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Nevin Manimala Statistics

Meta-analysis of prognostic factors in patients with knee arthroplasty

Front Surg. 2025 Jul 18;12:1584238. doi: 10.3389/fsurg.2025.1584238. eCollection 2025.

ABSTRACT

OBJECTIVE: To identify specific factors predicting functional outcomes, pain reduction, and patient satisfaction following knee arthroplasty through systematic review and meta-analysis.

METHODS: A comprehensive search of multiple databases (Pubmed, Embase, OVID, Medline, Cochrane Library, CNKI, Wanfang, VIP) was conducted for studies published from database inception to December 2024. Studies reporting associations between preoperative factors and standardized outcomes after knee arthroplasty were included. Two reviewers independently screened articles, extracted data, and assessed study quality using modified Jadad scale for randomized trials and MINORS for non-randomized studies. Random-effects meta-analyses were performed for pain duration and red blood cell distribution width (RDW), with meta-regression to assess their prognostic value for functional outcomes measured by standardized knee scores. Heterogeneity was assessed using I2 statistics, and publication bias was evaluated using Egger’s and Begg’s tests.

RESULTS: Eight studies were included in the final analysis: Four studies examining pain duration (n = 576 patients) and four studies examining RDW (n = 612 patients) met inclusion criteria. Significant heterogeneity was observed in both analyses (I2 = 87% and I2 = 91%, respectively, p < 0.01). Meta-regression revealed that shorter pain duration (<3 years) was significantly associated with better functional outcomes at 12-month follow-up [Weighted Mean Difference (WMD) = -4.532, 95%CI = (-6.439,-2.626), p < 0.001]. Normal preoperative RDW values (11.5-14.5%) were also significantly associated with improved functional outcomes [WMD = -1.742, 95%CI = (-2.371,-1.114), p < 0.001]. Subgroup analyses indicated that the predictive value of these factors was consistent across different surgical techniques (p = 0.42). Publication bias assessment showed no significant bias (Egger’s test p = 0.2094, Begg’s test p = 0.0833). The high heterogeneity limits the direct clinical application of these pooled estimates and necessitates cautious interpretation.

CONCLUSION: This meta-analysis identified shorter preoperative pain duration and normal RDW values as independent predictors of better functional outcomes following knee arthroplasty. However, the small number of included studies and high heterogeneity observed warrant cautious interpretation of these findings. These findings can help clinicians identify patients at risk of suboptimal outcomes and potentially guide personalized perioperative interventions. Further research is needed to establish optimal cutoff values and to evaluate the combined predictive power of these factors in clinical practice.

PMID:40755482 | PMC:PMC12315344 | DOI:10.3389/fsurg.2025.1584238

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Research on Postoperative Scar Quality of Sutures and Skin Surface Adhesives

J Plast Reconstr Surg. 2025 Jan 24;4(3):127-136. doi: 10.53045/jprs.2024-0044. eCollection 2025 Jul 27.

ABSTRACT

OBJECTIVES: This study aimed to compare the quality of scarring of DERMABOND PRINEO (Ethicon, Inc., Somerville, NJ, USA) by conducting a half-side test on the same wound to determine its superiority. If the utility of DERMABOND PRINEO is established, its use can be expanded for more cases and higher quality medical care can be provided.

METHODS: Patients who underwent two-stage breast reconstruction were included. The first surgery was half closed with DERMABOND PRINEO and nylon threads, and the time was measured. At the second surgery, all scars were removed, and a histopathological examination was done. Scars were evaluated with the Vancouver Scar Scale (VSS) and visual analogue scale (VAS), and statistical analysis was performed.

RESULTS: Time to closure was significantly shorter in the DERMABOND PRINEO group. Postoperative VSS scores for pliability were significantly lower in the suture group, and the total VSS score was significantly lower in the suture group from 3 to 6 months postoperatively. Patients rated postoperative wound pain, itching, appearance, and satisfaction with the VAS, but no significant differences were observed between the two groups. The scars were compared with hematoxylin-eosin staining and Elastica van Gieson staining. Differences were seen in the increase of elastic fibers in the dermal reticular layer, a characteristic difference between the two groups.

CONCLUSIONS: The use of DERMABOND PRINEO leads to a reduction in operative time and impacts the maturity of the scar. It is expected that the indications for DERMABOND PRINEO can be further expanded in the future.

PMID:40755474 | PMC:PMC12310342 | DOI:10.53045/jprs.2024-0044

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Relationship Between Patient-Reported Experiences and Treatment Satisfaction Among Men and Women in Residential Substance Use Treatment

Drug Alcohol Rev. 2025 Aug 4. doi: 10.1111/dar.70011. Online ahead of print.

ABSTRACT

INTRODUCTION: Understanding the experiences of women participating in residential alcohol and other drug (AOD) treatment is important in ensuring treatment effectively meets women’s needs. Patient-reported experience measures aid in assessing women’s experiences of treatment but are often used to quantify women’s treatment satisfaction without additional context regarding specific treatment experiences. This study examined the relationship between the domains of the Patient Reported Experience Measure for Addiction Treatment (PREMAT) and overall treatment satisfaction, including whether relationships differed by gender.

METHODS: N = 138 participants (30.9% women) from a not-for-profit residential AOD treatment service completed a survey regarding their experiences of and satisfaction with treatment, including the PREMAT. Descriptives, chi-square and Mann-Whitney U statistics examined gender differences in demographics. A generalised linear model assessed the relationship between PREMAT domain scores and overall treatment satisfaction (Client Satisfaction Questionnaire), controlling for age and weeks in treatment, including whether relationships differed by gender. Relative weight statistics examined the relative statistical importance of each PREMAT domain to overall satisfaction.

RESULTS: There were no gender differences on PREMAT item, domain or total scores. Controlling for age and weeks in treatment, significant predictors of overall treatment satisfaction were the PREMAT ‘self-determination and empowerment’ and ‘personal responsibility’ domains. The impact of ‘personal responsibility’ on overall satisfaction was weaker for women compared to men.

DISCUSSION AND CONCLUSIONS: Fostering individualised care and support, self-determination, empowerment and personal responsibility for care, are important aspects of residential treatment for both men and women. Further development of women-specific PREMs that address gendered experiences of treatment is warranted.

PMID:40755442 | DOI:10.1111/dar.70011

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α2-Macroglobulin Concentrations in Canine and Equine Serum Donors

Vet Ophthalmol. 2025 Aug 4. doi: 10.1111/vop.70057. Online ahead of print.

ABSTRACT

PURPOSE: To determine if serum α2-macroglobulin (A2M) concentration varies based on donor species-canine or equine-and signalment.

METHODS: Serum A2M concentration ([A2M]) was measured in healthy dogs (n = 30) and horses (n = 31) using species-specific ELISAs.

RESULTS: Canine and equine [A2M] median (IQR; range) were 98.70 ng/mL (92.79 ng/mL; 34.33-696.18 ng/mL) and 557 000 ng/mL (437 900 ng/mL; 62 600-3 042 900 ng/mL), respectively. Equine [A2M] was significantly higher than canine [A2M]. Depending on the statistical analysis performed, sex had either no statistical (p = 0.17) or medium practical (η2 = 0.07) effect on canine serum [A2M], with male dogs having higher [A2M] practically. There was no association between serum [A2M] and duration of serum storage at -80°C.

CONCLUSIONS: Equine serum [A2M] was exponentially higher than that of dogs. Sex may affect [A2M] in dogs. Further study is needed to evaluate how this difference affects antiprotease activity.

PMID:40755436 | DOI:10.1111/vop.70057

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Atrial fibrillation and female sex: use of oral anticoagulants in a large European cohort and residual risk of thromboembolism and stroke

Eur Heart J Qual Care Clin Outcomes. 2025 Aug 4:qcaf075. doi: 10.1093/ehjqcco/qcaf075. Online ahead of print.

ABSTRACT

BACKGROUND: The role of female sex in stroke risk and oral anticoagulant (OAC) use in atrial fibrillation (AF) remains controversial. This study evaluates sex-specific differences in OAC prescription, residual risk of stroke/TIA and thromboembolism (STE), and the predictive performance of CHA₂DS₂-VASc vs. CHA₂DS₂-VA scores.

METHODS: We analyzed data from a European prospective cohort. The association between female sex and OAC prescription was assessed in patients with CHA₂DS₂-VA score ≥1. We analyzed the residual STE risk in OAC-treated patients and compared the predictive performance of CHA₂DS₂-VASc and CHA₂DS₂-VA scores.

RESULTS: Among 10,080 patients (41.8% women; mean age 69.7 [SD 10.7] years) with CHA₂DS₂-VA ≥1, women had higher burden of comorbidities and less likely to receive OACs than men (OR 0.79, 95% CI: 0.69-0.90). In OAC-treated patients, STE rates were higher in women (IR 1.33 vs. 0.94 per 100 person-years). After adjusting for confounders and the competing risk of death, female sex was not statistically significantly associated with an increased risk of STE (sHR 1.24, 95% CI 0.89-1.74, P=0.210). CHA₂DS₂-VA and CHA₂DS₂-VASc scores had similar predictive performance (AUC 0.603 vs. 0.605, P=0.665). CHA₂DS₂-VA showed worse (ie. negative) reclassification compared to CHA₂DS₂-VASc (net reclassification index -0.088, 95% CI -0.164 to -0.001), with no significant differences in discrimination or net benefit.

CONCLUSIONS: In AF patients treated with OAC, the increased residual risk of STE associated with female sex was non-significant after adjusting for confounders and the competing risk of death. Both scores had similar predictive performance but CHA₂DS₂-VA showed worse reclassification compared to CHA₂DS₂-VASc.

PMID:40755396 | DOI:10.1093/ehjqcco/qcaf075

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Kidney Machine Perfusion Is Associated With Improved Long-Term Graft Survival Mediated by Reduced Delayed Graft Function: A Mate-Kidney Analysis

Artif Organs. 2025 Aug 4. doi: 10.1111/aor.15066. Online ahead of print.

ABSTRACT

BACKGROUND: Kidney machine perfusion (MP) prevents delayed graft function (DGF). Whether this benefit translates into improved long-term graft survival (LGS) remains uncertain. We evaluated the association between MP and LGS and its potential mediation by DGF.

METHODS: UNOS analysis of adult deceased donor kidney transplant recipients (KTRs) from January 2010 to June 2019. We selected KTRs with cold ischemia time (CIT) > 12 h and on tacrolimus maintenance. We included KTRs from dual-kidney donors and compared outcomes where one mate kidney received MP and the other did not. The primary endpoint was all-cause graft failure (GF) analyzed using a stratified multivariable Cox proportional hazards model. We assessed the association of MP and DGF with conditional logistic regression. We evaluated the mediation effect of DGF by combining the predictor and outcome models and bootstrapping with 1000 iterations to calculate 95% confidence intervals (CI).

RESULTS: We included 2355 mate-kidney pairs with 5.8 years (IQR 4-8) median follow-up. MP was associated with lower GF risk (aHR 0.86, 95% CI 0.75-0.98) and DGF odds (aOR 0.41, 95% CI 0.34-0.51) than no MP. DGF fully mediated the association between MP and GF, as the effect was no longer statistically significant after adjusting for DGF (aHR 0.89, 95% CI 0.78-1.03). DGF explained 76.8% of the association between MP and GF.

CONCLUSIONS: In mate-kidney pairs with discordant MP use and CIT > 12 h, MP was associated with decreased GF risk, mediated by decreased DGF likelihood. MP both mate kidneys with CIT > 12 h should be considered to potentially improve LGS.

PMID:40755387 | DOI:10.1111/aor.15066

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The role of gip in carbohydrate metabolism: Implications in the development of therapies for T2DM, a narrative review

Histol Histopathol. 2025 Jul 15:18967. doi: 10.14670/HH-18-967. Online ahead of print.

ABSTRACT

INTRODUCTION: For the last three decades, bariatric/metabolic surgeries have highlighted the relevance of certain gastrointestinal hormones in controlling and regulating glucose metabolism. The incretins have been a significant focus in developing therapies against Type 2 Diabetes Mellitus (T2DM). Glucagon-like peptide-1 (GLP-1) has been a primary focus in this field, leading to the development of analogues with high therapeutic potential and efficiency, such as semaglutide. However, recently another incretin, glucose-dependent insulinotropic polypeptide (GIP), has become a key target in T2DM drug development due to its complex pleiotropic effects, which include modulating insulin/glucagon secretion, acting on adipose tissue, and regulating appetite. The description of GIP properties as dual can be ambiguous, as this may refer either to its capacity to regulate both insulin and glucagon or to its distinct actions at the central versus peripheral level. Connecting this multifaceted activity was the rationale for developing combined GIP/GLP-1 analogues, like tirzepatide, and has culminated in triple-receptor agonists such as retratutide, which also engages the glucagon receptor (LY3437943). These multi-agonists potentially enhance the therapeutic potential of GLP-1 analogues.

COMMENTARIES: This review covers GIP physiology, its role within the context of T2DM, and the properties of GIP analogues, which represent a new line of drugs against T2DM. This field includes not only GIP analogues, since some are dual or triple agonists that also target GLP-1. We aim to elucidate the future perspectives offered by the use of these drugs.

PMID:40755350 | DOI:10.14670/HH-18-967

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Assessment of the status of DNA mismatch repair proteins by immunohistochemistry. Proposal for evaluation with two antibodies

Pol J Pathol. 2025;76(1):54-58. doi: 10.5114/pjp.2025.148390.

ABSTRACT

Determining the status of DNA mismatch repair (MMR) proteins is crucial for patients because they may respond differently to specific treatments and have a better prognosis. We proposed a panel with only 2 antibodies to determine the status of the MMR proteins, improving costs, workload, and delivery of results. Patients with adenocarcinoma and MMR determination were reclassified using only the evaluation of PMS2 and MSH6. The diagnostic performance of the 2-antibody test (proposed panel) and 4-antibody (traditional panel) test was compared against the polymerase chain reaction study (reference standard). A total of 202 cases were identified. The predominant histological type was adenocarcinoma not otherwise specified, the predominant histological grade was 2, and 60.9% of the cases were found in clinical stage II. When comparing the diagnostic performance of the traditional panel of 4 antibodies against a panel of 2 antibodies, no statistically significant differences were found (sensitivity 95.35% vs. 90.7%; specificity 98.74% vs. 98.11%; positive predictive value 95.35% vs. 92.86%; negative predictive value 98.74% vs. 97.50%; area under the curve 0.970 vs. 0.944; p = 0.419).Analysis of MMR status determination with only 2 antibodies demonstrates that it is as effective as using 4 antibodies.

PMID:40755331 | DOI:10.5114/pjp.2025.148390

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Immunohistochemical expression and association of hypoxia-inducible factor 1a and carbonic anhydrase IX in colorectal cancer

Pol J Pathol. 2025;76(1):16-24. doi: 10.5114/pjp.2025.149408.

ABSTRACT

The presented work focuses on hypoxia-inducible factor 1a (HIF-1a) and carbonic anhydrase IX (CA IX) in colorectal cancer (CRC). The HIF-1a protein shows increased expression due to hypoxia, resulting in up-regulation of CA IX, which is involved in the survival of hypoxic cancer cells in the tumour microenvironment, with overexpression in various types of carcinomas. HIF-1a and CA IX immunohistochemical analysis was performed on 111 CRC samples. The primary goal was to determine the correlation of expression of proteins with clinical-morphological parameters and mutual correlation of the proteins in question. The HIF-1a expression was detected in 72.1% of CRC samples with exclusive nuclear localisation. The immunoreaction intensity was predominantly strong. Carbonic anhydrase IX protein was expressed in 75.7% of cases. The membrane positivity and strong immunoreaction intensity were mainly noticed. No statistically significant correlation between the expression of studied proteins and clinical-morphological parameters was confirmed. However, the results proved a statistically significant correlation in mutual co-localisation of given proteins. Despite contradictory scientific data, our findings suggest a mutual correlation between HIF-1a and CA IX in CRC. The presented hypothesis that their overexpression may represent a potential new therapeutic target in colorectal carcinogenesis might unveil novel strategies in disease development.

PMID:40755327 | DOI:10.5114/pjp.2025.149408

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Expression of C-terminal tensin-like in breast carcinoma and its correlation with known prognostic factors

Pol J Pathol. 2025;76(1):10-15. doi: 10.5114/pjp.2025.149282.

ABSTRACT

C-terminal tensin-like (Cten) is a marker for poorly differentiated breast cancer. We evaluated the immunohistochemical expression of Cten in invasive breast carcinoma in our population and correlated it with known histopathologic prognostic variables. Fifty-seven specimens of modified radical mastectomy diagnosed as invasive ductal carcinoma were collected. The histopathologic findings were noted independent of the result of Cten. According to the results of Cten immunohistochemistry, the tumors were categorized as negative/mild, moderate, or high expression and were statistically corelated with histologic findings. In our study, 47 (82.5%) cases showed negative/mild expression, 2 (3.5%) cases showed moderate staining, and 8 (14%) cases showed strong expression of Cten. Positive Cten was present in pT4 stage tumors. Similarly, grade III tumor showed moderate expression in 2 (3.5%) cases and strong staining in 8 (14%) cases. Posi-tive expression of Cten was observed in cases with lymphovascular invasion (LVI) and high axillary lymph nodal involvement (N3). All these poor prognostic factors were significantly associated with moderate to high expression of Cten. We found that tumor size and extent, histologic grade, LVI, and lymph node status were significantly associated with Cten expression. C-terminal tensin-like can be used as marker of poor prognosis in breast carcinoma.

PMID:40755326 | DOI:10.5114/pjp.2025.149282