Tag: statistics

J Orthop Res. 2022 Dec 27. doi: 10.1002/jor.25506. Online ahead of print.

ABSTRACT

Since eccentric contractions contribute to the development of tendinopathy, sex differences in wrist torque and endurance may be involved in the pathophysiology of lateral epicondylitis and its refractoriness. Therefore, the present study investigated sex differences in wrist torque and endurance. The wrist extension and flexion torques of the 100 wrists of 25 males and 25 females were measured. The following parameters were assessed: muscle strength at the starting- and end point for the measurement, Δ muscle strength, i.e., amount of a loss over time, and the muscle endurance ratio, i.e., decrease rate over time. Each parameter in males and females was statistically analyzed. In wrist extension, muscle strength at the starting point was 6.1 Nm for males and 3.3 Nm for females (p <0.001); Δ Muscle strength was -0.052 Nm/sec for males and -0.038 Nm/sec for females (p=0.036); The muscle endurance ratio was 99.1 %/sec for males and 98.8 %/sec for females (p=0.015). In wrist flexion, muscle strength at the starting point and absolute value of Δ muscle strength were significantly larger in males than in females; No significant difference was observed in the muscle endurance ratio in wrist flexion between males and females. These results revealed sex differences in wrist torque and endurance. The muscle endurance ratio of the wrist extensors was lower in females than in males, which suggests that females need to exert more effort to maintain the wrist extension position under resistance. This may predispose the wrist extensor muscles in females to eccentric contractions. This article is protected by copyright. All rights reserved.

PMID:36573481 | DOI:10.1002/jor.25506

J Cosmet Dermatol. 2022 Dec 27. doi: 10.1111/jocd.15563. Online ahead of print.

ABSTRACT

BACKGROUND: Previous clinical and anatomic investigations have identified the clinical relevance of facial biomechanics. Based on this new understanding, principles for facial aesthetic procedures were established: Lateral Face First, Deep Layers First, and Upper Face First.

OBJECTIVE: To test the upper face first principle by showing that an injection sequence, starting in the upper face is superior to an injection sequence starting in the lower face.

METHODS: This study was designed as an interventional split-face study administering the same amount and type of soft tissue filler for the upper, middle, and lower face but in a different sequence: upper, middle, lower face versus lower, middle, and upper face. A total of 15 patients (5 males and 10 females) with a mean age of 39.4 years (9.6) and a mean BMI of 23.4 kg/m² (1.7) were studied. Follow-up at D0, D30, and D90 was conducted utilizing semiquantitative scores and objective 3D imaging.

RESULTS: Despite not reaching statistical significance, midfacial volume and jawline contouring were rated better at every follow-up visit (D0, D30, D90) when treated with the upper versus the lower face first injection algorithm. The global aesthetic improvement scale showed statistically significantly better values for the upper face first algorithm when compared to the lower face first algorithm at all evaluated time points with all p < 0.001.

CONCLUSION: Applying the upper face first injection algorithm seems to result in better aesthetic outcomes when directly compared to the lower face first algorithm. Semiquantitative and objective outcome measurements confirm its clinical effectiveness.

PMID:36573471 | DOI:10.1111/jocd.15563

Geriatr Gerontol Int. 2022 Dec 27. doi: 10.1111/ggi.14520. Online ahead of print.

ABSTRACT

BACKGROUND: The benefits of physical activity are well-documented, and the prevalence of physical inactivity is high in older patients with chronic diseases. This study aimed to investigate the impact of an aerobic exercise intervention based on the capacity, opportunity, motivation-behavior (COM-B) model on physical activity and health-related outcomes in this population.

METHODS: Thirty-five participants were randomly assigned to the intervention group (IG) for an exercise intervention based on the COM-B model, and 33 were assigned to the control group (CG) for usual care. Physical activity levels, daily steps and bone mineral density T-value, body mass index, waist-hip ratio, subendocardial myocardial viability rate, central arterial pressure, growth index, brachial-ankle pulse wave velocity, ankle-arm index were measured at baseline, during the 12-week intervention, and after the 12-week follow-up.

RESULTS: Compared with the CG and pre-intervention, total physical activity in the IG increased significantly (P < 0.05); however, after the 12-week follow-up, total physical activity decreased. At the same time, the average daily steps of the elderly in both groups increased. Compared with the CG, at the 12-week follow-up, the bone mineral density T-value in the IG was significantly improved (P < 0.05). Compared with the pre-intervention values, during the 12-week intervention, bone mineral density T-value, body mass index, waist-hip ratio, subendocardial myocardial viability rate and central arterial pressure were significantly improved (P < 0.05); after the 12-week follow-up, brachial-ankle pulse wave velocity and ankle-arm index were significantly improved (P < 0.05). No statistically significant changes in the growth index were detected, independent of the group and time.

CONCLUSION: Theory-based exercise interventions can change the physical inactivity behavior of older people with chronic diseases, effectively promoting physical activity and improves bone mineral density T-value, controls body weight, and reduces cardiovascular risk and physiological indicators related to atherosclerosis. Geriatr Gerontol Int 2022; ••: ••-••.

PMID:36573456 | DOI:10.1111/ggi.14520

Sci Total Environ. 2022 Nov 26:160518. doi: 10.1016/j.scitotenv.2022.160518. Online ahead of print.

ABSTRACT

Current public health recommendations for desert dust storms (DDS) events focus on vulnerable population groups, such as children with asthma, and include advice to stay indoors and limit outdoor physical activity. To date, no scientific evidence exists on the efficacy of these recommendations in reducing DDS exposure. We aimed to objectively assess the behavioral responses of children with asthma to recommendations for reduction of DDS exposure. In two heavily affected by DDS Mediterranean regions (Cyprus & Crete, Greece), schoolchildren with asthma (6-11 years) were recruited from primary schools and were randomized to control (business as usual scenario) and intervention groups. All children were equipped with pedometer and GPS sensors embedded in smartwatches for objective real-time data collection from inside and outside their classroom and household settings. Interventions included the timely communication of personal DDS alerts accompanied by exposure reduction recommendations to both the parents and school-teachers of children in the intervention group. A mixed effect model was used to assess changes in daily levels of time spent, and steps performed outside classrooms and households, between non-DDS and DDS days across the study groups. The change in the time spent outside classrooms and homes, between non-DDS and DDS days, was 37.2 min (p_value = 0.098) in the control group and -62.4 min (p_value < 0.001) in the intervention group. The difference in the effects between the two groups was statistically significant (interaction p_value < 0.001). The change in daily steps performed outside classrooms and homes, was -495.1 steps (p_value = 0.350) in the control group and -1039.5 (p_value = 0.003) in the intervention group (interaction p_value = 0.575). The effects on both the time and steps performed outside were more profound during after-school hours. To summarize, among children with asthma, we demonstrated that timely personal DDS alerts and detailed recommendations lead to significant behavioral changes in contrast to the usual public health recommendations.

PMID:36573449 | DOI:10.1016/j.scitotenv.2022.160518

Cereb Cortex. 2022 Dec 27:bhac506. doi: 10.1093/cercor/bhac506. Online ahead of print.

ABSTRACT

Difficulty with attention is an important symptom in many conditions in psychiatry, including neurodiverse conditions such as autism. There is a need to better understand the neurobiological correlates of attention and leverage these findings in healthcare settings. Nevertheless, it remains unclear if it is possible to build dimensional predictive models of attentional state in a sample that includes participants with neurodiverse conditions. Here, we use 5 datasets to identify and validate functional connectome-based markers of attention. In dataset 1, we use connectome-based predictive modeling and observe successful prediction of performance on an in-scan sustained attention task in a sample of youth, including participants with a neurodiverse condition. The predictions are not driven by confounds, such as head motion. In dataset 2, we find that the attention network model defined in dataset 1 generalizes to predict in-scan attention in a separate sample of neurotypical participants performing the same attention task. In datasets 3-5, we use connectome-based identification and longitudinal scans to probe the stability of the attention network across months to years in individual participants. Our results help elucidate the brain correlates of attentional state in youth and support the further development of predictive dimensional models of other clinically relevant phenotypes.

PMID:36573438 | DOI:10.1093/cercor/bhac506

Catheter Cardiovasc Interv. 2022 Dec 27. doi: 10.1002/ccd.30532. Online ahead of print.

ABSTRACT

INTRODUCTION: The antithrombotic management following transcatheter aortic valve replacement (TAVR) in patients who do not have a concurrent indication for long-term anticoagulation therapy is an ongoing source of debate.

METHODS: We performed a systematic review and meta-analysis to compare direct oral anticoagulants (DOACs) versus antiplatelet therapy after TAVR in patients without a concomitant indication for chronic oral anticoagulation. PubMed, Embase, and Cochrane databases were searched. Only randomized controlled trials were included. Risk ratios (RR) with p < 0.05 were considered statistically significant.

RESULTS: Three studies were included, with 2922 patients who underwent TAVR, of whom 1463 (50.1%) received DOACs. Patients who received DOACs therapy had significantly higher all-cause mortality (RR: 1.68; 95% confidence intervals [CI]: 1.22-2.30; p = 0.001) and non-cardiovascular mortality (RR: 2.33; 95% CI: 1.13-4.80; p = 0.02). The incidence of major bleeding was not significantly different between the groups (5.3% vs. 3.8%; RR: 1.44; 95% CI: 0.90-2.32; p = 0.13). There was no difference between DOACs and antiplatelet therapy in terms of: ischemic stroke (RR: 1.28; 95% CI: 0.76-2.15; p = 0.35) and cardiovascular mortality (RR: 1.36; 95% CI: 0.92-2.03; p = 0.13). Lastly, the DOACs group had a significantly lower risk of valve thrombosis than the antiplatelet group (0.8% vs. 3.2%; RR: 0.27; 95% CI: 0.14-0.51; p < 0.0001).

CONCLUSION: In this meta-analysis of randomized studies comparing DOACs to antiplatelet therapy after TAVR in patients without a concomitant indication for anticoagulation, DOACs were associated with a lower incidence of valve thrombosis and a higher rate of all-cause mortality, driven by an increase in noncardiac causes of death.

PMID:36573426 | DOI:10.1002/ccd.30532

Cereb Cortex. 2022 Dec 27:bhac480. doi: 10.1093/cercor/bhac480. Online ahead of print.

ABSTRACT

During navigation, information at multiple scales needs to be integrated. Single-unit recordings in rodents suggest that gradients of temporal dynamics in the hippocampus and entorhinal cortex support this integration. In humans, gradients of representation are observed, such that granularity of information represented increases along the long axis of the hippocampus. The neural underpinnings of this gradient in humans, however, are still unknown. Current research is limited by coarse fMRI analysis techniques that obscure the activity of individual voxels, preventing investigation of how moment-to-moment changes in brain signal are organized and how they are related to behavior. Here, we measured the signal stability of single voxels over time to uncover previously unappreciated gradients of temporal dynamics in the hippocampus and entorhinal cortex. Using our novel, single voxel autocorrelation technique, we show a medial-lateral hippocampal gradient, as well as a continuous autocorrelation gradient along the anterolateral-posteromedial entorhinal extent. Importantly, we show that autocorrelation in the anterior-medial hippocampus was modulated by navigational difficulty, providing the first evidence that changes in signal stability in single voxels are relevant for behavior. This work opens the door for future research on how temporal gradients within these structures support the integration of information for goal-directed behavior.

PMID:36573396 | DOI:10.1093/cercor/bhac480

J Korean Med Sci. 2022 Dec 26;37(50):e349. doi: 10.3346/jkms.2022.37.e349.

ABSTRACT

BACKGROUND: The preventable trauma death rate survey is a basic tool for the quality management of trauma treatment because it is a method that can intuitively evaluate the level of national trauma treatment. We conducted this study as a national biennial follow-up survey project and report the results of the review of the 2019 trauma death data in Korea.

METHODS: From January 1, 2019 to December 31, 2019, of a total of 8,482 trauma deaths throughout the country, 1,692 were sampled from 279 emergency medical institutions in Korea. All cases were evaluated for preventability of death and opportunities for improvement using a multidisciplinary panel review approach.

RESULTS: The preventable trauma death rate was estimated to be 15.7%. Of these, 3.1% were judged definitive preventable deaths, and 12.7% were potentially preventable deaths. The odds ratio for preventable traumatic death was 2.56 times higher in transferred patients compared to that of patients who visited the final hospital directly. The group that died 1 hour after the accident had a statistically significantly higher probability of preventable death than that of the group that died within 1 hour after the accident.

CONCLUSION: The preventable trauma death rate for trauma deaths in 2019 was 15.7%, which was 4.2%p lower than that in 2017. To improve the quality of trauma treatment, the transfer of severe trauma patients to trauma centers should be more focused.

PMID:36573386 | DOI:10.3346/jkms.2022.37.e349

Folia Morphol (Warsz). 2022 Dec 27. doi: 10.5603/FM.a2022.0104. Online ahead of print.

ABSTRACT

The number of meta-analyses (MA) and systematic reviews (SR) on various medical issues has increased during the last two decades. The MA and SR results may differ from one another due to a number of factors such as inaccurate or diverse searches through the databases, discrepancies in the extraction process or in statistical analysis, among others. Some results may even contradict one another, resulting in confusion among readers. Umbrella reviews (UR) have allowed the collection of all available data on a medical issue into one concise study, making it the source of evidence-based medical knowledge to the highest degree. Furthermore, UR can resolve those problems by collecting all data and taking into account both MA and SR, making it the superior tool for physicians. Although the pros of UR are clear and the overall popularity of these types of study has increased tremendously, there is no available step-by-step guide on how to conduct one. Therefore, the objective of the present study was to provide researchers with a detailed tutorial on how to conduct an UR. UR represent the next major step in the advancement of evidence-based medicine, with great practical potential for physicians looking for the most up-to-date data on their topic of interest. We hope that our step-by-step guide may be a useful tool for researchers conducting UR in the future.

PMID:36573368 | DOI:10.5603/FM.a2022.0104

Folia Morphol (Warsz). 2022 Dec 27. doi: 10.5603/FM.a2022.0110. Online ahead of print.

ABSTRACT

The supraspinatus muscle, one of the four rotator cuff muscles, initiates abduction of the arm, simultaneously stretching the articular capsule at the glenohumeral joint, and also contributes to exorotation of the arm. In the present study we aimed to evaluate the age-specific normative values for morphometric parameters of the supraspinatus muscle in human fetuses at varying ages and to elaborate their growth models. Using anatomical dissection, digital image analysis (NIS Elements AR 3.0) and statistics (Student’s t-test, regression analysis), the length, width, circumference and projection surface area of the supraspinatus muscle were measured in 34 human fetuses of both sexes (16♂, 18♀) aged 18-30 weeks of gestation. Neither sex nor laterality differences were found in numerical data of the supraspinatus muscle. In the supraspinatus muscle its length and projection surface area increased logarithmically, while its width and circumference grew proportionately to gestational age. The following growth models of the supraspinatus muscle were established: y = -71.382 + 30.972 × ln(Age) ± 0.565 for length, y = -2.988 + 0.386 × Age ± 0.168 for greatest width (perpendicular to superior angle of scapula), y = -1.899 + 0.240 × Age ± 0.078 for width perpendicular to the scapular notch, y = -19.7016 + 3.381 × Age ± 2.036 for circumference, and y = -721.769 + 266.141 × ln(Age) ± 6.170 for projection surface area. The supraspinatus muscle reveals neither sex nor laterality differences in its size. The supraspinatus muscle grows logarithmically with reference to its length and projection surface area, and proportionately with respect to its width and circumference.

PMID:36573362 | DOI:10.5603/FM.a2022.0110