Category: Statistics

Hip Int. 2022 Dec 26:11207000221146116. doi: 10.1177/11207000221146116. Online ahead of print.

ABSTRACT

BACKGROUND: Total hip arthroplasty (THA) is an orthopaedic procedure that improves the quality of life in patients suffering from hip pain related to osteoarthritis, fractures, and avascular osteonecrosis of the femoral head. Different surgical approaches can be used for THA leading to different recovery times. Because of the lowering medium age of people undergoing THA, it is important to focus on the earlier return of physiological activity after surgery.

AIM: To evaluate the best approach for THA in terms of earlier return to activity.

METHOD: Studies comparing the postoperative outcomes in patients who underwent THA through different approaches were analysed focusing on patients’ self-reported outcomes, ADL score and UCLA activity score with a short follow-up.

RESULTS: A total of 1990 articles were identified in the search, and 14 met the inclusion criteria. The Review Manager software version 5.4 was used to conduct a meta-analysis to compare the direct anterior (DAA) and posterior (PA) approaches, which are the most adopted approaches. An earlier return to walk without aids and to independent ADLs were reported with DAA, but without statistical significance (respectively p = 0.06 and p = 0.10). The time to return to drive was similar among the 2 groups (p = 0.88). The return to work was faster with PA, but no statistical significance was reported (p = 0.47).

CONCLUSIONS: Further studies are needed with a larger number of patients, that present homogeneous outcomes, follow-ups and rehabilitation programmes, and that compare similar surgical approaches to assess the early return to activity of daily living after THA.

PMID:36571209 | DOI:10.1177/11207000221146116

J Obstet Gynaecol. 2022 Dec 26:2158315. doi: 10.1080/01443615.2022.2158315. Online ahead of print.

ABSTRACT

The aim of this study was to explore provider practices and attitudes towards routine follow-up counselling after prescription of contraceptives. An anonymous 16-item survey was pilot-tested and sent to providers of the Internal Medicine, Family Medicine, Pediatrics, and OBGYN departments of Thomas Jefferson University Hospitals (TJUH), an urban academic medical centre in Philadelphia, PA, USA. Frequency and descriptive statistics were used to analyse quantitative data while a framework analysis approach was applied to open-ended questions. Fifty percent of providers said they typically follow up with patients regarding a newly prescribed contraceptive. Only 15.3% said they do for an existing prescription. Eighty-three percent reported that it is important though only 30% believed follow-up guidelines were clear. Ultimately, there is a gap between providers’ interest in delivering follow-up care and established direction on how to do so.Impact StatementWhat is already known on the subject? Prescription contraceptive adherence is suboptimal. However, it is known that proactive follow-up has positive effects on prescription contraceptive adherence.What do the results of the study add? Most respondents believe that patients take their prescription contraception as prescribed. In light of this finding, providers are less likely to follow up with an existing prescription contraceptive. Interestingly, most respondents do believe that follow-up is important for patients using prescribed contraception but endorse that guidelines about follow-up are neither established nor clear.What are the implications of these findings for clinical practice and/or further research? Patient adherence to prescription contraceptives can be improved through optimised routine patient follow-up after initial prescription. This must be done in ways that minimise burdens to both patients and providers. Providers could benefit from clear guidelines regarding best practices. Future research is needed to understand how providers can best support patients on their contraceptive journey.

PMID:36571208 | DOI:10.1080/01443615.2022.2158315

Ann Palliat Med. 2022 Dec 12:apm-22-783. doi: 10.21037/apm-22-783. Online ahead of print.

ABSTRACT

BACKGROUND: Data is lacking as to the clinical presentation of erosive esophagitis (EE) in neurologically impaired children compared to non-neurologically impaired children (non-NIC). To determinate the clinical presentation, associations, management, and outcomes of EE in neurologically impaired children compared to children without neurologic impairment.

METHODS: Retrospective chart review of all esophagogastroduodenoscopies performed in pediatric patients at the University of Mississippi Medical Center from 1998 to 2020 with the diagnosis of EE. Fisher’s exact test was used to compare results from neurologically impaired children group and non-NIC. A probability <0.05 was considered statistically significant.

RESULTS: Forty-seven patients were diagnosed with EE and met study criteria. Twenty-six patients were neurologically impaired children, and 21 were non- neurologically impaired children. No significant difference was seen between age at diagnosis, sex, or hematologic markers of anemia. The most common indication for esophagogastroduodenoscopies in neurologically impaired children was hematemesis (65.4%), whereas abdominal pain (33.3%) was the most common in non-NIC. Neurologically impaired children were more likely to be treated with acid-blockade. Nine neurologically impaired children had gastrostomy tubes prior to diagnosis as opposed to 0 non-neurologically impaired children. After diagnosis, 8 neurologically impaired children underwent gastrostomy tube placement compared to 0 non-neurologically impaired children, and fundoplication was performed in 11 neurologically impaired children as compared to 1 non-NIC. The sensitivity of fecal occult blood test for detecting EE was higher for neurologically impaired children (91.7%) than for non-NIC (33.3%).

CONCLUSIONS: EE in neurologically impaired children presents differently than in non-neurologically impaired children with blood loss being the most common presentation in neurologically impaired children. Neurologically impaired children are more likely to be treated with acid-blockade prior to diagnosis, likely due to heightened risk for gastroesophageal reflux disease (GERD). Additionally, they are more likely to undergo surgical management of EE than non- neurologically impaired children.

PMID:36571169 | DOI:10.21037/apm-22-783

Ann Palliat Med. 2022 Dec 12:apm-22-826. doi: 10.21037/apm-22-826. Online ahead of print.

ABSTRACT

BACKGROUND: The occurrence of portal vein system thrombosis (PVST) after splenectomy in patients with Wilson disease (WD) can lead to serious complications. The early identification of high-risk patients can help improve patient prognosis. This study aimed to establish and validate a personalized nomogram for assessing the risk of PVST after splenectomy in patients with WD and hypersplenism.

METHODS: We retrospectively collected the data from 81 patients with WD and hypersplenism who underwent splenectomy. Based on whether PVST occurred within a month after the operation, they were divided into the PVST group and the non-PVST group. The clinical data of the 2 groups were compared, and univariate analysis was used to select the statistically significant features and incorporated into the least absolute shrinkage and selection operator (LASSO) regression model for optimization. Multivariate logistic regression analysis was used to determine the independent risk factors for PVST after splenectomy, which were then applied to establish a personalized nomogram. We calculated the concordance (C)-index and drew the receiver operating characteristic (ROC) curve, the model calibration curve, and the clinical decision analysis (DCA) curve to evaluate the accuracy, calibration, and clinical applicability of the model, respectively. We used bootstrapping for internal validation of the model.

RESULTS: Univariate analysis showed that the differences in preoperative portal vein diameter and velocity of portal blood flow, postoperative mean platelet volume (MPV), mean platelet distribution width (PDW), D-dimer, prothrombin time (PT), and the increase of platelet count (PLT) were of statistical significance (P<0.05). According to the results of the LASSO and multivariate logistic regression analyses, a model including preoperative portal vein diameter, preoperative portal blood flow velocity, postoperative D-dimer, and the increase of PLT was established to predict the risk of PVST after splenectomy. The model showed good accuracy with a C-index of 0.838 (95% CI: 0.750-0.926) and had a well-fitted calibration curve. Furthermore, internal validation showed it achieved a moderate C-index of 0.805. The DCA curve indicated that the model has clinical applicability when patients are treated at thresholds of 2-100%.

CONCLUSIONS: Establishing a predictive model for the risk of PVST in patients with WD and hypersplenism after splenectomy can help clinicians identify patients at high risk of PVST who require intervention measures.

PMID:36571168 | DOI:10.21037/apm-22-826

Drug Chem Toxicol. 2022 Dec 26:1-11. doi: 10.1080/01480545.2022.2160456. Online ahead of print.

ABSTRACT

This study aimed to estimate and compare dietary exposure to bisphenol A (BPA) in exclusively breastfed (EBF) and breastfed plus formula-fed (BF + FF) infants. A total of 70 mothers and their 0-6 month-old infants (40 in the EBF group and 30 in BF + FF group) were included in the study. After the questionnaire form was applied to the mothers, maternal breast milk, infant formula, and infant urine were collected from mother-infant dyads. Total BPA levels in breast milk, infant formula, and infant urine samples were analyzed by the high-pressure liquid chromatography (HPLC). While BPA was detected in 92.5% of the breast milk samples in the EBF group (mean ± SD = 0.59 ± 0.29 ng/mL), BPA was detected in all of the breast milk samples in the BF + FF group (mean ± SD= 0.72 ± 0.37 ng/mL) (p < 0.05). Similarly, 100% of the infant formula samples in the BF + FF group had detectable levels of BPA (mean ± SD = 7.54 ± 1.77 ng/g formula). The mean urinary BPA levels in the EBF infants (4.33 ± 1.89 µg/g creatinine) were not statistically different from the BF + FF infants (5.81 ± 0.11 µg/g creatinine) (p > 0.05). The average daily BPA intake in EBF infants (0.18 ± 0.13 µg/kg body weight (bw)/day) was found to be significantly higher than in BF + FF infants (0.12 ± 0.09 µg/kg bw/day) (p < 0.05). The estimated dietary intakes of BPA for infants in both groups were below the temporary tolerable daily intake (t-TDI) (4 µg/kg bw/day). Consequently, BPA intake of EBF and BF + FF infants were within safe daily limits during the first six months of life.

PMID:36571147 | DOI:10.1080/01480545.2022.2160456

Philos Trans R Soc Lond B Biol Sci. 2023 Feb 13;378(1870):20210358. doi: 10.1098/rstb.2021.0358. Epub 2022 Dec 26.

ABSTRACT

Actions in the world elicit data for learning and do so in a stream of interconnected events. Here, we provide evidence on how toddlers with their parent sample information by acting on toys during exploratory play. We observed 10 min of free-flowing and unconstrained object exploration of by toddlers (mean age 21 months) and parents in a room with many available objects (n = 32). Borrowing concepts and measures from the study of narratives, we found that the toy selections are not a string of unrelated events but exhibit a suite of what we call coherence statistics: Zipfian distributions, burstiness and a network structure. We discuss the transient memory processes that underlie the moment-to-moment toy selections that create this coherence and the role of these statistics in the development of abstract and generalizable systems of knowledge. This article is part of the theme issue ‘Concepts in interaction: social engagement and inner experiences’.

PMID:36571129 | DOI:10.1098/rstb.2021.0358

Indian J Otolaryngol Head Neck Surg. 2022 Dec 17:1-7. doi: 10.1007/s12070-022-03363-z. Online ahead of print.

ABSTRACT

To study the nasal framework of patients in relation to CT scan and observe the Nasofrontal angle and Nasofacial angle in patients. This study is a prospective observational study. It was done from January 2020 to December 2020. It involved selection of patients with nasal complaints and external nasal deformity followed by their CT scan evaluation. It included a 3D analysis of the CT scan using a computer software. Preoperative photographic evaluation of the patient was done in frontal, lateral and basal view for a better understanding and correlation. Thirty patients were evaluated and their 3D reconstructed CT scans were observed. The mean Nasofrontal angle was 116.69°. The mean was 110.43° in males and 126.08° in females. The mean Nasofacial Angle was 37.68. The mean was 43.05° in males and 29.62° in females. There was a significant statistical difference seen. The demand for rhinoplasty in India is on rise. The studies done in the past have evaluated patients using plain 2D CT films. In this study, 3D reconstruction of CT scan has been done. There are meagre studies which describe the aesthetics of Indian population. It aids in preoperative evaluation and plan of surgery, enables a good doctor-patient communication. Also, it can be used for clinical learning of resident doctors.

PMID:36571094 | PMC:PMC9758669 | DOI:10.1007/s12070-022-03363-z

Indian J Otolaryngol Head Neck Surg. 2022 Dec 19:1-7. doi: 10.1007/s12070-022-03340-6. Online ahead of print.

ABSTRACT

The main aim of the study was to assess various ENT symptoms in COVID 19 patients, also to investigate the severity of ENT symptoms among COVID 19 patients and find their relation on basis of scores among five discrete domains of SNOT 22 (Sino nasal Outcome Test). A prospective observational study was conducted among 135 patients between 18 to 75 years of age, in the month of September 2020 with COVID-19 infection having mild, moderate disease who were admitted to our hospital. Subjects were divided into groups according to their presenting ENT symptoms based on age, gender and other comorbidities and differences between the groups were examined. The sinonasal symptoms were assessed using the SNOT 22 questionnaire. A strong statistical significance with loss of smell and taste sensation was noted in patients above the age of 40 years. It was also noted that the patients who presented with cough above the age of 40 years were significantly more. Evaluation of sinonasal symptoms using SNOT 22 questionnaire showed that Extranasal rhinologic symptoms, Psychological dysfunction, Sleep dysfunction had significantly higher association among patients who were more than 40 years. We observed that, Extranasal rhinologic symptoms were significantly higher among males than females. There is thus an emergent need to develop a uniform tool to assess the various ENT symptoms. In our study we assessed the patients with COVID 19 using a standard questionnaire to observe the symptomatology, psychological and sleep dysfunctions due to sinonasal issues, and to closely understand the relationship of various symptoms in a meticulous manner.

PMID:36571091 | PMC:PMC9760531 | DOI:10.1007/s12070-022-03340-6

Educ Inf Technol (Dordr). 2022 Dec 20:1-21. doi: 10.1007/s10639-022-11528-0. Online ahead of print.

ABSTRACT

This research was conducted to determine the perceptions of school administrators and teachers about Covid-19 and distance education. The research is a descriptive study conducted to reflect the specific characteristics of the participants. In this context, the research model is the scanning model. In the population of the study, 31 school administrators and 156 teachers voluntarily participated in a province of Turkey in the 2020-2021 academic year. An easily accessible situation sampling technique was used in determining the participants. Within the scope of the research, a distance education satisfaction questionnaire was developed based on the experiences of the researcher himself, and an information form containing the personal information of the participants was used to collect data. The data within the scope of the research were collected by sending the data collection tool prepared online to school administrators and teachers. The data collection tool was delivered to participants via WhatsApp groups via google forms. While analyzing the data obtained within the scope of the study, descriptive statistical analyzes were made in all questions and basic statistical values ​​such as frequency, percentage, standard deviation, mode, median was reported. At the end of the study, it was determined that half of the participants did not consider the distance education conducted in their schools during the epidemic period to be sufficient. Administrators and teachers; 49.7% of them stated that they could partially benefit from distance education while conducting the lessons, 40.1% stated that it is not appropriate to conduct the lessons with distance education, and 10.2% stated that all the lessons could be conducted by distance education.

PMID:36571085 | PMC:PMC9765351 | DOI:10.1007/s10639-022-11528-0

Allergy Rhinol (Providence). 2022 Dec 15;13:21526575221144950. doi: 10.1177/21526575221144950. eCollection 2022 Jan-Dec.

ABSTRACT

OBJECTIVES: To assess the frequency of loss of smell and taste in children during Covid-19 infection and their prevalence along with other symptoms, as well as the recovery of chemosensory function once healed.

METHODS: To evaluate symptoms during infection, we adapted the Scandinavian adaptation of the Multi-Clinic Smell and Taste Questionnaire and the modified Monel-Jefferson questionnaire. For smell analysis we used Odor Identification (OI) and two variants of the Odor Discrimination (OD) test, and we compared the results with those of a control group.

RESULTS: We enrolled nine patients in our experimental group and nine in our control group. Fever was the most frequent symptom (55% of cases), followed by anosmia and ageusia (44% of cases), muscle pain and asthenia (22% of cases) and diarrhea, abdominal pain, cough, and headache (11% of cases). In 11% of cases, olfactory symptoms were the only manifestation of the disease. There was no statistically significant difference in OI test and OD tests between the two groups (Children healed from Covid-19 and Control Group).

CONCLUSION: Loss of smell and taste are the second most common symptoms of pediatric Covid-19, and they should always be tested because they can be the only manifestations of infection. Olfactory function in Covid-19 children decreases with increasing age and improves with the passage of time after illness.

PMID:36571076 | PMC:PMC9768832 | DOI:10.1177/21526575221144950