Tag: pubmed

PLoS One. 2021 Oct 11;16(10):e0258181. doi: 10.1371/journal.pone.0258181. eCollection 2021.

ABSTRACT

Mesophotic habitats could be sheltered from natural and anthropogenic disturbances and act as reproductive refuges, providing propagules to replenish shallower populations. Molecular markers can be used as proxies evaluating the connectivity and inferring population structure and larval dispersal. This study characterizes population structure as well as horizontal and vertical genetic connectivity of the broadcasting coral Pocillopora verrucosa from Ludao, a small oceanic island off the eastern coast of Taiwan. We genotyped 75 P. verrucosa specimens from three sites (Gongguan, Dabaisha, and Guiwan) at three depth ranges (Shallow: 7-15 m, Mid-depth: 23-30 m, and Deep: 38-45 m), spanning shallow to upper mesophotic coral reefs, with eight microsatellite markers. F-statistics showed a moderate differentiation (FST = 0.106, p<0.05) between two adjacent locations (Dabaisha 23-30 and Dabaisha 38-45 m), but no differentiation elsewhere, suggesting high levels of connectivity among sites and depths. STRUCTURE analysis showed no genetic clustering among sites or depths, indicating that all Pocillopora individuals could be drawn from a single panmictic population. Simulations of recent migration assigned 30 individuals (40%) to a different location from where they were collected. Among them, 1/3 were assigned to deeper locations, 1/3 to shallower populations and 1/3 were assigned to the right depth but a different site. These results suggest high levels of vertical and horizontal connectivity, which could enhance the recovery of P. verrucosa following disturbances around Ludao, a feature that agrees with demographic studies portraying this species as an opportunistic scleractinian.

PMID:34634065 | DOI:10.1371/journal.pone.0258181

PLoS Comput Biol. 2021 Oct 11;17(10):e1009479. doi: 10.1371/journal.pcbi.1009479. Online ahead of print.

ABSTRACT

A central question in neuroscience is how context changes perception. In the olfactory system, for example, experiments show that task demands can drive divergence and convergence of cortical odor responses, likely underpinning olfactory discrimination and generalization. Here, we propose a simple statistical mechanism for this effect based on unstructured feedback from the central brain to the olfactory bulb, which represents the context associated with an odor, and sufficiently selective cortical gating of sensory inputs. Strikingly, the model predicts that both convergence and divergence of cortical odor patterns should increase when odors are initially more similar, an effect reported in recent experiments. The theory in turn predicts reversals of these trends following experimental manipulations and in neurological conditions that increase cortical excitability.

PMID:34634035 | DOI:10.1371/journal.pcbi.1009479

PLoS One. 2021 Oct 11;16(10):e0258329. doi: 10.1371/journal.pone.0258329. eCollection 2021.

ABSTRACT

BACKGROUND: Back pain patients are more likely to suffer from depression, anxiety and reduced quality of life. Pain drawing is a simple, frequently used anamnesis tool that facilitates communication between physicians and patients. This study analysed pain drawings to examine whether pain drawing is suitable as a screening tool for signs of anxiety, depression or reduced quality of life, as the detection of these symptoms is essential for successful treatment.

METHODS: Pain drawings of 219 patients with lower back pain were evaluated retrospectively. Pain drawings are a schematic drawing of a human being. Six variables of the pain drawing were analysed. Subscales of the Hospital Anxiety and Depression Scale (HADS) and the Mental Component Summary (MCS) of the Short Form 12 (SF-12) were used to measure anxiety, depression and quality of life, respectively. Descriptive statistics, uni- and multivariate linear regression analyses and analysis of variance were performed. Logistic regression analyses were conducted for suitable variables.

RESULTS: We revealed significant positive correlations between the variables “filled body surface” and “number of pain sites” and the anxiety (HADS-A) and depression subscales (HADS-D) of the HADS (p<0.01). The same predictors had significant negative correlations with the MCS (p<0.01). However, the sensitivity and specificity of the variable “number of pain sites” were too low compared to those for existing screening tests to consider it as a screening tool for anxiety, depression and quality of life (HADS-A: sensitivity: 45.2%, specificity: 83.3%; HADS-D: sensitivity: 61.1%, specificity: 51%; MCS: sensitivity: 21.2%, specificity: 85.7%).

CONCLUSIONS: There were significant correlations between the amount of filled body surface and the number of pain sites in the pain drawing and anxiety, depression and quality of life. Although useful in routine clinical practice, pain drawing cannot be used as a screening tool based on our results.

PMID:34634060 | DOI:10.1371/journal.pone.0258329

J Pak Med Assoc. 2021 Aug;71(Suppl 5)(8):S51-S54.

ABSTRACT

OBJECTIVE: To compare the inter-observer reliability of Shatzker classification and Khan Classification of Tibial plateau fractures.

METHODS: This retrospective cohort study was conducted at The Indus Hospital, Karachi, Pakistan. Radiographs of 50 patients who presented with tibial plateau fractures from March 2015 to November 2016 were collected. Two observers classified these cases independently according to Shatzker and Khan Classification. Gwet’s AC1 statistics applied to assess inter-observer reliability of both the classification systems.

RESULTS: Moderate inter-observer agreement for Schatzker classification (p<0.001) and slight inter-observer agreement on Khan Classification (p=0.738) was observed.

CONCLUSIONS: Khan Classification is more comprehensive in classifying tibial plateau fractures and can be used for clinical research purpose, while Shatzker classification with better inter-observer reliability is applicable for routine clinical practice.

PMID:34634016

J Pak Med Assoc. 2021 Aug;71(Suppl 5)(8):S59-S63.

ABSTRACT

OBJECTIVE: To evaluate the risk factors for postoperative complications in fracture neck femur treated with cannulated screws.

METHODS: This cross sectional series was performed at the Department of Trauma and Orthopaedics, Jinnah Postgraduate Medical Centre, Karachi from January 2015 to December 2019. A Total of 149 patients with close fracture neck femur of either gender between 20-60 years of age were included in the study. Patients with hip arthritis and pathological fractures such as tumours were excluded. Minimum three cannulated screws were used to fix the fracture with parallel configuration in compression mode. Patients were followed and evaluated for fracture healing and related complications such as nonunion and Avascular necrosis for two years. Descriptive statistics were calculated and stratification was done. Post stratification chi square test was applied taking p-value ? ≤0.05 as statistically significant.

RESULTS: There were 113 (75.8%) male and 36 (24.2%)female patients. Mean age was 37.54±10.66 years. Mean operation time was 38.56±4.61 minutes. Out of these, 93 (62.4%) injuries were caused by motor vehicle accident, 34(22.8%) fall and 22(14.8%) by sports injury. Garden type III fracture was observed in 69 (46.3%) patients followed by 41 (27.5%) fractures of grade-IV. Fracture union was observed in 126 (84.6%) patients at a mean time of 4.0±1.1months and non-union in 23 (15.4%) cases whereas rate of avascular necrosis was noted in 28 (18.8%) cases and were significantly associated with age, injury mode, time from injury to surgery and fracture classification. Non-union was significantly associated with open reduction and delayed fixation of fracture for more than 24 hours.

CONCLUSIONS: Although cannulated screws are a universally accepted method of fixation for femoral neck fractures, the incidence of complications such as Avascular necrosis and non-union is quite high particularly in young males meeting a motor vehicle accident, undergoing open reduction for displaced fractures even with early diagnosis and treatment.

PMID:34634018

J Pak Med Assoc. 2021 Aug;71(Suppl 5)(8):S26-S31.

ABSTRACT

OBJECTIVE: A retrospective cohort study was performed at a UK major trauma centre to identify whether timing of surgical fixation of closed unstable ankle fracture affected the rate of major wound complications.

METHODS: Consecutive cases of unstable ankle fractures treated with open reduction internal fixation (ORIF) between March 2014 to December 2016 were included in this retrospective cohort study. Data were collected from 2018 onwards allowing a minimum follow-up of 2 years. Patients under the age of 18, polytrauma, open fractures and those requiring external fixation were excluded. Timing of ORIF were categorised into early (within 24 hours of injury) and delayed (after 24 hours of injury). Primary outcome was major soft tissue complications (defined as deep wound infections or wound breakdown that required further surgery). Secondary outcomes included fixation failure, and symptomatic metal work requiring removal.

RESULTS: A total of 235 consecutive cases were included. There were 108(46%) patients in the early fixation group, and 127(54%) patients in the delayed fixation group. Seven major wound complications were identified. Five of which were in the early group, and 2 in the late group. There was no statistically significant difference in the major wound complication rates between the early and delayed surgery groups (p = 1.000).

CONCLUSIONS: No significant difference was observed in the rate of major soft tissue complications between early and delayed fixation for isolated unstable ankle fractures.

PMID:34634011

J Pak Med Assoc. 2021 Aug;71(Suppl 5)(8):S32-S34.

ABSTRACT

OBJECTIVE: To determine the effect of soft Transforaminal Interbody Lumbar Interbody Fusion (sTLIF) in postoperative discitis not responding to conservative treatment.

METHODS: This cross-sectional study was conducted in Department of Spine Surgery, CMH Rawalpindi from August 2016 to July 2019. Patients who underwent discectomy were observed and those presenting with postoperative discitis were included in the study. Pain was noted on visual analogue scale before and after the intervention and differences in two readings were noted. Data was collected on predesigned proforma. Statistical analysis was done on SPSS 20.0.

RESULTS: Mean age of these patients was 45±12.34 years. The mean pain score on VAS before treatment was 8.33±0.65 and after treatment was 2±0.95. There was statistically significant reduction in pre-treatment and post-treatment pain on VAS (p=0.000).

CONCLUSIONS: Postoperative discitis is present among a small number of patients after spine surgery and pain is significantly reduced after the treatment of discitis with TLIF.

PMID:34634012

J Pak Med Assoc. 2021 Aug;71(Suppl 5)(8):S17-S21.

ABSTRACT

OBJECTIVE: To compare the combination of corticosteroid injection and physiotherapy with physiotherapy alone in patients of frozen shoulder in terms of SPADI score.

METHODS: This study included 80 patients of either gender from PMC and affiliated hospitals of Faisalabad with ages between 18-55 years having frozen shoulder of either gender with more than 1 month duration. Patients having frozen shoulder secondary to trauma, cerebrovascular accident and taking steroid injections were excluded. Combination of corticosteroid injection and physiotherapy was performed in combination therapy group (n=40) and physiotherapy alone was performed in Single therapy group (n=40).

RESULTS: A total of 80 patients, 30(37.5%) males and 50(62.5%) females were selected for the study. Each group, combination therapy and single therapy had 40 patients each. The combination therapy group included 18(45.0%) males and 22(44.0%) females whereas the single therapy group comprised of 12(39.9%) males and 28(70%) females. The treatment method was independent of duration of disease (p= 0.251 for c2= 1.317). After six weeks of treatment, the t-test applied on SPADI score showed that combined treatment is better than the single treatment method (p= 0.016). However, both treatment methods were found same after stratification of duration of disease.

CONCLUSIONS: Combination of corticosteroid injection and physiotherapy is more effective than the physiotherapy alone in resolving the shoulder pain and disability of shoulder.

PMID:34634009

J Pak Med Assoc. 2021 Aug;71(Suppl 5)(8):S21-S25.

ABSTRACT

OBJECTIVE: To compare pre-operative characteristics and peri-operative findings in patients undergoing unilateral total knee arthroplasty (UTKA) and simultaneous bilateral total knee arthroplasty (BTKA). To work out safety criterion for selection of patients for simultaneous BTKA.

METHODS: Patients undergoing UTKA (39) and BTKA (36) in Department of Orthopaedic Surgery, Combined Military Hospital, Rawalpindi from March 2014 to August 2014 were compared in terms of patient characteristics, underlying pathology, peri-operative blood loss, transfusion requirements and in hospital complications.

RESULTS: The mean age of patients undergoing UTKA was 61±11 years and those undergoing BTKA was 64±8 years, with similar male to female ratio (1:1.8) in both groups. Males undergoing BTKA were significantly older than other patients (71±6 years). Primary osteoarthritis was the most common initial diagnosis (59% in UTKA and 89% in BTKA, p<0.05) followed by rheumatoid arthritis. Average blood loss per knee was higher in BTKA procedures but difference did not reach statistical significance. Blood transfusion requirements in BTKA patients not receiving antifibrinolytic agent were significantly higher than in similar UTKA patients (75% vs 17%, p<0.05) but were significantly reduced with peri-operative administration of antifibrolytic therapy (30% BTKA, p<0.05). Complication rates, low in both, were more frequent in BTKA patients with co-morbidities.

CONCLUSIONS: In patients requiring bilateral knee replacements, staged total knee replacement [i.e. the two knees are replaced with a gap of at least 3 months] is a safe approach. Unilateral knee replacement is associated with lesser complications and blood transfusion requirements as compared to simultaneous bilateral total knee replacements.

PMID:34634010

Anesth Analg. 2021 Oct 11. doi: 10.1213/ANE.0000000000005773. Online ahead of print.

ABSTRACT

Researchers reporting results of statistical analyses, as well as readers of manuscripts reporting original research, often seek guidance on how numeric results can be practically and meaningfully interpreted. With this article, we aim to provide benchmarks for cutoff or cut-point values and to suggest plain-language interpretations for a number of commonly used statistical measures of association, agreement, diagnostic accuracy, effect size, heterogeneity, and reliability in medical research. Specifically, we discuss correlation coefficients, Cronbach’s alpha, I2, intraclass correlation (ICC), Cohen’s and Fleiss’ kappa statistics, the area under the receiver operating characteristic curve (AUROC, concordance statistic), standardized mean differences (Cohen’s d, Hedge’s g, Glass’ delta), and z scores. We base these cutoff values on what has been previously proposed by experts in the field in peer-reviewed literature and textbooks, as well as online statistical resources. We integrate, adapt, and/or expand previous suggestions in attempts to (a) achieve a compromise between divergent recommendations, and (b) propose cutoffs that we perceive sensible for the field of anesthesia and related specialties. While our suggestions provide guidance on how the results of statistical tests are typically interpreted, this does not mean that the results can universally be interpreted as suggested here. We discuss the well-known inherent limitations of using cutoff values to categorize continuous measures. We further emphasize that cutoff values may depend on the specific clinical or scientific context. Rule-of-the thumb approaches to the interpretation of statistical measures should therefore be used judiciously.

PMID:34633993 | DOI:10.1213/ANE.0000000000005773