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Nevin Manimala Statistics

Higher complication rate after nail compared with plate fixation of ankle fractures in patients aged 60 years or older: a prospective, randomized controlled trial

Bone Joint J. 2023 Jan;105-B(1):72-81. doi: 10.1302/0301-620X.105B1.BJJ-2022-0595.R1.

ABSTRACT

AIMS: The aim of this study was to compare the functional and radiological outcomes and the complication rate after nail and plate fixation of unstable fractures of the ankle in elderly patients.

METHODS: In this multicentre study, 120 patients aged ≥ 60 years with an acute unstable AO/OTA type 44-B fracture of the ankle were randomized to fixation with either a nail or a plate and followed for 24 months after surgery. The primary outcome measure was the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score. Secondary outcome measures were the Manchester-Oxford Foot Questionnaire, the Olerud and Molander Ankle score, the EuroQol five-dimension questionnaire, a visual analogue score for pain, complications, the quality of reduction of the fracture, nonunion, and the development of osteoarthritis.

RESULTS: At 24 months, the median AOFAS score was equivalent in the two groups (nail 90 (interquartile range (IQR) 82 to 100), plate 95 (IQR 87 to 100), p = 0.478). There were statistically more complications and secondary operations after nail than plate fixation (p = 0.024 and p = 0.028, respectively). There were no other significant differences in the outcomes between the two groups.

CONCLUSION: The functional outcome after nail and plate fixation was equivalent; however, the complication rate and number of secondary operations was significantly higher after nail fixation. These results suggest that plate fixation should usually be the treatment of choice for unstable ankle fractures in the elderly.Cite this article: Bone Joint J 2023;105-B(1):72-81.

PMID:36587258 | DOI:10.1302/0301-620X.105B1.BJJ-2022-0595.R1

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First-time revision knee arthroplasty using a hinged prosthesis : temporal trends, indications, and risk factors associated with re-revision using data from the National Joint Registry for 3,855 patients

Bone Joint J. 2023 Jan;105-B(1):47-55. doi: 10.1302/0301-620X.105B1.BJJ-2022-0522.R1.

ABSTRACT

AIMS: The aim of this study was to identify variables associated with time to revision, demographic details associated with revision indication, and type of prosthesis employed, and to describe the survival of hinge knee arthroplasty (HKA) when used for first-time knee revision surgery and factors that were associated with re-revision.

METHODS: Patient demographic details, BMI, American Society of Anesthesiologists (ASA) grade, indication for revision, surgical approach, surgeon grade, implant type (fixed and rotating), time of revision from primary implantation, and re-revision if undertaken were obtained from the National Joint Registry data for England, Wales, Northern Ireland, and the Isle of Man over an 18-year period (2003 to 2021).

RESULTS: There were 3,855 patient episodes analyzed with a median age of 73 years (interquartile range (IQR) 66 to 80), and the majority were female (n = 2,480, 64.3%). The median time to revision from primary knee arthroplasty was 1,219 days (IQR 579 to 2,422). Younger age (p < 0.001), decreasing ASA grade (p < 0.001), and indications for revision of sepsis (p < 0.001), unexplained pain (p < 0.001), non-polyethylene wear (p < 0.001), and malalignment (p < 0.001) were all associated with an earlier time to revision from primary implantation. The median follow-up was 4.56 years (range 0.00 to 17.52), during which there were 410 re-revisions. The overall unadjusted probability of re-revision for all revision HKAs at one, five, and ten years after surgery were 2.7% (95% confidence interval (CI) 2.2 to 3.3), 10.7% (95% CI 9.6 to 11.9), and 16.2% (95% CI 14.5 to 17.9), respectively. Male sex (p < 0.001), younger age (p < 0.001), revision for septic indications (p < 0.001) or implant fracture (p = 0.010), a fixed hinge (p < 0.001), or surgery performed by a non-consultant grade (p = 0.023) were independently associated with an increased risk of re-revision.

CONCLUSION: There were several factors associated with time to first revision. The re-revision rate was 16.2% at ten years; however, the risk factors associated with an increased risk of re-revision could be used to counsel patients regarding their outcome.Cite this article: Bone Joint J 2023;105-B(1):47-55.

PMID:36587261 | DOI:10.1302/0301-620X.105B1.BJJ-2022-0522.R1

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Interpreting decision-analytic modelling-based economic evaluations in orthopaedics

Bone Joint J. 2023 Jan;105-B(1):17-20. doi: 10.1302/0301-620X.105B1.BJJ-2022-1119.

ABSTRACT

Economic evaluation provides a framework for assessing the costs and consequences of alternative programmes or interventions. One common vehicle for economic evaluations in the healthcare context is the decision-analytic model, which synthesizes information on parameter inputs (for example, probabilities or costs of clinical events or health states) from multiple sources and requires application of mathematical techniques, usually within a software program. A plethora of decision-analytic modelling-based economic evaluations of orthopaedic interventions have been published in recent years. This annotation outlines a number of issues that can help readers, reviewers, and decision-makers interpret evidence from decision-analytic modelling-based economic evaluations of orthopaedic interventions.Cite this article: Bone Joint J 2023;105-B(1):17-20.

PMID:36587252 | DOI:10.1302/0301-620X.105B1.BJJ-2022-1119

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Nevin Manimala Statistics

Draft Genome Sequence Resource of CBPPT1, a ‘Candidatus Phytoplasma trifolii’-Related Strain Associated with Potato Purple Top Disease in the Columbia Basin, U.S.A

Plant Dis. 2022 Dec 31:PDIS08221788A. doi: 10.1094/PDIS-08-22-1788-A. Online ahead of print.

NO ABSTRACT

PMID:36587246 | DOI:10.1094/PDIS-08-22-1788-A

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Nevin Manimala Statistics

Therapeutic effects of magnesium and vitamin B6 in alleviating the symptoms of restless legs syndrome: a randomized controlled clinical trial

BMC Complement Med Ther. 2022 Dec 31;23(1):1. doi: 10.1186/s12906-022-03814-8.

ABSTRACT

BACKGROUND AND OBJECTIVE: Restless legs syndrome/Willis-Ekbom Disease (RLS/WED) is one of the most prevalent sleep disorders. There are contradicting data about the effectiveness of magnesium and vitamin B6 in alleviating the symptoms of this condition. Therefore, this study aimed to assess the efficacy of magnesium and vitamin B6 in alleviating the symptoms of RLS/WED.

METHODS: A single-blind study was conducted on individuals with this illness for at least three months. Randomly, 75 patients were assigned into three groups: magnesium, vitamin B6, and placebo. The experimental group received daily doses of 40 mg vitamin B6 or 250 mg magnesium oxide. While others in the control group merely received a placebo. Patients’ disease severity and sleep quality were evaluated three times using standard questionnaires (at the beginning of the study, one and two months after therapy). Utilizing SPSS22 software and the ANOVA, t-test, and repeated measure tests, statistical analysis was conducted.

RESULTS: The mean and standard deviation of sleep quality and disease severity at the beginning of the trial and throughout the first month following the intervention did not differ statistically between the three groups. In the second month following the intervention, the mean and standard deviation of sleep quality and disease severity were significantly different (P = 0.001).

CONCLUSION: Taking magnesium and vitamin B6 supplements can reduce the severity of symptoms of RLS/WED patients and improve their sleep quality.

PMID:36587225 | DOI:10.1186/s12906-022-03814-8

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Nevin Manimala Statistics

PhenoExam: gene set analyses through integration of different phenotype databases

BMC Bioinformatics. 2022 Dec 31;23(1):567. doi: 10.1186/s12859-022-05122-x.

ABSTRACT

BACKGROUND: Gene set enrichment analysis (detecting phenotypic terms that emerge as significant in a set of genes) plays an important role in bioinformatics focused on diseases of genetic basis. To facilitate phenotype-oriented gene set analysis, we developed PhenoExam, a freely available R package for tool developers and a web interface for users, which performs: (1) phenotype and disease enrichment analysis on a gene set; (2) measures statistically significant phenotype similarities between gene sets and (3) detects significant differential phenotypes or disease terms across different databases.

RESULTS: PhenoExam generates sensitive and accurate phenotype enrichment analyses. It is also effective in segregating gene sets or Mendelian diseases with very similar phenotypes. We tested the tool with two similar diseases (Parkinson and dystonia), to show phenotype-level similarities but also potentially interesting differences. Moreover, we used PhenoExam to validate computationally predicted new genes potentially associated with epilepsy.

CONCLUSIONS: We developed PhenoExam, a freely available R package and Web application, which performs phenotype enrichment and disease enrichment analysis on gene set G, measures statistically significant phenotype similarities between pairs of gene sets G and G’ and detects statistically significant exclusive phenotypes or disease terms, across different databases. We proved with simulations and real cases that it is useful to distinguish between gene sets or diseases with very similar phenotypes. Github R package URL is https://github.com/alexcis95/PhenoExam . Shiny App URL is https://alejandrocisterna.shinyapps.io/phenoexamweb/ .

PMID:36587217 | DOI:10.1186/s12859-022-05122-x

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Nevin Manimala Statistics

Internalized stigma and associated factors among people with mental illness at University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia, 2021

Int J Ment Health Syst. 2022 Dec 31;16(1):58. doi: 10.1186/s13033-022-00567-2.

ABSTRACT

BACKGROUND: Internalized stigma has been found to be high among people with mental illness (PWMI) and it results in poor treatment outcome, increased disability and high economic burden. So, this study was designed to determine the prevalence and associated factors of high internalized stigma among PWMI attending psychiatric follow-up at University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia, 2021.

METHODS: A cross-sectional study was conducted among PWMI (n = 365), and internalized stigma was measured by using internalized stigma of mental illness 29 (ISMI-29) scale. The data was entered in to EPI DATA software (4.6.0.2) and analyzed by Statistical Package for Social Sciences version 20. A binary logistic regression was used to identify factors associated with internalized stigma and reported with 95% confidence interval (CI). P-value < 0.05 was considered as statistically significant.

RESULTS: The prevalence of high internalized stigma was found to be 27.9% (95% CI 23.1-32.6). A male gender (AOR = 0.332; 95% CI 0.175-0.629), occupation, specifically government employee (AOR = 0.309; 95% CI 0.118-0.809), life time substance use (AOR = 3.561; 95% CI 1.867-6.793), low self-esteem (AOR = 8.313; 95% CI 3.641-18.977), and history of hospitalization (AOR = 4.236; 95% CI 1.875, 9.570) were factors significantly associated with higher internalized stigma.

CONCLUSION: The result of this study showed that there was an intermediate prevalence of high internalized stigma among PWMI at University of Gondar Comprehensive Specialized Hospital. The hospital needs to take immediate action to fight internalized stigma by focusing on females, people with low self-esteem, individuals with history of lifetime substance use, and people who have history of hospital admission.

PMID:36587213 | DOI:10.1186/s13033-022-00567-2

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Nevin Manimala Statistics

Microbial identification from traumatized immature permanent teeth with periapical lesions using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry

BMC Oral Health. 2022 Dec 31;22(1):661. doi: 10.1186/s12903-022-02562-y.

ABSTRACT

BACKGROUND: This study aims at identifying the microbiota in traumatized immature permanent teeth with periapical lesions using Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).

METHODS: The study included 16 immature maxillary central incisors with periapical lesions in 13 patients. Field decontamination and negative control samples were performed before and after access cavity preparation. Root canal samples were taken using sterile stainless-steel hand files following field decontamination. In-office inoculation and pure sub-cultures were performed. Bacterial isolates were prepared for MALDI-TOF MS (Bruker, Billerica, MA USA) analysis using the formic acid extraction method. A comparison of the prevalence of isolated microorganisms was done using a one-sample chi-square test. Comparisons between identified microbial species with the, cone beam computed tomography periapical index (CBCT PAI) scores and lesion volume were also conducted. The Chi-square test was applied to investigate the association between the categorical variables .

RESULTS: Out of the forty isolates recovered from the 16 traumatized teeth included in the present study with the mean patients’ age of 10.93 ± 1.77, 37 isolates were reliably identified by MALDI-TOF MS. Twelve teeth (62.5%) were polymicrobial. The recovered bacteria belonged to five phyla, 15 genera and 25 species. Firmicutes were the predominant phylum (P < 0.001) over Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria. Gram positive bacteria were significantly more prevalent than Gram negative (p = 0.03). Facultative anaerobes were the most prevalent (P < 0.001) compared to the obligate anaerobes and the obligate aerobes. The latter were the least prevalent. Statistically, significant differences existed in the comparison between CBCT PAI scores according to bacterial gram staining.

CONCLUSION: Traumatized immature permanent teeth with periapical lesions showed a significant predominance of Gram-positive facultative anaerobes. MALDI-TOF MS provided accurate identification of numerous viable endodontic microbes.

PMID:36587207 | DOI:10.1186/s12903-022-02562-y

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Nevin Manimala Statistics

Impact of weekday and weekend mobility and public policies on COVID-19 incidence and deaths across 76 large municipalities in Colombia: statistical analysis and simulation

BMC Public Health. 2022 Dec 31;22(1):2460. doi: 10.1186/s12889-022-14781-7.

ABSTRACT

BACKGROUND: Despite widespread restrictions on residents’ mobility to limit the COVID-19 pandemic, controlled impact evaluations on such restrictions are rare. While Colombia imposed a National Lockdown, exceptions and additions created variations across municipalities and over time. METHODS: We analyzed how weekend and weekday mobility affected COVID-19 cases and deaths. Using GRANDATA from the United Nations Development Program (UNDP) we examined movement in 76 Colombian municipalities, representing 60% of Colombia’s population, from March 2, 2020 through October 31, 2020. We combined the mobility data with Colombia’s National Epidemiological Surveillance System (SIVIGILA) and other databases and simulated impacts on COVID-19 burden. RESULTS: During the study period, Colombians stayed at home more on weekends compared to weekdays. In highly dense municipalities, people moved less than in less dense municipalities. Overall, decreased movement was associated with significant reductions in COVID-19 cases and deaths two weeks later. If mobility had been reduced from the median to the threshold of the best quartile, we estimate that Colombia would have averted 17,145 cases and 1,209 deaths over 34.9 weeks, reductions of 1.63% and 3.91%, respectively. The effects of weekend mobility reductions (with 95% confidence intervals) were 6.40 (1.99-9.97) and 4.94 (1.33-19.72) times those of overall reductions for cases and deaths, respectively.

CONCLUSIONS: We believe this is the first evaluation of day-of-the week mobility on COVID-19. Weekend behavior was likely riskier than weekday behavior due to larger gatherings and less social distancing or protective measures. Reducing or shifting such activities outdoors would reduce COVID-19 cases and deaths.

PMID:36587205 | DOI:10.1186/s12889-022-14781-7

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Nevin Manimala Statistics

High-density lipoprotein subclasses and cardiovascular disease and mortality in type 2 diabetes: analysis from the Hong Kong Diabetes Biobank

Cardiovasc Diabetol. 2022 Dec 31;21(1):293. doi: 10.1186/s12933-022-01726-y.

ABSTRACT

OBJECTIVE: High-density lipoproteins (HDL) comprise particles of different size, density and composition and their vasoprotective functions may differ. Diabetes modifies the composition and function of HDL. We assessed associations of HDL size-based subclasses with incident cardiovascular disease (CVD) and mortality and their prognostic utility.

RESEARCH DESIGN AND METHODS: HDL subclasses by nuclear magnetic resonance spectroscopy were determined in sera from 1991 fasted adults with type 2 diabetes (T2D) consecutively recruited from March 2014 to February 2015 in Hong Kong. HDL was divided into small, medium, large and very large subclasses. Associations (per SD increment) with outcomes were evaluated using multivariate Cox proportional hazards models. C-statistic, integrated discrimination index (IDI), and categorial and continuous net reclassification improvement (NRI) were used to assess predictive value.

RESULTS: Over median (IQR) 5.2 (5.0-5.4) years, 125 participants developed incident CVD and 90 participants died. Small HDL particles (HDL-P) were inversely associated with incident CVD [hazard ratio (HR) 0.65 (95% CI 0.52, 0.81)] and all-cause mortality [0.47 (0.38, 0.59)] (false discovery rate < 0.05). Very large HDL-P were positively associated with all-cause mortality [1.75 (1.19, 2.58)]. Small HDL-P improved prediction of mortality [C-statistic 0.034 (0.013, 0.055), IDI 0.052 (0.014, 0.103), categorical NRI 0.156 (0.006, 0.252), and continuous NRI 0.571 (0.246, 0.851)] and CVD [IDI 0.017 (0.003, 0.038) and continuous NRI 0.282 (0.088, 0.486)] over the RECODe model.

CONCLUSION: Small HDL-P were inversely associated with incident CVD and all-cause mortality and improved risk stratification for adverse outcomes in people with T2D. HDL-P may be used as markers for residual risk in people with T2D.

PMID:36587202 | DOI:10.1186/s12933-022-01726-y