Category: Statistics

PLoS One. 2023 Dec 20;18(12):e0295623. doi: 10.1371/journal.pone.0295623. eCollection 2023.

ABSTRACT

The aims of this study in elite youth French players were to 1) describe the anthropometric and physical characteristics of international and non-international players from U16 to U20, and 2) compare these characteristics across age categories and playing standard (international or non-international). Altogether, 1423 players from the French Rugby Federation’s academies participated in a physical testing battery, part of its national young player development pathway. From seasons 2010 to 2020, players were assessed for anthropometric (body mass and height), off-field (bench press; isometric squat, vertical jump) and on-field physical characteristics (aerobic capacity: maximal aerobic speed [MAS]; speed: 10-m, 50-m sprint). A 2-way mixed model analysis of variance (ANOVA) was used to compare physical characteristics across age categories and playing standards. Two separate models were used for forwards and backs. A main statistical effect was observed for age category and playing standard (range p < 0.05 -p < 0.001). Pair-wise category comparisons showed that older players were generally taller, heavier, stronger, faster and demonstrated better aerobic qualities than younger peers. The same results were observed for INT compared with NI players while INT forwards were also taller and heavier than NI peers (range p < 0.01 -p < 0.001). Findings revealed a clear progression in anthropometric characteristics and physical qualities throughout the age development pathway in elite young French rugby players. Findings also identified certain physical qualities (strength, power and speed) necessary at younger levels to achieve international standard.

PMID:38117784 | DOI:10.1371/journal.pone.0295623

PLoS One. 2023 Dec 20;18(12):e0293146. doi: 10.1371/journal.pone.0293146. eCollection 2023.

ABSTRACT

This study establishes a risk index system to evaluate the financial risks of foreign agricultural investment in Belt and Road countries. Agricultural foreign investment risk prevention has emerged as a crucial concern across various sectors globally. We assess the four key dimensions such as political and military risk, economic market risk, social and cultural risk, and resource and environmental risk. We employ the Vertical and Horizontal Leveling Method and Entropy Weighting Method (VHSD-EM) for measuring and analyzing foreign agricultural investment risk levels in Belt and Road countries from 2014 to 2021. Moreover, we used spatial correlation analysis, the Getis-Ord Gi* statistic, to identify hot and cold spots of agricultural foreign investment risks. First political & military, and environmental risks are the main influencing factors of agricultural foreign investment risk. The average AFDI level exceeded in Southeast and South Asia, and certain spillover effects were found in Southeast Asia. Second, the Belt and Road” initiative effectively reduces the risk of AFDI and helps to weaken the spillover effect among fellow countries. A significant spillover effect in AFDI from neighboring countries can lead to high-risk areas for sustained AFDI formation. Third to address such challenges, the Chinese government has prerequisites to enhance foreign agricultural investments in Belt and Road countries and establish a measurement index for agricultural investment risks. Government needs to establish a public service system to enhance the development of large-scale multinational agricultural enterprises. Foreign cooperation is essential for multi and bilateral investment negotiation and optimizing the financial tools to mitigate agricultural foreign direct investment risk in Belt and Road countries.

PMID:38117758 | DOI:10.1371/journal.pone.0293146

Medicina (B Aires). 2023;83(6):927-938.

ABSTRACT

INTRODUCTION: Pregnant women often experience food aversions and cravings, of which little is known about their characteristics and consequences. The objective was to know the prevalence of food cravings and aversions, the characteristics of the pattern of foods that are craved or avoided, and the reasons behind their presence.

METHODS: Observational, descriptive and cross-sectional study. A validated questionnaire was applied to 370 pregnant and postpartum women in public hospitals. Maternal and neonatal variables were measured with descriptive statistics and those associated with the phenomena under study were identified using logistic regression models and cluster analysis using the multivariate technique.

RESULTS: A presence of cravings from 71 to 80% and aversions from 55 to 65% was detected. The most craved foods were fruits and sweet foods and the most avoided meats and mate. The maternal characteristics predictive of cravings were: being younger (OR 0.94), vomiting (OR 2.23), and having gained more weight than expected were negatively associated with the presence of cravings (OR 0.44). The variables associated with the aversions were the absence of a history of hypertension (OR 0.13), a history of macrosomia (OR 2.70), nausea (OR 1.86) and complications during pregnancy (OR 2.23).

DISCUSSION: This work allowed to characterize food cravings and aversions during pregnancy and to know their high frequency.

PMID:38117712

Medicina (B Aires). 2023;83(6):890-899.

ABSTRACT

INTRODUCTION: Juvenile myoclonic epilepsy (JME) is an epileptic syndrome with onset in childhood and adolescence with myoclonus, absences, and generalized tonic-clonic seizures. Reflex stimuli such as sensitivity to light or photosensitivity, eyelid opening and closing, and praxis induction produce epileptiform discharges and seizures. These reflex triggers are not all systematically studied.

OBJECTIVE: Examine reflex features in patients with JME.

METHODS: One hundred adolescents and adults with JME who received different anti-seizure treatments were evaluated consecutively. A standard electroencephalogram was performed with an intermittent light stimulation (SLI) protocol and another for the evaluation of praxias through neurocognitive activity (CNA). The statistical analysis was descriptive and of correlation with a p > 0.05.

RESULTS: Current age was 28±11 (14-67). The seizure began at 15 years ±3 (Range 8-25 years). They presented myoclonus and generalized tonic-clonic seizures in 58%. 50% received valproic acid and 31% continued with seizures. Epileptiform discharges at rest 20%; hyperventilation 30%; eyelid opening and closing 12%; photoparoxysmal response in SLI 40%; CNA 23%. Higher percentage of discharges and delay in performing CNA in those who presented seizures. Valproic acid compared to other drugs did not demonstrate superiority in seizure control.

CONCLUSIONS: These findings confirm the importance of studying reflex traits for diagnosis, follow-up, and therapeutic control.

PMID:38117708

Cancer Biol Ther. 2024 Dec 31;25(1):2287120. doi: 10.1080/15384047.2023.2287120. Epub 2023 Dec 20.

ABSTRACT

This study was designed to evaluate the diagnostic efficacy of relevant parameters of ¹⁸F-prostate-specific membrane antigen (PSMA)-1007 PET/CT in predicting the pathological grade of primary prostate cancer. Briefly, a prospective analysis was performed on 53 patients diagnosed with prostate cancer by systematic puncture biopsy, followed by ¹⁸F-PSMA-1007 PET/CT examination prior to treatment within 10 d. The patients were grouped in accordance with the Gleason grading system revised by the International Association of Urology Pathology (ISUP). They were divided into high-grade group (ISUP 4-5 group) and low-grade group (ISUP 1-3 group). The differences in maximum standardized uptake value (SUVmax), tumor-to-background ratio (TBR), intraprostatic PSMA-derived tumor volume (iPSMA-TV), and intraprostatic total lesion PSMA (iTL-PSMA) between the high- and low-grade group were statistically significant (p < .001). No significant difference was found for mean standardized uptake value (SUVmean) between the high- and low-grade groups (Z = -1.131, p = .258). Besides, binary multivariate logistic regression analysis showed that only iPSMA-TV and iTL-PSMA were independent predictors of the pathological grading, for which the odds ratios were 18.821 [95% confidence interval (CI): 2.040-173.614, p = .010] and 0.758 (95% CI: 0.613-0.938, p = .011), respectively. The area under the ROC of this regression model was 0.983 (95% CI: 0.958-1.00, p < .001). Only iTL-PSMA was a significant parameter for distinguishing ISUP-4 and ISUP-5 groups (Z = -2.043, p = .041). In a nutshell, ¹⁸F-PSMA-1007 PET/CT has good application value in predicting the histopathological grade of primary prostate cancer. Three-dimensional volume metabolism parameters iPSMA-TV and iTL-PSMA were found to be independent predictors for pathological grade.

PMID:38117551 | DOI:10.1080/15384047.2023.2287120

Cancer Res. 2023 Dec 20. doi: 10.1158/0008-5472.CAN-23-0900. Online ahead of print.

ABSTRACT

Cigarette smoke, containing both nicotine and carcinogens, causes lung cancer. However, not all smokers develop lung cancer, highlighting the importance of the interaction between host susceptibility and environmental exposure in tumorigenesis. Here, we aimed to delineate the interaction between metabolizing ability of tobacco carcinogens and smoking intensity in mediating genetic susceptibility to smoking-related lung tumorigenesis. Single-variant and gene-based associations of 43 tobacco carcinogen-metabolizing genes with lung cancer were analyzed using summary statistics and individual-level genetic data, followed by causal inference of Mendelian randomization, mediation analysis, and structural equation modeling. Cigarette smoke-exposed cell models were used to detect gene expression patterns in relation to specific alleles. Data from the International Lung Cancer Consortium (29,266 cases and 56,450 controls) and UK Biobank (2,155 cases and 376,329 controls) indicated that the genetic variant rs56113850 C>T located in intron 4 of CYP2A6 was significantly associated with decreased lung cancer risk among smokers [odds ratio (OR) = 0.88, 95% confidence interval = 0.85-0.91, P = 2.18×10-16], which might interact (Pinteraction = 0.028) with and partially be mediated (ORindirect = 0.987) by smoking status. Smoking intensity accounted for 82.3% of the effect of CYP2A6 activity on lung cancer risk but entirely mediated the genetic effect of rs56113850. Mechanistically, the rs56113850 T allele rescued the downregulation of CYP2A6 caused by cigarette smoke exposure, potentially through preferential recruitment of transcription factor HLTF. Together, this study provides additional insights into the interplay between host susceptibility and carcinogen exposure in smoking-related lung tumorigenesis.

PMID:38117513 | DOI:10.1158/0008-5472.CAN-23-0900

JAMA Netw Open. 2023 Dec 1;6(12):e2347195. doi: 10.1001/jamanetworkopen.2023.47195.

ABSTRACT

IMPORTANCE: Home-delivered meals promote food security and independence among homebound older adults. However, it is unclear which of the 2 predominant modes of meal delivery, daily-delivered vs mailed (or drop-shipped) frozen meals, promotes community living for homebound older adults with dementia.

OBJECTIVE: To assess the risk of nursing home admission within 6 months between homebound individuals receiving daily-delivered vs drop-shipped frozen meals.

DESIGN, SETTING, AND PARTICIPANTS: This pilot, multisite, 2-arm, pragmatic clinical trial included older adults with self-reported dementia on waiting lists for meals at 3 Meals on Wheels (MOW) programs in Texas and Florida between April 7 and October 8, 2021, to assess time to nursing home placement.

INTERVENTIONS: Participants were randomized to receive either meals delivered by an MOW driver or frozen meals that were mailed to participants’ homes every 2 weeks. Participants received their assigned intervention for up to 6 months.

MAIN OUTCOMES AND MEASURES: The primary study outcome was days from randomization to a Minimum Data Set nursing home admission assessment within 6 months. Feasibility of conducting this type of study was examined by tracking enrollment, examining baseline characteristics, monitoring participants’ intervention fidelity, measuring the proportion of participants linked with Centers for Medicare & Medicaid Services (CMS) data, and analyzing the primary study outcome.

RESULTS: Among 325 eligible participants who were randomized, 243 enrolled in the study (mean [SD] age, 81 [8.0] years; 152 (62.6%) were female): 128 to the daily-delivered meals group and 115 to the drop-shipped frozen meals group; 119 participants (49.0%) lived alone. Among the total participants enrolled, 227 (93.4%) were linked deterministically to their CMS data; probabilistic methods were used to link the remaining 16 participants (6.6%). At 6 months from randomization, 160 participants (65.8%) were still receiving meals, and 25 (10.1%; 95% CI, 6.3%-14.0%) were admitted to a nursing home. After adjusting for sex, race and ethnicity, age, program, and living arrangement and the use of death as a censoring event, the adjusted log hazard ratio of nursing home placement between daily-delivered and drop-shipped frozen meals was -0.67 (95% CI, -1.52 to 0.19).

CONCLUSIONS AND RELEVANCE: This pilot randomized clinical trial demonstrated the feasibility of enrolling participants with self-reported dementia on waiting lists at MOW programs, linking their data, and evaluating outcomes. While this pilot study was not powered to detect meaningful, statistically significant differences in nursing home placement, its feasibility and initial results warrant exploration in a follow-on, adequately powered trial.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04850781.

PMID:38117500 | DOI:10.1001/jamanetworkopen.2023.47195

JAMA Netw Open. 2023 Dec 1;6(12):e2348439. doi: 10.1001/jamanetworkopen.2023.48439.

ABSTRACT

IMPORTANCE: Psychiatric conditions in parents are associated with many psychiatric and nonpsychiatric outcomes in offspring. However, it remains unknown whether this intergenerational transmission is attributable to broader psychopathology comorbidity or to specific conditions.

OBJECTIVE: To estimate associations between general and specific psychopathology factors in parents and a wide range of register-based outcomes in their offspring.

DESIGN, SETTING, AND PARTICIPANTS: This Swedish national register-based cohort study included 2 947 703 individuals born between 1970 and 2000 and followed up with participants through December 31, 2013. Statistical analysis was performed from October 2022 to October 2023.

EXPOSURES: Hierarchical factor model consisting of 1 general and 3 specific psychopathology factors fit to 9 parental psychiatric diagnoses and violent criminal court convictions.

MAIN OUTCOMES AND MEASURES: A total of 31 outcomes were measured in offspring and sorted into 6 broad clusters: psychotic-like outcomes, neurodevelopmental outcomes, internalizing outcomes, externalizing outcomes, behavior and accidents, and psychosocial outcomes.

RESULTS: Of 2 947 703 individuals, 1 518 252 (51.5%) were male, and the mean (SD) age at the end of follow-up was 28.7 (8.9) years. The general psychopathology factor in parents was significantly associated with all 31 offspring outcomes (range: odds ratio [OR] for accidents, 1.08 [95% CI, 1.07-1.08] to OR for social welfare recipiency, 1.40 [95% CI, 1.39-1.40]), which means that children whose parents scored 1 SD above the mean on the general psychopathology factor had an 8% to 40% higher odds of different studied outcomes. The specific psychotic factor in parents was primarily associated with all 5 psychotic-like outcomes (range: OR for prescription of antiepileptics, 1.05 [95% CI, 1.04-1.06] to OR for schizophrenia, 1.25 [95% CI, 1.23-1.28]) and the specific internalizing factor in parents was primarily associated with all 6 internalizing outcomes (range: OR for prescription of anxiolytics, 1.10 [95% CI, 1.09-1.10] to OR for depression, 1.13 [95% CI, 1.12-1.13]) and all 6 neurodevelopmental outcomes (range: OR for intellectual disability, 1.02 [95% CI, 1.01-1.03] to OR for autism spectrum disorder, 1.10 [95% CI, 1.09-1.11]) in offspring. The specific externalizing factor in parents was associated with all 6 externalizing outcomes (range: OR for violent crimes, 1.21 [95% CI, 1.19-1.23] to OR for oppositional defiant disorder, 1.32 [95% CI, 1.32-1.33]) and all 6 internalizing outcomes (range: OR for obsessive-compulsive disorder, 1.01 [95% CI, 1.00-1.02] to OR for posttraumatic stress disorder, 1.13 [95% CI, 1.12-1.13]) in offspring.

CONCLUSIONS AND RELEVANCE: This cohort study of the Swedish population suggests that the intergenerational transmission of psychiatric conditions across different types of spectra may largely be attributable to a parental general psychopathology factor, whereas specific factors appeared to be primarily responsible for within-spectrum associations between parents and their offspring. Professionals who work with children (eg, child psychologists, psychiatrists, teachers, and social workers) might benefit from taking the total number of parental psychiatric conditions into account, regardless of type, when forecasting child mental health and social functions.

PMID:38117496 | DOI:10.1001/jamanetworkopen.2023.48439

JAMA Netw Open. 2023 Dec 1;6(12):e2348557. doi: 10.1001/jamanetworkopen.2023.48557.

ABSTRACT

IMPORTANCE: There is interest in reducing long-term benzodiazepine prescribing given harms associated with use, but the cumulative risks or benefits of discontinuation are unknown.

OBJECTIVE: To identify the association of benzodiazepine discontinuation with mortality and other adverse events among patients prescribed stable long-term benzodiazepine therapy, stratified by baseline opioid exposure.

DESIGN, SETTING, AND PARTICIPANTS: This comparative effectiveness study with a trial emulation approach included data from a US commercial insurance database between January 1, 2013, and December 31, 2017. Eligible participants were adults with stable long-term benzodiazepine prescription treatment. Data were analyzed between December 2022 and November 2023.

EXPOSURE: Benzodiazepine discontinuation, defined as no benzodiazepine prescription coverage for 31 consecutive days identified during a 6-month grace period after baseline.

MAIN OUTCOME AND MEASURES: Mortality during 12 months of follow-up; secondary outcomes included nonfatal overdose, suicide attempt or self-inflicted injury, suicidal ideation, and emergency department use, identified in medical claims. Inverse probability weighting was used to adjust for baseline confounders that potentially affected treatment assignment and censoring due to death or disenrollment. Primary analysis used an intention-to-treat approach; a secondary per-protocol analysis estimated associations after accounting for nonadherence. Analyses were stratified by opioid use.

RESULTS: The study included 213 011 (136 609 female [64.1%]; mean [SD] age, 62.2 [14.9] years; 2953 Asian [1.4%], 18 926 Black [8.9%], 22 734 Hispanic [10.7%], and 168 398 White [60.2%]) and 140 565 (91 811 female [65.3%]; mean [SD] age, 61.1 [13.2] years; 1319 Asian [0.9%], 15 945 Black [11.3%], 11 989 Hispanic [8.5%], and 111 312 White [79.2%]) patients with stable long-term benzodiazepine use without and with opioid exposure, respectively. Among the nonopioid exposed, the adjusted cumulative incidence of death after 1 year was 5.5% (95% CI, 5.4%-5.8%) for discontinuers, an absolute risk difference of 2.1 percentage points (95% CI, 1.9-2.3 percentage points) higher than for nondiscontinuers. The mortality risk was 1.6 (95% CI, 1.6-1.7) times that of nondiscontinuers. Among those with opioid exposure, the adjusted cumulative incidence of death was 6.3% (95% CI, 6.0%-6.6%) for discontinuers, an absolute risk difference of 2.4 percentage points (95% CI, 2.2-2.7 percentage points) higher than for nondiscontinuers and a mortality risk 1.6 (95% CI, 1.5-1.7) times that of nondiscontinuers. Cumulative incidence of secondary outcomes was also higher among discontinuers.

CONCLUSIONS AND RELEVANCE: This study identifies small absolute increases in risk of harms among patients with stable long-term prescription benzodiazepine treatment who appear to discontinue relative to continuing treatment, including those with and without recent prescription opioid exposure. Policy broadly promoting benzodiazepine discontinuation may have unintended risks.

PMID:38117495 | DOI:10.1001/jamanetworkopen.2023.48557

JAMA Netw Open. 2023 Dec 1;6(12):e2348814. doi: 10.1001/jamanetworkopen.2023.48814.

ABSTRACT

IMPORTANCE: PIK3CA mutations may be associated with outcomes of patients with ERBB2/HER2-positive early breast cancer (EBC).

OBJECTIVES: To assess if PIK3CA mutations among patients with ERBB2/HER2-positive EBC are associated with treatment response and outcome, and if these associations vary by hormone receptor (HR) status or intrinsic molecular subtype (IMS).

DESIGN, SETTING, AND PARTICIPANTS: This cohort study derived data on 184 patients from the phase 3 neoadjuvant Cancer and Leukemia Group B (CALGB) 40601 trial that enrolled patients with ERBB2/HER2-positive EBC in North America between January 1, 2008, and December 31, 2012. Participants received neoadjuvant paclitaxel with trastuzumab, lapatinib, or both. Statistical analysis was performed from March 23, 2022, to March 9, 2023.

EXPOSURES: Gene expression profiling by RNA sequencing with Prediction Analysis of Microarray 50-determined IMS and PIK3CA mutations from whole-exome sequencing were obtained from pretreatment biopsies from 184 of 305 trial participants.

MAIN OUTCOMES AND MEASURES: The primary end point was pathologic complete response (pCR) and the secondary end point of event-free survival (EFS). The association of PIK3CA mutations with pCR and EFS by HR status and IMS was estimated using logistic and Cox proportional hazards regression models.

RESULTS: All 184 participants were women, with a median age of 49 years (range 24-75 years). A total of 121 participants (66%) had clinical stage II tumors; 32 (17%) had PIK3CA mutations, most frequently H1047R (38% [12 of 32]) and E545K (22% [7 of 32]). PIK3CA mutations were present in 20 of 102 cases of HR-positive EBC (20%) and 12 of 82 cases HR-negative EBC (15%) and varied by IMS (luminal B, 9 of 25 [36%]; luminal A, 2 of 21 [10%]; and ERBB2/HER2-enriched tumors, 19 of 102 [19%]). Pathologic complete response rates were lower in PIK3CA mutated than PIK3CA wild type in the overall population (34% [11 of 32] vs 49% [74 of 152]; P = .14) and were significantly different among those receiving trastuzumab (30% [7 of 23] vs 54% [63 of 117]; P = .045). At a median follow-up of 9 years, PIK3CA mutations were significantly associated with worse EFS in the overall cohort (hazard ratio, 2.58 [95% CI, 1.24-5.35]; P = .01), which persisted in a multivariable model including pCR, HR status, stage, and IMS (hazard ratio, 2.52 [95% CI, 1.16-5.47]; P = .02). The negative association of PIK3CA mutation was significant in HR-positive (hazard ratio, 3.60 [95% CI, 1.45-8.96]; P = .006) and luminal subtypes (hazard ratio, 4.84 [95% CI, 1.08-21.70]; P = .04), but not in nonluminal and HR-negative tumors.

CONCLUSIONS AND RELEVANCE: In ERBB2/HER2-positive EBC, PIK3CA mutations were associated with lower pCR rates and independently associated with worse long-term EFS. These findings appear to be associated with PIK3CA mutations in HR-positive and luminal EBC.

PMID:38117494 | DOI:10.1001/jamanetworkopen.2023.48814