Category: Statistics

Pharmacy (Basel). 2023 Jul 14;11(4):117. doi: 10.3390/pharmacy11040117.

ABSTRACT

Knee osteoarthritis is the most popular type of osteoarthritis that causes extreme pain in the elderly. Currently, there is no cure for osteoarthritis. To lessen clinical symptoms, glucosamine was suggested. The primary goal of our systematic review study is to evaluate the effectiveness and safety of glucosamine based on recent studies. Electronic databases such as PubMed, Scopus, and Cochrane were used to assess the randomized controlled trial (RCT). From the beginning through March 2023, the papers were checked, and if they fulfilled the inclusion criteria, they were then examined. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and Visual Analog Scale (VAS) scales were considered the main outcome measures. A total of 15 studies were selected. Global pain was significantly decreased in comparison to placebo, as measured by the VAS index, with an overall effect size of standardized mean difference (SMD) of -7.41 ([95% CI] 14.31, 0.51). The WOMAC scale confirmed that pain, stiffness, and physical function had improved, however the effects were insufficient. A statistical update also revealed that there were no reports of serious medication interactions or significant adverse events. To summarize, glucosamine is more effective than a placebo at reducing pain in knee osteoarthritis patients. In long-term treatment, oral glucosamine sulfate 1500 mg/day is believed to be well tolerated.

PMID:37489348 | DOI:10.3390/pharmacy11040117

Implement Sci Commun. 2023 Jul 24;4(1):85. doi: 10.1186/s43058-023-00465-9.

ABSTRACT

BACKGROUND: Knowledge translation (KT) is a key competency for trainees (graduate students and post-doctoral fellows), the new generation of researchers who must learn how to synthesize, disseminate, exchange, and ethically apply knowledge to improve patient and health system services, products, and outcomes. KT training is a key enabler to support KT competency development. Yet, there is a dearth of research on the design, delivery, and evaluation of KT training for trainees.

METHODS: The study applied a QUAN(qual) mixed methods approach with an embedded experimental model design. A heart and lung patient was also recruited to participate as a partner and researcher in the study. A multi-faceted KT intervention for trainees was designed, delivered, and evaluated. Data were collected using surveys and focus groups. Quantitative data were analyzed using descriptive and inferential statistics in R Studio and MS Excel. Qualitative data were analyzed in NVivo using thematic analysis.

RESULTS: Participation in each KT intervention varied, with 8-42 participants attending KT webinars, 61 attendees in the Three Minute Thesis (3MT) Competition Heat, and 31 participants in the Patient & Public Forum. In total, 27 trainees and 4 faculty participated in at least one of the KT webinars. Trainee participants reported satisfaction, as well as statistically significant increases in 10/13 KT competencies after receiving one or more components of the KT intervention. Additionally, participating faculty, patients, and the public were satisfied with the intervention components they participated in. Several challenges and facilitators were also identified to improve the KT intervention.

CONCLUSIONS: The KT intervention is a promising initiative that can be adopted and adapted across various post-secondary settings to support trainees’ competency development in KT. This evaluation demonstrates that trainees will respond to opportunities for KT training and that capacity for KT competencies can be advanced through a multi-faceted intervention that involves trainees, faculty, patients, and health system collaborators in its design and delivery. This evaluation study contributes the design and results of a novel KT intervention for multi-stakeholders.

TRIAL REGISTRATION: N/A.

PMID:37488655 | DOI:10.1186/s43058-023-00465-9

Mycoses. 2023 Jul 24. doi: 10.1111/myc.13634. Online ahead of print.

ABSTRACT

Onychomycosis is common among immunosuppressed individuals. Renal transplant recipients (RTR) and lupus nephritis (LN) patients are submitted to corticosteroid and other immunosuppressive therapy; and diabetes mellitus (DM) patients are intrinsically immunocompromised.

OBJECTIVES: The aim of this study was to characterise and identify fungal infections on the nails (feet and hands) in immunocompromised patients.

METHODS: The clinical material, nail scales (foot and/or hand), was collected from 47 RTR, 66 LN, 67 DM, and 78 immunocompetent individuals (control group). Phenotypic and molecular analyses were performed.

RESULTS: A total of 258 patients were examined. There was a female predominance, except in the RTR. The average age was 52 years old. Lateral distal subungual onychomycosis (OSDL) (75.2%), mainly affecting the hallux nail, was frequent. The predominance of dermatophyte on toenails and Candida species on fingernails was statistically significant. A higher frequency of fingernail involvement in LN and DM, and for LN, the difference was significant (p = .0456). Infections by Candida spp. were more frequent in DM. Using molecular methods, 87.2% of diagnoses were confirmed, identifying fungal agents at the species level. Dermatophytes, Trichophyton rubrum and Trichophyton interdigitale and the species of Candida, C. parapsilosis and C. albicans, were the most frequent fungal agents.

CONCLUSIONS: Molecular techniques (sequencing of ITS regions of rDNA) offer greater accuracy, although there is no difference, regarding the detection. Clinical presentation and fungal species may differ somewhat from the general population. Immunosuppression did not increase fungal detection positivity.

PMID:37488648 | DOI:10.1111/myc.13634

Contracept Reprod Med. 2023 Jul 25;8(1):40. doi: 10.1186/s40834-023-00235-x.

ABSTRACT

BACKGROUND: Globally, approximately 290,000 women between the ages of 15 and 49 died from pregnancy-related problems in 2014 alone, with these sub-Saharan Africa accounts for 65% (179,000) of the deaths. Although studies are conducted on modern contraceptives, information is scarce on multinomial regression analysis at the national level data. Therefore, this study aimed to assess modern contraceptive method utilization and determinant factors among women in Ethiopia.

METHODS: Data for this study were extracted from the national representative 2019 Ethiopian Mini Demographic and Health Survey. Data was collected using a 2-stage cluster design, in which enumeration areas formed the first stage and households made the second stage. The survey was conducted from March 21, 2019, to June 28, 2019. The analysis was done using multinomial logistic regression using STATA software version 14. The overall categorical variables with a P value of < 0.25 at the binomial analysis were included in the final model of the multinomial logistic regression model in which odds ratios with 95% CIs were estimated to identify the independent variables of women’s modern contraceptive utilization. P values less than 0.05 were used to declare statistical significance. All analysis was done on weighted data.

RESULTS: A total of 8885 (weighted) participants were included in the current study from these,. The current study revealed that the prevalence of modern contraceptive utilization was 28.1% (95%CI: 27.6.7-28.6%). Factors like: women 25 to 34 years (aRRR = 1.5;95% CI:1.2-1.9), 35 to 44 years (aRRR = 2.4; 95% CI: 3.3-5.4), and greater than 45 years (aRRR = 2.9; 95% CI: 2.2-3.7); place of residence (rural; aRRR = 0.89; 95% CI 0.81-0.99), higher educational status (aRRR = 0.035;95%CI:0.61-0.98), grandmultipara (aRRR = 1.73;95%CI:1.6-1.9), and wealth index (poorer aRRR = 0.541;95%CI:0.46-0.631.9) were the factors significantly associated with the outcome variable.

CONCLUSIONS: In this, modern contraceptive utilization is low as compared to other countries. It was influenced by age, place of residence, education, the number of children, and wealth index. This suggests that creating awareness of contraceptive utilization is paramount for rural residence women by policymakers and health managers to empower women for family planning services. Moreover, all stakeholders, including governmental and nongovernmental organizations, better to emphasize on modern contraceptive use.

PMID:37488640 | DOI:10.1186/s40834-023-00235-x

J Orthop Surg Res. 2023 Jul 24;18(1):526. doi: 10.1186/s13018-023-04019-6.

ABSTRACT

INTRODUCTION: Patellar instability (PI) at an early age is believed closely correlated with bone loss in the development of the femoral trochlea and can cause trochlear dysplasia. However, the molecular mechanism of PI-induced bone loss has not been established. The Janus kinase (JAK)/signal transducers and activators of transcription (STAT) signaling pathway plays an important role in bone development by regulating the expression of osteoprotegerin (OPG) and receptor activator of nuclear factor kappa B ligand (RANKL). The aim of this study was to explore the association of JAK1/STAT3 signaling to PI-induced subchondral bone loss in the femoral trochlea.

METHODS: Four-week-old male C57BL/6 mice were randomly divided into two groups (n = 50/group). Mice in the experimental group underwent surgery to induce PI. Distal femurs were collected 2 and 4 weeks after surgery (n = 25 knees/each time point, each group). Microcomputed tomography and histological observations were performed to investigate the morphology of the femoral trochlea and changes in bone mass. qPCR, western blot, and immunohistochemistry analyses were performed to evaluate the expression of JAK1, STAT3, RANKL, and OPG in subchondral bone. A t test was performed for the statistical analysis; a P value < 0.05 was considered to be statistically significant.

RESULTS: In the experimental group, subchondral bone loss in the femoral trochlea was observed two and four weeks after PI; morphological changes, such as a flatter trochlear groove and an increased sulcus angle, were observed in the femoral trochlea; qPCR, western blot, and immunohistochemistry analyses showed higher expression of JAK1, STAT3, and RANKL and lower expression of OPG (P < 0.05).

CONCLUSION: PI-induced subchondral bone loss in the femoral trochlea and resulted in trochlear dysplasia in growing mice. This bone loss is associated with activation of the JAK1/STAT3 signaling pathway, which weakens the function of osteoblasts and stimulates both formation and function of osteoclasts.

PMID:37488636 | DOI:10.1186/s13018-023-04019-6

Chiropr Man Therap. 2023 Jul 24;31(1):22. doi: 10.1186/s12998-023-00494-0.

ABSTRACT

BACKGROUND: Evidence-based practice (EBP) is the integration of best research evidence with clinical expertise and patients’ values and preferences. Little is known about knowledge, attitudes, and application of EBP among chiropractic students and trainees. Our aims were to (1) examine the feasibility of implementing a new journal club format within a Swiss university chiropractic healthcare education setting, and (2) assess the associations between the new journal club implementation and EBP characteristics among chiropractic students.

METHODS: A before-and-after study was conducted through a newly implemented journal club with 5th and 6th year chiropractic students and postgraduate trainees between 1 and 2021 and 31 July 2021. The journal club was developed based on the “community of practice” and “team-based learning” conceptual frameworks. EBP knowledge, attitudes, personal application, and future use, were assessed with a validated questionnaire. We summarised participant characteristics using descriptive statistics, estimated before-and-after EBP total and subscale scores (i.e., knowledge, attitudes, personal application, and future use), and conducted an exploratory subgroup analysis based on journal club attendance (Group A: 3-5 sessions attended; Group B: ≤ 2 sessions attended).

RESULTS: Among 32 eligible students and trainees, 29 participants (mean age 26 years; 79% women) were enrolled: 25 (78%) responded to the pre- and 29 (91%) to the post-assessment surveys. Most (80%) were chiropractic students and 20% were postgraduate trainees. Group A consisted of 12 (41%) and Group B of 17 (59%) participants, respectively. We found reasonable feasibility for the new journal club format and our findings were compatible with no difference in before-and-after EBP scores (median EBP total score before: 72.6 [IQR, 63.7-77.4], and after: 73.4 [IQR, 61.3-78.2]). Exploratory subgroup analyses based on journal club attendance were consistent with our overall findings.

CONCLUSION: Our study suggests that the newly implemented journal club and embedding chiropractic educational research within the journal club were feasible and acceptable. Small before-and-after differences in the EBP subscale scores for knowledge, attitudes, personal application, and future use were observed in chiropractic students and postgraduate trainees. The small study size and short timeframe during a single semester limit potential inferences.

PMID:37488634 | DOI:10.1186/s12998-023-00494-0

Res Integr Peer Rev. 2023 Jul 24;8(1):10. doi: 10.1186/s41073-023-00131-7.

ABSTRACT

BACKGROUND: In many grant review settings, proposals are selected for funding on the basis of summary statistics of review ratings. Challenges of this approach (including the presence of ties and unclear ordering of funding preference for proposals) could be mitigated if rankings such as top-k preferences or paired comparisons, which are local evaluations that enforce ordering across proposals, were also collected and incorporated in the analysis of review ratings. However, analyzing ratings and rankings simultaneously has not been done until recently. This paper describes a practical method for integrating rankings and scores and demonstrates its usefulness for making funding decisions in real-world applications.

METHODS: We first present the application of our existing joint model for rankings and ratings, the Mallows-Binomial, in obtaining an integrated score for each proposal and generating the induced preference ordering. We then apply this methodology to several theoretical “toy” examples of rating and ranking data, designed to demonstrate specific properties of the model. We then describe an innovative protocol for collecting rankings of the top-six proposals as an add-on to the typical peer review scoring procedures and provide a case study using actual peer review data to exemplify the output and how the model can appropriately resolve judges’ evaluations.

RESULTS: For the theoretical examples, we show how the model can provide a preference order to equally rated proposals by incorporating rankings, to proposals using ratings and only partial rankings (and how they differ from a ratings-only approach) and to proposals where judges provide internally inconsistent ratings/rankings and outlier scoring. Finally, we discuss how, using real world panel data, this method can provide information about funding priority with a level of accuracy in a well-suited format for research funding decisions.

CONCLUSIONS: A methodology is provided to collect and employ both rating and ranking data in peer review assessments of proposal submission quality, highlighting several advantages over methods relying on ratings alone. This method leverages information to most accurately distill reviewer opinion into a useful output to make an informed funding decision and is general enough to be applied to settings such as in the NIH panel review process.

PMID:37488628 | DOI:10.1186/s41073-023-00131-7

Trials. 2023 Jul 24;24(1):472. doi: 10.1186/s13063-023-07303-2.

ABSTRACT

BACKGROUND: Tinnitus is a leading cause of disease burden globally. Several therapeutic strategies are recommended in guidelines for the reduction of tinnitus distress; however, little is known about the potentially increased effectiveness of a combination of treatments and personalized treatments for each tinnitus patient.

METHODS: Within the Unification of Treatments and Interventions for Tinnitus Patients project, a multicenter, randomized clinical trial is conducted with the aim to compare the effectiveness of single treatments and combined treatments on tinnitus distress (UNITI-RCT). Five different tinnitus centers across Europe aim to treat chronic tinnitus patients with either cognitive behavioral therapy, sound therapy, structured counseling, or hearing aids alone, or with a combination of two of these treatments, resulting in four treatment arms with single treatment and six treatment arms with combinational treatment. This statistical analysis plan describes the statistical methods to be deployed in the UNITI-RCT.

DISCUSSION: The UNITI-RCT trial will provide important evidence about whether a combination of treatments is superior to a single treatment alone in the management of chronic tinnitus patients. This pre-specified statistical analysis plan details the methodology for the analysis of the UNITI trial results.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04663828 . The trial is ongoing. Date of registration: December 11, 2020. All patients that finished their treatment before 19 December 2022 are included in the main RCT analysis.

PMID:37488627 | DOI:10.1186/s13063-023-07303-2

BMC Oral Health. 2023 Jul 24;23(1):517. doi: 10.1186/s12903-023-03227-0.

ABSTRACT

BACKGROUND: The aim of the current study is to assess the surface roughness of several recent nickel-titanium (Ni-Ti) rotary endodontic instruments, namely: Protaper next (PTN); Hyflex CM (CM); Hyflex EDM (EDM); WaveOne gold (WOG); and trunatomy (TN), before and after application of 5.25% sodium hypochlorite (NaOCl) irrigant solution.

METHODS: In this in vitro study, five recently introduced rotary endodontic instruments of different metallurgical properties and designs were subjected to Atomic Force Microscopy (AFM) analysis, and then each file was rotated in 5.25% NaOCl for 15 min., with speed and torque according to manufacturer’s instructions. The instruments were then subjected to AFM analysis again. The surface roughness average (Sa) parameter was calculated. Data were analyzed by Paired T test, One-way ANOVA and Tukey tests.

RESULTS: There was a statistically significant decrease in the surface roughness of all rotary endodontic instruments after immersion in irrigants (P ≤ 0.05).

CONCLUSION: The new TN and PTN instruments showed the least surface roughness. All tested Ni-Ti rotary endodontic instruments after irrigants exposure showed a varying increase in surface roughness.

PMID:37488612 | DOI:10.1186/s12903-023-03227-0

Cancer Imaging. 2023 Jul 24;23(1):71. doi: 10.1186/s40644-023-00584-5.

ABSTRACT

BACKGROUND: To build and validate a radiomics nomogram based on preoperative CT scans and clinical data for detecting synchronous ovarian metastasis (SOM) in female gastric cancer (GC) cases.

METHODS: Pathologically confirmed GC cases in 2 cohorts were retrospectively enrolled. All cases had presurgical abdominal contrast-enhanced CT and pelvis contrast-enhanced MRI and pathological examinations for any suspicious ovarian lesions detected by MRI. Cohort 1 cases (n = 101) were included as the training set. Radiomics features were obtained to develop a radscore. A nomogram combining the radscore and clinical factors was built to detect SOM. The bootstrap method was carried out in cohort 1 as internal validation. External validation was carried out in cohort 2 (n = 46). Receiver operating characteristic (ROC) curve analysis, decision curve analysis (DCA) and the confusion matrix were utilized to assess the performances of the radscore, nomogram and subjective evaluation model.

RESULTS: The nomogram, which combined age and the radscore, displayed a higher AUC than the radscore and subjective evaluation (0.910 vs 0.827 vs 0.773) in the training cohort. In the external validation cohort, the nomogram also had a higher AUC than the radscore and subjective evaluation (0.850 vs 0.790 vs 0.675). DCA and the confusion matrix confirmed the nomogram was superior to the radscore in both cohorts.

CONCLUSIONS: This pilot study showed that a nomogram model combining the radscore and clinical characteristics is useful in detecting SOM in female GC cases. It may be applied to improve clinical treatment and is superior to subjective evaluation or the radscore alone.

PMID:37488597 | DOI:10.1186/s40644-023-00584-5