Tag: statistics

J Ovarian Res. 2022 Dec 1;15(1):125. doi: 10.1186/s13048-022-01063-4.

ABSTRACT

BACKGROUND: Complex epithelial neoplasms of the ovary (CENO), an uncommon pathological histotype in ovarian cancer, comprises adenosquamous carcinoma and adenocarcinoma with metaplasia. Owing to the rarity of relevant reports, there are currently no statistics on outcomes based on large samples. Meanwhile high-grade serous ovarian cancer (HGSOC) is the most common histotype in ovarian cancer which has a recognized first-line treatment regimen and poor prognosis. Thus, we aimed to determine the characteristics, prognosis, and independent predictors of survival for CENO, compare them with those of HGSOC and construct prognostic predictive models and nomograms.

METHODS: We used the Surveillance, Epidemiology, and End Results (SEER) database to determine patients diagnosed with CENO or HGSOC from 2000 to 2017. Clinical, demographic, and treatment characteristics were compared between these groups. Propensity score matching, Cox risk regression analysis, Kaplan-Meier survival curves, and the Least Absolute Shrinkage and Selection Operator regression analysis were employed for analyzing the data.

RESULTS: Here, 31,567 patients with HGSOC and 216 patients with CENO between 2000 and 2017 in the SEER database were enrolled. Age < 57 years, unmarried, and early-stage diseases were more common in patients with CENO than in those with HGSOC. Women with CENO were less likely to receive adjuvant chemotherapy (65.7% vs. 79.4%) but more likely to receive radiotherapy (6.0% vs. 0.8%; both p < 0.001) than those with HGSOC. Year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors for overall and cancer-specific survival in CENO. Overall survival rates were significantly lower for CENO than for more malignant HGSOC.

CONCLUSIONS: In summary, CENO was rare in ovarian cancer, while the year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors. Compared with other common malignant ovarian tumors, CENO had a poor prognosis. Prognostic predictive models and nomograms had been determined to predict the individual survival rates of patients with CENO. These methods could improve evaluations of survival and therapeutic decisions for patients.

PMID:36456989 | DOI:10.1186/s13048-022-01063-4

Trials. 2022 Dec 1;23(1):968. doi: 10.1186/s13063-022-06919-0.

ABSTRACT

BACKGROUND: Antimicrobial coatings of implants are of interest to reduce infection rate in orthopedic surgery. Demonstration of clinical effectiveness of such coated implants to obtain market approval is challenging. The objective of this article is to define a design for a randomized controlled trial to evaluate the clinical performance of a silver-coating for locking plates for fracture treatment.

METHODS: The study design has to respect different criteria, such as feasibility, focus on overall complications, such as functional impairment, fracture healing, and particularly on infection rates. Distal tibia fractures were chosen due to the high prevalence of infections in this type of injuries, which warrants a particular benefit of antimicrobial prophylaxis and thus might allow to see a statistical trend in favor of the coated product. The study design was defined as a randomized, controlled, subject and observer-blinded, multi-center study in subjects with fractures of the distal tibia with a total of 226 patients. A number of 113 patients are planned for each of the two treatment arms with treatment of the fracture with a silver-coated device (first arm) or with an uncoated device (second arm). Inclusion criteria are closed fractures of the distal tibia according to the Tscherne-Oestern classification or open fractures of the distal tibia according to the Gustilo-Anderson classification in subjects older than 18 years. Primary outcome parameter is the Anticipated Adverse Device Effects (AADE) including all typical complications of this type of injury, such as functional impairment of the affected limb, non-union, and infections based on a non-inferiority study design. Also, silver-typical complications, such as argyria, are included. Secondary parameters are infection rates and fracture healing. Follow-up of patients includes five visits with clinical and X-ray evaluations with a follow-up time of 12 months.

DISCUSSION: Demonstration of clinical effectiveness of antimicrobial coatings of fracture fixation devices remains a challenge. Definition of a prospective randomized pre-market trial design and recruitment of clinical sites for such a study is possible. A confirmative proof of the expected clinical benefit in terms of reduction of device-related infections will be addressed with a prospective post-market clinical follow-up study in a second step due to the large sample size required.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05260463. Registered on 02 March 2022.

PMID:36456987 | DOI:10.1186/s13063-022-06919-0

BMC Nephrol. 2022 Dec 1;23(1):385. doi: 10.1186/s12882-022-03011-2.

ABSTRACT

AIM: Royal Darwin Hospital (RDH) is the main tertiary hospital that has performed more than 600 biopsies since its establishment. Although Indigenous people in Australia’s Northern Territory (NT) has the highest rate of renal replacement therapy, the histopathology pattern of their renal diseases is still under discussed. We aimed to analyse the histopathology pattern of patients undergoing renal biopsy in RDH from June 2007 to June 2020. Secondary aims include clinical indication and survival analysis of patients with kidney biopsies.

METHODS: We conducted a retrospective cohort study on all native kidney biopsy reports from patients over the age of 16, from June 2007 to June 2020. Descriptive statistics was used to summarise age, sex, indigeneity, histopathological pattern, and mortality. Categorical values were expressed as absolute frequencies and percentages. Survival analysis was performed using multivariate analyses and Cox proportional hazard regression model.

RESULTS: There were 364 native renal biopsies included in the analysis. Sub-nephrotic proteinuria was the most common clinical indication for kidney biopsy (n = 160,47.8%). Diabetes nephropathy (DN) was the most common pathological finding (n = 71,12.8%). Indigenous population who had dialysis performs poorly compared to their non-indigenous counterpart (HR 2.37,95% CI 1.53-3.67,p < 0.001).

CONCLUSION: Diabetic nephropathy is the most common native kidney biopsy in the NT with higher mortality among indigenous patients. This study supports the previous findings of indigenous female excess, younger age of kidney disease requiring kidney biopsy, and excess of diabetic nephropathy in the top-end of the NT. It can be speculated that some diabetic patients had atypical features prompting a biopsy.

PMID:36456968 | DOI:10.1186/s12882-022-03011-2

BMC Med Educ. 2022 Dec 1;22(1):831. doi: 10.1186/s12909-022-03882-x.

ABSTRACT

OBJECT: GP residents’s has the obligation to take task with the public health prevetion. GP residents receive the public health training during their college study period and the residents training. The sudden outbreak of the COVID-19 epidemic, highlight the importance and competence of the community prevention as the front line of epidemic prevention and control, pushing the general practitioner (GP) residents into the front team of epidemic prevention and control. Residents’ participation in epidemic prevention and control is not only a field workload participation in public health disease prevention and control, but also a rare and value-oriented training experience. This study aims to explores the research on the training content, ability improvement and cognitive load of the resident, and to demonstrate past and future training effects of epidemic prevention and control.

METHODS: Object cognitive load scale (NASA-TLX scale) and self-developed questionnaires were adopted to conduct a questionnaire survey on resident doctors who were in GP training program from West China Hospital of Sichuan University, and finally 190 questionnaires were collected. SPSS 23.0 statistical software for statistical analysis of data.

RESULT: Most indicators of cognitive load NASA scale are at a “moderate” level by the GP residents, generally indicating that the intensity of on-site epidemic prevention and control (training) can be tolerated. The chi-square test is used to study the status of “How responsible you are for epidemic prevention and control in a community in the future”, the residents grade shows no significant difference while ” how many months after the outbreak when you participated in the epidemic prevention” shows significant difference, the result show that GP residents already have konwledge and skills for the public health prevetion, they need more attitude and mental preparation. Continuing education will have a significant positive relationship with the GP residents’s confidence of the prevetion ofpublic health prevetion.

CONCLUSION: Former medical school education and training at the regulatory training stage have a good effect for residents to master the ability of epidemic prevention and control, and to prepare for the needs of epidemic prevention and control physically and mentally. After this stage, the epidemic prevention and control training under the real situation will make a great contribution to the self-assessment and performance improvement of the final general practitioners.

PMID:36456960 | DOI:10.1186/s12909-022-03882-x

BMC Health Serv Res. 2022 Dec 1;22(1):1462. doi: 10.1186/s12913-022-08796-4.

ABSTRACT

BACKGROUND: When a new guideline is published there is a need to understand how its recommendations can best be implemented in real-world practice. Yet, guidelines are often published with little to no roadmap for organizations to follow to promote adherence to their recommendations. The purpose of this study was to evaluate the impact of using a common process model to implement a single clinical practice guideline across multiple physical therapy clinical settings.

METHODS: Five organizationally distinct sites with physical therapy services for patients with peripheral vestibular hypofunction participated. The Knowledge to Action model served as the foundation for implementation of a newly published guideline. Site leaders conducted preliminary gap surveys and face-to-face meetings to guide physical therapist stakeholders’ identification of target-behaviors for improved guideline adherence. A 6-month multimodal implementation intervention included local opinion leaders, audit and feedback, fatigue-resistant reminders, and communities of practice. Therapist adherence to target-behaviors for the 6 months before and after the intervention was the primary outcome for behavior change.

RESULTS: Therapist participants at all sites indicated readiness for change and commitment to the project. Four sites with more experienced therapists selected similar target behaviors while the fifth, with more inexperienced therapists, identified different goals. Adherence to target behaviors was mixed. Among four sites with similar target behaviors, three had multiple areas of statistically significantly improved adherence and one site had limited improvement. Success was most common with behaviors related to documentation and offering patients low technology resources to support home exercise. A fifth site showed a trend toward improved therapist self-efficacy and therapist behavior change in one provider location.

CONCLUSIONS: The Knowledge to Action model provided a common process model for sites with diverse structures and needs to implement a guideline in practice. Multimodal, active interventions, with a focus on auditing adherence to therapist-selected target behaviors, feedback in collaborative monthly meetings, fatigue-resistant reminders, and developing communities of practice was associated with long-term improvement in adherence. Local rather than external opinion leaders, therapist availability for community building meetings, and rate of provider turnover likely impacted success in this model.

TRIAL REGISTRATION: This study does not report the results of a health care intervention on human participants.

PMID:36456945 | DOI:10.1186/s12913-022-08796-4

BMC Oral Health. 2022 Dec 1;22(1):555. doi: 10.1186/s12903-022-02546-y.

ABSTRACT

BACKGROUND: The purpose of this retrospective study was to evaluate the mandibular shape differences between a group of success and a group of failure Anterior Open Bite (AOB) malocclusion early orthodontic treatment in growing subjects, in order to identify mandibular features of relapse.

METHODS: Twenty three patients (7 males, 16 females, 9.3 years ±1,5 years) were enrolled from the Department of Orthodontics at the University of Rome Tor Vergata. Inclusion criteria were: white ancestry, overbite < 0 mm, mixed dentition phase, end-to-end or Class I molar relationship, first skeletal class assessed on lateral cephalograms (0° < ANB < 4°), cervical skeletal maturation CS1-CS2, no previous orthodontic treatment, no congenital diseases. Pre-treatment (T1) lateral cephalograms were acquired. Each patient underwent early orthodontic treatment with Rapid Maxillary Expander (RME) and Bite Block (BB) or Quad-Helix Crib (QHC) until open bite correction. Radiographic records were recollected at T2 (permanent dentition, skeletal cervical maturation CS3-CS4). Mean interval time T2-T1 was 4.2 years ±6 months. According to treatment stability, a Relapse Group (RG 11 patients, 3 M, 8F; 13.7 years ±8 months, 7 subjects treated with RME/BB, 4 with QH/C) and a Success Group (SG, 12 patients, 4 M, 8F; 13.4 ± 10 months, 7 subjects treated with QH/C, 5 with RME/BB) were identified. On the lateral radiographs the mandibular length (Co-Gn), the inferior gonial angle (NGo^GoMe) and the antegonial notch depth (AND) were analyzed. Then the mandibular Geometric Morphometric analysis (GMM) was applied. Intergroup statistically significant differences were found using student’s t-tests. Procrustes analysis and principal component analysis (PCA) were performed for the GMM.

RESULTS: At T1 no statistically significant differences were found between RG and SG, however higher values of antegonial notch depth were found in RG. T2-T1 comparison showed in RG statistically significant increases in Co-Gn (p = 0.04), NGo^GoMe angle (p = 0.01) and antegonial notch depth (p = 0,04). PC1 confirmed the increase in the antegonial notch depth in RG when compared to SG at T2.

CONCLUSIONS: The increased antegonial notch depth associated with the increased mandibular length and the increased gonial angle could be responsible of relapse of early orthodontic treatment in open bite growing subjects.

PMID:36456943 | DOI:10.1186/s12903-022-02546-y

BMC Oral Health. 2022 Dec 1;22(1):547. doi: 10.1186/s12903-022-02579-3.

ABSTRACT

BACKGROUND: Pain and clicking are the primary complaints in patients suffering from temporomandibular joint disc displacement with reduction (DDwR), negatively affecting the patients’ quality of life, making the treatment essential. This prospective randomized controlled trial (RCT) was conducted to evaluate the effectiveness of botulinum toxin type-A (BTX-A) and low level laser therapy (LLLT) in comparison to anterior repositioning appliance (ARA) for the treatment of DDwR.

METHODS: A total of 27 patients were randomly allocated to 3 groups; ARA (control group), BTX-A, and LLLT; with 9 patients each. All patients were evaluated before and 3 months after the treatment using a visual analogue scale (VAS) and magnetic resonance imaging (MRI).

RESULTS: At 3 months follow-up, all groups showed a significant reduction in pain assessed by VAS (P = 0.007). Measured on MRI, there was a significant improvement in disc position and joint space index (JSI) in BTX-A group (P < 0.001, P = 0.011) and LLLT group (P = 0.002, P = 0.017) in comparison to the control group (P = 0.087, P = 0.066) respectively. As for time of recovery, a statistically significant difference was observed in BTX-A group (P < 0.001) and LLLT (P < 0.001) group in comparison to ARA group, which showed the most prolonged duration for reduction of DDwR symptoms.

CONCLUSION: We concluded that BTX-A and LLLT could be considered effective alternative treatment modalities to ARA regarding reducing joint pain, clicking, and improving disc position in patients with symptomatic DDwR.

TRIAL REGISTRATION: This prospective double-blinded RCT has been registered at ClinicalTrials.gov with identification number: NCT05194488, 18/1/2022.

PMID:36456937 | DOI:10.1186/s12903-022-02579-3

BMC Endocr Disord. 2022 Dec 2;22(1):299. doi: 10.1186/s12902-022-01207-z.

ABSTRACT

BACKGROUND: GnRHa treatment was established for improving final adult height (FAH) in children presenting with Idiopathic central precocious puberty (ICPP) up to age 8, while several controversies remained for older age groups. The primary objective was to evaluate whether boys diagnosed with ICPP over 9 years of chronological age (CA) could achieve a height benefit from GnRHa treatment.

METHODS: We retrospectively evaluated the medical records of 23 boys treated for idiopathic central precocious puberty between January 2018 and January 2021 at Jiangsu Children’s Medical Center. All patients started treatment with intramuscular depot GnRHa at a dose of 80-100 μg/kg, followed by continuous intramuscular injection every 28 days at a dose of 60-80 μg/kg. The hormonal parameters, bone age/chronological age ratio, FAH, growth velocity (GV), tanner staging and body mass index (BMI) were assessed during the treatment period.

RESULTS: After one course of treatment (3 months), the basal FSH and testosterone levels were reduced, while the basal LH value was not significantly changed compared with those before treatment. Furthermore, the mean BA/CA ratio reduction was statistically significant at month 12. The mean PAH following administration of GnRHa after 12 months was statistically improved compared with those at baseline. In addition, the clinical sign of puberty and GV were significantly improved and the BMI remained unchanged as desired at month 12.

CONCLUSIONS: This analysis highlighted the positive outcome on the decrease in the rate of bone maturation, with a favorable effect on progression of clinical signs of puberty. Furthermore, our study confirmed PAH was improved even in the older children at onset of treatment (ages 9-10), emphasizing the importance of personalized treatment in such population.

PMID:36456936 | DOI:10.1186/s12902-022-01207-z

BMC Plant Biol. 2022 Dec 2;22(1):557. doi: 10.1186/s12870-022-03955-5.

ABSTRACT

Containing the largest number of species, the orchid family provides not only materials for studying plant evolution and environmental adaptation, but economically and culturally important ornamental plants for human society. Previously, we collected genome and transcriptome information of Dendrobium catenatum, Phalaenopsis equestris, and Apostasia shenzhenica which belong to two different subfamilies of Orchidaceae, and developed user-friendly tools to explore the orchid genetic sequences in the OrchidBase 4.0. The OrchidBase 4.0 offers the opportunity for plant science community to compare orchid genomes and transcriptomes and retrieve orchid sequences for further study.In the year 2022, two whole-genome sequences of Orchidoideae species, Platanthera zijinensis and Platanthera guangdongensis, were de novo sequenced, assembled and analyzed. In addition, systemic transcriptomes from these two species were also established. Therefore, we included these datasets to develop the new version of OrchidBase 5.0. In addition, three new functions including synteny, gene order, and miRNA information were also developed for orchid genome comparisons and miRNA characterization.OrchidBase 5.0 extended the genetic information to three orchid subfamilies (including five orchid species) and provided new tools for orchid researchers to analyze orchid genomes and transcriptomes. The online resources can be accessed at https://cosbi.ee.ncku.edu.tw/orchidbase5/.

PMID:36456919 | DOI:10.1186/s12870-022-03955-5

BMC Med Res Methodol. 2022 Dec 1;22(1):308. doi: 10.1186/s12874-022-01783-7.

ABSTRACT

BACKGROUND: Altering cover letter information to reduce non-response bias in trauma research could inadvertently leave survey participants unprepared for potentially upsetting questions. In an unsolicited, mailed survey, we assessed participants’ change in affect post-survey after altering key cover letter information and promising different incentives. We tested direct and indirect effects of participants carefully reading the cover letter on changes in their affect post-survey.

METHODS: In a 3X2X2 randomized, factorial trial, 480 male and 480 female, nationally representative Veterans who were applying for posttraumatic stress disorder disability benefits were randomized to receive one of 12 different cover letters. The cover letters provided general versus more explicit information about the survey’s trauma content and how their names were selected for study; we also promised different incentives for returning the survey. The main outcome was change in affect post-survey. We examined five potential moderators: combat or military sexual trauma exposure, posttraumatic stress disorder or serious mental illness diagnosis, and recency of military service. Mediators between reading the cover letter carefully and post-survey affect included how participants rated the cover letters’ information and whether they thought the cover letters prepared them for the survey’s content. A Bonferroni corrected alpha of 0.003 was the threshold for statistical significance.

RESULTS: One hundred ninety men and 193 women reported their pre-and post-survey affect. Across all study conditions, out of 16 possible points, the net change in affect post-survey was less than a quarter-point for men and women. Mean changes in post-survey affect did not differ statistically significantly across any of the study factors (ps > 0.06); nor were there statistically significant interactions between any of the study factors and the 5 moderators after accounting for multiple comparisons (ps > 0.02). After controlling for pre-survey affect, reading the cover letter carefully had small effects on changes in post-survey affect, with larger associations seen in the women compared to men. Mediators’ effects were often in opposite directions for men and women.

CONCLUSION: General descriptions of a survey’s trauma content appear ethically defensible. Research on cover letters’ impacts on survey participants’ emotional reactions and how those impacts differ by gender is needed.

PMID:36456912 | DOI:10.1186/s12874-022-01783-7