Tag: statistics

Otol Neurotol. 2025 Feb 20. doi: 10.1097/MAO.0000000000004459. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine comfort (C) and threshold (T) levels in adult cochlear implant (CI) recipients over the first 18 months postactivation.

STUDY DESIGN: Retrospective review of longitudinal CI programming data.

SETTING: Tertiary academic center.

PATIENTS: A total of 480 CIs among 428 adult CI recipients.

INTERVENTIONS: Cochlear implantation with Cochlear Ltd. devices with subsequent programming to behavioral standards using Custom Sound® fitting software.

MAIN OUTCOME MEASURES: Charge levels needed to achieve C and T levels were measured longitudinally using Custom Sound®, from time of activation to a minimum of 6 and a maximum of 18 months postactivation. Charge (nC) levels were calculated as the product of pulse width (μs) and current amplitude (μA) to standardize among implant models. Changes in C and T charge levels over time were evaluated using repeated-measures analysis of variance.

RESULTS: When considering the entire electrode, the largest increases were seen at 1 month postactivation, and C and T charge levels did not increase significantly after 6 and 12 months, respectively. These findings were consistent across patient age at implantation and sex. When considering proximal electrodes only, C and T levels did not increase significantly after 6 months. In distal electrodes only, C levels did not increase significantly after 6 months, but T levels continued to demonstrate small, but statistically significant increases up to 18 months postactivation.

CONCLUSIONS: Across the entire electrode, we observed the largest changes in C and T charge levels at 1 month postactivation. Small increases in C and T levels continued out to 6 and 12 months, respectively, but may be of limited clinical significance. The stability of programming levels over time may support selective de-escalation of CI follow-up after the initial postactivation period, but, given small yet persistent increases with time, most notably in the distal electrodes, alternatives for follow-up or remote programming may still be encouraged.

PMID:40059752 | DOI:10.1097/MAO.0000000000004459

Forensic Sci Int. 2025 Feb;367:112357. doi: 10.1016/j.forsciint.2024.112357. Epub 2024 Dec 25.

ABSTRACT

The history of torture and other forms of ill-treatment or abuse is relied largely upon asylum seekers’ self-reporting given that several forms of torture don’t leave permanent marks. To the extent, however, that physical findings exist they are valuable confirmatory evidence in support of an asylum application. The aim of this study was to retrospectively document the self-reported history of torture and other forms of abuse, alongside the physical evidence and the degree of consistency observed during examinations of asylum seekers conducted at the Department of Legal Medicine, University Hospital of Montpellier, France, during a 4-year period. The information was retrieved through retrospective analysis of all consecutive cases of the asylum seekers examined from January 1, 2019, to December 30, 2022. Exclusion criterion was age under 18 years old. A total number of 495 asylum seekers were included in the study for the aforementioned period (males 68.1 % and females 31.9 %). Mean of age was 29.90 years. The majority of the sample was originated from Sub-Saharan Africa (76.6 %). The most common method of torture/abuse was blunt force impact (88.5 %). A history of incised wounds (stabs and cuts), burns, gunshot use, and food deprivation were mentioned in 31.2 %, 21.4 %, 7.9 % and 5.6 % of the cases, respectively. Psychological abuse and sexual abuse were reported by 58.0 % and 22.9 % of the asylum seekers, respectively. Female genital mutilation was reported by 34.0 % of the female asylum seekers, coming almost exclusively from Sub-Saharan Africa. The perpetrator was a member of the family in 30.6 % of the cases, followed by police/army (27.7 %). Old injuries were observed on head in 56.4 %, on neck in 3.6 %, on trunk in 58.8 %, on upper extremities in 77.2 %, on lower extremities in 74.3 % and on genital/anal area in 13.3 % of the cases. Regarding the type of injuries observed during forensic clinical examination, history of blunt forces was positively associated with scars (p = 0.004), teeth injuries (p = 0.014) and fractures (p = 0.009). A positive statistical association was shown between compatibility grading 2-4 and burns (p = 0.015), as well as female genital mutilation (p < 0.001). A positive statistical association was shown between compatibility grading 1 and the method of torture/abuse when this was reported to be sexual abuse ((p = 0.008) and blunt force impact (p < 0.001). The results of the study will contribute to the gained knowledge about torture invoked injuries, improving thus the capability of forensic examiners to conduct comprehensive medical evaluations regarding alleged torture survivors.

PMID:40059743 | DOI:10.1016/j.forsciint.2024.112357

J Athl Train. 2025 Mar 10. doi: 10.4085/1062-6050-0700.24. Online ahead of print.

ABSTRACT

Scientific inquiry aims to minimize bias and ensure accurate conclusions. A critical yet often overlooked issue in sports medicine and exercise science research is the family-wise error rate (FWER) and experimental-wise error rate (EWER), which increase with multiple statisticalinferences, inflating the risk of Type I errors. While FWER corrections are standard in post-hoc ANOVA tests, they are inconsistently applied in broader research contexts. Using an example from our research team of over 67 million regression models, we illustrate how failing to correct for FWER can create spurious findings. Approximately 3 million (4.4%) models werestatistically significant (p<0.05), aligning with the expected false-positive rate. This underscores the necessity of solutions such as preregistration, false discovery rate control, and Bayesian approaches. Without proper corrections, erroneous conclusions may mislead clinical decision- making and potentially harm patients, highlighting the importance of rigorous statistical methods in evidence-based sports medicine.

PMID:40059734 | DOI:10.4085/1062-6050-0700.24

Psychol Med. 2025 Mar 10;55:e79. doi: 10.1017/S0033291725000236.

ABSTRACT

Cannabis use is highly prevalent in people with schizophrenia and is related to adverse clinical outcomes, including relapse and hospitalization. However, the relationship between cannabis and suicide remains inconclusive. This study aimed to systematically review and meta-analyze the relationship between cannabis use and suicide-related outcomes in people with schizophrenia. A comprehensive search of Medline, Embase, and PsycINFO for cross-sectional, case-control, and longitudinal studies was conducted using search terms from database inception to November 2024 inclusive. Computation of odds ratios (ORs) and hazard ratios (HRs) was performed using random effects models with DerSimonian-Laird estimation. All studies were appraised for quality. We also evaluated heterogeneity, publication bias and performed sub-group analyses and meta-regression. Twenty-nine studies comprising 36 samples met eligibility criteria. Cannabis use was not associated with odds of suicide death or suicidal ideation but was associated with risks of suicide death (HR = 1.21, 95% CI = 1.04 – 1.40) and odds of attempted suicide (OR = 1.40, 95% CI = 1.16 – 1.68). While between-sample heterogeneity was moderate in analyses of attempted suicide (I² = 39.6%, p = 0.03), there was no publication bias. Summary effects remained significant in most sub-groups, but just failed to reach significance in longitudinal studies of attempted suicide (OR = 1.40, 95% CI = 0.97 – 1.68) and studies investigating first episode samples (OR = 1.24, 95% CI = 0.99 – 1.55). Cannabis use is significantly associated with some, but not all, suicide-related outcomes in people with schizophrenia. More work is needed to examine potential mechanisms of significant relationships.

PMID:40059733 | DOI:10.1017/S0033291725000236

J Athl Train. 2025 Mar 10. doi: 10.4085/1062-6050-0673.24. Online ahead of print.

ABSTRACT

Context Lean sports, endurance running, have been at the forefront of disordered eating and body image research, particularly in female populations. Yet, little is known about how athletic men and women differ in body checking behaviors, a known risk factor for body dissatisfaction and disordered eating, across sport type and athletic status. Objective The purpose of this study was to examine gender differences on measures of eating behavior and body checking between full-time collegiate student-athletes and nonathletes. Design Cross-sectional study. Setting NCAA DI collegiate athletics. Participants Two-hundred fifty-nine full-time college students (n = 174 student-athletes, 85 nonathletes) Main Outcome Measures Primary outcomes included self-reported disordered eating behavior and body checking behavior through the EAT-26 and the Body Checking Questionnaire (BCQ) and the Male BCQ (MBCQ). We explored differences based on sport type, team, individual, or nonathlete, and gender identity. Results There was a statistically significant multivariate main effect of gender F(10, 464) = 9.219, p<0.001, 𝜂 2 = 0.166, and a significant multivariate interaction of gender and sport type F(15, 699) = 2.806, p=0.001, 𝜂 2 = 0.057. Follow-up comparisons for team sport athletes showed that women scored significantly higher (p<0.001) on the MBCQ compared to men. Women team sport athletes also scored significantly higher on the MBCQ than women nonathletes (p < 0.001). Conversely, nonathlete men scored significantly higher on the MBCQ than men team and individual sport athletes (p = 0.003 and p = 0.048, respectively). Conclusions Findings suggest that body checking behaviors traditionally studied as masculine occur more frequently in women than men. This effect seems to be driven by women team sport athletes, who reported engaging in more body checking behaviors on the MBCQ than nonathletes. Therefore, assessments based on traditional views of maleness and femaleness may overlook significant risk factors for eating disorders (ED) in college athletes.

PMID:40059732 | DOI:10.4085/1062-6050-0673.24

Orthop Surg. 2025 Mar 10. doi: 10.1111/os.70015. Online ahead of print.

ABSTRACT

BACKGROUND: The impact of posterior lateral tibial plateau fractures (PLTPFs) on knee joint stability after anterior cruciate ligament (ACL) reconstruction has garnered widespread attention. However, limited literature exists on the co-occurrence of ACL tibial avulsion fractures (ACLAFs) and PLTPFs. The objective of this study is to investigate the prevalence of PLTPFs in adult ACLAF patients and assess the impact of concurrent PLTPFs on postoperative knee function.

METHODS: This retrospective study analyzed adults, who underwent arthroscopic surgery for ACLAF at our institution between January 2016 and January 2022. Demographic and preoperative/postoperative imaging data were collected, focusing on meniscus and ligament injuries, Segond fractures, PLTPFs, and tibial plateau slope. Patients were grouped into isolated ACLAF (I-ACLAF) and ACLAF with concurrent PLTPFs (ACLAF-PLTPF). The ACLAF-PLTPF group was further divided into Group A (PLTPFs not exceeding the anterior edge of the lateral meniscus posterior horn) and Group B (PLTPFs exceeding this edge). Clinical outcomes were evaluated using International Knee Documentation Committee and Tegner scores. The study also examined the morphology of PLTPFs and their specific affected areas. Statistical analysis was performed using the Mann-Whitney U tests for continuous variables and Fisher’s exact tests for categorical variables.

RESULTS: The study included 62 patients with a mean follow-up of 41 ± 17 months. Among these, 71.0% (44/62) patients with ACLAF also had PLTPFs. The ACLAF-PLTPF group showed a significantly steeper lateral tibial plateau slope than the I-ACLAF group (10.86° ± 5.47° vs. 7.17° ± 3.68°, p = 0.011). Segond fractures were present in 22.7% of the ACLAF-PLTPF group, compared to none in the I-ACLAF group (p = 0.027). IKDC and Tegner scores were lower in the ACLAF-PLTPF group (80.7 ± 5.2 and 4, respectively) than in the I-ACLAF group (87.4 ± 6.4 and 4.5, respectively), with statistical significance (p < 0.001 and p = 0.008, respectively). Older age correlated with a greater extent of concurrent PLTPFs (p = 0.038). Additionally, Patients in Group B exhibited a significantly higher incidence of meniscal injury (22.2% vs. 53.8%, p = 0.036) and poorer postoperative knee joint function compared to those in Group A (IKDC 82.3 ± 2.8 vs. 78.5 ± 5.6, p = 0.013). More extensive PLTPFs were linked to increased fracture collapse and a higher rate of lateral meniscus injuries.

CONCLUSION: PLTPFs demonstrated a high prevalence in adults with ACLAF. Additionally, the ACLAF-PLTPF cohort frequently showed reduced postoperative knee function. Simultaneous management of severe concomitant PLTPFs may improve long-term outcomes in patients with ACLAF.

PMID:40059695 | DOI:10.1111/os.70015

Transfusion. 2025 Mar 10. doi: 10.1111/trf.18177. Online ahead of print.

ABSTRACT

BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) and emergency department thoracotomy (EDT) are effective methods of aortic occlusion (AO) for life-threatening bleeding; however, complete AO can lead to visceral ischemia. Partial REBOA (P-REBOA) has been proposed as an alternative to the completely occlusive REBOA (C-REBOA) to balance hemorrhage control and perfusion. Using the Aortic Occlusion for Resuscitation in Trauma (AORTA) multicenter, observational registry, we tested the hypothesis that P-REBOA resulted in better outcomes compared to EDT and C-REBOA.

STUDY DESIGN AND METHODS: We queried the 2017-2023 AORTA registry for adults who underwent EDT, C-REBOA, or P-REBOA in the emergency department (ED). Patients with chest penetrating injuries were excluded. We compared mortality, ventilator-free-days (VFD), and ICU-free-days (ICUFD) using survival analysis or generalized linear models to adjust for confounders.

RESULTS: Overall, 921 patients underwent EDT (n = 613, 66.6%), C-REBOA (n = 224, 24.3%), or P-REBOA (n = 84, 9.1%); 83.1% died. After confounder adjustment, compared to P-REBOA, both C-REBOA and EDT were associated with a lower likelihood of attaining hemodynamic improvement and stability as well as with higher mortality (adjusted hazard ratio, aHR = 1.84; 95% CI: 1.01-1.60 and aHR = 3.32; 95% CI: 1.96-2.78, respectively). EDT patients had less VFD and ICUFD than those undergoing C-REBOA and P-REBOA, but there were no differences between the two endovascular procedures. Among patients who survived >48 h, EDT was more likely to be associated with complications compared to the other two procedures.

DISCUSSION: P-REBOA was more likely to be associated with improved hemodynamic stability and reduced mortality compared to C-REBOA and EDT, suggesting this modality may be a better AO procedure for patients with no penetrating thoracic injuries.

PMID:40059692 | DOI:10.1111/trf.18177

Orthop Surg. 2025 Mar 10. doi: 10.1111/os.70016. Online ahead of print.

ABSTRACT

OBJECTIVES: Different alignment strategies (kinematic alignment [KA] versus mechanical alignment [MA]) during total knee arthroplasty (TKA) significantly influence postoperative patellar tracking. This study aimed to compare radiological parameters of patellar tracking and clinical outcomes between KA-TKA and MA-TKA via the mini-subvastus approach.

METHODS: This prospective randomized controlled study included 234 patients who underwent KA-TKA and MA-TKA from January 2022 to October 2023. The preoperative and postoperative patellar tilt, lateral patellar shift, knee society score (KSS), oxford knee score (OKS), and intraoperative patellar lateral retinacular release (LRR) rate were measured. In addition, radiological parameters and clinical outcomes were compared between the LRR and non-LRR groups. Independent samples t test and chi-square test were used to compare the differences between groups.

RESULTS: Two-hundred and thirty-four patients were followed up for 12 months post-TKA. No significant differences were observed between the two groups in terms of the demographics and pre- or post-operative radiological parameters of patellar tracking (p > 0.05). The postoperative KSS and OKS were significantly higher in the KA group than in the MA group (p < 0.05). The LRR rate was 6.7% (8/120) in the KA group and 25.4% (29/114) in the MA group, and the difference was statistically significant (x² = 15.476, p < 0.001). The preoperative patella tilt and lateral patellar shift were greater in the LRR group (p < 0.001) and the postoperative OKS was lower (p < 0.05).

CONCLUSIONS: KA-TKA via the mini-subvastus approach can achieve both good patellar tracking and clinical outcomes. Avoiding muscle damage and refraining from excessive soft tissue release are crucial to improving postoperative patient comfort. In our opinion, KA-TKA via the mini-subvastus approach may be a more suitable surgical option.

PMID:40059658 | DOI:10.1111/os.70016

J Ocul Pharmacol Ther. 2025 Mar 10. doi: 10.1089/jop.2024.0110. Online ahead of print.

ABSTRACT

Corticosteroid use as an anti-inflammatory agent in infective conjunctivitis has been met with concerns about prolonged infection. This systematic review aims to evaluate the safety and efficacy of corticosteroids as a treatment for infective conjunctivitis. A comprehensive search was conducted on PubMed, Cochrane, Scopus, ScienceDirect, Embase, and ProQuest for clinical trials of topical corticosteroids with or without combination with other medications in bacterial or viral conjunctivitis up to November 2023. The studies were screened, and data on safety and efficacy were extracted. The quality of studies was assessed using the Jadad Scale. Meta-analysis was performed using the random-effects model, with heterogeneity assessed with the I² statistic. We found ten clinical trials that met the inclusion criteria. Overall meta-analysis revealed significant clinical resolution in dexamethasone-containing therapy compared to non-corticosteroid treatment (OR 1.51; 95% CI 1.19-1.92), with several studies reporting significantly reduced clinical symptoms severity. Two of the six studies assessing viral and bacterial eradication reported significantly improved viral clearance rates. Meta-analysis indicated no difference in ocular adverse effects compared to nonsteroid therapy (OR 1.33; 95% CI 0.82-2.16). In conclusion, corticosteroid use in infective conjunctivitis is relatively safe and may help improve clinical resolution and reduce symptom severity, especially when combined with antibiotics and antiseptics.

PMID:40059644 | DOI:10.1089/jop.2024.0110

Child Obes. 2025 Mar 10. doi: 10.1089/chi.2024.0361. Online ahead of print.

ABSTRACT

Background: Enhancing the quality of Family Child Care Home (FCCH) meals is an opportunity to impact children’s diet and health. The purpose of this study is to assess Happy Healthy Homes (HHH) randomized controlled trial impact on health-related foods and nutrients served to and consumed by young children and achievement of Child and Adult Care Food Program (CACFP) requirements and best practices. Methods: Forty-five CACFP participating FCCHs in a moderately sized midwestern city were recruited in 2017-2018 and randomized to nutrition intervention (NUT n = 24) or control (CON n = 21). Participants received two in-home, individual 90-minute education sessions, one 3-hour small group class, and a 15-minute check-in phone call over 3 months. Outcomes include 3- and 12-month served and consumed fiber, sugar, grains, vegetables, and fruit and achievement of CACFP Best Practices. Primary analyses at 12 months used a mixed model under an intent-to-treat paradigm to account for repeated measures on participants with 3-month outcomes. Sensitivity analyses were completed on those with complete 12-month measures. Results: There were no statistically significant group-by-time effects for foods served, consumed, or CACFP Best Practices score in the primary analysis. However, in sensitivity analysis, the CACFP Best Practice score (out of 18) increased in NUT +0.5 from 8.9 ± 1.5 at baseline at 12 months and decreased -0.9 in CON from 9.9 ± 1.7 at baseline, group by time p = 0.05. Conclusions: The HHH intervention did improve the CACFP Best Practices score for lunches served. The study’s effect may have been limited due to sample size and attrition. Trial Registration: Clinicaltrials.gov, NCT03560050. Retrospectively registered on 23 May 2018. First participant enrolled October 2017.

PMID:40059639 | DOI:10.1089/chi.2024.0361