Tests for Probability of A Reaction and Difference Between Reactions Where Treatment Increases Marker-Values of Particular Subjects but Decreases Others

Author(s):  
Torao Ishida ◽  
Ken Takagi ◽  
Gui-feng Wang ◽  
Nobuyuki Tanahashi ◽  
Jun Kawanokuchi ◽  
...  

Abstract PD-1 has a role in regulating the response of the immune system to the cells of the human body. Paris et al. reported that combination antiretroviral therapy did not change % CD4+ of PD-1highCTLA-4lowCD127high early/intermediated T cells of human immunodeficiency virus infected patients but increased the percent of the marker limited to initial CD4 counts <200 with Wilcoxon signed-rank test. We hypothesized that the treatment increased the marker value in patients whose initial marker value is less than a particular value and decreased the marker value in other patients and that the test misleadingly concluded that the treatment did not change the marker value. General subgroup analyses correctly estimate the statistical significance of such a reaction or difference between such reactions only when the reaction of both of subgroups or both difference between such subgroups is statistically significant. We propose Ishida’ t-test for paired samples that can correctly judge the probability without division of the group into subgroups, and Ishida’ t-test for unpaired samples that can correctly judge the statistical significance of the difference between such reactions. We also showed that many treatments cause such increase and decrease of marker values relating PD-1 of subjects.

2017 ◽  
Author(s):  
Ιωάννης Γεραμάς

Σκοπός μελέτης. Σκοπός της παρούσας μελέτης είναι η αξιολόγηση της ακουστικής ανίχνευσης και αντίληψης των βαρήκοων - κωφών ασθενών μετά την κοχλιακή εμφύτευση.Υλικό και μέθοδος. Στην παρούσα μελέτη εξετάστηκαν 123 τυχαιοποιημένοι ασθενείς (57 άνδρες και 66 γυναίκες ηλικίας από 6 μέχρι και 82 ετών) οι οποίοι χωρίστηκαν σε 4 κατηγορίες:Κατηγορία I: ενήλικες μεταγλωσσικά βαρήκοοι - κωφοί Κατηγορία II: παιδιά σχολικής ηλικίας από 6 έως 16 ετώνΚατηγορία III: παιδιά σχολικής ηλικίας από 6 έως 16 ετών με συνοδά νευρολογικά προβλήματαΚατηγορία IV: ενήλικες προγλωσσικά βαρήκοοι - κωφοί, που υποβλήθηκαν σε κοχλιακή εμφύτευση αργότερα, οι οποίοι πριν το χειρουργείο χρησιμοποιούσαν κάποιο ακουστικό βοήθημα, κάνοντας χρήση του προφορικού λόγου Όλοι οι εξεταζόμενοι είχαν υποβληθεί σε κοχλιακή εμφύτευση τουλάχιστον δύο χρόνια πριν από την ημερομηνία εξέτασης τόσο στο Κέντρο Κοχλιακών Εμφυτεύσεων της Β’ ΩΡΛ Πανεπιστημιακής Κλινικής του Νοσοκομείου “ΑΤΤΙΚΟΝ” όσο και στην Α’ Πανεπιστημιακή ΩΡΛ Κλινική του Νοσοκομείου “ΑΧΕΠΑ”. Για τη διεξαγωγή των μετρήσεων στην παρούσα μελέτη χρησιμοποιήσαμε την τονική ακοομετρία ελευθέρου πεδίου, τη δοκιμασία διάκρισης δισύλλαβων λέξεων / προτάσεων της ομιλητικής ακοομετρίας στην ελληνική γλώσσα (με τη χρήση ψηφιακού δίσκου και ζωντανά με τη βοήθεια λογοθεραπευτή) σε ένταση ακρόασης 65 dB HL. Για την καταγραφή της πραγματικής συνεισφοράς του κοχλιακού εμφυτεύματος στην καθημερινή ζωή των ασθενών μας μετά το χειρουργείο, χρησιμοποιήσαμε τα ειδικά ερωτηματολόγια CAP test (Categories of Auditory Performance) και GBI test (Glasgow Benefit Inventory). Αποτελέσματα. Στην κατηγορία Ι εξετάσαμε 29 ασθενείς. Ο μέσος όρος ανίχνευσης του ήχου στο τονικό ακοόγραμμα ελευθέρου πεδίου ήταν 26 dB HL και το ποσοστό διάκρισης λέξεων / προτάσεων στη δοκιμασία της ομιλητικής ακοομετρίας ήταν 87,72% / 82,55% (όταν τα σενάρια δίνονταν από τον ψηφιακό δίσκο) και 95,66% / 95,45% (όταν εκφωνούνταν ζωντανά από τη λογοθεραπεύτρια της ομάδας). Ομοίως οι μετρήσεις CAP μετά το χειρουργείο είχαν βελτιωθεί σημαντικά (Wilcoxon signed rank test, p - value < 0.001) από το επίπεδο ΙΙ στο επίπεδο VII όπως και o δείκτης οφέλους της Γλασκόβης (+47,88).Στην κατηγορία ΙΙ εξετάσαμε συνολικά 60 ασθενείς. Ο μέσος όρος ανίχνευσης του ήχου ήταν 21dB HL και το ποσοστό επιτυχίας στη διάκριση λέξεων / προτάσεων: 88% / 84,88% και 94,5% / 92,1%. αντίστοιχα. Οι μετρήσεις CAP μετά το χειρουργείο εμφάνισαν και αυτές σημαντική βελτίωση (Wilcoxon signed rank test, p - value < 0.001) από το επίπεδο Ι στο επίπεδο VII όπως και ο δείκτης οφέλους της Γλασκόβης (+51,47).Στην κατηγορία ΙΙΙ εξετάσαμε 20 ασθενείς. Ο μέσος όρος ανίχνευσης του ήχου 24dB HL και το ποσοστό διάκρισης των λέξεων / προτάσεων: 56,6% / 48,8% και 70,35% / 55,95% αντίστοιχα. Οι μετρήσεις CAP (Wilcoxon signed rank test, p - value < 0.001) μετά το χειρουργείο εμφάνισαν σημαντική βελτίωση από το επίπεδο 0 στο επίπεδο V όπως και o δείκτης οφέλους της Γλασκόβης (+41,52).Στην κατηγορία IV εξετάσαμε 14 ασθενείς. Ο μέσος όρος ανίχνευσης του ήχου 26dB HL και ποσοστό διάκρισης των λέξεων / προτάσεων: 45,14% / 33,64% και 60,57% / 51,29% αντίστοιχα. Οι μετρήσεις CAP (paired samples t-test, p - value < 0.001) μετά το χειρουργείο είχαν βελτιωθεί από το επίπεδο ΙI στο επίπεδο VI ενώ o δείκτης οφέλους της Γλασκόβης (GBI test) μετά τη χειρουργική επέμβαση παρουσίασε και αυτός θετική μεταβολή (+44,63).ΣυμπέρασμαΤο συμπέρασμα που προκύπτει από την παρούσα μελέτη αφορά τη σημαντική βελτίωση των όλων των κατηγοριών των εξεταζόμενων (σε επίπεδο σημαντικότητας 5%) τόσο στη δοκιμασία του τονικού ακοογράμματος ελευθέρου πεδίου (p-values < 0.001, τιμές ακοομετρικού διαγράμματος > 90 dB HL πριν από το χειρουργείο) όσο και στη δοκιμασία της ομιλητικής ακοομετρίας (p-values < 0.001, ποσοστό ακουστικής διάκρισης < 40% πριν από το χειρουργείο). Την καλύτερη διάκριση της ομιλίας φαίνεται να εμφανίζουν τα παιδιά της κατηγορίας ΙΙ μαζί με τους ενήλικες της κατηγορίας Ι (καθώς τα αντίστοιχα p values ήταν μικρότερα από 0,05). Αντίθετα οι εξεταζόμενοι της κατηγορίας ΙΙΙ και IV δεν είχαν ανάλογα αποτελέσματα (p-value = 0.000 < 0.05). Αυτό μπορεί να ερμηνευτεί από το γεγονός ότι οι μεν ασθενείς της κατηγορίας IV συνέχισαν να χρησιμοποιούν μετά το χειρουργείο τη νοηματική γλωσσά, ενώ οι ασθενείς της κατηγορίας ΙΙΙ είχαν καθυστερημένη λεκτική πρόοδο λόγω των συνοδών νευρολογικών προβλημάτων. Εντούτοις από το ερωτηματολόγιο CAP test (p-values < 0.001) προκύπτει ότι η ακουστική ικανότητα των κωφών ασθενών που συμμετείχαν στην μελέτη μας, ανεξαρτήτου κατηγορίας, παρουσίασε σημαντική βελτίωση μετά το χειρουργείο του κοχλιακού εμφυτεύματος. Όλοι οι παραπάνω εξεταζόμενοι επίσης επιβεβαίωσαν τη θετική επίδραση της επέμβασης στην ποιότητα της ζωής τους (p-value = 0.183 > 0.05), σύμφωνα με το ερωτηματολόγιο GBI test


Author(s):  
I Ketut Widana

The working practice of the engineering students is part of the learning process that is irreducible and indispensable. The composition of  lecturing between theoretical and practical one is 40% to 60%. With this condition, the students spend more time at the laboratory. Generally, the students perform in the laboratory work by standing position. The design of research is observational cross-sectional. The method applied is observation, interview and measuring. The subjects of research are practicing students amounting to 21 students. Referring to the analysis of statistical test or Wilcoxon signed ranks test, the difference of effect of work position is significant, namely p < 0.05 towards musculoskeletal disorders (MSDs) before and after working. The quantity of the average complaint after working is score 44.62 ± 9.47. The result of Wilcoxon signed rank test shows that there is significant different effects of standing work position, namely p < 0.05 towards fatigue generally before and after working. The degree of the working pulse is on the average of 110.78  ± 17.80 bpm (beats per minutes) which can be categorized into the medium workload. Using paired t-test, the result is p < 0.05.


2021 ◽  
Author(s):  
Nuno Neuparth ◽  
Marta Fonseca ◽  
Beatriz Oliveira ◽  
Inês Canha ◽  
Hélder Dores ◽  
...  

Pathophysiology at NOVA Medical School adopted the concept mapping methodology to promote the visual display of pathophysiological reasoning and learning, based on clinical vignettes. The objective of this project is to identify and label the linking words, in order to study their role in the structure and organization of the concept maps constructed by the students. We used an adopted classification of linking words, categorized in 5 groups: dynamic, static, illustrative, definition and clinical case information. At the end of the semester the concept maps related to the respiratory (mid-semester) and endocrine systems (end of semester) were analyzed and compared. We found linking words not included in any of the five categories, thus a group named “other” has been created. Statistically significant differences were found in dynamic and “other” categories (p=0,049 and p= 0,011, respectively; Wilcoxon signed-rank test). The dynamic words were the most commonly used, probably reflecting students’ need to better describe pathophysiological mechanisms, and the difference found was probably due an improvement in the learning process and concept maps building technic. It would be interesting next year to conduct a more detailed analysis, increasing the sample and ensuring a more robust dataset. 


2021 ◽  
Vol 12 (1) ◽  
pp. 53-61
Author(s):  
Jyotish S Jayandan ◽  
James Chacko ◽  
Devipriya Soman ◽  
Mahesh C Kundagol

Allergic Asthma is one among the diseases which imposes a great burden on the subjects by hampering the quality of life of patients, reducing productivity, and causing work absence. The literary search hinted that there are no published works reporting both clinical and immunological(IgE) outcomes in Allergic Asthma. So the present study was a pre and post test clinical study to evaluate the effect of Ayurvedic line of management in inducing both immunological(IgE) and clinical outcomes in Allergic Asthma. In this study 30 patients were administered classical Virecana Karma (drug induced purgation) followed by Shamanoushadi (internal medicine) for 30 days. Statistical Analysis was done using SPSS VER. 20. Wilcoxon signed rank test was used to evaluate the Subjective parameters, in order to interpret the time of significant change. For objective parameters Paired Samples t- Test was used to evaluate the difference of significant change. The results showed improvement in the subjective criteria, objective criteria and the overall effect of the therapy with the exception of no statistically significant results in immunomodulatory (IgE) effect which proves that the particular management protocol adopted is found to be clinically efficant but not effective in inducing changes at the immune level.


Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Kwan Hon Benjamin Leung ◽  
Matthew Yang ◽  
Christopher Sun ◽  
Katherine S Allan ◽  
Natalie Wong ◽  
...  

Introduction: Delays in defibrillation of in-hospital cardiac arrests (IHCAs) can reduce the likelihood of survival. Mathematical optimization has been shown to improve public location defibrillator placement but has not been applied to in-hospital defibrillator placement. Objective: To determine if mathematical optimization of in-hospital defibrillator placements can reduce distances to IHCAs compared to current placements in a large academic teaching hospital. Methods: We identified all treated IHCAs and defibrillator placements in St. Michael’s Hospital in Toronto, Canada from Jan. 2007 to Jun. 2017 and mapped them to a 3-D representation of the hospital that we developed from blueprints. An equal number of optimal defibrillator locations was identified using a mathematical optimization model that minimizes the average distance between IHCAs and the closest defibrillator in a 10-fold cross-validation approach. The optimized and current defibrillator locations were compared in terms of average distance to the out-of-sample IHCAs in each fold. We repeated the analysis excluding IHCAs and defibrillators in intensive care units (ICUs), operating theaters (OTs), and the emergency department (ED). Significance in the difference of average distance was determined using a Wilcoxon signed-rank test. Results: We identified 537 treated IHCAs and 53 defibrillators within the hospital during the study period. Of these, 236 IHCAs and 38 defibrillators were outside of ICUs, OTs, and the ED. Optimal defibrillator placements reduced the average defibrillator-to-IHCA distance from 17.1 m to 3.8 m, a relative decrease of 77.8% (P<0.01) on all IHCAs compared to current defibrillator placements. For non-ICU/OT/ED IHCAs, the average distance was reduced from 18.3 m to 9.8 m, a relative decrease of 46.4% (P<0.01). Conclusion: Optimization-guided placement of in-hospital defibrillators can significantly reduce the distance from an IHCA to the closest defibrillator.


2020 ◽  
Vol 36 (2) ◽  
pp. 84-90
Author(s):  
Dinesh Pal Mudaranthakam ◽  
Colin Cernik ◽  
Leslie Curtis ◽  
Blake Griffith ◽  
Jinxiang Hu ◽  
...  

Background: Background: An investigational pharmacy is responsible for all tasks related to receiving, storing, and dispensing of any investigational drugs. Traditional methods of inventory and protocol tracking on paper binders are very tedious and could be error-prone. Objective: To evaluate the utilization of the IDS to efficiently manage the inventory within an investigational Pharmacy. We hypothesize that the IDS will reduce the drug processing time. Methods: Our pharmacy tracked the drug processing time before and after using the IDS including the receiving, dispensing, and inventory. As part of the receiving the study drug pharmacists tracked the time it took a pharmacist to complete the tasks of logging the study drug before and after the implementation of the IDS system. In addition, the pharmacy also timed the process for drug dispensing and a full investigational drug inventory check. Wilcoxon signed-rank test was used to compare the difference in the meantime of total processing before and after the IDS. Results: Utilization of the IDS system showed significant reduction in processing time, and improvement of efficiency in inventory management. Additionally, the usability survey of the IDS demonstrated that the IDS system helped pharmacists capture data consistently across every clinical trial. Conclusion: Our results demonstrates how technology helps pharmacists to focus on their actual day to day medication-related tasks rather than worrying about other operational aspects. Informatics team continues to further enhance the features such as monitor portal, and features related to finance – generation of invoices, billing reconciliation, etc.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Mansor Shakiba ◽  
Hoshang Sanadgol ◽  
Hamid Reza Azmoude ◽  
Mohamad Ali Mashhadi ◽  
Hassan Sharifi

Background. Although uremic pruritus is a common and upsetting problem of chronic kidney disease, there is no approved treatment for it. This study was undertaken to find the efficiency of sertraline as a possible treatment for uremic pruritus.Methods. 19 ESRD patients under hemodialysis with severe chronic pruritus were randomly selected to participate in this before-after clinical trial. Before and after starting treatment with sertraline, a detailed pruritus history was obtained and pruritus graded by the 30-item inventory of pruritus that patients based on priorities grade allocated to 3 classes. Subjects were treated with sertraline 50 mg oral daily for four months, with monthly assessments of pruritus symptoms.Results. Before treatment with sertraline, the grade of pruritus in 9 (47.4%) patients was moderate and severe in 10 (52.6%) patients. After treatment, grade of pruritus in 11 (57.8%) patients was weak, 6 (31.5%) have moderate and only 2 (10.7%) patients have severe pruritus. Of 10 patients with severe pruritus, 5 (50%) patients experiencing weak pruritus, and 4 (40%) patients have moderate pruritus after treatment. Based on Wilcoxon signed-rank test, the difference between the grade of pruritus before and after treatment with sertraline was significant (P=0.001).Conclusions. Although no definitive recommendation can be made regarding treatment of uremic pruritus, we found an increased antipruritic effect of sertraline in ESRD patients.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Adileh Shirmohammadi ◽  
Leila Roshangar ◽  
Mohammad Taghi Chitsazi ◽  
Reza Pourabbas ◽  
Masoumeh Faramarzie ◽  
...  

Purpose. The aim of this study was to evaluate the efficacy of anorganic bovine bone (Bio-Oss) in comparison with nanocrystalline hydroxyapatite (Ostim) in sinus floor augmentation. Methods. Ten patients aged 40–80 were selected. All the patients needed sinus floor augmentation due to insufficient bone for simultaneous implant placement. The patients underwent panoramic radiography and cone beam computed tomography (CBCT) prior to surgical procedure. After lifting the sinus membrane, Bio-Oss and Ostim are randomly grafted at one of the two sides. Biopsies were obtained from areas identified 5 months after the surgery and before implant placement and then were prepared for histological analysis. Statistical analysis was performed with nonparametric Wilcoxon signed-rank test for comparison of histological and radiological parameters between the two groups. Results. Histological findings revealed a significant increase in percentages of new bone in the Ostim group (P=0.015). Furthermore, new bone density was greater with Ostim compared to Bio-Oss (P=0.038); however, the difference in height increase after surgery did not reach statistical significance (P=0.191). Conclusion. Despite the limitations of this trial, Ostim and Bio-Oss are useful biomaterials in sinus augmentation and Ostim seems to be even more effective in new bone formation.


2018 ◽  
Vol 8 (1) ◽  
pp. 50
Author(s):  
Ahmad Yunadi ◽  
Wiwik Ardiyanti

<p>Penelitian ini bertujuan untuk mengetahui perbedaan omzet penjualan sebelum dan sesudah menggunakan program kampung UKM digital pada Sanggar Batik Kayu Krebet Sendangsari Pajangan Bantul yang mendapatkan program kampung UKM digital dari Pemerintah Daerah Bantul. Sanggar Batik Kayu di dusun Krebet yang mendapatkan program kampung UKM digital sebanyak 5 sanggar. Omzet penjualan yang dipakai adalah omzet yang didapatkan melalui pemasaran konvensional dan <em>online</em> melalui; <em>Facebook, Instagram, Website, Blanja.com, dan Qlapa.</em></p><p>Data dalam penelitian ini merupakan data kuantitatif dan kualitatif dengan menggunakan data campuran. Data diperoleh dari 5 Sanggar Batik Kayu Krebet yang mendapatkan hibah program kampung UKM digital. Metode analisis data yang digunakan peneliti dalam penelitian ini adalah menggunakan <em>uji paired sample t test</em> dan <em>uji wilxocon signed rank test</em>.</p><p>Hasil penelitian yang di dapat dengan menggunakan uji <em>paired sample t test</em> menunjukkan bahwa terdapat perbedaan yang signifikan antara omzet penjualan sebelum dan sesudah menggunakan fasilitas program kampung UKM digital dengan <em>uji paired sample t test, </em>adapun hasil uji taraf sig-2 tailed 0,36. Sedangkan hasil uji dengan <em>wilxocon signed rank test</em> mempunyai taraf nilai Z sebesar -2,023, dengan signifikansi 2- tailed sebesar 0,043. Artinya nilai signifikansi 0,043 &lt; 0,05, maka Hο ditolak atau ada perbedaan omzet penjualan sebelum dan sesudah menggunakan fasilitas program kampung UKM digital.</p><p> </p>


2020 ◽  
Vol 24 (3) ◽  
pp. 162-167
Author(s):  
Michał Sawczyn

Background and Study Aim: To examine the effects of periodized functional strength training (FST) on FMS scores of sport university students with higher risk of injury. Material and Methods: Thirty three  participants (age 21.6±1.3 years, height 177.8±6.9 m, mass 80.4±7.7 kg) with FMS total score ≤ 14 were selected from eighty two volunteered students of University of Physical Education and Sport in Gdańsk and randomly assigned to experimental group (n=16) and control group (n=17). The FMS test was conducted one week before and one week after the 12 week training intervention. The experimental group participated in FST program through 12 weeks. The control group did not engaged in any additional physical activity than planned in their course of study. The  collected  data  were  analysed  using Statistica 13.3 pl (StatSoft Inc). Wilcoxon signed rank test was used to establish the statistical significance of the difference between FMS total scores within each group and Mann Whitney U test between groups before and after the 12 week training intervention. Results: 45 % of volunteers in the first FMS testing showed total scores ≤14. The experimental group that participated in FST program changed significantly FMS total scores after 12 weeks (p<0.05). There were also significant differences in FMS total score between groups after the experiment (p<0.05). Conclusions: There is a need for injury prevention programs for students of University of Physical Education and Sport in Gdańsk. It is clear from this study that FST is effective in improving FMS total score in students with cut off score ≤14.


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