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Nevin Manimala Statistics

A Comparison of PROMIS Scores of Metatarsophalangeal Joint Arthrodesis and Polyvinyl Alcohol Hydrogel Implant Hemiarthroplasty for Hallux Rigidus

JB JS Open Access. 2024 Aug 19;9(3):e23.00158. doi: 10.2106/JBJS.OA.23.00158. eCollection 2024 Jul-Sep.

ABSTRACT

BACKGROUND: The current literature shows similar clinical outcomes between first metatarsophalangeal (MTP) joint arthrodesis and synthetic cartilage implant (SCI) hemiarthroplasty in the treatment of hallux rigidus; however, prior studies have not reported validated patient-reported outcome measures (PROMs). To our knowledge, this is the first study to compare PROMs using 6 domains of the validated Patient-Reported Outcomes Measurement Information System (PROMIS) in patients treated for hallux rigidus with MTP joint arthrodesis and with SCI hemiarthroplasty. In addition, this novel study provides comparative data on the complication and revision rates for each procedure.

METHODS: A single-center, retrospective registry search identified all patients with preoperative PROMIS scores who underwent MTP joint arthrodesis or SCI hemiarthroplasty for hallux rigidus between February 2016 and June 2021. The study aimed to determine if the 2 procedures showed statistically or clinically equivalent PROMIS scores in 6 domains: physical function, pain interference, pain intensity, global physical health, global mental health, and depression. A multivariable linear regression analysis was performed to compare adjusted 1-year postoperative PROMIS scores between the 2 cohorts. Complication and revision rates were also compared.

RESULTS: The study included 82 patients who underwent SCI hemiarthroplasty and 101 who underwent MTP joint arthrodesis. Demographic data and preoperative hallux rigidus severity showed no significant differences between the cohorts. PROMIS scores were mostly comparable between the 2 groups, except for the pain intensity domain. The patients who underwent MTP joint arthrodesis exhibited significantly better pain relief at 1 and 2 years postoperatively, which was supported by adjusted postoperative PROMIS scores. At 2 years, the SCI group had worse pain intensity scores and lower global physical health scores. There were no differences between the cohorts in additional PROMIS scores or complication data.

CONCLUSIONS: While outcomes in most of the domains were similar, MTP joint arthrodesis was more effective at mitigating pain intensity compared with SCI hemiarthroplasty. This information can guide patient counseling and decision-making when considering surgical intervention for hallux rigidus.

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

PMID:39161931 | PMC:PMC11328988 | DOI:10.2106/JBJS.OA.23.00158

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Nevin Manimala Statistics

A retrospective comparative study of patient-reported outcome measures, pre-treatment and twelve months post-treatment using tumescent liposuction for the management of lower limb lipoedema

JPRAS Open. 2024 Jun 4;41:285-294. doi: 10.1016/j.jpra.2024.05.007. eCollection 2024 Sep.

ABSTRACT

BACKGROUND: Lipoedema is a painful adipose tissue disorder, affecting the limbs of women, that is resistant to diet and exercise. The purpose of the study was to evaluate the retrospective health-related quality-of-life (HRQoL) outcomes for patients with lower limb lipoedema (LLL) following tumescent liposuction (TL).

METHODS: Forty-seven patients received TL over 5 years from 2015-2020 for LLL. As part of their routine treatment evaluation, each patient completed 4 validated HRQoL questionnaires at initial assessment. The questionnaires examined the patients’ experiences relating to anxiety and depression, lower extremity function, appearance, and symptoms. The same questionnaires were posted to the patients after an average of 12 months post-procedure/s to establish the outcomes of the intervention.

RESULTS: The study demonstrated that patients’ HRQoL improved at 12 months (average) following TL. The results of all the questionnaires were statistically significant, and patients with stage 3 LLL showed the most improvement in outcomes.

CONCLUSION: The findings demonstrated that TL achieves positive HRQoL outcomes in patients with LLL; however, long-term follow-up is needed to determine if the benefits sustain. Additionally, larger prospective controlled studies are required to provide robust evidence for this procedure.

PMID:39161914 | PMC:PMC11332691 | DOI:10.1016/j.jpra.2024.05.007

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Nevin Manimala Statistics

Bidirectional relationship between Helicobacter pylori infection and nonalcoholic fatty liver disease: insights from a comprehensive meta-analysis

Front Nutr. 2024 Aug 5;11:1410543. doi: 10.3389/fnut.2024.1410543. eCollection 2024.

ABSTRACT

BACKGROUND: Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD) represent significant concerns in global health. However, the precise relationship between H. pylori and NAFLD remains a subject of ongoing debate. This study endeavors to elucidate the association between H. pylori infection and the susceptibility to NAFLD. Furthermore, we aim to investigate the interplay among H. pylori infection, NAFLD, and metabolic syndrome (MetS).

METHODS: We conducted an extensive search of the PubMed, EMBASE, and Web of Science databases spanning from inception to January 2024. Our examination focused on rigorous studies investigating the correlation between H. pylori infection and NAFLD. Utilizing a random-effects model, we computed the pooled odds ratio (OR) and corresponding 95% confidence interval (CI). Additionally, we assessed statistical heterogeneity, performed sensitivity analyses, and scrutinized the potential for publication bias.

RESULTS: Thirty-four studies involving 175,575 individuals were included in our meta-analysis. Among these, 14 studies (involving 94,950 patients) demonstrated a higher incidence of NAFLD in H. pylori infection-positive individuals compared to H. pylori infection-negative individuals [RR = 1.17, 95% CI (1.10, 1.24), Z = 4.897, P < 0.001]. Seventeen studies (involving 74,928 patients) indicated a higher positive rate of H. pylori infection in patients with NAFLD compared to those without NAFLD [RR = 1.13, 95% CI (1.02, 1.24), Z = 2.395, P = 0.017]. Sensitivity analyses confirmed the robustness of these findings, and funnel plot analysis revealed no significant publication bias. Furthermore, we observed associations between H. pylori infection or NAFLD and various metabolic factors, including body mass index (BMI), blood pressure, lipids, liver function, and kidney function.

CONCLUSION: Our meta-analysis presents evidence supporting a reciprocal relationship between H. pylori infection and the susceptibility to NAFLD. Nevertheless, additional investigations are warranted to bolster this correlation and unravel the underlying mechanisms involved.

PMID:39161913 | PMC:PMC11332609 | DOI:10.3389/fnut.2024.1410543

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The vitamin D status in a Chinese osteogenesis imperfecta population and its correlation with bone metabolic markers and bone density

Front Nutr. 2024 Aug 5;11:1390668. doi: 10.3389/fnut.2024.1390668. eCollection 2024.

ABSTRACT

OBJECTIVE: Studies on the baseline vitamin D levels in osteogenesis imperfecta (OI) patients before medication are scarce. This study assessed the vitamin D status of a population with OI at both the overall level and within different age groups. It correlated baseline 25-hydroxyvitamin D (25(OH)D) levels with other bone-related factors, biochemical markers, and bone density.

PATIENTS AND METHODS: We collected 25(OH)D levels from 95 OI patients in East China (59 under 18 years old and 36 over 18 years old). Postmenopausal women and men over 50 years old are excluded. Measurements included body indicators, biochemical markers, and bone mineral density (BMD) assessed by Dual-energy X-ray absorptiometry (DXA). Data analysis was performed using SPSS 26.0.

RESULTS: In the overall population, among those under 18 years old, and among those over 18 years old, 87.4, 83.1, and 94.4%, respectively, were vitamin D deficient (<30 ng/mL), while 47.4, 40.7, and 58.3% had vitamin D deficiency (<20 ng/mL), respectively. In the overall population and among those under 18 years old, serum 25(OH)D levels were negatively correlated with age and parathyroid hormone (PTH) levels, and 25(OH)D levels (<10 ng/mL, 10-20 ng/mL, 20-30 ng/mL, >30 ng/mL) showed a negative correlation with BMI. In OI patients under 18 years old, serum 25(OH)D was negatively correlated with serum β-CTX levels. In adult male OI population, 25(OH)D levels were negatively correlated with OI severity (Type I, IV, III). No statistically significant correlation was found between 25(OH)D levels and BMD Z-scores.

CONCLUSION: This study on OI in East China reveals significant vitamin D insufficiency and deficiency in baseline levels among pediatric, adolescent and adult OI patients. It assesses the correlation of 25(OH)D levels with various influencing factors, providing crucial insights into understanding the impact of OI on vitamin D status across different age groups and aiding in better clinical management of OI patients.

PMID:39161912 | PMC:PMC11333034 | DOI:10.3389/fnut.2024.1390668

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Assessing causal association of circulating micronutrients and systemic lupus erythematosus susceptibility: a Mendelian randomization study

Front Nutr. 2024 Aug 5;11:1359697. doi: 10.3389/fnut.2024.1359697. eCollection 2024.

ABSTRACT

BACKGROUND: Previous studies showed the conflicting associations between circulating micronutrient levels and systemic lupus erythematosus (SLE). Therefore, we aimed to clarify the causal association between circulating micronutrient levels and the risk of SLE by two-sample Mendelian randomization (MR) analysis.

METHODS: 56 single nucleotide polymorphisms (SNPs) significantly associated with 14 circulating micronutrients (vitamin A, B6, B9, B12, C, D and E, phosphorus, calcium, magnesium, copper, iron, zinc, and selenium) in published genome-wide association studies (GWAS) were used as instrumental variables (IVs). And summary statistics related to SLE were obtained from the IEU OpenGWAS database. We used the MR Steiger test to estimate the possible causal direction between circulating micronutrients and SLE. In the MR analysis, inverse variance weighting (IVW) method and the Wald ratio was as the main methods., Moreover, the MR-Pleiotropy residuals and outliers method (MR-PRESSO), Cochrane’s Q-test, MR-Egger intercept method and leave-one-out analyses were applied as sensitivity analyses. Additionally, we conducted a retrospective analysis involving the 20,045 participants from the Third National Health and Nutritional Examination Survey (NHANES III). Weight variables were provided in the NHANES data files. Univariate and multivariate logistic regression analyses were performed to determine the associations between circulating micronutrients and SLE.

RESULTS: The MR estimates obtained from the IVW method revealed potential negative correlations between circulating calcium (OR: 0.06, 95% CI: 0.01-0.49, P = 0.009), iron levels (OR: 0.63, 95% CI: 0.43-0.92, P = 0.016) and the risk of SLE. The results remained robust, even under various pairs of sensitivity analyses. Our retrospective analysis demonstrated that the levels of vitamin D, serum total calcium, and serum iron were significantly lower in SLE patients (N = 40) when compared to the control group (N = 20,005). Multivariate logistic regression analysis further established that increased levels of vitamin D and serum total calcium served as protective factors against SLE.

CONCLUSION: Our results provided genetic evidence supporting the potential protective role of increasing circulating calcium in the risk of SLE. Maintaining adequate levels of calcium may help reduce the risk of SLE.

PMID:39161911 | PMC:PMC11333035 | DOI:10.3389/fnut.2024.1359697

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Nevin Manimala Statistics

Food waste awareness among Italian university students: results of an online survey

Front Nutr. 2024 Aug 5;11:1401581. doi: 10.3389/fnut.2024.1401581. eCollection 2024.

ABSTRACT

INTRODUCTION: Food waste (FW) represents a significant social and environmental problem, with 1.3 billion tons of food wasted yearly worldwide. Even if consumers are increasingly aware of the phenomenon, it remains relevant, and understanding the behaviors of specific target audience segments appears instrumental to the planning of effective interventions. To this end, we designed an observational study to investigate, throughout an online questionnaire, FW-related habits of university students in a Southern Italian region.

METHODS: A representative sample of 431 students from the University of Catanzaro Magna Graecia completed an online survey aimed at investigate FW related behaviors. A descriptive analysis was performed on the whole cohort, and a formal statistical analysis was carried out after excluding responders who had not correctly followed the survey instructions (n = 85). Differences were assessed by chi square (χ 2) tests. A food wasting score was generated, and differences in the score values were analyzed by Student T-test. Linear and multiple regression analyses were performed to identify factors contributing to the score.

RESULTS: Overall, the results of our survey show a high prevalence of virtuous behaviors in the food purchasing phase; while, at home, less than 50% of respondents apply easy-to-implement waste prevention rules. The statistical analysis showed that the major determinants of FW were: no direct involvement in grocery shopping and male gender. Indeed, even if we observed several significant differences comparing subgroups based on established or putative determinants of FW behaviors, none survived matching for group size, gender and relevant food managing (shopping, storing, cooking) habits. The only exception was the more appropriate handling of “use by” products by respondents who received structured nutrition teaching, as opposed to students whose academic courses do not include this subject (adjusted p = 0.008).

CONCLUSION: Our data suggest that young adults are trying to implement strategies to reduce FW, even if there is room for improvement, particularly in the storage phase. Extending nutrition education to all university programs may be helpful in reaching this goal.

PMID:39161909 | PMC:PMC11333036 | DOI:10.3389/fnut.2024.1401581

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Optimizing first-line TKI treatment efficacy in PD-L1-positive EGFR-mutated NSCLC: the impact of antiangiogenic agents

Front Pharmacol. 2024 Aug 5;15:1391972. doi: 10.3389/fphar.2024.1391972. eCollection 2024.

ABSTRACT

BACKGROUND: In individuals receiving treatment with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), those exhibiting positive PD-L1 expression might experience reduced progression-free survival (PFS). However, the effects on overall survival (OS) and the determination of efficacious treatment approaches are still not well-defined.

METHODS: In our retrospective study, we examined data from 193 NSCLC patients with advanced EGFR mutations who received first-line TKI treatments, treated at two centers of Shaw Hospital in Zhejiang, China. This analysis covered a period from 1 January 2016 to 30 April 2023.

RESULTS: Patients with PD-L1 positivity exhibited a markedly shorter average PFS (9.5 months versus 17.8 months, P < 0.001) and OS (44.4 months versus 65.7 months, P = 0.016) relative to those without PD-L1 expression. This difference in both PFS and OS remained statistically significant even after adjusting for multiple factors (P < 0.001 for PFS and P = 0.028 for OS). In the PD-L1-positive cohort, introducing combination antiangiogenic significantly extended both PFS (from 9.1 to 25.7 months, P = 0.026) and OS (from 42 to 53.5 months, P = 0.03). Post-first-line TKI therapy, 39.3% of PD-L1-positive patients and 54.5% of PD-L1-negative patients developed the T790M mutation (P = 0.212), with no notable difference in PFS from second-line TKI treatments between the groups. Additionally, subsequent combination therapy with immunotherapy markedly prolonged OS in the PD-L1-positive group. However, for PD-L1-negative patients, neither combination antiangiogenic therapy nor later-line immunotherapy demonstrated significant benefits in PFS or OS.

CONCLUSION: For PD-L1-positive patients, combined antiangiogenic treatments and immunotherapy can significantly improve survival outcomes. In contrast, PD-L1-negative patients show less benefit from these therapies, highlighting the greater efficacy of these treatments in PD-L1-positive individuals.

PMID:39161896 | PMC:PMC11330760 | DOI:10.3389/fphar.2024.1391972

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Dataset of received optical power on pork meat for optical in-body communications studies

Data Brief. 2024 Jul 15;55:110749. doi: 10.1016/j.dib.2024.110749. eCollection 2024 Aug.

ABSTRACT

The utilization of actual biological tissue (e.g., pork meat samples) and tissue-mimicking phantoms for optical-based in-body data and energy transfer studies is crucial. Near-infrared (NIR) light, a part of the light spectrum that falls between visible light and infrared, is highly advantageous as a carrier for data transmission due to its superior ability to penetrate biological tissue, for instance, the human body. Using pork meat samples as a propagation medium for prolonged experiments is challenging due to the deterioration of meat quality caused by drying in the temperature chamber. Typically, a controlled-temperature chamber can be utilized to warm the tissue samples to 37 °C. Some experiments need to be carried out over long periods, in some cases exceeding one hour, including the demonstration of transmitting large-size data (e.g., high-definition images or videos) in real-time through biological tissue using NIR LED. Moreover, for statistical analysis, some experiments need to be repeated, therefore degradation of the tissue sample should be avoided. Furthermore, experiments may also encompass investigations into optical wireless power transfer (OWPT) conducted on biological tissues under NIR illumination and employing energy harvester-based commercial photovoltaic cells (PV) at the receiving ends, which would require a long time to charge the storage (e.g., battery or supercapacitor) fully. Using phantoms for such an experiment is also not straightforward, requiring careful consideration, such as standardization issues. One possible approach to address this challenge is to conduct experiments in a free-space environment (e.g., sample-free) while guaranteeing that the optical power received in free-space is equivalent to that obtained through biological tissue. This can be achieved by carefully controlling the LED’s current and arranging the optical channel’s distance to achieve comparable results. The received optical power is the primary parameter for comparing free-space and biological tissue setups. This dataset provides settings for NIR LEDs ( P m a x = 375 mW and λ = 810 nm), allowing in-body communication experiments in a free-space environment. The LED’s current settings in this dataset (free-space) are equivalent in comparison to those used in a test-bed using biological tissue with 5 (five) different variations of LED currents (i.e., 500 mA, 400 mA, 300 mA, 200 mA, and 100 mA). The dataset consists of six pork meat samples with different thicknesses and fat-muscle layer compositions, resulting in 36 data points. This dataset holds significant potential for reuse in any biomedical research, particularly in the fields of in-body communication and energy transfer utilizing light.

PMID:39161879 | PMC:PMC11332801 | DOI:10.1016/j.dib.2024.110749

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Temporal trends, in-hospital outcomes, and risk factors of acute myocardial infarction among patients with epilepsy in the United States: a retrospective national database analysis from 2008 to 2017

Front Neurol. 2024 Aug 5;15:1378682. doi: 10.3389/fneur.2024.1378682. eCollection 2024.

ABSTRACT

BACKGROUND: The relationship between epilepsy and risk of acute myocardial infarction (AMI) is not fully understood. Evidence from the Stockholm Heart Study indicates that the risk of AMI is increased in people with epilepsy. This study aims to analyze the temporal trends in prevalence, adverse clinical outcomes, and risk factors of AMI in patients with epilepsy (PWE).

METHODS: Patients aged 18 years or older, diagnosed with epilepsy with or without AMI and hospitalized from January 1, 2008, to December 31, 2017, were identified from the National Inpatient Sample (NIS) database. The Cochran-Armitage trend test and logistic regressions were conducted using SAS 9.4. Odds ratios (ORs) were generated for multiple variables.

RESULTS: A total of 8,456,098 inpatients were eligible for our analysis, including 181,826 comorbid with AMI (2.15%). The prevalence of AMI diagnosis in PWE significantly increased from 1,911.7 per 100,000 hospitalizations in 2008 to 2,529.5 per 100,000 hospitalizations in 2017 (Ptrend < 0.001). Inpatient mortality was significantly higher in epilepsy patients with AMI compared to those without AMI (OR = 4.61, 95% CI: 4.54 to 4.69). Factors significantly associated with AMI in PWE included age (≥75 years old vs. 18 ~ 44 years old, OR = 3.54, 95% CI: 3.45 to 3.62), atherosclerosis (OR = 4.44, 95% CI: 4.40 to 4.49), conduction disorders (OR = 2.21, 95% CI: 2.17 to 2.26), cardiomyopathy (OR = 2.11, 95% CI: 2.08 to 2.15), coagulopathy (OR = 1.52, 95% CI: 1.49 to 1.54), dyslipidemia (OR = 1.26, 95% CI: 1.24 to 1.27), peptic ulcer disease (OR = 1.23, 95% CI: 1.13 to 1.33), chronic kidney disease (OR = 1.23, 95% CI: 1.22 to 1.25), smoking (OR = 1.20, 95% CI: 1.18 to 1.21), and weight loss (OR = 1.20, 95% CI: 1.18 to 1.22).

CONCLUSION: The prevalence of AMI in PWE increased during the decade. Mortality rates were high among this population, highlighting the need for comprehensive attention to prophylaxis for risk factors and early diagnosis of AMI in PWE by physicians.

PMID:39161871 | PMC:PMC11330761 | DOI:10.3389/fneur.2024.1378682

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Exploring the water, sanitation and hygiene status and health outcomes in Zimbabwe: a scoping review protocol

BMJ Open. 2024 Aug 19;14(8):e082224. doi: 10.1136/bmjopen-2023-082224.

ABSTRACT

BACKGROUND: The sixth United Nations Sustainable Development Goal emphasises universal access to clean water, sanitation and hygiene (WASH) to ensure human well-being as a fundamental human right for sustainable development. In Zimbabwe, WASH reforms began more than a century ago from the preindependence to postindependence era. However, countries face pressing challenges in improving their related health outcomes. Therefore, this scoping review aims to explore WASH status and how it influences health outcomes in Zimbabwe.

METHODS AND ANALYSIS: The leading databases to be searched for relevant sources published in English with an unrestricted search back until May 2024 include PubMed, EBSCO, SAGE, SpringerLink, Cochrane Library, ScienceDirect, Scopus, Web of Science and African Journals Online. A search string was developed for retrieving literature, and reports from key stakeholders in the WASH sector will be included in this study as grey literature. The study will employ a two-step screening process for identifying relevant literature incorporating Cohen’s kappa coefficient statistics to estimate the inter-rater reliability between two independent reviewers using Mendeley and Rayyan software. The Strengthening the Reporting of Observational Studies in Epidemiology checklist for observational studies and the Consolidated Standards of Reporting Trials checklist for randomised controlled trials will be used for the quality checks. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will guide this study in terms of data collection, extraction and analysis from relevant literature. Data charting was used to present and interpret the findings. The entire process is scheduled to commence in June 2024, with the manuscript anticipated to be submitted to a journal in October 2024.

ETHICS AND DISSEMINATION: This review will use only published data; therefore, no ethical clearance is required. The findings will be disseminated to relevant stakeholders through peer-reviewed journals, meetings, conferences, seminars and forums.

PMID:39160105 | DOI:10.1136/bmjopen-2023-082224