Category: Statistics

Pulm Pharmacol Ther. 2022 Jan 12:102111. doi: 10.1016/j.pupt.2022.102111. Online ahead of print.

ABSTRACT

BACKGROUND: The best duration of antibiotic treatment for chronic obstructive pulmonary disease (COPD) exacerbations is uncertain.

OBJECTIVE: To evaluate whether a short course of antibiotic therapy is as effective as the standard longer treatment for exacerbations of patients with COPD.

METHODS: We searched Pubmed/MEDLINE and trials in relevant systematic reviews from the inception up to March 2021, with no language restrictions. Randomised controlled trials comparing short-course antibiotic therapy (≤5 days) with standard antibiotic therapy (≥6 days) for exacerbations of patients aged ≥40 with spirometrically-confirmed COPD were included. Three outcomes were considered: end-of-therapy clinical cure, bacterial eradication and adverse events. Statistical analyses included random effects meta-analyses using odds ratios and assessment of heterogeneity.

RESULTS: Of 1274 citations found, eight were eligible for inclusion, seven of which recruited outpatients. Overall, short-course antibiotic treatments were not significantly different from those of long-course treatments for clinical cure (odds ratio [OR] 1.14, 95% CI 0.91; 1.44) and for bacterial eradication (OR 1.16, 95% CI 0.91; 1.48). Adverse events were observed in 379 (21.1%) patients receiving short-term antibiotic regimens, while 412 (22.8%) patients receiving the standard regimens reported adverse events (OR 0.83, 95% CI 0.62; 1.11). The heterogeneity of the studies was low.

CONCLUSION: In relation to clinical and bacteriological efficacy, a short course of antibiotic treatment is equivalent to longer conventional treatment in mainly outpatients with exacerbations of COPD. Moreover, shorter exposure to antibiotics may decrease the risk developing antimicrobial resistance and, hence, might become first-line therapy for the management of ambulatory COPD patients.

PMID:35032637 | DOI:10.1016/j.pupt.2022.102111

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Dec 30;42(3):29-36. doi: 10.2478/prilozi-2021-0032.

ABSTRACT

Problematic smartphone use and or addiction is defined as a form of behaviour characterized by the compulsive use of a smartphone that results in various forms of physical, psychological, or social harm. Global popularity in the area of the use of smartphones has raised concerns about the negative effects associated with problematic smartphone use, especially in the younger population. Having no consensual definition of smartphone addiction (SA), this behavioural addiction is based on the classic addiction symptomology that was included in DSM-5 criteria for compulsive gambling and substance abuse (APA 2013) This article provides a review of current research related to SA. Articles were found in the PUBMED database using related key words. Statistics confirm the exponential rise of this problem globally, especially in children and adolescents. Therefore, one must make this a high priority among public health issues.

PMID:35032372 | DOI:10.2478/prilozi-2021-0032

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Dec 30;42(3):89-95. doi: 10.2478/prilozi-2021-0039.

ABSTRACT

Aim of the study: The aim of this study is to determine the values of salivary enzyme biomarkers (alkaline phosphatase – ALP, aspartate aminotransferase – AST and lactate dehydrogenase – LDH) in subjects with healthy and diseased periodontium and to investigate the possibility of using these salivary enzymes as diagnostic and prognostic markers. Methods: We collected saliva with the spitting method from all examinees in the morning, using the recommendations provided by Navazesh. The values of the enzymes in saliva were determined spectro-photometrically, with the following methods: ALP-IFCC, AST-IFCC, LDH-PYRUVATE. IGI Silness-Löe was used to determine the presence of gingival inflammation, and to determine the presence of clinically manifest periodontitis, we determined the clinical loss of periodontal attachment with a graduated periodontal probe. For statistical purposes, we used the method of ANOVA Chi Square and Student’s t-test. Results: The difference in the average salivary AST and LDH values between the first and the second group, as well between the first and third group is statistically significant (p < 0.000). The difference in the average salivary AST and LDH values between the examinees with gingivitis and the examinees with clinically manifest periodontal disease is statistically insignificant (p < 0.485101 for AST, p < 0.816665 for LDH). The difference in the average salivary levels of ALP between the three groups is statistically significant (p < 0.000). Conclusion: The salivary levels of AST, LDH, and ALP can be used as diagnostic markers, while ALP can also be used as a prognostic marker for periodontal disease.

PMID:35032371 | DOI:10.2478/prilozi-2021-0039

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Dec 30;42(3):97-106. doi: 10.2478/prilozi-2021-0040.

ABSTRACT

The development of spontaneous bacterial peritonitis (SBP) is a serious and life-threatening condition in patients with cirrhosis and ascites. The aim of this study was to determine the diagnostic potential of calprotectin in ascites, for SBP in patients with liver cirrhosis and ascites before and after antibiotic treatment and to compare the mean values of calprotectin in ascites in patients with and without SBP. This prospective-observational study was comprised of 70 patients with cirrhosis and ascites, divided into two groups, the SBP and the non-SBP group. Quantitative measurements of calprotectin in ascites was completed with the Quantum Blue Calprotectin Ascites test (LF-ASC25), using the Quantum Blue Reader. The average value of calprotectin in the SBP group was 1.5 ± 0.40 μg / mL, and in the non-SBP group it was lower (0.4 ± 0.30). The difference between the mean values was statistically significant with p <0.05. The mean value of calprotectin in ascites before therapy among the SBP group was 1.5 ± 0.4, and after antibiotic therapy, the value decreased significantly to 1.0 ± 0.6; the difference between the mean values was statistically significant with p <0.05. ROC analysis indicated that calprotectin contributed to the diagnosis of SBP with a 94.3% sensitivity rating (to correctly identify positives), and the specificity was 62.5%, which corresponded to the value of 0.275. Our research confirmed that ascitic calprotectin was a good predictor, and is significantly associated with the occurrence of SBP in patients with liver cirrhosis. By monitoring the value of calprotectin in ascites on the 7th day of antibiotic treatment, the effectiveness of antibiotic treatment in patients with SBP can be determined.

PMID:35032370 | DOI:10.2478/prilozi-2021-0040

Biometrics. 2022 Jan 15. doi: 10.1111/biom.13623. Online ahead of print.

ABSTRACT

Research of complex associations between a gene network and multiple responses has attracted extensive attention. A great challenge in analyzing genetic data is posited by the presence of the genetic network that is typically unknown in applications. Moreover, mismeasurement of responses introduces additional complexity to distort usual inferential procedures. In this paper, we consider the problem with mixed binary and continuous responses which are subject to mismeasurement and associated with complex structured covariates. We first start with the case where data are precisely measured. We propose a generalized network structured model and develop a two-step inferential procedure. In the first step, we employ a Gaussian graphical model to facilitate the covariates network structure, and in the second step, we incorporate the estimated graphical structure of covariates and develop an estimating equation method. Furthermore, we extend the development to accommodating mismeasured responses. We consider two cases where the information on mismeasurement is either known or estimated from a validation sample. Theoretical results are established and numerical studies are conducted to evaluate the finite sample performance of the proposed methods. We apply the proposed method to analyze the outbred Carworth Farms White mice data arising from a genome-wide association study. This article is protected by copyright. All rights reserved.

PMID:35032335 | DOI:10.1111/biom.13623

Endocrine. 2022 Jan 15. doi: 10.1007/s12020-022-02980-6. Online ahead of print.

ABSTRACT

PURPOSE: This study was performed to compare the utility of the semi-automated and automated side-cut core biopsy needles for thyroid nodules.

METHODS: Between January 2014 and March 2020, biopsy was performed for 278 thyroid nodules using the semi-automated core needle and for 225 nodules using the automated core needle. Nondiagnostic rate, inconclusive rate, diagnostic performance and complication rates were evaluated and compared between two core needle types.

RESULTS: There were 1.2% (6/503) nondiagnostic results and 15.9% (80/503) inconclusive results. Nondiagnostic rate between two needle types was not significantly different. The semi-automated type (33/278, 11.9%) showed lower inconclusive rate than the automated type (47/225, 20.9%) (p = 0.006). The sensitivity, specificity, PPV, NPV and diagnostic accuracy for diagnosis of malignancy of the semi-automated type were 70.18, 100, 100, 84.96 and 88.89%, respectively; the corresponding rates of automated type were 70.45, 100, 100, 86.6, and 89.84%. There were 12 minor complications: four hematomas (4/278, 1.4%) for the semi-automated type and eight hematomas (8/225, 3.6%) for the automated type, which difference was not statistically significant.

CONCLUSION: Core needle biopsy for thyroid nodules using either the semi-automated or automated needle is a safe diagnostic tool. Semi-automated needle has lower inconclusive rate than automated needle.

PMID:35032314 | DOI:10.1007/s12020-022-02980-6

Neurourol Urodyn. 2022 Jan 15. doi: 10.1002/nau.24864. Online ahead of print.

ABSTRACT

OBJECTIVES: Percutaneous and transcutaneous posterior tibial nerve stimulation (PTNS and TTNS) showed a promising effect on overactive bladder (OAB) and interstitial cystitis/painful bladder syndrome. We aimed to give a systematic review and meta-analysis on the efficacy and safety of these therapeutic methods as well.

METHODS: We searched studies available on PubMed, Embase, Cochrane, Scopus, Web of Science, and ProQuest on March 31, 2021, to find both published and unpublished studies. The retrieved articles were screened by two independent researchers and then the selected studies were critically appraised by Cochrane risk-of-bias tool for randomized trials, and Joanna Briggs Institute’s checklist for quasi-experimental studies. Finally, the results of studies were synthesized using Review Manager (RevMan) 5.4 statistical software when the data were homogenous. The meta-analysis was performed by calculating the effect size (mean difference) and their 95% confidence intervals (CIs).

RESULTS: Of the total 3194 publications, 68 studies were included in our qualitative evaluation and 9 studies (11 trials) in the quantitative stage. When TTNS or PTNS were compared to sham, placebo, no treatment, or conservative management, a decrease in frequency of urination was observed in both TTNS (mean difference [MD]: -3.18, 95% CI: -4.42 to -1.94, and p < 0.00001), and PTNS (MD: -2.84, 95% CI: -4.22 to -1.45, and p < 0.00001), and overall TTNS or PTNS (MD: -2.95, 95% CI: -4.01 to -1.88, and p < 0.00001). Significant improvements in mean voiding volume (MVV) and decreasing nocturia were also observed.

CONCLUSIONS: Nerve stimulations either PTNS or TTNS appear to be effective interventions in treating refractory idiopathic OAB in terms of daily voiding frequency, MVV, urgency episodes, and nighttime voiding frequency. However, our result did not show any improvement in terms of urinary incontinence, postvoid residual volume or urge incontinence, and maximum cystometric capacity which emphasized the efficacy of these modalities on dry-OAB rather than wet-OAB.

PMID:35032328 | DOI:10.1002/nau.24864

Breast Cancer. 2022 Jan 15. doi: 10.1007/s12282-021-01329-7. Online ahead of print.

ABSTRACT

BACKGROUND: Due to the lack of clinical trials on the efficacy of chemotherapy in older patients, an optimal treatment strategy has not been developed. We investigated whether adjuvant chemotherapy could improve the survival of older patients with breast cancer in Japan.

METHODS: We retrospectively analyzed data of patients with breast cancer aged ≥ 70 years who underwent breast cancer surgery in eight hospitals between 2008 and 2013. Clinical treatment and follow-up data were obtained from the patients’ medical electric records.

RESULTS: A total of 1095 patients were enrolled, of which 905 were included in the initial non-matched analysis. The median age and follow-up period were 75 (range 70-93) and 6.3 years, respectively. Of these patients, 127 (14%) received adjuvant chemotherapy (Chemo group) while the remaining 778 (86%) did not (Control group). The Chemo group was younger (mean age in years 73 vs 76; P < 0.0001), had a larger pathological tumor size (mean mm 25.9 vs 19.9; P < 0.0001), and more metastatic axillary lymph nodes (mean numbers 2.7 vs 0.7; P < 0.0001) than the Control group. The disease-free survival (DFS) and overall survival (OS) did not differ significantly between the two groups (P = 0.783 and P = 0.558). After matched analyses, DFS was found to be significantly prolonged with adjuvant chemotherapy (P = 0.037); however, OS difference in the matched cohort was not statistically significant (P = 0.333).

CONCLUSION: The results showed that adjuvant chemotherapy was associated with a reduced risk of recurrence, but survival benefits were limited.

PMID:35032302 | DOI:10.1007/s12282-021-01329-7

J Behav Med. 2022 Jan 15. doi: 10.1007/s10865-021-00274-2. Online ahead of print.

ABSTRACT

There is an increased interest in the use of personalized medicine approaches in the prevention or treatment of obesity, however, few studies have used these approaches to identify individual differences in treatment effects. The current study demonstrates the use of the predicted individual treatment effects framework to test for individual differences in the effects of the ACTION-PAC intervention, which targeted the treatment and prevention of obesity in a high school setting. We show how methods for personalized medicine can be used to test for significant individual differences in responses to an intervention and we discuss the potential and limitations of these methods. In our example, 25% of students in the preventive intervention, were predicted to have their BMI z-score reduced by 0.39 or greater, while at other end of the spectrum, 25% were predicted to have their BMI z-score increased by 0.09 or more. In this paper, we demonstrate and discuss the process of using methods for personalized medicine with interventions targeting adiposity and discuss the lessons learned from this application. Ultimately, these methods have the potential to be useful for clinicians and clients in choosing between treatment options, however they are limited in their ability to help researchers understand the mechanisms underlying these predictions.

PMID:35032253 | DOI:10.1007/s10865-021-00274-2

Hum Cell. 2022 Jan 15. doi: 10.1007/s13577-021-00665-2. Online ahead of print.

NO ABSTRACT

PMID:35032298 | DOI:10.1007/s13577-021-00665-2