Category: Statistics

J ISAKOS. 2024 Jul 21:S2059-7754(24)00131-7. doi: 10.1016/j.jisako.2024.07.003. Online ahead of print.

ABSTRACT

INTRODUCTION: Previous studies on rotator cuff tears have examined both clinical and radiographic parameters which may influence post-operative clinical outcomes. While rotator cuff tears are frequently classified by size or depth, there is currently no literature available examining the thickness of the remnant tendon, and its impact on post-operative outcomes. We hypothesize that decreased pre-operative transverse tendon thickness will result in poorer post-operative clinical outcomes.

METHODS: We prospectively recruited patients who underwent arthroscopic repair of small to medium full-thickness rotator cuff tears. These patients were followed up for a minimum of 2 years post-operatively. Basic biodata, as well as Visual Analog Scale (VAS) for pain, Constant-Murley Score (CMS), UCLA Shoulder Score (USS), and Oxford Shoulder Score (OSS) at 3 different time points (pre-operatively, 1 year post-operatively, and 2 year post-operatively) were collected. Transverse tendon thickness was measured by independent blinded radiologists on pre-operative ultrasonographic images. Wilcoxon signed-rank test was used to compare outcome scores and multivariable robust linear model was fitted to assess the effect of transverse tendon thickness on post-operative scores.

RESULTS: A total of 63 patients were enrolled in this study, predominantly female (65%) and had a median age of 72 years. Pre-operatively, the median transverse cuff thickness was 5.0 mm and median tear size was 1.4 cm. The median VAS at preoperative was 7, which reduced to 0 at 2 year post-operative, indicating statistically significant improvement in pain levels (p<0.001). Statistically significant improvement in shoulder function measured by CMS, UCLA score and OSS were also seen over time (p<0.001). Robust regression analysis revealed that transverse cuff thickness had no statistically significant effect on VAS (p=0.99), CMS (p=0.84), UCLA score (p=0.22), and OSS scores (p=0.73) at 2 year postoperatively.

DISCUSSION: Pre-operative transverse tendon thickness of small- to mid-sized supraspinatus tears do not influence clinical outcomes after arthroscopic repair. Differences in transverse tendon thickness may have an association with tendon healing but does not translate to an association with post-operative outcomes in terms of pain, function, and patient reported outcome measures. Level of evidenceIV.

PMID:39043294 | DOI:10.1016/j.jisako.2024.07.003

Chemosphere. 2024 Jul 21:142918. doi: 10.1016/j.chemosphere.2024.142918. Online ahead of print.

ABSTRACT

Coastal wetlands possess significant carbon storage capabilities. However, in coastal soil-plant systems augmented with biochar and microorganisms, the mechanisms of these amendments and carbon participation remain unclear. This study utilized pot experiments to explore how Enteromorpha prolifera biochar and Arbuscular mycorrhizal fungi (AMF) affect soil organic carbon (SOC), carbon-related microbes, photosynthetic and osmotic system of Suaeda salsa. The results showed biochar reduced exchangeable sodium percentage by 6.9% through adsorption and ion exchange, and increased SOC content by 34.4%. The abundance of carbon-related microorganisms (Bacteroidota and Chloroflexi) was increased and carbon metabolizing enzyme (cellulase and sucrase) activity in the soil was enhanced. AMF significantly improved plant growth compared with CK, as evidenced by the enhanced dry weight by 2.34 times. A partial least squares pathway model (PLS-PM) and correlation analysis suggested that the combined effect of biochar and AMF could be outlined as two pathways: soil and plant. Biochar increased SOC, improved the growth of soil carbon metabolizing microorganisms, and further promoted the activity of carbon-related enzymes. Additionally, AMF facilitated nutrient absorption by plants through root symbiosis, with biochar further enhancing this process by acting as a nutrient adsorber. These combined effects of biochar and AMF at soil and plant level enhanced the photosynthetic process of Suaeda salsa. The transport of photosynthetic products to the roots can increase the carbon storage in the soil. This study provides quantitative evidence supporting the increase of carbon storage in coastal wetland soil-plant systems through a combined application of biochar and AMF.

PMID:39043273 | DOI:10.1016/j.chemosphere.2024.142918

J Obstet Gynecol Neonatal Nurs. 2024 Jul 20:S0884-2175(24)00248-X. doi: 10.1016/j.jogn.2024.06.004. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify factors associated with the receipt, completion, and goals of palliative care birth plans during the prenatal period.

DESIGN: Retrospective observational study of medical record data.

SETTING: Midwestern U.S. quaternary pediatric hospital.

PARTICIPANTS: Maternal-fetal dyads who received maternal-fetal medicine and palliative care from July 2016 through June 2021 (N = 128).

METHODS: Using demographic and clinical predictors, we performed descriptive statistics, group comparisons (chi-square or Fisher exact test and Wilcoxon rank sum test or Student t test), and logistic regression for three outcomes: birth plan offered, birth plan completed, and goals of care (comfort-focused vs. other).

RESULTS: Of 128 dyads, 60% (n = 77) received birth plans, 30% (n = 23) completed them, and 31% (n = 40) expressed comfort-focused goals. Participants with comfort-focused goals compared to other goals were more likely to receive birth plans, odds ratio (OR) = 7.20, 95% confidence interval (CI) [1.73, 29.9], p = .01. Participants of non-Black minority races had lower odds of being offered birth plans when compared to White participants, OR = 0.11, 95% CI [0.02, 0.68], p = .02. Odds of being offered (OR = 11.54, 95% CI [2.12, 62.81], p = .005) and completing (OR = 4.37, 95% CI [1.71, 11.17], p < .001) the birth plan increased with each prenatal palliative care visit. Compared to those without, those with neurological (OR = 9.32, 95% CI [2.60, 33.38], p < .001) and genetic (OR = 4.21, 95% CI [1.04, 17.06], p = .04) diagnoses had increased odds of comfort-focused goals.

CONCLUSION: Quality improvement efforts should address variation in the frequency at which birth plans are offered. Increasing palliative care follow-up may improve completion of the birth plan.

PMID:39043263 | DOI:10.1016/j.jogn.2024.06.004

Can J Ophthalmol. 2024 Jul 20:S0008-4182(24)00172-8. doi: 10.1016/j.jcjo.2024.05.030. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) compared with conventional phacoemulsification cataract surgery (CPCS).

METHODS: Randomized controlled trials (RCTs) were systematically searched in PubMed, Embase, Cochrane Library, ClinicalTrials.gov, CNKI, and Wanfang. Main outcomes were visual acuity, capsulotomy parameters, effective lens position, and complications. Secondary outcomes included refractive outcomes, intraoperative parameters, and corneal parameters.

RESULTS: In total, 41 RCTs involving 9310 eyes were included. There was a statistically significant difference in favour of FLACS over CPCS for uncorrected distance visual acuity at 12 months (mean difference [MD] -0.03; 95% CI -0.05 to -0.01); corrected distance visual acuity at 1 week (MD -0.05; 95% CI -0.07 to -0.02) and 12 months (MD -0.02; 95% CI -0.04 to -0.00); area of capsulotomy at 1 month (MD 4.04 mm²; 95% CI 3.45-4.64) and 6 months (MD 5.02 mm²; 95% CI 3.28-6.77); and intraocular lens centroid-pupil centroid distance at 1 week (MD -0.06 mm; 95% CI -0.08 to -0.05), 1 month (MD -0.07 mm; 95% CI -0.09 to -0.06), and 6 months (MD -0.06 mm; 95% CI -0.07 to -0.04). With regard to surgical complications, FLACS was less than CPCS for the incidence of decentred IOL (odds ratio 0.06; 95% CI 0.01-0.24). However, FLACS did not increase the incidence of other intraoperative or postoperative complications except subconjunctival hemorrhage.

CONCLUSIONS: Both FLACS and CPCS are effective and safe. FLACS achieves better visual outcomes in the early postoperative period and long-term follow-up, accompanied by more accurate capsulotomy and more optimized effective lens position than CPCS. However, no difference of visual outcomes was found after middle-term follow-up.

PMID:39043258 | DOI:10.1016/j.jcjo.2024.05.030

Proc Biol Sci. 2024 Aug;291(2027):20240788. doi: 10.1098/rspb.2024.0788. Epub 2024 Jul 24.

ABSTRACT

Cyanobacteria can form complex interactions with heterotrophic microorganisms, but this relationship is susceptible to nutrient concentrations. Disentangling the cyanobacteria-bacteria interactions in relation to nutrient supply is essential to understanding their roles in geochemical cycles under global change. We hypothesize that enhanced nutrient supply in oligotrophic oceans can promote interactions among cyanobacteria and bacteria. Therefore, we investigated the planktonic bacteria and their interactions with cyanobacteria in relation to elevated nutrients caused by enhanced upwelling around a shallow and a deep seamount in the tropical western Pacific Ocean. We found obviously higher complexity of network occurred with significantly more cyanobacteria in the deep chlorophyll maximum layer of the shallow seamount when compared with that of the deep seamount. Cyanobacteria can shape bacterial interaction and community evenness in response to relatively high nutrient concentrations. The effects of the nutrients on cyanobacteria-related networks were further estimated based on the Tara Oceans data. Statistical analyses further showed a facilitative effect of nitrate concentrations on cyanobacteria-bacteria mutualistic interactions in the global oligotrophic ocean. By analysing the Tara Ocean macrogenomic data, we detected functional genes related to cyanobacteria-bacteria interactions in all samples, indicating the existence of a mutualistic relationship. Our results reveal cyanobacteria-bacteria interaction in response to nutrient elevation in oligotrophic ocean and highlight the potentially negative effects of global change on the bacterial community from the view of the bio-interaction.

PMID:39043236 | DOI:10.1098/rspb.2024.0788

Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241261076. doi: 10.1177/10760296241261076.

ABSTRACT

Pulmonary embolism (PE) is a heterogenous condition with variable clinical presentations. Thrombin generation potential (TGP) and biomarkers, and blood cellular indices can reflect the underlying pathophysiology and risk stratification of PE. This case-control study analyzed TGP in 209 PE patients from Loyola University, Pulmonary Embolism Response Team program compared to normal human plasma (NHP) controls. The present study evaluates TGP and biomarkers, and cellular indices in relation to PE severity, according to the European Society of Cardiology (ESC) guidelines. Statistical analysis including median with interquartile range (IQR), 2-tailed Wilcoxon Mann-Whitney test, Chi-square test, and Spearman Correlational analysis were performed. There were 209 patients with PE, with an almost equal distribution between sex, and a median age of 63 years. Significant downregulation in peak thrombin and endogenous thrombin potential (ETP), as well as upregulation in lag time, were observed in PE patients versus controls. Biomarker analysis revealed pronounced elevations, with D-dimer demonstrating the most significant increase. Blood cellular indices also rose in PE patients, correlating with disease severity. PE severity was associated with higher TGP and biomarker levels. Mortality rates differed significantly across risk categories and were highest in patients with elevated cellular indices. TGP and biomarkers are intricately linked to PE severity and can aid in risk stratification. Elevated cellular indices are associated with increased mortality, highlighting their potential as prognostic markers. These findings could enhance the precision of PE management strategies.

PMID:39043231 | DOI:10.1177/10760296241261076

Chronic Illn. 2024 Jul 23:17423953241264875. doi: 10.1177/17423953241264875. Online ahead of print.

ABSTRACT

OBJECTIVES: Chronic diseases contribute significantly to healthy years lost (HYLs). It is critical to investigate which are the most contributing diseases to enable enhancing health programs’ effectiveness in improving health expectancy. This paper investigates disease-specific contributions to years lived with chronic diseases in Algeria and examines their recent evolution.

METHODS: We used morbidity data from the last three waves of the Multiple Indicator Cluster Surveys of 2006, 2012-13, and 2018-19. The studied chronic diseases included hypertension, cardiovascular diseases (CVDs), joint diseases, respiratory diseases, and diabetes. We calculated disease-specific contributions using the cause-deleted health expectancy approach. Then, we analyzed time changes and gender-based differences in contributions.

RESULTS: The leading cause of HYLs in women is hypertension, followed by diabetes, joint diseases, CVDs, and respiratory diseases. The same ranking applies to men, with joint diseases coming last. The time evolution of relative disease-specific contributions shows an increase in CVDs for women and diabetes for both genders, against a decrease for the other diseases.

DISCUSSION: To improve chronic disease-free life expectancy in Algeria, effective prevention programs must be implemented, with an emphasis on hypertension and diabetes. Further investigation into the risk factors affecting the prevalence and incidence of these diseases is also required.

PMID:39043229 | DOI:10.1177/17423953241264875

J Diabetes Complications. 2024 Jul 16;38(9):108810. doi: 10.1016/j.jdiacomp.2024.108810. Online ahead of print.

ABSTRACT

AIM: To determine the association between atherogenic markers, such as total cholesterol/high density lipoprotein cholesterol ratio (TC/HDL-C), triglycerides/HDL-C ratio (TG/HDL-C), and triglycerides-glucose index (TyG), and the risk of 1-year amputation in adults with diabetic foot in a tertiary level hospital.

METHODS: Retrospective cohort study conducted in 162 adult patients with diabetic foot. The outcome was amputation, defined as “primary amputation in patients’ clinical history after their first hospitalization due to foot ulcer.”. The cutoff point was determined using Youden’s J statistic. The relative risk (RR) was presented as an association measure.

RESULTS: A TyG index of >9.4 [RR: 1.64 (1.10-2.45)] was associated with a high risk of amputation after 1-year in adults with diabetic foot. However, while a TC/HDL ratio of >4.69 [RR: 1.38 (0.94-2.03)] and a TG/HDL-C ratio > 3.57 [RR: 1.35 (0.89-2.06)] did not show associations with risk of amputation after 1-year.

CONCLUSIONS: Only a TyG index of >9.4 was associated with an increased risk of 1-year amputation in adults with diabetic foot. Future studies with larger samples and a longitudinal design may provide more robust evidence and a better understanding of clinical implications.

PMID:39042958 | DOI:10.1016/j.jdiacomp.2024.108810

J Oncol Pharm Pract. 2024 Jul 23:10781552241263832. doi: 10.1177/10781552241263832. Online ahead of print.

ABSTRACT

INTRODUCTION: Hypersensitivity reactions (HSR) are a known adverse effect of paclitaxel, occurring in approximately 10% of patients, typically during the first or second infusion of the medication. Corticosteroids, histamine-1 and histamine-2 receptor antagonists are given prior to paclitaxel infusions to reduce the incidence of HSR. There are limited data that suggest administration of cetirizine given prior to a platinum infusion as secondary prophylaxis may reduce HSR rates.

METHODS: The objective of this study was to assess the impact of a novel paclitaxel hypersensitivity prevention protocol including high-dose cetirizine administered 12 and 6 h prior to paclitaxel infusion on the rate of HSR compared to a historical control. The primary objective was the rate of HSR of any grade after the first cycle of paclitaxel. Secondary outcomes included grade of infusion reaction and incidence of severe HSR.

RESULTS: A total of 104 patients were included for analysis in the cetirizine group and 124 in the control group. Hypersensitivity reactions occurred in 37 (16.2%) patients in the overall population, and no statistical difference was observed between groups. (13.46% vs 18.55%; p = 0.23). Numerically more grade 3-4 HSRs occurred in the control group than the treatment group (30.77% vs 69.23; p = 0.51).

CONCLUSIONS: The addition of cetirizine to paclitaxel infusions resulted in numerically lower rates of HSR and a reduction in severity of grade 3-4 HSRs. Future studies with more robust compliance data and a larger patient population would be needed to appropriately assess the efficacy of our novel treatment regimen.

PMID:39042936 | DOI:10.1177/10781552241263832

J Oncol Pharm Pract. 2024 Jul 23:10781552241264553. doi: 10.1177/10781552241264553. Online ahead of print.

ABSTRACT

INTRODUCTION: Nigeria is a low-middle income country located in sub-Saharan Africa. Although cancer burden has continued to increase over time, there is a lack of pharmacists who specialize in oncology providing pharmaceutical care. The objectives of this study were to understand the perception of hematology/oncology pharmacy practice in Nigeria as well as the unmet education needs.

METHOD: This is a cross-sectional survey conducted in December 2023. Pharmacists who were active members of various pharmacy organizations in Nigeria were invited to complete the survey. The survey focused on the perceptions of training needs in oncology pharmacy, current challenges and opportunities, as well as resources and support needed. Descriptive statistics were utilized for the data analysis.

RESULTS: Of the 263 responders, the largest group fell between 25 and 34 years old (35%), over half received a Bachelor of Pharmacy as their highest degree (53%), and majority did not receive any oncology pharmacy training as part of their education (73%). Many respondents strongly agreed that pharmacists in Nigeria need specialized training to better serve cancer patients (79%). Cancer therapeutics and chemotherapy pharmacology were more prioritized compared to other training needs (mean (SD): 2.63(1.95) and 2.69(1.64), respectively). The main challenge that respondents faced was a lack of relevant skills and knowledge in oncology pharmacy (mean (SD): 2.23(1.53)). More than a fourth of the respondents were aware about the board certification process (28.8%), citing overcoming the cost barrier as the main obstacle for taking the board examination (mean (SD): 1.92 (1.38)). Respondents preferred online courses and onsite specialty training (75%) as the mode of training to address unmet needs.

CONCLUSION: Despite the challenges and unmet education needs in hematology/oncology clinical practice, Nigerian pharmacists are very willing to expand their knowledge and improve their skills in patient care. The findings of this study can inform policy makers, healthcare administrators, and pharmacy educators in developing global partnerships among pharmacy organizations which employ targeted strategies like sponsorships to address such unmet needs.

PMID:39042932 | DOI:10.1177/10781552241264553