Tag: statistics

Int J Biostat. 2023 Apr 3. doi: 10.1515/ijb-2022-0083. Online ahead of print.

ABSTRACT

COVID-19 survival data presents a special situation where not only the time-to-event period is short, but also the two events or outcome types, death and release from hospital, are mutually exclusive, leading to two cause-specific hazard ratios (csHR _d and csHR _r ). The eventual mortality/release outcome is also analyzed by logistic regression to obtain odds-ratio (OR). We have the following three empirical observations: (1) The magnitude of OR is an upper limit of the csHR _d : |log(OR)| ≥ |log(csHR _d )|. This relationship between OR and HR might be understood from the definition of the two quantities; (2) csHR _d and csHR _r point in opposite directions: log(csHR _d ) ⋅ log(csHR _r ) < 0; This relation is a direct consequence of the nature of the two events; and (3) there is a tendency for a reciprocal relation between csHR _d and csHR _r : csHR _d ∼ 1/csHR _r . Though an approximate reciprocal trend between the two hazard ratios is in indication that the same factor causing faster death also lead to slow recovery by a similar mechanism, and vice versa, a quantitative relation between csHR _d and csHR _r in this context is not obvious. These results may help future analyses of data from COVID-19 or other similar diseases, in particular if the deceased patients are lacking, whereas surviving patients are abundant.

PMID:36996414 | DOI:10.1515/ijb-2022-0083

Prev Chronic Dis. 2023 Mar 30;20:E21. doi: 10.5888/pcd20.220211.

ABSTRACT

We used data from the US Cancer Statistics database to determine trends in cancer incidence, stratified by age, race, and ethnicity, among women aged 20 years or older during an 18-year study period (2001-2018). We limited analysis to cancers associated with 5 modifiable risk factors: tobacco use, excess body fat, alcohol consumption, insufficient physical activity, and human papillomavirus infection. The incidence of cancers associated with obesity have risen, particularly among women aged 20 to 49 years (vs ≥50 y) and among Hispanic women. Strategies that address obesity rates in these populations may help decrease cancer risk.

PMID:36996404 | DOI:10.5888/pcd20.220211

Med Ultrason. 2023 Mar 30;25(1):48-55. doi: 10.11152/mu-3913.

ABSTRACT

AbstractPurpose To determine the feasibility and diagnostic value of percutaneous ultrasound-guided subacromial bursography (PUSB) in the diagnosis of rotator cuff tears.Methods Between July 2019 to October 2021, 78 patients who had suspected rotator cuff injury and who were admitted to the Second Affiliated Hospital of Xi’an Jiaotong University were selected, including 32 males and 46 females, aged 31-70 years (mean age 53.9±9.1 years), with a course of 1D-2 years. The MRI, US and PUSB images of patients were retrospectively analyzed to obtain the diagnostic and predictive indexes (sensitivity, specificity, positive predictive value，negative predictive value and accuracy) of these three methods for different rotator cuff tears types (full-thickness tears, partial-thickness tears and no tears of rotator cuff ). With the results of shoulder arthroscopy serving as the standard, PUSB results were compared with MRI and US results using the X2 -test (a=0.05, two-sided).Results In all 78 patients, the overall accuracy of MRI, US, and PUSB in diagnosing rotator cuff tears was 82.1% (64/78), 75.6% (59/78) and 96.2% (75/78), respectively (P < 0.001). Among 21 patients with full-thickness tears, the numbers of cases correctly diagnosed by MRI, US and PUSB were 19, 19 and 21, respectively. The sensitivity and specificity of MRI, US and PUSB in diagnosing full-thickness tears were 90.5%, 90.5%, 100% and 98.2%, 93.0%, 100%, respectively. The diagnostic accuracies of full-thickness rotator cuff tears were 90.5%, 90.5% and 100%, respectively, with no statistical difference (P = 0.344). Among 42 patients with partial-thickness tears, the numbers of patients whose cases were correctly diagnosed on MRI, US and PUSB were 32, 27 and 40, respectively. The sensitivity and specificity of MRI, US and PUSB in diagnosing partial-thickness tears were 76.2%, 64.3%, and 95.2% and 88.9%, 88.9%, and 97.2%, respectively. The diagnostic accuracies of partial-thickness rotator cuff tears were 76.2% (32/42), 64.3% (27/42) and 95.2% (40/42), respectively (P＜0.05). Among the 15 patients without tears, the numbers of misdiagnosed cases by MRI, US and PUSB were 2, 2, and 1, respectively, and they were all misdiagnosed as partial-thickness tears. The sensitivity and specificity of MRI, US and PUSB in the diagnosis of complete rotator cuff were 86.7%, 86.7%, and 93.3% and 85.7%, 82.5% and 96.8%, respectively, and the accuracies in diagnosing no tears were 86.7% (13/15), 86.7% (13/15) and 87.5% (14/15), respectively (P = 0.997).Conclusions It is feasible to diagnose rotator cuff tears by PUSB, which can be used as an important supplement imaging method to evaluate rotator cuff tears.

PMID:36996393 | DOI:10.11152/mu-3913

J Clin Oncol. 2023 Mar 30:JCO2202120. doi: 10.1200/JCO.22.02120. Online ahead of print.

ABSTRACT

PURPOSE: A previous study by the International Berlin-Frankfurt-Münster Study Group (I-BFM-SG) on childhood KMT2A-rearranged (KMT2A-r) AML demonstrated the prognostic value of the fusion partner. This I-BFM-SG study investigated the value of flow cytometry-based measurable residual disease (flow-MRD) and evaluated the benefit of allogeneic stem-cell transplantation (allo-SCT) in first complete remission (CR1) in this disease.

METHODS: A total of 1,130 children with KMT2A-r AML, diagnosed between January 2005 and December 2016, were assigned to high-risk (n = 402; 35.6%) or non-high-risk (n = 728; 64.4%) fusion partner-based groups. Flow-MRD levels at both end of induction 1 (EOI1) and 2 (EOI2) were available for 456 patients and were considered negative (<0.1%) or positive (≥0.1%). End points were 5-year event-free survival (EFS), cumulative incidence of relapse (CIR), and overall survival (OS).

RESULTS: The high-risk group had inferior EFS (30.3% high risk v 54.0% non-high risk; P < .0001), CIR (59.7% v 35.2%; P < .0001), and OS (49.2% v 70.5%; P < .0001). EOI2 MRD negativity was associated with superior EFS (n = 413; 47.6% MRD negativity v n = 43; 16.3% MRD positivity; P < .0001) and OS (n = 413; 66.0% v n = 43; 27.9%; P < .0001), and showed a trend toward lower CIR (n = 392; 46.1% v n = 26; 65.4%; P = .016). Similar results were obtained for patients with EOI2 MRD negativity within both risk groups, except that within the non-high-risk group, CIR was comparable with that of patients with EOI2 MRD positivity. Allo-SCT in CR1 only reduced CIR (hazard ratio, 0.5 [95% CI, 0.4 to 0.8]; P = .00096) within the high-risk group but did not improve OS. In multivariable analyses, EOI2 MRD positivity and high-risk group were independently associated with inferior EFS, CIR, and OS.

CONCLUSION: EOI2 flow-MRD is an independent prognostic factor and should be included as risk stratification factor in childhood KMT2A-r AML. Treatment approaches other than allo-SCT in CR1 are needed to improve prognosis.

PMID:36996387 | DOI:10.1200/JCO.22.02120

J Clin Oncol. 2023 Mar 30:JCO2202394. doi: 10.1200/JCO.22.02394. Online ahead of print.

ABSTRACT

PURPOSE: Enzalutamide and abiraterone both target androgen receptor signaling but via different mechanisms. The mechanism of action of one drug may counteract the resistance pathways of the other. We sought to determine whether the addition of abiraterone acetate and prednisone (AAP) to enzalutamide prolongs overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) in the first-line setting.

PATIENTS AND METHODS: Men with untreated mCRPC were randomly assigned (1:1) to receive first-line enzalutamide with or without AAP. The primary end point was OS. Toxicity, prostate-specific antigen declines, pharmacokinetics, and radiographic progression-free survival (rPFS) were also examined. Data were analyzed using an intent-to-treat approach. The Kaplan-Meier estimate and the stratified log-rank statistic were used to compare OS between treatments.

RESULTS: In total, 1,311 patients were randomly assigned: 657 to enzalutamide and 654 to enzalutamide plus AAP. OS was not statistically different between the two arms (median, 32.7 [95% CI, 30.5 to 35.4] months for enzalutamide v 34.2 [95% CI, 31.4 to 37.3] months for enzalutamide and AAP; hazard ratio [HR], 0.89; one-sided P = .03; boundary nominal significance level = .02). rPFS was longer in the combination arm (median rPFS, 21.3 [95% CI, 19.4 to 22.9] months for enzalutamide v 24.3 [95% CI, 22.3 to 26.7] months for enzalutamide and AAP; HR, 0.86; two-sided P = .02). However, pharmacokinetic clearance of abiraterone was 2.2- to 2.9-fold higher when administered with enzalutamide, compared with clearance values for abiraterone alone.

CONCLUSION: The addition of AAP to enzalutamide for first-line treatment of mCRPC was not associated with a statistically significant benefit in OS. Drug-drug interactions between the two agents resulting in increased abiraterone clearance may partly account for this result, although these interactions did not prevent the combination regimen from having more nonhematologic toxicity.

PMID:36996380 | DOI:10.1200/JCO.22.02394

Prosthet Orthot Int. 2023 Mar 30. doi: 10.1097/PXR.0000000000000228. Online ahead of print.

ABSTRACT

BACKGROUND: There is a gap in the research about the influence of wearing or not wearing a prosthesis for muscle strength assessment in transfemoral amputees (TFA) and how it is associated with functional mobility.

OBJECTIVES: The aim of this study was to compare the muscle isometric strength of the residual limb with and without the prosthesis in people with TFA and to analyze associations between muscle strength and functional mobility.

STUDY DESIGN: Cross-sectional study.

METHODS: 20 subjects with TFA were included. A handheld dynamometer was used for the assessment of residual limb muscle strength. Functional mobility was assessed with the Timed Up and Go test. The Wilcoxon rank sum test with the rank biserial correlation effect size were used.

RESULTS: There were statistically significant differences when testing isometric strength of the residual limb with and without the prosthesis (flexion [p = 0.007], extension [p < 0.001], and abduction [p = 0.003]). There was association between functional mobility and flexion and abduction strength with the prosthesis (p = 0.005, p = 0.01).

CONCLUSIONS: Measurements of muscle strength of the residual limb were different when assessed with and without the prosthesis. Isometric strength of the residual limb in abduction and flexion using the prosthesis were correlated with functional mobility.

PMID:36996310 | DOI:10.1097/PXR.0000000000000228

PLoS One. 2023 Mar 30;18(3):e0283537. doi: 10.1371/journal.pone.0283537. eCollection 2023.

ABSTRACT

Zoonotic spillover of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to humans in December 2019 caused the coronavirus disease 2019 (COVID-19) pandemic. Serological monitoring is critical for detailed understanding of individual immune responses to infection and protection to guide clinical therapeutic and vaccine strategies. We developed a high throughput multiplexed SARS-CoV-2 antigen microarray incorporating spike (S) and nucleocapsid protein (NP) and fragments expressed in various hosts which allowed simultaneous assessment of serum IgG, IgA, and IgM responses. Antigen glycosylation influenced antibody binding, with S glycosylation generally increasing and NP glycosylation decreasing binding. Purified antibody isotypes demonstrated a binding pattern and intensity different from the same isotype in whole serum, probably due to competition from the other isotypes present. Using purified antibody isotypes from naïve Irish COVID-19 patients, we correlated antibody isotype binding to different panels of antigens with disease severity, with binding to the S region S1 expressed in insect cells (S1 Sf21) significant for IgG, IgA, and IgM. Assessing longitudinal response for constant concentrations of purified antibody isotypes for a patient subset demonstrated that the relative proportion of antigen-specific IgGs decreased over time for severe disease, but the relative proportion of antigen-specific IgA binding remained at the same magnitude at 5 and 9 months post-first symptom onset. Further, the relative proportion of IgM binding decreased for S antigens but remained the same for NP antigens. This may support antigen-specific serum IgA and IgM playing a role in maintaining longer-term protection, important for developing and assessing vaccine strategies. Overall, these data demonstrate the multiplexed platform as a sensitive and useful platform for expanded humoral immunity studies, allowing detailed elucidation of antibody isotypes response against multiple antigens. This approach will be useful for monoclonal antibody therapeutic studies and screening of donor polyclonal antibodies for patient infusions.

PMID:36996259 | DOI:10.1371/journal.pone.0283537

PLoS One. 2023 Mar 30;18(3):e0283629. doi: 10.1371/journal.pone.0283629. eCollection 2023.

ABSTRACT

BACKGROUND: Vaccination is a global success story, one of the most effective and successful health interventions for health and development, saving the lives of millions of children every year. In 2018, nearly 870,000 Ethiopian children did not receive the life-saving measles, diphtheria, and tetanus vaccines. This study aimed to determine what factors influence children’s immunization status in Ethiopia.

METHODS: Immunization status was examined in a sample of 1843 children aged 12-24 months using data from the 2019 Ethiopian Mini Demographic and Health Survey 2019. The study used percentages to show the prevalence of immunization status among children. The marginal likelihood effect was used to determine the impact of each category of the explanatory variable on one response category of immunization status. Ordinal logistic regression models were constructed, and the best-fitting model was selected to identify significant immunization status variables.

RESULTS: The immunization prevalence among children was 72.2% (34.2% fully immunized and 38.0% partially immunized), while about 27.8% of children were non-immunized. The fitted partial proportional odds model revealed that child immunization status was significantly associated with region afar (OR = 7.90; CI: 4.78-11.92), family planning use (OR = 0.69; CI: 0.54-0.88), residence (OR = 2.22;CI: 1.60-3.09), antenatal visit (OR = 0.73;CI: 0.53-0.99), and delivery place (OR = 0.65;CI: 0.50-0.84).

CONCLUSIONS: Vaccinating children was a significant step forward in improving and protecting child health in Ethiopia, as the proportion of non-immunized children was about 27.8%. The study showed that the prevalence of non-immunization status among rural children was 33.6% and about 36.6% among children from non-educated mothers. As a result, it is agreeable that treatments are better to focus on targeting essential childhood vaccinations by promoting maternal education about family planning, antenatal visits, and maternal access to health care.

PMID:36996256 | DOI:10.1371/journal.pone.0283629

PLoS One. 2023 Mar 30;18(3):e0280315. doi: 10.1371/journal.pone.0280315. eCollection 2023.

ABSTRACT

INTRODUCTION: Despite much emphasis on the reproductive health of women, maternal mortality is still high, especially in postnatal period.

OBJECTIVE: To assess the prevalence of postnatal care use and reasons for defaults among mothers attending the child immunization clinics in Enugu, Nigeria.

METHODS: This was a cross-sectional comparative study of 400 consecutive nursing mothers who presented at the Institute of Child Health of UNTH and ESUTH, Enugu for Second dose of the Oral Polio Vaccine (OPV2) for their babies at 10 weeks postpartum. Data was collected using Interviewer-administered questionnaire and subsequently analyzed with version 22.0 IBM SPSS software, Chicago, Illinois. A p-value of less than 0.05 was considered as statistically significant.

RESULT: The prevalence of the 6th week postnatal clinic attendance among the mothers was 59%. The majority of the women (60.6%) who had antenatal care by skilled birth attendants attended postnatal clinic. Unawareness and being healthy were the main reasons for not attending postnatal clinic. Following multivariate analysis, place of antenatal (OR = 2.870, 95% C.I = 1.590-5.180, p < 0.001) and mode of delivery (OR = 0.452, 95% C.I = 0.280-0.728, p = 0.001) were the only significant predictors of postnatal clinic attendance (p < 0.05).

CONCLUSION: Postnatal clinic attendance by women in Enugu is still suboptimal. The main reason for non-attendance of the 6th week postnatal clinic was lack of awareness. There is need for healthcare professionals to create awareness about the importance of postnatal care and encourage mothers to attend.

PMID:36996250 | DOI:10.1371/journal.pone.0280315

PLoS One. 2023 Mar 30;18(3):e0283313. doi: 10.1371/journal.pone.0283313. eCollection 2023.

ABSTRACT

Statistical physics is widely used to study the nonlinear mechanical behaviors of rock. For the limitations of existing statistical damage models and Weibull distribution, a new statistical damage with lateral damage is established. In addition, by introducing the maximum entropy distribution function and the strict constraint on damage variable, a expression of the damage variable matching the proposed model is obtained. Through comparing with the experimental results and the other two statistical damage models, the rationality of the maximum entropy statistical damage model is confirmed. The proposed model can better reflect the strain-softening behavior for rocks and respond to the residual strength, which provides a theoretical reference for practical engineering construction and design.

PMID:36996233 | DOI:10.1371/journal.pone.0283313