Category: Statistics

BMC Genomics. 2023 Aug 2;24(1):431. doi: 10.1186/s12864-023-09512-0.

ABSTRACT

The H9c2 myoblast cell line, isolated from the left ventricular tissue of rat, is currently used in vitro as a mimetic for skeletal and cardiac muscle due to its biochemical, morphological, and electrical/hormonal signaling properties. During culture, H9c2 cells acquire a myotube phenotype, where a critical component is the inclusion of retinoic acid (RA). The results from some authors on H9c2 suggested that thousands of genes respond to RA stimuli, while others report hundreds of genes responding to RA over different cell types. In this article, using a more appropriate experimental design, we first confirm the H9c2 cardiac phenotype with and without RA and report transcriptomic and physiological changes regarding calcium handling, bioenergetics, and other biological concepts. Interestingly, of the 2360 genes showing a transcriptional change, 622 genes were statistically associated with the RA response. Of these genes, only 305 were RA-specific, and the rest also showed a culture-time component. Thus, the major expression changes (from 74 to 87%) were indeed due to culture conditions over time. Unexpectedly, only a few components of the retinol pathway in KEGG responded to RA. Our results show the role of RA in the H9c2 cultures impacting the interpretation using H9c2 as an in vitro model.

PMID:37533008 | DOI:10.1186/s12864-023-09512-0

BMC Emerg Med. 2023 Aug 2;23(1):82. doi: 10.1186/s12873-023-00856-0.

ABSTRACT

Informed consent for emergency surgery is a process in which a patient or their next of kin must make quick decisions required for surgery in a life-threatening situation or surgery that may have life-altering outcomes. The objective of the study was to describe patients and their next of kin experiences and factors influencing the informed consent process in two urban university teaching hospitals in Uganda.

METHODS: A cross-sectional survey involving patients who underwent emergency surgery and their next of kin was conducted in two tertiary care hospitals; one public and one private-not-for profit institution. A questionnaire was administered to collect sociodemographic information, type of Surgery that was done, how informed consent was obtained and experiences and expectations from the informed consent process. Univariate and multivariate analyses of the variables was done.

RESULTS: We collected data from 210 patients from a public hospital and 170 from a private-not-for profit hospital. Overall, most patients did not have the risks of the surgery communicated to them (79.7%), were not given alternative options (87.6%) and had no opportunity to ask questions (57.4%). Patients at the private institution had 3.35 times the odds of expecting the consent form to be explained to them than those at the public institution. Patients at the public hospital had 0.12 times the odds of preferring to have consent administered by a nurse than patients at the private institution OR 0.12 (0.05-0.29, p < 0.001). Patients in the public institution had 0.18 times the odds of preferring to have consent administered by a doctor than patients in the private institution OR 0.18 (0.08-0.45, p < 0.001).

CONCLUSION: Patients in both public and private institutions are not informed about the risks of surgery, alternative options and are not given the opportunity to ask questions. Interpretation of the findings of this study on patient preferences on who administered consent though statistically significant were inconclusive due to the responses not being mutually exclusive.

PMID:37532992 | DOI:10.1186/s12873-023-00856-0

J Headache Pain. 2023 Aug 2;24(1):101. doi: 10.1186/s10194-023-01636-8.

ABSTRACT

BACKGROUND: To date, real-world evidence on persistence to anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs) or onabotulinumtoxinA have excluded eptinezumab. This retrospective cohort study was performed to compare treatment persistency among patients with migraine on anti-CGRP mAbs (erenumab, fremanezumab, galcanezumab, or eptinezumab) or onabotulinumtoxinA.

METHODS: This retrospective study used IQVIA PharmMetrics data. Adult patients with migraine treated with an anti-CGRP mAb or onabotulinumtoxinA who had 12 months of continuous insurance enrollment before starting treatment were included. A “most recent treatment episode” analysis was used in which the most recent episode was defined as the latest treatment period with the same drug (anti-CGRP mAb or onabotulinumtoxinA) without a ≥ 15-day gap in medication supply on/after June 25, 2020, to December 31, 2021. Patients were indexed at the start of their most recent episode. Patients were considered non-persistent and discontinued the therapy associated with their most recent episode if there was ≥ 15-day gap in medication supply. A Cox proportional-hazards model estimated the discontinuation hazard between treatments. The gap periods and cohort definition were varied in sensitivity analyses.

RESULTS: The study included 66,576 patients (median age 46 years, 88.6% female). More eptinezumab-treated patients had chronic migraine (727/1074), ≥ 3 previous acute (323/1074) or preventive (333/1074) therapies, and more prior treatment episodes (3) than other treatment groups. Based on a 15-day treatment gap, patients on subcutaneous anti-CGRP mAbs had a 32% (95% CI: 1.19, 1.49; erenumab), 42% (95% CI: 1.27, 1.61; galcanezumab), and 58% (95% CI: 1.42, 1.80; fremanezumab) higher discontinuation hazard than those receiving eptinezumab, with this relationship attenuated, but still statistically significant based on 30-day and 60-day treatment gaps. There was no significant difference in the discontinuation hazard between eptinezumab and onabotulinumtoxinA. Based on a 15-day treatment gap among patients who newly initiated therapy, the discontinuation hazard of subcutaneous anti-CGRP mAbs remained significantly higher compared to eptinezumab and onabotulinumtoxinA.

CONCLUSION: Patients treated with eptinezumab demonstrated persistency that was higher than subcutaneous anti-CGRP mAbs and similar to onabotulinumtoxinA.

PMID:37532991 | DOI:10.1186/s10194-023-01636-8

BMC Public Health. 2023 Aug 2;23(1):1474. doi: 10.1186/s12889-023-16352-w.

ABSTRACT

BACKGROUND: Increased coverage for institutional delivery (ID) is one of the essential factors for improved maternal and child health (MCH). Though, ID increased over time, out-of-pocket expenditure (OOPE) for the care-seeking families had been found to be growing, parallelly. Hence, we estimated OOPE in public and private health centres for ID, along with their sources and attributing factors and compared state and union territory-wise, so that financial risk protection can be improved for MCH related services.

METHODS: We used women’s data from the National Family Health Survey, 2019-2021 (NFHS-5). Reproductive aged women (15-49 years) delivering one live child in last 5 years (n = 145,386) in any public or private institutions, were included. Descriptive statistics were presented as frequency and proportions. OOPE, was summarized as median and interquartile range (IQR). To estimate the extent for each covariate’s effect, linear regression model was conducted.

RESULTS: Overall median OOPE for ID was Rs. 4066 (median OOPE: private hospitals: Rs.25600, public hospitals: Rs.2067). Health insurance was not sufficient to slash OOPE down at private facilities. Factors associated significantly to high OOPE were mothers’ education, elderly pregnancy, complicated delivery, birth order of the latest child etc. CONCLUSION: A standard norm for ID should be implemented as a component of overseeing and controlling inequality. Aiding the needy is probably just one side of the solution, while the focus is required to be shifted towards reducing disparity among the health facilities, so that the beneficiaries do not need to spend on essential services or during emergencies.

PMID:37532981 | DOI:10.1186/s12889-023-16352-w

Environ Sci Pollut Res Int. 2023 Aug 3. doi: 10.1007/s11356-023-29001-x. Online ahead of print.

ABSTRACT

In the real world, humans are exposed to multiple metal(loid)s (designated hereafter metals) that contain essential metals as well as toxic metals. Exposure to the metal mixture was assumed to be associated with renal function impairment; however, there is no consensus on available studies. Therefore, we here explored the association between multiple metals exposure and indicators of renal function in the general population from southeastern China. A total of 11 metals with 6 human essential metals and 5 toxic metals were determined in the selected 720 subjects. In addition, serum uric acid (SUA), serum creatinine (SCR), and the estimated glomerular filtration rate (eGFR) were measured or calculated as indicators of renal function. Using multiple flexible statistical models of generalized linear model, elastic net regression, and Bayesian kernel machine regression, the joint as well as the individual effect of metals within the mixture, and the interactions between metals were explored. When exposed to the metal mixture, the statistically non-significantly increased SUA, the significantly increased SCR, and the significantly declined eGFR were observed. In addition, the declined renal function may be primarily attributed to lead (Pb), arsenic (As), and nickel (Ni) exposure. Finally, interactions, such as the synergistic effect between Pb and Mo on SUA, whereas the antagonistic effect between Ni and Cd on SCR and eGFR were identified. Our finding suggests that combined exposure to multiple metals would impair renal function. Therefore, reducing exposure to toxic heavy metals of Pb, As, and Cd and limiting exposure to the human essential metal of Ni would protect renal function.

PMID:37532974 | DOI:10.1007/s11356-023-29001-x

Environ Sci Pollut Res Int. 2023 Aug 3. doi: 10.1007/s11356-023-28847-5. Online ahead of print.

ABSTRACT

We aim to study the impact of green fiscal policy on enterprise green innovation by applying a time-varying difference-in-difference (DID) model, and treat the comprehensive demonstration city of fiscal policy for energy conservation and emission reduction (CPEE) in China as a quasi-natural experiment. The results show that the CPEE can significantly improve enterprise’s green innovation performance of pilot area. This net policy effect is valid after a series of robustness tests to control for various potential confounding factors. Heterogeneity analysis reveals that the effect of CPEE is stronger for state-owned enterprises and enterprises in high energy consumption industries or industries with higher industrial concentration. In addition, the effect of CPEE is various among different categories of green patents, which is stronger for the types of alternative energy production category, waste management category, administrative supervision and design category. The mechanism test indicates that the CPEE can improve the green innovation performance by increasing enterprise’ investment in research and development, promoting territorial industrial transformation and upgrading, and enhancing enterprise executives’ environmental awareness. To achieve the carbon peaking and carbon neutrality goals, the green enabling role of fiscal reform pilot policy in transition economies and the applicability of localized policies should be excavated.

PMID:37532973 | DOI:10.1007/s11356-023-28847-5

Environ Sci Pollut Res Int. 2023 Aug 2. doi: 10.1007/s11356-023-29045-z. Online ahead of print.

ABSTRACT

In the design waste collection systems, it is common practice to use a constant specific fuel consumption (e.g. litres per amount of waste collected or distance travelled). This is also the approach used in many cases for fleet management, namely, for decision-making on more fuel-efficient equipment acquisition. However, the specific fuel consumption is not constant and there are spatial and temporal variations. Accounting for this variability becomes relevant if a more refined cost or environmental optimization is intended. The present research effort evaluates the energy intensity of the waste collection service in the Cascais municipality, reporting the differences and the magnitude of the variability for the mixed waste collection service. Statistically significant differences are found between the circuits, the trucks, months of the year and days of the week. It is discussed that extrapolating average fuel consumption rates for decision-making in new waste collection systems may be prone to substantial error.

PMID:37532971 | DOI:10.1007/s11356-023-29045-z

J Math Biol. 2023 Aug 2;87(2):36. doi: 10.1007/s00285-023-01967-9.

ABSTRACT

We prove that it is possible to obtain the exact closure of SIR pairwise epidemic equations on a configuration model network if and only if the degree distribution follows a Poisson, binomial, or negative binomial distribution. The proof relies on establishing the equivalence, for these specific degree distributions, between the closed pairwise model and a dynamical survival analysis (DSA) model that was previously shown to be exact. Specifically, we demonstrate that the DSA model is equivalent to the well-known edge-based Volz model. Using this result, we also provide reductions of the closed pairwise and Volz models to a single equation that involves only susceptibles. This equation has a useful statistical interpretation in terms of times to infection. We provide some numerical examples to illustrate our results.

PMID:37532967 | DOI:10.1007/s00285-023-01967-9

Mar Pollut Bull. 2023 Jul 31;194(Pt B):115293. doi: 10.1016/j.marpolbul.2023.115293. Online ahead of print.

ABSTRACT

This study aimed to investigate the sediment transport pathways and geochemical parameters in the Izmir Gulf to determine the heavily impacted areas by natural and anthropogenic parameters. The grain size trend analysis was used to determine sediment transport patterns and, statistical methods were employed to identify the sources and distribution of chemical elements in sediments. The main factors that were affecting the area were identified as lithogenic, anthropogenic, maritime traffic, biogenic and shipyard activities. The tannery industry (Cr), maritime traffic and shipyard/dock activities (Cu and Zn), road traffic run-offs (Pb and Zn), and untreated domestic waste discharges (TOC and S) were identified as the sources of metals. Contamination rankings based on metal concentrations indicated higher pollution levels in the Inner Gulf compared to the Central Gulf. Zinc and chromium were found to pose significant risks to benthic organisms. The pollutants tended to accumulate in deposition zones, following sediment transport directions.

PMID:37531664 | DOI:10.1016/j.marpolbul.2023.115293

J Infect Dis. 2023 Aug 2:jiad305. doi: 10.1093/infdis/jiad305. Online ahead of print.

ABSTRACT

BACKGROUND: The epidemiology of respiratory viral infections is complex. How infection with one respiratory virus affects risk of subsequent infection with the same or another respiratory virus is not well described.

METHODS: We retrospectively analyzed data from a longitudinal household cohort study from October 2019-June 2021. Enrolled households completed active surveillance for acute respiratory illness (ARI), and participants with ARI self-collected nasal swabs; after April 2020, participants with ARI or laboratory-confirmed SARS-CoV-2 and their household members self-collected nasal swabs. Specimens were tested via multiplex RT-PCR for respiratory viruses. A Cox regression model with a time-dependent covariate examined risk of subsequent detections following a specific primary viral detection.

RESULTS: Rhinovirus was the most frequently detected pathogen in study specimens (n=406, 9.5%). Among 51 participants with multiple viral detections, rhinovirus to seasonal coronavirus (8, 14.8%) was the most common viral detection pairing. Relative to no primary detection, there was a 1.03-2.06-fold increase in risk of subsequent virus detection in the 90 days following primary detection; risk varied by primary virus: parainfluenza, rhinovirus, and respiratory syncytial virus were statistically significant.

CONCLUSIONS: Primary virus detection was associated with higher risk of subsequent virus detection within the first 90 days after primary detection.

PMID:37531658 | DOI:10.1093/infdis/jiad305