A robust likelihood approach to inference for paired multiple binary endpoints data.

We introduce a robust likelihood approach to inference for paired multiple binary endpoints data. One can easily implement the methodology without dealing with the model that incorporates a large number of joint probabilities of no direct relevance to the inference of interest. We present the robust score test statistic for testing the equality of two treatment effects to exemplify the utility and simplicity of the method.

Inference about binocular sensitivity and specificity of screening tests for paired organs.

Recently Perera et al. introduced two new binocular accuracy measures to evaluate diagnostic tests for paired organs. They adopted the Gaussian copula model to account for correlation between fellow eyes.

A reproducible robust likelihood approach to inference about marginal characteristics of binary data in paired settings.

We introduce a robust likelihood approach to inference about marginal distributional characteristics for paired data without modeling correlation/joint probabilities. This method is reproducible in that it is applicable to paired settings with various sizes. The virtue of the new strategy is elucidated via testing marginal homogeneity in paired triplet scenario.

Robust likelihood inference for diagnostic accuracy measures for paired organs.

Paired data arise naturally in Ophthalmology where pairs of eyes undergo diagnostic tests to predict the presence of certain diseases. The common correlation model is popular for modeling the joint probabilities of responses from fellow eyes for inference about accuracy measures. One of the assumptions underlying the model is exchangeability of fellow eyes that stipulates the accuracy measures such as sensitivities/specificities of fellow eyes be equal.

A robust likelihood approach to inference about the kappa coefficient for correlated binary data.

We construct a legitimate likelihood function for the agreement kappa coefficient for correlated data without specifically modelling all levels of correlation. This makes available the likelihood ratio test, the score test and other tools without the knowledge of the underlying distributions. This parametric robust likelihood approach applies to general clustered data scenarios.

A robust likelihood approach to inference about the difference between two multinomial distributions in paired designs.

Pairing serves as a way of lessening heterogeneity but pays the price of introducing more parameters to the model. This complicates the probability structure and makes inference more intricate. We employ the simpler structure of the parallel design to develop a robust score statistic for testing the equality of two multinomial distributions in paired designs.

A new likelihood approach to inference about predictive values of diagnostic tests in paired designs.

Intuitively, one only needs patients with two positive screening test results for positive predictive values comparison, and those with two negative screening test results for contrasting negative predictive values. Nevertheless, current existing methods rely on the multinomial model that includes superfluous parameters unnecessary for specific comparisons. This practice results in complex statistics formulas.

Development of a chip-based multiplexed immunoassay using liposomal nanovesicles and its application in the detection of pathogens causing female lower genital tract infections.

Objective: Cervicovaginitis is a highly prevalent disease that is a burden on healthcare globally. Immediate and adequate treatment can eradicate the infection and block subsequent complications. The feasibility of achip-based multiplexed immunoassay using liposomal nanovesicles was tested.

Are we satisfied with the tools for the diagnosis of gonococcal infection in females?

Gonorrhea (Neisseria gonorrhoeae) is a common sexually transmitted infection in women, with a heavy burden on female and neonatal health, because sequelae occur, such as female infertility, ectopic pregnancy, neonatal ophthalmitis and infection, and chronic pelvic pain. Prompt and appropriate antibiotic treatment can cure infection and avoid complications. However, adequate treatment is not easy, because early and rapid identification of gonorrhea is interfered with by many factors, including the complicated mixed microflora of the vagina and cervix, non-user-friendly culture systems, and lack of immediate availability of results, even with a combination of subjective complaint and high clinical suspicion.

Diagnosis of Chlamydia infection in women.

Objects: Chlamydia (Chlamydia trachomatis) is a common sexually transmitted infection that places a heavy burden on women and neonatal health. To avoid severe sequelae such as female infertility, ectopic pregnancy, neonatal infection, such as ophthalmitis, and chronic pelvic pain prompt and appropriate antibiotic treatment seems the best policy in treating this group of patients. However, adequate treatment is not easy because many factors can interfere with an early and rapid identification of Chlamydia infection, including complicated mixed microflora of the vagina and cervix, a nonuser-friendly detection system, and the time required for identification, even with the combination of specific complaints and a high level of clinical alertness.

Effectiveness of a theory-based postpartum sexual health education program on women's contraceptive use: a randomized controlled trial.

Background: The aim of this study was to evaluate the effectiveness of a refined theory-based Interactive Postpartum Sexual Health Education Program to enhance postpartum women's effective contraceptive behavior.

Study Design: Participants (N=250) were randomized to three groups. Experimental Group A received our intervention program via strategies that matched participants' learning preparedness, as determined by the transtheoretical model.

Increased spinal prodynorphin gene expression in reinflammation-associated hyperalgesia after neonatal inflammatory insult.

Background: Neuroplasticity induced by neonatal inflammation is the consequence of a combination of activity-dependent changes in neurons. We investigated neuronal sensitivity to a noxious stimulus in a rat model of neonatal hind-paw peripheral inflammation and assessed changes in pain behaviour at the physiological and molecular levels after peripheral reinflammation in adulthood.

Results: A decrease in paw withdrawal latency (PWL) after a heat stimulus was documented in rats that received inflammatory injections in their left hind paws on postnatal day one (P1) and a reinflammation stimulus at postnatal 6-8 weeks of age, compared with normal rats.

Nonsteroidal anti-inflammatory drugs for wounds: pain relief or excessive scar formation?

The inflammatory process has direct effects on normal and abnormal wound healing. Hypertrophic scar formation is an aberrant form of wound healing and is an indication of an exaggerated function of fibroblasts and excess accumulation of extracellular matrix during wound healing. Two cytokines--transforming growth factor-beta (TGF-beta) and prostaglandin E2 (PGE2)--are lipid mediators of inflammation involving wound healing.

Port wound closure assisted by Foley catheter: an easier way to provide fascia security.

Aim: Specific laparoscopy-related complications, such as incisional hernia (trocar hernia) or hemorrhage, are worthy of our special attention. Preventing and managing these complications safely and efficiently are important, suggesting that a definite closure of the 10-12 mm port wound after laparoscopy is needed; for this, a newer, simpler method was used.

Methods: Ninety-six patients with benign ovarian tumor warranting laparoscopic surgery were enrolled into the study.

Incidence density and relative risk of nosocomial infection in Taiwan's Only Children's Hospital, 1999-2003.

We report on 2,688 nosocomial infection episodes involving 3,238 pathogens in Taiwan's only children's hospital. The mean annual incidence density was 4.06 cases per 1,000 patient-days.

Parametric robust inferences for correlated ordinal data.

The aim of this article is to provide asymptotically valid likelihood inferences about regression parameters for correlated ordinal response variables. The legitimacy of this novel approach requires no knowledge of the underlying joint distributions so long as their second moments exist. The efficacy of the proposed parametric approach is demonstrated via simulations and the analyses of two real data sets.

Comparing several means of dependent populations of count: a parametric robust approach.

We propose a parametric robust procedure for comparing several means of dependent populations of counts. The validity of the proposed method requires no knowledge of the true underlying joint distributions so long as they have finite second moments. The efficacy of this novel technique is demonstrated by simulations and the analysis of a data set from the Taiwan National Health Insurance Research Database.

Regression Diagnostic under Model Misspecification.

We propose two novel diagnostic measures for the detection of influential observations for regression parameters in linear regression. Traditional diagnostic statistics focus on the effect of deletion of data points either on parameter estimates, or on predicted values. A data point is regarded as influential by the new methods if its inclusion determines a significantly different likelihood function for the parameter of interest.

Self-administered acupressure reduces the symptoms that limit daily activities in bronchiectasis patients: pilot study findings.

Aims And Objectives: To examine and compare the effects of acupressure on the perceived health-related quality of life of the participants with bronchiectasis.

Background: In an attempt to offer comfort, pain control and symptom management, nursing is becoming increasingly involved in offering complementary-alternative medicine as part of its caring-healing focus in comprehensive patient care. Acupressure is one such modality that is being increasingly used by both medical and nursing professionals.

A simple and exploratory way to determine the mean-variance relationship in generalized linear models.

This paper introduces an exploratory way to determine how variance relates to the mean in generalized linear models. This novel method employs the robust likelihood technique introduced by Royall and Tsou.A urinary data set collected by Ginsberg et al.

The relationship of pain, uncertainty, and hope in Taiwanese lung cancer patients.

The impact of cancer pain on the quality of life of lung cancer patients is obvious, but the relationship of cancer pain to uncertainty and level of hope in cancer patients is not clear and has been the subject of only a few studies. The purpose of this study is to look at the relationship of pain to uncertainty and hope in Taiwanese lung cancer patients. A cross-sectional and descriptive correlational design was used in this study.

Changes in levels of hope after diagnostic disclosure among Taiwanese patients with cancer.

The purposes of this study were to explore the extent to which the practice of disclosing cancer diagnoses to patients is used in Taiwan, to examine the relation between cancer diagnosis disclosure and levels of hope, and to investigate the relation between length of time since diagnosis and levels of hope. The participants in this study were 124 Taiwanese oncology inpatients and outpatients. Of these patients, 79% were informed of their cancer diagnosis.

Overcoming patient-related barriers to cancer pain management for home care patients. A pilot study.

The purpose of this pilot study was to explore the effectiveness of a pain education program to overcome patient-related barriers in managing cancer pain for Taiwanese home care patients with cancer. The pain education program was developed based on previous studies of Taiwanese patient-related barriers to cancer pain management. The Barriers Questionnaire-Taiwan form, the Brief Pain Inventory, the Medication Adherence Questionnaire, and a demographic questionnaire were used for data collection.