Tag: statistics

Int J Periodontics Restorative Dent. 2022 May-Jun;42(3):e67-e74. doi: 10.11607/prd.4926.

ABSTRACT

This study evaluated the pull-off force between titanium abutments and zirconia crowns that were bonded using four different cements and two abutment heights (AHs). In total, 24 titanium abutments (3-mm AH: n = 12; 5-mm AH: n = 12; taper: 7.5 degrees) and 24 zirconia crowns were designed, manufactured, cemented with one of four dental cements (one temporary, two semi-permanent, one permanent), stored in water for 24 hours, and thermocycled (37,500 cycles, equal to ~4 years in vivo). The pull-off force needed to separate the abutment and crown in each combination was determined eight times per combination of cement type and abutment height. Statistical analysis was conducted at a significance level of P < .05. The permanent self-adhesive composite cement showed a high pull-off force with a risk for crown fracture (mean: 381 N for 3-mm AH; 617 N for 5-mm AH). In contrast, the temporary zinc-oxide cement showed frequent premature decementation after thermocycling (mean: 14 N with 3-mm AH; 28 N with 5-mm AH). Both semi-permanent methacrylate-based cements ranked between the other cements (mean: 31 N/37 N for 3-mm AH; 120 N/72 N for 5-mm AH). Statistically significant differences were found between all cements (ANOVA P < .001). The abutment heights differed significantly for all cements (P < .005) except for the temporary zinc-oxide cement. Methacrylate-based cements were the most reliable cements for semi-permanent mounting of zirconia crowns on titanium abutments. They provide sufficient retention to avoid unintended loosening and are weak enough to remove the crown without causing damage.

PMID:35472113 | DOI:10.11607/prd.4926

J Neuropathol Exp Neurol. 2022 Apr 26:nlac020. doi: 10.1093/jnen/nlac020. Online ahead of print.

ABSTRACT

This study investigates the presence of a hollow recess at the midline undersurface of tumors primarily localized within the third ventricle (3V). This structure was originally identified by magnetic resonance imaging (MRI) of 6 3V craniopharyngiomas (CPs) from our series and was then methodically scrutinized in autopsy studies (n = 1091) and MRI scans (n = 5558) of CPs and in 1251 3V tumors reported in the medical literature from 1839 to 2021. A recess at the tumor base was identified in 110 CPs, 95 with a verified papillary histology (papillary craniopharyngioma [PCP]) and 15 with typical gross appearance of PCP. Topographically, 90 tumors were strictly within the 3V (82%); 20 developed at the infundibulo-tuberal region of the 3V floor (18%). Morphologically, 2 main types of recess were identified: (i) a long, narrow recess with either a duct-like or a tubular shape that reached the central region of the CP (n = 47, 42.5%); and (ii) a short recess extending only a few millimeters into the lesion, either with a duct-like or a shallow cleft-like morphology (n = 63, 57.5%). Thus, the presence of a basal recess represents a pathological hallmark of a subpopulation of 3V PCPs. The presumed nature and diagnostic significance of this novel finding is comprehensively addressed.

PMID:35472085 | DOI:10.1093/jnen/nlac020

Hum Reprod. 2022 Jan 28;37(2):366-383. doi: 10.1093/humrep/deab254.

ABSTRACT

STUDY QUESTION: Is there a shared genetic or causal association of endometriosis with asthma or what biological mechanisms may underlie their potential relationships?

SUMMARY ANSWER: Our results confirm a significant but non-causal association of endometriosis with asthma implicating shared genetic susceptibility and biological pathways in the mechanisms of the disorders, and potentially, their co-occurrence.

WHAT IS KNOWN ALREADY: Some observational studies have reported a pattern of co-occurring relationship between endometriosis and asthma; however, there is conflicting evidence and the aetiology, as well as the underlying mechanisms of the relationship, remain unclear.

STUDY DESIGN, SIZE, DURATION: We applied multiple statistical genetic approaches in the analysis of well-powered, genome-wide association study (GWAS) summary data to comprehensively assess the relationship of endometriosis with asthma. Endometriosis GWAS from the International Endogene Consortium (IEC, 17 054 cases and 191 858 controls) and asthma GWAS from the United Kingdom Biobank (UKB, 26 332 cases and 375 505 controls) were analysed. Additional asthma data from the Trans-National Asthma Genetic Consortium (TAGC, 19 954 cases and 107 715 controls) were utilized for replication testing.

PARTICIPANTS/MATERIALS, SETTING, METHODS: We assessed single-nucleotide polymorphism (SNP)-level genetic overlap and correlation between endometriosis and asthma using SNP effect concordance analysis (SECA) and linkage disequilibrium score regression analysis (LDSC) methods, respectively. GWAS meta-analysis, colocalization (GWAS-PW), gene-based and pathway-based functional enrichment analysis methods were applied, respectively, to identify SNP loci, genomic regions, genes and biological pathways shared by endometriosis and asthma. Potential causal associations between endometriosis and asthma were assessed using Mendelian randomization (MR) methods.

MAIN RESULTS AND THE ROLE OF CHANCE: SECA revealed significant concordance of SNP risk effects across the IEC endometriosis and the UKB asthma GWAS. Also, LDSC analysis found a positive and significant genetic correlation (rG = 0.16, P = 2.01 × 10-6) between the two traits. GWAS meta-analysis of the IEC endometriosis and UKB asthma GWAS identified 14 genome-wide significant (Pmeta-analysis < 5.0 × 10-8) independent loci, five of which are putatively novel. Three of these loci were consistently replicated using TAGC asthma GWAS and reinforced in colocalization and gene-based analyses. Additional shared genomic regions were identified in the colocalization analysis. MR found no evidence of a significant causal association between endometriosis and asthma. However, combining gene-based association results across the GWAS for endometriosis and asthma, we identified 17 shared genes with a genome-wide significant Fisher’s combined P-value (FCPgene) <2.73 × 10-6. Additional analyses (independent gene-based analysis) replicated evidence of gene-level genetic overlap between endometriosis and asthma. Biological mechanisms including ‘thyroid hormone signalling’, ‘abnormality of immune system physiology’, ‘androgen biosynthetic process’ and ‘brain-derived neurotrophic factor signalling pathway’, among others, were significantly enriched for endometriosis and asthma in a pathway-based analysis.

LARGE SCALE DATA: The GWAS for endometriosis data were sourced from the International Endogen Consortium (IEC) and can be accessed by contacting the consortium. The GWAS data for asthma are freely available online at Lee Lab (https://www.leelabsg.org/resources) and from the Trans-National Asthma Genetic Consortium (TAGC).

LIMITATIONS, REASONS FOR CAUTION: Given we analysed GWAS datasets from mainly European populations, our results may not be generalizable to other ancestries.

WIDER IMPLICATIONS OF THE FINDINGS: This study provides novel insights into mechanisms underpinning endometriosis and asthma, and potentially their observed relationship. Findings support a co-occurring relationship of endometriosis with asthma largely due to shared genetic components. Agents targeting ‘selective androgen receptor modulators’ may be therapeutically relevant in both disorders. Moreover, SNPs, loci, genes and biological pathways identified in our study provide potential targets for further investigation in endometriosis and asthma.

STUDY FUNDING/COMPETING INTEREST(S): National Health and Medical Research Council (NHMRC) of Australia (241,944, 339,462, 389,927, 389,875, 389,891, 389,892, 389,938, 443,036, 442,915, 442,981, 496,610, 496,739, 552,485, 552,498, 1,026,033 and 1,050,208), Wellcome Trust (awards 076113 and 085475) and the Lundbeck Foundation (R102-A9118 and R155-2014-1724). All researchers had full independence from the funders. Authors do not have any conflict of interest.

PMID:35472084 | DOI:10.1093/humrep/deab254

Spine (Phila Pa 1976). 2022 Apr 21. doi: 10.1097/BRS.0000000000004374. Online ahead of print.

ABSTRACT

STUDY DESIGN: Prospective cohort study.

OBJECTIVE: To evaluate whether sagittal and spinopelvic alignment correlate with preoperative patient-reported outcomes (PROs) in degenerative lumbar spondylolisthesis (DLS) with spinal stenosis.

SUMMARY OF BACKGROUND DATA: Positive global sagittal balance and spinopelvic malalignment are strongly correlated with symptom severity in adult spinal deformity, but this correlation has not been evaluated in DLS.

METHODS: Patients were enrolled in the Canadian Spine Outcomes Research Network (CSORN) prospective DLS study at 7 centres between January 2015 and May 2018. Correlation was assessed between the following preoperative PROs: Oswestry Disability Index (ODI), numeric rating scale (NRS) leg pain and NRS back pain and the following preoperative sagittal radiographic parameters SS, PT, PI, SVA, LL, TK, T1SPI, T9SPI, and PI-LL. Patients were further divided into groups based on spinopelvic alignment: Group 1 PI-LL<10°; Group 2 PI-LL≥10° with PT < 30°; and Group 3 PI-LL≥10° with PT≥30°. Preoperative PROs were compared among these 3 groups and were further stratified by those with SVA<50 mm and SVA≥50 mm.

RESULTS: 320 patients (61% female) with mean age of 66.1 years were included. Mean (SD) preoperative PROs were: NRS leg pain 7.4 (2.1), NRS back pain 7.1 (2.0), and ODI 45.5 (14.5). Preoperative radiographic parameters included: SVA 27.1 (33.4) mm, LL 45.7 (13.4º), PI 57.6 (11.9), and PI-LL 11.8 (14.0º). Weak but statistically significant correlations were observed between leg pain and PT (r = -0.114) and PI (ρ = -0.130), and T9SPI with back pain (r = 0.130). No significant differences were observed among the three groups stratified by PI-LL and PT. No significant differences in PROs were observed between patients with SVA<50 mm compared to those with SVA≥50 mm.

CONCLUSIONS: Sagittal and spinopelvic malalignment does not appear to significantly influence baseline PROs in patients with degenerative lumbar spondylolisthesis.

LEVEL OF EVIDENCE: Prognostic Level II.

PMID:35472076 | DOI:10.1097/BRS.0000000000004374

J Am Acad Orthop Surg. 2022 Apr 25. doi: 10.5435/JAAOS-D-21-01169. Online ahead of print.

ABSTRACT

INTRODUCTION: Fragility fractures are an enduring source of morbidity in the elderly with unfortunate frequency and rising costs. Although the predominant cause of fractures is generally understood to be falls, the exact stratification of the causes of fractures presenting to the emergency department has not yet been described in the literature. We sought out to stratify the primary products associated with fractures in the elderly, further describing the anatomic location of the fracture and setting of injury.

METHODS: We queried the National Electronic Injury Surveillance System database for all fractures in patients older than 65 years from January 1, 2000, to December 31, 2019. We analyzed demographic data, patient disposition, anatomic fracture location, and injury setting for the top 20 causes of fractures. Trends, proportions and distributions were analyzed using descriptive statistics.

RESULTS: A total of 901,418 visits to the Emergency Department were reviewed. Of these, 216,657 (24%) were found to have fractures. The top 20 causes for fractures accounted for a total of 173,557 (19%) fractures. The average age in our population was 80.1 years (SD 8.7). Women constituted most of the patients (127,753 [74%]). Flooring (58,347 [33.6%]) was the most common product associated with the cause of fractures, with stairs/steps (29,804 [17.2%]) and bed/bed frames (19,004 [10.9%]) being the second and third most common, respectively. Lower extremity fractures (97,195 [56%]) were more common than upper extremity fractures (63,899 [37%]). The lower trunk (pelvis, femoral neck, and lower spine) was the most common anatomic location of fractures reported (64,132 [37.0%]). Most fractures occurred either at home (113,158 [65.2%]) or at a public setting (31,162 [18.0%]).

CONCLUSIONS: Most products associated with fractures among mature adults were related to flooring, stairs, or bedding. This study offers a detailed understanding on the common products associated with fractures in mature adults and aids in discussing preventive measures for lowering fracture risk with patients, communities, and healthcare systems.

PMID:35472060 | DOI:10.5435/JAAOS-D-21-01169

Psychosom Med. 2022 Apr 27. doi: 10.1097/PSY.0000000000001087. Online ahead of print.

ABSTRACT

OBJECTIVE: Recent research identified that workplace factors play a role in the development of diabetes mellitus (DM). This study examines the longitudinal association of work-related overqualification with the incidence of DM over a 14-year follow-up period.

METHODS: We used data from the 2003 Canadian Community Health Survey linked to the Ontario Health Insurance Plan and the Canadian Institute for Health Information Discharge Abstract databases. Cox-proportional hazards regression models were performed to evaluate the relationship between overqualification and the incidence of DM.

RESULTS: Over the study period, there were 91,835 person-years of follow-up (median follow-up 13.7 years). The final sample included 7,026 respondents (mean age at baseline = 47.1; SD = 8.2; 47% female). An elevated risk of DM was associated with substantial overqualification (HR = 1.58, 95% CI: 1.01 – 2.49) after adjustment for socio-demographic, health and work variables. Additional adjustment for body mass index (BMI) and health behaviours attenuated this risk (HR = 1.30, 95% CI: 0.81 – 2.08). Underqualification was not associated with the incidence of DM in adjusted regression models. We did not observe any statistical difference in the effects of overqualification on DM risk across sex or education groups.

CONCLUSIONS: This study adds to the growing body of research literature uncovering the relationships between work exposures and DM risk. The results from the study suggest that higher BMI, and to a lesser extent health behaviours, may be mediating factors in the association between overqualification and incident DM. Further research on the association of overqualification with DM is warranted.

PMID:35472044 | DOI:10.1097/PSY.0000000000001087

Am J Hematol. 2022 Apr 26. doi: 10.1002/ajh.26581. Online ahead of print.

ABSTRACT

Iron overload is a severe general complication of hereditary anemias. Treatment with iron chelators is hampered by important side-effects, high costs and the lack of availability in many countries with high prevalence of hereditary anemias. In this phase III randomized placebo-controlled trial we assigned adults with non-transfusion-dependent hereditary anemias with mild-to-moderate iron overload to receive esomeprazole (at a dose of 40mg twice daily) or placebo for 12 months in a cross-over design. The primary end point was change of liver iron content measured by MRI. A total of thirty participants were enrolled in the trial. Treatment with esomeprazole resulted in a statistically significant reduction in liver iron content that was 0.55 mg Fe/g dw larger than after treatment with placebo (95%CI [0.05 to 1.06]; p=0.03). Median baseline liver iron content at start of esomeprazole was 4.99 versus 4.49 mg Fe/g dw at start of placebo. Mean delta liver iron content after esomeprazole treatment was -0.57 (SD 1.20) versus -0.11 mg Fe/g dw (SD 0.75) after placebo treatment. Esomeprazole was well tolerated, reported adverse events were mild and none of the patients withdrew from the study due to side effects. In summary, esomeprazole resulted in a significant reduction in liver iron content when compared to placebo in a heterogeneous group of patients with non-transfusion-dependent hereditary anemias. From an international perspective this result can have major implications given the fact that proton pump inhibitors may frequently be the only realistic therapy for many patients without access to or not tolerating iron chelators. This article is protected by copyright. All rights reserved.

PMID:35472008 | DOI:10.1002/ajh.26581

J Am Acad Orthop Surg Glob Res Rev. 2022 Apr 1;6(4). doi: 10.5435/JAAOSGlobal-D-21-00016.

ABSTRACT

Whether to undergo bilateral total knee arthroplasty (BTKA) depends on patient and surgeon preferences. We used the National Inpatient Sample to compare temporal trends in BTKA utilization and in-hospital complication rates among TKA patients ≥50 with Medicare/Medicaid versus private insurance from 2007 to 2016. We used multivariable logistic regression to assess the association between insurance type and trends in utilization and complication rates adjusting for individual-, hospital-, and community-level covariates, using unilateral TKA (UTKA) for reference. Discharge weights were used for nationwide estimates. About 132,400 (49.5%) Medicare/Medicaid patients and 135,046 (50.5%) privately insured patients underwent BTKA. Among UTKA patients, 62.7% had Medicare/Medicaid, and 37.3% had private insurance. Over the study period, BTKA utilization rate decreased from 7.18% to 5.63% among privately insured patients and from 4.59% to 3.13% among Medicaid/Medicare patients (P trend difference <0.0001). In multivariable analysis, Medicare/Medicaid patients were less likely to receive BTKA than privately insured patients. Although Medicare/Medicaid patients were more likely to develop in-hospital complications after UTKA (adjusted odds ratio, 1.06; 95% confidence interval, 1.002 to 1.12; P = 0.04), this relationship was not statistically significant for BTKAs. In this nationwide sample of TKA patients, BTKA utilization rate was higher in privately insured patients compared with Medicare/Medicaid patients. Furthermore, privately insured patients had lower in-hospital complication rates than Medicare/Medicaid patients.

PMID:35472007 | DOI:10.5435/JAAOSGlobal-D-21-00016

Inflamm Bowel Dis. 2022 Apr 26:izac088. doi: 10.1093/ibd/izac088. Online ahead of print.

ABSTRACT

BACKGROUND: There is lack of knowledge concerning postpartum infections in women with inflammatory bowel disease (IBD). Our aim is to determine the 30-day postpartum infectious complications in women with and without IBD who have a caesarian section, normal vaginal delivery, or assisted vaginal delivery.

METHODS: We used Danish national registries to establish a study population of liveborn, singleton births from January 1, 1997, through December 31, 2015. We examined 30-day postpartum maternal infectious complications in women with and without IBD, according to the mode of delivery. Statistical models were adjusted for multiple confounders.

RESULTS: In all, 3255 women with and 207 608 without IBD had a caesarian section. Within 30 days postpartum, 4.5% of women with and 3.7% without IBD had an infectious complication. Increased infectious complications included overall infections (adjusted OR [aOR], 1.83; 95% confidence interval [CI], 1.35-2.47), infections of the gastrointestinal tract (aOR, 4.36, 95% CI 2.34-8.10), and infections of the skin and subcutaneous tissue (aOR, 4.45; 95% CI, 2.30-8.50). Other puerperal infections, urological and gynecological, and other infections were increased, although not significantly. For vaginal deliveries, 1.6% of 5771 women with IBD and 1.3% of 793 110 women without IBD had an infectious complication, and the aOR of infections of the gastrointestinal tract was 3.17 (95% CI, 1.47-6.85). There were too few outcomes to calculate the risk of infections after assisted vaginal delivery.

CONCLUSIONS: The risk of a 30-day postpartum infectious complication is increased in women with IBD. Physicians should carefully monitor their patients postpartum to prevent these adverse outcomes.

PMID:35472003 | DOI:10.1093/ibd/izac088

J Am Coll Health. 2022 Apr 26:1-4. doi: 10.1080/07448481.2022.2066976. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to identify out-of-hospital cardiac arrest characteristics for patients treated by collegiate-based emergency medical services (CBEMS) organizations.

PARTICIPANTS: CBEMS organizations provided data via the National Collegiate EMS Foundation Cardiac Arrest Data Registry.

METHODS: CBEMS organization details, patient demographics, cardiac arrest characteristics and treatments, and prehospital outcomes for cases spanning October 2007 to May 2020 were analyzed with descriptive statistics.

RESULTS: There were 65 OHCA entries. The majority were for male patients (82%) and a notable number of cases occurred in patients 45 years of age or younger (41%). Cases were frequently witnessed (71%) with high rates of bystander cardiopulmonary resuscitation (57%) and defibrillation (29%) prior to EMS arrival. Almost half of the patients (48%) had achieved return of spontaneous circulation until care was transferred to a provider of equal/higher level.

CONCLUSIONS: CBEMS organizations may be well situated to respond rapidly to on-campus OHCAs.

PMID:35472006 | DOI:10.1080/07448481.2022.2066976