Category: Statistics

Transl Vis Sci Technol. 2023 Jan 3;12(1):13. doi: 10.1167/tvst.12.1.13.

ABSTRACT

PURPOSE: Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. We assessed the presence of these abnormalities in Alzheimer’s dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging.

METHODS: UWF images from 103 participants (28 with Alzheimer’s dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity.

RESULTS: Participants with Alzheimer’s dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching.

CONCLUSIONS: Statistically significant differences in the retinal vasculature in peripheral regions of the retina were observed among the distinct cognitive stages. However, larger studies are required to establish the clinical importance of our findings. UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer’s disease.

TRANSLATIONAL RELEVANCE: This pilot work reports an investigation into which retinal vasculature measurements may be useful surrogate measures of cognitive decline, as well as technical developments (e.g., measurement standardization), that are first required to establish their recommended use and translational potential.

PMID:36622689 | DOI:10.1167/tvst.12.1.13

JAMA Netw Open. 2023 Jan 3;6(1):e2249568. doi: 10.1001/jamanetworkopen.2022.49568.

ABSTRACT

IMPORTANCE: Little is known about the long-term economic and social outcomes for children with longitudinally assessed comorbid externalizing and internalizing symptoms, especially compared with children with externalizing symptoms or internalizing symptoms only.

OBJECTIVE: To examine the association between childhood trajectories of externalizing, internalizing, and comorbid symptoms and long-term economic and social outcomes.

DESIGN, SETTING, AND PARTICIPANTS: A 32-year prospective cohort study linked with administrative data was conducted in school-aged participants aged 6 to 12 years in the Québec Longitudinal Study of Kindergarten Children (N = 3017) followed up from 1985 to 2017. Data analysis was conducted between August 1, 2021, and March 31, 2022.

EXPOSURES: Teacher-rated behavioral symptoms were used to categorize children from age 6 to 12 years into developmental profiles using group-based trajectory modeling.

MAIN OUTCOMES AND MEASURES: Multivariable regression models were used to test the association between childhood symptom profile group and adult employment earnings, welfare receipt, intimate partnership status, and having children living in the household. Participant sex, IQ, and socioeconomic background were adjusted for.

RESULTS: Of 3017 participants in this sample, 1594 (52.8%) were male and 1423 (47.2%) were female. Per confidentiality rules established by Statistics Canada, income variables were rounded to base 100 and count variables were rounded to base 10; the mean (SD) age was 37 (0.29) years at follow-up. Four symptom profiles were identified: no/low (n = 1369 [45.4%]), high externalizing (882 [29.2%]), high internalizing (354 [11.7%]), and comorbid (412 [13.7%]) symptoms. Compared with the no/low symptom profile, participants in the high externalizing-only profile earned $5904 (95% CI, -$7988 to -$3821) less per year and had 2.0 (95% CI, 1.58-2.53) times higher incidence of welfare receipt, while participants in the high internalizing group earned $8473 (95% CI, -$11 228 to -$5717) less per year, had a 2.07 (95% CI, 1.51-2.83) higher incidence of welfare receipt, and had a lower incidence of intimate partnership (incident rate ratio [IRR], 0.89; 95% CI, 0.80-0.99). Participants in the comorbid profile fared especially poorly: they earned $15 031 (95% CI, -$18 030 to -$12 031) less per year, had a 3.79 (95% CI, 2.75-5.23) times higher incidence of annual welfare receipt, and were less likely to have an intimate partner (IRR, 0.71; 95% CI, 0.63-0.79) and children living in the household (IRR, 0.86; 95% CI, 0.80-0.92). Estimated lost earnings over a 40-year working career were $140 515 for the high externalizing, $201 657 for the high internalizing, and $357 737 for the comorbid profiles.

CONCLUSIONS AND RELEVANCE: In this cohort study, children exhibiting sustained childhood high externalizing, high internalizing, or comorbid symptoms were at increased risk of poor economic and social outcomes into middle age. These findings suggest that children exhibiting comorbid problems were especially vulnerable and that early detection and support are indicated.

PMID:36622675 | DOI:10.1001/jamanetworkopen.2022.49568

JAMA Netw Open. 2023 Jan 3;6(1):e2250126. doi: 10.1001/jamanetworkopen.2022.50126.

ABSTRACT

IMPORTANCE: Factors associated with the risk of dementia remain to be fully understood. Systemic infections are hypothesized to be such factors and may be targets for prevention and screening.

OBJECTIVE: To investigate the association between hospitalization with infection and incident dementia.

DESIGN, SETTING, AND PARTICIPANTS: Data from the community-based Atherosclerosis Risk in Communities (ARIC) study, a prospective cohort study, were used. Enrollment occurred at 4 research centers in the US, initiated in 1987 to 1989. The present study includes data up to 2019, for 32 years of follow-up. Data analysis was performed from April 2021 to June 2022.

EXPOSURES: Hospitalizations with infections were identified via medical record review for selected International Classification of Diseases, Ninth Revision (ICD-9) and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, from baseline until administrative censoring or dementia diagnosis. Participants were considered unexposed until first hospitalization with infection and exposed thereafter. Selected infection subtypes were also considered.

MAIN OUTCOMES AND MEASURES: Incident dementia and time-to-event data were identified through surveillance of ICD-9 and ICD-10 hospitalization and death certificate codes, in-person assessments, and telephone interviews. A sensitivity analysis was conducted excluding cases occurring within 3 years or beyond 20 years from exposure. Data were collected before study hypothesis formulation.

RESULTS: Of the 15 792 ARIC study participants, an analytical cohort of 15 688 participants who were dementia free at baseline and of Black or White race were selected (8658 female [55.2%]; 4210 Black [26.8%]; mean [SD] baseline age, 54.7 [5.8] years). Hospitalization with infection occurred among 5999 participants (38.2%). Dementia was ascertained in 2975 participants (19.0%), at a median (IQR) of 25.1 (22.2-29.1) years after baseline. Dementia rates were 23.6 events per 1000 person-years (95% CI, 22.3-25.0 events per 1000 person-years) among the exposed and 5.7 events per 1000 person-years (95% CI, 5.4-6.0 events per 1000 person-years) among the unexposed. Patients hospitalized with infection were 2.02 (95% CI, 1.88-2.18; P < .001) and 1.70 (95% CI, 1.55-1.86; P < .001) times more likely to experience incident dementia according to unadjusted and fully adjusted Cox proportional hazards models compared with individuals who were unexposed. When excluding individuals who developed dementia less than 3 years or more than 20 years from baseline or the infection event, the adjusted hazard ratio was 5.77 (95% CI, 4.92-6.76; P < .001). Rates of dementia were significantly higher among those hospitalized with respiratory, urinary tract, skin, blood and circulatory system, or hospital acquired infections. Multiplicative and additive interactions were observed by age and APOE-ε genotype.

CONCLUSIONS AND RELEVANCE: Higher rates of dementia were observed among participants who experienced hospitalization with infection. These findings support the hypothesis that infections are factors associated with higher risk of dementias.

PMID:36622673 | DOI:10.1001/jamanetworkopen.2022.50126

Eur Geriatr Med. 2023 Jan 9. doi: 10.1007/s41999-022-00733-2. Online ahead of print.

ABSTRACT

METHODS: This is a longitudinal observational study with a convenience subsample from the international Back Complaints in the Elders (BACE)-Brazil. Frailty was assessed by researchers at baseline, 6 and 12 months according to the Frailty Phenotype. Pain was assessed using a Numerical Pain Scale (NPS). Disability was assessed using the Roland Morris Disability Questionnaire.

RESULTS: A total of 155 older women (70.4 ± 5.4 years) participated. Follow-up for 6 and 12 months in this study was associated with a change of older women to worse frailty levels (OR = 2.83, 95% CI 1.98-4.67; p < 0.01). A significant association was observed between greater pain intensity and the transition of the older women through the frailty levels (β = – 0.73; p < 0.01) when inserting the pain variable at baseline of the statistical model. Older women who reported greater pain intensity worsened their frailty level. The same happened when the disability variable was inserted in the model (β = – 0.74; p < 0.01). The criteria proposed by Fried et al. were able to identify frailty throughout the follow-up and no prevalence of any item.

CONCLUSIONS: In older women, relevant factors such as pain and disability are closely linked to the frailty phenomenon. Thus, the frailty syndrome must be assessed, monitored and treated in relation to the individualities of older adults, as those with back pain and greater disabilities are more susceptible to frailty.

PMID:36622621 | DOI:10.1007/s41999-022-00733-2

Environ Sci Pollut Res Int. 2023 Jan 9. doi: 10.1007/s11356-022-25080-4. Online ahead of print.

ABSTRACT

As an efficient, economical, and clean energy, natural gas plays an important role in the development of the new energy revolution. Accurate prediction of natural gas consumption and production can adjust energy deployment in advance, which can ensure the stable operation of natural gas. Considering the complex and non-linear characteristics of natural gas production and consumption data, this paper develops a new hybrid forecasting model (WPD-VMD-LSTM) based on the fuzzy entropy, variational mode decomposition (VMD), wavelet packet decomposition (WPD), and Long Short-Term Memory (LSTM). In this model, WPD and VMD undertake the tasks of primary and secondary decompositions, respectively; fuzzy entropy is used for the preprocessing process before the re-decomposition; and LSTM is used to predict the decomposed time series. In particular, the different criteria set by fuzzy entropy lead to the establishment of two prediction models. Then, two models are used to study monthly natural gas consumption and production in the USA. The results demonstrate that the proposed model performs significantly better than other comparable models and the target model has some practical value. Meanwhile, models may cope with different types of energy data, and models can accurately predict energy transformations with strong applicability, which can be applied to future energy forecasting in various fields. Finally, the constructed models are used to forecast the NGC and NGP in the USA in the next 3 years and make reasonable policy recommendations based on the forecast results.

PMID:36622613 | DOI:10.1007/s11356-022-25080-4

Environ Sci Pollut Res Int. 2023 Jan 9. doi: 10.1007/s11356-022-24739-2. Online ahead of print.

ABSTRACT

Over the years, public infrastructure projects have generated substantial attention as they take the initiative to enrich sustainable community development. This paper looks to identify if the delays in public projects significantly impact the sustainable community development. A questionnaire survey approach is used to collect data. This study employed the partial least square structural equation modeling to examine the hypothesized model. Data obtained from 325 project experts in the Pakistani construction industry provided empirical support for the study. The outcome of the statistical analysis showed that project delay significantly influences sustainable community development. Based on the findings, this study suggests valuable insights to project management planners and executors to improve strategic planning for project executions through proper sustainability approaches.

PMID:36622583 | DOI:10.1007/s11356-022-24739-2

Behav Genet. 2023 Jan 9. doi: 10.1007/s10519-022-10131-w. Online ahead of print.

ABSTRACT

Most human traits are influenced by the interplay between genetic and environmental factors. Many statistical methods have been proposed to screen for gene-environment interaction (GxE) in the post genome-wide association study era. However, most of the existing methods assume a linear interaction between genetic and environmental factors toward phenotypic variations, which diminishes statistical power in the case of nonlinear GxE. In this paper, we present a flexible statistical procedure to detect GxE regardless of whether the underlying relationship is linear or not. By modeling the joint genetic and GxE effects as a varying-coefficient function of the environmental factor, the proposed model is able to capture dynamic trajectories of GxE. We employ a likelihood ratio test with a fast Monte Carlo algorithm for hypothesis testing. Simulations were conducted to evaluate validity and power of the proposed model in various settings. Real data analysis was performed to illustrate its power, in particular, in the case of nonlinear GxE.

PMID:36622576 | DOI:10.1007/s10519-022-10131-w

J Racial Ethn Health Disparities. 2023 Jan 9. doi: 10.1007/s40615-022-01504-2. Online ahead of print.

ABSTRACT

BACKGROUND: Restraints are often utilized in the emergency department (ED) to prevent patients from injuring themselves or others while managing their agitation in order to deliver appropriate medical care. Chemical and physical restraints are ordered at the discretion of the medical provider and typically employed after reasonable verbal de-escalation has been attempted. While health inequities and racial bias in medicine and healthcare have been well-established, information on the differences in the selection and use of restraints by race and ethnicity are scarce.

METHODS: This retrospective cohort study utilized national data from HCA Healthcare ED and inpatient database with patient visits from 2016 to 2019 to evaluate the relationships between race and ethnicity and the utilization of restraints in the ED. Associations are reported using linear and logistic regression analyses.

RESULTS: The study population included 12,229 unique ED admissions for patients 16 and older with diagnoses of aggression or agitation who had either chemical or physical restraints used. There was no statistically significant difference when comparing Black or other race to White patients and the type of restraint used. Hispanic patients received 0.206 fewer doses of chemical restraints compared to White patients (p = 0.008, 95% C.I. [-0.359, -0.053]) and were slightly less likely to receive physical restraints compared with White patients (p = 0.044, 95% C.I. [0.467, 0.989]), but there was no difference between use of physical restraint and Black or other patients compared to White patients.

CONCLUSIONS: In this national sample of agitated and/or aggressive ED patients who were restrained, Hispanic patients were slightly less likely to receive physical restraints and received fewer doses of chemical restraints than White patients. There were no differences between Black or other patients compared to White patients in restraint type, number of doses of chemical restraint or time to application of either restraint type. This suggests that physicians apply the use of chemical restraints to agitated and aggressive ED patients based on factors that are not associated with race and ethnicity.

PMID:36622570 | DOI:10.1007/s40615-022-01504-2

Behav Res Methods. 2023 Jan 9. doi: 10.3758/s13428-022-02013-0. Online ahead of print.

ABSTRACT

Trend is one of the data aspects that is an object of assessment in the context of single-case experimental designs. This assessment can be performed both visually and quantitatively. Given that trend, just like other relevant data features such as level, immediacy, or overlap does not have a single operative definition, a comparison among the existing alternatives is necessary. Previous studies have included illustrations of differences between trend-line fitting techniques using real data. In the current study, I carry out a simulation to study the degree to which different trend-line fitting techniques lead to different degrees of bias, mean square error, and statistical power for a variety of quantifications that entail trend lines. The simulation involves generating both continuous and count data, for several phase lengths, degrees of autocorrelation, and effect sizes (change in level and change in slope). The results suggest that, in general, ordinary least squares estimation performs well in terms of relative bias and mean square error. Especially, a quantification of slope change is associated with better statistical results than quantifying an average difference between conditions on the basis of a projected baseline trend. In contrast, the performance of the split-middle (bisplit) technique is less than optimal.

PMID:36622560 | DOI:10.3758/s13428-022-02013-0

Ann Surg Oncol. 2023 Jan 9. doi: 10.1245/s10434-022-12863-9. Online ahead of print.

ABSTRACT

BACKGROUND: SWOG 0809 is the only prospective study of adjuvant chemotherapy followed by chemoradiation focusing on margin status in patients with extrahepatic cholangiocarcinoma (EHCC) and gallbladder cancer (GBCA); however, the effects of adjuvant therapy by nodal status have never been reported in this population.

METHODS: Patients with resected EHCC and GBCA, stage pT2-4, node-positive (N+) or margin-positive (R1) who completed four cycles of chemotherapy followed by radiotherapy were included. Cox regression was used to compare overall survival (OS), disease-free survival (DFS), local recurrence, and distant metastasis by nodal status. DFS rates were compared with historical data via a one-sample t-test.

RESULTS: Sixty-nine patients [EHCC, n = 46 (66%); GBCA, n = 23 (33%)] were evaluated, with a median age of 61.7 years and an R0 rate of 66.7% and R1 rate of 33.3%. EHCC versus GBCA was more likely to be N+ (73.9% vs. 47.8%, p = 0.03). Nodal status did not significantly impact OS (hazard ratio [HR] 1.98, 95% confidence interval [CI] 0.86-4.54, p = 0.11) or DFS (HR 1.63, 95% CI 0.77-3.44, p = 0.20). Two-year OS was 70.6% for node-negative (N0) disease and 60.9% for N+ disease, while 2-year DFS was 62.5% for N0 tumors and 49.8% for N+ tumors. N+ versus N0 tumors showed higher rates of distant failure (42.2% vs. 25.0%, p = 0.04). The 2-year DFS rate in N+ tumors was significantly higher than in historical controls (49.8% vs. 29.7%, p = 0.004).

CONCLUSIONS: Adjuvant therapy is associated with favorable outcome independent of nodal status and may impact local control in N+ patients. These data could serve as a benchmark for future adjuvant trials, including molecular-targeted agents.

PMID:36622529 | DOI:10.1245/s10434-022-12863-9