Tag: statistics

J Orthop Trauma. 2025 Oct 6. doi: 10.1097/BOT.0000000000003093. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the occurrence and risk factors for breakage of 2.7 mm variable angle (VA) locking screws from Depuy – Synthes during removal.

METHODS: Design: Retrospective cohort study.

SETTING: Two urban tertiary care hospitals in India.

PATIENT SELECTION CRITERIA: Patients from 2018 to 2024, undergoing removal of VA locked implants after healing of distal humerus (AO/OTA 13 – A2,3 and 13 – C1,2,3) and distal tibia fractures (AO/ OTA 43 – A1,2,3 and C2,3).Outcome measures and comparisons: The primary outcome measure was breakage of 2.7 mm VA locked screws. Difference in breakage between titanium and stainless-steel screws were examined. Age, gender, bone quality (measured in Hounsfield units using preoperative computerised tomography), body mass index, screw length, and time between surgery and implant removal were analysed for association with screw breakage.

RESULTS: Of 28 patients included, 16 patients underwent removal of titanium implants from the distal humerus and 12 patients underwent removal of stainless-steel implants from the distal tibia. There were 16 males and 12 females with mean age of 41years (range 20-20, SD 15). 95 out of 254 VA locking screws were reported broken during removal. 46 out of 105 (43.8%) stainless steel screws broke compared to 49 out of 149 (32.8%) titanium screws. This difference was not statistically significant (p = 0.234). Younger age (β = -0.48, SE = 0.2, p = 0.022), longer screw length (β = 0.21, SE = 0.23, p = 0.038) and a longer interval between surgery and removal (β = 0.43, SE = 0.42, p = 0.002) were associated with a higher incidence of screw breakage.

CONCLUSIONS: A high incidence of breakage was observed during removal of 2.7 mm VA titanium and stainless-steel locking screws. Younger patients, longer screws and late removal were associated with more risk for breakage. It is important for patients undergoing removal of these implants to be adequately informed and surgeons should be prepared to address this challenge intraoperatively.

LEVEL OF EVIDENCE: IV Retrospective cohort study.

PMID:41056442 | DOI:10.1097/BOT.0000000000003093

Rheumatology (Oxford). 2025 Oct 7:keaf481. doi: 10.1093/rheumatology/keaf481. Online ahead of print.

ABSTRACT

OBJECTIVE: To report a VEXAS syndrome patient presenting with muscular manifestations, at diagnosis and to review the literature on this rare involvement.

METHODS: We conducted a narrative review through 3 databases (Cochran, PubMed and Google Scholar) to identify all reports of muscle involvement associated with VEXAS syndrome. No statistical analysis was performed.

RESULTS: We reported a 73-year-old male VEXAS syndrome patient presenting with muscular manifestations with ptosis, trismus, lower limb myalgia and identified 15 other patients in the literature. All were male with a median age of 71. The most common UBA1 mutations in exon 3, codon 41 involved methionine 41. Muscle inflammation at the onset of VEXAS syndrome was diagnosed by MRI or CT scan. It mostly involved orbital and facial muscles (n = 7), causing diplopia, proptosis, periorbital oedema or chemosis, and the muscles of the lower limbs, causing myalgia, weakness or oedema (n = 7). Muscle histological analysis was also performed in a few cases (n = 5) and revealed an inflammatory infiltrate with macrophages. Other symptoms were quite common: fever, skin and lung involvement, chondritis, arthralgia and thromboembolic events. Corticosteroid therapy was a routine, and the use of corticosteroid-sparing agents was almost systematic.

CONCLUSION: Taken together, these new data describe the specific muscle involvement of VEXAS syndrome and extend its phenotypic spectrum. It enables us to identify three very distinct manifestations of muscle involvement: orbital, facial, and lower limb inflammation. A case series study would provide a better description of these symptoms.

PMID:41056436 | DOI:10.1093/rheumatology/keaf481

J Appl Physiol (1985). 2025 Oct 7. doi: 10.1152/japplphysiol.00393.2025. Online ahead of print.

ABSTRACT

Understanding the dynamic interaction between cardiovascular and cerebrovascular systems during exercise is essential to evaluate the mechanisms supporting brain perfusion. This study examined age- and sex-specific differences in cardiovascular and cerebrovascular dynamic response and used systems modeling to assess physiological coupling during moderate intensity exercise. We recruited adults to complete a single session of moderate intensity exercise on a recumbent stepper. Middle cerebral artery blood velocity (MCAv), mean arterial pressure (MAP), heart rate (HR), and end-tidal CO₂ (P_ETCO₂) were continuously recorded. In 164 participants, we analyzed the dynamic responses to exercise using mono-exponential modeling and functional data analysis. Granger causality within a subject-specific vector autoregression framework evaluated directional influence among physiological signals. Advancing age was associated with an attenuated dynamic response for MCAv, P_ETCO₂, and HR while MAP was elevated. Older adults exhibited significantly smaller MCAv amplitude and slower time constants than young and middle-aged groups. While sex did not influence overall MCAv, MAP, or HR kinetics, men had significantly higher P_ETCO₂ throughout exercise. Granger causality analysis revealed bidirectional coupling among MCAv, HR, MAP, and P_ETCO₂. Prior P_ETCO₂ levels significantly predicted MCAv while MAP had both short- and long-lag predictive effects on MCAv. MCAv also influenced subsequent changes in MAP and P_ETCO₂, indicating feedback regulation. P_ETCO₂ emerged as a dominant driver of MCAv, though systemic interactions reflect an integrated physiological network with multi-component feedback loops. This study advances understanding of cerebrovascular regulation and highlights the utility of systems modeling during exercise.

PMID:41056428 | DOI:10.1152/japplphysiol.00393.2025

Br J Radiol. 2025 Oct 7:tqaf246. doi: 10.1093/bjr/tqaf246. Online ahead of print.

ABSTRACT

OBJECTIVES: To validate the diagnostic accuracy of pelvic floor ultrasound (PFUS) for pelvic organ prolapse (POP) and its correlation with the Pelvic Organ Prolapse Quantification (POP-Q) staging system by performing a rigorous quantitative comparison of anatomical measurements between women with POP and asymptomatic controls.

METHODS: In this prospective observational study, 80 women with clinically confirmed POP and 60 asymptomatic controls underwent standardized PFUS and POP-Q examinations. PFUS was utilized to measure bladder, uterine, and rectal positions during maximal Valsalva maneuver. POP-Q staging was conducted by two blinded urogynecologists (inter-rater reliability κ = 0.87). Statistical analyses included Spearman’s correlation (ρ), diagnostic performance metrics (sensitivity, specificity, accuracy), and group comparisons using t-tests or chi-square tests.

RESULTS: The POP group exhibited significant organ descent versus controls, including mean bladder descent (4.5 ± 1.2 cm vs. 1.8 ± 0.3 cm; P = 0.004) and uterine descent (5.2 ± 1.4 cm vs. 2.05 ± 0.40 cm; P = 0.012). PFUS measurements demonstrated strong correlation with POP-Q stages (compartment-specific ρ = 0.87-0.91). Overall agreement was 90.0% (ρ = 0.92, P < 0.001), with high diagnostic accuracy (93.5%), sensitivity (>90%), and specificity (>96%).

CONCLUSIONS: PFUS is a reliable, non-invasive method to quantify pelvic organ displacement, showing excellent agreement with the clinical standard POP-Q system. Its high diagnostic performance supports its integration into clinical practice for objective diagnosis, severity grading, and comprehensive anatomical characterization of POP.

ADVANCES IN KNOWLEDGE: This study provides robust evidence validating PFUS as a reproducible objective tool for POP assessment.

PMID:41056418 | DOI:10.1093/bjr/tqaf246

Altern Ther Health Med. 2025 Oct 8:AT11654. Online ahead of print.

ABSTRACT

BACKGROUND: Digital media has transformed health communication, with TikTok emerging as a key platform for disseminating herbalism-related content. Reliance on such content, particularly among young adults, necessitates a critical examination of the presentation and engagement of such information online.

PRIMARY STUDY OBJECTIVE: This study investigates the representation of herbal wellness on TikTok, examining the relationship between content typologies, influencer credibility, user engagement metrics, and their implications for public health communication.

METHODS/DESIGN: A cross-sectional, descriptive analysis was conducted using the first 120 videos under the #herbalism hashtag, captured on January 30, 2025. Two independent reviewers employed a coding scheme adapted from established methodologies to classify content into themes (e.g., personal experiences, spiritual health, and educational). Statistical analyses, including Mann-Whitney U tests and Spearman’s correlation, were performed to evaluate differences and associations in engagement metrics.

SETTING: The study was performed on TikTok, a social media platform characterized by short-form videos and use among young adults.

SAMPLE: 120 videos were analyzed. Although detailed demographic data of viewers was unavailable, the content primarily targeted a young adult audience.

INTERVENTION: This observational study involved no direct intervention; instead, it systematically categorized and analyzed naturally occurring digital content.

PRIMARY OUTCOME MEASURES: Engagement was quantified using metrics such as likes, comments, views, saves, and shares. These were correlated with specific content themes and influencer attributes.

RESULTS AND DISCUSSION: Videos referencing spiritual health exhibited higher engagement across multiple metrics, while those featuring personal experiences witnessed lower user interaction. The correlation analyses corroborated these trends, highlighting the influential role of thematic content in shaping audience responses.

CONCLUSION: Findings underscore the dominance of influencer-driven, spiritually resonant herbalism content on TikTok, and raise concerns about frequent uncredentialed expert input. These insights suggest opportunities for integrating evidence-based messaging into digital health communications to mitigate misinformation and enhance public engagement.

KEYWORDS: herbalism, TikTok, content analysis, social media, digital health communication, public health.

PMID:41056388

J Surg Orthop Adv. 2025 Fall;34(3):156-160.

ABSTRACT

The purpose of this study was to compare the incidence of various short-term complications and healthcare utilization between traditional and computer-assisted total knee arthroplasty (CA-TKA). Traditional TKA and CA-TKA cases were extracted from the American College of Surgeons’ National Surgical Quality Improvement Program. Patients were matched using patient and demographic variables. Outcomes were compared between the two patient groups after exact matching. Multivariate logistic regression was performed to identify independent risk factors for various outcome measures. The authors identified 159,521 patients that underwent traditional TKA and 3,464 patients that underwent CA-TKA. After matching, CA-TKA patients were more likely to have a nonhome discharge and a hospital length of stay greater than 2 days. Other outcome measures-readmission, reoperation, mortality, and surgical/medical complications-were comparable between groups. Patients undergoing computer-assisted TKA were more likely to have a nonhome discharge and a hospital length of stay greater than 2 days. (Journal of Surgical Orthopaedic Advances 34(3):156-160, 2025).

PMID:41056383

J Surg Orthop Adv. 2025 Fall;34(3):152-155.

ABSTRACT

Racial differences have been reported in the utilization of total knee arthroplasty (TKA), and there exists differences in pain management between African American and Caucasian patients. There are insufficient data concerning racial differences in perioperative pain management for patients after TKA for osteoarthritis of the knee. This is a retrospective study of 804 African American patients who had primary TKA between 2013 and 2022 at a single academic medical center. Patients were matched, 2:1, to Caucasian patients having TKA using American Society of Anesthesiologists score, age, gender, and body mass index. Demographic data and perioperative variables, including pain scores, morphine equivalents required at multiple time points, operative time, length of stay, and opioid refills were evaluated. A significantly higher proportion of African American than Caucasian patients had opioid medication prescribed within 90 days preoperatively (38% African American vs. 22% Caucasian patients). African American patients had significantly higher preoperative pain scores (3.28 vs. 2.26) than Caucasian patients and received significantly higher doses of morphine equivalents both preoperatively and postoperatively. The proportion of African American patients with opioid medication refills within 90 days postoperatively was significantly higher than Caucasian patients (73% vs. 33%). However, African American patients received significantly less intraoperative morphine equivalents. The reasons for the racial differences in perioperative pain management after TKA at one medical center are unknown and require additional study. However, these results suggest that pain management protocols, including standardized opioid medication, be implemented for patients of all races after primary TKA. (Journal of Surgical Orthopaedic Advances 34(3):152-155, 2025).

PMID:41056382

J Surg Orthop Adv. 2025 Fall;34(3):142-151.

ABSTRACT

The purpose of this study is to determine if differences exist in patient-reported outcome measures (PROMs), revision rates, and postoperative health care utilization between individuals that have a history of taking anti-estrogen medication prior to total joint arthroplasty (TJA) and those who have not in matched cohorts. Patients undergoing primary TJA from 2015 to 2023 were reviewed retrospectively. Demographics, history of medication use, PROMs pre- and post-TJA, revision TJA history, and post-TJA hospital utilization were extracted from medical records. Propensity score matching was then performed at 10:1 control to patients with a history of taking anti-estrogen medication prior to TJA accounting for age, race, American Society of Anesthesiologists physical status classification, and body mass index. Patient PROMs, revision rate, and post-TJA hospital utilization were then compared. After applying exclusion criteria, stratifying the groups into total hip arthroplasty (THA) and total knee arthroplasty (TKA), and propensity score matching, the outcomes of 345 THAs and 549 TKAs were analyzed. Patients taking anti-estrogen medications who underwent THA had significantly higher Patient-Reported Outcome Measures Information System (PROMIS) Pain Interference scores; PROMIS Physical Function scores at 6 weeks, lower PROMIS Physical Function at 1 year; and higher rates of readmission at 90 days. There was no difference in PROMs or hospital utilization between groups in patients that underwent TKA. Patients with a history of taking anti-estrogen medications had meaningful improvement after THA and TKA. Although PROMs were similar between groups after TKA, PROMs suggest that patients taking anti-estrogen medication may have worse pain early after THA as well as worse overall function. (Journal of Surgical Orthopaedic Advances 34(3):142-151, 2025).

PMID:41056381

Eur J Psychotraumatol. 2025 Dec;16(1):2562724. doi: 10.1080/20008066.2025.2562724. Epub 2025 Oct 7.

ABSTRACT

Background: Borderline personality disorder (BPD) is less understood in adolescents than in adults. The extent to which BPD can be conceptualised as a trauma-related disorder remains an ongoing debate. Most existing studies relied on Western adult samples.Objectives: This study examined BPD features and their relationship with trauma-related factors (i.e. adverse experiences and post-traumatic and dissociative symptoms) in a sample of Chinese adolescents.Methods: A total of 1,147 Chinese adolescents from two public schools (mean age = 16.4; 54.6% female) completed the Adverse Childhood Experiences Questionnaire, the Self-Report Dissociative Disorders Interview Schedule-Borderline Personality Disorder, the International Trauma Questionnaire, and the Dissociative Experiences Scale-Taxon.Results: In this sample, 9.9% endorsed ≥5 BPD features on a screening tool (sensitivity = 95.2%; specificity = 64.9%). Most (89%) participants with ≥5 BPD features reported childhood abuse/neglect, compared to 21.3% for those with <5 BPD features. Among participants with ≥5 BPD features, 64.9% screened positive for dissociative symptoms (52.6%) and/or ICD-11 PTSD/CPTSD (41.2%). Trauma-related factors explained 52.9% of the variance in BPD features, which were most strongly associated with disturbances in self-organisation (DSO) symptoms (β = .306, p < .001), emotional abuse (β = .145, p < .001), PTSD symptoms (β = .137, p < .001), and dissociative symptoms (β = .136, p < .001).Conclusion: BPD features are not rare among Chinese adolescents, warranting public health attention. Moreover, given the high rates of childhood abuse/neglect (89%) and dissociation/PTSD/CPTSD (64.9%) in adolescents with ≥5 BPD features, and considering the close relationship between trauma-related factors and BPD features, prevention and treatment of BPD features among young people should take trauma-related factors into consideration.

PMID:41055930 | DOI:10.1080/20008066.2025.2562724