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Nevin Manimala Statistics

Whether temporal discounting is domain-specific between health outcomes and money: a systematic review and meta-analysis

Int J Clin Pharm. 2024 Dec 24. doi: 10.1007/s11096-024-01846-3. Online ahead of print.

ABSTRACT

BACKGROUND: Temporal discounting, the preference for immediate over delayed rewards, affects decision-making in domains like health and finance. Understanding the differences in how people discount health outcomes compared to monetary rewards is crucial to shaping health policy and technology assessments.

AIM: This systematic review and meta-analysis aimed to compare temporal discounting parameters between health outcomes and monetary rewards and evaluate their overall relationship.

METHOD: Studies were retrieved from PubMed, Embase, Web of Science, and the Cochrane Library up to December 2023. Standardized mean differences (SMD) assessed discounting differences between statistical indicators, and correlation coefficients were transformed into Fisher’s Z scores. Subgroup analyses based on population, tradability, magnitude, sign, and experimental process explored potential heterogeneity.

RESULTS: A total of 32 studies were included: 29 studies (47 pairs of health and money) for the comparative meta-analysis and 19 studies (32 pairs) for the correlation meta-analysis. No significant differences were found between health and money discounting, although the individuals were more patient with the health outcomes and more impulsive with the money. In the sign effect subgroup, health discounting for delayed losses was lower than for monetary losses (SMD: – 0.293; 95% CI: – 0.458, – 0.129). The pooled correlation coefficient (r) for all studies was 0.333 (95% CI: 0.283-0.383), indicating a moderate association. In subgroup analysis, when the indicator was the discount rate, the pooled r value for 16 studies was 0.278 (95% CI: 0.231, 0.325).

CONCLUSION: Although no significant statistical differences were found between health and money discounting, a moderate correlation was observed, supporting consistent discount rate settings for health technology assessments.

PMID:39718761 | DOI:10.1007/s11096-024-01846-3

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Mental Health Disparities Between Both-, Other- and Same-Sex Attracted Adolescents: The Role of Bullying Victimization, Gender and Age

J Youth Adolesc. 2024 Dec 24. doi: 10.1007/s10964-024-02124-1. Online ahead of print.

ABSTRACT

Research shows that both-sex attracted adults have poorer mental health than other- and same-sex attracted adults, but evidence regarding whether similar disparities exist among adolescents remains limited. To investigate this, the current study examines differences in life satisfaction and emotional problems between both-, other- and same-sex attracted adolescents. It also studies whether bullying victimization can explain these differences and whether the associations vary by gender and age. Cross-sectional data from the nationally-representative Dutch Health Behavior in School-aged Children (HBSC) study conducted in 2017 and 2021 were analyzed, including 11,683 adolescents (Mage = 14.7, SD = 1.60; 49.7% girls). Both-sex attracted adolescents (n = 507, 4.3%) report lower life satisfaction and more emotional problems than their other- (n = 10,930, 93.6%) and same-sex attracted peers (n = 246, 2.1%). Bullying victimization partially explains the mental health disparities between both- and other-sex attracted adolescents, yet does not account for differences between both- and same-sex attracted peers. The links between romantic attraction and mental health outcomes were similar across gender and age, but differences existed concerning bullying victimization. The results suggest that both-sex attracted adolescents are a unique group that deserves special attention in the literature on mental health disparities.

PMID:39718754 | DOI:10.1007/s10964-024-02124-1

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Offset sublaminar hook is an efficient tool for the prevention of distal junctional failure after kyphotic deformity correction

Spine Deform. 2024 Dec 24. doi: 10.1007/s43390-024-01027-2. Online ahead of print.

ABSTRACT

PURPOSE: To assess the radiological outcomes and complications focusing on distal junctional failure (DJF) of adult spinal deformity patients who underwent thoracolumbar fixation with the use of offset sublaminar hooks (OSH) distally.

METHODS: Retrospective review of a prospective, multicenter adult spinal deformity database (2 sites). Inclusion criteria were age of at least 18 years, presence of a spinal deformity with thoraco-lumbar instrumentation ending distally with OSH (pelvis excluded), with minimum 2 years of follow-up. Demographic data, spinopelvic parameters, functional outcomes and complications were collected. Data was analyzed using descriptive statistics. Statistical significance was set to p < 0.05.

RESULTS: 32 patients met the inclusion criteria, with the main etiologies being Scheuermann kyphosis and post-traumatic kyphosis. There was a significant correction of thoracic or thoraco-lumbar kyphosis (from 83° to 45° in case of posterior column osteotomy, p < 0.001, and from 49° to 11° in case of a three-column osteotomy, p < 0.001). DJF occurred in 9.3% of the patients including 1 patient who presented distal hook dislodgement and 2 patients who presented a compression fracture below the lowest instrumented vertebra. Oswestry Disability Index score improved in the majority of the patients (from 34.3 to 18.1, p < 0.05).

CONCLUSIONS: This is the first paper to propose offset sublaminar hook as a safe and efficient tool for protection of the distal end of the construct in kyphotic ASD surgery when not going down to the pelvis. It showed satisfactory radiological and clinical outcome with an acceptable rate of complications and no distal junctional failure that required revision surgery.

PMID:39718744 | DOI:10.1007/s43390-024-01027-2

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Bromocriptine Versus Levodopa and other treatments in Parkinson’s Disease: an updated Meta-analysis Involving more than 4000 patients across 12 randomized clinical trials

Acta Neurol Belg. 2024 Dec 24. doi: 10.1007/s13760-024-02711-w. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this meta-analysis was to conduct a comparative study by systematically examining and analyzing trials that studied the impacts of levodopa and bromocriptine, either separately or together, in treating Parkinson’s disease (PD).

METHODS: An extensive literature search was conducted across PubMed (Medline), Scopus, and Web of Science databases, using targeted keywords for studies published up to October 2024. The methodological quality of included RCTs was assessed with the Cochrane Risk of Bias 2 (RoB 2) tool, and bias evaluation was performed using RevMan (version 5). Statistical analyses were conducted in STATA version 17, applying random-effects models. The overall quality of evidence was evaluated using the GRADE approach.

RESULTS: The thorough evaluation identified 12 randomized controlled trials with a total of 4,060 participants, 1,956 in the intervention group and 2,104 in the comparison group, all diagnosed with PD. A combined effect size of 0.18 (SMD: 0.18; 95% CI: -0.03, 0.39) was found through quantitative analysis of motor scales for the Unified Parkinson’s Disease Rating Scale (UPDRS). An effect size of 0.50 (OR: 0.50; 95% CI: 0.31, 0.80) was determined for dyskinesia. Dystonia occurrences showed a significant effect size of 0.44 (OR: 0.44; 95% CI: 0.24, 0.81; I2: 87.28%; P value: 0.0001). Hallucination and dizziness occurrences showed effect sizes of 0.91 (OR: 0.91; 95% CI: 0.36, 2.30) and 1.36 (OR: 1.36; 95% CI: 0.91, 2.04) overall, respectively. Quality assessment revealed high-certainty evidence for dyskinesia and dystonia reduction with bromocriptine, while other outcomes showed low to very low certainty. Meta-regression analyses showed no significant correlation between population characteristics and outcomes.

CONCLUSION: This thorough meta-analysis offers an understanding of how bromocriptine compares in effectiveness to levodopa and other treatments for managing PD.

PMID:39718740 | DOI:10.1007/s13760-024-02711-w

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The survival prediction analysis and preliminary study of the biological function of YEATS2 in hepatocellular carcinoma

Cell Oncol (Dordr). 2024 Dec 24. doi: 10.1007/s13402-024-01019-4. Online ahead of print.

ABSTRACT

PURPOSE: Our study aims to develop and validate a novel molecular marker for the prognosis and diagnosis of hepatocellular carcinoma (HCC) MATERIALS & METHODS: We retrospectively analyzed mRNA expression profile and clinicopathological data of HCC patients fetched from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO) and The International Cancer Genome Consortium (ICGC) datasets. Univariate Cox regression analysis was performed to collect differentially expressed mRNA (DEmRNAs) from HCC and non-tumor tissues, and YEATS2, a prognostic marker, was identified by further analysis. ROC curve, survival analysis and multivariate Cox regression analysis as well as nomograms were used to evaluate the prognosis of this gene. Finally, the biological function of this gene was preliminarily discussed by using single gene Gene Set Enrichment Analysis (GSEA), and the YEATS2 overexpression and knockdown hepatoma cell line was used to verify the results in vitro and in vivo.

RESULTS: Based on the clinical information of HCC in TCGA, GEO and ICGC databases, the gene YEATS2 with significant differences from HCC was identified. There was a statistical difference in the survival prognosis between the two databases and the ROC curve showed that the survival of HCC in both TCGA, GSE14520 and ICGC groups had a satisfactory predictive effect. Univariate and multivariate Cox regression analysis showed that YEATS2 was an independent prognostic factor for HCC, and Nomograms, which combined this prognostic feature with significant clinical features, provided an important reference for the clinical prognostic diagnosis of HCC. Next, we constructed overexpression and knockdown YEATS2 cell line in Hep3B and LM3 cells, and further proved that overexpression YEATS2 promote the proliferation and migration of HCC cells by CCK8, colony formation experiment, and transwell assays, and knockdown YEATS2 inhibited the proliferation and migration of HCC cells by CCK8, colony formation experiment, and transwell assays. Finally, the biological function of YEATS2 was preliminarily explored through GSEA analysis of a single gene, and it was found that it was significantly correlated with cell cycle and DNA repair, which provided us with ideas for further analysis. Furthermore, the knockdown of YEATS2 promoted radiation-induced DNA damage, enhanced radiosensitivity, and ultimately inhibited the proliferation of hepatocellular carcinoma cells in vitro and in vivo.

CONCLUSIONS: Our study identified a promising prognostic marker for hepatocellular carcinoma that is useful for clinical decision-making and individualized treatment.

PMID:39718737 | DOI:10.1007/s13402-024-01019-4

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Assessing masked hypertension and ambulatory arterial stiffness index in children congenital kidney malformations

Clin Exp Nephrol. 2024 Dec 24. doi: 10.1007/s10157-024-02612-5. Online ahead of print.

ABSTRACT

BACKGROUND: Patients diagnosed with congenital kidney malformations are at an increased risk of developing hypertension, proteinuria, and progressing to chronic kidney disease (CKD). The present study aimed to determine the frequency of masked hypertension and ambulatory arterial stiffness index (AASI) in patients with congenital kidney malformations.

METHODS: The study included 174 patients with congenital kidney malformations (48 patients with unilateral renal agenesis (URA), 40 patients with ectopic kidney (EK), 36 patients with horseshoe kidney (HK), 31 patients with multicystic dysplastic kidney (MCDK), 19 patients with unilateral renal hypoplasia (URH), and 45 healthy controls.

RESULTS: The mean age was 12.9 ± 2.9 years, and the male-to-female ratio was 1.5. No significant differences were observed between the congenital kidney malformations groups concerning age, sex, follow-up period, proteinuria, or estimated glomerular filtration rate (eGFR) (P > 0.05). Nevertheless, the prevalence of masked hypertension exhibited a statistically significant increase in the congenital kidney malformations groups (except the URH group) compared to the control group (P < 0.05). The AASI was significantly greater in the congenital kidney malformations groups than in the control group (P < 0.05). The nighttime diastolic blood pressure (DBP), mean arterial pressure (MAP), and DBP index were significantly different between the congenital kidney malformations groups (P < 0.05). However, there were no significant differences in nondipping pattern, proteinuria, or masked hypertension between the congenital kidney malformations groups.

CONCLUSIONS: Patients with congenital kidney malformations should be periodically evaluated throughout life for BP. Based on the present findings, we strongly recommend ABPM for the diagnosis of masked hypertension and outcomes, including AASI score.

PMID:39718736 | DOI:10.1007/s10157-024-02612-5

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Effects of smokeless tobacco on cancer incidence and mortality: a global systematic review and meta-analysis

Cancer Causes Control. 2024 Dec 24. doi: 10.1007/s10552-024-01933-w. Online ahead of print.

ABSTRACT

INTRODUCTION: The prevalence of smokeless tobacco consumption remains high despite policies on reduction interventions. This study aims to quantify the associations between smokeless tobacco use with cancer incidence and mortality globally.

METHODS: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and PROSPERO protocol (ID: CRD42023390468). A comprehensive literature search was performed using PubMed, Web of Science, and Scopus databases, covering the period from January 1, 2000, to February 28, 2023. We included peer-reviewed observational studies, specifically case-control and cohort studies, where smokeless tobacco use was the primary exposure and cancer incidence, or mortality were the main outcomes. Three independent reviewers screened titles, abstracts, and full texts, and extracted data from the included studies. Risk of bias was assessed by the same three reviewers. Any disagreements were resolved through discussion with a fourth reviewer. We performed random-effects meta-analyses and assessed heterogeneity and publication bias to ensure the robustness of our findings.

RESULTS: Of the 3,611 articles identified, 80 were included in the final analysis. Increased risks were observed for cancer mortality [Risk Ratio (RR) 1.38, 95% Confidence Interval (CI) 1.22-1.56] and incidence [RR 1.17, 95% CI 1.08-1.27]. The specific cancer sites with increased mortality risk included head and neck cancers, as well as stomach cancer. For cancer incidence, associations were observed with head and neck, oral, esophageal, stomach, and pancreatic cancers. Significant heterogeneity (I2 statistic 65% to 90%) was observed among most cancer outcomes.

CONCLUSION: Our study found significant associations between smokeless tobacco use and cancer incidence and mortality. Targeted policy interventions, such as stricter regulations on smokeless tobacco use, are recommended to reduce its consumption and mitigate the associated cancer risks.

PMID:39718727 | DOI:10.1007/s10552-024-01933-w

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Standardized protocol during acetabular fracture surgery results in low rates of heterotopic ossification

Eur J Orthop Surg Traumatol. 2024 Dec 24;35(1):47. doi: 10.1007/s00590-024-04144-w.

ABSTRACT

PURPOSE: To assess the rate of heterotopic ossification (HO) following acetabular surgery with a standardized protocol via the Kocher-Langenbeck. Secondarily, to evaluate patient characteristics, injury variables, and perioperative data among patients with HO and no HO.

METHODS: This was a retrospective case series from an academic Level I trauma center. Included patients had displaced acetabular fractures treated via Kocher-Langenbeck approach with debridement of (1) gluteus minimus muscle (GMM) from the posterior wall and column up to the superior gluteal neurovascular bundle, (2) unhealthy appearing piriformis muscle without fascial disruption, and (3) superior and inferior gemelli in the location of implant placement. Those with posterior hip dislocations and gluteus medius injury received prophylactic indomethacin.

RESULTS: Fifty-seven patients met inclusion criteria. Thirteen patients (22.8%) developed HO, and 44 patients (77.2%) had no evidence of HO. Ten (17%) patients developed mild HO (Brooker classification (BC) I/II), 3 (5%) developed moderate HO (BC III), and no patients developed severe HO (BC IV). There were no differences in the prevalence of elementary versus associated acetabular fracture patterns or individual fracture patterns among cohorts. Patients with HO had longer times to surgical intervention (5.3 ± 5.1 days vs. 2.4 ± 1.6 days, p = 0.002) and length of intensive care unit (ICU) stay (6.7 ± 12.2 days vs. 1.5 ± 3.3 days, p = 0.013) compared with the no HO cohort. There was no difference in rates of HO prophylaxis use and subsequent HO among cohorts.

CONCLUSION: This study describes a standardized protocol developed by the senior author that resulted in low rates of HO following acetabular fixation via the Kocher-Langenbeck approach. Patients with HO had a significantly longer time to surgical intervention and length of ICU level of care.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors of a complete description of levels of evidence.

PMID:39718662 | DOI:10.1007/s00590-024-04144-w

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Assessment of potentially toxic and rare earth elements in surface soils of Dong Nai, Vietnam

Environ Geochem Health. 2024 Dec 24;47(2):31. doi: 10.1007/s10653-024-02327-2.

ABSTRACT

This study investigates the quantities of Rare Earth Elements (REEs) and Potentially Toxic Elements (PTEs) in Dong Nai Province’s surface soils. Atomic Absorption Spectrometry (AAS) and Instrumental Neutron Activation Analysis (INAA) were used to determine element concentrations. To validate the concentration results, established reference materials (NIST 2711 and IAEA Soil-7) were used. Element concentrations followed a certain order, with Mn, Cr, V, and Zn dominating, except for Al, which were used to determine the enrichment factor. Arsenic (As) concentrations ranged from 0.8 to 37.5 mg/kg, exceeding global averages but below Vietnam quality standards. Cadmium (Cd) concentrations ranged from 0.03 to 0.16 mg/kg, below global averages and quality standards. Cobalt (Co) and chromium (Cr) concentrations ranged from 0.5 to 135.1 mg/kg and 18 to 844 mg/kg, respectively, with notable percentages of samples exceeding global averages. Copper (Cu) and lead (Pb) exhibited elevated concentrations, with varying proportions exceeding quality standards. Manganese (Mn) and antimony (Sb) exceeded global averages in a significant percentage of samples. Vanadium (V) concentrations surpassed the crustal average by over half of the sites. Zinc (Zn) concentrations were below reference values. REEs showed significantly higher concentrations than global soil averages, with a substantial proportion of samples exceeding reference values. Geo Accumulation Index (Igeo), Enrichment Factor (EF), and Pollution Load Index (PLI) analyses provided a detailed numerical assessment of contamination and soil quality. Statistical analysis showed correlations and clusters of toxic elements and highlighted the spatial distribution of samples based on elemental compositions.

PMID:39718640 | DOI:10.1007/s10653-024-02327-2

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Effectiveness of the repeated 3-time-balloon-inflation method in reducing coronary stent edge dissection

Heart Vessels. 2024 Dec 24. doi: 10.1007/s00380-024-02510-6. Online ahead of print.

ABSTRACT

The optimal procedural protocol for coronary stent deployment remains undetermined. Post-dilation with a high-pressure balloon is often performed to optimize the stent expansion. However, high-pressure dilation also carries the potential risk of coronary artery injury. A previous in vitro study reported that multiple-times balloon inflation at the same pressure resulted in better stent expansion compared to one-time balloon inflation. In our facility, we frequently perform the repeated 3-time-balloon-inflation method, wherein the stent delivery balloon was inflated 3 times at nominal pressure to deploy the stent, to improve stent expansion without high-pressure balloon inflation. Although this method seems effective in avoiding excessive high-pressure dilation, its clinical data are insufficient. In this study, we investigated the clinical outcomes of the repeated 3-time-balloon-inflation method. This retrospective study included 370 patients with 467 stented coronary lesions. These subjects were divided into two groups: one with standard balloon inflation and the other with repeated 3-time balloon inflation, and treatment outcomes were compared. The repeated 3-time-balloon-inflation group had 254 lesions, and the standard-balloon-inflation group had 213 lesions. Stent edge dissection occurred in 6 lesions (2.8%) in the standard-balloon-inflation group, whereas did not occur in the repeated 3-time-balloon-inflation group. A statistically significant difference remained even after propensity score matching (p = 0.040). The final minimum stent area and long-term clinical outcomes were not significantly different between the two groups. The repeated 3-time-balloon-inflation method may reduce stent edge dissection while demonstrating comparable minimal stent area and long-term outcomes to the standard-balloon-inflation method.

PMID:39718636 | DOI:10.1007/s00380-024-02510-6