Tag: statistics

J Acoust Soc Am. 2023 May 1;153(5):2690. doi: 10.1121/10.0017888.

ABSTRACT

Localization and tracking of marine animals can reveal key insights into their behaviors underwater that would otherwise remain unexplored. A promising nonintrusive approach to obtaining location information of marine animals is to process their bioacoustic signals, which are passively recorded using multiple hydrophones. In this paper, a data processing chain that automatically detects and tracks multiple odontocetes (toothed whales) in three dimensions (3-D) from their echolocation clicks recorded with volumetric hydrophone arrays is proposed. First, the time-difference-of-arrival (TDOA) measurements are extracted with a generalized cross-correlation that whitens the received acoustic signals based on the instrument noise statistics. Subsequently, odontocetes are tracked in the TDOA domain using a graph-based multi-target tracking (MTT) method to reject false TDOA measurements and close gaps of missed detections. The resulting TDOA estimates are then used by another graph-based MTT stage that estimates odontocete tracks in 3-D. The tracking capability of the proposed data processing chain is demonstrated on real acoustic data provided by two volumetric hydrophone arrays that recorded echolocation clicks from Cuvier’s beaked whales (Ziphius cavirostris). Simulation results show that the presented MTT method using 3-D can outperform an existing approach that relies on manual annotation.

PMID:37129673 | DOI:10.1121/10.0017888

JAMA. 2023 May 2;329(17):1460-1468. doi: 10.1001/jama.2023.5302.

ABSTRACT

IMPORTANCE: Implantation failure remains a critical barrier to in vitro fertilization. Prednisone, as an immune-regulatory agent, is widely used to improve the probability of implantation and pregnancy, although the evidence for efficacy is inadequate.

OBJECTIVE: To determine the efficacy of 10 mg of prednisone compared with placebo on live birth among women with recurrent implantation failure.

DESIGN, SETTING, AND PARTICIPANTS: A double-blind, placebo-controlled, randomized clinical trial conducted at 8 fertility centers in China. Eligible women who had a history of 2 or more unsuccessful embryo transfer cycles, were younger than 38 years when oocytes were retrieved, and were planning to undergo frozen-thawed embryo transfer with the availability of good-quality embryos were enrolled from November 2018 to August 2020 (final follow-up August 2021).

INTERVENTIONS: Participants were randomized (1:1) to receive oral pills containing either 10 mg of prednisone (n = 357) or matching placebo (n = 358) once daily, from the day at which they started endometrial preparation for frozen-thawed embryo transfer through early pregnancy.

MAIN OUTCOMES AND MEASURES: The primary outcome was live birth, defined as the delivery of any number of neonates born at 28 or more weeks’ gestation with signs of life.

RESULTS: Among 715 women randomized (mean age, 32 years), 714 (99.9%) had data available on live birth outcomes and were included in the primary analysis. Live birth occurred among 37.8% of women (135 of 357) in the prednisone group vs 38.8% of women (139 of 358) in the placebo group (absolute difference, -1.0% [95% CI, -8.1% to 6.1%]; relative ratio [RR], 0.97 [95% CI, 0.81 to 1.17]; P = .78). The rates of biochemical pregnancy loss were 17.3% in the prednisone group and 9.9% in the placebo group (absolute difference, 7.5% [95% CI, 0.6% to 14.3%]; RR, 1.75 [95% CI, 1.03 to 2.99]; P = .04). Of those in the prednisone group, preterm delivery occurred among 11.8% and of those in the placebo group, 5.5% of pregnancies (absolute difference, 6.3% [95% CI, 0.2% to 12.4%]; RR, 2.14 [95% CI, 1.00 to 4.58]; P = .04). There were no statistically significant between-group differences in the rates of biochemical pregnancy, clinical pregnancy, implantation, neonatal complications, congenital anomalies, other adverse events, or mean birthweights.

CONCLUSIONS AND RELEVANCE: Among patients with recurrent implantation failure, treatment with prednisone did not improve live birth rate compared with placebo. Data suggested that the use of prednisone may increase the risk of preterm delivery and biochemical pregnancy loss. Our results challenge the value of prednisone use in clinical practice for the treatment of recurrent implantation failure.

TRIAL REGISTRATION: Chinese Clinical Trial Registry Identifier: ChiCTR1800018783.

PMID:37129654 | DOI:10.1001/jama.2023.5302

Ther Adv Respir Dis. 2023 Jan-Dec;17:17534666231158276. doi: 10.1177/17534666231158276.

ABSTRACT

BACKGROUND: In coronavirus disease 2019 (COVID-19) patients, elevated levels of inflammatory cytokines from over stimulation of immune cells have become a concern due to the potential outburst of cytokine storm that damages the tissues and organs, especially the lungs. This leads to the manifestation of COVID-19 symptoms, such as pneumonia, acute respiratory distress syndrome (ARDS), multiple organ failure, and eventually death. Mesenchymal stromal/stem cells (MSCs) are currently one of hopeful approaches in treating COVID-19 considering its anti-inflammatory and immunomodulatory functions. On that account, the number of clinical trials concerning the use of MSCs for COVID-19 has been increasing. However, the number of systematic reviews and meta-analysis that specifically discuss its potential as treatment for the disease is still lacking. Therefore, this review will assess the safety and efficacy of MSC administration in COVID-19 patients.

OBJECTIVES: To pool evidence on the safety and efficacy of MSCs in treating COVID-19 by observing MSC-related adverse effects as well as evaluating its effects in reducing inflammatory response and improving pulmonary function.

DATA SOURCES AND METHODS: Following literature search across six databases and one trial register, full-text retrieval, and screening against eligibility criteria, only eight studies were included for data extraction. All eight studies evaluated the use of umbilical cord-derived mesenchymal stromal/stem cell (UC-MSC), infused intravenously. Of these eight studies, six studies were included in meta-analysis on the incidence of mortality, adverse events (AEs), and serious adverse events (SAEs), and the levels of C-reactive protein (CRP) and interleukin (IL)-6. Meta-analysis on pulmonary function was not performed due to insufficient data.

RESULTS: MSC-treated group showed significantly lower risk of mortality than the control group (p = 0.03). No statistical significance was observed on the incidence of AEs (p = 0.78) and SAEs (p = 0.44), and the levels of CRP (p = 0.06) and IL-6 (p = 0.09).

CONCLUSION: MSCs were safe for use, with lower risk of mortality and no association with AEs. Regarding efficacy, descriptive analysis showed indications of improvement on the inflammatory reaction, lung clearance, and oxygenation status despite the lack of statistical significance in meta-analysis of CRP and IL-6. Nevertheless, more studies are needed for affirmation.

REGISTRATION: This systematic review and meta-analysis was registered on the PROSPERO database (no. CRD42022307730).

PMID:37128999 | DOI:10.1177/17534666231158276

Nurs Open. 2023 May 2. doi: 10.1002/nop2.1769. Online ahead of print.

ABSTRACT

AIM: To examine registered nurses’ individual strengths (psychological capital and grit) and an organizational resource (organizational justice) as well as associated work-related outcomes. In a time of a global nursing shortage, there is an urgent need to identify strengths and resources that can have a positive impact on the health, well-being and retention of registered nurses.

DESIGN: A cross-sectional survey.

METHODS: A nationwide convenience sample of 514 registered nurses responded to a survey. Data were collected using a self-reported questionnaire between March and May 2018. Data were analysed using descriptive statistics and multivariate path analysis.

RESULTS: Participants rated their psychological capital and grit moderately high. Grit and organizational justice were found to have significant direct effects on psychological capital. Furthermore, psychological capital had positive direct effects on engagement and the perception of well-conducted everyday nursing as well as negative direct effects on burnout, the stress of conscience and the intent to leave the profession.

CONCLUSION: The results suggest that nurse leaders and managers could consider improving registered nurses’ well-being with two complementary approaches. It might be useful to reinforce positive, individual strengths, such as psychological capital, and at the same time create more favourable nursing work environments, for example by strengthening organizational justice.

IMPLICATIONS FOR THE PROFESSION: Psychological capital and grit are emerging concepts in nursing workforce research. Identifying registered nurses’ positive strengths and resources is important for inventing interventions that enhance nurses’ engagement and well-being as well as reduce turnover intentions.

IMPACT: Nurse leaders and managers play crucial roles in managing and developing registered nurses’ individual strengths and organizational resources. This has gained even more importance now as the COVID-19 pandemic could have a long-term negative impact on nurses’ well-being.

REPORTING METHOD: The study is reported following STROBE guidelines.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:37128977 | DOI:10.1002/nop2.1769

Worldviews Evid Based Nurs. 2023 May 2. doi: 10.1111/wvn.12649. Online ahead of print.

ABSTRACT

BACKGROUND: With the increase in life expectancy around the globe, the incidence of postoperative delirium (POD) among older people (≥65 years) is growing. Previous studies showed a wide variation in the incidence of POD, from 4% to 53%, with a lack of specific evidence about the incidence of POD by specific surgery type among older people. The aim of this systematic review and meta-analysis was to determine the incidence of POD by surgery type within populations 65 years and over.

METHODS: Databases including PubMed, Cochrane library, Embase, and CINAHL were searched until October 2020. Due to the relatively higher number of meta-analyses undertaken in this area of research, a streamlined systematic meta-analysis was proposed.

RESULTS: A total of 28 meta-analyses (comprising 284 individual studies) were reviewed. Data from relevant individual studies (n = 90) were extracted and included in the current study. Studies were grouped into eight surgery types and the incidence of POD for orthopedic, vascular, spinal, cardiac, colorectal, abdominal, urologic, and mixed surgeries was 20%, 14%, 13%, 32%, 14%, 30%, 10%, and 26%, respectively. POD detection instruments were different across the studies, with Confusion Assessment Method (CAM & CAM-ICU) being the most frequently adopted.

LINKING EVIDENCE TO ACTION: This study showed that POD incidence in older people undergoing surgery varied widely across surgery type. The more complex surgeries like cardiac and abdominal surgeries were associated with a higher risk of POD. This highlights the need to include the level of surgery complexity as a risk factor in preoperative assessments.

PMID:37128953 | DOI:10.1111/wvn.12649

Int Health. 2023 May 2:ihad030. doi: 10.1093/inthealth/ihad030. Online ahead of print.

ABSTRACT

BACKGROUND: The desire to have children among mothers living with HIV remains a serious public health issue in nations with low coverage for antiretroviral therapy and the prevention of mother-to-child transmission, even if it is feasible to have an HIV-negative child. Therefore, this study aimed to assess fertility desire and associated factors among antiretroviral therapy-attending HIV-positive women at Hiwot Fana Specialized University Hospital, in Harari, Ethiopia.

METHODS: A facility-based cross-sectional study design was employed among 639 anti retro-viral therapy attending HIV – positive women by systematic random sampling method selected from June 15 to November 30, 2020. A binary logistic regression model was fitted to identify the associated factors with fertility desire. Descriptive results were presented in percentages, whereas analytical results were reported in adjusted ORs (AORs) with a 95% CI. At p=0.05, statistical significance was declared.

RESULTS: A total of 639 participants were included in the study; 69.5%(95% CI 65.7 to 72.9%) of the participants had fertility desire. Younger age (<35 years) (AOR=2.35, 95% CI 1.27 to 4.35), married women (AOR=3.02, 95% CI 1.32 to 12.25), childless women (AOR=2.86, 95% CI 1.17 to 4.82) and women whose duration of HIV diagnosis was ≤5 years (AOR=0.41, 95% CI 0.20 to 0.71) were significantly associated with fertility desire.

CONCLUSION: The majority of the study participants have a desire to have children. In light of the high prevalence of fertility desire among antiretroviral therapy-attending HIV-positive women, it is recommended to counsel younger women on reproductive planning and encourage partner testing.

PMID:37128936 | DOI:10.1093/inthealth/ihad030

Hand (N Y). 2023 May 2:15589447231167883. doi: 10.1177/15589447231167883. Online ahead of print.

ABSTRACT

BACKGROUND: Scapho-lunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) of the wrist are the most common types of wrist arthritis. We compared the union rate and complication profile of patients with SLAC and SNAC wrist undergoing 4 corner arthrodesis with partially threaded or fully threaded headless compression screws.

METHODS: A single-center retrospective review was conducted to identify all patients treated for SLAC and SNAC with 4 corner fusion using headless compression screws from 2016 to 2021. A total of 33 patients undergoing surgery on 35 wrists were identified and included in the study. Demographics, comorbidities, complication profile, and radiographs were collected and compared between groups.

RESULTS: One hundred percent (16/16) of partially threaded and 84.2% (16/19) of fully threaded screws demonstrated union by minimum 10-week follow-up. The total complication rate (avascular necrosis of lunate, screw loosening, etc.) was 31.4%; 52.6% of wrists implanted with fully threaded screws experienced complications compared with a 6.3% complication rate with partially threaded screws. The difference was statistically significant between the 2 groups (P = .004).

CONCLUSIONS: Four corner arthrodesis using antegrade compression screws is an effective, reproducible method to achieve fusion in the wrist. The use of fully threaded screws was associated with more complications than with partially threaded screws, although union rate was not significantly different. Future studies with larger sample sizes would be useful to fully elucidate differences between these 2 constructs.

PMID:37128854 | DOI:10.1177/15589447231167883

Int J Gynaecol Obstet. 2023 May 2. doi: 10.1002/ijgo.14820. Online ahead of print.

ABSTRACT

OBJECTIVE: The authors aimed to use a large two-sample Mendelian randomization (MR) study to reveal the causality between age at menarche (AAM) and polycystic ovary syndrome (PCOS) incidence.

METHODS: The authors collected summary statistics from the hitherto largest genome-wide association studies conducted in AAM and PCOS in the same ancestry. MR with inverse variance weighting was conducted as the main analysis method, while weighted median and MR-Egger regression were used for comprehensive analysis. As for pleiotropy detection, inverse variance weighting, MR-Egger regression, Mendelian Randomization Pleiotropy Residual Sum and Outlier, as well as leave-one-out analysis were used to detect pleiotropy. Risk factor analysis was conducted to investigate the underlying mechanisms linking AAM to PCOS.

RESULTS: Each standard deviation increment in AAM was associated with a significantly lower incidence of PCOS (odds ratio, 0.86 [95% confidence interval, 0.75-0.98]). After adjustment in horizontal pleiotropy by eliminating four outliers, this pathogenic association was still statistically detected. All pleiotropy indexes were without statistical differences, which suggested the conclusions were robust. It showed the causal association between later AAM and lower body mass index, lower fasting insulin level and insulin resistance.

CONCLUSION: Our MR analysis verified that a slightly later onset age (15 to 18 years) at menarche could reduce the risk of PCOS. A more comprehensive investigation in a prospective setting is strongly advised.

PMID:37128830 | DOI:10.1002/ijgo.14820

Arthritis Care Res (Hoboken). 2023 May 2. doi: 10.1002/acr.25139. Online ahead of print.

ABSTRACT

OBJECTIVE: Some people with systemic sclerosis (SSc) report positive mental health, despite severe disease manifestations, which may be associated with resilience, but no resilience measure has been validated in SSc. We assessed validity, reliability, and differential item functioning (DIF) between English- and French-language versions of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in SSc.

METHODS: Eligible participants were enrolled in the Scleroderma Patient-centered Intervention Network Cohort and completed the CD-RISC-10 between August 2022 and January 2023. We used Confirmatory factor analysis (CFA) to evaluate the CD-RISC-10 factor structure and conducted DIF analysis across languages with Multiple-Indicator Multiple-Cause models. We tested convergent validity with another measure of resilience and measures of self-esteem and depression and anxiety symptoms. We assessed internal consistency and test-retest reliability using Cronbach’s alpha and intraclass correlation coefficient (ICC).

RESULTS: We included 962 participants. CFA supported a single-factor structure (Tucker Lewis Index = 0.99, Comparative Fit Index = 0.99, Root Mean Square Error of Approximation = 0.08, 90% confidence interval 0.07 to 0.09). We found no meaningful DIF. Internal consistency was high (α =0.93, 95% confidence interval 0.92 to 0.94), and we found correlations with other measures of psychological functioning were moderate to large (|r| = 0.57 to 0.78) and confirmed study hypotheses. The scale showed good 1-2 week test-retest reliability (ICC = 0.80, 95% confidence interval 0.75 to 0.85) in a subsample of 230 participants.

CONCLUSION: The CD-RISC-10 is a valid and reliable measure of resilience in SSc with score comparability across English and French versions. This article is protected by copyright. All rights reserved.

PMID:37128826 | DOI:10.1002/acr.25139

J Cosmet Dermatol. 2023 May 2. doi: 10.1111/jocd.15747. Online ahead of print.

ABSTRACT

BACKGROUND: Since there is currently no conclusion on the efficacy and adverse effects of oxymetazoline, this meta-analysis attempts to explore its efficacy and adverse events, so as to provide guidance for clinical medication.

METHODS: We searched PubMed, Embase, and Cochrane Library from the establishment of the database to May 2021. We included studies that patients were randomly assigned to receive oxymetazoline or vehicle, and we excluded duplicate publications, research without full text, incomplete information or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.

RESULTS: The pooled results show that the 3 (RR = 1.76, 95% CI: 1.53-2.03), 6 (RR = 1.71, 95% CI: 1.47-2.00), 9 (RR = 1.63, 95% CI: 1.40-1.90), 12 (RR = 1.41, 95% CI: 1.18-1.67) -hours CEA success rate and the 3 (RR = 1.65, 95% CI: 1.34-2.03), 6 (RR = 1.75, 95% CI: 1.43-2.14), 9 (RR = 1.63, 95% CI: 1.33-2.00), 12 (RR = 1.78, 95% CI: 1.45-2.18) -hours SSA success rate after oxymetazoline treatment for rosacea is significantly higher than that of vehicle. Additionally, the pooled results show that the incidence of TEAEs after treatment with oxymetazoline is significantly higher than that of vehicle (RR = 1.34, 95% CI: 1.10-1.2). However, our analysis of specific adverse events found that the oxymetazoline group was only significantly higher than the vehicle group in the incidence of application-site dermatitis (RR = 8.91, 95% CI: 1.76-45.23), and there was no statistical significance in the difference in the incidence of other adverse events.

CONCLUSION: Oxymetazoline is effective and can be selected for the treatment of persistent facial erythema of rosacea. Additionally, application-site dermatitis was the most important one.

PMID:37128814 | DOI:10.1111/jocd.15747