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Nevin Manimala Statistics

Standardization of the Arabic Version of the Adult ADHD Self-Report Screening Scale for DSM-5 (ASRS-5) Among Adults in Saudi Arabia: Variability of ADHD Screening According to Sociodemographic Variables

J Atten Disord. 2025 Jan 24:10870547251313879. doi: 10.1177/10870547251313879. Online ahead of print.

ABSTRACT

OBJECTIVE: This study investigated the psychometric properties of the Arabic version of the Adult Self-Report Scale-5 (the ASRS-5-AR) within a large sample of adults residing in Saudi Arabia.

METHODS: This cross-sectional study applied the ASRS-5-AR to a random sample of 4,299 Saudi and non-Saudi adults, aged 19 to 66 years (31.16 ± 9.26 years), living in the regions of Riyadh, Makkah, and the Eastern Province in Saudi Arabia. Collected data were analyzed using IBM SPSS Statistics 26, JASP 0.18.3.0 software, and MedCalc 22.030 statistical software.

RESULTS: The ASRS-5-AR demonstrated strong internal consistency, with all six items showing significant positive correlation with the total score (.675-.735). Results of confirmatory factor analysis revealed a goodness-of-fit coefficient of 0.983 for the one-factor model and McDonald’s omega, Cronbach’s α, and Spearman-Brown coefficients of 0.786, 0.788, and 0.724, respectively. In addition, the findings revealed statistically significant differences in self-reported ADHD symptoms based on age (F = 18.68; p < .001), level of education (F = 2.61; p < .05), and marital status (F = 22.30; p < .001). However, there were no significant differences in self-reported ADHD symptoms between males and females (t = 0.625; p > .05) or Saudi and non-Saudi participants (t = 0.409; p > .05) or based on region of residence (t = 2.19; p > .05).

CONCLUSIONS: This study provides valuable insights into the psychometric properties of the ASRS-5-AR within a large sample of adults in Saudi Arabia. The findings demonstrate acceptable reliability of the ASRS-5-AR within this population. While these findings suggest the ASRS-5-AR may be a useful tool for initial assessment, further research is crucial. Future studies should focus on establishing accurate cutoff scores by comparing a general population sample with a clinically diagnosed sample of adults with ADHD in Saudi Arabia. This will allow for a more accurate evaluation of the scale’s utility in identifying individuals who may require further clinical assessment.

PMID:39851051 | DOI:10.1177/10870547251313879

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Dynamic Importance of Genomic and Clinical Risk for Coronary Artery Disease Over the Life Course

Circ Genom Precis Med. 2025 Jan 24:e004681. doi: 10.1161/CIRCGEN.124.004681. Online ahead of print.

ABSTRACT

BACKGROUND: Earlier identification of high coronary artery disease (CAD) risk individuals may enable more effective prevention strategies. However, existing 10-year risk frameworks are ineffective at earlier identification. We sought to understand how the variable importance of genomic and clinical factors across life stages may significantly improve lifelong CAD event prediction.

METHODS: A longitudinal study was performed using data from 2 cohort studies: the FOS (Framingham Offspring Study) with 3588 participants aged 19 to 57 years and the UKB (UK Biobank) with 327 837 participants aged 40 years to 70 years. A total of 134 765 and 3 831 734 person-time years were observed in FOS and UKB, respectively. Hazard ratios for CAD were calculated for polygenic risk score (PRS) and clinical risk factors at each age of enrollment. The relative importance of PRS and pooled cohort equations in predicting CAD events was also evaluated by age groups.

RESULTS: The importance of CAD PRS diminished over the life course, with a hazard ratio of 3.58 (95% CI, 1.39-9.19) at the age of 19 years in FOS and a hazard ratio of 1.51 (95% CI, 1.48-1.54) by the age of 70 years in UKB. Clinical risk factors exhibited similar age-dependent trends. PRS significantly outperformed pooled cohort equations in identifying subsequent CAD events in the 40- to 45-year age group, with 3.2-fold more appropriately identified events. Overall, adding PRS improved the area under the receiving operating curve of the pooled cohort equations by an average of +5.1% (95% CI, 4.9%-5.2%) across all age groups; among individuals <55 years, PRS augmented the area under the curve-ROC of the pooled cohort equations by 6.5% (95% CI, 5.5%-7.5%; P<0.001).

CONCLUSIONS: Genomic and clinical risk factors for CAD display time-varying importance across the lifespan. The study underscores the added value of CAD PRS, particularly among individuals younger than 55 years, for enhancing early risk prediction and prevention strategies. All results are available at https://surbut.github.io/dynamicHRpaper/index.html.

PMID:39851049 | DOI:10.1161/CIRCGEN.124.004681

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Nevin Manimala Statistics

Associations between specific and cumulative adverse childhood experiences, childhood obesity, and obesogenic behaviours

Eur J Psychotraumatol. 2025 Dec;16(1):2451480. doi: 10.1080/20008066.2025.2451480. Epub 2025 Jan 24.

ABSTRACT

Background: Individuals impacted by adverse childhood experiences (ACEs) are at greater risk of developing obesity, however, few studies have prospectively measured ACEs and obesity during childhood. Associations with the adoption of obesogenic behaviours during childhood, which directly contribute to obesity are also understudied.Objective: To examine associations between individual and cumulative ACEs, obesity, and obesogenic behaviours during childhood.Methods: Data came from Growing Up in New Zealand. The study sample was restricted to those who provided obesity data at age 8 and one child per mother, resulting in an analytic sample of 4895 children. A newly developed ACEs index consisted of nine individual ACEs and cumulative ACEs scores (0, 1, 2, 3, 4+ ACEs), two obesity measures (BMI and waist circumference/height ratio), and eight obesogenic behaviours including unhealthy dietary behaviours, inadequate sleep duration, excessive screen time, and physical inactivity were included in the analyses.Results: ACEs were prevalent among this cohort of NZ children. By age eight, 87.1% of children experienced at least one ACE and 16% experienced at least 4 ACEs. Six individuals assessed ACEs showed significant associations with childhood obesity (AORs ranging from 1.22 to 1.44). A significant dose-response effect was observed where the experience of a higher number of ACEs was associated with greater risk for obesity (AORs increased from 1.78 for one ACE to 2.84 for 4+ ACEs). Further, a significant dose-response relationship was found between experiencing two or more ACEs and higher odds of adopting obesogenic behaviours (AORs ranging from 1.29 for physical inactivity to 3.16 for no regular breakfast consumption).Conclusions: ACEs exposure contributes to population-level burden of childhood obesity. Our findings highlight the importance of a holistic understanding of the determinants of obesity, reinforcing calls for ACEs prevention and necessitating incorporation of ACEs-informed services into obesity reduction initiatives.

PMID:39851037 | DOI:10.1080/20008066.2025.2451480

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Microfragmented adipose tissue versus platelet-rich plasma in the treatment of knee osteoarthritis: a systematic review and meta-analysis

Acta Orthop Belg. 2024 Sep;90(3):549-558. doi: 10.52628/90.3.12669.

ABSTRACT

This meta-analysis focuses on the controversial efficacy and safety of microfragmented adipose tissue (MFAT) as compared with platelet-rich plasma (PRP) in the clinical treatment of knee osteoarthritis (KOA). We have attempted to provide an evidence-based medicine protocol for the conservative treatment of KOA. Researchers collected and compared randomized controlled trials (RCTs) that used microfragmented adipose tissue and platelet-rich plasma to treat knee osteoarthritis. We searched CNKI, Wanfang Database, CMJD, PubMed, Sinomed, Cochrane Library, and Embase for studies published up to May 31, 2023. Two investigators independently screened literature, extracted data, and assessed bias risk using the Cochrane bias risk tool. The researchers then performed a meta-analysis using Revman 5.4 statistics software provided by the Cochrane Library. A total of 4 randomized controlled trials involving 266 patients (326 knees) were included. There were 161 knees in the MFAT group and 165 knees in the PRP group. Meta-analysis showed a statistically significant difference in VAS scores between the MFAT group and the PRP group at 12 months after treatment [MD=0.99, 95% CI (0.31, 1.67), P=0.004]. This result showed that VAS scores were lower in the PRP group than in the MFAT group, and that PRP injection reduced pain more effectively than MFAT injection. At 6 months after treatment, Tegner activity scale scores in the MFAT group were higher than that in the PRP group [MD=0.65, 95% CI (0.11, 1.19), P=0.02], and the difference was statistically significant. There were no significant differences in the remaining indicators between the two groups. Based on this meta-analysis, PRP appears to be more effective than MFAT in treating KOA in terms of long-term pain relief. However, MFAT was superior to PRP in improving short-term activity function. Overall, there was no significant difference between MFAT and PRP in the treatment of KOA. In addition, MFAT does not increase the risk of adverse events compared to PRP. However, at present, there are few clinical studies on MFAT and PRP, which need to be verified by more rigorously designed clinical trials.

PMID:39851028 | DOI:10.52628/90.3.12669

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Impact of avascular necrosis on outcomes in the management of developmental dysplasia of hip: a systematic review

Acta Orthop Belg. 2024 Sep;90(3):535-542. doi: 10.52628/90.3.12274.

ABSTRACT

Avascular necrosis (AVN) is a known complication during the management of developmental dysplasia of the hip (DDH). It has the potential to alter the growth of the head or acetabulum and prevent the best outcomes. While past literature has evaluated the risks of AVN and strategies to avoid it, studies on the impact of AVN on the outcomes are scarce. In this systematic review, we aim to study the extent of the effects of AVN on the outcomes, in the management of DDH. In this systematic review series for 1990 to 2021 were pooled. The clinical and radiological outcomes of the AVN and non-AVN groups were compared. The effects of other modifying factors were also evaluated. A total of 170 AVN and 585 non-AVN hips from 21 papers were compared. The analysis did not show any statistically significant difference between the AVN and non-AVN groups in terms of clinical or radiological parameters. Interestingly patients who had the index surgery at a younger age had a higher risk of further surgery, with acetabular osteotomy being the most common secondary procedure. The negative impact of AVN may not be as severe as previously thought. Thus, the fear of AVN should not take precedence over the primary goal of DDH management i.e. obtaining a stable concentric mobile hip.

PMID:39851026 | DOI:10.52628/90.3.12274

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Total hip arthroplasty after pelvic osteotomy: a meta-analysis

Acta Orthop Belg. 2024 Sep;90(3):523-533. doi: 10.52628/90.3.10758.

ABSTRACT

Several studies suggested that total hip arthroplasty (THA) was more technical demanding following previous pelvic osteotomy (PO), resulting in poor outcomes compared with primary THA. However, the other studies regarding this topic had reported contradictory results. Therefore, we conducted this meta-analysis to compare the clinical results and other parameters between total hip arthroplasty following pelvic osteotomy and primary total hip arthroplasty. We systematically searched PubMed, the Cochrane Library, EMBASE, Web of Science, Scopus, EBSCO and Web of science from inception to September 2020. This study compared the outcomes between THA following previous PO and primary THA with respect to operative time, blood loss, Harris hip score (HHS), revision rates, complication rates, cup position, cup size, cup coverage and hip joint center. 14 studies with 3913 participants were included. The THA after PO group had longer operative time (MD, 13.8 mins; 95% CI, 4.73 to 22.87 mins; P=0.003), greater blood loss (MD, 82.21 ml; 95% CI, 27.94 to 136.48 ml; P=0.003), worse HHS (MD, -2.79 points; 95% CI, -4.08 to -1.50 points; P<0.00001), smaller acetabular anteversion angle (MD, -3.98°; 95% CI, -6.72 to -1.24°; P=0.004), larger cup size (MD, 1.52 mm; 95% CI, 0.75 to 2.28 mm; P=0.0001), more lateral (MD, 2.83 mm; 95% CI, 1.22 to 4.43 mm; P=0.0005) and superior (MD, 2.26 mm; 95% CI, 1.11 to 3.40 mm; P=0.0001) hip joint center. No statistically significant differences were demonstrated between the THA after PO group and primary THA group in revision rates, complication rates, acetabular abduction angle, cup coverage. THA after pelvic osteotomy was associated with inferior intraoperative outcomes, lower functional scores and worse inferior positioning of acetabular component compared with primary THA. Due to the alerted anatomical structure after PO, the findings of current study implicated that preoperative assessment such as computed tomography scan should be conducted in order to achieve satisfactory results.

PMID:39851025 | DOI:10.52628/90.3.10758

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Outcome, severity of injury and length of sick leave after an ankle fracture: an observational register study

Acta Orthop Belg. 2024 Sep;90(3):475-483. doi: 10.52628/90.3.12839.

ABSTRACT

There is a lack in understanding the reasons for different lengths of sick leave in patients who sustain ankle fractures. The aim of this study is to examine variations in the length of sick leave in ankle fracture patients and how treatment, type of ankle fracture and the patient-reported outcome are associated with the length of sick leave. In this study were data from the Swedish Social Insurance Agency (SSIA) and the Swedish Fracture Register (SFR), combined. Patients who sustained an ankle fracture were identified and the length of the sick leave calculated. Variables associated to the length of the sick leave were analysed. Fifty-three percent of the patients were on sick leave for an average of 88 days. Factors that were associated with the length of sick leave were an open fracture, operative treatment, multiple treatments, AO/OTA classification, and previous sick leave. Patients on sick leave for 22 weeks or more scored 15 points (CI 95% 12-18) worse on the dysfunction index of the Short Musculoskeletal Function Assessment in the 1-year follow-up compared to the pre- injury survey. This can be compared to 3 points (CI 95% 2-5) lower in patients with the shortest sick leave. There is an association between the severity of the injury and the length of sick leave following an ankle fracture, as well as between the patient-reported outcome after one year and the length of the sick leave.

PMID:39851020 | DOI:10.52628/90.3.12839

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The top 100 most-cited total knee arthroplasty publications

Acta Orthop Belg. 2024 Sep;90(3):463-473. doi: 10.52628/90.3.12420.

ABSTRACT

The object is to objectively identify the 100 most influential scientific publications in total knee arthroplasty (TKA) and provide an analysis of their main characteristics. The Clarivate Analytics Web of Knowledge database was used to obtain data and metrics of TKA research. The search list was sorted by the number of citations, and articles were included or excluded based on relevance to TKA. The information extracted for each article included author name, publication year, country of origin, journal name, article type, and the level of evidence. These 100 studies generated a total of 35,399 cita- tions, with an average of 355.9 citations per article. The most-cited article was cited 1273 times. The 100 studies included in this analysis were published between 2000 and 2017. 23 different journals published these 100 publications. Majority of the publications were from United States (n = 52), followed by UK (n = 10) and Canada (n = 8). The most prevalent study designs were case series (n = 32) and cohort studies (n = 30). The 100 most influential articles in TKA were cited a total of 35,399 times. The study designs most prevalent were case series and cohort studies. This article serves as a reference to direct orthopedic surgeons to the 100 most influential studies in total knee arthroplasty. More than half of the studies are from North America, and three journals hold two-thirds of the 100 most cited publications on the topic.

PMID:39851019 | DOI:10.52628/90.3.12420

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Reamed versus unreamed proximal femoral nailing for intertrochanteric fractures in geriatric patients. A retrospective case control study

Acta Orthop Belg. 2024 Sep;90(3):455-461. doi: 10.52628/90.3.11997.

ABSTRACT

Cephalomedullary nail is the gold standard treatment for intertrochanteric fracture in geriatric population. The aim of the study was to investigate the differences of the reamed versus the unreamed short proximal femoral nailing (PFN), in terms of the duration of surgery and the outcome. The impact of patients and fracture characteristics to the outcome was also evaluated. A retrospective analysis of 158 elderly patients, who sustained intertrochanteric fracture of the femur, with a minimum follow up of one year, was performed. 78 patients underwent a reamed proximal femoral nailing (PFN) whereas 80 patients underwent an unreamed PFN. The duration of surgery, the outcome and the complications between the reamed and the unreamed nailing were compared. A logistic regression was also conducted to estimate the risk factors affecting mortality. The mean duration of surgery for reamed and unreamed G nail was 48,87 min (C.I.: 47,30-50,44) and 42,45 min (C.I.: 41,30-43,60) respectively. No statistically significant difference regarding the need for transfusion and complications, such as wound healing problems and screw cut out was identified between the two types of nailing. The most important factors affecting mortality were the ASA (beta coefficient: 3,127, p-value: 0,002) and the need for transfusion (beta coefficient: 1,367, p-value: 0,05). The only difference found between the reamed and the unreamed PFN was the operation time, which was less for the later one. Both types of fixation were similar in terms of outcome and complications.

PMID:39851018 | DOI:10.52628/90.3.11997

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The benefits of a dedicated orthopaedic trauma room

Acta Orthop Belg. 2024 Sep;90(3):443-447. doi: 10.52628/90.3.13030.

ABSTRACT

The aim of this comparative study was to examine the possible benefits of a dedicated Orthopaedic Trauma Room (DOTR) and in the care of patients with proximal femur fractures. A retrospective study of all orthopaedic cases with a hip fracture from 2020 to 2022 at CHC Montlegia has been undertaken, the group is compared to patients with the same impairment from 2018-2020 admitted to Saint Joseph/Esperance CHC hospitals (before the merge and the existence of a DOTR). The delay between the arrival at the emergency department and transfer to the operating room, as well as the mortality are evaluated. The length of hospital stay, the operating time, the ASA score, and the Charlson Index were also examined. A total of 734 cases were analysed, with 384 patients pre-DOTR and 350 patients post-DOTR. The 2 groups were compara- ble in gender, age, fracture type, Asa-score and Charlson Index. The time to the operating room (OR) has been reduced by 14h36 (37h35 vs 23h09, p< 0,001). There was no statistical difference detected in mortality after implementation of an DOTR, not after 3 months, neither a year. Novel oral anticoagulants (NOAC) intake showed no significant effect on the mortality postoperatively. The Length of hospital stay in your study was decreased by 1, 54 days (p< 0,001). A dedicated orthopaedic trauma room reduced the time to OR and the length of hospital stay. There was no statistical difference detected in mortality after implementation of an DOTR, not after 3 months, neither a year. With a DOTR, the care of trauma patients can be optimized and should become a standard of care.

PMID:39851016 | DOI:10.52628/90.3.13030