Tag: statistics

J Opt Soc Am A Opt Image Sci Vis. 2025 Dec 1;42(12):1890-1899. doi: 10.1364/JOSAA.565216.

ABSTRACT

The influence of disorder in the spatial arrangement of identical, homogeneous spherical particles of an infinite two-dimensional (2D) array on the energy density spectra of the electric and magnetic fields on their surfaces under normal incidence of a plane electromagnetic wave is studied. The consideration is based on a semi-analytical statistical method (SASM) developed by us. Radial distribution functions based on the hard-disk model are used to simulate particle arrangements in arrays. We wrote a formula for this function describing the perfect azimuthally averaged lattice and analyzed in detail the energy densities for different deviations of particle centers from the nodes of the perfect lattice. The calculation results for a partially ordered array and imperfect and perfect lattices of silver (Ag), crystalline silicon (c-Si), and titanium oxide (TiO₂) particles with sizes of 50 and 300 nm are presented in the wavelength range of 0.3-1.1 µm for a host medium with a refractive index close to that of water. They demonstrate the contribution of the disorder effect to the optical response of the system and allow finding the optimal characteristics of lattice-induced resonances for energy densities on the particle surface. Such data are necessary for solving problems of increasing the efficiency of converting light energy absorbed by the system into other types of energy. The spectra of energy densities obtained under the SASM are in excellent agreement with the data of the numerical finite element method (FEM). To complete the picture, the near-field data are accompanied by far-field data for the incoherent component of the light.

PMID:41411564 | DOI:10.1364/JOSAA.565216

J Opt Soc Am A Opt Image Sci Vis. 2025 Dec 1;42(12):1846-1863. doi: 10.1364/JOSAA.576308.

ABSTRACT

We introduce two families of vergence functions to express ocular wavefront aberrations in diopters, bridging aberrometry, and clinical refraction. First, we build a fully orthogonal vergence basis (V~), analogous to Zernike polynomials, which preserves mode orthogonality and supports unbiased coefficient statistics. In our VL-VH basis (V), a clear separation between low-degree and high-degree prevents the intrusion of low-degree terms into high-degree modes, which could otherwise hinder direct clinical interpretation. The vergence function expansions in both bases are derived from wavefront slopes through radial differentiation. We demonstrate their clinical utility through three cases: a normal eye, a keratoconic eye, and a post-myopic LASIK eye. The VL-VH basis provides stable refraction estimates across pupil sizes by fitting low-degree terms over central regions, closely matching subjective refraction. In contrast, the orthogonal V~ basis shows pupil-dependent refraction due to peripheral wavefront influence. In eyes with significant spherical aberration, the bases yield markedly different refractive predictions, with VL-VH better aligning with clinical measurements. Pyramid plots, dioptric maps, and coefficient histograms facilitate aberration visualization and diagnosis. These vergence-based tools enhance the integration of advanced aberrometry into clinical practice.

PMID:41411558 | DOI:10.1364/JOSAA.576308

J Clin Gastroenterol. 2025 Dec 19. doi: 10.1097/MCG.0000000000002309. Online ahead of print.

ABSTRACT

GOALS: To compare the effectiveness, durability, and safety of vedolizumab and upadacitinib for CD through 52 weeks.

BACKGROUND: Comparative real-world data for vedolizumab versus upadacitinib in Crohn’s disease (CD) are limited.

STUDY: This retrospective cohort study included 139 adults with active CD who began vedolizumab (n=72) or upadacitinib (n=67) during 2023 at a large academic health system. Co-primary outcomes were steroid-free clinical remission (SFCR) at 12 and 52 weeks and treatment discontinuation within 52 weeks; secondary outcomes included clinical response at 12 and 52 weeks. Inverse probability of treatment weighting balanced relevant confounders. Logistic regression was used for binary outcomes and Cox proportional hazards and competing risks regression were used for treatment discontinuation. Adverse events were ascertained by manual chart review.

RESULTS: After weighting, all covariates were balanced (standardized mean differences <0.10). At 12 weeks, vedolizumab was associated with lower odds of clinical response versus upadacitinib (OR: 0.36; 95% CI: 0.16-0.85). There were no significant differences for SFCR, treatment discontinuation, or other outcomes through 52 weeks. Competing risks regression, accounting for adverse events as competing events, showed a higher incidence of treatment discontinuation due to nonresponse for vedolizumab, but this did not reach statistical significance. Adverse events within 52 weeks were comparable (vedolizumab 33% vs. upadacitinib 39%; P=0.45), and discontinuations due to adverse events were infrequent (3% vs. 6%).

CONCLUSIONS: In this tertiary-center cohort, upadacitinib produced faster clinical response at 12 weeks, but SFCR, durability, and safety profiles were similar through 52 weeks.

PMID:41411531 | DOI:10.1097/MCG.0000000000002309

J Glob Health. 2025 Dec 19;15:04323. doi: 10.7189/jogh.15.04323.

ABSTRACT

BACKGROUND: Risk prediction models for cardiovascular diseases (CVDs) have been widely applied in clinical practice and in designing prevention policies globally, yet their accuracy across different regions with distinct epidemiological profiles remains uncertain. We examined the regional variation in risk distribution and agreement between these models.

METHODS: We analysed 53 nationally representative health surveys in seven regions. Using the World Health Organization (WHO), SCORE2, and Framingham CVD risk prediction models, we estimated the respondents’ 10-year CVD risk and categorised them into low-, moderate-, or high-risk groups.

RESULTS: We included 86 430 individuals aged 40-69 years without a history of CVD in our analysis. Globally, CVD risk estimates differed substantially across models (WHO: 7.75%; 95% confidence interval (CI) = 7.70-7.80; SCORE2: 3.72%; 95% CI = 3.69-3.75; Framingham: 12.42%; 95% CI = 12.34-12.50). We also noted regional disparities in identifying moderate- and high-risk subjects, particularly in South Asia (WHO: 12.57%; 95% CI = 11.63-13.51; SCORE2: 18.24%; 95% CI = 17.14-19.33; Framingham: 29.40%; 95% CI = 28.11-30.70), sub-Saharan Africa (WHO: 16.30%; 95% CI = 15.78-16.83; SCORE2: 22.69%; 95% CI = 22.09-23.28; Framingham: 33.85%; 95% CI = 33.18-34.52), East Asia & the Pacific (WHO: 21.06%; 95% CI = 20.57, 21.55; SCORE2: 31.03%; 95% CI = 30.47, 31.59; Framingham: 45.54%; 95% CI = 44.93-46.14), and Latin America & the Caribbean (WHO: 23.09%; 95% CI = 21.48-24.70; SCORE2: 41.56%; 95% CI = 39.68-43.44; Framingham: 55.83%; 95% CI = 53.94-57.72), with greater than two-fold differences across models. Agreement in classifying individuals into low-, moderate-, or high-risk groups remained relatively high across risk models (63.1%), but varied considerably across regions, from 73.91% in South Asia to 47.54% in Latin America & the Caribbean.

CONCLUSIONS: The CVD risk estimates produced by the WHO, SCORE2, and Framingham models varied significantly across regions, with poor consistency in identifying at-risk individuals in some regions. These discrepancies may lead to undertreatment and inefficient use of otherwise limited healthcare resources. Region-specific adaptations are needed to enhance risk targeting, promote equity, and improve the overall effectiveness of primary prevention.

PMID:41411530 | DOI:10.7189/jogh.15.04323

J Am Acad Orthop Surg Glob Res Rev. 2025 Dec 16;9(12). doi: 10.5435/JAAOSGlobal-D-25-00397. eCollection 2025 Dec 1.

ABSTRACT

BACKGROUND: Limited data exist on factors contributing to delayed repair of patellar tendon ruptures. This study describes the experience of a single surgeon managing acute and chronic patellar tendon tears, focusing on patient demographics, socioeconomic characteristics, and short-term surgical outcomes.

METHODS: We conducted a retrospective cohort analysis of patellar tendon repairs performed at a single institution from January 2017 to January 2024. Patients were stratified into acute or chronic groups based on whether surgery occurred within 6 weeks of injury. Socioeconomic background was assessed using the area deprivation index, reported as national percentiles (1% to 100%) and state-normed deciles (1 to 10), with higher rankings indicating greater disadvantage. Mann-Whitney U and chi square tests were used for analysis.

RESULTS: Of the 70 patients included, 45 underwent acute and 25 chronic repairs. Groups did not differ significantly in age, body mass index, race/ethnicity, comorbidities, insurance status, or area deprivation index scores. Surgical complications, infection, revision surgery rates, and postoperative range of motion scores were not statistically different. Functional outcomes such as strength and return to work were not measured.

DISCUSSION: Within our predominantly minority, single-surgeon cohort, our analysis of socioeconomic characteristics revealed an average to moderate level of disadvantage with no notable demographic differences between the two groups. In addition, when appropriately managed, we found no statistically significant differences in surgical complications and postoperative range of motion values. These results reflect a specific practice setting and population. Broader studies incorporating functional outcomes and more diverse populations are needed to better understand delayed presentations and optimize care.

PMID:41411521 | DOI:10.5435/JAAOSGlobal-D-25-00397

J Am Acad Orthop Surg Glob Res Rev. 2025 Dec 16;9(12). doi: 10.5435/JAAOSGlobal-D-24-00398. eCollection 2025 Dec 1.

ABSTRACT

AIMS: Reconstructing hips in moderate-to-severe developmental dysplasia of the hip (DDH) in adults, such as Hartofilakidis type B-C, presents a notable challenge. Despite various surgical procedures available, no approach has shown consistent long-term success. This observational study aimed to report the long-term survivorship and outcomes of a “selective osteotomy treatment algorithm,” which involves selective osteotomy combined with anatomic hip restoration, for moderate-to-severe DDH.

METHODS: We retrospectively reviewed 24 patients with Hartofilakidis type B (moderate) or C (severe) DDH who underwent total hip arthroplasty with selective osteotomy approach at Siriraj Hospital, Mahidol University, Thailand from 2001 to 2021. We employed a Kaplan-Meier curve to assess procedure survivorship, with revision surgery as the end point. Clinical, functional outcomes assessed with Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement score, complications, and radiological assessments during follow-up were recorded.

RESULTS: The mean patient age was 56.8 ± 11.8 years (range 37 to 78 years), and mean height was 152.0 ± 11.7 cm (range 111 to 167 cm). The median surgical time was 84 minutes (range 50 to 300 minutes), with a median estimated blood loss of 450 mL (range 100 to 4000 mL). The median follow-up time was 7.8 years (range 4 to 21 years). The Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement score improved markedly from baseline, with a mean anchor-based increase of 23.70 ± 0.04 at 6 months postoperatively. Three cases encountered revision surgery due to osteotomy nonunion with stem fracture, early dislocation, and periprosthetic joint infection. The survival probability at 12 years was 83.7%. No sciatic nerve injuries were reported. No radiographic pathology was detected during follow-up.

CONCLUSION: Selective osteotomy combined with anatomic hip restoration is a feasible and effective approach for managing moderate-to-severe DDH, as it demonstrated favorable long-term outcomes. Our approach may serve as a treatment option for patients with similar challenging deformities.

PMID:41411505 | DOI:10.5435/JAAOSGlobal-D-24-00398

J Am Acad Orthop Surg Glob Res Rev. 2025 Dec 16;9(12). doi: 10.5435/JAAOSGlobal-D-24-00361. eCollection 2025 Dec 1.

ABSTRACT

INTRODUCTION: Musculoskeletal complications associated with end-stage renal disease (ESRD) are known to predispose patients to an increased risk of hip fractures. The aging population and the effects of treatments pose challenges to advancements in bone health management. This study is one of the largest to date, examining patient demographics and temporal trends among ESRDpatients with hip fractures.

METHODS: A retrospective analysis of data from the United States Renal Data System, spanning 1977 to 2012, was conducted. Two cohorts of 115,386 sex-matched and age-matched patients with ESRD were studied: those with hip fractures and patients without hip fractures. Statistical significance was determined by a P value <0.05. Clinical significance was assessed using effect size (ES).

RESULTS: The incidence of hip fractures among patients with ESRD increased by 3,369% between 1977 and 2007, followed by an 11% decrease from 2007 to 2012. ESRD patients with hip fractures were significantly more likely to be White (77.7% vs. 76.1%; P < 0.001, ES: 0.02) and older (71.6 vs. 71.2, P < 0.001; ES: 0.03). No difference in sex was observed between cohorts: male (47.0% vs. 47.0%) and female (53.0% vs. 53.0%).

DISCUSSION: The temporal trend reflects current ESRD literature but contrasts with trends seen in the general population, partly because of the increased lifespan of these patients and thus longer dialysis, a known risk factor of fractures. Our data support current literature that White race is an independent risk factor of hip fractures, which may be due to genetic variations in vitamin D, FGF-23 metabolism, and bioavailability. The earlier onset of hip fractures in patients with ESRD may offset the effect of menopause-driven fractures observed in the general population.

PMID:41411504 | DOI:10.5435/JAAOSGlobal-D-24-00361

J Am Acad Orthop Surg Glob Res Rev. 2025 Dec 16;9(12). doi: 10.5435/JAAOSGlobal-D-25-00057. eCollection 2025 Dec 1.

ABSTRACT

INTRODUCTION: Intermediate outcomes of foraminal decompression (FD) have not been reported using biportal endoscopic assistance (biportal endoscopic-foraminal decompression [BE-FD]). The goal of this study was to evaluate the clinical and radiologic outcomes of FD and analyzing risk factors for less successful outcomes.

METHODS: Patients who underwent BE-FD for single-level lumbar foraminal stenosis were enrolled. Demographic and radiographic parameters were collected. For clinical evaluation, Oswestry Disability Index and Visual Analog Scale (VAS) for back and leg pain were used. Patients were divided into group A with excellent and group B with less satisfactory results.

RESULTS: A total of 141 patients were selected for this study. Ninety-eight of 141 (69.5%) had excellent outcomes. Group B had improvement in Oswestry Disability Index and VAS leg but less than group A. VAS back did not differ between the groups. Fourteen of patients (9.9%) required revision fusion surgery. In univariate analysis, smaller preoperative intervertebral disk height (IVD), smaller preoperative foraminal height (FH), and more disk wedging (DW) were associated with poorer outcomes. Larger change in IVD, FH, and DW was also associated with suboptimal outcomes and lower level of surgery. In multivariate analysis, level of surgery, preoperative DW, and change in IVD, FH, and DW were notable.

CONCLUSION: BE-FD was able to provide notable symptom improvement; only 9.9% required revision surgery. Lumbar foraminal stenosis pathology in the lower lumbar, less preoperative IVD and FH, and higher disk wedge angle should be taken care with caution when FD is considered because clinical improvement may be less than those patients without those risk factors.

PMID:41411496 | DOI:10.5435/JAAOSGlobal-D-25-00057

J Am Acad Orthop Surg Glob Res Rev. 2025 Dec 16;9(12). doi: 10.5435/JAAOSGlobal-D-25-00106. eCollection 2025 Dec 1.

ABSTRACT

BACKGROUND: Second victim syndrome (SVS) occurs when healthcare providers experience emotional distress after an adverse medical event. Although studied in other specialties, research is limited on its prevalence in orthopaedic surgery, particularly among Hispanic surgeons. This study evaluated SVS among Hispanic orthopaedic surgeons using the Second Victim Experience and Support Tool and identified support disparities.

METHODS: A survey containing the Second Victim Experience and Support Tool questionnaire was sent through e-mail and completed by 70 orthopaedic surgeons in Puerto Rico. Responses were collected electronically from May to September 2024. Descriptive statistics and Likert scores assessed SVS dimensions and support preferences.

RESULTS: The prevalence of psychological distress was moderate (mean: 3.1; SD: 1.2), with emotional distress being the most pronounced. Physical symptoms were less prominent (mean: 2.3; SD: 1.4). Colleague (mean: 2.2; SD: 1.0) and supervisor support (mean: 2.4; SD: 0.9) were inadequate. Institutional support had moderate gaps (mean: 2.7; SD: 1.2). Non-work-related support was highly valued (mean: 1.8; SD: 1.1). Professional self-efficacy declined, increasing self-doubt (mean: 2.6; SD: 1.3). Turnover intention and absenteeism were low (2.2 each). Preferred support included peer discussions (mean: 3.9; SD: 0.8) and employee counseling services (mean: 3.5; SD: 0.9).

CONCLUSION: Hispanic orthopaedic surgeons experience notable distress and insufficient institutional support following adverse medical events. These findings highlight the importance of implementing strategies to mitigate the impact of SVS and improve resilience among healthcare providers.

PMID:41411493 | DOI:10.5435/JAAOSGlobal-D-25-00106

J Am Acad Orthop Surg Glob Res Rev. 2025 Dec 16;9(12). doi: 10.5435/JAAOSGlobal-D-25-00059. eCollection 2025 Dec 1.

ABSTRACT

INTRODUCTION: Proximal femoral fractures (PFFs) are a notable source of morbidity and mortality in elderly populations, with 1-year mortality rates ranging from 15% to 30% and projected incidence set to rise markedly. Interdisciplinary care models, including the integration of a nurse practitioner (NP), have shown the potential to improve outcomes in this vulnerable population.

METHODS: We held a retrospective cohort study to evaluate the impact of adding a geriatric NP to the orthopedic department on mortality and hospitalization outcomes in patients with PFFs. A total of 2,065 patients were included: 1,300 from the preintervention period (2017 to 2020) and 765 from the NP-intervention period (2021 to 2024).

RESULTS: Key outcomes revealed a notable reduction in in-hospital mortality from 5.6% to 2.4% (P = 0.0005) and an improvement in 1-year survival rates during the NP-intervention period. Kaplan-Meier analysis and Cox regression demonstrated a notable survival benefit with NP involvement, with average survival extending from 1.3 to 2.3 years (P < 0.001). The average length of stay decreased from 9.3 to 8.4 days (P = 0.003), and patient transfers to other departments were reduced by nearly one third.

CONCLUSION: These results highlight the positive effect of a geriatric NP on survival, hospital efficiency, and continuity of care for elderly PFF patients. The NP-led model, focusing on perioperative coordination, discharge planning, and comprehensive care, offers a promising approach to address the growing demand for geriatric fracture management, supporting its broader implementation to improve clinical and economic outcomes.

IMPLICATIONS FOR CLINICAL PRACTICE: Our findings support the adoption of geriatric-focused, NP-led interventions in orthopedic settings to optimize the care of elderly fracture patients, aligning with current trends in interdisciplinary approaches to geriatric health care. Expanding this model may improve outcomes on a larger scale, addressing the growing needs of an aging population while promoting high-quality, cost-effective care in geriatric fracture management.

PMID:41411485 | DOI:10.5435/JAAOSGlobal-D-25-00059