Tag: statistics

Zhongguo Zhong Yao Za Zhi. 2023 Feb;48(3):625-635. doi: 10.19540/j.cnki.cjcmm.20221102.103.

ABSTRACT

This study explored the feasibility of mineral element content and ratios of nitrogen isotopes to discriminate the cultivation mode of Dendrobium nobile in order to provide theoretical support for the discrimination of the cultivation mode of D. nobile. The content of 11 mineral elements(N, K, Ca, P, Mg, Na, Fe, Cu, Zn, Mn, and B) and nitrogen isotope ratios in D. nobile and its substrate samples in three cultivation methods(greenhouse cultivation, tree-attached cultivation, and stone-attached cultivation) were determined. According to the analysis of variance, principal component analysis, and stepwise discriminant analysis, the samples of different cultivation types were classified. The results showed that the nitrogen isotope ratios and the content of elements except for Zn were significantly different among different cultivation types of D. nobile(P<0.05). The results of correlation analysis showed that the nitrogen isotope ratios, mineral element content, and effective component content in D. nobile were correlated with the nitrogen isotope ratio and mineral element content in the corresponding substrate samples to varying degrees. Principal component analysis can preliminarily classify the samples of D. nobile, but some samples overlapped. Through stepwise discriminant analysis, six indicators, including δ~(15)N, K, Cu, P, Na, and Ca, were screened out, which could be used to establish the discriminant model of D. nobile cultivation methods, and the overall correct discrimination rates after back-substitution test, cross-check, and external validation were all 100%. Therefore, nitrogen isotope ratios and mineral element fingerprints combined with multivariate statistical analysis could effectively discriminate the cultivation types of D. nobile. The results of this study provide a new method for the identification of the cultivation type and production area of D. nobile and an experimental basis for the quality evaluation and quality control of D. nobile.

PMID:36872225 | DOI:10.19540/j.cnki.cjcmm.20221102.103

Zhongguo Zhong Yao Za Zhi. 2023 Feb;48(3):608-613. doi: 10.19540/j.cnki.cjcmm.20221031.101.

ABSTRACT

This paper introduced the overview of the "eight trends" of Chinese medicinal materials(CMM) industry in 2021, analyzed the problems of CMM production, and put forward development suggestions. Specifically, "eight trends" could be summarized as follows.(1) The growing area of CMM tended to be stable, and some provinces began to release the local catalog of Dao-di herbs.(2) The protection process of new varieties accelerated, and a number of excellent varieties were bred.(3) The theory of ecological cultivation was further enriched, and the demonstration effect of ecological cultivation technology was prominent.(4) Some CMM realized complete mechanization and formed typical model cases.(5) The number of cultivation bases using the traceability platform increased, and provincial internet trading platforms were set up.(6) The construction of CMM industrial clusters accelerated, and the number of provincial-level regional brands increased rapidly.(7) Many new agricultural business entities were founded nationwide, and a variety of methods were used to drive the intensified development of CMM.(8) A number of local TCM laws were promulgated, and the management regulation of food and medicine homology substances catalogs was issued. On this basis, four suggestions for CMM production were proposed.(1) It is suggested to speed up the formulation of the national catalog of Dao-di herbs and carry out the certification of Dao-di herbs production bases.(2) Ecological planting of forest and grassland medicine should be further strengthened in terms of technical research and promotion based on the principle of ecological priority.(3) The basic work of disaster prevention should be paid more attention and technical measures for disaster mitigation should be developed.(4) The planted area of commonly used CMM should be incorporated into the national regular statistical system.

PMID:36872223 | DOI:10.19540/j.cnki.cjcmm.20221031.101

JACC Heart Fail. 2023 Feb 20:S2213-1779(23)00073-2. doi: 10.1016/j.jchf.2023.01.018. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with a recent heart failure (HF) hospitalization have a high risk of rehospitalization and mortality. Early treatment may have a substantial impact on patient outcomes.

OBJECTIVES: The study sought to study the outcomes and effect of empagliflozin according to timing of prior HF hospitalization.

METHODS: EMPEROR-Pooled (EMPEROR-Reduced (EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Reduced Ejection Fraction) and EMPEROR-Preserved (EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Preserved Ejection Fraction) combined) included 9,718 HF patients who were grouped according to the recency of HF hospitalization (none, <3 months, 3-6 months, 6-12 months, >12 months). The primary outcome was a composite of time to first of HF hospitalization or cardiovascular death, over a median follow-up of 21 months.

RESULTS: The primary outcome event rates (per 100 person-years) in the placebo group were 26.7, 18.1, 13.7, and 2.8 for patients hospitalized within 3 months, 3-6 months, 6-12 months, and >12 months, respectively. The relative risk reduction of primary outcome events with empagliflozin was similar across HF hospitalization categories (P interaction = 0.67). The primary outcome absolute risk reduction was more pronounced among patients with a recent HF hospitalization but without statistical heterogeneity of treatment effect: -6.9, -5.5, -0.8, and -0.6 events prevented per 100 person-years for patients hospitalized within <3 months, 3-6 months, 6-12 months, and >12 months, respectively, and -2.4 events prevented per 100 person-years of follow-up in those without a prior HF hospitalization (P interaction = 0.64). Empagliflozin was safe irrespective of HF hospitalization recency.

CONCLUSIONS: Patients with a recent HF hospitalization have a high risk of events. Empagliflozin reduced HF events regardless of HF hospitalization recency.

PMID:36872213 | DOI:10.1016/j.jchf.2023.01.018

Tech Coloproctol. 2023 Mar 5. doi: 10.1007/s10151-023-02775-5. Online ahead of print.

ABSTRACT

PURPOSE: Anorectal, sexual, and urinary dysfunction are common issues after rectal cancer surgery, although seldom explored. The primary aim of this study was to investigate postoperative anorectal functional results.

METHODS: Patients with mid/low-rectal cancer treated with transanal TME (TaTME) with primary anastomosis with/without diverting stoma between 2015 and 2020 were reviewed and selected if they had a minimum follow-up of 6 months (from the primary procedure or stoma reversal). Patients were interviewed using validated questionnaires and the primary outcome was bowel function based on Low Anterior Resection Syndrome (LARS) scores. Statistical analyses were performed to identify clinical/operative variables correlated with worse outcomes. A random forest (RF) algorithm was computed to classify patients at a greater risk of minor/major LARS.

RESULTS: Ninety-seven patients were selected out of 154 TaTME performed. Overall, 88.7% of the patients had a protective stoma and 25.8% reported major LARS at mean follow-up of 19.0 months. Statistical analyses documented that age, operative time, and interval to stoma reversal correlated with LARS outcomes. The RF analysis disclosed worse LARS symptoms in patients with longer operative time (> 295 min) and stoma reversal interval (> 5.6 months). If the interval ranged between 3 and 5.6 months, older patients (> 65 years) reported worse outcomes. Finally, no statistical difference was documented when comparing the rate of minor/major LARS in the first 27 cases versus others.

CONCLUSION: One-quarter of the patients developed major LARS after TaTME. An algorithm based on clinical/operative variables, such as age, operative time, and time to stoma reversal, was developed to identify categories at risk for LARS symptoms.

PMID:36871281 | DOI:10.1007/s10151-023-02775-5

Int J Circumpolar Health. 2023 Dec;82(1):2179453. doi: 10.1080/22423982.2023.2179453.

ABSTRACT

Even though China Antarctic medical care has made huge progress, dental care has always been a neglected area. Dental health is well-known to be closely related with life quality and work efficiency. Hence, knowing the dental care situation there and providing ways to improve are urgently needed. We choose doctors who worked in China Antarctic station as a window to see the whole picture by sending questionnaire. The results showed dental visits ranked second high, the ratio of doctors who got pre-departure dental knowledge education and screen is low. What is worse, none of them got any after-departure dental check. Their dental knowledge is not as good as we expect, and they were troubled by dental problems in Antarctic. Interestingly, most dental problems were treated by non-dentist with no essential equipment, but 2/3 of them were satisfied with the outcome. As for the dental-related diet and behaviour, snacks eating and alcohol drinking are the strongest predictors of dental pain and gum problem. Those findings are crucial to Antarctic dental care and research.

PMID:36871248 | DOI:10.1080/22423982.2023.2179453

Circulation. 2023 Mar 5. doi: 10.1161/CIRCULATIONAHA.123.064188. Online ahead of print.

ABSTRACT

Background: One in eight people with heart disease has poor medication adherence that, in part, is related to copayment costs. This study tested whether eliminating copayments for high-value medications among low-income older adults at high cardiovascular risk would improve clinical outcomes. Methods: This randomized 2×2 factorial trial studied 2 distinct interventions in Alberta, Canada: eliminating copayments for high value preventive medications and a self-management education and support program (reported separately). The findings for the first intervention, which waived the usual 30% copayment on 15 medication classes commonly used to reduce cardiovascular events, compared to usual copayment, is reported herein. The primary outcome was the composite of death, myocardial infarction, stroke, coronary revascularization, and cardiovascular-related hospitalizations over a three-year followup. Rates of the primary outcome and its components were compared using negative binomial regression. Secondary outcomes included quality of life(EQ-5D index score), medication adherence, and overall healthcare costs. Results: 4,761 individuals were randomized and followed for a median of 36 months. There was no evidence of statistical interaction(p=0.99) or of a synergistic effect between the two interventions in the factorial trial with respect to the primary outcome, which allowed us to evaluate the effect of each intervention separately. The rate of the primary outcome was not reduced by copayment elimination, (521 vs 533 events, incidence rate ratio(IRR) 0.84, 95%CI 0.66 to 1.07, p=0.162). The IRR for non-fatal MI, non-fatal stroke, and cardiovascular death (0.97; 95% CI 0.67 to 1.39), death (0.94 (95%CI 0.80 to 1.11) and for cardiovascular-related hospitalizations (0.78 (95%CI 0.57 to 1.06) did not differ between groups. No significant between-group changes in quality of life over time were observed(mean difference 0.012, 95%CI -0.006 to 0.030, p=0.19). The proportion of participants who were adherent to statins was 0.72 vs 0.69 for the copayment elimination vs usual copayment groups, respectively(mean difference 0.03, 95% CI 0.006-0.06, p=0.016). Overall adjusted health care costs did not differ ($3,575, 95%CI -605 to 7,168, p=0.098). Conclusions: In low-income adults at high cardiovascular risk, eliminating copayments (average $35 a month) did not improve clinical outcomes or reduce healthcare costs, despite a modest improvement in adherence to medications.

PMID:36871215 | DOI:10.1161/CIRCULATIONAHA.123.064188

Circulation. 2023 Mar 5. doi: 10.1161/CIRCULATIONAHA.123.064189. Online ahead of print.

ABSTRACT

Background: Self-management education and support (SMES) interventions have modest effects on intermediate outcomes for those at risk of cardiovascular disease, but few studies have measured or demonstrated an impact on clinical endpoints. Advertising for commercial products is known to influence behavior, but advertising principles are not typically incorporated into SMES design. Methods: This randomized trial studied the impact of a novel tailored SMES program designed by an advertising firm among a population of low-income older adults at high cardiovascular risk in Alberta, Canada. The intervention included health promotion messaging from a fictitious “peer” and facilitated relay of clinical information to patients’ primary care provider and pharmacist. The primary outcome was the composite of death, myocardial infarction, stroke, coronary revascularization, and hospitalizations for cardiovascular-related ambulatory care-sensitive conditions. Rates of the primary outcome and its components were compared using negative binomial regression. Secondary outcomes included quality of life (EQ-5D index score), medication adherence, and overall healthcare costs. Results: We randomized 4,761 individuals, with a mean age of 74.4 years, of whom 46.8% were female. There was no evidence of statistical interaction (p=0.99) or of a synergistic effect between the two interventions in the factorial trial with respect to the primary outcome, which allowed us to evaluate the effect of each intervention separately. Over a median follow-up time of 36 months, the rate of the primary outcome was lower in the group that received SMES compared with the control group (incidence rate ratio (IRR): 0.78, 95% confidence interval (CI): 0.61-1.00, p=0.047). No significant between-group changes in quality of life over time were observed (mean difference 0.0001, 95%CI -0.018 to 0.018, p=0.99). The proportion of participants who were adherent to medications was not different between the two groups (p = 0.199 for statins, and p=0.754 for ACEi/ARBs). Overall adjusted health care costs did not differ between those receiving SMES and the control group ($2,015, 95%CI -1,953 to 5,985, p=0.320). Conclusions: In low-income older adults, a tailored SMES program using advertising principles reduced the rate of clinical outcomes compared with usual care, though the mechanisms of improvement are unclear and further studies are required.

PMID:36871212 | DOI:10.1161/CIRCULATIONAHA.123.064189

Otolaryngol Head Neck Surg. 2023 Mar 5. doi: 10.1002/ohn.162. Online ahead of print.

ABSTRACT

OBJECTIVE: Describe the effect that cochlear implantation (CI) has on audiometric outcomes and quality of life (QOL) in patients with single-sided deafness (SSD).

STUDY DESIGN: Retrospective case review.

SETTING: Tertiary university hospital system.

METHODS: Preoperative and postoperative AzBio performance and Cochlear Implant Quality of Life-35 (CIQOL-35) Profile scores in CI patients with SSD were compared, and postoperative measures were compared to those from CI patients without SSD.

RESULTS: Seventeen patients with unilateral CI and contralateral unaided pure-tone averages ≤30 dB were included. The median age was 60.2 (interquartile range [IQR], 50.9-64.9 years), and 7/17 (41%) were women. Median daily use was 8.2 hour (IQR, 5.4-11.9 h). The median preoperative AzBio quiet score in the ear to be implanted was 3% (IQR, 0%-6%). After a median follow-up of 12.0 months, the median postoperative AzBio quiet score was 76% (IQR, 47%-86%) (p < .01). SSD subjects demonstrated statistically significant improvements in median scores on the following CIQOL-35 subdomains following implantation: Entertainment (17 preoperatively vs 21 postoperatively), Listening Effort (12 vs 14), Social (17 vs 22), and Global (28 vs 35; p < .05). SSD patients achieved equal or higher postoperative CIQOL-35 scores in most subdomains (6/7) compared to an age-matched group of non-SSD CI recipients who underwent unilaterally (N = 19) or sequential (N = 6) implantation.

CONCLUSION: SSD CI patients not only demonstrate significant improvements in speech perception testing in the implanted ear but also exhibit improvement in multiple QOL subdomains on the CIQOL-35, the only validated cochlear implant QOL instrument.

PMID:36871181 | DOI:10.1002/ohn.162

Dig Dis Sci. 2023 Mar 4. doi: 10.1007/s10620-023-07885-6. Online ahead of print.

ABSTRACT

OBJECTIVES: Colorectal cancer (CRC) is the third most common malignancy in the US. Several factors are associated with increased/decreased CRC risk and often linked to adenomatous colorectal polyps (CRP). Recent studies suggest a lower risk of neoplastic lesions among irritable bowel syndrome (IBS) patients. We aimed to systematically assess the occurrence of CRC and CRP in IBS patients.

METHODS: Searches of the Medline, Cochrane, and EMBASE databases were performed, blindly and independently, by two investigators. Studies of CRC or CRP incidence in IBS patients (diagnosed by Rome or other symptom-based criteria) were eligible for inclusion. CRC and CRP effect estimates were pooled in meta-analyses using random models.

RESULTS: Of 4941 non-duplicate studies, 14 were included, comprising 654,764 IBS patients and 2,277,195 controls in 8 cohort studies, and 26,641 IBS patients and 87,803 controls in 6 cross-sectional studies. Pooled analysis revealed a significantly decreased prevalence of CRP in IBS subjects vs. controls, with a pooled odds ratio (OR) of 0.29 (95% CI (0.15, 0.54)). There was significant heterogeneity between studies (I² = 96%, p < 0.01). This finding persisted when studies which did not report pre-cancerous polyps separately were excluded (OR 0.23, 95% CI (0.15, 0.35), I² = 85%, p < 0.01). CRC prevalence was lower in IBS subjects, but this did not reach statistical significance (OR 0.40, 95% CI (0.09, 1.77]).

CONCLUSION: Our analyses reveal a decreased incidence of colorectal polyps in IBS, although CRC did not reach significance. Mechanistic studies with detailed genotypic analysis and clinical phenotyping are needed to better elucidate the potentially protective effect of IBS on CRC development.

PMID:36871131 | DOI:10.1007/s10620-023-07885-6

Aging Clin Exp Res. 2023 Mar 5. doi: 10.1007/s40520-023-02363-5. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to accurately evaluate the cardiac structure and function of the frail population in elderly patients with normal ejection fraction (EF) using the 3D volume quantification and speckle tracking of echocardiography, to explore the correlation between frailty and cardiac structure and function.

METHODS: A total of 350 elderly aged 65 and above in-patients, excluding those with congenital heart disease, cardiomyopathy, and severe valvular heart disease, were included in the study. Patients were divided into non-frail, pre-frail, and frail group. Echocardiography techniques including speckle tracking and 3D volume quantification, were used to analyze the cardiac structure and function of the study subjects. Comparative analysis was statistically significant if P < 0.05.

RESULTS: The cardiac structure of the frail group was different compared with non-frail patients, the frail group demonstrated increased left ventricular myocardial mass index (LVMI), but decreased stroke volume. Cardiac function was also impaired in the frail group: reservoir strain and conduit strain of left atrium, strain of right ventricular (RV) free wall, strain of RV septum, 3D EF of RV, and global longitudinal strain of LV were significantly decreased. Frailty was significantly and independently associated with LV hypertrophy (OR 1.889; 95% CI 1.240,2.880; P = 0.003), LV diastolic dysfunction (OR 1.496; 95% CI 1.016,2.203; P = 0.041), left ventricular global longitudinal strain (LVGLS) reduction (OR 1.697; 95% CI 1.192, 2.416; P = 0.003), and reduced RV systolic function (OR 2.200; 95% CI 1.017, 4.759; P = 0.045).

CONCLUSION: Frailty is closely associated with several heart structural and functional alterations, which not only manifested as LV hypertrophy and reduced LV systolic function, but also decreased LV diastolic function, RV systolic function, and left atrial systolic function. Frailty is an independent risk factor for LV hypertrophy, LV diastolic dysfunction, LVGLS reduction, and reduced RV systolic function.

TRIAL REGISTRATION NUMBER: ChiCTR2000033419. Date of registration: May 31, 2020.

PMID:36871112 | DOI:10.1007/s40520-023-02363-5