Category: Statistics

J Healthc Eng. 2022 Jan 7;2022:8414135. doi: 10.1155/2022/8414135. eCollection 2022.

ABSTRACT

The objective of this study was to explore rehabilitation of patients with acute kidney injury (AKI) treated with Xuebijing injection by using intelligent medical big data analysis system. Based on Hadoop distributed processing technology, this study designed a medical big data analysis system and tested its performance. Then, this analysis system was used to systematically analyze rehabilitation of sepsis patients with AKI treated with Xuebijing injection. It is found that the computing time of this system does not increase obviously with the increase of cases. The results of systematic analysis showed that the glomerular filtration rate (59.31 ± 3.87% vs 44.53 ± 3.53%) in the experimental group was obviously superior than that in the controls after one week of treatment. The levels of urea nitrogen (9.32 ± 2.21 mmol/L vs. 14.32 ± 0.98 mmol/L), cystatin C (1.65 ± 0.22 mg/L vs. 2.02 ± 0.13 mg/L), renal function recovery time (6.12 ± 1.66 days vs. 8.66 ± 1.17 days), acute physiology and chronic health evaluation system score (8.98 ± 2.12 points vs. 12.45 ± 2.56 points), sequential organ failure score (7.22 ± 0.86 points vs. 8.61 ± 0.97 points), traditional Chinese medicine (TCM) syndrome score (6.89 ± 1.11 points vs. 11.33 ± 1.23 points), and ICU time (16.43 ± 2.37 days vs. 12.15 ± 2.56 days) in the experimental group were obviously lower than those in the controls, and the distinctions had statistical significance (P < 0.05). The significant efficiency (37.19% vs. 25.31%) and total effective rate (89.06% vs. 79.06%) in the experimental group were obviously superior than those in the controls, and distinction had statistical significance (P < 0.05). In summary, the medical big data analysis system constructed in this study has high efficiency. Xuebijing injection can improve the renal function of sepsis patients with kidney injury, and its therapeutic effect is obviously better than that of Western medicine, and it has clinical application and promotion value.

PMID:35035861 | PMC:PMC8759879 | DOI:10.1155/2022/8414135

J Cosmet Dermatol. 2022 Jan 16. doi: 10.1111/jocd.14777. Online ahead of print.

ABSTRACT

UV absorption properties of bioactive agents has lead to their screening and development to provide photo protection. Safranal is one such secondary plant metabolite obtained from Saffron (Crocus sativus) and reported to possess antioxidant and antisolar properties. The objective of this research was to design a suitable delivery system for the topical delivery of Safranal and to develop broad spectrum polyherbal sun protection cream with mild photoprotection. Safranal loaded Solid Lipid Nanoparticles (SLN) were formulated using probe sonication technique. The effect of variables like lipid concentration, surfactant concentration and stirring time were studied using central composite design using Design Expert 7.0 (Stat-Ease, Inc, USA). Particle size analysis of prepared SLN revealed the particles in the range of 460nm-980nm (F9). Entrapment efficiency was found between 88% and 99% . SLN was further characterized by techniques like DSC, FTIR and TEM. These SLN were combined with zinc oxide, pearl powder, Pterocarpus santalinus; a natural colorant with skin whitening effect and dispersed in a dermatological acceptable carrier with excellent skin nourishing properties. Other natural ingredients namely Almond oil, Hen egg oil and Aloevera gel were also incorporated due to their Sun protection properties. Evaluation of sunscreen cream by transmittane method showed good texture, excellent rheological properties, optimum pH and stability. The developed product showed broad spectrum of sunscreen protection with SPF 9.22, UV-A ++ and *** Boot Star Rating. The significant inhibitory activity of Safranal on matrix metalloproteinases (MMPs) analyzed by biochemical Investigation method and a higher SPF established that this bioorganic molecule is a strong photoprotective agent. Designing of Solid lipid nanoparticles and incorporation of other traditional ingredients in the recipe augmented its antisolar property and provided an all natural sunscreen.

PMID:35034408 | DOI:10.1111/jocd.14777

Echocardiography. 2022 Jan 15. doi: 10.1111/echo.15292. Online ahead of print.

ABSTRACT

AIMS: This study aimed to explore the validation and the diagnostic value of multiple right ventricle (RV) volumes and functional parameters derived from a novel artificial intelligence (AI)-based three-dimensional echocardiography (3DE) algorithm compared to cardiac magnetic resonance (CMR).

METHODS AND RESULTS: A total of 51 patients with a broad spectrum of clinical diagnoses were finally included in this study. AI-based RV 3DE was performed in a single-beat HeartModel mode within 24 hours after CMR. In the entire population, RV volumes and right ventricular ejection fraction (RVEF) measured by AI-based 3DE showed statistically significant correlations with the corresponding CMR analysis (p < 0.05 for all). However, the Bland-Altman plots indicated that these parameters were slightly underestimated by AI-based 3DE. Based on CMR derived RVEF < 45% as RV dysfunction, end-systolic volume (ESV), end-systolic volume index (ESVi), stroke volume (SV), and RVEF showed great diagnostic performance in identifying RV dysfunction, as well as some non-volumetric parameters, including tricuspid annular systolic excursion (TAPSE), fractional area change (FAC), and free-wall longitudinal strains (LS) (p < 0.05 for all). The cutoff value was 43% for RVEF with a sensitivity of 94% and specificity of 67%.

CONCLUSION: AI-based 3DE could provide rapid and accurate quantitation of the RV volumes and function with multiple parameters. Both volumetric and non-volumetric measurements derived from AI-based 3DE contributed to the identification of the RV dysfunction.

PMID:35034377 | DOI:10.1111/echo.15292

Hepatology. 2022 Jan 16. doi: 10.1002/hep.32347. Online ahead of print.

ABSTRACT

We aimed to develop and validate machine learning algorithms to predict direct-acting antiviral (DAA) treatment failure among patients with hepatitis C virus (HCV) infection. We used HCV-TARGET registry data to identify HCV-infected adults receiving all-oral DAA treatment and having virologic outcome. Potential pre-treatment predictors (n=179) included sociodemographic, clinical characteristics, and virologic data. We applied multivariable logistic regression (MLR) as well as elastic net (EN), random forest (RF), gradient boosting machine (GBM), and feedforward neural network (FNN) machine learning algorithms to predict DAA treatment failure. Training (n=4,894) and validation (n=1,631) patient samples had similar sociodemographic and clinical characteristics (mean age, 57 years; 60% male; 66% White; 36% with cirrhosis). Of 6525 HCV-infected adults, 95.3% achieved sustained virologic response, whereas 4.7% experienced DAA treatment failure. In the validation sample, machine learning approaches performed similarly in predicting DAA treatment failure (C statistic [95% CI]: GBM, 0.69 [0.64-0.74]; RF, 0.68 [0.63-0.73]; FNN, 0.66 [0.60-0.71]; EN, 0.64 [0.59-0.70]), and all four outperformed MLR (0.51 [0.46-0.57]). Using the Youden index to identify the balanced risk score threshold, GBM had 66.2% sensitivity and 65.1% specificity, and 12 individuals were needed to evaluate to identify one DAA treatment failure. Over 55% of patients with treatment failure were classified by the GBM in the top three risk decile subgroups (positive predictive value: 6% to 14%). The top 10 GBM-identified predictors included albumin, liver enzymes (aspartate aminotransferase, alkaline phosphatase), total bilirubin levels, sex, HCV viral loads, sodium level, hepatocellular carcinoma, platelet levels, and tobacco use. CONCLUSIONS: Machine learning algorithms performed effectively for risk prediction and stratification of DAA treatment failure.

PMID:35034373 | DOI:10.1002/hep.32347

Biometrics. 2022 Jan 16. doi: 10.1111/biom.13622. Online ahead of print.

ABSTRACT

The restricted mean survival time (RMST) evaluates the expectation of survival time truncated by a prespecified time point, because the mean survival time in presence of censoring is typically not estimable. The frequentist inference procedure for RMST has been widely advocated for comparison of two survival curves, while research from the Bayesian perspective is rather limited. For the RMST of both right- and interval-censored data, we propose Bayesian nonparametric estimation and inference procedures. By assigning a mixture of Dirichlet processes (MDP) prior to the distribution function, we can estimate the posterior distribution of RMST. We also explore another Bayesian nonparametric approach using the Dirichlet process mixture model and make comparisons with the frequentist nonparametric method. Simulation studies demonstrate that the Bayesian nonparametric RMST under diffuse MDP priors leads to robust estimation and under informative priors it can incorporate prior knowledge into the nonparametric estimator. Analysis of real trial examples demonstrates the flexibility and interpretability of the Bayesian nonparametric RMST for both right- and interval-censored data. This article is protected by copyright. All rights reserved.

PMID:35034347 | DOI:10.1111/biom.13622

Int Endod J. 2022 Jan 16. doi: 10.1111/iej.13680. Online ahead of print.

ABSTRACT

AIM: To propose a clinical approach strategy on the diagnosis, treatment, and evaluation of external cervical tooth resorption (ECR) cases. To investigate and discuss the outcome of this approach.

METHODOLOGY: A clinical approach strategy on ECR was developed based on a retrospective observation study of 542 teeth. 47 teeth were excluded due to lack of clinical/radiographical information, and 182 were immediately extracted. This approach had three steps: diagnosis, treatment planning, and evaluation. During diagnosis, the medical, dental history and clinical/radiographical characteristics were evaluated. Depending on the resorption extent, ECR cases were categorized into four classes according to Heithersay’s classification. During treatment planning, a treatment decision flowchart was prepared based on four main decisive criteria: probing feasibility, pain, location and extent of resorption (class), and existence of bonelike tissue. Three treatment options were applied: a) extraction, b) monitoring, or c) conservative treatment by external, internal, or combination of internal-external treatments. During evaluation, assessment of ECR progression, tooth survival and other factors like esthetics and periodontal attachment were performed. Descriptive statistical analysis of the outcome for up to ten years (for the overall clinical approach and for each individual treatment decision), was carried out with OriginLabs OriginPro 9 and Microsoft Excel 365.

RESULTS: A three-step strategy was developed on how to deal with ECR cases. Indicative examples of each treatment decision were presented and discussed. The overall survival rate of this strategy was 84.6% (3 years), 70.3% (5 years), 42.7% (8 years) and 28.6% (10 years). Higher survival rate was observed for external treatment decision than for internal. The success of each treatment decision depended on the extent of the resorption (class). The success of a treatment decision should be based on the long-term outcome, as a different evolution can be observed with time.

CONCLUSIONS: A clinical approach strategy was introduced on ECR pathosis. This strategy was not solely based on ECR class, as other important decisive criteria were considered. This step-wise approach, has a 70.3% survival rate with a mean of 5 years. This work will hopefully provide an incentive for a broader collaboration, to potentially establish a universally accepted ECR treatment strategy.

PMID:35034370 | DOI:10.1111/iej.13680

Qual Life Res. 2022 Jan 16. doi: 10.1007/s11136-021-03064-0. Online ahead of print.

ABSTRACT

PURPOSE: To translate, culturally adapt and validate the Coronary Revascularisation Outcome Questionnaire (CROQ), a disease-specific tool for measuring health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), into Serbian language (CROQ-S).

METHODS: Validation study was performed at the Clinic for Cardiac Surgery and Clinic for Cardiology, University Clinical Centre of Serbia. We included a convenience sample of 600 patients with IHD divided into four groups. Acceptability, reliability and validity of the CROQ-S were assessed.

RESULTS: CROQ-S was acceptable to patients as demonstrated by less than 1% of missing data for each single item. Cronbach’s Alpha was higher than the criterion of 0.70 for all scales in each version except the Cognitive Functioning scale which only met this criterion in the CABG pre-revascularisation version. Mean values of item-total correlations were greater than 0.30 for all scales except the Cognitive Functioning scale in both the pre-revascularisation groups. Compared to the original version, exploratory factor analysis in our study showed more factors; however, the majority of items had a factor loading greater than 0.3 on the right scale. Correlations of CROQ-S scales with the 36-Item Short Form Health Survey and Seattle Angina Questionnaire showed the expected pattern whereby scales measuring similar constructs were most highly correlated.

CONCLUSION: CROQ-S is an acceptable, reliable and valid disease-specific instrument for measuring HRQoL in this sample of Serbian speaking patients with IHD both before and after coronary revascularisation. However, the Cognitive Functioning scale did not meet all the psychometric criteria and further validation of its responsiveness is required.

PMID:35034321 | DOI:10.1007/s11136-021-03064-0

Pharmacoecon Open. 2022 Jan 16. doi: 10.1007/s41669-021-00321-3. Online ahead of print.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is the second most common neurodegenerative disorder, with an increasing prevalence worldwide. Estimates of the economic burden associated with PD vary widely across existing studies due to differences in setting and study design. The prevalence and cost of care for PD in Luxembourg are currently unknown.

OBJECTIVE: The aims of this study were to estimate (1) the prevalence of PD in Luxembourg and (2) the cost of care for PD to the national healthcare insurance based on routinely collected healthcare data.

METHODS: This analysis was based on individual patient-level data collected by the national healthcare insurance in Luxembourg during 2007-2017, which covers over 95% of the resident population. People with PD were identified based on drug reimbursement profiles. Cost of care was estimated according to a comparative analysis of the healthcare resources consumed by people with PD compared with an age- and sex-matched control group.

RESULTS: We determined a PD prevalence of 928 per 100,000 individuals aged 50 years and older in 2016, higher in men (1032 per 100,000) than in women (831 per 100,000). The total mean cost of care for PD was estimated at €22,673 per patient per year in 2016, with the highest costs being associated with long-term care (69%).

CONCLUSION: This was the first attempt to estimate the prevalence and cost of care of PD in Luxembourg. The work demonstrated the usefulness of routinely collected data in Luxembourg for such analyses. Our study confirms the significant burden of PD to the healthcare system, especially on long-term care.

PMID:35034346 | DOI:10.1007/s41669-021-00321-3

Radiol Med. 2022 Jan 16. doi: 10.1007/s11547-021-01440-x. Online ahead of print.

ABSTRACT

AIM: To evaluate the emotional state and organizational well-being of healthcare workers in radiation oncology departments, during the COVID pandemic.

METHODS: A survey was carried out with three questionnaires: Impact of Event Scale-Revised (IES-R); Italian ANAC questionnaire; and Maslach Burnout Inventory (MBI). Comparisons between groups were done by Student’s t test.

RESULTS: Seventy-eight questionnaires for 26 workers were analyzed. Thirty-three percent of the sample obtained an IES-R high score, such as post-traumatic syndrome. In terms of organizational well-being, younger age and lower working seniority were statistically significant for higher score of ANAC items (p < 0.5). Regarding MBI, 0, 27 and 50% high scores of emotional exhaustion, depersonalization and personal accomplishment were reported, respectively. Low working seniority and male sex were correlated with high score of personal accomplishment (p:0.05; p:0.03).

CONCLUSION: Intervention to promote mental health well-being should be implemented in radiation oncology department.

PMID:35034319 | DOI:10.1007/s11547-021-01440-x

Infect Dis Ther. 2022 Jan 16. doi: 10.1007/s40121-021-00579-4. Online ahead of print.

ABSTRACT

INTRODUCTION: We previously demonstrated the efficacy of a frozen dalbavancin-heparin (DH) lock solution against biofilms of staphylococci. However, as enterococci also commonly cause catheter-related bloodstream infections (C-RBSI), we assessed the bioactivity of frozen dalbavancin (D) and DH against enterococci.

METHODS: Over 6 months, we compared the bioactivity of a solution of DH (1 mg/ml) with that of D in terms of cfu counts and metabolic activity against biofilms of Enterococcus faecalis and Enterococcus faecium (four strains each). For each solution, we individually compared results obtained at each time point (months 3 and 6) with baseline (month 0). We also compared the median DH value of each variable at baseline and at months 3 and 6 of freezing with the values obtained for D alone. We used both statistical and clinical criteria when results were within 25% of the reference value.

RESULTS: At the end of the experiment (month 6), neither a statistically nor a clinically significant reduction in the bioactivity of D solution was observed in terms of cfu count and metabolic activity against enterococcal biofilms. Regarding the DH solution, we found both statistical and clinical significance in the median percentage reduction in metabolic activity between months 0 and 6 in E. faecalis strains (51.8% vs. 77.8%, P = 0.007). Moreover, after freezing, the DH solution lost significant bioactivity compared with the D solution, especially in E. faecalis.

CONCLUSION: A dalbavancin lock solution can be frozen for up to 6 months with no negative effect on its bioactivity against enterococcal biofilms. However, when combined with heparin, its efficacy was reduced. Therefore, we recommend that if lock therapy with frozen dalbavancin is used in the management of enterococcal C-RBSI, heparin should be added simultaneously at the time of catheter lock.

PMID:35034289 | DOI:10.1007/s40121-021-00579-4