Enzalutamide in metastatic castration-resistant prostate cancer, real-world data

Objective: Androgen deprivation therapy (ADT) is used alone or in combination with docetaxel or androgen inhibitors in the initial treatment of metastatic prostate cancer (PC) (mPC). Enzalutamide is an androgen receptor inhibitor that is used orally and plays a role in different steps of the androgen receptor (AR) signal pathway. The aim of this study is to determine the real life data of patients using enzalutamide for metastatic PC. Material and Methods: The 118 patients from a totally 6 centers using enzalutamide treatment were included in this retrospective analysis. Clinical information of patients was recorded from patient files or automation records. Results: Median OS was 71 months, and median PFS was five months (4,1 – 5,9 months). There was no association of Gleason score with OS and PFS (p = 0.5 and p = 0.4, respectively). Although those who were metastatic at the time of diagnosis lived longer than those who developed metastases later, the difference was not statistically significant (p = 0.9). Likewise, there was no relationship between the time of metastasis development and PFS (p = 0.2). There was no difference in OS and PFS between patients with visceral metastasis and those without (p = 0.3, p = 0.5, respectively). Conclusion: Enzalutamide is an effective and safe agent in accordance with the literature in the patient group included in this study, although some patients may have an unresponsiveness to enzalutamide or develop progression under the enzalutamide treatment. More studies are needed to understand which patient group can benefit more from enzalutamide.

A Review of Bootstrap Methods in Ranked Set Sampling

This chapter provides a brief review of the existing resampling methods for RSS and its implementation to construct a bootstrap confidence interval for the mean parameter. The authors present a brief comparison of these existing methods in terms of their flexibility and consistency. To construct the bootstrap confidence interval, three methods are adopted, namely, bootstrap percentile method, bias-corrected and accelerated method, and method based on monotone transformation along with normal approximation. Usually, for the second method, the accelerated constant is computed by employing the jackknife method. The authors discuss an analytical expression for the accelerated constant, which results in reducing the computational burden of this bias-corrected and accelerated bootstrap method. The usefulness of the proposed methods is further illustrated by analyzing real-life data on shrubs.

Real-Life Data on Total Vitamin D3 (25-Hydroxyvitamin D) Concentrations in Basrah, Iraq

Background: People from our region need a higher dose of vitamin D to maintain their serum 25(OH)D levels at concentrations greater than 20 ng/mL. This study aimed to obtain real data on vitamin D status in Basrah. Methods: Retrospective data analysis of patients seen over 2 years from May 2017 to the end of May 2019 at the Faiha Specialized Diabetes, Endocrine and Metabolism Centre (FDEMC) in Basrah, a tertiary referring center of southern Iraq. Results: The cohort included 3692 persons. Vitamin D deficiency was evident among 62.5% of the studied persons (66.5% of women and 48.7% of men). Univariate analysis for factors associated with vitamin D deficiency found it was significantly associated with female sex (OR, 2.095; 95% CI, 1.793 to 2.448; P<0.0001), age less than 44 years (OR, 2.6; 95% CI, 2.328 to 3.065; P<0.0001), nonmarried status (including single, widow and divorced) (OR, 0.768; 95% CI, 0.656 to 0.900; P<0.0001), nulliparous or unmarried status (OR, 0.684; 95% CI, 0.583 to 0.803; P<0.0001), housewife status (OR, 0.806; 95% CI, 0.673 to 0.967; P=0.020), and rural status (OR, 1.195; 95% CI, 1.034 to 1.382; P=0.016). No significant association was found between vitamin D deficiency and BMI. In multivariate logistic regression analyses, only female sex (OR, 0.513; 95% CI, 0.437 to 0.603; P<0.0001) and age less than 44 years (OR, 2.662; 95% CI, 2.252 to 3.147; P<0.0001), nulliparous or unmarried (OR, 0.814; 95% CI, 0.680 to 0.973; P=0.024) and rural residency (OR, 0.773; 95% CI, 0.647 to 0.924; P<0.0001) remained significantly associated. Conclusion: Women, a younger age, nulliparous, and a rural residency were associated with vitamin D deficiency.

The Empathic Communication Analytical Framework (ECAF): A multimodal perspective on emotional communication in interpreter-mediated consultations

Empathic communication (EC) in healthcare occurs when patients express empathic opportunities, such as emotions, to which doctors respond empathically. This interactional process during which participants try to achieve specific communicative goals (e.g., seeking and displaying empathy) serves as a context in which doctors and patients perform verbal and nonverbal actions and collaboratively co-construct meaning. This applies to interpreter-mediated consultations (IMCs) too, where interpreters perform additional actions of a similar kind. However, there is a dearth of research on the ways in which participants perform these actions in the context of EC, and how these actions in turn help (re)shape the context of EC in IMCs (Theys et al., 2020). To date, any tools for studying EC investigate participants’ actions in isolation, without studying them in the context of EC or in relation to the participants’ awareness of their own and others’ ongoing interactions. In this article, we present the Empathic Communication Analytical Framework (ECAF). The tool draws on valid, complementary analytical tools that allow for a fine-grained, three-level multimodal analysis of interactions. The first level of analysis allows for instances of EC in spoken language IMCs to be identified and for participants’ verbal actions in the context of EC to be studied. The second level allows analysts to investigate participants’ verbal and nonverbal actions in the previously identified context of EC. The third level of analysis links the participants’ concurrent verbal and nonverbal (inter)actions to their levels of attention and awareness and shows how participants’ actions are shaped and in turn help to reshape the context of EC in IMCs. In this article, we present the various levels of the ECAF framework, discuss its application to real-life data, and adopt a critical stance towards its affordances and limitations by looking into one excerpt of EC in IMCs. It is shown that the three distinct yet interconnected levels of analysis in the ECAF framework allow participants’ concurrent multimodal interactions in the context of EC to be studied.

A Novel Generator of Continuous Probability Distributions for the Asymmetric Left-skewed Bimodal Real-life Data with Properties and Copulas

This paper presents a novel two-parameter G family of distributions. Relevant statistical properties such as the ordinary moments, incomplete moments and moment generating function are derived. Using common copulas, some new bivariate type G families are derived. Special attention is devoted to the standard exponential base line model. The density of the new exponential extension can be “asymmetric and right skewed shape” with no peak, “asymmetric right skewed shape” with one peak, “symmetric shape” and “asymmetric left skewed shape” with one peak. The hazard rate of the new exponential distribution can be “increasing”, “U-shape”, “decreasing” and “J-shape”. The usefulness and flexibility of the new family is illustrated by means of two applications to real data sets. The new family is compared with many common G families in modeling relief times and survival times data sets.

An extensive extension of exponentiated exponential distribution using alpha power transformation – statistical properties and applications in engineering science

In this article, an extension of exponentiated exponential distribution is familiarized by adding an extra parameter to the parent distribution using alpha power technique. The new distribution obtained is referred to as Alpha Power Exponentiated Exponential Distribution. Various statistical properties of the proposed distribution like mean, variance, central and non-central moments, reliability functions and entropies have been derived. Two real life data sets have been applied to check the flexibility of the proposed model. The new density model introduced provides the better fit when compared with other related statistical models.