RESUMEN
The summary receiver operating characteristic (SROC) curve has been recommended as one important meta-analytical summary to represent the accuracy of a diagnostic test in the presence of heterogeneous cutoff values. However, selective publication of diagnostic studies for meta-analysis can induce publication bias (PB) on the estimate of the SROC curve. Several sensitivity analysis methods have been developed to quantify PB on the SROC curve, and all these methods utilize parametric selection functions to model the selective publication mechanism. The main contribution of this article is to propose a new sensitivity analysis approach that derives the worst-case bounds for the SROC curve by adopting nonparametric selection functions under minimal assumptions. The estimation procedures of the worst-case bounds use the Monte Carlo method to approximate the bias on the SROC curves along with the corresponding area under the curves, and then the maximum and minimum values of PB under a range of marginal selection probabilities are optimized by nonlinear programming. We apply the proposed method to real-world meta-analyses to show that the worst-case bounds of the SROC curves can provide useful insights for discussing the robustness of meta-analytical findings on diagnostic test accuracy.
Asunto(s)
Metaanálisis como Asunto , Método de Montecarlo , Sesgo de Publicación , Curva ROC , Sesgo de Publicación/estadística & datos numéricos , Humanos , Simulación por Computador , Pruebas Diagnósticas de Rutina/estadística & datos numéricos , Modelos Estadísticos , Estadísticas no Paramétricas , Interpretación Estadística de DatosRESUMEN
OBJECTIVE: This study investigated the significance of serum hypoxia-inducible factor (HIF)-1α/HIF-2 α and Chitinase 3-Like protein 1 (YKL-40) levels in the assessment of vascular invasion and prognostic outcomes in patients with Follicular Thyroid Cancer (FTC). METHODS: This prospective study comprised 83 patients diagnosed with FTC, who were subsequently categorized into a recurrence group (17 cases) and a non-recurrence group (66 cases). The pathological features of tumor vascular invasion were classified. Serum HIF-1α/HIF-2α and YKL-40 were quantified using a dual antibody sandwich enzyme-linked immunosorbent assay, while serum Thyroglobulin (Tg) levels were measured using an electrochemiluminescence immunoassay method. The Spearman test was employed to assess the correlation between serum factors, and the predictive value of diagnostic factors was determined using receiver operating characteristic curve analysis. A Cox proportional hazards regression model was utilized to analyze independent factors influencing prognosis. RESULTS: Serum HIF-1α, HIF-2α, YKL-40, and Tg were elevated in patients exhibiting higher vascular invasion. A significant positive correlation was observed between Tg and HIF-1α, as well as between HIF-1α and YKL-40. The cut-off values for HIF-1α and YKL-40 in predicting recurrence were 48.25 pg/mL and 60.15 ng/mL, respectively. Patients exceeding these cut-off values experienced a lower recurrence-free survival rate. Furthermore, serum levels surpassing the cut-off value, in conjunction with vascular invasion (v2+), were identified as independent risk factors for recurrence in patients with FTC. CONCLUSION: Serum HIF-1α/HIF-2α and YKL-40 levels correlate with vascular invasion in FTC, and the combination of HIF-1α and YKL-40 predicts recurrence in patients with FTC.
Asunto(s)
Adenocarcinoma Folicular , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico , Biomarcadores de Tumor , Proteína 1 Similar a Quitinasa-3 , Subunidad alfa del Factor 1 Inducible por Hipoxia , Invasividad Neoplásica , Valor Predictivo de las Pruebas , Humanos , Proteína 1 Similar a Quitinasa-3/sangre , Femenino , Masculino , Subunidad alfa del Factor 1 Inducible por Hipoxia/sangre , Persona de Mediana Edad , Pronóstico , Adulto , Adenocarcinoma Folicular/sangre , Adenocarcinoma Folicular/patología , Adenocarcinoma Folicular/mortalidad , Estudios Prospectivos , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/sangre , Biomarcadores de Tumor/sangre , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/mortalidad , Anciano , Recurrencia Local de Neoplasia/sangre , Recurrencia Local de Neoplasia/patología , Ensayo de Inmunoadsorción Enzimática , Valores de Referencia , Adulto Joven , Estadísticas no Paramétricas , Curva ROCRESUMEN
AIM: The research aimed to determine the attitudes of students studying in health-related departments toward sexual myths and the factors affecting them. METHODS: The study is descriptive research involving 287 students enrolled in health-related departments. The data were collected using a "Descriptive Information Form" and the "Sexual Myths Scale (SMS)" and analyzed using the SPSS 22.0 software package. The SPSS 22.0 package program was used to evaluate the data. In statistical analysis, Spearman correlation analysis was employed to determine the relationship between continuous variables and the SMS score, and the statistical significance level was accepted as p<0.05. RESULTS: The total score was found to be 53.57±17.54 (min: 28.00 to max: 140.00), reflecting a moderate level. There was a statistically significant difference between the total score of SMS according to gender, family type, maternal employment status, and paternal education level (p<0.05). It was also determined that male students, students whose mothers were unemployed, who lived in extended families, and whose fathers had low education had lower SMS scores. CONCLUSION: Despite students studying in health-related departments and receiving relevant courses, their level of sexual myths remains at a moderate level, indicating the presence of knowledge gaps and misconceptions in the subject matter. Therefore, it is crucial to implement comprehensive education and counseling services on reproductive and sexual health for all university students.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Conducta Sexual , Humanos , Masculino , Femenino , Universidades , Adulto Joven , Encuestas y Cuestionarios , Adulto , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Adolescente , Estudios Transversales , Brasil , Factores Sexuales , Factores Socioeconómicos , Estudiantes del Área de la Salud/estadística & datos numéricos , Estudiantes del Área de la Salud/psicología , Estadísticas no ParamétricasRESUMEN
The aim of this study was to evaluate the wettability and adhesion of self-organized TiO2 nanotubes formed on the surface of 8 commercially pure titanium (CP-Ti) disks and 12 dental implants (n = 12) by anodization in a glycerol-H2O (50-50 v/v) electrolyte containing NH4F. Two disk specimens were not submitted to anodization (controls). The nanotubes thus obtained had average dimensions of 50 nm in diameter by 900 nm in length. The treated disk specimens were stored for 2, 14 and 35 days (n = 2), and the wettability of their surfaces was evaluated with a goniometer at the end of each storing period. The adhesion of nanotubes to titanium was evaluated by field emission scanning electron microscopy after subjecting the 12 implants to a simulation of clinical stress in two-part synthetic bone blocks. After installing the implants with the application of an insertion torque, the two halves of the block were separated, and the implants were removed. The nanotubes remained adhered to the substrate, with no apparent deformation. The contact angles after 14 days and 35 days were 16.47° and 17.97°, respectively, values significantly higher than that observed at 2 days, which was 9.24° (p < 0.05). It was concluded that the method of anodic oxidation tested promoted the formation of a surface suitable for clinical use, containing nanotubes with levels of wettability and adhesion to titanium compatible with those obtained by other methods found in the literature. The wettability, however, did not prove stable over the tested storage periods.
Asunto(s)
Implantes Dentales , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Nanotubos , Oxidación-Reducción , Propiedades de Superficie , Titanio , Humectabilidad , Titanio/química , Factores de Tiempo , Nanotubos/química , Reproducibilidad de los Resultados , Valores de Referencia , Análisis de Varianza , Estadísticas no ParamétricasRESUMEN
Borosilicate glass was developed to enhance the mechanical behavior and smoothness of dental zirconia as an alternative to conventional glaze. This study assessed the mechanical and optical properties of 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) coated with borosilicate glass or a commercial glaze fired for an extended period of time. Disc-shaped 3Y-TZP zirconia specimens (Zpex, Tosoh) were sintered at 1550°C for 2 hours. The specimens were divided into three groups: as-sintered (control, C); commercial glaze (G); and borosilicate glass (SL). The glaze and borosilicate glass were applied over the zirconia and fired for 20 minutes at 950°C and 1200°C, respectively. Biaxial flexural strength, fractography, X-ray diffraction (XRD), roughness (Ra and Rz), fracture toughness (Vickers indentation method), color difference (∆E00), and translucency (TP00) analyses were conducted. The t-test or the one-way ANOVA and Tukey's tests were used to analyze the data (α = 0.05). Flexural strength data were subjected to the Weibull analysis. The SL group exhibited the highest flexural strength (1025.8 MPa), whereas the C (859.41 MPa) and G (816.0 MPa) groups exhibited similar values. The SL group also had the highest characteristic strength. The fracture origin in all groups was on the zirconia surface. XRD analysis revealed that the specimens from the SL group contained tetragonal, cubic, and monoclinic phases. The SL group presented the lowest surface roughness. Fracture toughness in the SL group was lower than in the C group, but similar to that observed in the G group. The translucency and color differences observed in the G and SL groups were similar. Borosilicate glass enhanced the flexural strength of 3Y-TZP, promoted the smoothest surface, and exhibited optical properties similar to those of the glaze.
Asunto(s)
Vidrio , Ensayo de Materiales , Propiedades de Superficie , Difracción de Rayos X , Itrio , Circonio , Circonio/química , Itrio/química , Vidrio/química , Análisis de Varianza , Factores de Tiempo , Resistencia Flexional , Silicatos/química , Reproducibilidad de los Resultados , Valores de Referencia , Estadísticas no Paramétricas , Color , Fenómenos Ópticos , Pruebas de Dureza , Materiales Dentales/químicaRESUMEN
The aim of this study was to assess the effect of adding arginine at different concentrations to commercial and experimental orthodontic resins on shear bond strength (SBS), as well as on the antimicrobial activity of arginine against S. mutans. Metal brackets were bonded onto the surface of 120 bovine incisors using Transbond, OrthoCem, and an experimental resin (ER), adding 0, 2.5, 5, and 7 wt.% of arginine. The SBS test was performed in deionized water at 37 ºC for 24 h, at 0.5 mm/min. SBS test results were subjected to two-way ANOVA and Tukey's test (α = 0.05). CFU/mL data (antimicrobial assessment) were assessed by Kruskal-Wallis and Dunn's tests (α = 0.05). No statistical difference between the resins was observed in untreated groups (p > 0.05). The addition of arginine at 2.5% (27.7 MPa) and 5% (29.0 MPa) increased the SBS of Transbond when compared (p < 0.05) to OrthoCem (18.5 and 15.6 MPa, respectively) and ER (16.3 and 18.1 MPa, respectively). Arginine at 7% improved the SBS of Transbond (24.1 MPa) and ER (21.0 MPa), which was statistically higher (p < 0.05) than OrthoCem (12.6 MPa). OrthoCem did not show a statistically significant difference at the three concentrations of arginine (p > 0.05). The addition of arginine to resins reduced the count of S. mutans (p < 0.05). As for ER, all concentrations of arginine significantly decreased CFU/mL (p < 0.05). Among commercial resins, only 7% of arginine significantly reduced CFU/mL. The addition of arginine did not interfere with the bond strength and demonstrated antibacterial activity against S. mutans.
Asunto(s)
Arginina , Ensayo de Materiales , Soportes Ortodóncicos , Cementos de Resina , Resistencia al Corte , Streptococcus mutans , Arginina/química , Arginina/farmacología , Animales , Bovinos , Streptococcus mutans/efectos de los fármacos , Análisis de Varianza , Cementos de Resina/química , Factores de Tiempo , Reproducibilidad de los Resultados , Propiedades de Superficie/efectos de los fármacos , Estadísticas no Paramétricas , Valores de Referencia , Recubrimiento Dental Adhesivo/métodos , Bisfenol A Glicidil MetacrilatoRESUMEN
BACKGROUND: PRKAG2 syndrome typically manifests in adolescence and early adulthood, progressing with left ventricular hypertrophy, arrhythmias, and risk of sudden death. Findings of echocardiographic markers before clinical manifestation in children of patients affected by the disease can facilitate prevention strategies and therapeutic planning for this patient group. OBJECTIVE: To identify the existence of echocardiographic findings that manifest early in children of parents affected by PRKAG2 syndrome, while they are still asymptomatic. METHODS: In this cross-sectional observational study, 7 participants who were children of parents with established diagnosis of PRKAG2 syndrome, between the ages of 9 months and 12 years, with proven genetic diagnosis, underwent conventional and advanced echocardiography. Their findings were compared to those of a control group composed of 7 age- and sex-matched volunteers who were healthy from a cardiovascular point of view. P values < 0.05 were considered significant. RESULTS: Conventional echocardiography showed statistically significantly higher values in the case group for left atrium, interventricular septum, left ventricular posterior wall, indexed ventricular mass, and relative wall thickness (p < 0.05). Global longitudinal systolic strain on 2-dimensional echocardiography did not show statistical significance between the case and control groups. None of the parameters on 3-dimensional echocardiography showed statistical significance between groups. CONCLUSION: Children diagnosed with PRKAG2 showed echocardiographic findings indicative of a tendency toward cardiac hypertrophy. Echocardiography can be a useful tool in the evaluation and follow-up of this patient group before the onset of clinical manifestations.
FUNDAMENTO: A síndrome do PRKAG2 tipicamente se manifesta na adolescência e início da idade adulta, cursando com hipertrofia ventricular esquerda, arritmias e risco de morte súbita. O achado de marcadores ecocardiográficos antes da manifestação clínica nos filhos de pais acometidos pela doença pode facilitar a estratégia de prevenção e planejamento terapêutico para esse grupo de pacientes. OBJETIVO: Identificar a existência de achados ecocardiográficos que se manifestem precocemente nos filhos de pais acometidos por síndrome do PRKAG2, enquanto ainda assintomáticos. MÉTODOS: Estudo observacional transversal em que sete participantes, filhos de pais com diagnóstico estabelecido de síndrome do PRKAG2, com idades entre 9 meses e 12 anos e diagnóstico genético comprovado, foram submetidos à ecocardiografia convencional e por técnicas avançadas, tendo seus achados comparados aos de grupo controle composto por sete voluntários pareados por sexo e idade, hígidos do ponto de vista cardiovascular. Um valor de p < 0,05 foi considerado significante. RESULTADOS: A ecocardiografia convencional mostrou valores aumentados com significância estatística no grupo caso para átrio esquerdo, septo interventricular, parede posterior do ventrículo esquerdo, massa ventricular indexada e espessura relativa da parede (p < 0,05). O strain sistólico longitudinal global obtido pelo ecocardiograma bidimensional não mostrou diferença estatisticamente significativa entre os grupos caso e controle. Nenhum dos parâmetros ao ecocardiograma tridimensional apresentou significância estatística entre os grupos. CONCLUSÃO: Crianças diagnosticadas com PRKAG2 demonstraram achados ecocardiográficos indicativos de tendência à hipertrofia cardíaca. A ecocardiografia pode ser uma ferramenta útil na avaliação e seguimento desse grupo de pacientes, antes do início de manifestações clínicas.
Asunto(s)
Hipertrofia Ventricular Izquierda , Humanos , Niño , Femenino , Masculino , Estudios Transversales , Estudios de Casos y Controles , Preescolar , Lactante , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Ecocardiografía , Valores de Referencia , Síndrome de Wolff-Parkinson-White/diagnóstico por imagen , Síndrome de Wolff-Parkinson-White/fisiopatología , Síndrome de Wolff-Parkinson-White/genética , Estadísticas no Paramétricas , Proteínas Quinasas Activadas por AMPRESUMEN
BACKGROUND: Cognitive dysfunction is frequently seen in multiple sclerosis (MS). However, there are conflicting findings regarding the factors it is associated with. OBJECTIVE: To investigate the relationship between aerobic capacity, strength, disability, depression, fatigue, and cognitive reserve and function. METHODS: The mobile applications Trail Making Test (TMT A-B), Digit Span Test (DST), Visuospatial Memory Test (VSMT), and Tap Fast were used in the cognitive function evaluation. Functional performance was assessed with the 6-minute walk test (6MWT), 5-Time Sit-to-Sand (5STS) test, and grip strength. Cognitive Reserve Index (CRI), Beck Depression Inventory, Fatigue Severity Scale (FSS), and Nottingham Health Profile were also used. RESULTS: A significant difference was found between the MS and control groups only in the 6MWT, STS-5, grip strength, TMT, VSMT, and Tap Fast. Good correlation was found between the TMT-A and 6MWT and physical mobility. A fair correlation was shown between grip strength, energy, and pain status. A good correlation was found between TMT-B and 6MWT, and a fair relationship with disability, cognitive reserve, and pain. Good correlation was observed between the DST and 6MWT, left grip strength, pain, and energy status; fair correlations were found between right grip strength, cognitive reserve, and physical mobility. Good correlation was found between the VSMT and energy. A fair relationship between disability, cognitive reserve, and pain was demonstrated. Good correlation was observed between the Tap Fast score and disability, 5STS, FSS, energy, and physical mobility. A fair relationship was found between pain and social isolation. CONCLUSION: It has been shown that cognitive performance in MS is related to disability, functional performance, cognitive reserve, fatigue, and general health. TRIAL REGISTRATION: NCT06084182.
ANTECEDENTES: A disfunção cognitiva é frequentemente observada na esclerose múltipla (EM). No entanto, existem resultados conflitantes sobre os fatores aos quais está associada. OBJETIVO: Investigar a relação entre capacidade aeróbica, força, incapacidade, depressão, fadiga e reserva e função cognitiva. MéTODOS: Os aplicativos móveis Trail Making Test (TMT A-B), Digit Span Test (DST), Visuoespacial Memory Test (VSMT) e Tap Fast foram utilizados na avaliação da função cognitiva. O desempenho funcional foi avaliado por meio do teste de caminhada de 6 minutos (TC6), Teste de Sentar-Levantar Cinco Vezes (TSL5) e força de preensão manual. Também foram utilizados Índice de Reserva Cognitiva (IRC), Inventário de Depressão de Beck, Escala de Gravidade de Fadiga (EGF) e Perfil de Saúde de Nottingham. RESULTADOS: Foi encontrada diferença significativa entre os grupos EM e controle apenas no TC6, TSL5, força de preensão, TMT, VSMT e Tap Fast. Foi encontrada boa correlação entre o TMT-A e o TC6 e a mobilidade física. Foi demonstrada uma correlação razoável entre força de preensão, energia e estado de dor. Foi encontrada uma boa correlação entre o TMT-B e o TC6, e uma relação razoável com incapacidade, reserva cognitiva e dor. Foi observada boa correlação entre o DST e o TC6, força de preensão esquerda, dor e estado energético; correlações justas foram encontradas entre força de preensão direita, reserva cognitiva e mobilidade física. Foi encontrada boa correlação entre o VSMT e a energia. Foi demonstrada uma relação justa entre incapacidade, reserva cognitiva e dor. Foi observada boa correlação entre o escore Tap Fast e incapacidade, TLS5, EGF, energia e mobilidade física. Foi encontrada uma relação justa entre dor e isolamento social. CONCLUSãO: Foi demonstrado que o desempenho cognitivo na EM está relacionado com incapacidade, desempenho funcional, reserva cognitiva, fadiga e saúde geral. REGISTRO DE TESTE: NCT06084182.
Asunto(s)
Reserva Cognitiva , Evaluación de la Discapacidad , Fatiga , Esclerosis Múltiple , Tiempo de Reacción , Humanos , Masculino , Esclerosis Múltiple/fisiopatología , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/psicología , Reserva Cognitiva/fisiología , Femenino , Adulto , Persona de Mediana Edad , Fatiga/fisiopatología , Fatiga/etiología , Tiempo de Reacción/fisiología , Cognición/fisiología , Pruebas Neuropsicológicas , Fuerza de la Mano/fisiología , Disfunción Cognitiva/fisiopatología , Disfunción Cognitiva/etiología , Depresión/fisiopatología , Estudios de Casos y Controles , Prueba de Paso , Estudios Transversales , Valores de Referencia , Estadísticas no ParamétricasRESUMEN
The aim of this study was to evaluate whether polymorphisms in SOD2 and SOD3 genes modulate the oral health-related quality of life (OHRQoL) of Para athletes with dental caries experience. The cross-sectional study included 264 Para athletes (143 in athletics, 61 in weightlifting and 60 in swimming). A trained and calibrated team recorded the decayed, missing and filled teeth index (DMFT). The Brazilian version of the Oral Health Impact Profile (OHIP-14) was used to measure OHRQoL. Genomic DNA was extracted from the athletes' saliva, and genetic polymorphisms in the SOD2 (rs5746136 and rs10370) and SOD3 (rs2855262 and rs13306703) genes were analyzed by real-time polymerase chain reaction. Univariate and multivariate analyses were performed. A multivariate General Linear Model analysis, adjusted for sex, revealed that the SOD3 gene polymorphism (rs2855262) had a significant effect on the psychological disability domain [codominant (p = 0.045) and recessive (p=0.038) models]. The SOD2 gene polymorphism (rs5746136) had a significant effect on the total OHIP-14 score [dominant model (p = 0.038)] and the psychological discomfort [dominant model (p = 0.034)] and physical disability [codominant model (p=0.037)] domains. Presence of the SOD2 rs10370 polymorphism led to statistical differences in the total score [codominant (p = 0.026) and dominant (p = 0.023) models] and the handicap domain scores [codominant (p = 0.027) and dominant (p = 0.032) models]. Polymorphisms of the SOD2 and SOD3 genes may be important biomarkers of OHRQoL in Para athletes with dental caries experience.
Asunto(s)
Atletas , Salud Bucal , Calidad de Vida , Superóxido Dismutasa , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Análisis de Varianza , Atletas/psicología , Atletas/estadística & datos numéricos , Brasil , Estudios Transversales , Caries Dental/genética , Índice CPO , Polimorfismo Genético/genética , Polimorfismo de Nucleótido Simple , Reacción en Cadena en Tiempo Real de la Polimerasa , Valores de Referencia , Saliva/química , Estadísticas no Paramétricas , Superóxido Dismutasa/genéticaRESUMEN
OBJECTIVE: A combination of peripheral blood mesenchymal stem cells (PBMSCs) and platelet rich fibrin matrix (PRFM) could be a probable periodontal regenerative material with the synergy of the added benefits of each material. This randomized controlled clinical trial aimed to evaluate the regenerative capacity of supercell (PRFM and PBMSCs) compared with that of PRFM alone in human periodontal mandibular intraosseous defects (IOD). METHODOLOGY: This study included 17 patients of both sexes (12 men, 5 women) aged 30-55 years (mean age = 37.7±4.4 years) who fulfilled the inclusion criteria (radiographic and clinical evaluation for bilateral IOD with probing pocket depth (PPD ≥ 6 mm). A split-mouth design was used in each patient. A total of 34 sites in the mandibular arch randomly received PRFM alone + open flap debridement (OFD) [Control sites] or supercell (PRFM+PBMSCs) + OFD [Test sites]. The clinical parameters plaque index (PI), gingival index (GI), PPD, clinical attachment level (CAL), and in the radiographic parameters; defect depth (DD) and defect fill percentage (DFP) were recorded at baseline, 3 and 6 months postoperatively. Early wound healing index (EHI) was used at 1 week to assess wound healing ability. RESULTS: At 6 months, radiographic parameters revealed significant reduction in DD (P<0.001) and significant DFP values in the test group compared with the control group. The supercell showed significant improvement in PPD and CAL at the end of 6 months (P<0.001). EHI scores at 1 week showed no statistically significant difference between the test and control groups. CONCLUSION: Supercell can be considered a regenerative material in the treatment of periodontal IODs.
Asunto(s)
Trasplante de Células Madre Mesenquimatosas , Fibrina Rica en Plaquetas , Humanos , Persona de Mediana Edad , Femenino , Masculino , Adulto , Resultado del Tratamiento , Factores de Tiempo , Trasplante de Células Madre Mesenquimatosas/métodos , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Regeneración Tisular Guiada Periodontal/métodos , Pérdida de Hueso Alveolar/terapia , Pérdida de Hueso Alveolar/cirugía , Células Madre Mesenquimatosas , Regeneración Ósea/fisiología , Regeneración Ósea/efectos de los fármacos , Valores de Referencia , Índice Periodontal , Índice de Placa Dental , Cicatrización de Heridas/fisiologíaRESUMEN
In disciplines from biology to climate science, a routine task is to compute a correlation between a pair of time series and determine whether the correlation is statistically significant (i.e., unlikely under the null hypothesis that the time series are independent). This problem is challenging because time series typically exhibit autocorrelation and thus cannot be properly analyzed with the standard iid-oriented statistical tests. Although there are well-known parametric tests for time series, these are designed for linear correlation statistics and thus not suitable for the increasingly popular nonlinear correlation statistics. There are also nonparametric tests that can be used with any correlation statistic, but for these, the conditions that guarantee correct false positive rates are either restrictive or unclear. Here, we describe the truncated time-shift (TTS) test, a nonparametric procedure to test for dependence between 2 time series. We prove that this test correctly controls the false positive rate as long as one of the time series is stationary, a minimally restrictive requirement among current tests. The TTS test is versatile because it can be used with any correlation statistic. Using synthetic data, we demonstrate that this test performs correctly even while other tests suffer high false positive rates. In simulation examples, simple guidelines for parameter choices allow high statistical power to be achieved with sufficient data. We apply the test to datasets from climatology, animal behavior, and microbiome science, verifying previously discovered dependence relationships and detecting additional relationships.
Asunto(s)
Simulación por Computador , Factores de Tiempo , Animales , Modelos Estadísticos , Estadísticas no Paramétricas , Interpretación Estadística de DatosRESUMEN
BACKGROUND: Heart failure (HF) is a leading cause of hospitalization and mortality worldwide and places a great economic burden on healthcare systems. Identification of prognostic factors in HF patients is of great importance to establish optimal management strategies and to avoid unnecessary invasive and costly procedures in end-stage patients. OBJECTIVES: In the current study, we aimed to investigate the association between diastolic strain parameters including E/e' SR, and short-term outcomes in advanced HF patients. METHODS: The population study included 116 advanced HF with reduced ejection fraction (HFrEF) patients. Clinical, laboratory, and echocardiographic evaluations of the patients were performed within the first 24 hours of hospital admission. Patients were followed for one month and any re-hospitalization due to worsening of HF symptoms and any mortality was recorded. The level of significance adopted in the statistical analysis was 5%. RESULTS: E/e' SR was significantly higher in the patient group compared to the control group (p=0.001). During one-month follow-up, 13.8% of patients died and 37.1% of patients were rehospitalized. Serum NT-ProBNP (p=0.034) and E/e' SR (p=0.033) were found to be independent predictors of mortality and ACEI use (p=0.027) and apical 3C strain (p=0.011) were found to be independent predictors of rehospitalization in the patient group. CONCLUSION: Findings of the current prospective study demonstrate that E/e' SR measured by speckle tracking echocardiography is an independent and sensitive predictor of short-term mortality in advanced HFrEF patients and may have a role in the identification of end-stage HFrEF patients.
FUNDAMENTO: A insuficiência cardíaca é uma das principais causas de hospitalização e mortalidade em todo o mundo e representa um grande fardo económico para os sistemas de saúde. A identificação de fatores prognósticos em pacientes com IC é de grande importância para estabelecer estratégias de manejo ideais e evitar procedimentos invasivos e dispendiosos desnecessários em pacientes em estágio terminal. OBJETIVOS: No presente estudo, nosso objetivo foi investigar a associação entre parâmetros de strain diastólico, incluindo E/e' SR, e resultados de curto prazo em pacientes com IC avançada. MÉTODOS: O estudo populacional incluiu 116 pacientes com insuficiência cardíaca avançada com fração de ejeção reduzida (ICFEr) avançada. Avaliações clínicas, laboratoriais e ecocardiográficas dos pacientes foram realizadas nas primeiras 24 horas de internação. Os pacientes foram acompanhados por um mês e qualquer reinternação por piora dos sintomas de IC e qualquer mortalidade foi registrada. O nível de significância adotado na análise estatística foi de 5%. RESULTADOS: A E/e' SR foi significativamente maior no grupo de pacientes em comparação ao grupo controle (p=0,001). Durante o acompanhamento de um mês, 13,8% dos pacientes morreram e 37,1% dos pacientes foram reinternados. NT-ProBNP sérico (p=0,034) e E/e' SR (p=0,033) foram considerados preditores independentes de mortalidade e o uso de IECA (p=0,027) e strain 3C apical (p=0,011) foram considerados independentes preditores de reinternação no grupo de pacientes. CONCLUSÃO: Os resultados do presente estudo prospectivo demonstram que a E/e' SR medida pela ecocardiografia com speckle tracking é um preditor independente e sensível de mortalidade em curto prazo em pacientes com ICFEr avançada e pode ter um papel na identificação de pacientes com ICFEr em estágio terminal.
Asunto(s)
Insuficiencia Cardíaca , Readmisión del Paciente , Volumen Sistólico , Humanos , Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/fisiopatología , Masculino , Femenino , Readmisión del Paciente/estadística & datos numéricos , Persona de Mediana Edad , Anciano , Volumen Sistólico/fisiología , Pronóstico , Diástole/fisiología , Factores de Tiempo , Péptido Natriurético Encefálico/sangre , Factores de Riesgo , Ecocardiografía , Estudios Prospectivos , Fragmentos de Péptidos/sangre , Estadísticas no Paramétricas , Valores de ReferenciaRESUMEN
BACKGROUND: Echocardiography is essential for the assessment of patients with heart transplants. However, normal values in such individuals are not clearly defined. OBJECTIVES: To compare conventional echocardiographic and speckle tracking variables between patients with unrejected heart transplants and healthy individuals. METHODS: :A prospective study was conducted with adult patients having undergone heart transplantation at least one year earlier and submitted to endomyocardial biopsy followed by transthoracic echocardiogram (TTE). Conventional TTE measures and mechanical heart strain assessments using speckle tracking were performed and the results were compared to those of a group of healthy volunteers. Statistical significance was set at 5% (p < 0.05). RESULTS: Thirty-six transplant patients without rejection were analyzed and compared to 30 healthy individuals. Chagas disease was the main reason for transplantation. Lower left ventricular global longitudinal strain expressed in absolute values was found (11.99% in transplant patients vs. 20.60% in controls; p <0.0001), right ventricular free wall longitudinal strain (16.67% in transplant patients vs. 25.50% in controls; p <0.0001) and myocardial work indices (p < 0.0001) as well as a larger size of the left atrium (38.17 ml/m2 in transplant patients vs. 18.98 ml/m2 in controls; p <0.0001) and greater mass and relative wall thickness (p <0.0001). CONCLUSION: Stable patients having undergone heart transplants without rejection have differences concerning echocardiographic variables compared to healthy individuals. These findings indicate that conventional echocardiographic measures and heart mechanics are altered in transplant patients even in the absence of rejection. Such findings are relevant to the clinical context and follow-up of the patient.
FUNDAMENTO: A ecocardiografia é essencial para avaliação do coração transplantado. No entanto, os valores de normalidade no transplante cardíaco (TC) não estão claramente definidos. Objetivos: Comparar parâmetros ecocardiográficos convencionais e pela técnica de Speckle Tracking entre pacientes transplantados cardíacos sem rejeição e uma população de indivíduos saudáveis. MÉTODOS: Foram estudados prospectivamente pacientes adultos, com menos de 1 ano de TC, que realizaram biópsia endomiocárdica de vigilância seguido de ecocardiograma transtorácico (ETT). Medidas convencionais de ETT acrescidas da avaliação de mecânica cardíaca por meio do Strain pelo Speckle Tracking foram realizadas e comparadas com um grupo de voluntários saudáveis. A significância estatística adotada para o estudo foi de 5%. RESULTADOS: Avaliou-se 36 pacientes transplantados sem rejeição, os quais foram comparados com 30 indivíduos saudáveis. Observou-se redução nos valores de Strain Global Longitudinal de Ventrículo Esquerdo em valor absoluto (11,99% transplantados, 20,60% controle, p<0,0001), Strain de parede livre de Ventrículo Direito (transplantados 16,67%, controle 25,50%, p<0,0001) e dos índices de trabalho miocárdico (p<0,0001), maior tamanho do átrio esquerdo (38,17 ml/m2 transplantados, controle 18,98 ml/m2, p<0,0001), maior índice de massa e espessura relativa das paredes (p<0,0001) e a presença da Doença de Chagas como principal etiologia para o transplante. CONCLUSÃO: Os transplantados cardíacos estáveis e sem rejeição apresentaram diferenças com relação aos parâmetros ecocardiográficos comparados com indivíduos saudáveis. Estes achados indicam que medidas ecocardiográficas convencionais e de mecânica cardíaca são alteradas em transplantados mesmo na ausência de rejeição e podem ser relevantes para o contexto clínico e acompanhamento dos pacientes.
Asunto(s)
Ecocardiografía , Trasplante de Corazón , Humanos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Estudios Prospectivos , Ecocardiografía/métodos , Estudios de Casos y Controles , Valores de Referencia , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Biopsia , Estadísticas no ParamétricasRESUMEN
BACKGROUND: Accurate prediction of subject recruitment, which is critical to the success of a study, remains an ongoing challenge. Previous prediction models often rely on parametric assumptions which are not always met or may be difficult to implement. We aim to develop a novel method that is less sensitive to model assumptions and relatively easy to implement. METHODS: We create a weighted resampling-based approach to predict enrollment in year two based on recruitment data from year one of the completed GRIPS and PACE clinical trials. Different weight functions accounted for a range of potential enrollment trajectory patterns. Prediction accuracy was measured by Euclidean distance for enrollment sequence in year two, total enrollment over time, and total weeks to enroll a fixed number of subjects, against the actual year two enrollment data. We compare the performance of the proposed method with an existing Bayesian method. RESULTS: Weighted resampling using GRIPS data resulted in closer prediction evidenced by better coverage of observed enrollment with the prediction intervals and smaller Euclidean distance from actual enrollment in year 2, especially when enrollment gaps were filled prior to the weighted resampling. These scenarios also produced more accurate predictions for total enrollment and number of weeks to enroll 50 participants. These same scenarios outperformed an existing Bayesian method for all 3 accuracy measures. In PACE data, using a reduced year 1 enrollment resulted in closer prediction evidenced by better coverage of observed enrollment with the prediction intervals and smaller Euclidean distance from actual enrollment in year 2, with the weighted resampling scenarios better reflecting the seasonal variation seen in year (1) The reduced enrollment scenarios resulted in closer prediction for total enrollment over 6 and 12 months into year (2) These same scenarios also outperformed an existing Bayesian method for relevant accuracy measures. CONCLUSION: The results demonstrate the feasibility and flexibility for a resampling-based, non-parametric approach for prediction of clinical trial recruitment with limited early enrollment data. Application to a wider setting and long-term prediction accuracy require further investigation.
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Teorema de Bayes , Selección de Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Anciano , Pacientes Internos/estadística & datos numéricos , Estadísticas no Paramétricas , FemeninoRESUMEN
Recently, it was recommended to omit tied observations before applying the two-sample Wilcoxon-Mann-Whitney test McGee M. et al. (2018). Using a simulation study, we argue for exact tests using all the data (including tied values) as a preferable approach. Exact tests, with tied observations included guarantee the type I error rate with a better exploitation of the significance level and a larger power than the corresponding tests after the omission of tied observations. The omission of ties can produce a considerable change in the shape of the sample, and so can violate underlying test assumptions. Thus, on both theoretical and practical grounds, the recommendation to omit tied values cannot be supported, relative to analysing the whole data set in the same way whether or not ties occur, preferably with an exact permutation test.
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Simulación por Computador , Estadísticas no Paramétricas , Humanos , Interpretación Estadística de Datos , Modelos EstadísticosRESUMEN
Introdução:O diabetes mellitus é uma doença metabólica caracterizada pelo controle inadequado dos níveis de glicose no sangue, principalmente um estado crônico de hiperglicemia, causado por diferentes processos patogênicos, levando a complicaçõesdosistema nervoso do diabético queincluem axonopatias, doenças neurodegenerativas, doenças neurovasculares e comprometimento cognitivo geral.Objetivo:Avaliar as complicações clínicas da diabetes tipo 2 em mulheres. Metodologia:Tratou-se de um transversal, do tipo prevalência. Foram usados dois grupos de mulheres, onde todas as mulheres estavam com diagnóstico de diabetes Tipo 2 e idade de 40 e 60 anos, comotratamentooral -G1e com tratamentocominsulinoterapia G2,ambosfornecidospelarede pública Para comparação das variáveis estudadas foi utilizado o método de Mann-Whitney, adotando-se o nível de significância menor que 5% (p, valor ,0,05). Resultados:Aproporçãode pessoas com diabetes no Piauí, com consulta e hemoglobina glicada solicitada no primeiro quadrimestre de 2021, 2022, 2023, foi de18, 16 e 34 percentuais,respectivamenteeem Boa Hora nos mesmos quadrimestres foi 36, 39, 56 percentuais, respectivamente.Osprocedimentoshospitalares-por local de residência -Piauí foi de um total de 1.193e em Boa Hora 24. O grupo de mulheres estudadas mostrou uma diferença significativa para a glicemia em jejum e a Hemoglobina glicada quando comparados os grupos G1 e G2. Quase 100% da amostra estava obesa (IMC > 25), não fumava e não praticava atividade física.Conclusões:Concluiu-se que a as pacientes tiveram um agravamento do adoecimento ao longo dos anos com aumento de medicação. A ausência das boas práticas de promoção de saúde, atividade física e alimentação, podem ter contribuídocom o agravamento. Outrossim há necessidade urgente de uma intervenção para mudança de hábitos na população para que a medicalização seja diminuída para a promoção da saúde (AU).
Introduction: Diabetes mellitus is a metabolic disease characterized by inadequate control of blood glucose levels, mainly a chronic state of hyperglycemia, caused by different pathogenic processes, leading to complications of the nervous system including axonopathies, neurodegenerative diseases,neurovascular diseases and general cognitive impairment.Objective: To evaluate the clinical complications of type 2 diabetes in women.Methodology: This was a cross-sectional, prevalence study.Two groupsof women were used, where all women were diagnosed with Type 2 diabetes and aged between 40 and 60 years, with oral treatment -G1 and treatment with insulin therapy -G2, both provided by the public network .To compare the variables studied, the Mann-Whitney method was used, adopting a significance level of less than 5% (p, value 0.05).Results:The proportion of people with diabetes in Piauí, with consultation and glycated hemoglobin requested in the first four months of 2021, 2022, 2023, was 18, 16 and34 percentages, respectively and in Boa Hora in the same four months it was 36, 39, 56percentages, respectively.SUS hospital procedures -by place of residence -Piauí was a total of 1,193 and in Boa Hora 24. The group of women studied showed a significant difference in fasting blood glucose and glycated hemoglobin when comparing groups G1 and G2.Almost 100% of the sample was obese (BMI > 25), did not smoke and did not practice physical activity.Conclusions: It was concluded that the patients' illness worsened over the years with increased medication.The absence of good health promotion practices, physical activity and nutrition may have contributed to the worsening.Furthermore, there is an urgent need for intervention to change habits in the population so that medicalization is reduced to promote health (AU).
Introducción: La diabetes mellitus ecaracterizada por un control inadecuado de los niveles de glucosa en sangre, principalmente un estado crónico de hiperglucemia, causado por diferentes procesos patogénicos, derivando en complicaciones del sistema nervioso incluyendo axonopatías, enfermedades neurodegenerativas, enfermedades neurovasculares y deterioro cognitivo general.Objetivo: Evaluar las complicaciones clínicas de la diabetes tipo 2 en mujeres.Metodología: Se trata de un estudio transversal de prevalencia.Se utilizaron dos grupos de mujeres, donde todas fueron diagnosticadas con diabetes tipo 2 y con edades entre 40 y 60 años, con tratamiento oral -G1 y tratamiento con insulinoterapia -G2, ambos prestados por la red pública.Para comparar las variables estudiadas se utilizó el método de Mann-Whitney, adoptando un nivel de significancia inferior al 5% (p, valor 0,05).Resultados:La proporción de personas con diabetes en Piauí, con consulta y hemoglobina glucosilada solicitada en los primeros cuatro meses de 2021, 2022, 2023, fuede 18, 16 y 34 porcentajes, respectivamente y en Boa Hora en los mismos cuatro meses fue de 36 , 39, 56 porcentajes, respectivamente.Los procedimientos hospitalarios del SUS -por lugar de residencia -en Piauí fueron en total 1.193 y en Boa Hora 24. El grupo de mujeres estudiado presentó diferencia significativa en la glucemia en ayunas y en la hemoglobina glucosilada al comparar los grupos G1 y G2.Casi el 100% de la muestra era obesa (IMC > 25), no fumaba y no practicaba actividad física.Conclusiones:Se concluyó que la enfermedad de los pacientes empeoró con el paso de los años con el aumento de la medicación.La ausencia de buenas prácticas de promoción de la salud, actividad física y nutrición puede haber contribuido al empeoramiento.Además, es urgente intervenir para cambiar los hábitos de la población para promover la salud (AU).
Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Enfermedades Neurodegenerativas/patología , Diabetes Mellitus Tipo 2/patología , Neuropatías Diabéticas/patología , Hiperglucemia , Hiperglucemia/inducido químicamente , Estudios Transversales/métodos , Estadísticas no Paramétricas , Diabetes Mellitus/patologíaRESUMEN
Many existing methodologies for analyzing spatiotemporal point patterns are developed based on the assumption of stationarity in both space and time for the second-order intensity or pair correlation. In practice, however, such an assumption often lacks validity or proves to be unrealistic. In this paper, we propose a novel and flexible nonparametric approach for estimating the second-order characteristics of spatiotemporal point processes, accommodating non-stationary temporal correlations. Our proposed method employs kernel smoothing and effectively accounts for spatial and temporal correlations differently. Under a spatially increasing-domain asymptotic framework, we establish consistency of the proposed estimators, which can be constructed using different first-order intensity estimators to enhance practicality. Simulation results reveal that our method, in comparison with existing approaches, significantly improves statistical efficiency. An application to a COVID-19 dataset further illustrates the flexibility and interpretability of our procedure.
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COVID-19 , Simulación por Computador , Análisis Espacio-Temporal , Humanos , Estadísticas no Paramétricas , Modelos Estadísticos , SARS-CoV-2 , Biometría/métodos , Interpretación Estadística de DatosRESUMEN
The consumption and sharing of information on social media contribute to the circulation of false health content. In this sense, popular belief-driven posts recommending the use of amber necklaces to prevent symptoms of teething can be easily found on social media, even when they offer health risks for children. Accordingly, this study aimed to characterize posts in Portuguese by identifying message-based factors associated with higher user interactions of Facebook. A total of 500 Facebook posts published in Portuguese between August 2016 and August 2021 were retrieved by CrowdTangle, and analyzed quantitatively according to time of publication, total user interaction, and post overperforming score, and then qualitatively by two independent investigators, according to motivation, authors' profiles, and sentiment. The data were evaluated by descriptive analysis, Mann-Whitney U test, chi-square test, and multiple logistic regression models regarding interaction metrics. The posts were published predominantly by commercial profiles, with social, psychological, and financial motivations, and expressed positive sentiment. Furthermore, time of publication (OR=2.65), regular user profiles (OR=3.30), and neutral/negative sentiment (OR=2.76) were associated positively with total interactions, whereas only time of publication was associated with post overperforming scores (OR=1.65). In conclusion, Facebook posts promoting efficacy of amber necklaces in managing teething symptoms are primarily created by commercial profiles with vested interests in marketing the product. The key factors that contribute to the success of posts containing false information about amber necklaces on Facebook can be identified by considering the author's profile, sentiment, and time of publication.
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Medios de Comunicación Sociales , Humanos , Erupción Dental/fisiología , Estadísticas no Paramétricas , Factores de Tiempo , Modelos Logísticos , Difusión de la Información/métodos , Portugal , MotivaciónRESUMEN
This study aimed to assess whether dentists correctly understand the benefit of a dental treatment when it is presented using absolute numbers or relative risk reduction (RRR). This parallel-group randomized controlled trial recruited dentists from 3 postgraduate courses in Rio de Janeiro, Brazil. Participants received, in sequentially numbered sealed opaque envelopes, the description of a hypothetical scenario of the benefit (avoidance of multiple tooth loss) of nonsurgical periodontal treatment without or with antibiotics. Treatment benefit was presented in 2 different formats: absolute numbers or RRR. Dentists were given 10 minutes to read the treatment scenario and answer 5 questions. The final sample for analysis included 101 dentists. When asked to estimate the number of patients out of 100 who would avoid multiple tooth loss without antibiotics, 17 dentists (33%) in the absolute numbers group and 12 (25%) in the RRR group provided the correct response (p = 0.39). Regarding treatment with antibiotics, 26 dentists (50%) in the absolute numbers group and 14 (29%) in the RRR group provided the correct response (p = 0.04). Only 16 dentists (31%) in the absolute numbers group and 12 (25%) in the RRR group gave correct answers for both questions (p = 0.51). Most dentists did not correctly understand the benefit of the treatment, irrespective of the format it was presented. Slightly more dentists correctly understood the benefit of the treatment when it was presented as absolute numbers than as RRR.
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Antibacterianos , Odontólogos , Humanos , Odontólogos/estadística & datos numéricos , Odontólogos/psicología , Femenino , Masculino , Antibacterianos/uso terapéutico , Brasil , Adulto , Estadísticas no Paramétricas , Conducta de Reducción del Riesgo , Medición de Riesgo , Persona de Mediana Edad , Enfermedades Periodontales/terapia , Enfermedades Periodontales/prevención & control , Pérdida de Diente/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Competencia Clínica/estadística & datos numéricosRESUMEN
This is a nonclinical, controlled, and triple-blind study to investigate the effects of codeine-associated geraniol on the modulation of orofacial nociception and its potential central nervous system depressing effect in an animal model. The orofacial antinociceptive activity of geraniol in combination with codeine was assessed through the following tests: (i) formalin-induced pain, (ii) glutamate-induced pain, and (iii) capsaicin-induced pain. Six animals were equally distributed into six groups and received the following treatments, given intraperitoneally (i.p.) 30 minutes before the experiments: a) geraniol/codeine 50/30 mg/kg; b) geraniol/codeine 50/15 mg/kg; c) geraniol/codeine 50/7.5 mg/kg; d) geraniol 50 mg/kg; e) codeine 30 mg/kg (positive control); or f) 0.9% sodium chloride (negative control). We performed pain behavior analysis after the injection of formalin (20 µL, 20%), glutamate (20 µL, 25 µM), and capsaicin (20 µL, 2.5 µg) into the paranasal region. Rubbing time of the paranasal region by the hind or front paw was used as a parameter. In the neurogenic phase of the formalin test, the geraniol/codeine at 50/7.5 mg/kg was able to promote the maximum antinociceptive effect, reducing nociception by 71.9% (p < 0.0001). In the inflammatory phase of the formalin test, geraniol/codeine at 50/30 mg/kg significantly reduced orofacial nociception (p < 0.005). In the glutamate test, geraniol/codeine at 50/30 mg/kg reduced the rubbing time by 54.2% and reduced nociception in the capsaicin test by 66.7% (p < 0.005). Geraniol alone or in combination does not promote nonspecific depressing effects on the central nervous system. Based on our findings, we suggest the possible synergy between geraniol and codeine in the modulation of orofacial pain.