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Nevin Manimala Statistics

Cannabis use and suicide in people with a diagnosis of schizophrenia: a systematic review and meta-analysis of longitudinal, case control, and cross-sectional studies

Psychol Med. 2025 Mar 10;55:e79. doi: 10.1017/S0033291725000236.

ABSTRACT

Cannabis use is highly prevalent in people with schizophrenia and is related to adverse clinical outcomes, including relapse and hospitalization. However, the relationship between cannabis and suicide remains inconclusive. This study aimed to systematically review and meta-analyze the relationship between cannabis use and suicide-related outcomes in people with schizophrenia. A comprehensive search of Medline, Embase, and PsycINFO for cross-sectional, case-control, and longitudinal studies was conducted using search terms from database inception to November 2024 inclusive. Computation of odds ratios (ORs) and hazard ratios (HRs) was performed using random effects models with DerSimonian-Laird estimation. All studies were appraised for quality. We also evaluated heterogeneity, publication bias and performed sub-group analyses and meta-regression. Twenty-nine studies comprising 36 samples met eligibility criteria. Cannabis use was not associated with odds of suicide death or suicidal ideation but was associated with risks of suicide death (HR = 1.21, 95% CI = 1.04 – 1.40) and odds of attempted suicide (OR = 1.40, 95% CI = 1.16 – 1.68). While between-sample heterogeneity was moderate in analyses of attempted suicide (I2 = 39.6%, p = 0.03), there was no publication bias. Summary effects remained significant in most sub-groups, but just failed to reach significance in longitudinal studies of attempted suicide (OR = 1.40, 95% CI = 0.97 – 1.68) and studies investigating first episode samples (OR = 1.24, 95% CI = 0.99 – 1.55). Cannabis use is significantly associated with some, but not all, suicide-related outcomes in people with schizophrenia. More work is needed to examine potential mechanisms of significant relationships.

PMID:40059733 | DOI:10.1017/S0033291725000236

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Examining Gender Norms of Eating Behavior and Body Checking in NCAA Student- Athletes

J Athl Train. 2025 Mar 10. doi: 10.4085/1062-6050-0673.24. Online ahead of print.

ABSTRACT

Context Lean sports, endurance running, have been at the forefront of disordered eating and body image research, particularly in female populations. Yet, little is known about how athletic men and women differ in body checking behaviors, a known risk factor for body dissatisfaction and disordered eating, across sport type and athletic status. Objective The purpose of this study was to examine gender differences on measures of eating behavior and body checking between full-time collegiate student-athletes and nonathletes. Design Cross-sectional study. Setting NCAA DI collegiate athletics. Participants Two-hundred fifty-nine full-time college students (n = 174 student-athletes, 85 nonathletes) Main Outcome Measures Primary outcomes included self-reported disordered eating behavior and body checking behavior through the EAT-26 and the Body Checking Questionnaire (BCQ) and the Male BCQ (MBCQ). We explored differences based on sport type, team, individual, or nonathlete, and gender identity. Results There was a statistically significant multivariate main effect of gender F(10, 464) = 9.219, p<0.001, đťś‚ 2 = 0.166, and a significant multivariate interaction of gender and sport type F(15, 699) = 2.806, p=0.001, đťś‚ 2 = 0.057. Follow-up comparisons for team sport athletes showed that women scored significantly higher (p<0.001) on the MBCQ compared to men. Women team sport athletes also scored significantly higher on the MBCQ than women nonathletes (p < 0.001). Conversely, nonathlete men scored significantly higher on the MBCQ than men team and individual sport athletes (p = 0.003 and p = 0.048, respectively). Conclusions Findings suggest that body checking behaviors traditionally studied as masculine occur more frequently in women than men. This effect seems to be driven by women team sport athletes, who reported engaging in more body checking behaviors on the MBCQ than nonathletes. Therefore, assessments based on traditional views of maleness and femaleness may overlook significant risk factors for eating disorders (ED) in college athletes.

PMID:40059732 | DOI:10.4085/1062-6050-0673.24

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Posterolateral Tibial Plateau Fractures in Adult Anterior Cruciate Ligament Avulsion Effect on Postoperative Knee Function

Orthop Surg. 2025 Mar 10. doi: 10.1111/os.70015. Online ahead of print.

ABSTRACT

BACKGROUND: The impact of posterior lateral tibial plateau fractures (PLTPFs) on knee joint stability after anterior cruciate ligament (ACL) reconstruction has garnered widespread attention. However, limited literature exists on the co-occurrence of ACL tibial avulsion fractures (ACLAFs) and PLTPFs. The objective of this study is to investigate the prevalence of PLTPFs in adult ACLAF patients and assess the impact of concurrent PLTPFs on postoperative knee function.

METHODS: This retrospective study analyzed adults, who underwent arthroscopic surgery for ACLAF at our institution between January 2016 and January 2022. Demographic and preoperative/postoperative imaging data were collected, focusing on meniscus and ligament injuries, Segond fractures, PLTPFs, and tibial plateau slope. Patients were grouped into isolated ACLAF (I-ACLAF) and ACLAF with concurrent PLTPFs (ACLAF-PLTPF). The ACLAF-PLTPF group was further divided into Group A (PLTPFs not exceeding the anterior edge of the lateral meniscus posterior horn) and Group B (PLTPFs exceeding this edge). Clinical outcomes were evaluated using International Knee Documentation Committee and Tegner scores. The study also examined the morphology of PLTPFs and their specific affected areas. Statistical analysis was performed using the Mann-Whitney U tests for continuous variables and Fisher’s exact tests for categorical variables.

RESULTS: The study included 62 patients with a mean follow-up of 41 ± 17 months. Among these, 71.0% (44/62) patients with ACLAF also had PLTPFs. The ACLAF-PLTPF group showed a significantly steeper lateral tibial plateau slope than the I-ACLAF group (10.86° ± 5.47° vs. 7.17° ± 3.68°, p = 0.011). Segond fractures were present in 22.7% of the ACLAF-PLTPF group, compared to none in the I-ACLAF group (p = 0.027). IKDC and Tegner scores were lower in the ACLAF-PLTPF group (80.7 ± 5.2 and 4, respectively) than in the I-ACLAF group (87.4 ± 6.4 and 4.5, respectively), with statistical significance (p < 0.001 and p = 0.008, respectively). Older age correlated with a greater extent of concurrent PLTPFs (p = 0.038). Additionally, Patients in Group B exhibited a significantly higher incidence of meniscal injury (22.2% vs. 53.8%, p = 0.036) and poorer postoperative knee joint function compared to those in Group A (IKDC 82.3 ± 2.8 vs. 78.5 ± 5.6, p = 0.013). More extensive PLTPFs were linked to increased fracture collapse and a higher rate of lateral meniscus injuries.

CONCLUSION: PLTPFs demonstrated a high prevalence in adults with ACLAF. Additionally, the ACLAF-PLTPF cohort frequently showed reduced postoperative knee function. Simultaneous management of severe concomitant PLTPFs may improve long-term outcomes in patients with ACLAF.

PMID:40059695 | DOI:10.1111/os.70015

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Partial REBOA Zone 1 is associated with lower mortality compared to complete REBOA Zone 1 and emergency department thoracotomy: A cohort study using the AORTA registry

Transfusion. 2025 Mar 10. doi: 10.1111/trf.18177. Online ahead of print.

ABSTRACT

BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) and emergency department thoracotomy (EDT) are effective methods of aortic occlusion (AO) for life-threatening bleeding; however, complete AO can lead to visceral ischemia. Partial REBOA (P-REBOA) has been proposed as an alternative to the completely occlusive REBOA (C-REBOA) to balance hemorrhage control and perfusion. Using the Aortic Occlusion for Resuscitation in Trauma (AORTA) multicenter, observational registry, we tested the hypothesis that P-REBOA resulted in better outcomes compared to EDT and C-REBOA.

STUDY DESIGN AND METHODS: We queried the 2017-2023 AORTA registry for adults who underwent EDT, C-REBOA, or P-REBOA in the emergency department (ED). Patients with chest penetrating injuries were excluded. We compared mortality, ventilator-free-days (VFD), and ICU-free-days (ICUFD) using survival analysis or generalized linear models to adjust for confounders.

RESULTS: Overall, 921 patients underwent EDT (n = 613, 66.6%), C-REBOA (n = 224, 24.3%), or P-REBOA (n = 84, 9.1%); 83.1% died. After confounder adjustment, compared to P-REBOA, both C-REBOA and EDT were associated with a lower likelihood of attaining hemodynamic improvement and stability as well as with higher mortality (adjusted hazard ratio, aHR = 1.84; 95% CI: 1.01-1.60 and aHR = 3.32; 95% CI: 1.96-2.78, respectively). EDT patients had less VFD and ICUFD than those undergoing C-REBOA and P-REBOA, but there were no differences between the two endovascular procedures. Among patients who survived >48 h, EDT was more likely to be associated with complications compared to the other two procedures.

DISCUSSION: P-REBOA was more likely to be associated with improved hemodynamic stability and reduced mortality compared to C-REBOA and EDT, suggesting this modality may be a better AO procedure for patients with no penetrating thoracic injuries.

PMID:40059692 | DOI:10.1111/trf.18177

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Comparison of Patellar Tracking Following Kinematic Alignment Versus Mechanical Alignment Total Knee Arthroplasty via the Mini-Subvastus Approach

Orthop Surg. 2025 Mar 10. doi: 10.1111/os.70016. Online ahead of print.

ABSTRACT

OBJECTIVES: Different alignment strategies (kinematic alignment [KA] versus mechanical alignment [MA]) during total knee arthroplasty (TKA) significantly influence postoperative patellar tracking. This study aimed to compare radiological parameters of patellar tracking and clinical outcomes between KA-TKA and MA-TKA via the mini-subvastus approach.

METHODS: This prospective randomized controlled study included 234 patients who underwent KA-TKA and MA-TKA from January 2022 to October 2023. The preoperative and postoperative patellar tilt, lateral patellar shift, knee society score (KSS), oxford knee score (OKS), and intraoperative patellar lateral retinacular release (LRR) rate were measured. In addition, radiological parameters and clinical outcomes were compared between the LRR and non-LRR groups. Independent samples t test and chi-square test were used to compare the differences between groups.

RESULTS: Two-hundred and thirty-four patients were followed up for 12 months post-TKA. No significant differences were observed between the two groups in terms of the demographics and pre- or post-operative radiological parameters of patellar tracking (p > 0.05). The postoperative KSS and OKS were significantly higher in the KA group than in the MA group (p < 0.05). The LRR rate was 6.7% (8/120) in the KA group and 25.4% (29/114) in the MA group, and the difference was statistically significant (x2 = 15.476, p < 0.001). The preoperative patella tilt and lateral patellar shift were greater in the LRR group (p < 0.001) and the postoperative OKS was lower (p < 0.05).

CONCLUSIONS: KA-TKA via the mini-subvastus approach can achieve both good patellar tracking and clinical outcomes. Avoiding muscle damage and refraining from excessive soft tissue release are crucial to improving postoperative patient comfort. In our opinion, KA-TKA via the mini-subvastus approach may be a more suitable surgical option.

PMID:40059658 | DOI:10.1111/os.70016

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Corticosteroid as Treatment in Infective Conjunctivitis: A Systematic Literature Review and Meta-Analysis

J Ocul Pharmacol Ther. 2025 Mar 10. doi: 10.1089/jop.2024.0110. Online ahead of print.

ABSTRACT

Corticosteroid use as an anti-inflammatory agent in infective conjunctivitis has been met with concerns about prolonged infection. This systematic review aims to evaluate the safety and efficacy of corticosteroids as a treatment for infective conjunctivitis. A comprehensive search was conducted on PubMed, Cochrane, Scopus, ScienceDirect, Embase, and ProQuest for clinical trials of topical corticosteroids with or without combination with other medications in bacterial or viral conjunctivitis up to November 2023. The studies were screened, and data on safety and efficacy were extracted. The quality of studies was assessed using the Jadad Scale. Meta-analysis was performed using the random-effects model, with heterogeneity assessed with the I2 statistic. We found ten clinical trials that met the inclusion criteria. Overall meta-analysis revealed significant clinical resolution in dexamethasone-containing therapy compared to non-corticosteroid treatment (OR 1.51; 95% CI 1.19-1.92), with several studies reporting significantly reduced clinical symptoms severity. Two of the six studies assessing viral and bacterial eradication reported significantly improved viral clearance rates. Meta-analysis indicated no difference in ocular adverse effects compared to nonsteroid therapy (OR 1.33; 95% CI 0.82-2.16). In conclusion, corticosteroid use in infective conjunctivitis is relatively safe and may help improve clinical resolution and reduce symptom severity, especially when combined with antibiotics and antiseptics.

PMID:40059644 | DOI:10.1089/jop.2024.0110

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Three- and Twelve-Month Changes in Child and Adult Care Food Program Best Practices and Preschool Children’s Dietary Intake in Family Child Care Homes after the Happy Healthy Homes Randomized Controlled Trial

Child Obes. 2025 Mar 10. doi: 10.1089/chi.2024.0361. Online ahead of print.

ABSTRACT

Background: Enhancing the quality of Family Child Care Home (FCCH) meals is an opportunity to impact children’s diet and health. The purpose of this study is to assess Happy Healthy Homes (HHH) randomized controlled trial impact on health-related foods and nutrients served to and consumed by young children and achievement of Child and Adult Care Food Program (CACFP) requirements and best practices. Methods: Forty-five CACFP participating FCCHs in a moderately sized midwestern city were recruited in 2017-2018 and randomized to nutrition intervention (NUT n = 24) or control (CON n = 21). Participants received two in-home, individual 90-minute education sessions, one 3-hour small group class, and a 15-minute check-in phone call over 3 months. Outcomes include 3- and 12-month served and consumed fiber, sugar, grains, vegetables, and fruit and achievement of CACFP Best Practices. Primary analyses at 12 months used a mixed model under an intent-to-treat paradigm to account for repeated measures on participants with 3-month outcomes. Sensitivity analyses were completed on those with complete 12-month measures. Results: There were no statistically significant group-by-time effects for foods served, consumed, or CACFP Best Practices score in the primary analysis. However, in sensitivity analysis, the CACFP Best Practice score (out of 18) increased in NUT +0.5 from 8.9 ± 1.5 at baseline at 12 months and decreased -0.9 in CON from 9.9 ± 1.7 at baseline, group by time p = 0.05. Conclusions: The HHH intervention did improve the CACFP Best Practices score for lunches served. The study’s effect may have been limited due to sample size and attrition. Trial Registration: Clinicaltrials.gov, NCT03560050. Retrospectively registered on 23 May 2018. First participant enrolled October 2017.

PMID:40059639 | DOI:10.1089/chi.2024.0361

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Household Food Insecurity and Metabolic Syndrome in Adults: A Meta-Analysis

Metab Syndr Relat Disord. 2025 Mar 10. doi: 10.1089/met.2024.0194. Online ahead of print.

ABSTRACT

Background: Household food insecurity (HFI) refers to the lack of access to safe and nutritious food, and this condition may be associated with the occurrence of metabolic syndrome (MetS). Thus, this study aimed to conduct a quantitative synthesis (meta-analysis) to summarize the evidence from epidemiological studies on the association between HFI and MetS. Methods: A systematic search was conducted in the PubMed, Embase, Web of Science, and Latin American and Caribbean Health Sciences Information Center databases to retrieve epidemiological studies published until October 2023. The entire process of selection, data extraction, and assessment of article quality was independently performed by two reviewers. The quality of the studies was evaluated using the criteria proposed by the National Institutes of Health instrument. The random-effects model was used to report the quantitative synthesis of combined data. The Q-test and I2 index were used to assess heterogeneity. Egger’s and Begg’s tests were employed to evaluate publication bias. Results: A total of 10 articles meeting the eligibility criteria were selected and included in this meta-analysis. High heterogeneity was observed among the studies (I2 > 70), along with a low risk of publication bias. Considering all ten included studies, no statistically significant association was found between HFI and MetS (odds ratio = 1.17; 95% confidence interval: 0.89-1.55; I2 = 79.9%). Conclusions: The findings of this meta-analysis did not reveal a statistically significant association between HFI and MetS, indicating the need for further studies aimed at exploring and expanding the scientific evidence on this relationship.

PMID:40059634 | DOI:10.1089/met.2024.0194

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Assessing the Efficacy of Spinal Cord Stimulation in Managing Painful Diabetic Neuropathy: A Systematic Review and Meta-Analysis

Neuromodulation. 2025 Mar 6:S1094-7159(25)00029-7. doi: 10.1016/j.neurom.2025.01.016. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetes mellitus affects more than half a billion people globally, often leading to painful diabetic neuropathy (PDN). Spinal cord stimulation (SCS) has emerged as a promising treatment for PDN.

OBJECTIVE: This meta-analysis evaluated the efficacy of SCS compared with the best medical therapy (BMT) for PDN.

MATERIALS AND METHODS: Following the Preferred Reporting Items of Systematic reviews and Meta-Analyses guidelines, a systematic search of the PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL data bases was conducted up to December 1, 2023 and updated on January 2, 2025. Data extraction was performed using Microsoft Excel, and quality assessment was conducted using Cochrane’s Risk of Bias 2.0 and ROBINS-1 tools. Statistical analysis and heterogeneity assessment were performed using Review Manager (RevMan) software (The Cochrane Collaboration, London, UK).

RESULTS: Nine clinical trials involving 407 patients were included. The analysis revealed significant pain reduction in the SCS group (mean difference [MD]: -5.46, 95% CI: [-6.09, -4.83], p < 0.00001). Subgroup analysis indicated pain relief benefits in both conventional SCS (MD: -4.176, 95% CI: [-4.865, -3.486], p < 0.001) and 10-kHz SCS (MD: -4.581, 95% CI: [-6.376, -2.785], p < 0.001). SCS also achieved higher treatment success rates (≥50% pain relief) than did BMT (risk difference: 0.59, 95% CI: [0.33, 0.85], p < 0.00001). Moreover, SCS significantly improved the EuroQol-5 Dimension utility index (MD: 0.16, 95% CI: [0.10, 0.23], p < 0.00001) and self-reported health (MD: 15.29, 95% CI: [4.51, 26.07], p = 0.005).

CONCLUSION: This meta-analysis provides robust evidence supporting SCS as an effective intervention for managing chronic pain and enhancing the quality of life in patients with PDN, highlighting its superiority to conventional medical therapy.

PMID:40057880 | DOI:10.1016/j.neurom.2025.01.016

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Sexual Health Outcomes in Sexual Minority and Heterosexual Men After Prostate Radiation Therapy

Int J Radiat Oncol Biol Phys. 2025 Mar 6:S0360-3016(25)00087-2. doi: 10.1016/j.ijrobp.2025.01.023. Online ahead of print.

ABSTRACT

PURPOSE/OBJECTIVES: To characterize the effects of prostate radiation therapy on sexual health outcomes in sexual minority men (SMM), particularly those engaging in receptive anal intercourse (RAI), and compare them with heterosexual men (HET).

METHODS AND MATERIALS: This retrospective cohort study included patients with intact prostates, ≥6 months after radiation therapy and androgen deprivation therapy (ADT), seen between June 2022 and August 2023, and sexually active with a partner in the prior 30 days. Patients self-reported sexual orientation, gender identity, sexual behaviors, and health outcomes using select items from Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction, Sexual Health Inventory for Men, and American Urological Association questionnaires. P values <.05 were considered statistically significant; mean differences (MD) ≥3 were considered clinically meaningful.

RESULTS: Of eligible participants, 39% HET (n = 57/145) and 68% SMM (n = 21/31) were sexually active with a partner in the last 30 days (P = .005); including 15 (71%) SMM engaging in RAI. Overall, 9% received brachytherapy, 46% external beam radiation therapy, 45% both; 14% received ADT. The cohort reported worse orgasm ability (3.3, P < .01), orgasm pleasure (MD: 7.2, P < .001), and sexual satisfaction (MD: 3.4, P < .001) compared with US general population normative scores for sexually active adult men. SMM were more likely to be single (72% vs 33%, P < .001) and have higher prostate-specific antigen at diagnosis than HET (P = .031). SMM engaging in RAI reported worse orgasm ability (MD: 3.5), orgasm pleasure (MD: 6.3, P < .05), and anal discomfort (MD: 9.0) compared with norms. For SMM engaging in RAI, brachytherapy with/without external beam radiation therapy was associated with worse orgasm pleasure (MD: 3.1), yet less anal pain (MD: 5.2) compared with external beam radiation therapy alone; the addition of ADT was associated with worse orgasm ability (MD: 14.1, P < .05), orgasm pleasure (MD: 10.7, P < .05), anal pain (MD: 6.8), and sexual satisfaction (MD: 6.1).

CONCLUSIONS: Prostate cancer treatments uniquely affect sexual health in SMM, particularly those engaging in RAI. Clinicians should inquire about sexual orientation, gender identity, and sexual behaviors when discussing treatments to align care with individual preferences.

PMID:40057858 | DOI:10.1016/j.ijrobp.2025.01.023