Category: Statistics

Eur Arch Otorhinolaryngol. 2024 Apr 4. doi: 10.1007/s00405-024-08570-8. Online ahead of print.

ABSTRACT

PURPOSE: While some factors have been well-shown to affect the decision-making in treating patients with vestibular schwannomas (VS), little is known on the role of deprivation. Our objective was to assess the effect of socioeconomic background on the management of patients with VS.

METHODS: This retrospective cohort study included 460 patients with sporadic VS from West of Scotland. The postcode-based, multifactorial Scottish Index of Multiple Deprivation (SIMD) was used to assess the socioeconomic background of each patient. We performed a multivariate analysis including tumour size, growth and patient age with management modality (observation, stereotactic radiotherapy, microsurgery) being the main outcome measure and outcome (need for additional treatment) an additional measure.

RESULTS: We found no significant difference in the demographics, tumour characteristics and primary treatment choice between patients with different SIMD scores. In addition, there was no statistically significant difference in the growth occurrence rates following first-line treatment (p = 0.964) and in the second-line treatment choice (p = 0.460).

CONCLUSIONS: Multiple deprivation does not affect decision making in patients with VS in the examined cohort. This is probably linked to the centralisation and uniformity of the service and might not necessarily be applicable to other health services without centralisation.

PMID:38573514 | DOI:10.1007/s00405-024-08570-8

Spine Deform. 2024 Apr 4. doi: 10.1007/s43390-024-00860-9. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescent idiopathic scoliosis (AIS) affects 1-3% of adolescents, and treatment approaches, including the density of constructs in surgical fusion, vary among orthopedic surgeons. Studies have sought to establish whether high-density or low-density constructs offer superior clinical and radiological outcomes, yet conclusive results are lacking. This meta-analysis aims to provide a definitive answer to the controversial and ambiguous question surrounding the efficacy of different pedicle screw densities in treating AIS.

METHODS: PubMed, Cochrane, and Google Scholar (page 1-20) were searched till December 2023. The studied outcomes were Major Cobb angle, major curve correction, lumbar curve, kyphosis (T5-T12), lumbar lordosis, coronal balance, LIV Tilt angle, TAV translation, LAV translation, apical trunk rotation, trunk shift, SRS-22, operative time, blood loss, complications and cost.

RESULTS: Twenty-four studies (total of 1985 patients, 1045 in LD group and 940 in HD group) were included in this meta-analysis. A statistically significant better improvement in ATR (p = 0.02) and LIV tilt angle (p = 0.02) was seen in the high-density group. On the other hand, longer operative time (p = 0.002), blood loss (p = 0.0004) and costs (p = 0.02) were seen in the high-density group. No difference was seen in the remaining radiographic and clinical outcomes between both surgeries.

CONCLUSION: Both low-density (LD) and high-density (HD) screw constructs show comparable and satisfactory radiographic and QOL for AIS patients. Furthermore, HD constructs had increased costs, operative time, and blood loss associated. However, a definitive conclusion cannot be made and more studies taking into account multiple additional variables are necessary to do so.

PMID:38573487 | DOI:10.1007/s43390-024-00860-9

Spine Deform. 2024 Apr 4. doi: 10.1007/s43390-024-00853-8. Online ahead of print.

ABSTRACT

PURPOSES: Autofusion (AF) during growing rod (GR) instrumentation for early-onset scoliosis (EOS) has been reported, but AF incidence, causation, and clinical implications remain unknown. This article aims to (1) quantify frequency and severity of AF, (2) determine risk factors for AF, and (3) assess the influence of AF on final curve correction and spinal lengthening.

METHODS: EOS patients were prospectively enrolled (2016-2021). Patients underwent evaluation, GR implantation, lengthenings, and posterior spinal fusion (PSF). Cobb angle and spinal length measurements were collected. AF was assessed and graded, with grades I-II being low-grade and III-V being high-grade. Exposure analysis quantified risk factors’ impact via odds ratios and Pearson regression correlates. Statistical significance was p ≤ 0.05 or ≥ 0.95.

RESULTS: 28 patients, with variable EOS diagnoses, were included. On average, GR were implanted at 8.54-year-old and lengthened over 4.66 years. 53.6% of patients received magnetically controlled GR (MCGR) and 46.4% traditional GR (TGR). The average construct bridged 13.4 levels. Over the lengthening period, for all indications, patients averaged 2.9 total open procedures. Curves corrected from 68.5º preoperatively to 35.3º after index GR to 35.6º after PSF. Spinal length increased from 30.0 cm preoperatively to 33.9 cm after index GR to 39.5 cm after PSF. AF grading was: 28.6% Grade I, 25.0% Grade II, 17.9% Grade III, 25.0% Grade IV, and 3.6% Grade V. Idiopathic EOS tended to have lower AF grades (p = 0.37). AF risk factors included GR age < 8 (10.4×, p = 0.01), any interval open procedures (6.3×, p = 0.05), and residual curve > 30º after index GR (13.7×, p = 0.02). Protective factors included preoperative spinal length of > 30.0 cm (0.11×, p = 0.01) and index MCGR (0.16×, p = 0.03). Maintenance of Cobb angles from index GR through PSF was relatively better in low-grade patients (p = 0.08). Spinal length gained was no different between low- and high-grade AF (p = 0.50).

CONCLUSIONS: This largest-to-date evaluation found AF is nearly ubiquitous in GR constructs, but with variable severity. Both risk factors and protective factors coincide with AF. Ultimately, even in high-grade AF, curve correction was maintained, and spinal lengthening was achieved.

LEVEL OF EVIDENCE: Level II-prospective cohort study.

PMID:38573486 | DOI:10.1007/s43390-024-00853-8

J Epidemiol Glob Health. 2024 Apr 4. doi: 10.1007/s44197-024-00218-4. Online ahead of print.

ABSTRACT

BACKGROUND: The burden of respiratory syncytial virus (RSV) in high-risk pediatric patients remains unclear. Therefore, this study aims to characterize pediatric RSV cases from January 2019 to December 2022 and assess the impact of the COVID-19 pandemic on RSV burden and RSV-related outcomes. In addition, examining factors influencing RSV-related hospitalization.

METHODS: This is a retrospective study that included pediatric patients (aged 14 and below) who presented at King Faisal Specialist Hospital and Research Centre (KFSHRC) in Riyadh, Saudi Arabia with RSV infection identified using real-time reverse-transcriptase polymerase chain reaction assays. Statistical analyses were performed using STATA.

RESULTS: A total of 885 RSV cases were reported; (56.05%) were males and (43.95%) were females with a median age of 24 months [interquartile range (IQR): 11-60]. 534 (60.34%) required hospitalization. As for RSV seasonality, there was a significant increase in RSV prevalence following the COVID-19 pandemic, escalating from 205 cases in 2019 to 425 cases in 2022. The increase in 2022 was evident in January and persisted from September to December, reaching its peak during the months of October (20.70% – 88 cases) and November (32.00% – 136 cases). About (27.12%) of RSV infected children were medically free patients. Symptomatic patients exhibited various clinical manifestations, with ventilation necessary in (13.11%) of cases. Further analysis revealed significant changes in RSV-related outcomes post-COVID-19, including a decrease in hospitalization rates, an increase in medically free patients, and a lower need for ventilation (p < 0.05). Notably, a significant proportion of RSV admissions occurred within the first 6 months of life, with (77.69%) in the age group of 0 to 5 months. In addition, previous RSV infection, prematurity, low birth weight, renal disease, congenital heart disease, endocrine/metabolic disease, neuro/neuromuscular diseases, and genetic disorders were positively associated with hospitalization (P < 0.05). Interestingly, asthma and bone marrow transplantation were negatively associated with hospitalization (P < 0.05). The mortality rate in this study is (2.37%) (21/885).

CONCLUSION: This study provides a comprehensive understanding of the demographic and clinical factors influencing RSV outcomes, highlighting the impact of the COVID-19 pandemic and shedding light on potential risk factors for RSV-related hospitalization. The highest prevalence of RSV during (September to January), aligning with global patterns and emphasizing the importance of timing in preventive strategies.

PMID:38573464 | DOI:10.1007/s44197-024-00218-4

Am J Cardiovasc Drugs. 2024 Apr 4. doi: 10.1007/s40256-024-00645-5. Online ahead of print.

NO ABSTRACT

PMID:38573459 | DOI:10.1007/s40256-024-00645-5

Interdiscip Sci. 2024 Apr 4. doi: 10.1007/s12539-024-00625-y. Online ahead of print.

ABSTRACT

Autism Spectrum Disorder (ASD) is defined as a neurodevelopmental condition distinguished by unconventional neural activities. Early intervention is key to managing the progress of ASD, and current research primarily focuses on the use of structural magnetic resonance imaging (sMRI) or resting-state functional magnetic resonance imaging (rs-fMRI) for diagnosis. Moreover, the use of autoencoders for disease classification has not been sufficiently explored. In this study, we introduce a new framework based on autoencoder, the Deep Canonical Correlation Fusion algorithm based on Denoising Autoencoder (DCCF-DAE), which proves to be effective in handling high-dimensional data. This framework involves efficient feature extraction from different types of data with an advanced autoencoder, followed by the fusion of these features through the DCCF model. Then we utilize the fused features for disease classification. DCCF integrates functional and structural data to help accurately diagnose ASD and identify critical Regions of Interest (ROIs) in disease mechanisms. We compare the proposed framework with other methods by the Autism Brain Imaging Data Exchange (ABIDE) database and the results demonstrate its outstanding performance in ASD diagnosis. The superiority of DCCF-DAE highlights its potential as a crucial tool for early ASD diagnosis and monitoring.

PMID:38573456 | DOI:10.1007/s12539-024-00625-y

Updates Surg. 2024 Apr 4. doi: 10.1007/s13304-024-01828-0. Online ahead of print.

ABSTRACT

Preoperative management of patients living with severe obesity can be challenging; in this context, the preoperative weight loss may help to obtain better outcomes and less morbidity for bariatric surgery. Therefore, we evaluated the effectiveness of GLP-1 analogue Liraglutide in preoperative weight loss. We performed a single-center, quasi-experimental prospective study. Eligible participants were adults in preoperative management for bariatric-metabolic surgery with body-mass index ≥ 48 kg/m². All patients were assigned liraglutide treatment, with an initial dose of 0.6 mg subcutaneous per day, the dose was increased each week until reaching 3.0 mg for 12 weeks. Weight loss and body composition were evaluated monthly using bioelectric impedance (BIA) (InBody 770 Scale®). We analyzed data using descriptive statistics, central tendency measures and dispersion for quantitative variables and absolute and relative frequencies for qualitative variables. A total of 37 individuals were included in this study, 28 (76%) were female and 9 (24%) were males, with an average age of 44 years. About the BMI, 19 patients (51%) had a BMI > 50 kg/m², 10 (27%) > 40 kg/m² and 8 (22%) > 60 kg/m²; with a total average BMI of 56.04 kg/m². The initial weight was 147.4 ± 14.9 kg which decreased to 139.3 ± 16.8 kg; after 3 months of liraglutide administration. A total of 35 patients had some degree of weight loss (94.6%), while 2 (5.40%) had no weight changes. The total weight loss was 5.50% at 3 months of liraglutide treatment. Liraglutide could be an effective adjuvant therapy for preoperative weight loss in patients living with severe obesity.

PMID:38573447 | DOI:10.1007/s13304-024-01828-0

Rapid Commun Mass Spectrom. 2024 Jun 15;38(11):e9738. doi: 10.1002/rcm.9738.

ABSTRACT

RATIONALE: Accurate identification of old rice samples from new ones benefits their market circulation and consumers. However, the current detection methods are still not satisfactory because of their insufficient accuracy or (and) time-consuming process.

METHODS: Chelating carboxylic acids (CCAs) were selectively extracted from rice, by stirring with chelating resin and a dilute Na₂CO₃ solution. The green analytical chemistry guidelines for sample preparation were investigated by using the green chemistry calculator AGREE prep. The extractant was determined by liquid chromatography-mass spectrometry (LC/MS), and statistical analysis of the analytical data was carried out to evaluate the significance of the difference by ChiPlot.

RESULTS: The limit of quantitation for the CCAs is in the range of 1 to 50 ng/mL, with a reasonable reproducibility. The CCAs in 23 rice samples were determined within a wide concentration range from 0.03 to 1174 μg/g. Intriguingly, the content of citric acid, malonic acid, α-ketoglutaric acid and cis-aconite acid in new rice was each found to be distinctively higher than that in old rice by several times. Even mixtures of old and new rice were found to show much difference in the concentration of citric acid and malic acid.

CONCLUSION: A green analytical method has been developed for the simultaneous determination of CCAs by LC/MS analysis, and the identification of old rice samples from new ones was easily carried out according to their CCA content for the first time. The results indicated that the described method has powerful potential for the accurate identification of old rice samples from new ones.

PMID:38572671 | DOI:10.1002/rcm.9738

Obes Rev. 2024 Apr 4:e13741. doi: 10.1111/obr.13741. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review aims to summarize the current body of evidence concerning the prevalence of obesity among clergy (i.e., the officially designated leaders of a religious group) in the United States.

METHOD: From November 2022 to February 2023, five databases, one data repository, and gray matter were searched for articles and data sources. The search was restricted to articles published or raw data collected from 2001 to 2021. Study quality was assessed with a template, and heterogeneity was assessed using the $I^2$ statistic. The protocol for this review was registered with PROSPERO (CRD42022376592).

RESULTS: Forty-seven studies of clergy obesity involving 35,064 individuals were eligible. The pooled prevalence estimate of obesity across studies was 34.8% (95% confidence interval [CI]: 32.5-37.2). Obesity prevalence was found to be increasing over time and to vary considerably between clergy from different religious traditions. Compared to national estimates, from 2005 onwards, obesity prevalence was higher than in the US adult population.

PMID:38572610 | DOI:10.1111/obr.13741

Obes Rev. 2024 Apr 4:e13743. doi: 10.1111/obr.13743. Online ahead of print.

ABSTRACT

Preoperative depression is prevalent among patients undergoing metabolic and bariatric surgery (MBS) and is a potentially modifiable risk factor. However, the impact of preoperative depression on MBS outcomes has not been systematically reviewed. A search of MEDLINE, Embase, Cochrane, and PsychINFO (inception to June 2023) was conducted for studies reporting associations between preoperative depression and any clinical or patient-reported outcomes after MBS. Eighteen studies (5 prospective and 13 retrospective) reporting on 5933 participants were included. Most participants underwent gastric bypass or sleeve gastrectomy. Meta-analyses were not conducted due to heterogeneity in reported outcomes; findings were instead synthesized using a narrative and tabular approach. Across 13 studies (n = 3390) the associations between preoperative depression and weight loss outcomes at 6-72 months were mixed overall. This may be related to differences in cohort characteristics, outcome definitions, and instruments used to measure depression. A small number of studies reported that preoperative depression was associated with lower quality of life, worse acute pain, and more perioperative complications after surgery. Most of the included studies were deemed to be at high risk of bias, resulting in low or very low certainty of evidence according to the Risk of Bias In Non-randomized Studies – of Exposure (ROBINS-E) tool. While the impact of preoperative depression on weight loss after MBS remains unclear, there is early evidence that depression has negative consequences on other patient-important outcomes. Adequately powered studies using more sophisticated statistical methods are needed to accurately estimate these associations.

PMID:38572605 | DOI:10.1111/obr.13743