Category: Statistics

Soc Choice Welfare. 2017 Jun;49(1):145-169. doi: 10.1007/s00355-017-1055-7. Epub 2017 May 16.

ABSTRACT

Is a larger population of people living good lives a better population, all else equal? This question is central to population issues in social welfare, ethics, and policy. Many answers in the philosophical literature argue that if a policy choice results in the birth of additional people living good lives, these extra lives are irrelevant to any evaluation of the policy. This paper applies the questionnaire-experimental method of empirical studies of social choice to investigate participants’ policy choices and social orderings with respect to population size and average well-being. In general, heterogeneous responses depended on the quantitative and qualitative properties of the question. In particular, an experimentally manipulated increase in population size caused an option to be more likely to be selected, on average. Overall, responses suggest that population size is not neutral to social welfare. Many participants, although not all, reported that a larger population of people living good lives could be strictly preferable, at small or no costs to average well-being.

PMID:39007124 | PMC:PMC11245279 | DOI:10.1007/s00355-017-1055-7

EClinicalMedicine. 2024 Jun 20;73:102681. doi: 10.1016/j.eclinm.2024.102681. eCollection 2024 Jul.

ABSTRACT

BACKGROUND: The outcome of patients with metastatic tumors who discontinued immune checkpoint inhibitors (ICIs) not for progressive disease (PD) has been poorly explored. We performed a meta-analysis of all studies reporting the clinical outcome of patients who discontinued ICIs for reasons other than PD.

METHODS: We searched PubMed, Embase and Scopus databases, from the inception of each database to December 2023, for clinical trials (randomized or not) and observational studies assessing PD-(L)1 and CTLA-4 inhibitors in patients with metastatic solid tumors who discontinued treatment for reasons other than PD. Each study had to provide swimmer plots or Kaplan-Meier survival curves enabling the reconstruction of individual patient-level data on progression-free survival (PFS) following the discontinuation of immunotherapy. The primary endpoint was PFS from the date of treatment discontinuation overall and according to tumor histotype, type of treatment and reason of discontinuation. The Combersure’s method was used to estimate meta-analytical non-parametric summary survival curves assuming random effects at study level.

FINDINGS: Thirty-six studies (2180 patients) were included. The pooled median PFS (mPFS) was 24.7 months (95% CI, 18.8-30.6) and the PFS-rate at 12, 24, and 36 months was respectively 69.8% (95% CI, 63.1-77.3), 51.0% (95% CI, 43.4-59.8) and 34.0% (95% CI, 27.0-42.9). Univariable analysis showed that the mPFS was significantly longer for patients with melanoma (43.0 months), as compared with non-small cell lung cancer (NSCLC, 13.5 months) and renal cell carcinoma (RCC, 10.0 months; between-strata comparison test p-value < 0.001); for patients treated with anti-PD-(L)1 + anti-CTLA-4 as compared with anti-PD-(L)1 monotherapy (44.6 versus 19.9 months; p-value < 0.001), and in NSCLC when the reason of treatment discontinuation was elective as compared with toxicity onset (19.6 versus 4.8 months; p-value = 0.003). The multivariable analysis confirmed these differences.

INTERPRETATION: The long-term outcome of patients who stopped ICIs for reasons other than PD was substantially affected by clinicopathological features: PFS after treatment discontinuation was longer in patients with melanoma, and/or treated with anti-PD-(L)1 + anti-CTLA-4, and shorter in patients with RCC or in those patients with NSCLC who stopped treatment for toxicity onset.

FUNDING: The Italian Ministry of University and Research (PRIN 2022Y7HHNW).

PMID:39007061 | PMC:PMC11245998 | DOI:10.1016/j.eclinm.2024.102681

Front Bioeng Biotechnol. 2024 Jun 24;12:1433811. doi: 10.3389/fbioe.2024.1433811. eCollection 2024.

ABSTRACT

Advances in computational fluid dynamics continuously extend the comprehension of aneurysm growth and rupture, intending to assist physicians in devising effective treatment strategies. While most studies have first modelled intracranial aneurysm walls as fully rigid with a focus on understanding blood flow characteristics, some researchers further introduced Fluid-Structure Interaction (FSI) and reported notable haemodynamic alterations for a few aneurysm cases when considering wall compliance. In this work, we explore further this research direction by studying 101 intracranial sidewall aneurysms, emphasizing the differences between rigid and deformable-wall simulations. The proposed dataset along with simulation parameters are shared for the sake of reproducibility. A wide range of haemodynamic patterns has been statistically analyzed with a particular focus on the impact of the wall modelling choice. Notable deviations in flow characteristics and commonly employed risk indicators are reported, particularly with near-dome blood recirculations being significantly impacted by the pulsating dynamics of the walls. This leads to substantial fluctuations in the sac-averaged oscillatory shear index, ranging from -36% to +674% of the standard rigid-wall value. Going a step further, haemodynamics obtained when simulating a flow-diverter stent modelled in conjunction with FSI are showcased for the first time, revealing a 73% increase in systolic sac-average velocity for the compliant-wall setting compared to its rigid counterpart. This last finding demonstrates the decisive impact that FSI modelling can have in predicting treatment outcomes.

PMID:39007055 | PMC:PMC11243300 | DOI:10.3389/fbioe.2024.1433811

Front Bioeng Biotechnol. 2024 Jun 28;12:1440206. doi: 10.3389/fbioe.2024.1440206. eCollection 2024.

NO ABSTRACT

PMID:39007054 | PMC:PMC11239540 | DOI:10.3389/fbioe.2024.1440206

MethodsX. 2024 Jun 13;13:102803. doi: 10.1016/j.mex.2024.102803. eCollection 2024 Dec.

ABSTRACT

An appropriate salt production methods must be implemented to increase salt production’s quantity and quality. This paper was prepared to introduce and demonstrate a new method, namely a geomembrane-based salt production method, which can contribute directly to increasing the quantity and quality of people’s salt production. This method can be applied quickly with simple equipment, so this method is easy to replicate in various salt production center areas. The results of statistical tests directly show that there is a fundamental difference between the quantity and quality of salt produced by salt farmers using conventional salt production methods and geomembrane-based salt production methods, where geomembrane-based salt production methods are capable of producing much higher quantities of salt production with better quality.•The geomembrane-based salt production method is easy to implement because it uses simple equipment and can be made independently by salt farmers.•Using a geomembrane in this method can prevent leaks in the salt crystallization pond and optimize heat from solar energy to optimize the quantity of salt production.•This method prevents direct contact of seawater with soil. The effect is that the quality of salt produced from geomembrane-based salt production methods is higher than conventional salt production methods.

PMID:39007028 | PMC:PMC11245934 | DOI:10.1016/j.mex.2024.102803

Cureus. 2024 Jul 12;16(7):e64441. doi: 10.7759/cureus.64441. eCollection 2024 Jul.

ABSTRACT

Background IL-19 and IL-24 induce proinflammatory cytokine production through the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway. The primary objective of this study was to investigate any changes in IL-19 and IL-24 expression between inflammatory bowel disease (IBD) patients and healthy controls, as well as before and after the initiation of biologics. The secondary objective was to investigate any relation between their expression and disease phenotype and activity. Methods IL-19 and IL-24 expression was measured in intestinal tissue samples from 121 patients with moderate to severe IBD versus healthy controls using immunohistochemistry. Their expression was then measured 12 months after treatment on the patient group treated with biologics. The disease activity was measured before and after treatment using the Harvey Bradshaw Index (HBI) for Crohn’s disease (CD) patients and the Mayo Score (MS) for ulcerative colitis (UC) patients. Data were analyzed using SPSS (IBM Inc., Armonk, New York). Results IL-19 expression was raised in the IBD group versus healthy controls. In the CD group, the IL-19 expression was related with the disease activity score post-biologic treatment. IL-24 was also highly expressed in patients with active UC and CD and was increased post-treatment. Its expression in UC was statistically related with the MS. Conclusions IL-24 and IL-19 are key factors in IBD-related intestinal inflammation and this is one of the few human studies to suggest that. An immunosuppressive role of IL-24 was demonstrated in the UC group. A future use as biomarkers of disease activity and response to treatment might be feasible.

PMID:39007024 | PMC:PMC11245665 | DOI:10.7759/cureus.64441

Cureus. 2024 Jul 12;16(7):e64434. doi: 10.7759/cureus.64434. eCollection 2024 Jul.

ABSTRACT

Background Although there has been steady growth in the number of postgraduate nurse practitioner (NP) and physician assistant/associate (PA) residency and fellowship programs in the United States, little is known about annual salaries paid to trainees across a national sample of postgraduate programs and specialties. We describe postgraduate program NP and PA trainee salaries and the relationship to specific variables. Methodology An electronic survey was distributed via email to 336 postgraduate NP, PA, and joint NP/PA residency/fellowship programs between November 2023 and December 2023. Frequency tables (for categorical variables) and descriptive statistics (for continuous variables) were used to summarize the data. Chi-square tests of independence were used to determine the relationship between trainee salary and program type, geographical location, and clinical setting. Results There was a statistically significant association between trainee salary for primary care and clinical profession (χ²(6) = 13.993, p = 0.022). Over half of NP respondents (52.1%) reported that their trainees had an annual salary between $76000 and $86000. The majority of PA respondents (57.1%) reported that their trainees had an annual salary below $75000. Respondents who were non-clinical professionals (50.0%) reported that their trainees had an annual salary of over $86000. The single physician respondent also reported that their trainees’ had an annual salary of over $86000. It appears that PA respondents were more likely to report lower trainee salaries than respondents who were NPs and non-clinical professionals. Additionally, respondents associated with primary care joint NP/PA cohorts were more likely to report higher trainee salaries than participants having NP-only cohorts. Lastly, there was a statistically significantly positive relationship between trainee salary and the number of postgraduate advanced practice provider (APP) trainees in psychiatric mental health (τ_b = 0.451, p = 0.006). Conclusion To the best of our knowledge, this national study is the first of its kind to examine and summarize APP postgraduate trainee annual salaries across multiple specialties. Additional studies are needed to clarify the relationships between trainee salaries and other variables.

PMID:39007022 | PMC:PMC11245340 | DOI:10.7759/cureus.64434

Acta Med Philipp. 2024 Jun 28;58(11):54-61. doi: 10.47895/amp.v58i11.9664. eCollection 2024.

ABSTRACT

BACKGROUND AND OBJECTIVES: Phantom and simulation models are valuable training tools for teaching and skill enhancement, yet high costs and limitations of commercial options drive the search for alternatives. This study evaluated the locally sourced phantom models developed for transvaginal and transabdominal gynecologic interventional ultrasound procedures, aiming to cater to the educational needs of OB-GYN ultrasound subspecialists.

METHODS: Four phantom models simulating biopsy and cyst aspiration/paracentesis through transvaginal and transabdominal approaches, were developed, and assessed by 37 ultrasound subspecialists in obstetrics and gynecology. The respondents, comprising 19 experienced and 18 with limited exposure to guided procedures, utilized an 11-item Likert-scored questionnaire to evaluate the models’ acceptability and suitability for training. Responses were analyzed using descriptive statistics.

RESULTS: Both experienced and less-experienced groups consistently assigned high scores, particularly highlighting the realistic ultrasound image and positioning of structures. The models proved effective in enhancing confidence and proficiency during simulation-based training for probe manipulation, aspiration, and biopsy procedures. While respondents identified concerns like durability and needle track marks, no significant differences emerged between the two groups in evaluating the model.

CONCLUSIONS: The overall evaluation of the developed phantom model was positive, showcasing its acceptability among end-users and suitability for training ultrasound-guided procedures in obstetrics and gynecology. The identified issues provide valuable insights for potential improvements in future iterations of the model.

PMID:39006995 | PMC:PMC11239992 | DOI:10.47895/amp.v58i11.9664

Acta Med Philipp. 2024 Jun 28;58(11):46-53. doi: 10.47895/amp.v58i11.8968. eCollection 2024.

ABSTRACT

BACKGROUND: Pelvic organ prolapse (POP) is an inconvenience that can affect a woman’s well-being. Reconstructive pelvic floor surgery involves repairing defects in the endopelvic fascia and pelvic floor musculature as close to the physiologic and anatomic norm. The cornerstone of successful prolapse repair is a strong apical support.

OBJECTIVE: The aim of the study is to determine the outcomes of abdominal sacrocolpopexy (ASC) and abdominal sacrohysteropexy (ASH) in the Philippines.

METHODS: The study utilized a descriptive study design to compare the pre-operative and post-operative Pelvic Organ Prolapse Quantification Score (POP-Q Score), presence of mesh complications, and urinary/bowel symptoms in patients operated within 2010-2016 in a Philippine tertiary training hospital. Based on recovered charts and inclusion/exclusion criteria, this study sampled 34 of 50 patient records. Statistical measures of median and range were used to describe pre-operative and post-operative POP-Q scores in any two follow-ups within 6-, 12-, 18-, and 24-month interval. The objective success rate and incidence of urinary/bowel symptoms were described using frequencies and percentages. Presence of any mesh erosion was noted for each follow-up. McNemar’s test was applied to assess the comparative occurrence of each symptom comparing between the pre-operative and first follow-up periods.

RESULTS: ASC had a success rate of 73.7% at six months and 56.3% at 12 months post-surgery. ASH showed an 84.6% success rate at six months and 71.4% at 12 months. Apical support has a 97% success rate without affecting the anterior or posterior compartments. Out of 20 ASC patients, 5 (25%) exhibited anterior compartment descent, whereas two out of 14 ASH patients (14.2%) had the same condition. It is observed that the anterior vaginal wall has the higher tendency to descend after reconstructive surgery, independent of route or technique. In addition, not all patients with surgical prolapse beyond -1 experienced symptomatic vaginal bulges. Overall, a notable decrease in the occurrence of urine symptoms was seen after the surgery. No mesh erosion was seen within the initial two years of follow-up but there was a single reported instance of abdominal hernia, an uncommon consequence.

CONCLUSION: This study demonstrated that ASC and ASH have good success rate in apical support; however, descent of the anterior or posterior compartment diminishes the overall success rate in terms of over-all objective POP-Q score. Both resulted to improvement in symptoms with minimal complications.

PMID:39006991 | PMC:PMC11239997 | DOI:10.47895/amp.v58i11.8968

Acta Med Philipp. 2024 Jun 28;58(11):29-38. doi: 10.47895/amp.v58i11.8977. eCollection 2024.

ABSTRACT

BACKGROUND: PCOS is a common gynecologic disorder and recent studies have found that they are more prone in developing depression and anxiety compared to the general population. The Hospital Anxiety and Depression Scale (HADS) is a popular and simple self-administered instrument reliable for detecting states of anxiety and depression. Using this simple screening tool, it may lead to the identification of such mental disorders that may warrant timely psychiatric referral.

OBJECTIVES: The study aims to determine the prevalence of anxiety and depression among PCOS patients using the HADS-P questionnaire and to determine the association between depression and anxiety and disease characteristics.

METHODS: Convenience sampling was done to recruit PCOS patients >18 years old in Philippine General Hospital. Cross-sectional design was used for the prevalence of depression and anxiety, while nested case control design for the evaluation of the predictors of depression and anxiety. The HADS-P, a self-administered rating scale with independent subscales for anxiety and depression, was administered to the participants after securing consent. A cut-off score of >8 points on either of the depression and anxiety subscale was used to determine their respective prevalence. Logistic regression analysis was used to determine the association of clinical variables with anxiety or depression.

RESULTS: A total of 253 patients with PCOS were recruited. On the basis of a HADS-P score of >8.0 per category, the prevalence of PCOS patients who were suggestive to have anxiety was 46.25% (n: 117, 95% CI: 39.98-52.60%), while 9.09% (n: 23, 95% CI: 5.85-13.33%) of them were suggestive to have depression. Crude logistic regression identified presence of depression, infertility, impaired glucose tolerance, and prominent acne as predictors of anxiety; whereas low parity, hirsutism, and presence of anxiety were predictors of depression. Adjusted logistic regression identified only presence of depression and infertility were significant predictors of anxiety (n: 116, LR χ² (5): 15.46, p<0.01); while presence of anxiety increased the odds of depression by 2- to 13-fold, it was not statistically significant (n: 116, LR χ² (5): 9.79, p: 0.08).

CONCLUSION: There is a high prevalence of anxiety and depression among PCOS patients. The factors that were seen to be significantly associated with the development of anxiety were the presence of depression, impaired glucose tolerance, infertility and prominent acne, while for the development of depression were the presence of anxiety, hirsutism, and low parity. Screening for anxiety and depression is of paramount importance and physicians should be vigilant for the need of possible psychiatric intervention.

PMID:39006990 | PMC:PMC11239981 | DOI:10.47895/amp.v58i11.8977