Category: Statistics

Microb Biotechnol. 2022 Aug 3. doi: 10.1111/1751-7915.14124. Online ahead of print.

ABSTRACT

There was inconsistent evidence regarding the use of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for microorganism identification with/without antibiotic stewardship team (AST) and the clinical outcome of patients with bloodstream infections (BSI). In a systematic review and meta-analysis, we evaluated the effectiveness of rapid microbial identification by MALDI-TOF MS with and without AST on clinical outcomes. We searched PubMed and EMBASE databases from inception to 1 February 2022 to identify pre-post and parallel comparative studies that evaluated the use of MALDI-TOF MS for microorganism identification. Pooled effect estimates were derived using the random-effects model. Twenty-one studies with 14,515 patients were meta-analysed. Compared with conventional phenotypic methods, MALDI-TOF MS was associated with a 23% reduction in mortality (RR = 0.77; 95% CI: 0.66; 0.90; I² = 35.9%; 13 studies); 5.07-h reduction in time to effective antibiotic therapy (95% CI: -5.83; -4.31; I² = 95.7%); 22.86-h reduction in time to identify microorganisms (95% CI: -23.99; -21.74; I² = 91.6%); 0.73-day reduction in hospital stay (95% CI: -1.30; -0.16; I² = 53.1%); and US$4140 saving in direct hospitalization cost (95% CI: $-8166.75; $-113.60; I² = 66.1%). No significant heterogeneity sources were found, and no statistical evidence for publication bias was found. Rapid pathogen identification by MALDI-TOF MS with or without AST was associated with reduced mortality and improved outcomes of BSI, and may be cost-effective among patients with BSI.

PMID:35921430 | DOI:10.1111/1751-7915.14124

Sci Adv. 2022 Aug 5;8(31):eabp9908. doi: 10.1126/sciadv.abp9908. Epub 2022 Aug 3.

ABSTRACT

Invertebrates constitute the majority of animal species and are critical for ecosystem functioning and services. Nonetheless, global invertebrate biodiversity patterns and their congruences with vertebrates remain largely unknown. We resolve the first high-resolution (~20-km) global diversity map for a major invertebrate clade, ants, using biodiversity informatics, range modeling, and machine learning to synthesize existing knowledge and predict the distribution of undiscovered diversity. We find that ants and different vertebrate groups have distinct features in their patterns of richness and rarity, underscoring the need to consider a diversity of taxa in conservation. However, despite their phylogenetic and physiological divergence, ant distributions are not highly anomalous relative to variation among vertebrate clades. Furthermore, our models predict that rarity centers largely overlap (78%), suggesting that general forces shape endemism patterns across taxa. This raises confidence that conservation of areas important for small-ranged vertebrates will benefit invertebrates while providing a “treasure map” to guide future discovery.

PMID:35921404 | DOI:10.1126/sciadv.abp9908

Vet Med Sci. 2022 Aug 3. doi: 10.1002/vms3.899. Online ahead of print.

ABSTRACT

This study examined whether radiographic images measurements of the calcaneus in cats are determinative of sex and breed. For this purpose, radiographic images of 70 cats (37 male and 33 females) of different ages (from one to 18 years) and different breeds (41 mix-breed, 18 Scottish Fold and 11 British Shorthair cats) without orthopaedic problems were used. Right tarsal joint radiographs of these orthopaedically healthy cats were taken. Four linear measurements and two angle values of the calcaneus were obtained from the radiographic images. The MANOVA result showed that the most determining factor between the three groups was the greatest width (p value = 0.001). Calcaneal body length, calcaneal greatest length and calcaneal shortest depth were higher in mix-breed cats. Calcaneal tuber length was higher in Scottish Fold cats. The only statistically significant difference between Scottish Fold and British Shorthair was in the calcaneal tuber length (p value = 0.04). In the comparison made between the sexes regardless of species, the linear measurements in males were higher than in females. It was determined that these parameters are statistically significant in terms of sex differentiation in cats. Dorsal and plantar calcaneal angles are not sex determinants in cats. The effect of age on other measurements was analysed by correlation test. However, the effect of age on the measurements was not statistically significant. Mix-breed cats were examined in four groups according to their colour (grey, black-white, yellow, tri-colour). No statistically significant difference was found between calcaneal measurements of cats with different skin colour genotypes. In this study, calcaneus measurements were both determinative between breeds and sexes in cats.

PMID:35921402 | DOI:10.1002/vms3.899

PLoS One. 2022 Aug 3;17(8):e0272358. doi: 10.1371/journal.pone.0272358. eCollection 2022.

ABSTRACT

INTRODUCTION: Tuberculosis (TB) is the leading killer of people living with HIV (PLHIV) and almost one-third of deaths in the world are attributed to it and many of these deaths occur in developing countries. Despite these evidences, after the implementation of universal test and treat (UTT) strategy, information regarding the incidence and predictors of tuberculosis among PLHIV is limited in Ethiopia. Therefore, this study aimed to assess the incidence and predictors of tuberculosis among patients enrolled in Anti-Retroviral Therapy (ART) after universal test and treat program at St. Peter hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia.

METHODS: Institutional-based retrospective cohort study was conducted from November 1 to 30, 2020. Simple random sampling was used to select a total of 539 adults records which was enrolled on ART. Data was collected and entered into EPI DATA 3.1 and analyzed using STATA version 14.1. Time-to-event distributions were estimated using Kaplan-Meier estimates. Hazards across different categories were compared using log-rank tests. Predictors were identified using the Cox proportional hazards model. The hazard ratio (HR) and 95% confidence interval (CI) were computed. Variables having P-value < 0.05 from the multivariable analysis were considered as a statistically significant.

RESULT: Among 539 records reviewed, 529 (98%) were included in the final analysis. The total follow-up period was 1529 Person-Year (PY). The incidence rate in this cohort was found to be 4.84 per 100-person year (95%CI,3.83-6.11). CD4 count<200 (AHR: 3.14,95% CI:1.64-7.10), poor adherence (AHR:2.16, 95% CI:1.21-3.85), underweight (AHR:2.42, 95% CI: 1.30-4.51), not taking isoniazid prophylaxis therapy (AHR: 2.78,95% CI: 1.06-7.30), being bedridden 3.06; (AHR: 3.06, 95% CI: 1.50-6.24), and baseline WHO stage three or four (AHR:2.33, 95% CI:1.08-5.02) were independent predictors for the incidence of TB among HIV positive patients.

CONCLUSION: In this study, the incidence of tuberculosis is relatively low as compared to studies done before the initiation of test and treat program in Ethiopia. low CD4count, poor level of adherence, low BMI, not taking IPT prophylaxis, bedridden functional status, and being on baseline WHO stage III or IV were found to increase the hazard of tuberculosis. Hence, close follow up, reminders, surveillance, and tracing mechanisms targeting this higher risk group would decrease Tuberculosis among PLHIV.

PMID:35921384 | DOI:10.1371/journal.pone.0272358

PLoS One. 2022 Aug 3;17(8):e0272437. doi: 10.1371/journal.pone.0272437. eCollection 2022.

ABSTRACT

BACKGROUND: The association between insulin resistance and cancer-mortality is not fully explored. We investigated the association between several insulin sensitivity indices (ISIs) and cancer-mortality over 3.5 decades in a cohort of adult men and women. We hypothesized that higher insulin resistance will be associated with greater cancer-mortality risk.

METHODS: A cohort of 1,612 men and women free of diabetes during baseline were followed since 1979 through 2016 according to level of insulin resistance (IR) for cause specific mortality, as part of the Israel study on Glucose Intolerance, Obesity and Hypertension (GOH). IR was defined according to the Mcauley index (MCAi), calculated by fasting insulin and triglycerides, the Homeostatic Model Assessment (HOMA), the Matsuda Insulin Sensitivity Index (MISI), and the Quantitative Insulin Sensitivity Check Index (QUICKI), calculated by plasma glucose and insulin.

RESULTS: Mean age at baseline was 51.5 ± 8.0 years, 804 (49.9%) were males and 871 (54.0%) had prediabetes. Mean follow-up was 36.7±0.2 years and 47,191 person years were accrued. Cox proportional hazard model and competing risks analysis adjusted for age, sex, country of origin, BMI, blood pressure, total cholesterol, smoking and glycemic status, revealed an increased risk for cancer-mortality, HR = 1.5 (95% CI: 1.1-2.0, p = 0.005) for the MCAi Q1 compared with Q2-4. No statistically significant associations were observed between the other ISIs and cancer-mortality.

CONCLUSION: The MCAi was independently associated with an increased risk for cancer-mortality in adult men and women free of diabetes and should be further studied as an early biomarker for cancer risk.

PMID:35921366 | DOI:10.1371/journal.pone.0272437

IEEE Trans Med Imaging. 2022 Aug 3;PP. doi: 10.1109/TMI.2022.3196007. Online ahead of print.

ABSTRACT

How spontaneous brain neural activities emerge from the underlying anatomical architecture, characterized by structural connectivity (SC), has puzzled researchers for a long time. Over the past decades, much effort has been directed toward the graph modeling of SC, in which the brain SC is generally considered as relatively invariant. However, the graph representation of SC is unable to directly describe the connections between anatomically unconnected brain regions and fail to model the negative functional correlations. Here, we extend the static graph model to a spatiotemporal varying hypergraph Laplacian diffusion (STV-HGLD) model to describe the propagation of the spontaneous neural activity in human brain by incorporating the Laplacian of the hypergraph representation of the structural connectome (hSC) into the regular wave equation. Theoretical solution shows that the dynamic functional couplings between brain regions fluctuate in the form of an exponential wave regulated by the spatiotemporal varying Laplacian of hSC. Empirical study suggests that the cortical wave might give rise to resonance with SC during the self-organizing interplay between excitation and inhibition among brain regions, which orchestrates the cortical waves propagating with harmonics emanating from the hSC while being bound by the natural frequencies of SC. Besides, the average statistical dependencies between brain regions, normally defined as the functional connectivity (FC), arises just at the moment before the cortical wave reaches the steady state after the wave spreads across all the brain regions. Comprehensive tests on four extensively studied empirical brain connectome datasets with different resolutions confirm our theory and findings.

PMID:35921340 | DOI:10.1109/TMI.2022.3196007

PLoS One. 2022 Aug 3;17(8):e0271934. doi: 10.1371/journal.pone.0271934. eCollection 2022.

ABSTRACT

OBJECTIVE: To assess sex differences in presentation and management of febrile children with respiratory symptoms attending European Emergency Departments.

DESIGN AND SETTING: An observational study in twelve Emergency Departments in eight European countries.

PATIENTS: Previously healthy children aged 0-<18 years with fever (≥ 38°C) at the Emergency Department or in the consecutive three days before Emergency Department visit and respiratory symptoms were included.

MAIN OUTCOME MEASURES: The main outcomes were patient characteristics and management defined as diagnostic tests, treatment and admission. Descriptive statistics were used for patient characteristics and management stratified by sex. Multivariable logistic regression analyses were performed for the association between sex and management with adjustment for age, disease severity and Emergency Department. Additionally, subgroup analyses were performed in children with upper and lower respiratory tract infections and in children below five years.

RESULTS: We included 19,781 febrile children with respiratory symptoms. The majority were boys (54%), aged 1-5 years (58%) and triaged as low urgent (67%). Girls presented less frequently with tachypnea (15% vs 16%, p = 0.002) and increased work of breathing (8% vs 12%, p<0.001) compared with boys. Girls received less inhalation medication than boys (aOR 0.82, 95% CI 0.74-0.90), but received antibiotic treatment more frequently than boys (aOR 1.09, 95% CI 1.02-1.15), which is associated with a higher prevalence of urinary tract infections. Amongst children with a lower respiratory tract infection and children below five years girls received less inhalation medication than boys (aOR 0.77, 95% CI 0.66-0.89; aOR 0.80, 95% CI 0.72-0.90).

CONCLUSIONS: Sex differences concerning presentation and management are present in previously healthy febrile children with respiratory symptoms presenting to the Emergency Department. Future research should focus on whether these differences are related to clinicians’ attitudes, differences in clinical symptoms at the time of presentation and disease severity.

PMID:35921337 | DOI:10.1371/journal.pone.0271934

PLoS One. 2022 Aug 3;17(8):e0269003. doi: 10.1371/journal.pone.0269003. eCollection 2022.

ABSTRACT

AIMS: Living alone, a reality in an increasing number of older adults recently, is a risk factor for low quality of life. This study identified the predictors of quality of life in older adults living alone based on mental health and the International Classification of Functioning, Disability, and Health.

METHODS: This secondary data analysis used information from the 2018 Assessing the Requirements of Customized Health Care and Daily Living Support Services survey (N = 1,022), collected from adults aged ≥ 65 living alone in Siheung City, South Korea, from August to October 2018. The exogenous variables were body functions (hand grip strength, timed “up and go” test score, and body mass index), daily living activities (Korean Instrumental Activities of the Daily Living Scale), social activity participation (social activity engagement, neighbor contacts, and family contacts), and participation in economic activity (frequency). The endogenous variables were mental health (Geriatric Depression Scale Short Form-Korean Version and UCLA Loneliness Scale) and quality of life (EuroQoL-5 Dimension-3 Level and EuroQoL-Visual Analog Scale).

RESULTS: After modifying the hypothetical model, which had failed to satisfy the recommended fitness level, the (modified) model had good fitness indices Q (CMIN / df) 2.90, GFI 1, AGFI 1, RMSEA 0.04, CFI 0.90 and PCFI 0.53. Of the nine pathways of the modified model, five were statistically significant. Quality of life was affected by body functions, daily living activities, social activity participation, and mental health. These variables explained 68.2% of the factors affecting quality of life.

CONCLUSIONS: By highlighting the role of mental health, this model provides a useful framework for improving the quality of life of older adults who live alone and function at various levels in the community. Focusing on advancing mental health through body functions, daily living activities, and social activity participation can improve quality of life.

PMID:35921330 | DOI:10.1371/journal.pone.0269003

PLoS Negl Trop Dis. 2022 Aug 3;16(8):e0010682. doi: 10.1371/journal.pntd.0010682. Online ahead of print.

ABSTRACT

In June 2021, the World Health Organization (WHO), recognizing the need for new diagnostics to support the control and elimination of onchocerciasis, published the target product profiles (TPPs) of new tests that would support the two most immediate needs: (a) mapping onchocerciasis in areas of low prevalence and (b) deciding when to stop mass drug administration programs. In both instances, the test should ideally detect an antigen specific for live, adult O. volvulus female worms. The preferred format is a field-deployable rapid test. For mapping, the test needs to be ≥ 60% sensitive and ≥ 99.8% specific, while to support stopping decisions, the test must be ≥ 89% sensitive and ≥ 99.8% specific. The requirement for extremely high specificity is dictated by the need to detect with sufficient statistical confidence the low seroprevalence threshold set by WHO. Surveys designed to detect a 1-2% prevalence of a given biomarker, as is the case here, cannot tolerate more than 0.2% of false-positives. Otherwise, the background noise would drown out the signal. It is recognized that reaching and demonstrating such a stringent specificity criterion will be challenging, but test developers can expect to be assisted by national governments and implementing partners for adequately powered field validation.

PMID:35921329 | DOI:10.1371/journal.pntd.0010682

PLoS One. 2022 Aug 3;17(8):e0271230. doi: 10.1371/journal.pone.0271230. eCollection 2022.

ABSTRACT

A spatially-resolved understanding of the intensity of a flood hazard is required for accurate predictions of infrastructure reliability and losses in the aftermath. Currently, researchers who wish to predict flood losses or infrastructure reliability following a flood usually rely on computationally intensive hydrodynamic modeling or on flood hazard maps (e.g., the 100-year floodplain) to build a spatially-resolved understanding of the flood’s intensity. However, both have specific limitations. The former requires both subject matter expertise to create the models and significant computation time, while the latter is a static metric that provides no variation among specific events. The objective of this work is to develop an integrated data-driven approach to rapidly predict flood damages using two emerging flood intensity heuristics, namely the Flood Peak Ratio (FPR) and NASA’s Giovanni Flooded Fraction (GFF). This study uses data on flood claims from the National Flood Insurance Program (NFIP) to proxy flood damage, along with other well-established flood exposure variables, such as regional slope and population. The approach uses statistical learning methods to generate predictive models at two spatial levels: nationwide and statewide for the entire contiguous United States. A variable importance analysis demonstrates the significance of FPR and GFF data in predicting flood damage. In addition, the model performance at the state-level was higher than the nationwide level analysis, indicating the effectiveness of both FPR and GFF models at the regional level. A data-driven approach to predict flood damage using the FPR and GFF data offer promise considering their relative simplicity, their reliance on publicly accessible data, and their comparatively fast computational speed.

PMID:35921327 | DOI:10.1371/journal.pone.0271230