Tag: statistics

Dermatology. 2023 Mar 21. doi: 10.1159/000530121. Online ahead of print.

ABSTRACT

BACKGROUND: Pemphigus vulgaris is a life-threatening autoimmune bullous disease characterized by flaccid blister formation. As there has been no macroscopic assessment of epidemiological characteristics, its disease burden in the general population remains unknown.

OBJECTIVES: To assess the global incidence rate of pemphigus vulgaris in the general population.

METHODS: The search was conducted in databases including Medline, Embase, Web of Science, and The Cochrane Library from inception to May 1st, 2022. We included original studies that either reported incidence of pemphigus vulgaris or provided raw data for calculating. Studies based on a specific population instead of the general population were excluded. Individual studies were summarized using random-effects mode. The pooled incidence rate of pemphigus vulgaris among the general population and subgroups were obtained. Heterogeneity (I2 statistic) was assessed with the χ2 test on Cochrane’s Q statistic.

RESULTS: 29 studies were eligible for final analysis and the pooled incidence rate of pemphigus vulgaris was 2.83 per million person-years (95%CI, 2.14-3.61). The incidence rate was similar between men and women and remained stable in the past half-century. Southern Asia showed the highest rate among subcontinents that had more than one study conducted as 4.94 per million person-years (95%CI, 2.55-8.10). Economic levels do not seem to have any bearing on incidence.

CONCLUSIONS: Despite the substantial heterogeneity among studies, this meta-analysis revealed the worldwide incidence rate of pemphigus vulgaris for the first time and may assist in assessing global disease burden and promoting health policy.

PMID:36944327 | DOI:10.1159/000530121

Urol Int. 2023 Mar 21:1-6. doi: 10.1159/000529688. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of the study was to investigate the effect of the diameter of the ureteral access sheath (UAS) used during RIRS on kidney injury based on acute kidney injury (AKI) biomarkers.

METHODS: This prospectively randomized controlled study included a total of 125 patients divided into three groups: group 1 (n = 52) in which a 12/14 Fr UAS was used, group 2 (n = 52) in which a 9.5/11.5 Fr UAS was used, and group 3 (n = 21) that was designed as the control group with no urogenital disease history. Urine samples were collected preoperatively and at the postoperative second and 24th hours after surgery and analyzed for AKI using the urinary kidney injury molecule-1 (uKIM-1), N-acetyl-ß-D-glucosaminidase, and neutrophil gelatinase-associated lipocain biomarkers.

RESULTS: In group 1, there was no statistical change in any of the three AKI biomarkers at the postoperative second or 24th hour compared to the preoperative period. In group 2, the values of all three AKI biomarkers were statistically significantly increased at the postoperative second and 24th hours compared to the preoperative period while no statistical difference was observed between the two postoperative evaluation times. At the postoperative second hour, the uKIM-1 value was statistically significantly higher in group 2 compared to group 1 (p = 0.043).

CONCLUSIONS: The results of our study showed that AKI was not observed in RIRS performed with a 12/14 Fr UAS while the use of a 9.5/11.5 Fr UAS resulted in AKI according to the assessment of the related biomarkers.

PMID:36944319 | DOI:10.1159/000529688

J Biomech. 2023 Mar 17;151:111548. doi: 10.1016/j.jbiomech.2023.111548. Online ahead of print.

ABSTRACT

Measuring and predicting accurate joint angles are important to developing analytical tools to gauge users’ progress. Such measurement is usually performed in laboratory settings, which is difficult and expensive. So, the aim of this study was continuous estimation of lower limb joint angles during walking using an accelerometer and random forest (RF). Thus, 73 subjects (26 women and 47 men) voluntarily participated in this study. The subjects walked at the slow, moderate, and fast speeds on a walkway, which was covered with 10 Vicon camera. Acceleration was used as input for a RF to estimate ankle, knee, and hip angles (in transverse, frontal, and sagittal planes). Pearson correlation coefficient (r) and Mean Square Error (MSE) were computed between the experimental and estimated data. Paired statistical parametric mapping (SPM) t-test was used to compare the experimental and estimated data throughout gait cycle. The results of this study showed that the MSE of joint angles between the experimental and estimated data ranged from 0.04 to 24.29 and r > 0.91. Moreover, the findings of SPM indicated that there was no significant difference between the experimental and estimated data of ankle, knee, and hip angles in all three planes throughout gait cycle. The results of our research developed a more accessible, portable procedure to quantifying lower limb joint angles by an accelerometer and RF. So, such wearable-based joint angles have the potential to be used in outside-laboratory settings to measure walking kinematics.

PMID:36944294 | DOI:10.1016/j.jbiomech.2023.111548

Clin Nutr. 2023 Mar 14;42(5):670-686. doi: 10.1016/j.clnu.2023.03.009. Online ahead of print.

ABSTRACT

BACKGROUND: The growing incidence of cancer globally, and the importance of nutrition support for these patients, emphasize the need for the development of nutritional clinical practice guidelines and consensus papers (CPGs) in the field. Numerous relevant CPGs have been published by several organizations worldwide. The aim of this systematic review was to compare the content of the existing CPGs and evaluate the quality of their development using the AGREE-II tool.

METHODS: A systematic literature search in PubMed, Embase and Web of Science databases was conducted for the identification of relevant CPGs and consensus papers. Eligible CPGs was blindly evaluated by four appraisers according to the Appraisal of Guidelines for Research and Evaluation ΙΙ (AGREE-II) tool.

RESULTS: In total 15 CPGs were identified and were evaluated. All but one set of CPGs underlined the importance of nutritional screening and assessment, whereas recommendations on nutritional interventions, supplements, management of complications and nutritional follow-up were also reported by several organizations. AGREE-II results showed that two CPGs were characterized as high, eight as moderate and five as low regarding their quality of development.

CONCLUSIONS: Variety on recommendations could be observed between CPGs that should be considered when applied into clinical practice. Limitations of the existing CPGs could be the fact that they are non-specific and only a minority of them are focused to specific cancer types. Frequent updates for CPGs and inclusion of more nutritional topics should be considered for some CPGs. Improvement of the quality of the CPGs development should also be pursued in future.

PMID:36944289 | DOI:10.1016/j.clnu.2023.03.009

Adv Med Sci. 2023 Mar 19;68(1):138-146. doi: 10.1016/j.advms.2023.02.005. Online ahead of print.

ABSTRACT

PURPOSE: Multimodal treatment is the standard of care in patients with locally advanced gastric cancer. Unfortunately, the response rate after neoadjuvant treatment remains limited. The ability to predict the response has a potential to improve patient outcomes by promoting a more individualized approach. We sought to describe the current state of research in pre-treatment molecular biomarkers of response to neoadjuvant therapy in gastric adenocarcinoma available for testing before the initiation of treatment and to perform a systematic review and meta-analysis in order to summarize and evaluate the potential methods.

METHODS: A systematic MEDLINE, EMBASE and CENTRAL literature search was conducted to extract articles on potentially predictive molecular biomarkers of pathological response to neoadjuvant therapy in patients with gastric- and esophago-gastric junction adenocarcinoma. Fixed and random effects models were used to undertake the meta-analysis when appropriate.

RESULTS: Data on predictive biomarkers was reported in 38 studies. These articles described 47 biomarkers showing statistical significance. After evaluation of all reported biomarkers, 3 of them met the inclusion criteria for meta-analysis. The meta-analysis results indicate that >5 ​ng/mL pre-therapeutic serum concentration of carcinoembryonic antigen (CEA; norm <5 ​ng/mL) is significantly associated with tumor response (RR ​= ​5.13, 95% CI 2.53-10.43, P ​= ​0.026).

CONCLUSION: Previous studies describe a large number of candidate biomarkers. Our meta-analysis indicated pre-therapeutic serum concentration of CEA >5 ​ng/mL as a potential and easy-accessible biomarker available for use before initiation of treatment. However, it could be only an additional tool for complex qualification for neoadjuvant therapy.

PMID:36944288 | DOI:10.1016/j.advms.2023.02.005

Comput Methods Programs Biomed. 2023 Jan 18;233:107360. doi: 10.1016/j.cmpb.2023.107360. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: The aim of this study is to solve the non-stationarity and complexity characteristics and huge individual differences in the electroencephalogram (EEG) signals for depression classification.

METHODS: To address those problems, the Lempel-Ziv complexity feature matrices were extracted from the EEG signals under the two paradigms of eyes open and eyes closed in the resting state. Topographical map of brain and statistical analysis were introduced to investigate the significance of eyes open and eyes closed EEG for depression classification. To promote the classification accuracy, feature matrices from the two paradigms were fused. And linear combination and concatenation fusion methods were proposed to further reveal the underlying mechanism of improving classification accuracy. Support vector machine (SVM), K-nearest neighbor, and decision tree classifiers were employed and compared to classify depression under the eyes open, eyes closed and fused paradigm.

RESULTS: The classification results of 10-fold cross-validation showed that the highest average accuracy (86.58%) under a single paradigm was achieved in the eyes-open state. The multiparadigm fusion method of concatenation was better than the linear combination. The best classification result was obtained using multiparadigm feature concatenation under the SVM classifier, yielding an accuracy of 94.03%.

CONCLUSION: The multiparadigm feature fusion method proposed in this paper can effectively improve the accuracy of depression classification. It was proved that eyes open and eyes closed EEG have complementary information, which was benefit for the cross-subject classification of depression. It provides new ideas for depression classification in clinics.

PMID:36944276 | DOI:10.1016/j.cmpb.2023.107360

Eur J Oncol Nurs. 2023 Feb 10;64:102277. doi: 10.1016/j.ejon.2023.102277. Online ahead of print.

ABSTRACT

PURPOSE: Cross-cultural competence of healthcare providers is crucial to create a culturally safe environment. Cancer poses special challenges to cross-culturally competent communication and decision-making. Yet, no research synthesis on cross-cultural competence interventions has focused specifically on oncology.

METHODS: We conducted a meta-analysis and qualitative review of literature on the effectiveness of cross-cultural competence interventions in oncology. No limitations were placed on publication date, language, oncology setting, or geographic region. Of 1.565 citations identified, 15 articles met the inclusion criteria. Information on study design, samples, measured outcomes, and effectiveness statistics were coded. Average weighted effects were calculated applying meta-analysis methodology.

RESULTS: Studies were published between 2000 and 2020; more than half in the last seven years; two thirds in the USA. Overall study quality was at a low to moderate level, notably only one study provided a control-group-design. In sum, nurses constituted the largest occupational group among participants. Results of the meta-analysis indicate that cross-cultural competence interventions have differential effects. While the overall effect of cross-cultural competence interventions was not statistically significant, results showed that the cross-cultural competence dimensions of knowledge and behavior did improve. Effects beyond that remain unclear.

CONCLUSIONS: We provide valuable information on research gaps. The lack of studies and insufficient methodological rigor of available studies show that more research is needed to support the claim that interventions actually improve the various dimensions of cross-cultural competence in oncology. To build a stronger evidence base, it is necessary to include patient-reported outcomes and to center their experiences in future research.

PMID:36944274 | DOI:10.1016/j.ejon.2023.102277

Rheumatology (Oxford). 2023 Mar 21:kead135. doi: 10.1093/rheumatology/kead135. Online ahead of print.

ABSTRACT

OBJECTIVES: Osteoarthritis has been the subject of abundant research in the last years with limited translation to the clinical practice, probably due to the disease’s high heterogeneity. In this study, we aimed to identify different phenotypes in Knee osteoarthritis (KOA) patients with joint effusion based on their metabolic and inflammatory profiles.

METHODS: A non-supervised strategy based on Statistical and Machine Learning methods was applied to 45 parameters measured on 168 female KOA patients with persistent joint effusion, consecutively recruited at our hospital after a monographic OA outpatient visit. Data comprised anthropometric and metabolic factors and a panel of systemic and local inflammatory markers. The resulting clusters were compared regarding their clinical, radiographic and ultrasound severity at baseline and their radiographic progression at two years.

RESULTS: Our analyses identified four KOA Inflammatory Phenotypes (KOIP): a group characterized by metabolic syndrome, probably driven by body fat and obesity, and by high local and systemic inflammation (KOIP-1); a metabolically healthy phenotype with mild overall inflammation (KOIP-2); a non-metabolic phenotype with high inflammation levels (KOIP-3) and; a metabolic phenotype with low inflammation and cardiovascular risk factors not associated with obesity (KOIP-4). Of interest, these groups exhibited differences regarding pain, functional disability and radiographic progression, pointing to a clinical relevance of the uncovered phenotypes.

CONCLUSION: Our results support the existence of different KOA phenotypes with clinical relevance and differing pathways regarding their pathophysiology and disease evolution, which entails implications in patients’ stratification, treatment tailoring and the search of novel and personalized therapies.

PMID:36944271 | DOI:10.1093/rheumatology/kead135

Phys Med Biol. 2023 Mar 21. doi: 10.1088/1361-6560/acc634. Online ahead of print.

ABSTRACT

Blood pool region of interest (ROI) data extracted from the field of view of a PET scanner can be impacted by both dispersive and background effects. This circumstance compromises the ability to correctly extract the arterial input function (AIF) signal. The paper explores a novel approach to addressing this difficulty. The method involves representing the AIF in terms of the whole-body impulse response (IP) to the injection profile. Analysis of a collection/population of directly sampled arterial data sets allows the statistical behaviour of the tracer’s IP to be evaluated. It is proposed that this information be used to develop a penalty term for construction of a data-adaptive method of regularization estimator of the AIF for use when dispersive and/or background effects maybe impacting the blood pool ROI data. Computational efficiency of the approach derives from the linearity of the IP representation of the AIF and the ability to substantially rely on quadratic programming techniques for numerical implementation.&#xD;Data from eight different tracers, used in PET cancer imaging studies, are considered. Sample image-based AIF extractions for brain studies with:¹⁸F-labeled fluoro-deoxyglucose (FDG) and fluoro-thymidine (FLT),¹¹C-labeled carbon dioxide (CO2) and¹⁵O-labeled water (H2O) are presented. Results are compared to the true AIF based on direct arterial sampling. Formal numerical simulations are used to evaluate the performance of the AIF extraction method when the ROI data has varying amounts of contamination, in comparison to a direct approach that ignores such effects. It is found that even with quite small amounts of contamination, the mean squared error of the regularized AIF is significantly better than the error associated with direct use of the ROI data.&#xD;Overall the proposed IP-based AIF extraction scheme offers a promising methodological approach for cases where the input ROI data may be contaminated by background and/or dispersion effects.&#xD.

PMID:36944257 | DOI:10.1088/1361-6560/acc634

Orthop Nurs. 2023 Mar-Apr 01;42(2):105-112. doi: 10.1097/NOR.0000000000000929.

ABSTRACT

Guided imagery distracts patients from disturbing feelings and thoughts, positively affects emotional well-being, and reduces pain by producing pleasing mental images. This study aimed to determine the effects of guided imagery on postoperative pain management in patients undergoing lower extremity surgery. This randomized controlled study was conducted between April 2018 and May 2019. This study included 60 patients who underwent lower extremity surgery. After using guided imagery, the posttest mean Visual Analog Scale score of patients in the intervention group was found to be 2.56 (1.00 ± 6.00), whereas the posttest mean score of patients in the control group was 4.10 (3.00 ± 6.00), and the difference between the groups was statistically significant (p <.001). Guided imagery reduces short-term postoperative pain after lower extremity surgery.

PMID:36944205 | DOI:10.1097/NOR.0000000000000929