Category: Statistics

Altern Ther Health Med. 2023 Oct 27:AT9503. Online ahead of print.

ABSTRACT

AIM: Cerebral infarction, a common type of stroke, results from a sudden interruption of blood flow to the brain, leading to a myriad of challenges and complications for patients. Among these complications, decreased muscle strength is a prominent issue that can have profound implications for patients’ overall well-being and functional independence. Decreased muscle strength in cerebral infarction often manifests as weakness, loss of mobility, and impaired ability to perform activities; the psychological impact of these physical limitations can lead to anxiety and depression, further exacerbating the patient’s condition. To investigate the effect of progressive rehabilitation nursing on the physical rehabilitation and quality of life of patients with cerebral infarction, to provide valuable insights and guidance for enhancing the functional recovery of individuals affected by cerebral infarction.

DESIGN: 100 cerebral infarction patients combined with decreased muscle strength admitted to our hospital between October 2019 and October 2020 were randomly selected as the study subjects for prospective analysis.

METHODS: They were divided into a control group (n = 50) and an experimental group (n = 50) using the random number table method. Patients in the control group underwent rehabilitation treatment, while patients in the experimental group underwent progressive rehabilitation nursing intervention guided by quality nursing intervention. The Fugl-Meyer Assessment (FMA) motor function score, National Institute of Health Stroke Scale (NIHSS) neurological function score, Barthel Index (BI), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores, nursing efficiency and the incidence rate of adverse mood after 1, 2 and 3 weeks of nursing were recorded and compared between the two groups.

RESULTS: The FMA and BI index scores of patients in the experimental group were notably higher than those in the control group, and the comparison was statistically significant (P < .05); The NIHSS, SAS and SDS scores of patients in the experimental group were notably lower than those of the control group, and the results of the comparison were statistically significant (P < .05); The nursing efficiency and nursing satisfaction of patients in the experimental group was remarkably higher, and the results of the comparison were statistically significant (P < .05); The incidence of bad mood in the experimental group was significantly lower than that in the control group after 1, 2 and 3 weeks of nursing, and the incidence rate of adverse mood in the experimental group was improved with time, that is, 1>2>3 weeks in descending order (P < .05).

PATIENT OR PUBLIC CONTRIBUTION: Progressive rehabilitation nursing not only enhances muscle strength and restores their physical functions to a certain extent while reducing the incidence of adverse reactions and physical function but also mitigates the risk of adverse mood states. Ultimately, it contributes to an improved overall quality of life and psychological well-being of patients affected by cerebral infarction.

PMID:37883759

Altern Ther Health Med. 2023 Oct 27:AT9342. Online ahead of print.

ABSTRACT

OBJECTIVE AND SIGNIFICANCE: Glioblastoma is a highly invasive brain tumor, and its treatment and management have long posed challenges in the fields of neurosurgery and oncology. This study aimed to explore the potential value of apparent diffusion coefficient (ADC) values in postoperative recurrent brain gliomas using magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI), with the goal of providing clinicians with more precise decision-making tools. In the context of the therapeutic challenges posed by glioblastomas, this research holds significant importance. The treatment of glioblastomas typically involves surgical resection, radiotherapy, and chemotherapy; however, its recurrence rate remains relatively high. Early detection of recurrence is crucial for implementing timely interventions, as it can impact patient survival and quality of life. ADC values within DWI may serve as a non-invasive tool to aid in the identification of potential recurrent lesions, thereby facilitating earlier therapeutic actions.

METHODS: A retrospective analysis was conducted on clinical data from 52 patients diagnosed with brain gliomas. All patients underwent MRI scans, contrast-enhanced imaging, and DWI. Based on the pathology results from the second surgery or radiological follow-up, patients were categorized into two groups: the recurrent group (31 cases) and the non-recurrent group (21 cases). The MRI diagnostic criteria followed the Chinese Guidelines for Diagnosis and Treatment of Central Nervous System Gliomas (2015 edition), and gliomas were classified into grades I-IV according to the WHO (2007 edition) pathological grading standards. Inclusion criteria encompassed postoperative pathological diagnosis of brain gliomas, absence of intracranial surgeries, brain parenchymal injuries, or other relevant medical histories, and all patients received postoperative adjuvant radiotherapy with a total dose exceeding 50 Gy, coupled with chemotherapy. Exclusion criteria excluded patients diagnosed with cerebral infarction, those with other intracranial conditions such as intracranial hypertension, and individuals with hepatic or renal dysfunction or known contrast agent allergies. ADC values for both groups were separately calculated, and receiver operating characteristic (ROC) curves were constructed. ROC area under the curve (AUC) was employed to assess the diagnostic accuracy of the two methods, along with the calculation of sensitivity (Sen) and specificity (Spe).

RESULTS: The ADCmean values (1.05 ± 0.25 mmys) and relative ADC (rADC)mean values (1.17 ± 0.38 mmys) of the recurrent group were lower than those of the non-recurrent group (1.33 ± 0.21 mmys, 1.36 ± 0.24 mmys), while the ADCmin values (1.03 ± 0.18 mmys) and ADCmax values (1.19 ± 0.21 mmys) of the recurrent group were lower than those of the non-recurrent group (1.21 ± 0.12 mmys, 1.35 ± 0.17 mmys), with statistically significant differences (P < .05). The AUC of ADCmean was 0.785, with Sen and Spe of 93.75% and 55%, respectively. The AUC of rADCmean was 0.702, with Sen and Spe of 86.2% and 65.21%, respectively. The AUC of ADCmin was 0.824, with Sen and Spe of 86.66% and 68.18%, respectively. The AUC of ADCmax is 0.715, with Sen and Spe of 77.77% and 60%, respectively.

CONCLUSION: The results of this study demonstrated the potential clinical utility of ADC values in the diagnosis of postoperative recurrence in gliomas. ROC analysis revealed that ADC values exhibited a high diagnostic accuracy, with the AUC reflecting their discriminative ability between the recurrence and non-recurrence groups. This finding may assist clinical practitioners in more precisely assessing patients’ risk of recurrence, further optimizing treatment strategies, and enhancing both survival rates and quality of life. Nevertheless, it is important to acknowledge several limitations in this study. Firstly, the relatively small sample size may limit the generalizability of the results. Additionally, due to the observational nature of this study, larger-scale and multicenter research is still required to validate these findings. Lastly, ADC values are influenced by various factors, including technical parameters and equipment variations, which necessitate further standardization and calibration efforts. Thus, while the results of this study hold promise for improving the management of glioma patients, further research is warranted to fully understand their potential clinical value.

PMID:37883754

Altern Ther Health Med. 2023 Oct 27:AT9313. Online ahead of print.

ABSTRACT

OBJECTIVE: Lung adenocarcinoma (NSCLC) is a common subtype of lung cancer, and its prevalence has gradually increased in recent years. There are various treatment methods for NSCLC, and surgical resection, as one of the important treatments, is crucial to improving the survival rate and quality of life of patients. To explore the effect and complications of video-assisted thoracic surgery (VATS) and radical thoracotomy for lung cancer (RTLC) in the treatment of stages IIB-IIIA non-small cell lung cancer (NSCLC).

METHODS: A total of 80 patients with NSCLC admitted to the hospital were enrolled between June 2019 and January 2021. According to the random number table method, they were divided into the VATS group (40 cases, VATS) and RTLC group (40 cases, RTLC). The operation time, intraoperative blood loss, postoperative drainage time, number of lymph node dissections, score of visual analogue scale (VAS) at 24 h after surgery, and hospitalization time were compared between the two groups. We chose specific inclusion criteria, including patients diagnosed with non-small cell lung cancer (NSCLC) who did not receive radiation therapy or chemotherapy before surgery, to ensure consistency and comparability across studies. We focused on indicators related to lung function and immune system, such as CD3+, CD4+ and CD8+ levels, as well as FEV1, FVC and MVV, to evaluate the impact of surgery on lung function and immune status. The levels of CD3+, CD4+, and CD8+ in both groups were detected by flow cytometry at 1 d before surgery and 3 d after surgery. The forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and maximal voluntary ventilation (MVV) in both groups were detected by spirometry before and at 1 month after surgery. The occurrence of postoperative complications in both groups was recorded. After 12 months of follow-up, survival rates in both groups were statistically analyzed. The progression-free survival (PFS) and 12-month overall survival (OS) in both groups were analyzed by the Kaplan-Meier method.

RESULTS: The incision length, operation time, intraoperative blood loss, postoperative drainage time, VAS score at 24 h after surgery, and hospitalization time in VATS group were significantly lower than those in RTLC group (P < .05). The two groups had no significant difference in the number of lymph node dissections (P > .05). At 3 d after surgery, levels of CD3+, CD4+ and CD8+ in VATS group were significantly higher than those in RTLC group (P < .05). At 1 month after surgery, FEV1, FVC, and MVV in VATS group operation were significantly higher than those in RTLC group (P < .05). The incidence of postoperative complications in VATS group was lower than that in RTLC group (5.00% vs. 20.00%) (P < .05). Kaplan-Meier survival analysis showed that there was no significant difference in 12-month OS or PFS between the two groups (P > .05).

CONCLUSIONS: The long-term curative effect of VATS and RTLC is comparable on patients with stages IIB-IIIA NSCLC. The former has advantages such as less surgical injury, faster postoperative recovery, and higher safety, which can reduce the incidence of postoperative complications. This study provides clinicians with important information about the treatment of stage IIb ~ IIIa NSCLC and helps them choose surgical methods more wisely. These results also alert physicians to focus on operative time, blood loss, and complication risk to maximize patient outcomes.

PMID:37883749

J Phys Chem B. 2023 Oct 26. doi: 10.1021/acs.jpcb.3c03670. Online ahead of print.

ABSTRACT

Monte Carlo (MC) stochastic sampling is a powerful tool in classical molecular simulations that directly connects the observable macroscopic properties of matter and the underlying atomistic interactions. This connection operates within the framework of the statistical mechanics proposed by Gibbs. Most MC simulations are “dynamic,” creating statistical ensembles of microstates via a Markovian chain, where each microstate in the ensemble depends only on its previous microstate. Herein, we re-examine an alternative form of MC that generates ensemble members through a “static” approach, building molecular systems stepwise. The basic theory for such an approach traces back to Rosenbluth and Rosenbluth, who proposed “static” stepwise sampling of a polymeric chain. It is almost as old as the Metropolis importance sampling approach used in dynamic MC, although the latter has been considerably more popular than the former. Herein, we address the main obstacle in static MC that has hindered the widespread adoption of Rosenbluth-based approaches in atomistic simulations. The obstacle lies in mapping the molecular accessible volume for adding a molecule in a Rosenbluth-like static sampling of atomistic configurations. We demonstrate a breakthrough by leveraging the ability to analytically map the inaccessible molecular volume and the accessible molecular surface owing to interatomically excluded volume interactions. This advance substantially enhances the ability to create molecular samples using a Rosenbluth-like static building process. The proposed approach can be used as a tool for creating initial configurations in MC or molecular dynamics simulations─a field where Rosenbluth-like static building has been applied. Additionally, this approach can be used as the first step in a perturbation scheme that accurately estimates free energy differences by estimating the chemical work related to molecule addition, removal, or reinsertion within the context of free energy perturbation schemes employed in molecular simulations.

PMID:37883744 | DOI:10.1021/acs.jpcb.3c03670

Aesthet Surg J. 2023 Oct 26:sjad341. doi: 10.1093/asj/sjad341. Online ahead of print.

ABSTRACT

BACKGROUND: Although maxillomandibular advancement is the treatment of choice for obstructive sleep apnea syndrome (OSAS) in the presence of underlying maxillo-mandibular complex hypoplasia, there is still a gap in the literature regarding the impact of genioplasty upon upper airway volume (UAV).

OBJECTIVES: The aim of this study was to evaluate the impact of isolated osseous genioplasty upon UAV.

METHODS: A retrospective analysis of all patients subjected to isolated osseous genioplasty between July 2015 and July 2022 was conducted. Cone-beam computed tomography was performed pre- and postoperatively to assess the chin and hyoid 3D spatial position and UAV changes after surgery.

RESULTS: A total of 44 patients were included in the study. Regarding surgical movements of the chin, almost all patients received a sagittal movement (n = 42; 39 forwards and 3 backwards), while in 8 patients a vertical movement (5 upwards and 3 downwards) was applied, and in 6 patients the chin was centered. A statistically significant increase in total UAV (p = 0.014) and at the level of the oropharynx (p = 0.004) was observed. Specifically, chin centering, up- and forwards movements enlarged the oropharynx volume (p = 0.006, 0.043 and 0.065, respectively). Chin advancement enlarged the hypopharynx volume (p = 0.032), as well as the upwards movement of the hyoid bone (p < 0.001).

CONCLUSIONS: The study suggests that aesthetic osseous genioplasty impacts upon the UAV: each 3D spatial chin movement impacts differently upon the upper airway by enlarging or narrowing it. However, further studies addressing the apnea-hypopnea index are required to assess its effectiveness in treating OSAS.

PMID:37883707 | DOI:10.1093/asj/sjad341

Telemed J E Health. 2023 Oct 26. doi: 10.1089/tmj.2023.0330. Online ahead of print.

ABSTRACT

Introduction: Limited research exists on outpatient telenutrition, and more evidence is needed on service utilization and program evaluation. This study explored service utilization trends and patterns of the Medical University of South Carolina (MUSC) Outpatient Telehealth Nutrition (OT Nutrition) service. Methods: De-identified patient service utilization data were obtained from MUSC’s OT Nutrition administrative files (2012-2020). Service utilization (referrals, visits scheduled, consultations, no-shows, no-show rate) was measured at the clinic level and stratified by patient type (adult/pediatric) and clinic rurality (rural/urban). Data were analyzed using descriptive statistics and a K-means cluster analysis. Results: Service utilization (2012-2020) reflected 6,212 referrals, 3,993 visits scheduled, and 2,880 consultations across 56 clinics. Yearly utilization trends showed high variability with no statistically significant differences observed on univariate comparisons of patient type or clinic rurality. The introduction of the Direct-To-Consumer modality mitigated a 36.7% decrease in consultations during the COVID-19 pandemic in 2020. Results of a K-means cluster analysis (p < 0.001) indicated 7% (n = 4) of clinics were very high and high utilizers, 36% (n = 21) were moderate and low utilizers, and 53% (n = 31) were very low utilizers. Discussion: Telenutrition can be delivered effectively to patients without requiring travel outside patients’ medical homes or residences. Although continued advocacy is necessary for South Carolina to expand telenutrition coverage, more research is needed to evaluate the OT Nutrition service. Cluster analysis is an effective tool for identifying statistically significant groupings of clinics based on service utilization and could be used with implementation science in future program evaluation.

PMID:37883641 | DOI:10.1089/tmj.2023.0330

Telemed J E Health. 2023 Oct 26. doi: 10.1089/tmj.2023.0108. Online ahead of print.

ABSTRACT

Background: Studies suggest that telemedicine worsens health care disparities in certain groups, partly owing to a lack of access to appropriate technology or poor technological literacy. Our aim was to use clinic no-show data to determine the impact of telemedicine on patient access to care in the ambulatory gastroenterology setting. Methods: Single-center retrospective study of ambulatory in-person and telemedicine clinic appointments comparing the 15-month prepandemic (PP) with the first 15 months during the pandemic (DTP) using an administrative database. Statistical analysis was performed using univariate and multivariable logistic regression. Results: About 9,746 and 12,808 patient-encounters were scheduled PP and DTP respectively. The no-show rate decreased from 9.8% to 6.9% DTP (p < 0.001). The no-show rate decreased for Black (p = 0.02) and non-Hispanic White patients (p = 0.018). The no-show rate increased for LatinX (p < 0.001) and Asian (p = 0.007) patients. In multivariate analysis, older patients and patients identifying as Black, Asian, or LatinX all had higher odds of no-show DTP (p < 0.05 for all). Patients from high-income counties were 43% less likely to no-show than those in the lowest income counties. Conclusions: The transition to telemedicine improves health care access by decreasing the overall no-show rate. Some groups have been negatively affected, including the older, lower income, LatinX, and Asian populations. Future studies should aim to identify the risk factors within these populations that can be modified to increase health care participation, including targeted application of in-person visits, and improved technology to drive engagement.

PMID:37883629 | DOI:10.1089/tmj.2023.0108

PLoS Comput Biol. 2023 Oct 26;19(10):e1011521. doi: 10.1371/journal.pcbi.1011521. Online ahead of print.

ABSTRACT

Predicting the effects of mutations on protein function is an important issue in evolutionary biology and biomedical applications. Computational approaches, ranging from graphical models to deep-learning architectures, can capture the statistical properties of sequence data and predict the outcome of high-throughput mutagenesis experiments probing the fitness landscape around some wild-type protein. However, how the complexity of the models and the characteristics of the data combine to determine the predictive performance remains unclear. Here, based on a theoretical analysis of the prediction error, we propose descriptors of the sequence data, characterizing their quantity and relevance relative to the model. Our theoretical framework identifies a trade-off between these two quantities, and determines the optimal subset of data for the prediction task, showing that simple models can outperform complex ones when inferred from adequately-selected sequences. We also show how repeated subsampling of the sequence data is informative about how much epistasis in the fitness landscape is not captured by the computational model. Our approach is illustrated on several protein families, as well as on in silico solvable protein models.

PMID:37883593 | DOI:10.1371/journal.pcbi.1011521

Science. 2023 Oct 27;382(6669):443-447. doi: 10.1126/science.abq6753. Epub 2023 Oct 26.

ABSTRACT

The understanding of nonequilibrium dynamics in many-body quantum systems is a fundamental issue in statistical physics. Experiments that probe universal properties of these systems can address such foundational questions. In this study, we report the measurement of universal dynamics triggered by a quench from the superfluid to normal phase across the Berezinskii-Kosterlitz-Thouless transition in a two-dimensional (2D) Bose gas. We reduced the density by splitting the 2D gas in two, realizing a quench across the critical point. The subsequent relaxation dynamics were probed with matter-wave interferometry to measure the local phase fluctuations. We show that the time evolution of both the phase correlation function and vortex density obeys universal scaling laws. This conclusion is supported by classical-field simulations and interpreted by means of real-time renormalization group theory.

PMID:37883542 | DOI:10.1126/science.abq6753

PLoS One. 2023 Oct 26;18(10):e0293598. doi: 10.1371/journal.pone.0293598. eCollection 2023.

ABSTRACT

Acute myocardial infarction is an acute-stage disease that requires prompt diagnosis and treatment. Primary percutaneous coronary intervention (pPCI) for ST-elevation myocardial infarction (STEMI) is a high-risk factor for post-contrast acute kidney injury (PC-AKI). This retrospective cohort study analyzed the data of 754 patients with STEMI who underwent pPCI and were integrated into the Fast Interrogation Rule for STEMI critical pathway program between 2015 and 2019. We aimed to determine the optimal cutoff baseline eGFR for identifying a high risk of PC-AKI after multivariable adjustment with statistically significant risk factors. We also compared the incidence rates of PC-AKI between the previous and current diagnostic criteria. The probability of PC-AKI increased when the baseline estimated glomerular filtration rate (eGFR) was ≤ 79mL/min/1.73 m2. The optimal cutoff baseline eGFR for high risk of PC-AKI was found to be an eGFR of ≤ 61 mL/min/1.73 m2 after multivariable adjustment. The current diagnostic criteria more accurately identified the patient group with impaired renal function. Our results have clinically significant implications for identifying patients at a high risk of developing PC-AKI, especially before and after the use of contrast agents in patients who require PCI for STEMI in the emergency department.

PMID:37883518 | DOI:10.1371/journal.pone.0293598