Category: Statistics

J Surg Res. 2025 Jan 23;306:397-406. doi: 10.1016/j.jss.2024.12.037. Online ahead of print.

ABSTRACT

INTRODUCTION: Unplanned, delayed readmissions (>30 ds) following oncologic surgeries can increase mortality and care costs and affect hospital quality indices. However, there is a dearth of literature on rectal cancer surgery. Hence, we aimed to assess the risk factors associated with delayed readmissions following rectal cancer surgery to improve targeted interventions, patient outcomes, and quality indices.

METHODS: For this case-control study, all adult patients in the US Rectal Cancer Consortium database who underwent surgery and subsequent readmission were included. Multivariable logistic regression described the association of factors associated with delayed readmission. Descriptive statistics were used to ascertain the most common causes of readmission.

RESULTS: Of the 1417 patients included in the analysis, 403 (28.4%) patients were readmitted postoperatively. Among these, 101 (25.1%) patients had delayed readmission. The median length of stay for early readmission was significantly longer when compared to delayed readmission (4 versus 2 ds, P < 0.01). American Society of Anesthesiologists-Physical Status score > II [odds ratio = 1.81] was associated with an increased risk of delayed readmissions, while intraoperative pelvic drain placement [odds ratio = 0.57] was associated with a reduced risk. Surgical site infection was the most common cause of delayed (18.4%) and early readmissions (27.4%).

CONCLUSIONS: The risk of readmission following surgery for rectal cancer extends beyond the commonly tracked 30 ds, with up to a quarter of readmissions happening more than 30 ds after surgery. Surgical site infection continues to be the leading cause of both early and delayed readmission, underscoring the need to double down on infection prevention bundles.

PMID:39854802 | DOI:10.1016/j.jss.2024.12.037

Clin Radiol. 2024 Dec 19;82:106780. doi: 10.1016/j.crad.2024.106780. Online ahead of print.

ABSTRACT

AIM: To provide a theoretical basis for the study of the pathogenesis of residual dizziness (RD) from the perspective of imaging.

MATERIALS AND METHODS: The general clinical data of the RD group and healthy control (HC) group were statistically analysed by two independent sample t tests, rank sum tests or chi-square tests. The imaging data of the two groups of people were preprocessed and statistically analysed by using the data processing and analysis for brain imaging (DPABI) software package.

RESULTS: Compared with the HC group, the grey matter volume (GMV) in the left medial superior frontal gyrus, the left superior temporal gyrus, the right cerebellum crus1 area, and the right calcarine were significantly reduced in the RD group; the functional connectivity (FC) between the ventromedial prefrontal cortex (vmPFC) and the post insula in the RD group was enhanced; The FC between the vmPFC and the occipital lobe, between the temporal lobe and the inferior parietal lobe, between the mid insula and the mid insula, between the post cingulate gyrus and the post cingulate gyrus was weakened.

CONCLUSION: 1. The GMV of many brain areas processing vestibular information of RD patients is reduced, the FC between them is weakened, which may be an important cause of RD. 2. The FC between many brain areas dealing with emotional information in RD patients is abnormal, which may be the adaptive response of them caused by emotional factors.

PMID:39854796 | DOI:10.1016/j.crad.2024.106780

Australas Psychiatry. 2025 Jan 24:10398562251316365. doi: 10.1177/10398562251316365. Online ahead of print.

ABSTRACT

OBJECTIVE: The Australian Institute of Health and Welfare publishes statistical indicator reports on the specialised mental health workforce. These include data for 2022-2023 on psychiatrists, mental health nurses, mental health occupational therapists, psychologists and mental health social workers. We provide a brief commentary on these reports, reflecting upon the implications of such changes for psychiatric practice and patient care.

CONCLUSIONS: Overall, there are fewer mental health workers with increasing distance from urban centres. There are insufficient rural psychiatrists with the NT and Queensland having higher rates per 100,000 in outer regional and remote areas. Psychologists and mental health nurses have the highest rates per 100,000 in rural areas. Though low in absolute rates per 100,000, mental health social workers are better distributed in rural compared to urban areas. Further data on public, private and non-governmental sector employment would be useful.

PMID:39854768 | DOI:10.1177/10398562251316365

Medicine (Baltimore). 2025 Jan 24;104(4):e41331. doi: 10.1097/MD.0000000000041331.

ABSTRACT

Colorectal cancer (CRC) is one of the most common cancers worldwide and inflammation is believed to play an important role in CRC. In this study, we comprehensively analyzed the causal association between 91 circulating inflammatory cytokines and the risk of CRC using Mendelian randomization (MR). Based on genome-wide association study summary statistics, we examined the causal effects of 91 circulating inflammatory cytokines on CRC. A series of MR methods, including bidirectional MR, replication sample MR, and multivariable MR, were employed to provide more robust causal estimates. After the validation with 3 MR methods and a series of sensitivity analyses, 2 circulating inflammatory factors were found to be significantly associated with the risk of CRC at the genetic level. Specifically, genetically predicted circulating levels of glial cell line-derived neurotrophic factor (GDNF) (OR = 1.12; 95% CI: 1.05-1.19; P = 2.72 × 10-4) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) (OR = 0.93; 95% CI: 0.91-0.99; P = 1.00 × 10-2) exerted causal effects on CRC risk. In conclusion, this study suggests that increased circulating levels of GDNF and TRAIL are associated with a higher and lower risk of CRC, respectively. GDNF and TRAIL may be 2 potential therapeutic targets that deserve future investigation.

PMID:39854755 | DOI:10.1097/MD.0000000000041331

Medicine (Baltimore). 2025 Jan 24;104(4):e41383. doi: 10.1097/MD.0000000000041383.

ABSTRACT

Social media are Internet-based services that allow participation in online communities and exchanges. Considering the high and increasing statistics of the use of social media all over the world and its impact on people’s lives, the present study aimed to determine the relationship between social media and nutritional attitudes and body image shame among Iranian female students. This cross-sectional study was performed on 201 female student of Tehran University of Medical Sciences in Tehran, Iran from May to December 2023. Data collection was done using a paper form. Data collection tools included a questionnaire on demographic information, Jahanbani social media use questionnaire, nutrition attitude questionnaire (EAT-26), and Body Image Shame Questionnaire (BISS). SPSS software version 28 was used for the descriptive analysis of the data, to examine the relationships between the studied variables, and to measure and evaluate the accuracy of the AMOS model. Based on the reported results, the indicator of social media usage had a significant and positive direct effect on the attitude towards nutrition of students (P < .05). Additionally, social media usage had a significant and positive direct effect on the indicator of body image shame of students (P < .05). Furthermore, students’ attitude towards nutrition had a significant and positive effect on the indicator of body image shame of students (P < .001). The findings underscore the need for interventions that address the negative effects of social media on young women’s perceptions of their bodies and their relationship with food. By promoting media literacy, body positivity, and healthy nutritional attitudes, it is possible to mitigate the harmful effects of social media and support the well-being of young women.

PMID:39854752 | DOI:10.1097/MD.0000000000041383

Medicine (Baltimore). 2025 Jan 24;104(4):e41356. doi: 10.1097/MD.0000000000041356.

ABSTRACT

BACKGROUND: In patients with advanced hepatocellular carcinoma (HCC) following sorafenib failure, regorafenib has been used as an initial second-line drug. It is unclear the real efficacy and safety of sorafenib-regorafenib sequential therapy compared to placebo or other treatment (cabozantinib or nivolumab or placebo) in advanced HCC.

METHODS: Four electronic databases (PubMed, Embase, Web of Science, and Ovid) were systematically searched for eligible articles from their inception to July, 2024. Included articles were selected based on strict eligibility criteria. Review Manager 5.4 software were performed for statistical analysis.

RESULTS: Ten studies with 2349 HCC patients of whom 1370 received regorafenib treatment, and 979 underwent cabozantinb, nivolumab or placebo were selected for meta-analysis. The results of our systematic review and meta-analysis found regorafenib could significantly prolong overall survival (standardized mean difference [SMD] = 0.16, 95% CI = 0.02 to 0.29, P = .02) than other treatment (cabozantinib or nivolumab or placebo) in second-line treatment of HCC following sorafenib failure. No significant difference in progression-free survival (SMD = -0.03; 95% CI = -0.13 to 0.06; P = .53), overall response rate (risk ratio [RR] = 0.59; 95% CI = 0.24 to 1.47; P = .26), disease control rate (RR = 1.23; 95% CI = 0.7 to 2.16; P = .48) between 2 groups. Subgroup analysis demonstrated that nivolumab has better overall response rate results than regorafenib (RR = 0.38; 95% CI = 0.24 to 0.61; P < .0001).

CONCLUSIONS: Compared with other treatment (cabozantinib or nivolumab or placebo), regorafenib seemed to be more effective for patients with HCC who have not responded to initial sorafenib treatment.

PMID:39854748 | DOI:10.1097/MD.0000000000041356

Medicine (Baltimore). 2025 Jan 24;104(4):e41405. doi: 10.1097/MD.0000000000041405.

ABSTRACT

The correlation between cathepsins and pulmonary arterial hypertension (PAH) is well-established, but the causative link between them remains uncertain. This study aimed to explore the causal role of circulating metabolites mediating cathepsins in PAH using Mendelian randomization (MR). A 2-sample 2-step MR method was used to identify causal relationship between cathepsins and PAH; causal relationship between circulating metabolites and PAH; and mediated effects of these circulating metabolites. GWAS summary statistics on circulating metabolites were from the Canadian longitudinal study on aging cohort, human plasma cathepsins from The INTERVAL study, and PAH from FinnGen version R10. Two-sample MR analyses involving 9 cathepsins (cathepsin B, E, F, G, H, L2, O, S, and Z). Cathepsin S was associated with high risk of PAH (OR: 1.346, 95% CI: 1.039-1.742, P = .024), and positively with circulating metabolite 1-oleoylglycerol (18:1) levels (OR: 1.062, 95% CI: 1.018-1.108, P = .005). Finally, mediation analysis showed evidence of mediated effect of cathepsin S on PAH through 1-oleoylglycerol (18:1) levels (OR: 0.062, CI: 0.0183-0.106) with a mediated proportion of 20.9% of the total effect. This study reveals cathepsin S increases the risk of PAH mediating by circulating metabolite 1-oleoylglycerol (18:1) levels.

PMID:39854747 | DOI:10.1097/MD.0000000000041405

Medicine (Baltimore). 2025 Jan 24;104(4):e41347. doi: 10.1097/MD.0000000000041347.

ABSTRACT

BACKGROUND: This study evaluates the efficacy of a novel bismuth subgallate-borneol compound ointment as an adjuvant therapy in promoting postoperative healing of infectious incisions after anorectal surgery.

METHODS: From June 2023 to October 2023, 46 patients with perianal abscess and anal fistula treated at our institution’s Anorectal Surgery Department were enrolled in this prospective randomized controlled study. Patients were randomly allocated into 2 groups: the experimental group (n = 23) received conventional wound care plus a proprietary ointment containing 4.5% bismuth subgallate and 0.7% d-borneol in a Vaseline base, while the control group (n = 23 cases) received conventional wound care alone (comprising daily wound cleansing, dressing changes and traditional Chinese medicine injection). Image J Software was used for collecting the data of wound area, and the wound healing rate and granulation growth rate of the 2 groups were calculated to evaluate the therapeutic effect of the 2 groups.

RESULTS: The growth rate of cured granulation in the experimental group was higher than that in the control group at all 3 predetermined observation points, with statistically significant difference (P < .05). Furthermore, the wound healing rate of the experimental group showed significant improvement by day 14 (P < .05).

CONCLUSION: The bismuth subgallate-borneol compound ointment, when used as an adjuvant to standard wound care protocols, demonstrates significant efficacy in treating post-anorectal surgery infectious wounds. Its dual-active component formulation appears to effectively promote both granulation tissue formation and wound healing, potentially through its documented antibacterial properties.

PMID:39854746 | DOI:10.1097/MD.0000000000041347

Medicine (Baltimore). 2025 Jan 24;104(4):e41265. doi: 10.1097/MD.0000000000041265.

ABSTRACT

BACKGROUND: This study investigates the therapeutic efficacy of dynamic neuromuscular stabilization (DNS) technology paired with Kinesio Taping in patients with persistent nonspecific low back pain, as well as the effect on neuromuscular function and pain self-efficacy.

METHODS: A randomized controlled clinical study was conducted to collect clinical data on DNS combined with KT for the treatment of chronic nonspecific low back pain from November 2023 to April 2024. The inclusion criteria were patients with chronic nonspecific lower back pain, aged between 18 and 30 years old, and without serious underlying medical conditions, such as cardiac disease, hypertension, and diabetes. The control group received Kinesio Tape therapy, and the experimental group received a combination of Kinesio Tape therapy and DNS technology. The treatment lasted for 6 weeks, 3 times a week. Patients were examined before and after treatment using the Visual Analog Rating Scale, Oswestry Dysfunction Score, and Pain Self-Efficacy Questionnaire. Multifidus and transversus abdominis muscle strength was tested using surface electromyography signals, and the patient’s joint mobility, maximal isometric muscle strength, and muscular endurance were tested using the Davy Spine Rehabilitation System. Internal lumbar and abdominal pressures were assessed using stabilizer pressure biofeedback.

RESULTS: A total of 32 subjects (17 males and 15 females) were enrolled, of which 16 were in the experimental group and 16 in the control group. After the treatment, the patients in both groups showed significant improvements in the visual analogue scale, Oswestry disability index, Chinese version of Pain Self-Efficacy Questionnaire (PSEQ), joint mobility, maximum isometric strength, muscle endurance, abdominal pressure, transverse abdominal muscle and multifidus muscle scales compared with the pretreatment results. (Chinese version of Pain Self-Efficacy Questionnaire) scales were significantly improved compared with the pretreatment; joint mobility, maximal isometric muscle strength, muscular endurance, intra-abdominal pressure, transversus abdominis and multifidus AEMG (average electromyography) were more significantly improved, and the differences were statistically significant (P < .05). The experimental group showed more significant improvement than the control group (P < .05).

CONCLUSION: DNS technology paired with Kinesio Taping can considerably improve neuromuscular function and enhance pain self-efficacy in chronic nonspecific low back pain patients, reducing discomfort and improving dysfunction.

PMID:39854745 | DOI:10.1097/MD.0000000000041265

Medicine (Baltimore). 2025 Jan 24;104(4):e41353. doi: 10.1097/MD.0000000000041353.

ABSTRACT

This study assesses the effect of carotid sinus blockade applied with a local anesthetic on hemodynamic parameters during carotid endarterectomy (CEA) operations performed under general anesthesia. The medical records of patients who underwent CEA under general anesthesia between January 2020 and December 2022, were retrospectively reviewed. It was recorded whether the patients received carotid sinus block with 2 mL of 2% prilocaine. Intraoperative and 48-hour postoperative hemodynamic data were examined in the patients included in the study. A total of 129 patients were evaluated in the study, with 70 patients who received carotid sinus blockade (Group I) and 59 patients who did not receive blockade (Group II) during CEA. The comparison of heart rate variability immediately before clamping, immediately after clamping, and at 5, 10, and 20 minutes post-clamping indicated a significantly greater reduction in Group II compared to Group I (P < .05). In the postoperative period, the total dose of glyceryl trinitrate administered was 40.8 ± 31.9 mg in Group I and 53 ± 17.2 mg in Group II, showing a statistically significant difference (P = .001). Additionally, blood pressure measurements during this period were significantly higher in Group II than in Group I (P < .05). While the application of a local anesthetic during CEA appears to provide better intraoperative heart rate and postoperative blood pressure control, attributing these results solely to local anesthesia may not be entirely accurate. Hemodynamic instability observed during and after CEA is influenced by various factors.

PMID:39854738 | DOI:10.1097/MD.0000000000041353