Category: Statistics

Arch Phys Med Rehabil. 2024 Jun 22:S0003-9993(24)01057-8. doi: 10.1016/j.apmr.2024.06.003. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the evidence regarding FES-cycling’s physiological and clinical effects.

DATA SOURCES: The study was conducted in accordance with PRISMA. PubMed, EMBASE, Cochrane Review, CINAHL, Scopus, Sport Discus, and Web of Science databases were used.

STUDY SELECTION: Randomized controlled trials involving FES-cycling were included. Studies that didn’t involve FES-cycling in the intervention group or without the control group were excluded. Two reviewers screened titles and abstracts and then conducted a blinded full-text evaluation. A third reviewer resolved discrepancies.

DATA EXTRACTION: Meta-analysis was performed using inverse variance for continuous data with effect measured by mean difference and random effects analysis model. A 95% confidence interval was adopted. The significance level was set at p<.05, and trends were declared at p=.05 to ≤ .10. The I² method was used for heterogeneity analysis. The minimal clinically important difference was calculated. Methodological quality was assessed by the risk-of-bias tool for randomized trials. The GRADE method was used for the quality of the evidence analysis.

RESULTS: A total of 52 studies were included. Metabolic, cardiocirculatory, ventilatory, and peripheral muscle oxygen extraction variables presented statistical (p<.05) and clinically important differences favoring FES-cycling, with moderate to high certainty of evidence. It also presented statistical (p<.05) and clinically important improvement in cardiorespiratory fitness, leg and total body lean mass, power, physical fitness in intensive care (moderate to high certainty of evidence), and torque (low certainty of evidence). It presented a trend (p=.05 to ≤.10) of improvement in muscle volume, spasticity, and mobility (low to moderate certainty of evidence). It showed no difference (p>.10) in six-minute walking distance, muscle cross-sectional area, bone density, and length of ICU stay (low to moderate certainty of evidence).

CONCLUSIONS: FES-cycling exercise is a more intense stimulus modality than other comparative therapeutic modalities and presented clinically important improvement in several clinical outcomes.

PMID:38914190 | DOI:10.1016/j.apmr.2024.06.003

Photodiagnosis Photodyn Ther. 2024 Jun 22:104257. doi: 10.1016/j.pdpdt.2024.104257. Online ahead of print.

ABSTRACT

PURPOSE: To investigate that the changes of lamina cribrosa (LC) thickness and depth after latanoprost therapy in primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients.

METHODS: In this single-center prospective cross-sectional study, 35 eyes from 35 patients with POAG or OHT (study group) and 26 age- and gender- matched healthy individuals (control group) were included. All participants were examined by spectral domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) mode for LC thickness and depth measurements at the first visit before latanoprost therapy and at visits after 1 (second visit) and 3 (third visit) months of latanoprost therapy.

RESULTS: The mean LC thickness in both horizontal and vertical scans of the study group were thinner than the control group (p < 0.001, for both). During latanoprost therapy in the study group, the LC thickness values in horizontal scans significantly differed over the three visits, gradually increased (p < 0.05). There was significantly decrease in LC depth in horizontal scans between the first and third visits, and the second and third visits (p = 0.003 and p = 0.008, respectively). The gradual decrease in LC depth in vertical scans was observed at all visits, but the statistically significant difference was between the first and third visits only (p = 0.048).

CONCLUSION: POAG/OHT patients showed more LC thinning compared with healthy individuals. The significant increase in LC thickness and the significant decrease in LC depth were detected after IOP reduction therapy with latanoprost in ocular hypertensive/ glaucomatous eyes.

PMID:38914184 | DOI:10.1016/j.pdpdt.2024.104257

J Dent. 2024 Jun 22:105153. doi: 10.1016/j.jdent.2024.105153. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effects of repeated cut-off and rescan procedures on the trueness of three intraoral scanners (IOS).

METHODS: A tooth model (#16) with a standard class II cavity was prepared, and the complete-arch was scanned using a laboratory scanner (D2000, 3Shape A/S) to obtain a reference scan. Then the typodont was scanned with three IOSs (3Shape TRIOS 3, CEREC Omnicam, and Medit i500) under two rescanning strategies (full-cut and partial-cut), with varying numbers of repeated cut-off and rescanning procedures (0, 1, 3, 5, 7, or 10). The trueness discrepancy between the reference and experimental digital scan was estimated using root mean square (RMS) calculations. Three regions of interest were selected to represent the rescanning, identification, and non-rescan area. And the discrepancies were analyzed using a linear mixed model (α=.05).

RESULTS: Cut-off and rescanning procedures significantly decreased the trueness of digital scans in all test conditions compared to the reference. However, no progressive increase in discrepancy was observed under any rescan conditions. Significant influences on trueness were found based on the IOS used, with the 3Shape system exhibiting lower RMS values. The partial-cut strategy showed lower RMS values compared to the full-cut strategy, albeit without statistical significance.

CONCLUSIONS: While repeated cut-off and rescanning procedures led to a decline in the quality of digital impressions, they did not result in discrepancy accumulation with repeated rescanning.

CLINICAL SIGNIFICANCE: To ensure high scanning accuracy in dental practice, it is advisable to minimize the rescanning area when correcting imperfections in digital scans. Additionally, selecting an appropriate scanner can help mitigate the negative effects of the rescanning technique.

PMID:38914183 | DOI:10.1016/j.jdent.2024.105153

Neurosci Biobehav Rev. 2024 Jun 22:105774. doi: 10.1016/j.neubiorev.2024.105774. Online ahead of print.

ABSTRACT

To provide an overview of treatments in the pipeline for adults with attention-deficit/hyperactivity disorder (ADHD), we searched https://clinicaltrials.gov/and and https://www.clinicaltrialsregister.eu/ from 01/01/2010-10/18/2023 for ongoing or completed phase 2 or 3 randomised controlled trials (RCTs), assessing pharmacological or non-pharmacological interventions for adults with ADHD with no current regulatory approval. We found 90 eligible RCTs. Of these, 24 (27%) reported results with statistical analysis for primary efficacy endpoints. While several pharmacological and non-pharmacological interventions had evidence of superiority compared to the control condition from a single RCT, centanafadine (norepinephrine, dopamine, and serotonin re-uptake inhibitor) was the only treatment with evidence of efficacy on ADHD core symptoms (small effect size=0.28-0.40) replicated in at least one additional RCT, alongside reasonable tolerability. Overall, the body of ongoing RCTs in adults with ADHD is insufficient, without any intervention on the horizon to match the efficacy of stimulant treatment or atomoxetine and with better tolerability profile. Additional effective and well tolerated treatments for adults with ADHD require development and testing.

PMID:38914177 | DOI:10.1016/j.neubiorev.2024.105774

Toxicol Appl Pharmacol. 2024 Jun 22:117014. doi: 10.1016/j.taap.2024.117014. Online ahead of print.

ABSTRACT

The OECD has approved two similar methods for testing the phototoxic potency of chemicals. The first method, OECD 432, is based on the cytotoxicity properties of materials to the mouse 3 T3 (clone A31) cell line (fibroblasts) after exposure to light. The second method, OECD 498, is based on the same properties but using reconstructed human epidermis – EpiDerm (stratified keratinocytes). The aim of this study was to compare these two methods using statistical tests (specificity, sensitivity, negative predictive value, positive predictive value and accuracy) and non-statistical characteristics (e.g. price and experimental duration, amount of material, level of complications, cell type, irradiation dose). Both tests were performed according to the relevant guidelines using the same 11 control substances. Higher performance values were observed for OECD 432 in both phototoxic and non-phototoxic classifications. The accuracy of OECD 432 was 90.9%, while that of OECD 498 was 72.7%. OECD 432 was also shorter and less expensive. On the other hand, OECD 498 was less complicated, and used human cells with stratum corneum, which better reflects real skin. This method can also be used with oily substances that are poorly soluble in water. However, both methods are important for testing the phototoxic properties of materials, and can be used alone or in a tiered strategy.

PMID:38914165 | DOI:10.1016/j.taap.2024.117014

J Arthroplasty. 2024 Jun 22:S0883-5403(24)00647-8. doi: 10.1016/j.arth.2024.06.048. Online ahead of print.

ABSTRACT

BACKGROUND: Unicompartmental knee arthroplasty (UKA) is an alternative to total knee arthroplasty for localized osteoarthritis. Recent advancements in UKA implant design and expanding patient criteria may have increased its utilization. However, few studies have examined the use of UKA in the United States. Thus, this study assessed the current and projected future trends of UKA and robotic UKA in the United States through 2035, along with postoperative outcomes.

METHODS: A collaborative healthcare research network was queried to identify patients who had undergone UKA. Primary outcomes measured included prevalence (P), incidence proportion (IP), and incidence rate (IR) from 2012 to 2022. Chi-square analyses were done to compare outcomes across categorical data. Regression modeling was performed to project UKA to the year 2035. Statistical significance was held at P < 0.05 for all analyses.

RESULTS: In 2022, 1,662 UKAs were performed within the network, a 590% increase from 2012 (241 performed). The incidence proportion increased on an average annual basis by 41.8%, the incidence rate by 50%, and the prevalence by 51.3%. A year following UKA, conversion to total knee arthroplasty was the most common orthopaedic complication (39.9%). As of 2022, there were 68 robotic UKAs performed, a 518% increase from the 11 performed in 2012. Regression analysis for UKA through 2035 showed that IP will be 0.04%, IR will be 1.75 x 10^-6 cases/person-day, and prevalence will be 0.3%.

CONCLUSION: These findings are consistent with prior studies indicating a higher utilization of UKA over the past decade. Reported complications were not uncommon, as nearly 40% of patients required a conversion to a total knee arthroplasty. Further research is needed to optimally identify criteria for appropriate patients and determine the benefits robotic UKA may provide, specifically reducing the risk of conversion to a TKA.

PMID:38914143 | DOI:10.1016/j.arth.2024.06.048

World Neurosurg. 2024 Jun 22:S1878-8750(24)01060-X. doi: 10.1016/j.wneu.2024.06.101. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: The aim of the current study was to compare the incidence of postoperative complications between MIS tubular, endoscopic and Robot-assisted TLIF techniques.

METHODS: Consecutive patients who underwent single or multi-level TLIF between 2020 and 2022. Pre-operative and post-operative patient reported outcomes (VAS Leg and ODI), demographic, and intra-operative variables were recorded. One way ANOVA with Bartlett’s equal-variance and Pearson chi-squared tests were used.

RESULTS: The current study included a total of 170 TLIF patients: 107 (63%) tubular, 42 (25%) endoscopic, and 21 (12%) robot-assisted. All three TLIF techniques had similar complication rates: tubular 6 (5.6%), endoscopic 2 (4.8%), and robot-assisted 1 (4.8%) all occurring within the first two weeks. Tubular TLIF reported the lowest incidence of new onset neurological symptoms, primarily radiculitis or numbness/tingling, at two weeks postoperatively (p<0.05) with 21 (20%) tubular, 17 (41%) endoscopic, and 9 (43%) robot-assisted patients. There were two revisions in the robot-assisted group, while tubular and endoscopic each had one within one year. There was no statistical difference in pre- or postoperative PROs between the TLIF groups.

CONCLUSIONS: The current study demonstrated that tubular, endoscopic, and robot-assisted TLIF procedures had similar complication rates. The tubular MIS TLIF reported less new neurological symptoms compared to endoscopic and robot-assisted TLIF procedures at two weeks postoperative, with all groups declining in symptom persistency at later time intervals. Average VAS scores continuously improved up to one year postoperatively amongst all groups.

PMID:38914133 | DOI:10.1016/j.wneu.2024.06.101

Int J Med Educ. 2024 Jun 21;15:66-79. doi: 10.5116/ijme.6667.2270.

ABSTRACT

OBJECTIVES: This study aims to assess the intercultural competence of general hospital workers in South Korea by examining their understanding of cultural diversity in healthcare and to identify factors influencing their intercultural competence.

METHODS: A cross-institutional survey was conducted with 439 participants from four South Korean general hospitals, employing inferential statistics such as one-way Analysis of Variance, Mann-Whitney U, and Kruskal-Wallis test followed by post-hoc, and multiple linear regression analyses.

RESULTS: While 85% (n = 362) of participants acknowledged the significance of multiculturalism in Korean society, only 11% (n = 49) felt competent in treating multicultural patients. Additionally, 72% (n = 315) experienced significant linguistic difficulties in medical communication. Multiple regression analysis identified advanced English competency, multicultural training experiences, and peer support with organizational awareness of multicultural importance as significant positive contributors to intercultural competence.

CONCLUSIONS: Despite recognizing the importance of multiculturalism, general hospital workers face significant language barriers and low self-efficacy in providing care to multicultural patients. To address these challenges, hospitals should designate resident translators for culturally appropriate communication. Furthermore, a tri-tiered training approach is proposed to enhance the five domains of intercultural competence among general hospital workers in Korea, including overarching multicultural training, occupation-specific courses, and long-term managerial programs aimed at managing cultural diversity effectively in healthcare settings.

PMID:38914074 | DOI:10.5116/ijme.6667.2270

Pain Med. 2024 Jun 24:pnae052. doi: 10.1093/pm/pnae052. Online ahead of print.

ABSTRACT

OBJECTIVE: The administration of local anaesthesia in intraperitoneal space as part of the multi-modal analgesic regimen has shown to be effective in reducing postoperative pain. Recent studies demonstrated that intraperitoneal lidocaine may provide analgesic effects. Primary objective was to determine the impact of intraperitoneal lidocaine on postoperative pain scores at rest.

DESIGN: We carried out a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

METHODS: Databases of MEDLINE, EMBASE, and CENTRAL were searched from their inception date until May 2023. Randomized clinical trials (RCT) comparing intraperitoneal lidocaine and placebo in adults undergoing surgery were included.

RESULTS: Our systematic review included 24 RCTs (n = 1,824). The intraperitoneal lidocaine group was significantly associated with lower postoperative pain scores at rest (MD: -0.87, 95% CI: -1.04 to -0.69) and at movement (MD: -0.50, 95% Cl: -0.93 to -0.08) among adult patients after surgery. Its administration also significantly decreased morphine consumption (MD: -6.42 mg, 95% Cl: -11.56 to -1.27), lowered the incidence of needing analgesia (OR: 0.22, 95% Cl: 0.14 to 0.35). Intraperitoneal lidocaine statistically reduced time to resume regular diet (MD: 0.16 days; 95% Cl: -0.31 to -0.01), and lowered postoperative incidence of nausea and vomiting (OR: 0.54, 95% Cl: 0.39 to 0.75).

CONCLUSIONS: In this review, our findings should be interpreted with caution. Future studies are warranted to determine the optimal dose of administering intraperitoneal lidocaine among adult patients undergoing surgery.

PMID:38913879 | DOI:10.1093/pm/pnae052

Network. 2024 Jun 24:1-57. doi: 10.1080/0954898X.2024.2367481. Online ahead of print.

ABSTRACT

The purpose of this paper is to test the performance of the recently proposed weighted superposition attraction-repulsion algorithms (WSA and WSAR) on unconstrained continuous optimization test problems and constrained optimization problems. WSAR is a successor of weighted superposition attraction algorithm (WSA). WSAR is established upon the superposition principle from physics and mimics attractive and repulsive movements of solution agents (vectors). Differently from the WSA, WSAR also considers repulsive movements with updated solution move equations. WSAR requires very few algorithm-specific parameters to be set and has good convergence and searching capability. Through extensive computational tests on many benchmark problems including CEC’2015 and CEC’2020 performance of the WSAR is compared against WSA and other metaheuristic algorithms. It is statistically shown that the WSAR algorithm is able to produce good and competitive results in comparison to its predecessor WSA and other metaheuristic algorithms.

PMID:38913877 | DOI:10.1080/0954898X.2024.2367481