levels of preoperative FBG and postoperative FBG in PPTDM patients exhibited statistically significant elevation compared to the control group (P < 0.05). There were no significant differences in surgery-related indicators between the two groups in operative time, number of dissected positive lymph nodes, total number of dissected lymph nodes, intraoperative blood loss and other related data (P > 0.05). Hospitalization duration of PPTDM patients was longer than control group (P = 0.047). PPTDM group had significantly higher expression concentrations of BUN, Cr, TG, LDL and Apo-B factors (P = 0.023, 0.024, 0.013, 0.045 and 0.017). 17 patients (5.03%) died in the PPTDM group and 4 patients (2.35%) in control group which had significantly difference (P = 0.020). In univariate and logostic multivariate regression analysis indicated tumor size, jaundice, BUN, Cr, TG, LDL, Apo-B concentrations and DP approach were significantly correlated to the risk for PPTDM (P < 0.05). ROC curve analysis results showed combining of preoperative and postoperation FBG showed the highest diagnostic efficacy, followed by postoperation FBG and preoperative FBG. The AUC areas of the three groups were 0.745, 0.623 and 0.588, respectively, and the critical values of the three groups were 9.81/9.95 mmol/L, 10.18 mmol/L and 10.23 mmol/L, respectively, with statistical significance (P < 0.05). Results were considered statistically significant if the p-value was less than 0.05.

CONCLUSION: PPTDM stands as a significant postoperative complication following pancreatic cancer surgery, characterized by a high incidence and severity. Several risk factors have garnered considerable attention among clinical surgeon. PPTDM may be an influential factor in postoperative prognosis of pancreatic cancer. The expression levels of preoperative and postoperative blood glucose hold diagnostic value for the long-term prognosis of pancreatic cancer patients. Early regulation and intervention by surgeons concerning perioperative FBG could potentially mitigate the risk of PPTDM.

PMID:39955538 | DOI:10.1186/s12957-025-03705-5

Genet Med. 2025 Feb 12:101375. doi: 10.1016/j.gim.2025.101375. Online ahead of print.

ABSTRACT

PURPOSE: AUTS2-related syndrome is a condition characterized by developmental delay, autism spectrum disorder, and intellectual disability. From alternative promoters AUTS2 encodes two distinct long and short isoforms encoding a putative transcriptional activator.

METHODS: Through a European collaborative study, we collected clinical and genotype data on the largest AUTS2- related syndrome cohort of 58 patients harboring genomic rearrangements or single nucleotide variants (SNVs).

RESULTS: Pathogenic SNVs were recurrently found in individuals from different countries, suggesting mutational hotspots. Independent from the underlying defect at the AUTS2 locus, we observed that autistic behavior, hyperactivity, learning difficulties and speech delay are common features of AUTS2- related syndrome. Among patients with SNVs, individuals carrying pathogenic variants affecting both the longer and the shorter AUTS2 transcripts showed a recognizable phenotype with microcephaly, brachycephaly, micro-retrognathia, broad nasal base and anteverted nares. Behavioral disorders were statistically more common in patients with variants affecting only the longer isoform. Arthrogryposis and stiff movements were only noticed in patients with SNVs.

CONCLUSION: This study provides a comprehensive clinical characterization of AUTS2- related syndrome, unravels few genotype-phenotype correlations and it suggests that disruption of the two distinct AUTS2 transcripts has a different impact on clinical phenotype.

PMID:39953909 | DOI:10.1016/j.gim.2025.101375

Natl Med J India. 2024 Sep-Oct;37(5):248-252. doi: 10.25259/NMJI_264_2022.

ABSTRACT

Background Overweight/obesity is an important risk factor for liver disease, affecting changes in liver function-related parameters. The fat mass and obesity associated (FTO) gene has been reported to have a link between overweight/obesity and liver fat metabolism. We studied the association of FTO rs9939609 variants with liver function-related parameters and overweight/obesity in Chinese adolescents aged 16 to 26 as freshmen. Methods We examined rs9939609 polymorphisms in 198 control and 173 overweight/obese people, and the genotypes of the samples were analyzed by Sanger sequencing. We investigated the effects of FTO gene polymorphism on overweight/obesity and liver function-related parameters. Results The values of aspartate transaminase (AST), alanine transaminase (ALT), gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) in overweight/obesity group were significantly higher than those in control group. The rs9939609 AA genotype increased the risk of overweight/obesity by 3.45 times independent of body mass index (BMI) compared with TT genotype, the rs9939609 (AA) genotype was significantly associated with AST and ALT. Conclusion FTO rs9939609 variants were associated with overweight/obesity and overweight/obesity has a significant influence on the increased liver function-related parameters. The rs9939609 (AA) positively correlated with AST and ALT levels. Overweight/obese patients should pay more attention to liver function-related parameters.

PMID:39953885 | DOI:10.25259/NMJI_264_2022

Natl Med J India. 2024 Sep-Oct;37(5):241-247. doi: 10.25259/NMJI_374_2022.

ABSTRACT

Background Several risk factors have been associated with early childhood caries (ECC). However, conclusive data are not available about the socio-demographic and behavioural factors which are associated with severe ECC (S-ECC). We assessed the severity and pattern of ECC in young children. We also looked for association of S-ECC with various sociobehavioural risk factors in a hospital-based setting. Methods We included 200 children, 1-6 years old, who reported with dental caries to a paediatric dental outpatient in a tertiary care hospital. Information about socio-demographics and various behavioural factors was recorded in a structured proforma using an interview method. The American Academy of Paediatric Dentistry (AAPD) criteria were used for categorizing children into ECC and severe ECC groups (S-ECC). Qualitative variables were analysed by chi-square test. Multiple logistic regression analysis was done to find the predictors of severe S-ECC. All statistical tests were done at a significance level of p<0.05. Results The majority of children (85%) had S-ECC and anterior-posterior (AP) caries pattern (77%). A significant association was found between the age of the child (p<0.001), absence of siblings (p=0.009), continuation of bottle feed or mother’s milk till the age of reporting to the hospital (p=0.007), frequency of night-time feed (p=0.048) and S-ECC. Conclusions A continued habit of milk feed from bottle/mother till the time of dental visit seeking treatment and night time-feeds more than twice had a significant association with S-ECC.

PMID:39953883 | DOI:10.25259/NMJI_374_2022

Natl Med J India. 2024 Sep-Oct;37(5):267-269. doi: 10.25259/NMJI_618_2022.

ABSTRACT

Background Didactic lectures form a large part of the teaching-learning process in medical education. To impart competency-based medical education (CBME) in the Covid-19 pandemic there was a shift to online learning. This pedagogical change would likely impact the efficacy of student learning outcomes. Several studies have shown that learning outcomes and knowledge retention increase considerably when lectures are interactive. However, the efficacy of online teaching with active learning strategies has not been studied. Methods At the Department of Biochemistry, Osmania Medical College, Hyderabad, we did this study with 203 first year MBBS students. Five sessions were conducted on the topic of ‘Enzymology’ with appropriate active learning methods. Each lecture session was preceded and followed by a test, which included multiple-choice questions (MCQs) and brief note questions (BNQs). Feedback of students, was recorded on the 5-point Likert scale from strongly agree to strongly disagree. Results The majority of students felt that answering questions in the pre-test required substantial effort compared to the post-test. The case scenarios included in the pre-test had a positive impact on the curiosity of students. The activities as part of self-directed learning were interesting, and enhanced understanding and retention. They felt lectures without pre-and post-tests were less efficacious and thus should be continued in all the classes. Conclusion Online lectures without pre-and post-test model were less efficacious. Online teaching, coupled with active learning increased interest and the understanding capacity of students.

PMID:39953874 | DOI:10.25259/NMJI_618_2022

Am J Mens Health. 2025 Jan-Feb;19(1):15579883251317095. doi: 10.1177/15579883251317095.

ABSTRACT

High allostatic load (AL), a measure of physiological dysregulation, has been linked with premature morbidity and mortality. There is a paucity of research assessing AL among non-Hispanic Black (NHB) and non-Hispanic White (NHW) American men of various age groups. This study investigated racial differences in AL among NHB and NHW adult men and assessed whether racial differences in AL varied by age. Data were drawn from NHB (n = 232) and NHW (n = 246) men in the Nashville Stress and Health Study. AL was based on the sum of 10 biomarkers that was dichotomized as high AL (four or more high-risk biomarkers) or low AL (fewer than four high-risk biomarkers). Modified Poisson regression models were estimated to assess race differences in AL, adjusting for age, socioeconomic status (SES), and health behaviors. Interactions assessed whether racial differences in AL varied between young (22-49 years) and older (50-69) men. NHB men had a higher prevalence of being in the high AL group (prevalence ratio [PR] = 1.54, confidence interval [CI] = [1.09, 2.18]), relative to NHW men in the total sample. Among young men ages 22 to 49 years, NHB men had a higher prevalence of being in the high AL group (PR = 2.09, CI = [1.25, 3.49]), relative to NHW men. Among older men ages 50 to 69 years, there were no racial differences in AL. Findings underscore the importance of identifying factors that are associated with high AL, which is critical to mitigate premature morbidity and mortality, among NHB men.

PMID:39953836 | DOI:10.1177/15579883251317095

J Man Manip Ther. 2025 Feb 15:1-8. doi: 10.1080/10669817.2025.2465729. Online ahead of print.

ABSTRACT

OBJECTIVES: Tactile sensitivity is one of the most important skills for developing competence in manual palpation. There is a lack of studies aimed at analyzing the development of tactile sensitivity during different levels of physiotherapy education. The present study aims to compare manual tactile sensitivity in two groups of physiotherapy students.

METHODS: Twenty first-year physiotherapy students (mean age 19.4 yrs ± 0.6) and twenty final-year physiotherapy students (mean age 23.7 yrs ± 3.7) participated in the study. For the tactile sensitivity test, 3 wooden tables were used, in which different geometric structures were engraved. Subjects were instructed to perform a tactile examination of the geometric structures and then reproduce them by drawing on a sheet of paper. The tactile time, drawing time, accuracy, and difficulty of the geometric structures were scored. A two-sample t-test was used for the between-groups comparison if more time in an educational program should result in differences in tactile time, drawing time, accuracy, and difficulty. Linear regression was used to compare the difficulty with the accuracy of all geometric structures. Wilcoxon test was used to test the intra-rater agreement.

RESULTS: The accuracy of the reproduction of geometric structures 1, 2 and 3 were 77.5%, 27.5% and 45%, for all physiotherapy students respectively. Final-year physiotherapy students spent more time exploring geometric structure 2 (p = 0.014) and geometric structure 3 (p = 0.0018) compared to first-year physiotherapy students. No statistically significant differences were found between groups in drawing time, accuracy, and difficulty of geometric structures. The examiner showed a high intra-rater agreement in the assessment (over 96%).

DISCUSSION/CONCLUSION: The study showed that the level of education and gained experience during laboratory teaching may be important in improving the palpation skills of physiotherapy students. Tactile sensitivity exercises should be included in physiotherapy education programs.

PMID:39953824 | DOI:10.1080/10669817.2025.2465729

J Viral Hepat. 2025 Mar;32(3):e70010. doi: 10.1111/jvh.70010.

ABSTRACT

Medication nonadherence among patients with chronic hepatitis B (CHB) can lead to severe liver disease progression, including liver cirrhosis and hepatocellular carcinoma (HCC). Yet the factors that influence adherence in high-risk groups, like Korean Americans, remain unclear. Thus, this study explored the psychosocial and clinical factors affecting medication adherence in CHB patients. A cohort of 365 Korean American patients with CHB from two clinics in Philadelphia and Los Angeles was studied. The 8-item Morisky Medication Adherence Scale (MMAS-8) gauged their adherence to antiviral medication. Using descriptive and multivariable logistic regression analyses, we identified factors associated with MMAS-8 scores. Of the participants, 78% were undergoing antiviral therapy, with over two-thirds (69%) reporting medium to high adherence levels. The multivariable logistic regression analysis revealed that age, knowledge of sequalae of CHB, perceived HBV stigma and possession of pharmacy plan were associated with medication adherence. Older participants had higher medication adherence than younger. High knowledge of sequalae of CHB and low perceived HBV stigma were associated with higher medication adherence. Having pharmacy plans was also associated with higher medication adherence to antiviral therapy. These findings highlight the critical role of person-related factors (e.g., knowledge and stigma) and healthcare factors in medication adherence. Future research should focus on developing targeted educational interventions focusing on personal factors to improve medication adherence among Korean American patients with CHB.

PMID:39953814 | DOI:10.1111/jvh.70010

Pharmacoepidemiol Drug Saf. 2025 Feb;34(2):e70109. doi: 10.1002/pds.70109.

ABSTRACT

PURPOSE: Many post-authorization safety studies focus on congenital malformations and rely on diagnosis codes found in US data sources. However, no authoritative standards exist for identifying and classifying malformations in these data. To address this, we translated an existing public health surveillance guide, the European Concerted Action on Congenital Anomalies and Twins (EUROCAT), into an ICD-10-CM code list for use in studies using US administrative healthcare data. The EUROCAT guide was selected for its decisive major or minor classification of each code. However, translation was required for use in US data sources since EUROCAT utilizes ICD-10-BPA which differs from ICD-10-CM (the coding system commonly encountered in US data sources).

METHODS: We mapped EUROCAT to ICD-10-CM. For each code, manual review was conducted by two or more researchers, and major/minor classification was based on code descriptions since some codes differed between coding systems.

RESULTS: A final code list was created, containing 916 ICD-10-CM codes for 744 major and 172 minor malformations. The code list contains ICD-10-CM codes, their corresponding descriptions, their major or minor classification and disease category according to EUROCAT, and variables indicating anomalies caused by genetic or infectious diseases unlikely attributable to a medication.

CONCLUSIONS: We adapted the EUROCAT Guide 1.5 into an ICD-10-CM code list for use in pregnancy studies using US data sources. This list includes new ICD-10-CM codes available in 2024. As new ICD-10-CM codes become available, or as the EUROCAT Guide is updated, further updates to this list will be needed.

PMID:39953813 | DOI:10.1002/pds.70109