Category: Statistics

J Clin Endocrinol Metab. 2023 Aug 14:dgad476. doi: 10.1210/clinem/dgad476. Online ahead of print.

ABSTRACT

CONTEXT: Intravenous glucocorticoids (IVGC) is an accessible and affordable treatment for Graves’ orbitopathy (GO), 4.5-gram protocol is well studied, but many details of treatment protocols need to be clarified.

OBJECTIVE: To compare the efficacy and safety of weekly and monthly protocol of IVGC in GO.

DESIGN: a prospective, randomized, observer-masked, single-center clinical trial, followed up to week 24.

SETTING: The third affiliated hospital of Southern Medical University.

PATIENTS: 58 GO Patients aged 18-60 years old with active and moderate-to-severe who have not received relevant treatment.

INTERVENTIONS: IVGC of the weekly protocol or monthly protocol, both received a cumulative dose of methylprednisolone 4.5g and had a duration of 12 weeks.

MAIN OUTCOME MEASURES: The overall effective rate, improvement of quality of life (QOL) and signal intensity ratio (SIR).

RESULTS: There was no significant difference in the effective rate between the two groups at week 12 and week 24 (86.21% VS 72.41%, P = 0.195; 86.21% VS 82.61%, P = 0.441), there was no significant difference in the improvement of CAS, exophthalmos, soft tissue involvement, diplopia and QOL. At week 24, the mean SIR and maximum SIR of two groups were lower than those before treatment, and there were no statistically significant difference between two groups. There was no significant difference in the incidence of adverse events between the two groups (31.03% VS 27.59%, P = 0.773).

CONCLUSIONS: The efficacy and safety of the two protocols are comparable, the monthly protocol could be used as an alternative to the weekly protocol.

PMID:37579198 | DOI:10.1210/clinem/dgad476

Proc Natl Acad Sci U S A. 2023 Aug 22;120(34):e2307372120. doi: 10.1073/pnas.2307372120. Epub 2023 Aug 14.

ABSTRACT

Determining the number of casualties and fatalities suffered in militarized conflicts is important for conflict measurement, forecasting, and accountability. However, given the nature of conflict, reliable statistics on casualties are rare. Countries or political actors involved in conflicts have incentives to hide or manipulate these numbers, while third parties might not have access to reliable information. For example, in the ongoing militarized conflict between Russia and Ukraine, estimates of the magnitude of losses vary wildly, sometimes across orders of magnitude. In this paper, we offer an approach for measuring casualties and fatalities given multiple reporting sources and, at the same time, accounting for the biases of those sources. We construct a dataset of 4,609 reports of military and civilian losses by both sides. We then develop a statistical model to better estimate losses for both sides given these reports. Our model accounts for different kinds of reporting biases, structural correlations between loss types, and integrates loss reports at different temporal scales. Our daily and cumulative estimates provide evidence that Russia has lost more personnel than has Ukraine and also likely suffers from a higher fatality to casualty ratio. We find that both sides likely overestimate the personnel losses suffered by their opponent and that Russian sources underestimate their own losses of personnel.

PMID:37579154 | DOI:10.1073/pnas.2307372120

Proc Natl Acad Sci U S A. 2023 Aug 22;120(34):e2301873120. doi: 10.1073/pnas.2301873120. Epub 2023 Aug 14.

ABSTRACT

Bacteria navigate natural habitats with a wide range of mechanical properties, from the ocean to the digestive tract and soil, by rotating helical flagella like propellers. Species differ in the number, position, and shape of their flagella, but the adaptive value of these flagellar architectures is unclear. Many species traverse multiple types of environments, such as pathogens inside and outside a host. We investigate the hypothesis that flagellar architectures mediate environment-specific benefits in the marine pathogen Vibrio alginolyticus which exhibits physiological adaptation to the mechanical environment. In addition to its single polar flagellum, the bacterium produces lateral flagella in environments that differ mechanically from water. These are known to facilitate surface motility and attachment. We use high-throughput 3D bacterial tracking to quantify chemotactic performance of both flagellar architectures in three archetypes of mechanical environments relevant to the bacterium’s native habitats: water, polymer solutions, and hydrogels. We reveal that lateral flagella impede chemotaxis in water by lowering the swimming speed but improve chemotaxis in both types of complex environments. Statistical trajectory analysis reveals two distinct underlying behavioral mechanisms: In viscous solutions of the polymer PVP K90, lateral flagella increase the swimming speed. In agar hydrogels, lateral flagella improve overall chemotactic performance, despite lowering the swimming speed, by preventing trapping in pores. Our findings show that lateral flagella are multipurpose tools with a wide range of applications beyond surfaces. They implicate flagellar architecture as a mediator of environment-specific benefits and point to a rich space of bacterial navigation behaviors in complex environments.

PMID:37579142 | DOI:10.1073/pnas.2301873120

Photobiomodul Photomed Laser Surg. 2023 Aug;41(8):435-444. doi: 10.1089/photob.2023.0051.

ABSTRACT

Background: Dry eye disease (DED) is a complex ocular surface inflammatory disorder with a multifactorial etiology. Therapies such as intense pulsed light (IPL) and heated eye mask (HEM) have been reported to improve the tear film lipid layer (TFLL) and signs and symptoms of DED. Methods: This randomized study aimed to compare the effects of IPL combined with HEM (IPL+HEM) group, IPL group, and control group in participants with evaporative DED. All participants were examined at baseline (D0), day 21 (D21), day 42 (D42), and day 84 (D84) for noninvasive tear breakup time (NITBUT), TFLL, corneal conjunctival staining (CS), meibomian gland quality (MGQ), meibomian gland expressibility (MGEx), and Ocular Surface Disease Index (OSDI). Results: The mean age of participants was IPL+HEM: 28.06 ± 3.88 years, IPL: 29.88 ± 4.68 years, and control: 28.52 ± 3.77 years. At D84, significant improvements in TFLL (p < 0.05), noninvasive tear breakup time (NITBUT) (p < 0.05), corneoconjunctival staining (CS) (p < 0.05), MGQ (p < 0.05), MGEx (p < 0.05), and OSDI (p < 0.05) were found in the IPL+HEM and IPL groups, whereas the control group had no significant improvements. Furthermore, ΔTFLL significantly correlated with ΔNITBUT (r = -0.678, p < 0.001), ΔCS (r = 0.321, p < 0.001), ΔMGQ (r = 0.669, p < 0.001), ΔMGEx (r = 0.598, p < 0.001), and ΔOSDI score (r = 0.649, p < 0.001). Conclusions: IPL therapy in combination with HEM and IPL therapy only can significantly improve the quality of TFLL and clinically reduce the sign and symptoms of evaporative DED. However, IPL therapy in combination with HEM was found to be more effective than IPL therapy alone.

PMID:37579133 | DOI:10.1089/photob.2023.0051

J Addict Med. 2023 Jul-Aug 01;17(4):463-467. doi: 10.1097/ADM.0000000000001125. Epub 2023 Jan 5.

ABSTRACT

OBJECTIVE: We sought to identify the sociodemographic and clinical characteristics associated with homelessnesss, and explore the relationship between homelessnesss and treatment outcomes among Black individuals.

METHODS: This is a secondary analysis of the subgroup of Black participants (n = 73) enrolled in “X:BOT,” a 24-week multisite randomized clinical trial comparing the effectiveness of extended-release naltrexone versus sublingual buprenorphine-naloxone (n = 570). Outcomes included medication initiation, return to extramedical use of opioids assessed by both self-report and urine toxicology, and engagement in medications for opioid use disorder (MOUD) treatment at 28 weeks postrandomization. Descriptive statistics were performed.

RESULTS: Black participants were mostly unmarried and male, and about a third were aged 21-30 years. Among people experiencing homelessnesss, more were uninsured (45.5% [10/22] vs 19.6% [10/51]), unemployed (77.3% [17/22] vs 64.7% [33/51]), and reported alcohol (40.9% [9/22] vs 23.5% [12/51]) and sedative use (54.5% [12/22] vs 17.6% [9/51]) within the previous 30 days. Compared with housed Black individuals, a slightly higher proportion of Black individuals experiencing homelessnesss successfully initiated study medication (81.1% [18/22] vs 72.6% [37/51]); similar proportions returned to opioid use during the trial (68.2% [15/22] vs 68.6% [35/51]) and were engaged in MOUD at 28 weeks after trial entry (72.2% [13/18] vs 69.7% [23/33]) among participants located for follow-up.

CONCLUSIONS: These descriptive results among Black patients participating in a trial of MOUD suggest that efficacious MOUD is possible despite homelessnesss with additional clinical supports such as those provided by a clinical trial.

PMID:37579110 | DOI:10.1097/ADM.0000000000001125

Pediatr Allergy Immunol Pulmonol. 2023 Aug 9. doi: 10.1089/ped.2023.0037. Online ahead of print.

ABSTRACT

Study Objective: Food allergy is an essential growing public health concern that affects the quality of life of children and their parents. This study aimed to identify the parents’ awareness and daily practice about food labels and allergy warnings on packaged foods. Materials and Methods: The study investigated the parents of children with food allergies who applied to the pediatric allergy outpatient clinic between October 01, 2020 and March 30, 2021. A total of 106 questionnaires were collected and statistically analyzed. Results: One hundred six parents with an average age of 31.6 ± 5.17 years were questioned. Most of the participants were mothers (88.7%). The most common food allergens observed in children were hen’s egg (75%), cow’s milk (56%), nuts (24.5%), peanuts (19.8%), walnuts (11.3%), and wheat (10.4%). Of the children, 39.6% rarely consumed packaged products, and the proportion of children who did not consume packaged products at all was 32.1%. All parents reported that they read the labels. Of them, 65.1% stated that allergy food labels were inadequate and it could be more noticeable if symbols (53.6%) or bold text (39.1%) were used for labeling. Conclusion: This study shows that parents with a diagnosis of food allergy in their child were highly aware of labels that indicate the content of the product. However, they thought that food labels are insufficient in scope and shape and needed to be improved. Parents preferred allergen labels with both symbols and bold text.

PMID:37579077 | DOI:10.1089/ped.2023.0037

J Phys Chem Lett. 2023 Aug 14:7469-7476. doi: 10.1021/acs.jpclett.3c00962. Online ahead of print.

ABSTRACT

Metal-organic framework (MOF) glasses have multiple potential applications, as they combine advantages of traditional glasses with those of MOFs. The melt-quenching process used to form MOF glasses typically leads to a significant decrease in porosity, but the structural origin of this thermally induced pore collapse remains largely unknown. Here, we study the melting process of three zeolitic imidazolate frameworks (ZIFs), namely ZIF-4, ZIF-62, and ZIF-76, using ab initio molecular dynamics (MD) simulations. By analyzing the MD data using topological data analysis, we show that while the three ZIF systems exhibit similar short-range order structural changes upon heating, they exhibit significant differences in their medium-range order structure. Specifically, ZIF-76 retains more of its medium-range order structures in the liquid state compared to the other glass-forming ZIF systems, which allows it to remain more porous than ZIF-4 and ZIF-62. As such, our results may aid in understanding the structural features that govern the ability to maintain porosity in the melt-quenched glassy state.

PMID:37579071 | DOI:10.1021/acs.jpclett.3c00962

J Laparoendosc Adv Surg Tech A. 2023 Aug 9. doi: 10.1089/lap.2023.0200. Online ahead of print.

ABSTRACT

Purpose: This study analyzed the safety and effectiveness of laparoscopic sleeve gastrectomy (LSG) in patients over 60 years old, in a long-term follow-up, in a high-volume bariatric center. Methods: We retrospectively analyzed all patients older than 60 years who underwent LSG in our center from January 2009 to December 2018. A prospectively collected database of 4991 consecutive LSG cases was reviewed. Results: One hundred seventy-nine sleeve gastrectomy procedures were performed in patients older than 60 years, 135 were aged 60-65 years (group A) and 44 were older than 65 years (group B). We reported five cases (2.7%) of early complications: three postoperative hemorrhages, one cardial leakage, and one perigastric abscess. No thromboembolic events or mortality rates were reported. The mean follow-up period was 5.5 years (66 months). The follow-up loss rate was about 29%. At last follow-up, the mean body-mass index/body mass/percentage of excess weight loss values were, respectively, 33.7 ± 7/86.1 ± 21/60.4 ± 28.6 in group A and 32.4 ± 6.4/82.6 ± 18/61.8 ± 33 in group B. We reported 5 (4.0%) trocar site hernias, 1 (0.8%) cardial junction stenosis, and 22 (18%) new outbreaks of gastroesophageal reflux (GERD). There were 7 reinterventions (5.7%): 5 for weight regain and 2 for GERD not responding to medical therapy. There were no statistically significant differences between the two age groups. Conclusions: LSG is a safe and effective treatment for severe obesity in people over 60 years old. There are no differences in results of patients over 65 years and between 60 and 65 years old. Scales that include associated medical problems and the patient’s general condition must be considered.

PMID:37579046 | DOI:10.1089/lap.2023.0200

Anal Chem. 2023 Aug 14. doi: 10.1021/acs.analchem.3c02389. Online ahead of print.

ABSTRACT

Mass spectrometry imaging (MSI) has gained increasing popularity for tissue-based diagnostics due to its ability to identify and visualize molecular characteristics unique to different phenotypes within heterogeneous samples. Data from MSI experiments are often assessed and visualized using various supervised and unsupervised statistical approaches. However, these approaches tend to fall short in identifying and concisely visualizing subtle, phenotype-relevant molecular changes. To address these shortcomings, we developed aggregated molecular phenotype (AMP) scores. AMP scores are generated using an ensemble machine learning approach to first select features differentiating phenotypes, weight the features using logistic regression, and combine the weights and feature abundances. AMP scores are then scaled between 0 and 1, with lower values generally corresponding to class 1 phenotypes (typically control) and higher scores relating to class 2 phenotypes. AMP scores, therefore, allow the evaluation of multiple features simultaneously and showcase the degree to which these features correlate with various phenotypes. Due to the ensembled approach, AMP scores are able to overcome limitations associated with individual models, leading to high diagnostic accuracy and interpretability. Here, AMP score performance was evaluated using metabolomic data collected from desorption electrospray ionization MSI. Initial comparisons of cancerous human tissues to their normal or benign counterparts illustrated that AMP scores distinguished phenotypes with high accuracy, sensitivity, and specificity. Furthermore, when combined with spatial coordinates, AMP scores allow visualization of tissue sections in one map with distinguished phenotypic borders, highlighting their diagnostic utility.

PMID:37579019 | DOI:10.1021/acs.analchem.3c02389

Interact J Med Res. 2023 Aug 14;12:e46900. doi: 10.2196/46900.

ABSTRACT

BACKGROUND: ChatGPT, a dialogue-based artificial intelligence language model, has shown promise in assisting clinical workflows and patient-clinician communication. However, there is a lack of feasibility assessments regarding its use for perioperative patient education in thoracic surgery.

OBJECTIVE: This study aimed to assess the appropriateness and comprehensiveness of using ChatGPT for perioperative patient education in thoracic surgery in both English and Chinese contexts.

METHODS: This pilot study was conducted in February 2023. A total of 37 questions focused on perioperative patient education in thoracic surgery were created based on guidelines and clinical experience. Two sets of inquiries were made to ChatGPT for each question, one in English and the other in Chinese. The responses generated by ChatGPT were evaluated separately by experienced thoracic surgical clinicians for appropriateness and comprehensiveness based on a hypothetical draft response to a patient’s question on the electronic information platform. For a response to be qualified, it required at least 80% of reviewers to deem it appropriate and 50% to deem it comprehensive. Statistical analyses were performed using the unpaired chi-square test or Fisher exact test, with a significance level set at P<.05.

RESULTS: The set of 37 commonly asked questions covered topics such as disease information, diagnostic procedures, perioperative complications, treatment measures, disease prevention, and perioperative care considerations. In both the English and Chinese contexts, 34 (92%) out of 37 responses were qualified in terms of both appropriateness and comprehensiveness. The remaining 3 (8%) responses were unqualified in these 2 contexts. The unqualified responses primarily involved the diagnosis of disease symptoms and surgical-related complications symptoms. The reasons for determining the responses as unqualified were similar in both contexts. There was no statistically significant difference (34/37, 92% vs 34/37, 92%; P=.99) in the qualification rate between the 2 language sets.

CONCLUSIONS: This pilot study demonstrates the potential feasibility of using ChatGPT for perioperative patient education in thoracic surgery in both English and Chinese contexts. ChatGPT is expected to enhance patient satisfaction, reduce anxiety, and improve compliance during the perioperative period. In the future, there will be remarkable potential application for using artificial intelligence, in conjunction with human review, for patient education and health consultation after patients have provided their informed consent.

PMID:37578819 | DOI:10.2196/46900