Category: Statistics

Arch Dermatol Res. 2024 Aug 24;316(8):575. doi: 10.1007/s00403-024-03329-x.

NO ABSTRACT

PMID:39180539 | DOI:10.1007/s00403-024-03329-x

Int Orthop. 2024 Aug 24. doi: 10.1007/s00264-024-06275-5. Online ahead of print.

ABSTRACT

AIM OF THE STUDY: The purpose of this study is to conduct a comparative analysis of the microbiological profiles in periprosthetic joint infections (PJIs) after total knee arthroplasty (TKA) between diabetic and non-diabetic patients. The study aims to address what are the variations in microbial colonization and infection patterns between diabetic and non-diabetic patients undergoing total knee arthroplasty.

METHODS: A retrospective analysis of 2,569 culture-positive cases of PJIs post-TKA was conducted, comparing outcomes between diabetic (n = 321) and non-diabetic (n = 2,248) patients. Demographic, clinical, and microbiological data were collected and analyzed using descriptive statistics, chi-squared tests, logistic regression, and other statistical tests.

RESULTS: Diabetic patients exhibited distinct microbial colonization patterns, with a higher prevalence of pathogens such as Staphylococcus aureus (p = 0.033), Pseudomonas aeruginosa (p < 0.001), Streptococcus spp. (Streptococcus agalactiae and Streptococcus dysgalactiae; p = 0.010, 0.016 respectively), Candida spp. (p = 0.010), and Corynebacterium spp. (p = 0.024). Additionally, diabetic patients were at increased risk of polymicrobial infections. Comorbidities associated with diabetes, including chronic pulmonary disease, renal insufficiency, and peripheral artery disease, were significantly more prevalent in diabetic patients and further complicated PJI outcomes.

CONCLUSION: This study underscores the importance of tailored perioperative antimicrobial strategies and vigilant infection control measures in diabetic patients undergoing TKA. Understanding the differential microbial profiles and associated comorbidities can inform targeted interventions to mitigate the risk of PJIs and improve outcomes in this high-risk population. Further research is warranted to elucidate the underlying mechanisms and optimize management strategies for diabetic patients undergoing TKA.

PMID:39180538 | DOI:10.1007/s00264-024-06275-5

Rheumatol Int. 2024 Aug 24. doi: 10.1007/s00296-024-05672-8. Online ahead of print.

ABSTRACT

Chemerin and resistin are adipokines studied as potential markers for early diagnosis and disease severity in patients with knee osteoarthritis (KOA) Therefore, we aimed to investigate the associations serum and synovial levels of chemerin and resistin with inflammatory parameters and ultrasonographic scores (US) in KOA individuals. Serum was collected from 28 patients with KOA and synovial fluid was obtained from 16 of them. Another 31 age and sex matched cases with no joint disease were included as healthy controls. Concentrations of chemerin, resistin, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) were determined with ELISA. Erythrocyte sedimentation rate (ESR), C-reactive protein, serum uric acid (UA) were measured in the patients group. Participants with KOA underwent US assessment using the Outcome Measures in Rheumatology (OMERACT) scores. Patients with KOA had statistically significant higher level of serum resistin than healthy controls [11.05 (3.78-24.13) ng/mL and 7.23 (3.83-12.19) respectively, p < 0.001]. A strong correlation was found between serum chemerin and ESR (r = 0.434, p = 0.021), uric acid (r = 0.573, p = 0.001) as well as the US (r=-0.872, p < 0.001). Serum resistin demonstrated significant association with TNF-alpha (r = 0.398, p = 0.044). In conclusion, both chemerin and resistin might contribute to inflammatory changes associated with KOA. Further studies are needed to elucidate their potential role in the pathogenesis of the disease.

PMID:39180525 | DOI:10.1007/s00296-024-05672-8

Angle Orthod. 2024 Aug 21. doi: 10.2319/010124-1.1. Online ahead of print.

ABSTRACT

OBJECTIVES: To develop and evaluate an automated method for combining a digital photograph with a lateral cephalogram.

MATERIALS AND METHODS: A total of 985 digital photographs were collected and soft tissue landmarks were manually detected. Then 2500 lateral cephalograms were collected, and corresponding soft tissue landmarks were manually detected. Using the images and landmark identification information, two different artificial intelligence (AI) models-one for detecting soft tissue on photographs and the other for identifying soft tissue on cephalograms-were developed using different deep-learning algorithms. The digital photographs were rotated, scaled, and shifted to minimize the squared sum of distances between the soft tissue landmarks identified by the two different AI models. As a validation process, eight soft tissue landmarks were selected on digital photographs and lateral cephalometric radiographs from 100 additionally collected validation subjects. Paired t-tests were used to compare the accuracy of measures obtained between the automated and manual image integration methods.

RESULTS: The validation results showed statistically significant differences between the automated and manual methods on the upper lip and soft tissue B point. Otherwise, no statistically significant difference was found.

CONCLUSIONS: Automated photograph-cephalogram image integration using AI models seemed to be as reliable as manual superimposition procedures.

PMID:39180503 | DOI:10.2319/010124-1.1

J Natl Cancer Inst. 2024 Aug 24:djae203. doi: 10.1093/jnci/djae203. Online ahead of print.

ABSTRACT

BACKGROUND: Both inflammation and insufficient physical inactivity contribute to individual-level risk of disease recurrence and death in stage III colon cancer. The extent to which increased inflammatory risk can be offset by sufficient physical activity remains unknown.

METHODS: This cohort study was nested within the CALGB/SWOG 80702 (Alliance) randomized trial. Inflammatory burden was quantified by high-sensitivity C-reactive protein, interleukin-6, and soluble tumor necrosis factor-α receptor 2 after recovery from tumor resection. Physical activity was measured during and after postoperative chemotherapy. The primary endpoint was disease-free survival.

RESULTS: The 3-year disease-free survival rate was 88.4% among patients with low inflammation and sufficient physical activity (referent group for all comparisons), 84.9% with low inflammation and insufficient physical activity [absolute risk difference (RD): -3.5%, 95% Confidence Interval (CI): -11.3, 4.3; P = .38], 78.0% with intermediate inflammation and insufficient physical activity (RD: -10.4%, 95% CI: -17.4, -3.3; P = .007), and 79.7% with high inflammation and insufficient physical activity (RD: -8.7%, 95% CI: -15.7, -1.6; P = .022). In contrast, the 3-year disease-free survival rate was 87.3% among patients with intermediate inflammation and sufficient physical activity (RD: -1.1%, 95% CI: -7.5, 5.3; P = .74) and 84.4% with high inflammation and sufficient physical activity (RD: -4.0%, 95% CI: -12.3, 4.3; P = .34).

CONCLUSION: In this observational study of stage III colon cancer patients, physical activity was associated with improved disease-free survival despite high inflammation. Patients with intermediate or high inflammation who were physically active had disease-free survival rates that were not statistically significantly different from those with low inflammation.

PMID:39180477 | DOI:10.1093/jnci/djae203

Eur J Cardiothorac Surg. 2024 Aug 24:ezae318. doi: 10.1093/ejcts/ezae318. Online ahead of print.

ABSTRACT

Overlap weighting (OW), using weights defined as the probability of receiving the opposite treatment, is a relatively new, alternative propensity score (PS)-based weighting technique used to adjust for confounding when estimating causal treatment effects. It has preferable properties compared to inverse probability of treatment weighting (IPTW) such as exact covariate balance, safeguards against extreme weights, and emphasis on medical equipoise, where treatment decisions are most uncertain. In this article we introduce the OW methodology, compare it to IPTW, and provide some strategies for assessing weighting impact, through an applied example of hospital mortality. When the PS distributions have large separation, IPTW has been shown to produce biased and less efficient estimates of the treatment effect, making OW a preferred method in such cases.

PMID:39180471 | DOI:10.1093/ejcts/ezae318

J Surg Educ. 2024 Aug 22;81(10):1374-1382. doi: 10.1016/j.jsurg.2024.07.009. Online ahead of print.

ABSTRACT

OBJECTIVE: The transition of Step 1 to pass/fail has generated concerns over selecting promising candidates. Holistic reviews integrate other proficiencies, including extracurriculars such as sports. Grit – defined as perseverance and passion for long-term goals – has been positively associated with competitive activities and is predictive of academic success. The prevalence and impact of sports participation and its relationship to grit in the general surgery resident population has not been described and was investigated in this study.

DESIGN: Surveys measuring sports participation and grit were distributed after the 2021 ABSITE. Grit was assessed through the short grit scale. Inferential statistics were performed.

SETTING/PARTICIPANTS: General surgery residents in all US training programs who completed the 2021 ABSITE.

RESULTS: Of 5468 respondents (response rate 59.6%), 2,548 (46.7%) were female, 917 (17.4%) URiM, 2171 (39.8%) married, and 1,069 (19.6%) parents. About 4284 (83.8%) residents reported being involved in competitive sports. Grit was higher in residents with a competitive sports history (3.67 ± 0.58 versus 3.60 ± 0.61, p = 0.0022). Greater time commitment and being part of a team was positively correlated to grit (both p < 0.0001). Individuals that self-identified as underrepresented in medicine (URiM) had higher grit (3.71 ± 0.59 versus 3.65 ± 0.58 for non-URiM, p < 0.0001) as did female (p = 0.0016), married residents (p < 0.0001), and parents (p < 0.0001). Being an athlete was associated with significantly higher grit for nearly all demographic subgroups, including URiM (p = 0.0068), married (p = 0.0175), and parents (p = 0.0487).

CONCLUSIONS: Higher grit was found in athletes and marginalized groups including females, URiM, and residents that were married or parents. Our data suggests that recruiting applicants of diverse backgrounds and experiences will result in a grittier cohort; a group potentially equipped to weather the arduous surgical residency training path. Recruiting residents with characteristics associated with higher grit can potentially impact diversity of the surgical workforce.

PMID:39178487 | DOI:10.1016/j.jsurg.2024.07.009

J Neurosurg Pediatr. 2024 Aug 23:1-11. doi: 10.3171/2024.6.PEDS24198. Online ahead of print.

ABSTRACT

OBJECTIVE: The authors assessed the safety and accuracy of stereoelectroencephalography (SEEG) electrode implantation in pediatric patients who had previously undergone craniotomy compared to those without prior cranial surgery.

METHODS: The authors performed a retrospective analysis of patients under 25 years of age with medically refractory epilepsy at a single institution who underwent SEEG electrode placement between March 2016 and July 2023. Surgical history and demographic characteristics were collected from the electronic medical records. The coordinates of the anchor bolts and their respective SEEG electrode contacts were manually annotated using postoperative head CT scans. Bolt coordinates were used to calculate the initiated electrode trajectory set by the bolt by using the least-squares method to define a line along the bolt, projected along the length of the electrode. The shortest distance from each electrode contact to this line was calculated to obtain the error measurement. Statistical analysis was conducted using the Kolmogorov-Smirnov test to compare the distribution of errors between groups, the Student t-test was used for continuous variables, and the chi-square/Fisher’s exact test was used for categorical variables.

RESULTS: Fifty-eight patients underwent a total of 60 SEEG placements and met the inclusion criteria. Eighteen had a history of prior craniotomy and 40 without prior surgery, indicating entirely native cranial bone. Mean age, sex, and mean number of electrodes implanted per surgery were similar between groups. For the electrode contact furthest from the bolt, a mean (IQR) deviation of 1.32 (0.73-2.53) mm was noted for the prior craniotomy group and 1.08 (0.65-1.55) mm for the native bone group (p < 0.0001). A greater number of outliers for the contact furthest from the bolt, defined as > 6 mm from the initiated electrode trajectory, was seen in the prior craniotomy group (p < 0.0001). The complication rate was low and not statistically different between groups.

CONCLUSIONS: The authors’ analysis draws attention to the effect of the intracranial biomechanical environment along the path of the electrode after traversing past the anchor bolt and found that prior craniotomy was associated with a higher number of contacts with a significant deviation from the initiated trajectory. Despite these deviations, we did not find a difference in the overall low complication rate in both groups. Therefore, the authors conclude that SEEG electrode placement is a safe option in pediatric patients even after prior craniotomy.

PMID:39178469 | DOI:10.3171/2024.6.PEDS24198

Phys Rev Lett. 2024 Aug 9;133(6):060601. doi: 10.1103/PhysRevLett.133.060601.

ABSTRACT

Transport measurements are fundamental for understanding condensed matter phenomena, from superconductivity to the fractional quantum Hall effect. Analogously, they can be powerful tools for probing synthetic quantum matter in quantum simulators. Here we demonstrate the measurement of in situ particle current in a superconducting circuit lattice and apply it to study transport in both coherent and bath-coupled lattices. Our method utilizes controlled tunneling in a double-well potential to map current to on-site density, revealing site-resolved current and current statistics. We prepare a strongly interacting Bose-Hubbard lattice at different lattice fillings, and observe the change in current statistics as the many-body states transition from superfluid to Mott insulator. Furthermore, we explore nonequilibrium current dynamics by coupling the lattice to engineered driven-dissipative baths that serve as tunable particle source and drain. We observe steady-state current in discrete conduction channels and interaction-assisted transport. These results establish a versatile platform to investigate microscopic quantum transport in superconducting circuits.

PMID:39178460 | DOI:10.1103/PhysRevLett.133.060601