Category: Statistics

Front Bioeng Biotechnol. 2025 May 27;13:1595935. doi: 10.3389/fbioe.2025.1595935. eCollection 2025.

ABSTRACT

PURPOSE: This study aimed to evaluate the effect of the degree of facet joint resection under the combined action of large-channel endoscopy and visualized trephines on lumbar biomechanics.

METHODS: The original CT data of a healthy male volunteer were selected. An L3-5 lumbar spine model, M0, was established via the three-dimensional finite element method. Different degrees of resection of the superior articular process of L4 were simulated via a visualized trephine during the operation, and six models were established (M1: tip resection; M2: resection of the ventral 1/3; M3: resection of the ventral 1/2; M4: resection of the ventral 2/3; M5: resection of the ventral 3/4; and M6: complete resection). Loads were applied to the model to simulate six motions of flexion, extension, left/right lateral bending, and left/right rotation. The stress distributions of the vertebral body, intervertebral disc and articular cartilage of the L3-4 segment and adjacent segments were observed.

RESULTS: Compared with M0, L4 vertebral stress was elevated in the M1 model, L4 vertebral stress was reduced in the M2 and M3 models, and L4 vertebral stress was significantly elevated in the M4, M5, and M6 models (P < 0.05). Compared with M0, the differences in the L3 vertebral body, L5 vertebral body, L3-4 disc, and L4-5disc stresses were not statistically significant (P > 0.05) in the M1, M2, and M3 models, whereas the stresses were significantly higher (P < 0.05) in the M4, M5, and M6 models. Compared with M0, the difference in L3-4 facet joints stress between the M1, M2 and M3 models was not statistically significant (P > 0.05), whereas the L3-4 facet joints stress between the M4, M5 and M6 models were significantly higher (P < 0.05), with a greater increase on the left facet joint.

CONCLUSION: When more than half of the superior articular process of L4 is resected under large-channel endoscopy, the stress on the vertebral body, intervertebral disc and articular cartilage of the L3-4 segment increases, which may cause iatrogenic instability but has no significant effect on the stress on the vertebral body or intervertebral disc of adjacent segments.

PMID:40497253 | PMC:PMC12149569 | DOI:10.3389/fbioe.2025.1595935

Front Bioeng Biotechnol. 2025 May 27;13:1597209. doi: 10.3389/fbioe.2025.1597209. eCollection 2025.

ABSTRACT

INTRODUCTION: The conventional (CDL) and sumo (SDL) deadlifts are two fundamental techniques used in competitive lifting and as effective exercises for strengthening the knee and hip muscles. This study aims to investigate their biomechanical differences through a comprehensive analysis of joint kinematics, joint kinetics, and muscle activation.

MATERIALS AND METHODS: Thirty experienced male lifters performed both CDL and SDL at 85% of their one repetition maximum (1-RM). Lower limb joint range of motion (ROM), internal joint moments, and muscle activation of key lower limb and spinal muscles were recorded and analyzed. Paired t-tests and Statistical parametric mapping (SPM) were used to compare parameters between lifting techniques (p < 0.025).

RESULTS: SDL showed greater ROM in the frontal and transverse planes, particularly at the hip and knee, whereas CDL involved greater hip flexion and ankle dorsiflexion. CDL generated higher hip extension moments, while SDL produced greater frontal and transverse plane joint moments at the hip and knee. Additionally, SDL induced a greater ankle inversion moment. In the transverse plane, ankle moments were higher in CDL during phase 1 and became greater in SDL in phase 2. Regarding EMG peak values, the biceps femoris exhibited greater activation in CDL across both phases. The tibialis anterior and the erector spinae thoracis demonstrated greater activation in CDL during phase 1 and phase 2, respectively. Conversely, the vastus lateralis exhibited higher peak activation in SDL, but only during phase 1.

CONCLUSION: CDL is more effective for targeting posterior chain, particularly the hip extensors, while SDL emphasizes anterior chain involvement and induces greater mediolateral stabilization demands. SDL may be particularly beneficial for knee reinforcement and increases frontal plane demands, supporting its relevance in rehabilitation contexts that require enhanced mediolateral stability. These findings highlight the importance of selecting the appropriate deadlift technique according to specific training or rehabilitation objectives.

PMID:40497251 | PMC:PMC12148905 | DOI:10.3389/fbioe.2025.1597209

JPRAS Open. 2025 Apr 15;45:42-54. doi: 10.1016/j.jpra.2025.04.006. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: Liposuction is a surgical method for fat aspiration, which reduces the amount of subcutaneous fat. Adipose tissue is important in regulating insulin sensitivity; however excess tissue accumulation, especially in the form of intra-abdominal fat, is associated with an increased risk of developing metabolic syndrome. Clinical findings associated with metabolic syndrome include central obesity, dyslipidemia, insulin resistance, hypertension, and atherosclerotic disease. Nevertheless, the long-term metabolic impact of liposuction is unclear. We aimed to analyze the effects of liposuction on the lipid profile, arterial blood pressure, and glucose metabolism in healthy women.

PATIENTS AND METHODS: Twelve patients who underwent liposuction were included in the study. The blood pressures, arterial blood pressure, and lipid profiles were measured before surgery and approximately 1 year after surgery. In addition, insulin sensitivities were measured using oral glucose tolerance test.

RESULTS: In the long term, liposuction led to a slight reduction of body fat (p<0.05), but it did not affect the blood pressure or insulin sensitivity. Although the levels of total and low-density lipoprotein cholesterol were reduced, these decreases were not statistically significant.

DISCUSSION: The results of the study are consistent with some of the published data, which indicated a slight decrease in blood lipids.

CONCLUSION: Small-volume liposuction does not appear to induce significant metabolic changes. A larger cohort and longer follow-ups are needed to evaluate the effects on the lipid profile, blood pressure, and glucose metabolism of the patients being studied.

PMID:40497245 | PMC:PMC12148641 | DOI:10.1016/j.jpra.2025.04.006

Ther Clin Risk Manag. 2025 Jun 5;21:841-850. doi: 10.2147/TCRM.S517790. eCollection 2025.

ABSTRACT

BACKGROUND: Enhanced Recovery After Surgery (ERAS) principles have gained widespread recognition for optimizing recovery across various surgical specialties. Effective management of postoperative pain plays a pivotal role in facilitating early rehabilitation and enhancing patient outcomes, particularly in ankle fracture surgery. This study investigated the effectiveness of rehabilitation therapies rooted in ERAS protocols in alleviating postoperative wound pain and improving recovery for patients undergoing ankle fracture surgery.

METHODS: A total of 376 patients who underwent ankle fracture surgery between December 2022 and December 2023 were included in this retrospective analysis. Of these, 190 patients received ERAS-guided rehabilitation, while 186 underwent standard rehabilitation care. The ERAS program encompassed tailored interventions such as multimodal pain control, prompt mobilization, and personalized physical therapy regimens. Pain intensity was evaluated using the Visual Analog Scale (VAS) at 24 hours, 48 hours, and 7 days postoperatively. Additional metrics, including the duration of hospital stay, complication rates, and patient satisfaction, were also assessed.

RESULTS: Patients in the ERAS group experienced significantly lower VAS scores than the standard care group at 24 hours (4.2 ± 1.1 vs 5.6 ± 1.4, P<0.001), 48 hours (3.1 ± 0.9 vs 4.4 ± 1.2, P<0.001), and 7 days post-surgery (2.0 ± 0.7 vs 3.1 ± 0.9, P<0.001). Furthermore, those receiving ERAS care had a shorter average hospital stay (5.1 ± 1.6 days vs 6.7 ± 2.1 days, P<0.001) and reported higher levels of satisfaction (92.1% vs 78.4%, P<0.001). However, there were no statistically significant differences in overall complication rates between the two groups (3.7% vs 4.3%, P=0.712).

CONCLUSION: Rehabilitation therapies incorporating ERAS principles demonstrate substantial benefits in reducing postoperative wound pain and expediting recovery in ankle fracture surgery patients. These findings underscore the value of integrating ERAS-driven protocols into clinical practice to enhance patient experiences and postoperative outcomes.

PMID:40497243 | PMC:PMC12149278 | DOI:10.2147/TCRM.S517790

Patient Prefer Adherence. 2025 Jun 6;19:1693-1701. doi: 10.2147/PPA.S524213. eCollection 2025.

ABSTRACT

BACKGROUND: Patient contentment is an indicator of the quality of pharmacy services. Pharmacists can recognize and resolve drug-related issues, provide patients with the information they need, raise patient contentment, and improve the standard of patient care. Utilizing E-prescription (Wasfaty) is one of the key services in the healthcare system that achieves the aspiration of the Kingdom’s Vision 2030 by improving efficiency, accuracy, and convenience for patients and healthcare professionals. The present study seeks to evaluate the effect of the Wasfaty app on patients’ contentment in the Tabuk region and the factors associated with it.

METHODS: A cross-sectional study was conducted from January to March 2024 in Tabuk among patients using the Wasfaty app. Data was collected using a convenience sampling technique and a self-administered questionnaire. The analysis of the data was conducted using SPSS software version 27.0. Descriptive statistics (mean, percentage, standard deviation, p-value) illustrate the respondents and their characteristics. Mantel-Haenszel test was used to estimate the odds ratio. Significance was reached when p < 0.05.

RESULTS: A total of 422 beneficiaries participated in the study. The majority of respondents were female (55.2%) and the majority were under 50 years. Only 23.5% of the included population visit the community pharmacy for chronic diseases. A majority of the participants (68.7%) viewed Wasfaty services positively. Availability of the Wasfaty service, medication availability, detailed instructions by pharmacists, efficiency of the Wasfaty app, and service speed and waiting time were positively associated with their overall positive experience.

CONCLUSION: The results of our study demonstrated overall high contentment with Wasfaty app and its effectiveness in improving patient medication management. The factors associated with the patient’s contentment helps in promoting the quality of care provided to the patients.

PMID:40497235 | PMC:PMC12151085 | DOI:10.2147/PPA.S524213

Patient Prefer Adherence. 2025 Jun 5;19:1661-1672. doi: 10.2147/PPA.S525522. eCollection 2025.

ABSTRACT

PURPOSE: Over-the-counter (OTC) medications are widely used for self-medication, yet their misuse can lead to adverse outcomes. This study aimed to assess the knowledge, awareness, and attitudes toward OTC drugs among Circassians and Chechens in Jordan.

METHODS: A cross-sectional study was conducted in September 2022 using an online survey targeting Circassians and Chechens aged 18 and above. The questionnaire was validated by clinical researchers and consisted of demographic data and questions on OTC drug use, awareness, and attitudes. Data from 418 participants were analyzed using descriptive and inferential statistics, with a significant level of p < 0.05.

RESULTS: The majority of participants were female (76.1%), married (78.5%), and almost half of the participants held a non-medical bachelor’s degree (49.3%). Analgesics (73.9%) and vitamins (56.7%) were the most used OTC drugs. Headache (65.6%), musculoskeletal pain (33.7%), and the common cold (25.4%) were the primary reasons for self-medication. Most participants (53.8%) expressed strong interest in knowing the side effects and contraindications of OTC drugs, while 72.5% checked expiry dates before use. Notably, 50.2% disagreed with the statement that OTC products have no side effects. Age and educational level were significantly associated with self-medication practices (p < 0.05).

CONCLUSION: Circassians and Chechens in Jordan exhibit high awareness of the risks associated with OTC drug use, yet self-medication practices remain prevalent. Public health interventions should focus on education campaigns to mitigate potential misuse and promote safe practices.

PMID:40497234 | PMC:PMC12149275 | DOI:10.2147/PPA.S525522

Cureus. 2025 May 11;17(5):e83907. doi: 10.7759/cureus.83907. eCollection 2025 May.

ABSTRACT

Objective Blood culture is the gold standard for diagnosing enteric fever (EF), but its unavailability in many health facilities often leads to the overuse of antimicrobials. This study aimed to determine whether EF can be predicted early using clinical features and basic laboratory parameters, thus bypassing the need for blood culture. Methodology This prospective cohort study, conducted from September 2015 to February 2017 in Delhi, included children (6 months to 15 years old) presenting with “fever without focus” within the first week of onset. Based on the investigation results, children were categorized into either Group I: blood culture positive for EF – Salmonella Typhi/Paratyphi; Group II: blood culture negative for EF but had another diagnosis; or Group III: cases in which the cause could not be established or were treated with empirical antibiotics, considered as the ambiguous group and excluded from the study. Results Out of the 350 cases, blood cultures confirmed EF in 73 children; 112 children had another diagnosis subsequently, and 165 cases could be placed in Group III. Blood culture is considered the gold standard. Logistic regression was applied to statistically significant clinical and laboratory parameters in children in Group I to identify independent predictors of EF. Duration of fever >4 days, rising trend of fever, coated tongue, splenomegaly, C-reactive protein (CRP) (>25 mg/L), serum glutamic pyruvic transaminase (SGPT) (>40 IU/L), and absolute eosinopenia were independent predictors of EF in this study. Conclusion In resource-limited settings, and short of blood culture, early prediction of EF is possible with clinical features and simple laboratory investigations.

PMID:40497217 | PMC:PMC12151450 | DOI:10.7759/cureus.83907

Cureus. 2025 May 10;17(5):e83868. doi: 10.7759/cureus.83868. eCollection 2025 May.

ABSTRACT

Objective The objective of this study is to compare titanium elastic nailing (TEN) to hip spica casting (HSC) in the treatment of paediatric femoral shaft fractures, focusing on hospital stay duration and time to initiation of weight bearing. Study design This was a quasi-experimental study conducted at the Department of Orthopaedic Surgery, Benazir Bhutto Hospital, Rawalpindi, over a six-month period. Duration and place of study The data for this study were collected at the Department of Orthopaedic Surgery, Benazir Bhutto Hospital, a major tertiary care and trauma referral centre, over a six-month period from 8 August 2018 to 8 February 2019. Patients and methods A total of 60 children aged 6-12 years with femoral shaft fractures were enrolled using consecutive sampling and divided into two groups based on the treatment provided by the consultant orthopaedic surgeon. Group A (n=30) received titanium elastic nailing, while Group B (n=30) underwent early hip spica casting after initial skin traction. Follow-ups were conducted at two, four, six, eight and 12 weeks to evaluate hospital stay, time to weight bearing and bone healing. Clinical assessment included the range of motion and pain evaluation to guide weight bearing. Data were analysed using SPSS version 22 (IBM Corp., Armonk, NY); means and standard deviations were calculated for quantitative variables, and independent t-tests were used for group comparisons. Stratification was done for age, gender and fracture side, with a p-value of <0.05 considered statistically significant. Results In Group A (TEN group), the mean duration of hospital stay was 3.93±0.78 days, compared to 3.03±1.03 days in Group B (HSC group) (p<0.05). The time to start weight bearing was 30.57±6.81 days in Group A and 59.5±14.03 days in Group B (p<0.05). In the TEN group, surgery was typically performed within 48-72 hours of injury, depending on patient stabilisation and operating room availability. In the HSC group, hip spica casting was applied within 72 hours of injury following initial skin traction. Weight-bearing decisions in both groups were based on a combination of clinical evaluation, including the absence of pain on movement and the restoration of joint mobility, and the radiological evidence of bone healing, defined as callus formation on at least three out of four cortices on anteroposterior (AP) and lateral radiographs. Conclusion This study observed that titanium elastic nailing was associated with the earlier initiation of weight bearing compared to hip spica casting in children aged 6-12 years with femoral shaft fractures. As hip spica casting is more commonly recommended for younger children under five years of age, our findings suggest that titanium elastic nailing may be a more suitable option in older paediatric patients, particularly in settings where surgical infrastructure is available. While TEN demonstrated potential advantages in terms of earlier functional recovery, it is important to interpret these findings within the context of the study’s focus on time to weight bearing and hospital stay.

PMID:40497210 | PMC:PMC12149466 | DOI:10.7759/cureus.83868

Cureus. 2025 May 11;17(5):e83898. doi: 10.7759/cureus.83898. eCollection 2025 May.

ABSTRACT

OBJECTIVE: The HEART pathway is a widely used clinical decision-making tool to risk-stratify patients presenting with chest pain in the emergency department (ED). A HEART score of 0-3 is generally accepted as “low risk,” often serving as a threshold for safe discharge. This study aimed to evaluate the performance of the HEART pathway in an urban academic ED and determine the associated rate of major adverse cardiac events (MACE) at a HEART score of 3. MACE were defined as all-cause mortality, cardiovascular death, myocardial infarction, heart failure hospitalization, or stroke within 90 days.

METHODS: We conducted a retrospective chart review of 1,284 ED visits for chest pain from September 1, 2017, to August 31, 2018, at Louisiana State University Health Shreveport (LSUHS), Shreveport, Louisiana. HEART scores, demographics, and 90-day MACE outcomes were collected and analyzed using non-parametric statistical methods.

RESULTS: Of 1,284 patients, 79 (6.2%) experienced MACE. Among patients with a HEART score of 3 or less, the MACE rate was 4.4% using Wilcoxon’s rank-sum test (p < 0.001). The HEART score showed a positive correlation with MACE using Spearman’s rank correlation coefficient (ρ = 0.223, p < 0.001). Age correlated moderately with the HEART score (ρ = 0.568), but not with MACE. Gender showed no significant correlation with either HEART score or MACE outcomes.

CONCLUSION: A HEART score of 3 was associated with a MACE rate higher than the traditionally accepted 2% threshold for low risk. Clinicians should approach disposition decisions for these patients with caution and consider shared decision-making and observation. Further research is needed to refine HEART score interpretation at this critical threshold.

PMID:40497209 | PMC:PMC12151265 | DOI:10.7759/cureus.83898

Cureus. 2025 May 11;17(5):e83901. doi: 10.7759/cureus.83901. eCollection 2025 May.

ABSTRACT

Introduction Virtual fracture clinics (VFCs) were established to improve the efficiency of orthopedic care by reducing unnecessary face-to-face consultations, decreasing waiting times, and providing timely specialist advice. This study aims to evaluate the utilization of the VFC at Addenbrooke’s Hospital, Cambridge University Hospital NHS Foundation Trust (Cambridge, GBR), over 12 months and assess its effectiveness in managing patients referred from emergency departments and minor injury units. Methods This retrospective study included all patients referred to the VFC between January 2023 and January 2024. Data were collected from hospital electronic records and analyzed using SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA). Patients were assessed by a consultant orthopaedic surgeon based on referral details and imaging findings. Clinical outcomes were documented as face-to-face consultation, discharge with patient-initiated follow-up (PIFU), or referral to subspecialty clinics. Results A total of 5,034 patients were reviewed by the VFC. The most common injuries involved the wrist, hand, foot, ankle, shoulder, and knee. Of the total patients, 62% were discharged with PIFU, while 30.4% required face-to-face consultation. Among patients initially discharged with PIFU, 16.9% were subsequently rebooked into subspecialty clinics for further evaluation. Statistical analysis demonstrated a significant association between injury type and VFC outcome, indicating a moderate effect size. Conclusions The VFC model effectively managed a substantial proportion of patients referred from emergency departments and minor injury units, providing safe and efficient care while reducing the burden on traditional fracture clinics.

PMID:40497207 | PMC:PMC12151311 | DOI:10.7759/cureus.83901