Tag: statistics

Lab Med. 2023 Nov 2;54(6):652-658. doi: 10.1093/labmed/lmad025.

ABSTRACT

OBJECTIVE: The aim of this study was to optimize the currently used direct spectrophotometric serum prolidase enzyme activity (SPEA) assay method and compare its diagnostic accuracy with current precipitation and direct spectrophotometric assay methods, AST-to-ALT ratio, age platelet index, AST-to-platelet ratio index, cirrhosis discriminate score, Doha score, FIB-4, FibroQ, fibrosis index, Goteborg University Cirrhosis Index , King’s score, and Pohl score for distinguishing Ishak F0 from F1-F3 in patients with chronic hepatitis B (CHB) infection.

METHODS: Liver biopsy results from 112 patients were included in this study.

RESULTS: The SPEA values were 529 (292-794) U/L, 671 (486-927) U/L, and 1077 (867-1399) U/L with the precipitation, current, and optimized direct spectrophotometric assay methods, respectively. According to multivariate logistic regression analysis optimized direct spectrophotometric SPEA was the only statistically significant parameter to predict the early stages of liver fibrosis.

CONCLUSIONS: Optimized direct spectrophotometric SPEA assay method could be used to distinguish early stages of liver fibrosis in patients with CHB infection instead of the currently used spectrophotometric SPEA assay methods and other evaluated liver fibrosis indexes.

PMID:37934976 | DOI:10.1093/labmed/lmad025

J Glob Health. 2023 Nov 9;13:04140. doi: 10.7189/jogh.13.04140.

ABSTRACT

BACKGROUND: The high costs of novel anticancer drugs have caused concern among healthcare stakeholders. To address the knowledge gap on the proportion of survival benefit with the related economic expenditure, we aimed to assess the correlation between the costs and value of innovative drugs targeted to specific tumours, before and after price negotiation policy implementation.

METHODS: We identified new drugs for lung and breast cancer that entered the National Reimbursement Drug List (NRDL) through price negotiation from 2016 to 2023. Therapeutic value consisted of traditional clinical endpoints, like the percentage improvement of overall survival (ΔOS%) and progression-free survival (ΔPFS%), and the quantified gains of the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). We calculated monthly drug costs and used Spearman’s correlation coefficient and Cohen’s kappa statistics for statistical analysis.

RESULTS: Twenty-nine innovative price-negotiated drugs were collected between 2016 and 2023. The median monthly costs were US$3381.31 out of NRDL and US$1095.88 within NRDL, with an ΔOS% of 22.24% (IQR = 6.45-29.48) and a ΔPFS% of 83.82% (IQR = 50.41-104.05). The median ASCO-VF score was 40.98, and 17 drugs scored the meaningful benefit of ESMO-MCBS. We found no association between clinical benefits and their costs before and after NRDL, either overall or for specific cancers. The agreement between the two frameworks was stable.

CONCLUSIONS: The negotiation policy decreased medication costs, but did not generate the expected correlation between the value and costs of anticancer drugs. Comprehensive value assessments need to be performed in the future to explore more in-depth findings and promote the affordability and availability of effective anticancer drugs.

PMID:37934965 | DOI:10.7189/jogh.13.04140

J Public Health (Oxf). 2023 Nov 2:fdad214. doi: 10.1093/pubmed/fdad214. Online ahead of print.

ABSTRACT

BACKGROUND: This meta-analysis reports the relationship between hepatitis B virus (HBV), hepatitis C virus (HCV), smoking and their combined impact on the development of hepatocellular carcinoma (HCC).

METHODS: We conducted a systematic search of PubMed, Web of Science and Scopus databases up to 15 July 2023. Observational studies investigating the association between HBV, HCV and smoking in the development of HCC were included. We assessed between-study heterogeneity using the I2 statistics. The effect sizes were estimated as odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model.

RESULTS: Out of 20 794 studies identified in the initial search, 32 observational studies involving 22 282 participants met the inclusion criteria. Our meta-analysis showed that the combined impact of HBV and smoking was associated with an OR of 19.81 (95% CI: 14.77, 26.58), HCV and smoking was associated with an OR of 24.86 (95% CI: 12.41, 49.79), and coinfection of HBV and HCV was associated with an OR of 32.58 (95% CI: 20.57, 51.60).

CONCLUSIONS: Our findings indicate a significant interaction between HBV, HCV and smoking in the development of HCC and highlight the importance of addressing smoking cessation and viral hepatitis prevention and treatment as potential strategies for reducing HCC.

PMID:37934962 | DOI:10.1093/pubmed/fdad214

J Public Health (Oxf). 2023 Nov 2:fdad209. doi: 10.1093/pubmed/fdad209. Online ahead of print.

ABSTRACT

BACKGROUND: This article addresses the urgent need for more evidence-based research using primary data to document how the COVID-19 pandemic affected the health and social wellbeing of disabled individuals. Our study sought to determine if adults with disabilities, and with specific types of disability, were more likely to suffer adverse health and social impacts related to COVID-19 than nondisabled adults in metropolitan Texas, during the first 18 months of the pandemic.

METHODS: We collected primary data from randomly selected residents in eight Texas metropolitan areas through a bilingual telephone survey in July 2021. Statistical analysis comprised multivariable generalized estimating equations that control for relevant sociodemographic and COVID-related risk factors, and spatial clustering.

RESULTS: Disabled survey respondents had been more adversely affected by COVID-19 than nondisabled respondents, in terms of mental and physical health, health care access, living conditions and social life. Significant disparities were also found for almost all COVID-19 impacts when the disabled category was disaggregated by disability type. Respondents experiencing cognitive and independent living difficulties were negatively impacted in all five areas of life examined.

CONCLUSIONS: Findings emphasize the need to consider a wide range of impacts associated with the COVID-19 pandemic that negatively affect the health and social wellbeing of disabled persons, as well as develop disability-inclusive policies that provide adequate protections.

PMID:37934958 | DOI:10.1093/pubmed/fdad209

Menopause. 2023 Nov 7. doi: 10.1097/GME.0000000000002273. Online ahead of print.

ABSTRACT

OBJECTIVE: Carotid artery intima media thickness (cIMT) and adventitial diameter (AD) are subclinical atherosclerosis indicators. Metabolic syndrome (MetS) and obesity are risk factors for atherosclerosis, but their combined impact on atherosclerosis risk is unknown. This study sought to examine the effect of the co-occurrence of MetS with obesity on cIMT and AD.

METHODS: The Study of Women’s Health Across the Nation (SWAN) is a multi-center, multi-ethnic study. Carotid ultrasound assessments and concurrent physiologic measurements were undertaken between 2009 and 2013. This cross-sectional analysis included 1,433 women with body mass index ≥18.5 kg/m2 and free of prevalent clinical cardiovascular disease. Multivariable linear regression models were used to relate maximum cIMT and AD (dependent variables) with obesity, MetS and their interaction.

RESULTS: The average age was 60.1 years (standard deviation [SD], 2.7 y). The prevalence of obesity and MetS was 44% and 35%, respectively. Women with obesity had a 0.051 mm larger mean cIMT and women with MetS had a 0.057 mm larger cIMT versus women without the respective conditions (both P < 0.001). There was a statistically significant interaction between obesity and MetS (P = 0.011); women with both had a model-adjusted predicted mean cIMT of 0.955 mm (95% confidence interval [CI], 0.897-1.013), higher than those with MetS alone (0.946 mm; 95% CI, 0.887-1.005), obesity alone (0.930 mm; 95% CI, 0.873-0.988), or neither condition (0.878 mm; 95% CI, 0.821-0.935). AD results were similar.

CONCLUSIONS: Early detection and treatment of atherosclerotic changes may prevent significant disease. This study suggests there is a minimal impact of obesity on carotid artery thickness beyond MetS alone. All individuals with metabolic dysfunction, regardless of obesity status, should be considered at increased risk for atherosclerotic changes.

PMID:37934935 | DOI:10.1097/GME.0000000000002273

J Chem Inf Model. 2023 Nov 7. doi: 10.1021/acs.jcim.3c01490. Online ahead of print.

ABSTRACT

The electrostatic properties of proteins arise from the number and distribution of polar and charged residues. Electrostatic interactions in proteins play a critical role in numerous processes such as molecular recognition, protein solubility, viscosity, and antibody developability. Thus, characterizing and quantifying electrostatic properties of a protein are prerequisites for understanding these processes. Here, we present PEP-Patch, a tool to visualize and quantify the electrostatic potential on the protein surface in terms of surface patches, denoting separated areas of the surface with a common physical property. We highlight its applicability to elucidate protease substrate specificity and antibody-antigen recognition and predict heparin column retention times of antibodies as an indicator of pharmacokinetics.

PMID:37934909 | DOI:10.1021/acs.jcim.3c01490

Rev Med Inst Mex Seguro Soc. 2023 Oct 2;61(Suppl 3):S437-S444. doi: 10.5281/zenodo.8319828.

ABSTRACT

BACKGROUND: Central Cord Syndrome is the most common incomplete spinal cord injury, and it represents 9% of all spinal injuries of the adult.

OBJECTIVE: to determine the risk factors associated with lethality or/and mechanical ventilation (MV) in patients with Central Cord Syndrome (CCS).

MATERIAL AND METHODS: upon a retrospective cohort with patients with posttraumatic CCS we evaluated at the time of emergency admission and until the hospital discharge. The dependent variable was dead or MV. We calculated incidence, relative risk (RR) with CI95% and a multivariate model for the association of statistically significant variables by means of a risk coefficient model upon the variables that evidenciated tendencies towards risk.

RESULTS: From 101 patients with CCS, 85.1% with a severe medullary canal stenosis and 9.9% required MV; the mortality was 13.9%. The only risk factor associated with dead was the use of MV with an RR of 3.6 (CI95% 1.4-9.5); the risk with tendencies towards MV was being older than 60 RR 5.4 (CI95% 0.6-44.2). Other factors demonstrated a tendency towards mortality, but they were not statistically significant.

CONCLUSIONS: MV is a risk factor associated with mortality, other factors evidenciated tendencies towards mortality; being older than 60, hypertension, diabetes mellitus, narrow spinal canal, more than 20 days of hospital stay and being intervened farther than 10 days from the accident. The incidence of mortality in our sample is greater than thus reported previously on other international articles. To know and identify these and other factors will let us identify patients with a greater risk of complications.

PMID:37934901 | DOI:10.5281/zenodo.8319828

Rev Med Inst Mex Seguro Soc. 2023 Oct 2;61(Suppl 3):S429-S436. doi: 10.5281/zenodo.8319823.

ABSTRACT

BACKGROUND: Nowadays elderly live longer but with more diseases and geriatric syndromes which can deteriorate their quality of life (QoL). Peritoneal dialysis (PD) is a renal replacement therapy which seeks to prolong an improve QoL; however, this is uncertain in elderly. Therefore, comparing QoL before and after starting dialysis in this population may let us know if there is a benefit at this level.

OBJECTIVE: Identify the QoL that patients have before and after PD.

MATERIAL AND METHODS: Longitudinal, comparative, prospective cohort, before and after study. Elderly with End Stage Renal Disease in whom hospitalization for PD was indicated. QoL was measured the instrument KDQOL SF 1.3. before and after 2 months of PD. Statistical Analysis: T paired test was performed with the basal value of QoL and after. Risks with 95% confidence intervals and X2 were obtained between the basal characteristics and the dependent variable of QoL.

RESULTS: 21 patients. After 2 months the QoL had an increment in comparison to basal QoL, but with no statistical significance (63.47 [SD 16.63] Vs 56.83 [16.01], P= 0.22. In the 7th decade PD increased QoL by 13.01 points (P= 0.04).

CONCLUSIONS: PD increases QoL in the 7th decade.

PMID:37934898 | DOI:10.5281/zenodo.8319823

Ginekol Pol. 2023 Nov 7. doi: 10.5603/gpl.97186. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study is to compare the evaluation of cervical length measured by the Bishop score and transvaginal ultrasonography in determining the need for prostaglandin application for cervical ripening in term nulliparous pregnancies.

MATERIAL AND METHODS: In our study, a total of 120 patients who were admitted to our hospital between February 2015 and August 2015 were divided into two groups as cervical length group and Bishop score group according to hospitalization order by applying the Permuted Block Randomization method, which is one of the Restricted Randomization methods. Each patient included in the study was evaluated with both the Bishop score and transvaginal ultrasonography. Groups were compared according to the APGAR scores in the 1st and 5th minutes, transition within 12 hours, birthing within 24 hours, birthing with only dinoprostone, birthing with only oxytocin, duration of administration of dinoprostone, duration of oxytocin administration, type of birth, rate of cesarean section, and need for neonatal intensive care.

RESULTS: While cervical ripening with dinoprostone was applied to 28 (46.7%) of 60 pregnant women in the Bishop group, labor induction with oxytocin was applied to the remaining 32 (53.3%) pregnant women. In the cervical length group, these values were 33 (55.0%) and 27 (45.0%), respectively. There was no statistically significant difference between study groups in terms of the need for dinoprostone for cervical ripening (p = 0.361). Of those with a Bishop score of 4 or below, 78.6% (n = 22) had a cervical length of over 28 mm, and 71.4% (n = 20) needed oxytocin. Of those with a Bishop score above 4, none of them had a cervical length greater than 28 mm. A statistically significant difference was found between those with a Bishop score of 4 or below and those above 4 in terms of cervical length (p < 0.05). Among those with a Bishop score of 4 or below, the percentage of those with a cervical length above 28 mm was significantly higher than that of those with a Bishop score above 4.

CONCLUSIONS: In our study, the delivery time of those with a cervical length of 28 mm and above was significantly higher than those with a cervical length of less than 28 mm, while the bishop score was significantly lower. In order to develop a more objective method that can replace the Bishop scoring system in determining the need for cervical ripening before labor induction, prospective randomized studies that screen larger numbers of patients are needed.

PMID:37934896 | DOI:10.5603/gpl.97186

Adv Mater. 2023 Nov 7:e2308843. doi: 10.1002/adma.202308843. Online ahead of print.

ABSTRACT

The practical implementation of memristors in neuromorphic computing and bio-mimetic sensing suffers from unexpected temporal and spatial variations due to the stochastic formation and rupture of conductive filaments (CFs). Here, we patterned the bio-compatible silk fibroin (SF) with an on-demand nanocone array by using thermal scanning probe lithography (t-SPL) to guide and confine the growth of CFs in the Silver/Silk Fibroin/Gold (Ag/SF/Au) memristor. Benefiting from the high fabrication controllability, cycle-to-cycle (temporal) standard deviation of the set voltage for the structured memristor has been significantly reduced by ∼95.5% (from 1.535 V to 0.0686 V) and the device-to-device (spatial) standard deviation has also been reduced to 0.0648 V. Besides, the statistical relationship between the structural nanocone design and the resultant performance was confirmed, optimizing at the small operation voltage (∼0.5 V) and current (100 nA), ultrafast switching speed (sub-100 ns), large on/off ratio (10⁴ ), and the smallest switching slope (SS < 0.01 mV/dec). Finally, the short-term plasticity and leaky integrated-and-fire behavior were emulated, and a reliable thermal nociceptor system was demonstrated for practical neuromorphic applications. This article is protected by copyright. All rights reserved.

PMID:37934889 | DOI:10.1002/adma.202308843