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51.
Analysis of count data from clinical trials using mixed effect analysis has recently become widely used. However, algorithms
available for the parameter estimation, including LAPLACE and Gaussian quadrature (GQ), are associated with certain limitations,
including bias in parameter estimates and the long analysis runtime. The stochastic approximation expectation maximization
(SAEM) algorithm has proven to be a very efficient and powerful tool in the analysis of continuous data. The aim of this study
was to implement and investigate the performance of a new SAEM algorithm for application to count data. A new SAEM algorithm
was implemented in MATLAB for estimation of both, parameters and the Fisher information matrix. Stochastic Monte Carlo simulations
followed by re-estimation were performed according to scenarios used in previous studies (part I) to investigate properties
of alternative algorithms (Plan et al., 2008, Abstr 1372 []). A single scenario was used to explore six probability distribution models. For parameter estimation, the relative bias
was less than 0.92% and 4.13% for fixed and random effects, for all models studied including ones accounting for over- or
under-dispersion. Empirical and estimated relative standard errors were similar, with distance between them being <1.7% for
all explored scenarios. The longest CPU time was 95 s for parameter estimation and 56 s for SE estimation. The SAEM algorithm
was extended for analysis of count data. It provides accurate estimates of both, parameters and standard errors. The estimation
is significantly faster compared to LAPLACE and GQ. The algorithm is implemented in Monolix 3.1, (beta-version available in
July 2009). 相似文献
52.
53.
分别用聚二醇,1-2丙醇,无水乙醇与水组成不同比例的二元溶剂系统,测定了弱极性药物SMZ及TMP在上述各系统中的溶解度。从而导出药物溶解度与二混合溶剂体积分类间的半实验方程。 相似文献
54.
先天性心脏病患儿术后多脏器功能障碍的预后分析 总被引:2,自引:1,他引:1
目的 探讨小儿先天性心脏病(先心病)术后多脏器功能障碍(MODS)预后情况及其影响因素,为对此类患儿进行针对性护理提供依据.方法 收集先心病术后并发MODS 77例患儿的临床资料.结果 11例放弃治疗出院,66例中44例救治存活,22例死亡.出现时间最早、累及最多的脏器为心脏;病死率最高的为累及中枢神经系统的患儿(57.69%),其次是累及血液系统的患儿(55.56%);患儿的病死率与累及脏器的数量呈显著正相关(P<0.01).死亡患儿手术体外循环时间和主动脉阻断时间显著长于存活患儿(均P<0.05),术中意外及术后心肺复苏发生率显著高于存活患儿(均P<0.05).结论 先心病术后患儿应加强心功能监护,特别是体外循环时间>120 min,主动脉阻断时间>60 min及术中发生过意外情况、术后采取过心肺复苏术的患儿;尽早采取有利措施避免其他脏器功能受损是提高患儿存活率的关键. 相似文献
55.
Open mesh versus non-mesh repair of groin hernia meta-analysis of randomized trials leased on individual patient data 总被引:1,自引:1,他引:0
Abstract
Background. The EU Hernia Trialists Collaboration was established to provide reliable evaluation of newer methods of groin hernia repair.
It involved 70 investigators in 20 countries.
Materials and methods. Twenty eligible trials (5016 participants) of open mesh vs. non-mesh groin hernia repair were identified. Meta-analysis was
performed using raw individual patient data where possible.
Results. Fewer hernia recurrences were reported after mesh repair. There were no clear differences between mesh and non-mesh groups
in complications. Overall, those in the mesh groups had a shorter hospital stay, quicker return to usual activities and less
frequent persisting pain, but individual trial results varied.
Conclusions. The review provides strong evidence that open mesh repair is associated with a reduction in the risk of recurrence of between
50% and 75%. There is also some evidence of quicker recovery and of lower rates of persisting pain following open mesh repair.
Electronic Publication 相似文献
56.
57.
Quantitative computed tomography (QCT) has been shown to be a precise and sensitive method for evaluating spinal bone mineral density (BMD) and skeletal response to aging and therapy. Precise and accurate determination of BMD using QCT requires a calibration standard to compensate for and reduce the effects of beam-hardening artifacts and scanner drift. The first standards were based on dipotassium hydrogen phosphate (K2HPO4) solutions. Recently, several manufacturers have developed stable solid calibration standards based on calcium hydroxyapatite (CHA) in water-equivalent plastic. Due to differences in attenuating properties of the liquid and solid standards, the calibrated BMD values obtained with each system do not agree. In order to compare and interpret the results obtained on both systems, cross-calibration measurements were performed in phantoms and patients using the University of California San Francisco (UCSF) liquid standard and the Image Analysis (IA) solid standard on the UCSF GE 9800 CT scanner. From the phantom measurements, a highly linear relationship was found between the liquid- and solid-calibrated BMD values. No influence on the cross-calibration due to simulated variations in body size or vertebral fat content was seen, though a significant difference in the cross-calibration was observed between scans acquired at 80 and 140 kVp. From the patient measurements, a linear relationship between the liquid (UCSF) and solid (IA) calibrated values was derived for GE 9800 CT scanners at 80 kVp (IA=[1.15×UCSF]-7.32). The UCSF normative database for women and men obtained with the liquid standard was corrected for use with the solid standard. Proper procedures for cross-calibrating QCT measurements and the appropriate uses of normative data are discussed. 相似文献
58.
59.
背景 糖尿病合并心力衰竭的患者数量庞大,达格列净作为新型降糖药物,目前已被指南推荐用于心力衰竭的治疗,但其改善心功能的作用机制还未完全明确。目的 研究达格列净对2型糖尿病(T2DM)合并慢性心力衰竭(CHF)患者血浆微小RNA-423-5p(miRNA-423-5p)表达的影响及其与心功能之间的相关性。方法 纳入2021-04-01至2021-11-30就诊于解放军第九六〇医院的T2DM合并CHF患者50例为研究对象,分为达格列净组(n=25)和对照组(n=25),达格列净组给予达格列净10 mg/d,对照组给予其他降糖药物,余治疗原则相同,治疗6个月。另纳入同一时期于本院健康体检的心功能正常者为健康人群组(n=25)。通过数字病历系统收集患者的基本资料,包括年龄、性别、吸烟史、高血压史、血压水平、体质指数(BMI)、血脂、血糖、肌酐(Cr)、氨基末端脑钠肽前体(NT-proBNP)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、纽约心脏病协会(NYHA)心功能分级、心脏彩超、合并用药情况,并留取血液标本进行miRNA-423-5p的检测。治疗4周进行门诊随访,收集患者心功... 相似文献
60.
利用生物芯片的高通量特性,系统地研究生物体基因和蛋白质表达及其相互作用,在最近十几年迅速发展。以图像为基础的生物芯片分析是生物芯片技术的重要组成部分,对其方法进行研究已成为当前的热点之一。目前很多针对生物芯片的分析方法不断涌现,这些方法涉及网格定位、靶点分割、数据提取和表达、几何校正、噪声消除等生物芯片分析子过程。本研究对以上各类分析方法进行了综述,分析了各类方法的不同应用,比较了多种算法的分析结果,并提出当前在生物芯片分析研究领域需要解决的关键问题。 相似文献