Search

Targeted therapies are becoming more common. In targeted therapy development, suppose its companion diagnostic test divides patients into a marker‐positive subgroup and its complementary marker‐negative subgroup. To find the right patient population for the therapy to target, inference on efficacy in the marker‐positive and marker‐negative subgroups as well as efficacy in the overall mixture population are all of interest. Depending on the type of clinical endpoints, inference on mixture population can be nontrivial and commonly used efficacy measures may not be suitable for a mixture population. Correlations among estimates of efficacy in the marker‐positive, marker‐negative, and overall mixture population play a crucial role in using an earlier phase study to inform on the design of a confirmatory study (e.g., determination of sample size). This article first shows that when the clinical endpoint is binary (such as respond or not), odds ratio is inappropriate as an efficacy measure in this setting, but relative response (RR) is appropriate. We show a safe way of calculating estimated correlations is to consider mixing subgroup response probabilities within each treatment arm first, and then derive the joint distribution of RR estimates. We also show, if one calculates RR within each subgroup first, how wrong the correlations can be if the Delta method derivation fails to take randomness of estimating the mixing coefficient into account. [ABSTRACT FROM AUTHOR]

Purpose: To compare the results of T1ρ MR imaging and 2D real-time shear-wave elastography (SWE) for liver fibrosis detection and staging.Methods: Twenty-nine rabbit models of CCl4-induced liver fibrosis were established and six untreated rabbits served as controls. T1ρ MR imaging and 2D real-time SWE examination were performed at 2, 4, 6, 8, 10, and 12 weeks. T1ρ values and liver stiffness (LS) values were measured. Fibrosis was staged according to the METAVIR scoring system. Correlation test was performed among T1ρ values, LS values, and fibrosis stage. Receiver operating characteristic (ROC) analysis was performed for assessing diagnostic performance of T1ρ and SWE in detection of no fibrosis (F0), substantial fibrosis (≥ F2), severe fibrosis (≥ F3), and cirrhosis (F4).Results: There was moderate positive correlation between fibrosis stage and T1ρ values (r = 0.566; 95% CI 0.291-0.754; P < 0.0001), and LS value (r = 0.726; 95% CI 0.521-0.851; P = 0.003). T1ρ values showed moderate positive correlations with LS values [r = 0.693; 95% confidence interval (CI) 0.472-0.832; P < 0.0001]. Areas Under ROC (AUROCs) were 0.861 (95% CI 0.705-0.953) for SWE and 0.856 (95% CI 0.698-0.950) for T1ρ (P = 0.940), 0.906 (95% CI 0.762-0.978) for SWE and 0.849 (95% CI 0.691-0.946) for T1ρ (P = 0.414), 0.870 (95% CI 0.716-0.958) for SWE and 0.799 (95% CI 0.632-0.913) for T1ρ (P = 0.422), and 0.846 (95% CI 0.687-0.944) for SWE and 0.692 (95% CI 0.517-0.835) for T1ρ (P = 0.137), when diagnosing liver fibrosis with ≥ F1, ≥ F2, ≥ F3, and F4, respectively. There was moderate positive correlation between inflammatory activity and T1ρ values (r = 0.520; 95% CI 0.158-0.807; P = 0.013).Conclusion: T1ρ imaging has potential for liver fibrosis detection and staging with good diagnostic capability similar to that of ultrasonography elastography. [ABSTRACT FROM AUTHOR]

BACKGROUND Chelating agents, such as small peptides, can decrease free iron content and increase iron bioavailability. They may have promising therapeutic potential and may prevent the pro-oxidant effects of low molecular weight iron. Hairtail is a species of fish that is rich in easily digestible proteins. We extended this strategy for iron delivery by using an enzymatic hydrolysate of hairtail as the chelating agent and found that the ferrous-chelating hairtail peptides have anti-anaemic activity in Sprague-Dawley rats with anaemia. RESULTS The anti-anaemic activity of ferrous-chelating hairtail peptides prepared by enzymatic hydrolysis of the hairtail and ferrous chelation was studied in rat models of iron deficiency anaemia. After the end of the 35 d experiment, we noted significant differences in haemoglobin, mean corpuscular volume, haemoglobin distribution width, and ferritin concentrations between those animals supplemented with ferrous-chelating hairtail peptides and FeSO4 and healthy animals. There were no negative side effects on the animals' growth or behaviour. There was no obvious inflammation in the intestinal mucosa lamina propria and no unbalance of intestinal flora. CONCLUSION The novel ferrous-chelating hairtail peptides may be a suitable fortificant for improving iron-deficiency status. Our findings demonstrated that this multi-tracer technique has many applications in nutritional research. © 2015 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

In tailored drug development, the patient population is thought of as a mixture of two or more subgroups that may derive differential treatment efficacy. To find the right patient population for the drug to target, it is necessary to infer treatment efficacy in subgroups and combinations of subgroups. A fundamental consideration in this inference process is that the logical relationships between treatment efficacy in subgroups and their combinations should be respected (for otherwise the assessment of treatment efficacy may become paradoxical). We show that some commonly used efficacy measures are not suitable for a mixture population. We also show that the current practice of over-simply extending the least squares means concept when estimating the efficacy in a mixture population is inappropriate. Proposing a new principle called subgroup mixable estimation, we establish the logical relationships among parameters that represent efficacy and develop a simultaneous inference procedure to confidently infer efficacy in subgroups and their combinations. Using oncology studies with time-to-event outcomes as an example, we show that the hazard ratio is not suitable for measuring treatment efficacy in a mixture population and provide appropriate efficacy measures with a rigorous inference procedure. [ABSTRACT FROM AUTHOR]

The purpose of this program is to improve the capacities of head nurses of operating hospital information system, relevant operation of the Intranet, electronic forms, and computerized processing system through nursing information educational courses and hands-on operation. The results of questionnaires show that head nurses score averagely 4.05 on the knowledge of computerized processing system in the hospital and 3.6, the lowest, on those of schedule arrangement of nursing personnel, cashier, and accounting operation. In addition, the knowledge of the Intranet operation scored averagely 4.28 and 3.8 on the operation of electronic forms and equipment maintenance and repairing request. After collecting, analyzing, compiling information and comparing to literature review, the researchers conclude the solutions as: (1) conducting nursing information training courses to improve knowledge of head nurses on relevant computerized processing system; (2) monitoring and evaluating nursing administration to promote heads-on evaluation operation for furthering understanding of individual operation problem. After the implementation of above proposed program, head nurses score 4.99 on the knowledge of hospital information and operation of relevant intranet system and demonstrate 88% of satisfaction level indicating the importance of conducting nursing information training courses to effectively improve computer operation capacity, work efficiency, and satisfaction level. [ABSTRACT FROM AUTHOR]

Background: The exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy. Methods: This research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data. Results: Results indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p < 0.05). Particularly, father support breastfeeding self-efficacy positively affected exclusive breastfeeding at six weeks postpartum after adjusting all the demographic characteristics of fathers (OR: 2.407; 95% CI: 1.017–4.121). Moreover, results show that the significant influencing factors of father support breastfeeding self-efficacy include breastfeeding knowledge, fatigue, positive affect, successfully experienced helping mothers to breastfeed, spousal relationships and companionship time. Conclusions: High-level father support breastfeeding self-efficacy effectively increased exclusive breastfeeding rate at six weeks postpartum. To enhance the exclusive breastfeeding rate, nurses or midwives can endeavour to design educational programmes or take supportive interventions customised for fathers, such as enhancing their breastfeeding knowledge education, reducing fatigue and mobilising positive emotions, thereby bolstering paternal self-efficacy in breastfeeding. [ABSTRACT FROM AUTHOR]