Category: Statistics

J Clin Med. 2024 Feb 26;13(5):1324. doi: 10.3390/jcm13051324.

ABSTRACT

Background: Performing an appropriate Class II direct restoration is a great challenge. The correct selection of the matrix system and the elements used for its stabilization will have a great impact on the result. The aim of this study is to show a new digital method for a predictable selection of the wedge and compare it with the conventional method. Methods: Sixty patients were randomly divided into two groups. In Group 0, the wedge was selected intraoperatively by visual examination, while in Group 1 the wedge was selected preoperatively through the measurement of the cervical embrasure on the bite-wing radiography. The number of wedges used, modifications to them, and tissue damage were registered, along with the quality of the proximal contact and the marginal adaptation. Results: Student’s t-test revealed a statistical difference between the number of wedges used, which was higher in Group 0 (p < 0.05). Pearson Chi-square test showed that tissue damage was statistically higher in Group 0 (p < 0.05), while there was no statistically significant difference between groups in wedge modifications (p > 0.05). Group 1 revealed a higher frequency of satisfactory proximal contact and marginal adaptation (p < 0.05). Conclusions: This new technique reduces wedges waste and tissue damage and provides an adequate interproximal anatomy.

PMID:38592699 | DOI:10.3390/jcm13051324

J Clin Med. 2024 Feb 28;13(5):1394. doi: 10.3390/jcm13051394.

ABSTRACT

BACKGROUND: Accurate pre-surgical templating of the pelvic tilt (PT) angle is essential for hip and spine surgeries, yet the reliability of PT annotations is often compromised by human error, inherent subjectivity, and variations in radiographic quality. This study aims to identify challenges leading to inadequate annotations at a landmark dimension and evaluating their impact on PT.

METHODS: We retrospectively collected 115 consecutive sagittal radiographs for the measurement of PT based on two definitions: the anterior pelvic plane and a line connecting the femoral head’s centre to the sacral plate’s midpoint. Five annotators engaged in the measurement, followed by a secondary review to assess the adequacy of the annotations across all the annotators.

RESULTS: The outcomes indicated that over 60% images had at least one landmark considered inadequate by the majority of the reviewers, with poor image quality, outliers, and unrecognized anomalies being the primary causes. Such inadequacies led to discrepancies in the PT measurements, ranging from -2° to 2°.

CONCLUSION: This study highlights that landmarks annotated from clear anatomical references were more reliable than those estimated. It also underscores the prevalence of suboptimal annotations in PT measurements, which extends beyond the scope of traditional statistical analysis and could result in significant deviations in individual cases, potentially impacting clinical outcomes.

PMID:38592694 | DOI:10.3390/jcm13051394

J Clin Med. 2024 Feb 21;13(5):1218. doi: 10.3390/jcm13051218.

ABSTRACT

Objective: This study aimed to assess the potential of PARP inhibitors to prevent cardiotoxicity. Methods: First, a re-analysis and update of a previously published study was conducted. Additional searches were conducted of the PubMed and Cochrane Central Register of Controlled Trials databases on 2 June 2023. After the selection process, the pooled odds ratio (OR) for cardiac adverse events (AEs) was calculated. Second, the FAERS database was examined for 10 frequently co-administered anticancer agents. The reporting odds ratio (ROR) was calculated based on the occurrence of cardiac AEs depending on the co-administration of PARP inhibitors. Results: Seven studies were selected for the meta-analysis. Although not statistically significant, co-administration of PARP inhibitors with chemotherapy/bevacizumab decreased the risk of cardiac AEs (Peto OR = 0.61; p = 0.36), while co-administration with antiandrogens increased the risk of cardiac AEs (Peto OR = 1.83; p = 0.18). A total of 19 cases of cardiac AEs were reported with co-administration of PARP inhibitors in the FAERS database. Co-administration of PARP inhibitors with chemotherapy/bevacizumab significantly decreased the risk of cardiac AEs (ROR = 0.352; 95% confidence interval (CI), 0.194-0.637). On the other hand, for antiandrogens co-administered with PARP inhibitors, the ROR was 3.496 (95% CI, 1.539-7.942). The ROR for immune checkpoint inhibitors co-administered with PARP inhibitors was 0.606 (95% CI, 0.151-2.432), indicating a non-significant effect on cardiac AEs. Conclusion: This study reports that PARP inhibitors show cardioprotective effects when used with conventional anticancer agents.

PMID:38592677 | DOI:10.3390/jcm13051218

Phys Chem Chem Phys. 2024 Apr 9. doi: 10.1039/d4cp00728j. Online ahead of print.

ABSTRACT

In situ 3D computed tomography imaging with statistical analysis successfully revealed the water accumulation and drainage characteristics in the stacked gas diffusion layers (GDLs) and membrane electrode assembly (MEA) of a polymer electrolyte fuel cell. Efficient water drainage at the interface between the cathode GDL and MEA was confirmed upon supplying oxygen to the cathode.

PMID:38592673 | DOI:10.1039/d4cp00728j

Infection. 2024 Apr 9. doi: 10.1007/s15010-024-02242-9. Online ahead of print.

ABSTRACT

PURPOSE: Diarrhea is an important cause of morbidity and mortality in immunocompromised patients. After including sapovirus to the viral gastroenteritis screening of our institution’s laboratory, we noticed an increase in sapovirus infections among kidney transplant recipients. Therefore, we assumed former gastrointestinal tract infections with unidentified pathogens could have been caused by sapovirus. To better understand the characteristics of a sapovirus infection in a high-risk group we initiated this study.

METHODS: Over a period of 6 months, all transplant recipients with diarrhea and later identified viral/unknown pathogens were included. Kidney function, levels of immunosuppressants and c-reactive protein, acid-base balance, onset of symptoms and time of hospitalization were analyzed.

RESULTS: Among 13 hospitalized kidney transplant recipients sapovirus was detected in four patients, while in the remaining nine, three were diagnosed with norovirus, one with cytomegalovirus, one with inflammatory bowel disease and in four patients no pathogen was identified. Even though statistically not significant, creatinine levels at admission tended to be higher in sapovirus patients (median: sapovirus: 3.3 mg/dl (1.3; 5.0), non-sapovirus: 2.5 mg/dl (1.1; 4.9), p = 0.710). Also, Tacrolimus levels showed the same trend (sapovirus: 13.6 ng/ml (12.9; 13.6), non-sapovirus: 7.1 ng/ml (2.6; 22.6), p = 0.279). On discharge creatinine levels improved equally in both groups (sapovirus: 1.7 mg/dl (1.4; 3.2), non-sapovirus: 2 mg/dl (1.0; 3.6), p = 0.825).

CONCLUSION: In high-risk patients, early symptomatic treatment remains crucial to protect the transplant`s function. In our cohort all patients recovered well. Larger cohorts and longer follow-up times are needed to detect the long-term consequences and a potential need for further research regarding specific treatment.

TRIAL REGISTRATION: The study has been registered on DRKS (trialsearch.who.int), Reg. Nr. DRKS00033311 (December 28th 2023).

PMID:38592660 | DOI:10.1007/s15010-024-02242-9

Infection. 2024 Apr 9. doi: 10.1007/s15010-024-02243-8. Online ahead of print.

ABSTRACT

PURPOSE: Since an increase in the occurrence of native vertebral osteomyelitis (VO) is expected and reliable projections are missing, it is urgent to provide a reliable forecast model and make it a part of future health care considerations.

METHODS: Comprehensive nationwide data provided by the Federal Statistical Office of Germany were used to forecast total numbers and incidence rates (IR) of VO as a function of age and gender until 2040. Projections were done using autoregressive integrated moving average model on historical data from 2005 to 2019 in relation to official population projections from 2020 to 2040.

RESULTS: The IR of VO is expected to increase from 12.4 in 2019 to 21.5 per 100,000 inhabitants [95% CI 20.9-22.1] in 2040. The highest increase is predicted in patients over 75 years of age for both men and women leading to a steep increase in absolute numbers, which is fourfold higher compared to patients younger than 75 years. While the IR per age group will not increase any further after 2035, the subsequent increase is due to a higher number of individuals aged 75 years or older.

CONCLUSIONS: Our data suggest that increasing IR of VO will seriously challenge healthcare systems, particularly due to demographic change and increasing proportions of populations turning 75 years and older. With respect to globally fast aging populations, future health care policies need to address this burden by anticipating limitations in financial and human resources and developing high-level evidence-based guidelines for prevention and interdisciplinary treatment.

PMID:38592659 | DOI:10.1007/s15010-024-02243-8

Spine Deform. 2024 Apr 9. doi: 10.1007/s43390-024-00869-0. Online ahead of print.

ABSTRACT

PURPOSE: The spine, hip, and knee are anatomically and biomechanically connected. Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are commonly employed to treat degenerative changes in the hip and knee, while fusion is used for spine degeneration. Spine deformity correction results in changes in sagittal alignment and pelvic parameters, and patients with stiff spines have higher rates of THA dislocation and revision due to instability. The goal of this study was to determine the prevalence of total joint arthroplasty (TJA) in adult spinal deformity (ASD) patients at our institution.

METHODS: Following Institutional Review Board approval, we retrospectively reviewed a list of cases performed by the senior author from 4/2017 to 5/2021. Patients > 18 years old undergoing preoperative evaluation for symptomatic lumbar degeneration or ASD were included. Patients < 18 years old, those diagnosed with adolescent idiopathic scoliosis, and non-fusion cases were excluded. Perioperative full-length standing EOS images were examined for the presence or absence of THA, TKA, or both. Demographic data was collected from patient electronic medical records, and statistical analyses were completed.

RESULTS: 572 consecutive cases were reviewed, and 322 were excluded. 250 cases (97M:153F) were included in the final analysis, with a mean age of 61.8 ± 11.2 years. A total of 74 patients had a TJA (29.4%). THA was present in 41 patients (16.4%), and TKA was present in 49 patients (19.6%). Males had a higher prevalence of TJA, THA, and TKA (29.9%, 16.5%, and 21.6%) than females (29.4%, 16.3%, and 18.3%).

CONCLUSIONS: This study revealed a high prevalence TJA rate of 29.4% in ASD at our institution. This rate surpasses the prevalence rate reported among the general population in previous studies. High prevalence of patients with ASD and TJA may merit special surgical consideration.

PMID:38592647 | DOI:10.1007/s43390-024-00869-0

Ann Surg Oncol. 2024 Apr 9. doi: 10.1245/s10434-024-15268-y. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer is the most common cancer in adolescents and young adults. Social media, particularly TikTok, has emerged as a crucial platform for sharing health information in this population. This study aims to characterize breast cancer surgery information on TikTok, focusing on content reliability, viewer reception, and areas for improvement.

METHODS: We queried the search terms “breast cancer surgery,” “mastectomy,” and “lumpectomy” on TikTok, evaluating the top 50 videos for each. After watching each video, characteristics were recorded including: creator characteristics, video metrics, viewer reception, and video content. Statistical analysis was performed using Spearman’s rank correlations and t-tests.

RESULTS: A total of 138 videos were analyzed (excluding 12 duplicates from the initial 150). These videos received 4,895,373 likes and 109,705 comments. The most common content types were storytelling (57%) and education (20%), and the most common creator types were patients (77.3%) and physicians (10.3%). Videos with educational content by physicians were rare (6.5%). Engagement varied on the basis of video length, search terms, and creator characteristics. Overall, viewer comments predominantly expressed support and interest.

CONCLUSIONS: Our study reveals that information on breast cancer surgery is widely shared on TikTok and has high viewer engagement. Factors influencing impact include video length, creator background, and search terms. While social media has democratized information sharing, there is a relative lack of physician creators providing objective and educational content. We highlight opportunities for health professionals to engage in social media as a tool for health education and ensure diverse and reliable healthcare content on these platforms.

PMID:38592623 | DOI:10.1245/s10434-024-15268-y

Int J Bipolar Disord. 2024 Apr 9;12(1):11. doi: 10.1186/s40345-024-00332-z.

ABSTRACT

BACKGROUND: Rapid cycling bipolar disorder (RCBD), characterized by four or more episodes per year, is a complex subtype of bipolar disorder (BD) with poorly understood characteristics.

METHOD: This multicenter, observational, longitudinal cohort study enrolled 520 BD patients across seven psychiatric institutions in China from January 2013 to January 2014. Participants were divided into RCBD and non-RCBD (NRCBD) groups based on the frequency of mood episodes in the preceding year. Data collection utilized a standardized form, supplemented by a medical record review, focusing on sociodemographic, clinical, and treatment characteristics. Statistical analysis involved independent samples t-tests, Kruskal-Wallis H tests, Chi-square or Fisher’s exact tests, with Bonferroni correction applied to account for multiple comparisons, and multivariable logistic regression to identify characteristics associated with RCBD.

RESULTS: Among the BD cohort, 9.4% were identified as current RCBD. Compared to NRCBD, RCBD patients had a shorter duration from the first psychiatric consultation to the diagnosis of BD, a reduced duration of their longest period of euthymia, a lower proportion of lifetime hospitalization history due to BD, and less use of electroconvulsive therapy (ECT) within the last 12 months. Additionally, they presented higher baseline scores on the Mood Disorder Questionnaire (MDQ) and the Brief 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). However, after applying the Bonferroni correction, these differences were not statistically significant. Multivariable logistic regression analysis identified three factors that were independently associated with RCBD: time from first psychiatric consultation to BD diagnosis (Odds Ratio [OR] = 0.512, P = 0.0416), lifetime hospitalization history due to BD (OR = 0.516, P = 0.0476), and ECT treatment within the past 12 months (OR = 0.293, P = 0.0472).

CONCLUSION: This study revealed that the duration from first psychiatric consultation to BD diagnosis, lifetime hospitalization history due to BD, and ECT treatment in the past year were associated with RCBD. Recognizing these factors could contribute to enhance the early identification and clinical outcomes of RCBD. Trial Registration Number Registry ClinicalTrials.gov NCT01770704. Date of Registration: First posted on January 18, 2013.

PMID:38592605 | DOI:10.1186/s40345-024-00332-z

Curr Cardiol Rep. 2024 Apr 9. doi: 10.1007/s11886-024-02047-0. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Risk models for mortality after percutaneous coronary intervention (PCI) are underutilized in clinical practice though they may be useful during informed consent, risk mitigation planning, and risk adjustment of hospital and operator outcomes. This review analyzed contemporary risk models for in-hospital and 30-day mortality after PCI.

RECENT FINDINGS: We reviewed eight contemporary risk models. Age, sex, hemodynamic status, acute coronary syndrome type, heart failure, and kidney disease were consistently found to be independent risk factors for mortality. These models provided good discrimination (C-statistic 0.85-0.95) for both pre-catheterization and comprehensive risk models that included anatomic variables. There are several excellent models for PCI mortality risk prediction. Choice of the model will depend on the use case and population, though the CathPCI model should be the default for in-hospital mortality risk prediction in the United States. Future interventions should focus on the integration of risk prediction into clinical care.

PMID:38592570 | DOI:10.1007/s11886-024-02047-0