Tag: statistics

Int J Surg. 2023 Dec 14. doi: 10.1097/JS9.0000000000000990. Online ahead of print.

ABSTRACT

BACKGROUND: Conversional bariatric surgery inherently has less weight loss (WL) compared to primary procedures. Adjunctive use of the GLP-1analogue, liraglutide with conversional Roux-en-RYGB Gastric Bypass (cRYGB) may maximize the WL benefits of surgery.

MATERIAL AND METHODS: This single-center randomized double-blind placebo-controlled trial included 80 patients randomized into two groups; the liraglutide group (40 patients) who received daily injections of liraglutide, and the placebo group (40 patients) who received normal saline starting at 6-weeks from cRYGB and continued for 6 months. After discontinuing the drugs at 6 months and unblinding, the patient were followed up to 12 months. The endpoints were percentage of total weight loss (%TWL) and percentage of excess weight loss (%EWL), and changes in the metabolic biomarkers, and complications within 30 and 90 days according to the global outcome benchmark (GOB) stratification.

RESULTS: In total, 38 patients in the liraglutide group and 31 in the placebo group completed the 24 weeks. Liraglutide group experienced better WL with a significantly higher mean %TWL at one month (10.27±1.39 vs. 8.41±2.08), at 6 weeks (12.65±1.77 vs. 10.47±2.23), at 6 months (18.29 ±1.74vs. 15.58 ±1.65), and at 12 months 24.15±2.35 versus 22.70±2.13 (all P<0.001). For %EWL, this was also significantly higher in the liraglutide group at all time points. A %TWL of>20% at 6 months of treatment was recorded in 6 (15.8%) patients in the liraglutide group and none in the placebo group (P=0.029). Both groups had comparable changes in metabolic biomarkers. Adverse events were recorded in 11 (27.5%) patients in the liraglutide, with no adverse events in the placebo group (P<0.001). Both groups had Clavien-Dindo scores I and II (5.0% and 2.5%), and GOB values indicated that 90.0% and 97.5% were low-risk patients.

CONCLUSION: Adjunctive use of liraglutide with cRYGB gives significantly higher WL and resolution of associated medical problems.

PMID:38100630 | DOI:10.1097/JS9.0000000000000990

Cancer. 2023 Dec 15. doi: 10.1002/cncr.35135. Online ahead of print.

ABSTRACT

Although cure rates remain low and effective screening strategies are elusive, the recent advances in systemic therapies over the past year highlighted in this review have prolonged survival for women with ovarian cancer. In 2022, the first antibody-drug conjugate for platinum-resistant ovarian cancer received accelerated US Food and Drug Administration (FDA) approval. Confirmatory studies examining the efficacy of mirvetuximab and other antibody-drug conjugates are underway. In the upfront setting, the first data establishing an overall survival benefit from poly(ADP-ribose) polymerase inhibitor maintenance was demonstrated after a 7-year follow-up period. In contrast, long-term updates from poly(ADP-ribose) polymerase inhibitor trials in the noncurative setting reported survival detriments, and the FDA withdrew the respective indications. Several trials attempted to improve upon the standard of care for platinum-sensitive ovarian carcinoma and those with rare ovarian cancer histologies (carcinosarcoma, clear cell carcinoma) but failed to demonstrate a clinically or statistically meaningful benefit. This leaves the open question of how to further optimize systemic therapy for advanced ovarian carcinoma to improve long-term survival and cure rates.

PMID:38100616 | DOI:10.1002/cncr.35135

Res Synth Methods. 2023 Dec 15. doi: 10.1002/jrsm.1693. Online ahead of print.

ABSTRACT

The trace plot is seldom used in meta-analysis, yet it is a very informative plot. In this article, we define and illustrate what the trace plot is, and discuss why it is important. The Bayesian version of the plot combines the posterior density of $\tau$ , the between-study standard deviation, and the shrunken estimates of the study effects as a function of $\tau$ . With a small or moderate number of studies, $\tau$ is not estimated with much precision, and parameter estimates and shrunken study effect estimates can vary widely depending on the correct value of $\tau$ . The trace plot allows visualization of the sensitivity to $\tau$ along with a plot that shows which values of $\tau$ are plausible and which are implausible. A comparable frequentist or empirical Bayes version provides similar results. The concepts are illustrated using examples in meta-analysis and meta-regression; implementation in R is facilitated in a Bayesian or frequentist framework using the bayesmeta and metafor packages, respectively.

PMID:38100240 | DOI:10.1002/jrsm.1693

Child Care Health Dev. 2023 Dec 15. doi: 10.1111/cch.13216. Online ahead of print.

ABSTRACT

INTRODUCTION: Developmental coordination disorder (DCD) is a neurodevelopmental disorder that affects children’s occupational performance and participation. It is known that the Covid pandemic has adversely affected the whole world in many areas. We aim to investigate the occupational performance and participation of children with DCD before and during the COVID-19.

METHODS: Sixty-five children aged 5-12 years included in the study were assessed by the Canadian Measure of Occupational Performance and the Participation and Environment Measure for Children and Youth.

RESULTS: Statistically significant differences were detected in occupational performance and satisfaction scores (p < 0.01). Additionally, except for ‘involvement in the home environment’ (p > 0.05), there were statistically significant differences in all other areas of participation (p < 0.01).

CONCLUSION: The occupational performance and participation of children with DCD are impacted during COVID-19. In addition, it is seen that the desire of families to change regarding participation has increased due to COVID-19. It would be beneficial to include strategies to improve these areas in the rehabilitation processes.

PMID:38100218 | DOI:10.1111/cch.13216

J Cosmet Dermatol. 2023 Dec 15. doi: 10.1111/jocd.16126. Online ahead of print.

ABSTRACT

PURPOSE: To determine the changes in the lower eyelid position, following ptosis surgery of the upper eyelid of the same eye in blepharoptosis patients.

METHODS: This prospective interventional before and after study included patients aged more than 5 years with blepharoptosis. Margin reflex distance one (MRD-1), MRD two (MRD-2), and levator function were measured before and the 6 months after the surgery.

RESULTS: Sixty patients with blepharoptosis (33 congenital and 27 acquired) were recruited. The mean age was 21.61 ± 10.82 and 59.8 ± 13.73 years in congenital and acquired groups, respectively. The mean MRD-1 improved from 1.95 ± 0.99 before treatment to 4.47 ± 0.47 after treatment (p < 0.001). The mean MRD-2 improved from 5.57 ± 0.63 before treatment to 4.95 ± 0.51 after treatment (p < 0.001). There was no statistically significant difference in MRD-1 and MRD-2 changes between the two groups (p > 0.05) There was no statistically significant correlation between MRD-2 changes and LF (r = -0.03. p = 0.83).

CONCLUSION: Present study showed a significant improvement in the condition of the lower eyelid improved after upper eyelid ptosis surgery.

PMID:38100212 | DOI:10.1111/jocd.16126

Trop Med Int Health. 2023 Dec 15. doi: 10.1111/tmi.13961. Online ahead of print.

ABSTRACT

OBJECTIVES: Despite declining TB notifications in Southern Africa, TB-related deaths remain high. We describe patient- and population-level trends in TB-related deaths in Eswatini over a period of 11 years.

METHODS: Patient-level (retrospective cohort, from 2009 to 2019) and population-level (ecological analysis, 2009-2017) predictors and rates of TB-related deaths were analysed in HIV-negative and HIV-coinfected first-line TB treatment cases and the population of the Shiselweni region. Patient-level TB treatment data, and population and HIV prevalence estimates were combined to obtain stratified annual mortality rates. Multivariable Poisson regressions models were fitted to identify patient-level and population-level predictors of deaths.

RESULTS: Of 11,883 TB treatment cases, 1302 (11.0%) patients died during treatment: 210/2798 (7.5%) HIV-negative patients, 984/8443 (11.7%) people living with HIV (PLHIV), and 108/642 (16.8%) patients with unknown HIV-status. The treatment case fatality ratio remained above 10% in most years. At patient-level, fatality risk was higher in PLHIV (aRR 1.74, 1.51-2.02), and for older age and extra-pulmonary TB irrespective of HIV-status. For PLHIV, fatality risk was higher for TB retreatment cases (aRR 1.38, 1.18-1.61) and patients without antiretroviral therapy (aRR 1.70, 1.47-1.97). It decreases with increasing higher CD4 strata and the programmatic availability of TB-LAM testing (aRR 0.65, 0.35-0.90). At population-level, mortality rates decreased 6.4-fold (-147/100,000 population) between 2009 (174/100,000) and 2017 (27/100,000), coinciding with a decline in TB treatment cases (2785 in 2009 to 497 in 2017). Although the absolute decline in mortality rates was most pronounced in PLHIV (-826/100,000 vs. HIV-negative: -23/100,000), the relative population-level mortality risk remained higher in PLHIV (aRR 4.68, 3.25-6.72) compared to the HIV-negative population.

CONCLUSIONS: TB-related mortality rapidly decreased at population-level and most pronounced in PLHIV. However, case fatality among TB treatment cases remained high. Further strategies to reduce active TB disease and introduce improved TB therapies are warranted.

PMID:38100203 | DOI:10.1111/tmi.13961

J Med Internet Res. 2023 Dec 15;25:e44599. doi: 10.2196/44599.

ABSTRACT

BACKGROUND: Loyalty card data automatically collected by retailers provide an excellent source for evaluating health-related purchase behavior of customers. The data comprise information on every grocery purchase, including expenditures on product groups and the time of purchase for each customer. Such data where customers have an expenditure value for every product group for each time can be formulated as 3D tensorial data.

OBJECTIVE: This study aimed to use the modern tensorial principal component analysis (PCA) method to uncover the characteristics of health-related purchase patterns from loyalty card data. Another aim was to identify card holders with distinct purchase patterns. We also considered the interpretation, advantages, and challenges of tensorial PCA compared with standard PCA.

METHODS: Loyalty card program members from the largest retailer in Finland were invited to participate in this study. Our LoCard data consist of the purchases of 7251 card holders who consented to the use of their data from the year 2016. The purchases were reclassified into 55 product groups and aggregated across 52 weeks. The data were then analyzed using tensorial PCA, allowing us to effectively reduce the time and product group-wise dimensions simultaneously. The augmentation method was used for selecting the suitable number of principal components for the analysis.

RESULTS: Using tensorial PCA, we were able to systematically search for typical food purchasing patterns across time and product groups as well as detect different purchasing behaviors across groups of card holders. For example, we identified customers who purchased large amounts of meat products and separated them further into groups based on time profiles, that is, customers whose purchases of meat remained stable, increased, or decreased throughout the year or varied between seasons of the year.

CONCLUSIONS: Using tensorial PCA, we can effectively examine customers’ purchasing behavior in more detail than with traditional methods because it can handle time and product group dimensions simultaneously. When interpreting the results, both time and product dimensions must be considered. In further analyses, these time and product groups can be directly associated with additional consumer characteristics such as socioeconomic and demographic predictors of dietary patterns. In addition, they can be linked to external factors that impact grocery purchases such as inflation and unexpected pandemics. This enables us to identify what types of people have specific purchasing patterns, which can help in the development of ways in which consumers can be steered toward making healthier food choices.

PMID:38100168 | DOI:10.2196/44599

Aliment Pharmacol Ther. 2023 Dec 15. doi: 10.1111/apt.17835. Online ahead of print.

ABSTRACT

BACKGROUND: Nutri-score is now widely available in food packages in Europe.

AIM: To study the overall nutritional quality of the diet in relation to risks of Crohn’s disease (CD) and ulcerative colitis (UC), in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort METHODS: We collected dietary data at baseline from validated food frequency questionnaires. We used a dietary index based on the UK Food Standards Agency modified nutrient profiling system (FSAm-NPS-DI) underlying the Nutri-Score label, to measure the nutritional quality of the diet. We estimated the association between FSAm-NPS-DI score, and CD and UC risks using Cox models stratified by centre, sex and age; and adjusted for smoking status, BMI, physical activity, energy intake, educational level and alcohol intake.

RESULTS: We included 394,255 participants (68.1% women; mean age at recruitment 52.1 years). After a mean follow-up of 13.6 years, there were 184 incident cases of CD and 459 incident cases of UC. Risk of CD was higher in those with a lower nutritional quality, that is higher FSAm-NPS-DI Score (fourth vs. first quartile: aHR: 2.04, 95% CI: 1.24-3.36; p-trend: <0.01). Among items of the FSAm-NPS-DI Score, low intakes of dietary fibre and fruits/vegetables/legumes/nuts were associated with higher risk of CD. Nutritional quality was not associated with risk of UC (fourth vs. first quartile of the FSAm-NPS-DI Score: aHR: 0.91, 95% CI: 0.69-1.21; p-trend: 0.76).

CONCLUSIONS: A diet with low nutritional quality as measured by the FSAm-NPS-DI Score is associated with a higher risk of CD but not UC.

PMID:38100159 | DOI:10.1111/apt.17835

Vet Med Sci. 2023 Dec 15. doi: 10.1002/vms3.1335. Online ahead of print.

ABSTRACT

BACKGROUND: Cheese is a popular dairy product consumed worldwide, and it has been implicated as a source of Coxiella burnetii infections.

OBJECTIVES: The present study aimed to describe the molecular prevalence and source analysis of C. burnetii in cheese samples.

METHODS: A systematic literature search was conducted using the Medline/PubMed, Science Direct, Web of Science, Scopus, and Google Scholar databases to identify studies reporting the molecular prevalence of C. burnetii in cheese samples. The pooled prevalence of C. burnetii in cheese samples was estimated using a random-effects model.

RESULTS: A meta-analysis was conducted using the mean and standard deviation values obtained from 13 original studies. The overall molecular prevalence of C. burnetii in cheese was estimated to be 25.2% (95% confidence interval [CI]: 13.1%-39.7%). The I² value of 96.3% (CI_95% 94.9-97.3) suggested high heterogeneity, with a τ² of 0.642 (CI_95% -0.141 to 0.881), and an χ² statistic of 323.77 (p < 0.0001).

CONCLUSIONS: In conclusion, our meta-analysis provides a thorough assessment of the molecular prevalence and source analysis of C. burnetii in cheese samples.

PMID:38100127 | DOI:10.1002/vms3.1335

Emerg Med Australas. 2023 Dec 15. doi: 10.1111/1742-6723.14360. Online ahead of print.

ABSTRACT

OBJECTIVE: Moderate risk patients with chest pain and no previously diagnosed coronary artery disease (CAD) who present to ED require further risk stratification. We hypothesise that management of these patients by ED physicians can decrease length of stay (LOS), without increasing patient harm.

METHODS: A prospective pilot study with comparison to a pre-intervention control group was performed on patients presenting with chest pain to an ED in Perth, Australia between May and October 2021, following the introduction of a streamlined guideline consisting of ED led decision making and early follow up. Patients had no documented CAD and were at moderate risk of major adverse cardiac events (MACE). Electronic data was used for comparison. Primary outcomes were total LOS and LOS following troponin.

RESULTS: One hundred eighty-six patients were included. Median total LOS was reduced by 62 min, but this change was not statistically significant (482 [360-795] vs 420 [360-525] min, P = 0.06). However, a significant 60 min decrease in LOS was found following the final troponin (240 (120-571) vs 180 (135-270) min, P = 0.02). There was no difference in the rate of MACE (0% vs 2%, P = 0.50), with no myocardial infarction or death.

CONCLUSIONS: Our study suggests that patients with no pre-existing CAD can be safely managed by emergency physicians streamlining their ED management and decreasing LOS. This pathway could be used in other centres following confirmation of the results by a larger study.

PMID:38100118 | DOI:10.1111/1742-6723.14360