Tag: statistics

Stat Med. 2023 Mar 31. doi: 10.1002/sim.9724. Online ahead of print.

ABSTRACT

Length-biased data occur often in many scientific fields, including clinical trials, epidemiology surveys and genome-wide association studies, and many methods have been proposed for their analysis under various situations. In this article, we consider the situation where one faces length-biased and partly interval-censored failure time data under the proportional hazards model, for which it does not seem to exist an established method. For the estimation, we propose an efficient nonparametric maximum likelihood method by incorporating the distribution information of the observed truncation times. For the implementation of the method, a flexible and stable EM algorithm via two-stage data augmentation is developed. By employing the empirical process theory, we establish the asymptotic properties of the resulting estimators. A simulation study conducted to assess the finite-sample performance of the proposed method suggests that it works well and is more efficient than the conditional likelihood approach. An application to an AIDS cohort study is also provided.

PMID:36999548 | DOI:10.1002/sim.9724

Clin Nephrol. 2023 Mar 31. doi: 10.5414/CN111038. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the formation of encrustation on double J stents (DJSs) using artificial urine.

MATERIALS AND METHODS: In this study, a static urinary system containing artificial urine was created, and a total of 45 DJSs were used to evaluate the formation of encrustation. Three groups of 15 DJSs were tested for 4, 8, or 14 weeks. The formation of encrustation on the DJSs over the weeks was analyzed using methods including X-ray powder diffraction (XRD), inductively coupled plasma spectrophotometer (ICP), and scanning electron microscope (SEM). Statistical analysis and the uncertainty test were used for data analysis using R language.

RESULTS: The ICP analyzed the weight of the calcium and magnesium, which are the major components of urinary stones and encrustation, and showed that it was the heaviest at 14 weeks. Measurement of the area of encrustation on the outer surface of the DJSs revealed that the encrustation area at the bottom of the stent was greater than that at the top of the stent, regardless of the experimental period (proximal part: ≤ 41,099 µm2, distal part: ≤ 183,259 µm2). Encrustation occurred around the side holes of DJSs and became bigger over time to fill up the side holes.

CONCLUSION: Encrustation spots included the bottom zone of the DJS and around the side holes. These results indicate that the performance of DJSs would be improved by modifying the shape of DJSs located near the bladder and side holes.

PMID:36999524 | DOI:10.5414/CN111038

J Cachexia Sarcopenia Muscle. 2023 Mar 31. doi: 10.1002/jcsm.13223. Online ahead of print.

ABSTRACT

BACKGROUND: Hand grip strength (HGS) is a powerful indicator of sarcopenia and other adverse health outcomes. Normative values for HGS for general Chinese people with a broad age spectrum are lacking. This study aims to establish normative values of HGS and explore the correlations between HGS and body composition among unselected people aged 8-80 in China.

METHODS: From 2012 to 2017, 39 655 participants aged 8-80 years in the China National Health Survey were included. Absolute HGS was measured using a Jamar dynamometer. The relative HGS was normalized by body mass index. Body composition indexes included body mass index, body fat percentage, muscle mass, fat mass index (FMI) and muscle mass index (MMI). Sex-specific smoothed centile tables for the P₁ , P₅ , P₂₅ , P₅₀ , P₇₅ , P₉₅ and P₉₉ centiles of HGS and body composition were generated using lambda-mu-sigma method. The correlations between muscle strength and body composition were estimated by partial Spearman correlation analysis.

RESULTS: The median values (25th and 75th percentile) of HGS in boys and girls (8-19 years old) were 22 (14, 34) kg and 18 (12, 22) kg, respectively; in men and women aged 20-80 were 39 (33, 44) kg and 24 (20, 27) kg, respectively. Values of upper and lower HGS across ages had three periods: an increase to a peak in the 20 s in men (with the 5th and 95th values of 30 and 55 kg, respectively) and 30 s in women (with the 5th and 95th values of 18 and 34 kg, respectively), preservation through midlife (20s-40 s), and then a decline after their 50 s. The lowest HGS values in both sexes were in the 70- to 80-year-old group, with the 5th and 95th percentile values of 16 and 40 kg in men, and 10 and 25 kg in women. There were substantial sex differences in body composition in the life course (all P values <0.001). In ageing, the decrease of muscle strength was faster than that of muscle mass in both sexes. The correlations between muscle mass and HGS were most robust than other correlations, especially in women (0.68 vs. 0.50), children and adolescents.

CONCLUSIONS: Our study established the age- and sex-specific percentile reference values for hand grip strength in an unselected Chinese population across a broad age-spectrum. The rich data can facilitate the practical appraisal of muscle strength and promote early prediction of sarcopenia and other impairments associated with neuromuscular disorders.

PMID:36999522 | DOI:10.1002/jcsm.13223

Ann Pharmacother. 2023 Mar 31:10600280231163192. doi: 10.1177/10600280231163192. Online ahead of print.

ABSTRACT

BACKGROUND: Acute agitation accounts for up to 2.6% of visits to the emergency department (ED). To date, a standard of care for the management of acute agitation has not been established. Few studies have evaluated antipsychotic and benzodiazepine combinations.

OBJECTIVE: The purpose of this study was to evaluate effectiveness and safety of combination therapy for acute agitation with intramuscular (IM) droperidol and midazolam (D+M) compared with IM haloperidol and lorazepam (H+L) in patients in the ED.

METHODS: This was a single-center, retrospective medical record review of patients presenting to a large, academic ED with acute agitation from July 2020 through October 2021. The primary outcome was percentage of patients requiring additional agitation medication within 60 minutes of combination administration. Secondary outcomes included average time to repeat dose administration and average number of repeat doses required before ED discharge.

RESULTS: A total of 306 patients were included for analysis: 102 in the D+M group and 204 in the H+L group. Repeat dose within 60 minutes occurred in 7 (6.9%) and 28 (13.8%) patients in the D+M and H+L groups, respectively (P = 0.065). A total of 28.4% of D+M patients and 30.9% of H+L patients required any repeat dose during their ED visit. Time to repeat dose was 12 and 24 minutes in the D+M and H+L, respectively (P = 0.22). The adverse event rate was 2.9% in each group.

CONCLUSION AND RELEVANCE: IM D+M resulted in a lower rate of repeat doses of acute agitation medication compared with IM H+L, though this was not statistically significant. Both therapies were safe, and the adverse event rate was low.

PMID:36999520 | DOI:10.1177/10600280231163192

Diagn Cytopathol. 2023 Mar 31. doi: 10.1002/dc.25133. Online ahead of print.

ABSTRACT

BACKGROUND: Several clinical groups consider cytological assessment under EBUS (Endobronchial Ultrasonography)-ROSE (Rapid Onsite Evaluation) as the golden standard for diagnosis and staging of intrathoracic lesions. On the other hand, some investigators proposed that EBUS-TBNA (Transbronchial Needle Aspiration) has considerably high false-negative rates for diagnosis. In this study, we analyzed our patient cohort (n = 152) with intrathoracic lesions and suspected malignancies evaluated by EBUS-ROSE. Our specific aims were: (i) to determine whether EBUS-ROSE could provide sufficient pathologic material for diagnosis and staging; (ii) to determine the fidelity of EBUS-ROSE-guided initial diagnoses in comparison to paraffin block diagnoses; (iii) to evaluate whether anatomical localization of sampled lymph nodes associate with material adequacy and final diagnoses.

METHODS: NCSS (Number Cruncher Statistical System) 2020 Statistical Software (Utah, USA) was used for statistical analysis.

RESULTS: In EBUS-ROSE cytological assessment, material adequacy was determined in 50,7% (n = 77) of the cases. Considering the paraffin block pathology as the golden standart, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates of EBUS-ROSE were 90,2%, 93,1%, 94,8%, 87,1%, and 91,4%, respectively. There was no statistically significant difference between the final pathology and EBUS cytology results (p > .05) with a non-random Kappa agreement rate as 82.9%. There were differences in material adequacy and diagnoses according to the localization of sampled lymph node stations.

CONCLUSIONS: EBUS-ROSE is efficient to decide for the adequacy of the pathological specimen and provides diagnoses with reliable fidelity.

PMID:36999482 | DOI:10.1002/dc.25133

J Cosmet Dermatol. 2023 Mar 31. doi: 10.1111/jocd.15715. Online ahead of print.

ABSTRACT

INTRODUCTION: Palmar hyperhidrosis or excessive palmar sweating can reduce one’s quality of life as it is associated with significant physical and occupational disabilities. We compared the gel and nanoemulgel of oxybutynin in treating these patients.

MATERIALS AND METHODS: This pilot study was performed as a double-blind controlled randomized clinical trial at Shahid Faghihi Hospital, Shiraz, Iran. In two randomly allocated groups of 15, patients diagnosed with primary palmar hyperhidrosis by an attending dermatologist applied half a fingertip (roughly 0.25 g) of 1% oxybutynin topical gel or 1% oxybutynin nanoemulgel to both palms every 12 h for one month. The Hyperhidrosis Disease Severity Scale (HDSS), Visual Analog Scale (VAS), and Dermatology Life Quality Index (DLQI) were used to assess the patients at the beginning and end of the study. Statistical analysis was performed using SPSS version 25.

RESULTS: The groups were similar in terms of age (p = 0.800), sex (p = 0.096), and baseline HDSS, VAS, and DLQI scores. The mean HDSS scores decreased significantly (p = 0.001) over time in patients receiving the gel (3.00 ± 1.00 vs. 2.33 ± 0.61) or nanoemulgel (2.92 ± 0.82 vs. 2.14 ± 0.53), without a significant difference between the groups. The same was true for the VAS and DLQI scores. Three patients in each group experienced transient, self-limited anticholinergic side effects (p = 0.983).

CONCLUSION: Oxybutynin gel and nanoemulgel offer equal safety and similar efficacy in reducing the disease severity and increasing the quality of life of patients with palmar hyperhidrosis.

PMID:36999480 | DOI:10.1111/jocd.15715

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Feb 28;48(2):221-230. doi: 10.11817/j.issn.1672-7347.2023.220053.

ABSTRACT

OBJECTIVES: Surgical robot system has broken the limitation of traditional surgery and shown excellent performance in surgery, and has been widely used in minimally invasive treatment in most areas of surgery. This study aims to verify the basic performance of the domestic surgical robot system and the safety and effectiveness of the integrated bipolar electrocoagulation and ultrasonic knife.

METHODS: The basic performance of the domestic surgical robot system was evaluated by completing the square knot and surgical knot, vertical and horizontal perforation and right ring perforation and suture, as well as picking up beans. Compared with laparoscopy, the safety and effectiveness of the domestic surgical robot after integrated interconnection bipolar electrocoagulation and ultrasonic scalpel were evaluated by detecting the vascular closure performance and the degree of histopathological damage in animals.

RESULTS: Compared with freehand knotting, domestic robot knotting speed and circumference were slightly worse, but better than laparoscopic knotting. There was no statistical significance in the tension difference of the surgical knots among the 3 methods (P>0.05), but the tension of the square knots made by the freehand and the domestic surgical robot was greater than that of the laparoscopy (P<0.05). The space required for both the left and right forceps heads of knots was smaller than that of laparoscopy (P<0.001), which successfully completed the 4 quadrant suture tasks, and the time of picking up beans was significantly less than that of laparoscopy (P<0.05). There was no significant difference in the temperature of the liver tissue after the bipolar electrocoagulation between the interconnected domestic surgical robot and the laparoscopy (P>0.05), and the acute thermal injury was observed under the light microscope. The temperature of the liver tissue treated by the domestic robotic ultrasound knife was higher than that of the laparoscopic ultrasound knife (P<0.05).

CONCLUSIONS: Domestic surgical robots are obviously superior to laparoscopy in suturing, knotting, and moving objects, and domestic surgical robots’ interconnect bipolar electrocoagulation and ultrasonic knife have achieved success in animal experiments, and hemostasis is considered to be safe and effective.

PMID:36999469 | DOI:10.11817/j.issn.1672-7347.2023.220053

Int J Urol. 2023 Mar 31. doi: 10.1111/iju.15184. Online ahead of print.

ABSTRACT

OBJECTIVE: This research was carried out to reduce the fear, anxiety and pain of 4-6 age circumcised children with therapeutic play and video animation interventions.

METHODS: This research was conducted as a randomized controlled study between November 2019 and April 2021. Using block randomization, 30 (n = 30) children were assigned to the control group, 30 (n = 30) to the therapeutic puppet group and 30 (n = 30) to the video animation group. Before the circumcision surgery, therapeutic puppet and video animation interventions were applied to children with scenario prepared with psychodrama technique. Fear, anxiety, and pain findings of children before and after surgery were determined.

RESULTS: The fear and anxiety scores of the children were similar before the nursing intervention in all groups, and that the fear and anxiety scores of therapeutic puppet play and video animation intervention groups had statistically lower than the control group after nursing intervention. The pain scores of the children from the therapeutic puppet play and video animation groups had lower pain scores than the control group after surgery (F = 5.24, p = 0.007).

CONCLUSIONS: Therapeutic play and video animation intervention can be effective in reducing fear and anxiety of children aged 4-6 before and after circumcision surgery.

PMID:36999456 | DOI:10.1111/iju.15184

J Cosmet Dermatol. 2023 Mar 31. doi: 10.1111/jocd.15734. Online ahead of print.

ABSTRACT

BACKGROUND: Cosmetics have become an integral part of our daily routine. In addition to causing a wide range of dermatological disorders, cosmetic preparations can also affect internal health. Men are less likely to be impacted than women.

OBJECTIVE: This study aimed at determining the awareness level among female patients regarding adverse reactions caused by cosmetic products.

METHOD: A cross-sectional study was performed among women who visited the Dermatology department of Kasturba Hospital, Manipal, Karnataka, from December 2020 to March 2022. The sample size included 400 respondents selected using the Convenience sampling method, and data were collected using a self-administered questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21, and descriptive statistics were applied.

RESULTS: The study found that many cosmetic users experienced negative side effects (44%). The primarily affected body site was the face (25.50%) followed by scalp and hair (10%). Products responsible for adverse events were skin care products (27.25%). Considerable percentage of patients self-medicated (22.25%) and only 15% of women consulted a dermatologist for cosmetic-related problems.

CONCLUSION: Awareness regarding the possibility of cosmetic-induced adverse effects as well as the proper use of cosmetics to reduce these adverse effects is imperative. Implementation of cosmetovigilance system will help to decrease the adverse events to a certain extent.

PMID:36999455 | DOI:10.1111/jocd.15734

J Biochem Mol Toxicol. 2023 Mar 31:e23355. doi: 10.1002/jbt.23355. Online ahead of print.

ABSTRACT

Tropisetron exerts a protective effect against cardiac complications, particularly cardiac hypertrophy. Oxidative stress and apoptosis are the main contributors to the pathogenesis of cardiac hypertrophy. Sirtuins, a family of histone deacetylases, are connected to cellular oxidative stress signaling and antioxidant defense. Sirtuins are also linked to apoptosis which is an important mechanism in the progression of cardiac hypertrophy to heart failure. Literature also suggests that tropisetron impedes apoptosis, partly mediated through an antioxidant mechanism. Therefore, we examined if tropisetron fights cardiac hypertrophy by adjusting sirtuin family proteins (Sirts) and components of mitochondrial death pathway, Bcl-associated X (BAX), Bcl-2-associated death promoter (BAD). Male Sprague-Dawley rats got divided into four groups, including control (Ctl), tropisetron (Trop), cardiac hypertrophy (Hyp), and hypertrophic rats under tropisetron treatment (Hyp + Trop). Pathological cardiac hypertrophy was induced by surgical abdominal aortic constriction (AAC). The increased expression of brain natriuretic peptide (BNP) in the Hyp group confirms the cardiac hypertrophy establishment. The mRNA levels of SIRT1, SIRT3, SIRT7, and BAD also upregulated in the hypertrophic group (p < 0.001). Postoperational administration of tropisetron for 3 weeks lowered the increased expression of BNP (p < 0.05) and BAD (p < 0.001), though the reduction of BAX expression was statistically insignificant (p > 0.05). Tropisetron treatment also restored the normal level of SIRT1/3/7 genes expression in the Hyp + Trop group (p < 0.05). Present findings suggest that tropisetron can suppress cardiomyocyte hypertrophy progression to heart failure by counteracting BNP, SIRT1, SIRT3, Sirt7, and BAD overexpression-mediated apoptosis in a rat model of cardiac hypertrophy.

PMID:36999403 | DOI:10.1002/jbt.23355