Оценка размера эффекта воздействия в квазиэкспериментальных исследованиях

Objectives. To estimate effect sizes in quasi-experimental studies.Methods. Methods of the theory of estimation, methods of mathematical statistics.Results. Estimation of the effect size on an ordinal scale, estimation of the effect size on a binary in the case of opposite direction effects in groups, in quasi-experimental studies for the analytical method "differences in  differences".Conclusion. The paper considers approaches to assessing absolute and standardized effect sizes in experimental and quasi-experimental studies. A brief review of the estimators of absolute and standardized effect sizes for quantitative and binary study variables is provided. The applied approach is proposed to assess the effect sizes of a binary variable in the case of opposite direction effects in groups within a quasi-experimental studies for the "differences in differences" analytical method. An example of assessment of absolute and standardized effect sizes of quantitative and binary variables in quasi-experimental studies in clinical epidemiology is considered. Цели. Поставлена задача оценить размер эффекта в квазиэкспериментальных исследованиях.Методы. Использованы методы теории оценивания и методы математической статистики.Результаты. Оценен размер эффекта на порядковой и бинарной шкалах в случае разнонаправленных эффектов в группах в квазиэкспериментальных исследованиях для аналитического метода «различие в различиях». Заключение. В работе представлены подходы к оценке абсолютных и стандартизированных размеров эффектов в экспериментальных и квазиэкспериментальных исследованиях. Дан краткий обзор оценок абсолютных и стандартизированных размеров эффектов для количественных и бинарных переменных исследования. Рассмотрен практический подход к оценке размеров эффектов порядковой и бинарной переменных в случае разнонаправленных эффектов в группах в квазиэкспериментальных исследованиях для аналитического метода «различие в различиях». Приведен пример расчетов абсолютных и стандартизированных размеров эффектов количественной и бинарной переменных в квазиэкспериметальных исследованиях в клинической эпидемиологии.

IMPROVEMENT OF PHARMACEUTICAL SPECIALISTS DURING THE PERIOD OF REFORMING MEDICINE AND PHARMACY IN UKRAINE

The article describes the need to determine the main directions and priorities of the development of the pharmaceutical industry in Ukraine, which is conditioned by real political and socioeconomic processes. The main element here is the introduction and development of a formular system - a complex of management methods for the application of rational, organizational and cost-effective methods of supplying and using drugs to ensure, in specific conditions, high quality medical care and optimal use of available resources.Key words: pharmaceutical industry, pharmacist, pharmacist, higher education

Predictive value of global longitudinal strain and geometry of left ventricle in patients with noncompaction cardiomyopathy

Aim. To assess the prognostic role of a decrease in longitudinal strain and an increase in the left ventricular sphericity index as predictors of NYHA class III heart failure (HF) progression, requiring hospitalization in a cohort of patients with noncompaction cardiomyopathy (NCM) in combination with dilated cardiomyopathy (DCM).Material and methods. We examined 90 patients with a combination of NCM and DCM aged 18 to 72 years (median age, 41 years; men — 73; women — 17), who, in addition to conventional echocardiographic and magnetic resonance imaging (MRI) characteristics, were studied for two-dimensional strain and global longitudinal strain (GLS) parameters and left ventricular sphericity index (SI) using cardiac MRI. The endpoints included NYHA class III HF progression, requiring hospitalization.Results. During the follow-up period (median follow-up, 36 (6; 152) months) in 59 of 90 (65,5%) patients with NCM in combination with DCM, symptoms progressed to NYHA class III HF, requiring hospitalization. Multivariate analysis showed following independent risk factors for HF-related hospitalization: a decrease in GLS <10% (hazard ratio (HR), 5,1; 95% confidence interval (CI), 1,6-16,7, p<0,007) and an increase in SI >0,5 (HR, 9,0; 95% CI, 2,2-37,8, p<0,003) .The 3-year event-free survival rate for patients with one risk factor (GLS, %<10 and SI <0,5; GLS, %>10 and SI >0,5) was 79,2±16,9% and 64,4±24,6%, respectively, while for the group with two risk factors (GLS, %<10 and SI>0,5) — 12,3%.Conclusion. Global longitudinal strain characteristics according to 2D Strain echocardiography and SI according to cardiac MRI are associated with adverse events in NCM and DCM combination and can be used to identify patients with a high risk of HF progression to NYHA class III, requiring hospitalization

Ранние функциональные результаты хирургического лечения опухолей единственной почки

Background. Tumors of a solitary kidney (SK) are extremely rare. They are an absolute indication for organ-preserving treatment. Decrease in the glomerular filtration rate (GFR) and development of acute kidney injury in early postoperative period often require hemodialysis, and patients have to stay in the ICU.Objective. Evaluation of short-term functional results and identification of factors affecting GFR decrease in the early postoperative period after partial nephrectomy for renal masses in the SK.Materials and methods. Analysis of patients’ data with tumor of the SK who underwent open partial nephrectomy at the Oncourology Department of the N.N. Alexandrov National Cancer Centre ofBelarus in the period of 16 years was performed. The study included 136 patients.Results. Multifactor regression analysis (including potential risk factors) revealed that the GFR decrease in the early postoperative period significantly correlated with multifocality (p = 0.028-), ischemia (p < 0.001), blood transfusion (p < 0.001), and the maximum tumor size (p = 0.006). Additional analyses didn’t show any statistically significant correlations between decrease of kidney function and duration of the SK status (n = 127; p = 0.31) or the volume of preserved parenchyma (n = 82; p = 0.77).Conclusion. Early GFR decrease after partial nephrectomy of the SK is strongly associated with ischemia time, blood transfusion, tumor size, and multifocality. In this study, the volume of preserved parenchyma didn’t affect early functional results of the surgery. Введение. Опухоль единственной почки (ЕП) встречается крайне редко и является абсолютным показанием к органосохраняющему лечению. Снижение скорости клубочковой фильтрации (СКФ) и развитие острой почечной недостаточности в раннем послеоперационном периоде часто требует проведение сеансов гемодиализа и нахождение пациента в отделении реанимации.Цель работы – оценка ближайших функциональных результатов резекции ЕП, выявление факторов, влияющих на степень снижения СКФ в раннем послеоперационном периоде.Материалы и методы. Проведен анализ данных пациентов, прооперированных в отделении онкоурологии РНПЦ ОМР им. Н.Н. Александрова за 16 лет с опухолью ЕП. Всего в исследование включено 136 пациентов.Результаты. По данным мультифакторного регрессионного анализа с  включением потенциальных факторов риска установлено, что статистически значимая корреляция со степенью снижения СКФ в раннем послеоперационном периоде отмечалась с мультифокальностью (p=0,028), длительностью ишемии (p < 0,001), гемотрансфузией (p < 0,001) и наибольшим размером опухоли (p=0,006). При выполнении дополнительных анализов данных не было выявлено статистически значимого влияния на степень снижения функции почки ни длительности статуса единственной почки (n=127, p=0,31), ни объёма сохраненной паренхимы (n=82, p=0,77).Заключение. Установлена статистически значимая связь длительности ишемии,  гемотрансфузии в интра- или послеоперационном периоде, размера опухоли и мультифокальности со степенью снижения почечной функции в раннем послеоперационном периоде после резекции ЕП. В данной работе объём сохраненной паренхимы не оказал влияния на ранние функциональные результаты операции.

Direct Observation of Martensitic Phase-Transformation Dynamics in Iron by 4D Single-Pulse Electron Microscopy

The in situ martensitic phase transformation of iron, a complex solid-state transition involving collective atomic displacement and interface movement, is studied in real time by means of four-dimensional (4D) electron microscopy. The iron nanofilm specimen is heated at a maximum rate of ∼10^(11) K/s by a single heating pulse, and the evolution of the phase transformation from body-centered cubic to face-centered cubic crystal structure is followed by means of single-pulse, selected-area diffraction and real-space imaging. Two distinct components are revealed in the evolution of the crystal structure. The first, on the nanosecond time scale, is a direct martensitic transformation, which proceeds in regions heated into the temperature range of stability of the fcc phase, 1185−1667 K. The second, on the microsecond time scale, represents an indirect process for the hottest central zone of laser heating, where the temperature is initially above 1667 K and cooling is the rate-determining step. The mechanism of the direct transformation involves two steps, that of (barrier-crossing) nucleation on the reported nanosecond time scale, followed by a rapid grain growth typically in ∼100 ps for 10 nm crystallites

Sponge spicules as blueprints for the biofabrication of inorganic–organic composites and biomaterials

While most forms of multicellular life have developed a calcium-based skeleton, a few specialized organisms complement their body plan with silica. However, of all recent animals, only sponges (phylum Porifera) are able to polymerize silica enzymatically mediated in order to generate massive siliceous skeletal elements (spicules) during a unique reaction, at ambient temperature and pressure. During this biomineralization process (i.e., biosilicification) hydrated, amorphous silica is deposited within highly specialized sponge cells, ultimately resulting in structures that range in size from micrometers to meters. Spicules lend structural stability to the sponge body, deter predators, and transmit light similar to optic fibers. This peculiar phenomenon has been comprehensively studied in recent years and in several approaches, the molecular background was explored to create tools that might be employed for novel bioinspired biotechnological and biomedical applications. Thus, it was discovered that spiculogenesis is mediated by the enzyme silicatein and starts intracellularly. The resulting silica nanoparticles fuse and subsequently form concentric lamellar layers around a central protein filament, consisting of silicatein and the scaffold protein silintaphin-1. Once the growing spicule is extruded into the extracellular space, it obtains final size and shape. Again, this process is mediated by silicatein and silintaphin-1, in combination with other molecules such as galectin and collagen. The molecular toolbox generated so far allows the fabrication of novel micro- and nanostructured composites, contributing to the economical and sustainable synthesis of biomaterials with unique characteristics. In this context, first bioinspired approaches implement recombinant silicatein and silintaphin-1 for applications in the field of biomedicine (biosilica-mediated regeneration of tooth and bone defects) or micro-optics (in vitro synthesis of light waveguides) with promising results

A many-analysts approach to the relation between religiosity and well-being

The relation between religiosity and well-being is one of the most researched topics in the psychology of religion, yet the directionality and robustness of the effect remains debated. Here, we adopted a many-analysts approach to assess the robustness of this relation based on a new cross-cultural dataset (N=10,535 participants from 24 countries). We recruited 120 analysis teams to investigate (1) whether religious people self-report higher well-being, and (2) whether the relation between religiosity and self-reported well-being depends on perceived cultural norms of religion (i.e., whether it is considered normal and desirable to be religious in a given country). In a two-stage procedure, the teams first created an analysis plan and then executed their planned analysis on the data. For the first research question, all but 3 teams reported positive effect sizes with credible/confidence intervals excluding zero (median reported β=0.120). For the second research question, this was the case for 65% of the teams (median reported β=0.039). While most teams applied (multilevel) linear regression models, there was considerable variability in the choice of items used to construct the independent variables, the dependent variable, and the included covariates

A Many-analysts Approach to the Relation Between Religiosity and Well-being

The relation between religiosity and well-being is one of the most researched topics in the psychology of religion, yet the directionality and robustness of the effect remains debated. Here, we adopted a many-analysts approach to assess the robustness of this relation based on a new cross-cultural dataset (N = 10, 535 participants from 24 countries). We recruited 120 analysis teams to investigate (1) whether religious people self-report higher well-being, and (2) whether the relation between religiosity and self-reported well-being depends on perceived cultural norms of religion (i.e., whether it is considered normal and desirable to be religious in a given country). In a two-stage procedure, the teams first created an analysis plan and then executed their planned analysis on the data. For the first research question, all but 3 teams reported positive effect sizes with credible/confidence intervals excluding zero (median reported β = 0.120). For the second research question, this was the case for 65% of the teams (median reported β = 0.039). While most teams applied (multilevel) linear regression models, there was considerable variability in the choice of items used to construct the independent variables, the dependent variable, and the included covariates

A many-analysts approach to the relation between religiosity and well-being

The relation between religiosity and well-being is one of the most researched topics in the psychology of religion, yet the directionality and robustness of the effect remains debated. Here, we adopted a many-analysts approach to assess the robustness of this relation based on a new cross-cultural dataset (N=10,535 participants from 24 countries). We recruited 120 analysis teams to investigate (1) whether religious people self-report higher well-being, and (2) whether the relation between religiosity and self-reported well-being depends on perceived cultural norms of religion (i.e., whether it is considered normal and desirable to be religious in a given country). In a two-stage procedure, the teams first created an analysis plan and then executed their planned analysis on the data. For the first research question, all but 3 teams reported positive effect sizes with credible/confidence intervals excluding zero (median reported β=0.120). For the second research question, this was the case for 65% of the teams (median reported β=0.039). While most teams applied (multilevel) linear regression models, there was considerable variability in the choice of items used to construct the independent variables, the dependent variable, and the included covariates