Category: Statistics

Z Orthop Unfall. 2021 May 18. doi: 10.1055/a-1471-8622. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to compare posterolateral fusion with transforaminal lumbar interbody fusion (PLF + TLIF) and PLF only in terms of revision surgery rates and complications, as well as functional and radiological outcomes in lumbar spinal stenosis (LSS) patients.

METHODS: Seventy-one patients (37 patients in the PLF + TLIF group and 34 patients in the PLF only group) who underwent surgery due to LSS between January 2013 and December 2016 were retrospectively investigated. Functional evaluation was performed by using the McGill-Melzack Pain Questionnaire (MPQ), Roland Morris Disability Questionnaire (RMDQ), and Oswestry Disability Index (ODI) scales pre-and postoperatively. Radiological evaluation was made by examining adjacent vertebrae, posterior ligamentous complex (PLC) morphology, and sagittal balance on magnetic resonance imaging (MRI).

RESULTS: Postoperative MPQ, RMDQ, and ODI scores were significantly better in the PLF + TLIF group (p < 0.001, p < 0.001, and p = 0.001, respectively). The complication rate was significantly higher in the PLF only group (p = 0.026). In the PLF + TLIF group, postoperative functional scores showed significant improvement in terms of the instrumented segment and level of interbody fusion. Postoperative functional scores showed significant improvement in PLF + TLIF patients with no complications, no revision surgery, no postoperative MRI findings, and neutral sagittal balance compared to the preoperative functional scores (p < 0.001).

CONCLUSION: PLF + TLIF is significantly superior in terms of functional scores and complications, despite the statistical similarity in terms of postoperative MRI findings and sagittal balance between the groups. Surgeons should prefer PLF + TLIF for the surgical treatment of LSS for better results.

PMID:34005826 | DOI:10.1055/a-1471-8622

Singapore Med J. 2021 May 19. doi: 10.11622/smedj.2021052. Online ahead of print.

ABSTRACT

INTRODUCTION: Neurofibromatosis type 1 (NF 1) is an autosomal dominant neurocutaneous disease characterised by multisystemic involvement, including bone tissue. Deformities and reduced bone mass are the main bone manifestations in NF1. Quantitative computed tomography (QCT) provides true volumetric bone mineral density (BMD) measurement. This study aimed to evaluate bone metabolism parameters and BMD in children with NF1 using QCT.

METHODS: The data of 52 paediatric NF1 patients (23 female, 29 male) was evaluated retrospectively. We investigated anthropometric measurements, biochemical parameters like total calcium, phosphate, magnesium, alkaline phosphatase, 25-hydroxyvitamin D (25OHD), parathyroid hormone, calcitonin, urinary calcium/creatinine ratio, and QCT parameters like lumbar trabecular and cortical BMD, trabecular area and cortical thickness. Comparisons of gender and puberty status were performed.

RESULTS: 25% of patients had skeletal deformities and 42.3% had 25OHD inadequacy (< 20 ng/mL). The frequency of 25OHD inadequacy was significantly higher in pubertal/postpubertal patients than prepubertal patients (61.9% vs. 29.0%, p = 0.019). Trabecular BMD Z-score was < -2.0 in 11.5% of patients; all with low BMD were at the pubertal/postpubertal stage. There was a significant negative correlation between age and trabecular Z-score (r = -0.41, p = 0.003). Mean cortical BMD was statistically similar between the genders and puberty groups. Puberty status, anthropometric Z-scores, and biochemical and QCT parameters were statistically similar between the genders (p > 0.05).

CONCLUSION: Paediatric NF1 patients may present with low BMD and 25OHD inadequacy, especially at puberty. QCT may be a useful tool to evaluate trabecular and cortical bone separately in NF1 patients.

PMID:34005845 | DOI:10.11622/smedj.2021052

Cerebrovasc Dis. 2021 May 18:1-8. doi: 10.1159/000516116. Online ahead of print.

ABSTRACT

BACKGROUND: The Los Angeles Motor Scale (LAMS) is a 3-item, 0-to-5-point motor stroke-deficit scale derived from the Los Angeles Prehospital Stroke Screen. We assessed the predictive validity (for interventions performed and discharge disposition) of the LAMS performed in the field by paramedics in a geographic region of over 5,200 km2, covering both rural and urban areas.

METHODS: We analyzed data gathered from Phase I of the LIT-PASS study (Large Vessel Occlusion Identification Through Prehospital Administration of Stroke Scales) which included all patients with suspected acute cerebrovascular disease, as assessed by the Balance, Eyes, Face, Arm, Speech, Terrible Headache/Time to Call 911 (BE-FAST) test.

RESULTS: Among 1,906 patients with median age 72 years (interquartile range [IQR] 60-81), 53% were female with a median on-scene time of 15 min (IQR 12-19). C statistics for the interventions of mechanical thrombectomy, alteplase administration, computed tomography angiography, and perfusion imaging were 0.681, 0.643, and 0.680, respectively. The cut point for predicting these 3 interventions was confirmed to be LAMS ≥ 4. LAMS ≥ 4 had sensitivity 0.730 (0.661-0.790) and specificity 0.570 (0.539-0.601) for mechanical intervention (endovascular thrombectomy, coiling, or clipping) and relative risk of 2.98 (2.19-4.07) for in-hospital death.

CONCLUSIONS: This real-world field study validates the LAMS as an effective tool for prehospital assessment of suspected strokes in determining transport decisions, with predictive validity for interventions performed.

PMID:34004604 | DOI:10.1159/000516116

Orthop Nurs. 2021 May-Jun 01;40(3):182-188. doi: 10.1097/NOR.0000000000000758.

ABSTRACT

General anesthesia, prolonged immobilization, and pain may adversely affect pulmonary function in patients undergoing prosthetic surgery. The aim of this study was to evaluate the effect of balloon-blowing exercises on pulmonary functions in patients undergoing total hip arthroplasty. The patients in the experimental group performed three sets of balloon-blowing exercises in the morning, at noon, and in the evening on the first to third days postoperatively. The increase in forced vital capacity (FVC) values between the control and experimental groups in the postoperative period was statistically significant (p < .001), in favor of the experimental group. The increase in forced expiratory volume during the first second (FEV1)/FVC ratio was found to be significantly higher in the experimental group than in the control group (p < .001). Patients who performed balloon-blowing exercises increased their FVC and FEV1/FVC ratio.

PMID:34004618 | DOI:10.1097/NOR.0000000000000758

Forensic Sci Int. 2021 May 7;324:110823. doi: 10.1016/j.forsciint.2021.110823. Online ahead of print.

ABSTRACT

Calls for blind proficiency testing in forensic science disciplines intensified following the 2009 National Academy of Sciences report and were echoed in the 2016 report by the President’s Council of Advisors on Science and Technology. Both practitioners and scholars have noted that “open” proficiency tests, in which analysts know they are being tested, allow for test-taking behavior that is not representative of behavior in routine casework. This study reports the outcomes of one laboratory’s blind quality control (BQC) program. Specifically, we describe results from approximately 2.5 years of blind cases in the latent print section (N = 376 latent prints submitted as part of 144 cases). We also used a widely available quality metrics software (LQMetrics) to explore relationships between objective print quality and case outcomes. Results revealed that nearly all BQC prints (92.0%) were of sufficient quality to enter into AFIS. When prints had a source present in AFIS, 41.7% of print searches resulted in a candidate list containing the true source. Examiners committed no false positive errors but other types of errors were more common. Average print quality was in the midpoint of the range (53.4 on a 0-to-100 scale), though prints were evenly distributed across the Good, Bad, and Ugly categories. Quality metrics were significantly associated with sufficiency determinations, examiner conclusions, and examiner accuracy. Implications for blind testing and the use of quality metrics in routine casework as well as proficiency testing are discussed.

PMID:34004529 | DOI:10.1016/j.forsciint.2021.110823

Sci Total Environ. 2021 May 6;787:147554. doi: 10.1016/j.scitotenv.2021.147554. Online ahead of print.

ABSTRACT

Antibiotic levels in black-odor water could reflect the usage amount of antibiotics in population. On the other hand, these antibiotics are the source of antibiotics in the environmental water. Currently, researches on antibiotics in black-odor sediments are still lacking. In this study, 174 black and odor sediment samples from 74 cities in 28 provinces in China were collected for analysis. Among 44 targeted antibiotics, 13 antibiotics were detected in more than 30% of sediment samples. Fluoroquinolones and tetracyclines were the predominant antibiotics in these field samples, with average concentrations of up to 2074 and 1902 ng/g dry weight (dw), respectively, followed by macrolides (87.9 ng/g dw), lincosamides (8.06 ng/g dw) and sulfonamides (8.38 ng/g dw). High antibiotic contamination levels were almost always detected in black-odor sludges from economically less developed small cities; however, the difference in antibiotic concentrations between well-developed and small cities in China was not statistically significant. In addition, among the seven regions within China, no significant difference in concentrations was observed for the most antibiotics. Variances in antibiotic composition patterns in the 28 provinces of China may be due to differences in bacterial resistance, prescription habits, efficacy, and sediment carbon concentrations among various regions. There were significant positive correlations among some antibiotics in the same or different classes.

PMID:34004531 | DOI:10.1016/j.scitotenv.2021.147554

Sci Total Environ. 2021 May 11;787:147671. doi: 10.1016/j.scitotenv.2021.147671. Online ahead of print.

ABSTRACT

A dedicated extremely low frequency (ELF) detector has been constructed and used successfully for Schumann Resonance (SRs) measurements in N.W. Greece. The main objective of this work was to investigate the effect of local lightning activity on the signal of our ELF detector and consequently on the estimated SRs parameters, namely the power, the frequency and the quality factor of each mode. Therefore, several measurements were taken into account for the ELF signal continuously recorded and the lightning intensity in a specific range around the ELF detector. Additionally, a simple filtering technique was used, in order to reject the distorted SRs spectra. The statistical analysis performed showed a positive and statistically significant correlation between the lightning events and the recorded magnetic component of the ELF signal. It was found that local lightnings have a significant impact on the SRs measurements, and it is necessary to be removed from the background signal.

PMID:34004542 | DOI:10.1016/j.scitotenv.2021.147671

Atherosclerosis. 2021 Apr 27;327:5-12. doi: 10.1016/j.atherosclerosis.2021.04.009. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The association between hysterectomy and cardiovascular disease (CVD) remains controversial and research focusing on different types of CVD, especially ischemic heart disease, is scant.

METHODS: This observational study was conducted with the National Health and Nutrition Examination Survey (NHANES) 2007-2018 using propensity score matching, propensity score overlap weighting, and logistic regression.

RESULTS: Among 15,257 women, 3476 (22.78%) had hysterectomy. Compared with non-hysterectomized women, hysterectomized women are more likely to be older, obese, with lower education level, and lower annual family income. Less favorable outcomes often occurred in unadjusted analysis. In adjusted, matched, and weighted analyses, the associations between hysterectomy and all outcomes were consistent, including ischemic heart disease (OR_unadjusted = 3.18[95%CI, 2.76-3.66]; OR_adjusted = 1.38[95%CI, 1.09-1.73]; OR_matched = 1.37[95%CI, 1.07-1.75]; OR_weighted = 1.38[95%CI, 1.12-1.71]), coronary heart disease (OR_unadjusted = 3.31[95%CI, 2.71-4.05]; OR_adjusted = 1.43[95%CI, 1.04-1.98]; OR_matched = 1.46[95%CI, 1.04-2.05]; OR_weighted = 1.45[95%CI, 1.06-1.99]), heart attack (OR_unadjusted = 3.04[95%CI, 2.51-3.68]; OR_adjusted = 1.47[95%CI, 1.09-1.99]; OR_matched = 1.42[95%CI, 1.03-1.95]; OR_weighted = 1.45[95%CI, 1.10-1.91]) and angina pectoris (OR_unadjusted = 3.29[95%CI, 2.66-4.08]; OR_adjusted = 1.34[95%CI, 0.95-1.89]; OR_matched = 1.30[95%CI, 0.91-1.87]; OR_weighted = 1.33[95%CI, 0.98-1.81]). In hysterectomized women, there were no significant associations between bilateral ovariectomy and ischemic heart disease (OR_unadjusted = 1.24[95%CI, 0.99-1.54]; OR_adjusted = 1.05[95%CI, 0.80-1.38]; OR_matched = 1.16[95%CI, 0.86-1.55]; OR_weighted = 0.93[95%CI, 0.68-1.27]), female hormones use and ischemic heart disease (OR_unadjusted = 0.94[95%CI, 0.76-1.16]; OR_adjusted = 0.81[95%CI, 0.62-1.07]; OR_matched = 0.89[95%CI, 0.66-1.20]; OR_weighted = 1.14[95%CI, 0.88-1.49]).

CONCLUSIONS: Hysterectomy may increase the risk of ischemic heart disease, especially for coronary heart disease and heart attack, but not for angina pectoris. As for the hysterectomized women, bilateral ovariectomy and female hormones use do not affect ischemic heart disease.

PMID:34004485 | DOI:10.1016/j.atherosclerosis.2021.04.009

Neurobiol Aging. 2021 Apr 22;105:16-24. doi: 10.1016/j.neurobiolaging.2021.04.005. Online ahead of print.

ABSTRACT

Intracranial arteriosclerosis has been increasingly recognized as a risk factor for cognitive impairment and even dementia. A possible mechanism linking intracranial arteriosclerosis to cognitive impairment and dementia involves structural brain changes including cerebral small vessel disease (CSVD). To assess whether intracranial carotid artery calcification (ICAC) and vertebrobasilar artery calcification (VBAC), as proxies for intracranial arteriosclerosis, are related to CSVD. Within the population-based Rotterdam Study, between 2003 and 2006 a computed tomography (CT)-based measurement of ICAC and VBAC and at least one magnetic resonance imaging (MRI) measurement of structural brain changes were performed from 2005 onwards in 1,489 participants. To estimate the burden of calcification independent of age, we computed age-adjusted percentile curves for ICAC and VBAC separately, based on the calcification volumes. Using the longitudinal MRI data, we assessed whether a larger calcification burden accelerates structural brain changes using appropriate statistical models for repeated outcome measures. A larger burden of ICAC and VBAC was associated with an increase of CSVD markers accelerating over time. A larger burden of ICAC and VBAC was not significantly (p > 0.05) associated with accelerated brain atrophy. Arteriosclerosis is related to accelerating structural brain changes over time.

PMID:34004492 | DOI:10.1016/j.neurobiolaging.2021.04.005

Respir Med. 2021 May 4;184:106441. doi: 10.1016/j.rmed.2021.106441. Online ahead of print.

ABSTRACT

AIM: to investigate the relation of pulmonary function impairment with mortality and the possible mediation by low-grade inflammation in a general adult population.

METHODS: A prospective investigation was conducted on 14,503 individuals from the Moli-sani study (apparently free from lung disease and acute inflammatory status at baseline; 2005-2010). The 2012 Global Lung Function Initiative percent predicted (% pred) value of forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% of FVC (FEF25-75) and FEV1 quotient (FEV1Q) index were used. C-reactive protein and blood cell counts were measured and a score of subclinical inflammation (INFLA-score) was calculated.

RESULTS: Over a median follow-up of 8.6y, 503 deaths (28.9% cardiovascular) were ascertained. Total mortality increased by 19% for each decrease in 1 standard deviation of FEV1% pred or FVC% pred (Hazard Ratio:1.19; 95% CI:1.11-1.28 and 1.19; 1.10-1.28, respectively). Comparable findings for FEV1Q (1.30; 1.15-1.47) were observed. A statistically significant increased risk in cardiovascular mortality of 23%, 32% and 49% was observed for 1 standard deviation decrease of FEV1% pred, FVC% pred and FEV1Q, respectively. INFLA-score mediated the association of FEV1% pred and FEV1Q with cardiovascular mortality by 22.3% and 20.1%, respectively. Subjects with FEV1, FVC lower than normal limit showed increased risk both in total and cardiovascular mortality. Abnormal FEF25-75 values were associated with 33% (1.33; 1.02-1.74) total mortality risk.

CONCLUSIONS: Obstructive lung function impairment was associated with decreased survival. Low-grade inflammation mainly mediated the association of FEV1 with cardiovascular mortality.

PMID:34004499 | DOI:10.1016/j.rmed.2021.106441