Tag: statistics

Clin Lab. 2023 Oct 1;69(10). doi: 10.7754/Clin.Lab.2023.230512.

ABSTRACT

BACKGROUND: The Helicobacter pylori eradication rate with standard triple therapy (STT) is continuously decreasing due to clarithromycin resistance. This study aimed to investigate the eradication rate of empirical and tailored therapy and explore various factors affecting this eradication rate using clarithromycin resistance test data for the last 4 years at a single institution in Daegu.

METHODS: From August 2018 to July 2021, a total of 1,395 patients diagnosed with H. pylori infection based on rapid urea testing and histology at Keimyung University Dongsan Hospital were retrospectively examined. Participants were classified into the empirical and tailored therapy groups according to the results of the clarithromycin resistance test using the polymerase chain reaction.

RESULTS: The overall eradication rate of empirical STT was 72.8%, and the eradication rate by year was 71.6% in 2018, 77.4% in 2019, 70.3% in 2020, and 70.6% in 2021; the differences were not statistically significant (p = 0.173). No significant difference was noted in the eradication rate according to gender, age, type of proton pump inhibitors, and use of probiotics. Significant differences were noted in the eradication rate according to the treat-ment period: 69.7% in the 7-day, 67.3% in the 10-day, and 81.4% in the 14-day group (p = 0.001). The eradication rate with STT was 87.4% in the non-resistant group. In the case of clarithromycin resistance, treatment was mainly with bismuth quadruple therapy (BQT), and the eradication rate was 86.1%. The eradication rate was higher with administration of BQT for 10 days or 14 days than for administration of BQT for 7 days, but with no statistical significance (p = 0.364).

CONCLUSIONS: Extending the treatment period of STT helped in improving the eradication rate, and tailored therapy through clarithromycin resistance testing showed superior results when compared to empirical therapy.

PMID:37844041 | DOI:10.7754/Clin.Lab.2023.230512

Clin Lab. 2023 Oct 1;69(10). doi: 10.7754/Clin.Lab.2023.230517.

ABSTRACT

BACKGROUND: The study investigates the prognostic impact of D-dimer levels in patients with cardiogenic shock (CS). Although D-dimer levels were found to be associated with prognosis in various clinical settings such as heart failure or acute myocardial infarction (AMI), the prognostic role of D-dimer levels in CS patients has not yet been clarified.

METHODS: Consecutive CS patients with and without concomitant AMI were prospectively included from 2019 to 2021. The prognostic impact of D-dimer levels was tested for 30-day all-cause mortality within the entire study cohort and stratified by the presence or absence of AMI. Statistical analyses included C-statistics, Kaplan-Meier, and multivariate Cox regression analyses.

RESULTS: One hundred and twenty-three consecutive CS patients were included with an overall all-cause mortality at 30 days of 55%. The median D-dimer level on admission was 8.44 mg/L, whereas D-dimer levels were higher in 30-day non-survivors compared to survivors (median 13.0 vs. 5.2 mg/L; p = 0.011). D-dimer levels above the median were associated with an increased risk of 30-day all-cause mortality compared to patients with lower D-dimer levels (66% vs. 54%, log rank p = 0.050; HR = 1.594; 95% CI 0.979 – 2.594; p = 0.061), especially in patients with non-AMI-related CS (65% vs. 30%, log rank p = 0.010). The prognostic value of D-dimer levels was still demonstrated after multivariate adjustment (HR = 1.024; 95% CI 1.004 – 1.045; p = 0.020).

CONCLUSIONS: D-dimer measurement may be a reliable biomarker to predict the risk of 30-day mortality in CS patients, especially in patients with non-AMI related CS.

PMID:37844039 | DOI:10.7754/Clin.Lab.2023.230517

Carbohydr Polym. 2023 Dec 15;322:121338. doi: 10.1016/j.carbpol.2023.121338. Epub 2023 Aug 28.

ABSTRACT

Machine learning (ML) has been used for many clinical decision-making processes and diagnostic procedures in bioinformatics applications. We examined eight algorithms, including linear discriminant analysis (LDA), logistic regression (LR), k-nearest neighbor (KNN), random forest (RF), gradient boosting machine (GBM), support vector machine (SVM), Naïve Bayes classifier (NB), and artificial neural network (ANN) models, to evaluate their classification and prediction capabilities for four tissue types in Wolfiporia extensa using their monosaccharide composition profiles. All 8 ML-based models were assessed as exemplary models with AUC exceeding 0.8. Five models, namely LDA, KNN, RF, GBM, and ANN, performed excellently in the four-tissue-type classification (AUC > 0.9). Additionally, all eight models were evaluated as good predictive models with AUC value > 0.8 in the three-tissue-type classification. Notably, all 8 ML-based methods outperformed the single linear discriminant analysis (LDA) plotting method. For large sample sizes, the ML-based methods perform better than traditional regression techniques and could potentially increase the accuracy in identifying tissue samples of W. extensa.

PMID:37839831 | DOI:10.1016/j.carbpol.2023.121338

Health Soc Care Deliv Res. 2023 Oct;11(17):1-114. doi: 10.3310/PRWQ4012.

ABSTRACT

BACKGROUND: Vertical integration means merging organisations that operate at different stages along the patient pathway. We focus on acute hospitals running primary care medical practices. Evidence is scarce concerning the impact on use of health-care services and patient experience.

OBJECTIVES: To assess the impact of vertical integration on use of hospital services, service delivery and patient experience and whether patients with multiple long-term conditions are affected differently from others.

DESIGN: Rapid, mixed methods evaluation with four work packages: (1) review of NHS trust annual reports and other sources to understand the scale of vertical integration across England; (2) development of the statistical analysis; (3) analysis of national survey data on patient experience, and national data on use of hospital services over the 2 years preceding and following vertical integration, comparing vertically integrated practices with a variety of control practices; and (4) focus groups and interviews with staff and patients across three case study sites to explore the impact of vertical integration on patient experience of care.

RESULTS: At 31 March 2021, 26 NHS trusts were in vertically integrated organisations, running 85 general practices across 116 practice sites. The earliest vertical integration between trusts and general practices was in 2015; a mean of 3.3 practices run by each trust (range 1-12). On average, integrated practices have fewer patients, are slightly more likely to be in the most deprived decile of areas, are more likely to hold an alternative provider medical services contract and have worse Quality and Outcomes Framework scores compared with non-integrated practices. Vertical integration is associated with statistically significant, modest reductions in rates of accident and emergency department attendances: 2% reduction (incidence rate ratio 0.98, 95% confidence interval 0.96 to 0.99; p < 0.0001); outpatient attendances: 1% reduction (incidence rate ratio 0.99, 95% confidence interval 0.99 to 1.00; p = 0.0061), emergency inpatient admissions: 3% reduction (incidence rate ratio 0.97, 95% confidence interval 0.95 to 0.99; p = 0.0062) and emergency readmissions: 5% reduction (incidence rate ratio 0.95, 95% confidence interval 0.91 to 1.00; p = 0.039), with no impact on length of stay, overall inpatient admissions or inpatient admissions for ambulatory care sensitive conditions. The falls in accident and emergency department and outpatient attendance rates are temporary. Focus groups and interviews with staff (N = 22) and interviews with patients (N = 14) showed that with vertical integration, health service improvements are introduced following a period of cultural interchange. Patients with multiple long-term conditions continue to encounter ‘navigation work’ choosing and accessing health-care provision, with diminishing continuity of care.

LIMITATIONS: In the quantitative analysis, we could not replicate the counterfactual of what would have happened in those specific locations had practices not merged with trusts. There was imbalance across three case study sites with regard to staff and patients recruited for interview, and the latter were drawn from patient participation groups who may not be representative of local populations.

CONCLUSIONS: Vertical integration can lead to modest reductions in use of hospital services and has minor or no impact on patient experience of care. Our analysis does not reveal a case for widespread roll-out of the approach.

FUTURE RESEARCH: Further quantitative follow-up of the longer-term impact of vertical integration on hospital usage and more extensive interviewing of patients and their carers about patient experiences of navigating care.

FUNDING: This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (BRACE Project no. 16/138/31) and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. 17. See the NIHR Journals Library website for further project information.

PMID:37839807 | DOI:10.3310/PRWQ4012

Angle Orthod. 2023 Oct 16. doi: 10.2319/030923-161.1. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine whether achieved outcome regarding overjet and overbite matched the predicted outcome following treatment with Invisalign (Align Technology, San Jose, Calif) aligner appliances.

MATERIALS AND METHODS: Data including pretreatment, predicted and achieved overjet, and overbite measurements provided by Align’s digital treatment facility, ClinCheck Pro, were evaluated. Descriptive statistics, Mann-Whitney U-test, and Wilcoxon rank-sum intraclass correlation (ICC) test results were calculated.

RESULTS: From an initial sample of 600, 355 adult patients satisfied the inclusion and exclusion criteria. ICC scores for data input were excellent. Median (interquartile range [IQR]) age was 30.14 (23.33, 39.92) years and most (n = 259; 72.95%) were women. Almost one-third (n = 101; 28.45%) had undergone extraction as part of their treatment. More aligners were prescribed in the initial digital treatment plan for patients (median, 44; IQR: 35, 51.5; minimum, 17; maximum, 92) undergoing extractions as part of their orthodontic treatment than those who were not (median, 24; IQR: 18.25, 32; minimum, 13; maximum, 85) (P < .0001). Planned changes in overjet differed significantly from achieved outcomes (P < .001). Planned increases in overbite resulted in up to more than twice (222.72%) as much increase than predicted. Planned reduction of overbite achieved 8.69% of its predicted reduction in extraction cases.

CONCLUSIONS: Achieved overjet and overbite measurements differed significantly from the predicted outcomes at the end of an initial sequence of aligners. Planned increases in overbite resulted in greater overbite correction than predicted, particularly in extraction cases. Planned overbite reduction was challenging, especially in patients with extractions.

PMID:37839803 | DOI:10.2319/030923-161.1

Angle Orthod. 2023 Oct 16. doi: 10.2319/052323-370.1. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of micro-osteoperforation (MOP) on the rate of piezocision-aided canine retraction (CR).

MATERIALS AND METHODS: The split-mouth study included 25 participants at the stage of commencing CR. The participants received flapless piezocision bilaterally at T0 (0 months) and MOP only on one side at T3 (3 months). The quadrant that received MOP at T3 served as the intervention, whereas the other quadrant served as the control. The primary outcome was the rate of CR, assessed using digital models. The angular change (AC) of the canine and the change in the buccal cortical bone thickness (BCBT) from before to after CR were also assessed using cone beam computed tomography.

RESULTS: The rate of CR was 0.82 ± 0.39 mm/month in the control quadrant vs 0.75 ± 0.44 mm/month in the intervention quadrant (P > .05). The AC of the canine was 2.00° ± 0.88° in the control quadrant vs 1.98° ± 0.86° in the intervention quadrant (P > .05). The crestal bone gain was 0.50 mm in the control quadrant vs 0.28 mm of bone loss in the intervention quadrant. The bone thickness at a 3-mm height was increased by 0.11 mm in the control quadrant vs a 0.29-mm decrease in the intervention quadrant. The bone thickness at a 6-mm height was decreased by 0.12 mm in the control quadrant vs a 0.15-mm decrease in the intervention quadrant. However, none of the changes or group differences in bone height or thickness were statistically significant (P > .05).

CONCLUSIONS: The periodic activation of a piezocision-aided CR site using MOP had no significant positive effect on the rate of CR, angulation of the canine, or changes in BCBT.

PMID:37839802 | DOI:10.2319/052323-370.1

Ophthalmol Glaucoma. 2023 Oct 13:S2589-4196(23)00194-1. doi: 10.1016/j.ogla.2023.10.007. Online ahead of print.

ABSTRACT

PURPOSE: To study the early postoperative efficacy and safety of an Ab Interno microhook trabeculotomy (microLOT) combined with cataract surgery in patients with open angle glaucoma.

METHODS: This prospective, randomized, interventional study was conducted on consecutive patients with visually significant cataract and mild – moderate open angle glaucoma. 114 patients were included for analysis. The patients were randomized to undergo microhook trabeculotomy with phacoemulsification (Group 1) or phacoemulsification alone (Group 2). All patients were evaluated on post-operative day 1, 15, and 30 as well as 3 months, 6 & 12 months post operatively. A p-value <0.05 was considered statistically significant. Baseline and follow-up visits were compared to determine the significant difference in the number of antiglaucoma medications (AGM), intraocular pressure (IOP), and best corrected visual acuity (BCVA).

RESULTS: There were 57 patients in each group. The baseline characteristics were similar between the two groups, except the number of AGM which were greater in Group 2. The mean preoperative IOP for Group 1 (phaco-microLOT) was 26.5 mmHg ±5.2 and Group 2 (phaco alone group) was 25.3 mmHg ±3.1 which decreased to 12.5 mmHg ±3.6(p<0.001) and 20.0 mmHg ± 2.7(p<0.001) at 12 months, respectively. LogMAR Visual acuity improved from 0.48 (IQR, 0.30-0.60) preop to 0.00 (0.00-0.18) post-op (p<0001) in Group 1 and improved from 0.30(IQR 0.30-0.48) to 0.00(0.00-0.00) in Group 2(p<0.001). In Group 1, the mean (SD) AGM used preoperatively was 0.6 (0.9) which was significantly reduced to 0.2 (0.5) at 12 months postoperatively, while in Group 2, at 12 months, the mean (SD) AGM used was reduced from 1.4(0.6) to 1.1(0.9). 90.3% of eyes in Group 1 achieved complete success at the end of one year. The most common complication was hyphema, noted in four patients with 1 eye requiring an anterior chamber washout.

CONCLUSION: Ab interno microhook trabeculotomy (microLOT) combined with phacoemulsification in patients with open angle glaucoma is an efficacious procedure with relatively minimal complications.

PMID:37839794 | DOI:10.1016/j.ogla.2023.10.007

J Endod. 2023 Oct 13:S0099-2399(23)00648-9. doi: 10.1016/j.joen.2023.10.003. Online ahead of print.

ABSTRACT

INTRODUCTION: The efficacy and safety of a single novel electronic pulp sensitivity tester with a transilluminator (PSTT) capable of providing four different tests was compared with gold standard (GS) pulp testing methods.

METHODS: Four hundred eighty teeth, including three from each quadrant and their contralateral and opposing teeth, were randomly assessed using PSTT or GS methods. Seven days later, the same teeth were assessed using the method not used earlier, so that all teeth were evaluated using both methods. Sixty previously root canal treated teeth, serving as negative controls, were assessed identically to the experimental groups. Results were analyzed using IBM SPSS (p<.05).

RESULTS: A higher percentage of teeth responded to cold and electricity using GS methods compared to PSTT (99.4 vs. 93.1, and 99.6 vs. 97.3, respectively). A lower percentage of teeth responded to heat using the GS method compared to PSTT (50.0 vs. 68.1). Chi-square tests determined differences in the proportion of sensitivity to temperature and electric testing methods were statistically significant (p<.001 and p=.004, respectively). No difference in proportion of sensitivity was observed for transillumination. Wilcoxon Sign-Rank test determined significantly shorter cold testing times using the GS method (p=.024). Shorter testing times were observed using the PSTT for heat (p<.001), EPT (p=.048), and transillumination (p=.001). Overall PSTT testing time was significantly shorter than GS testing time (p=.03). Tissue injury was not observed.

CONCLUSIONS: The PSTT efficiently and safely provided heat and transillumination for pulpal diagnosis. Improvements are needed to enhance the cold and electric stimulus efficacy.

PMID:37839772 | DOI:10.1016/j.joen.2023.10.003

Microb Pathog. 2023 Oct 13:106377. doi: 10.1016/j.micpath.2023.106377. Online ahead of print.

ABSTRACT

The prevalence of Blastocystis sp., its genetic diversity and the distribution of circulating subtypes (STs) were molecularly investigated in a cohort of autochthonous and immigrant patients with gastrointestinal symptoms hospitalized over the period February 2022-June 2023 at the Policlinico Ospedaliero-Universitario “Riuniti”, Foggia, in Southern Italy. The population variables, including patient geographical origin, gender and age classes were reported. Out of the 927 investigated patients, 36 (3.9%) were positive for Blastocystis sp. A statistically significant association with African origin and age classes >18 years old was found. ST1 (allele 4), ST2 (alleles 9, 13), ST3 (alleles 34, 36) and ST4 (allele 92) were the subtypes detected with a different distribution between autochthonous and immigrant patients. Co-infections with enteric protozoa such as Giardia duodenalis and Dientamoeba fragilis, pathogenic bacteria as Clostridioides difficile, Campylobacter jejuni and Aeromonas sp. and viral infections such as Norovirus were found in 33% of cases. This is the first study of Blastocystis sp., its circulating subtypes and allele variability among patients with different geographical origin in an area of Southern Italy, in the Central Mediterranean, characterized by high immigrant pressure. These results provide baseline data to better investigate a potential interaction between Blastocystis sp. and other risk factors in patients with gastrointestinal symptoms.

PMID:37839760 | DOI:10.1016/j.micpath.2023.106377

Chemosphere. 2023 Oct 13:140450. doi: 10.1016/j.chemosphere.2023.140450. Online ahead of print.

ABSTRACT

Determination of pharmaceuticals especially anticancer drugs is one of the important issues in environmental and medical investigation and creating good information about human health. The presence sturdy introducing an electroanalytical sensor based on molecularly imprinted polymer (MIP)/Multi-walled carbon nanotubes (MWCNTs)/Au@Fe₃O₄ nanoparticles modified carbon paste electrode (PE) to determine imatinib (IMA). The MIP/MWCNTs/Au@Fe₃O₄/PE showed catalytic activity and also a sensitive strategy to sensing IMA in the concentration range 1-1000 μM with a limit of detection of 0.013 μM. The MIP/MWCNTs/Au@Fe₃O₄/PE has shown interesting results in the analysis of IMA in real samples, and the interference investigations results show the high selectivity of the MIP/MWCNTs/Au@Fe₃O₄/PE in the monitoring of IMA in complex fluids such as tablet and blood serum and results approved by F-test and t-test as statistical methods.

PMID:37839746 | DOI:10.1016/j.chemosphere.2023.140450