Category: Statistics

J Appl Clin Med Phys. 2022 Jan 23. doi: 10.1002/acm2.13520. Online ahead of print.

ABSTRACT

Magnetic resonance imaging (MRI) is a valuable imaging modality for the assessment of both cardiac and non-cardiac structures. With a growing population of patients with cardiovascular implantable electronic devices (CIEDs), 50%-75% of these patients will need an MRI. MRI-conditional CIEDs have demonstrated safety of MRI scanning with such devices, yet non-conditional devices such as hybrid CIEDs which have generator and lead brand mismatch may pose a safety risk. In this retrospective study, we examined the outcomes of patients with hybrid CIEDs undergoing MRI compared to those patients with non-hybrid CIEDs. A total of 349 patients were included, of which 24 patients (7%) had hybrid CIEDs. The primary endpoint was the safety of MRI for patients with hybrid CIEDs as compared to those with non-hybrid devices, measured by the rate of adverse events, including death, lead or generator failure needing immediate replacement, loss of capture, new onset arrhythmia, or power-on reset. Secondary endpoints consisted of pre- and post-MRI changes of decreased P-wave or R-wave sensing by ≥50%, changes in pacing lead impedance by ≥50 ohms, increase in pacing thresholds by ≥ 0.5 V at 0.4 ms, and decreasing battery voltage of ≥ 0.04 V. The primary endpoint of any adverse reaction was present in 1 (4.2%) patient with a hybrid device, and consistent of atrial tachyarrhythmia, and in 10 (3.1%) patients with a non-hybrid device, and consisted of self-limited atrial and non-sustained ventricular arrhythmias; this was not statistically significant. No significant differences were found in the secondary endpoints. This study demonstrates that MRI in patients with hybrid CIEDs does not result in increased patient risk or significant device changes when compared to those patients who underwent MRI with non-hybrid CIEDs.

PMID:35066975 | DOI:10.1002/acm2.13520

Echocardiography. 2022 Jan 23. doi: 10.1111/echo.15303. Online ahead of print.

ABSTRACT

AIM: To evaluate the prognostic utility of red blood cell distribution width (RDW) and maximum left ventricular wall thickness (MLVWT) in patients with hypertrophic cardiomyopathy (HCM).

PATIENTS AND METHODS: This study is a retrospective cohort analysis. Patients diagnosed with HCM at the First Affiliated Hospital of Sun Yat-sen University from March 2014 to March 2019 were included. HCM patients were stratified into two groups based on the occurrence of major adverse cardiac events (MACE). Receiver operating characteristic (ROC) curves were then constructed and Cox regression models were employed to gauge the prognostic relevance of RDW and MLVWT for HCM patients. Kaplan-Meier analysis evaluated the survival and MACE-free rate in patients with different level of RDW and MLVWT.

RESULTS: A total of 300 patients with HCM were enrolled in this study and followed up for 40.56±18.33 months. Among them, 117 MACE (39.00%), 40 all-cause deaths (13.33%), and 29 cardiovascular deaths (9.67%). The level of RDW, MLVWT, creatinine (Cr), and B-type pro-brain natriuretic peptide (NT-ProBNP) were statistically different between the MACE group and non-MACE group (P < .05). Multivariate analysis showed that after adjusting for confounding factors, RDW and MLVWT were independent predictors of all-cause mortality and MACE in HCM patients. ROC showed that RDW > .13 and MLVWT > 23 mm are the cut-off value to predict all-cause mortality and MACE. The area under the ROC curve AUC of the combination predicting the occurrence of all-cause mortality and MACE are .823 and .820, respectively. Kaplan-Meier analysis showed that the survival rate and MACE-free survival rate of group 1 (RDW≦.13 and MLVWT≦23 mm) were significantly higher than group 2 (RDW > .13 or MLVWT > 23 mm), and group 3 (RDW > .13 and MLVWT > 23 mm) (P = .000).

CONCLUSION: We determined that increased RDW and MLVWT was independently associated with MACE incidence and risk of mortality in HCM patients. Combined evaluation of RDW and MLVWT yielded a more accurate predictive model of HCM patient outcomes relative to the use of either of these metrics in isolation. Our research can provide a theoretical basis in the occurrence of MACE for the high-risk HCM and intervene them properly and timely.

PMID:35066909 | DOI:10.1111/echo.15303

Bioelectromagnetics. 2022 Jan 23. doi: 10.1002/bem.22389. Online ahead of print.

ABSTRACT

We investigated the potential relationship between receipt of electroconvulsive therapy (ECT) and development of amyotrophic lateral sclerosis (ALS). We conducted a cohort study using a sample of more than one million beneficiaries enrolled in the U.S. Medicare health insurance program from 1997 to 2017. Using time-varying proportional hazard modeling, we compared ALS occurrence among patients diagnosed with psychiatric conditions who received ECT to ALS occurrence among patients diagnosed with psychiatric conditions but who did not receive ECT. We observed moderately increased, but imprecise, hazard ratios (HR) for ALS following ECT (HR = 1.39, 95% confidence interval [CI]: 0.69-2.80). A statistically significant increase in the HR of ALS was observed among those who received more than 10 ECT treatments (>10 treatments, HR = 2.24, 95% CI: 1.00-5.01), compared to those receiving no ECT, with an even stronger association observed among subjects older than 65 years (HR = 3.03, 95% CI: 1.13-8.10). No monotonic exposure-response relationship was detected in categorical analyses. Our results provide weak support for the hypothesis that receipt of ECT increases the risk of developing ALS. Additional studies in larger populations, or in populations where ECT is more common, will be needed to refute or confirm an association between receipt of ECT and subsequent development of ALS. © 2022 Bioelectromagnetics Society.

PMID:35066895 | DOI:10.1002/bem.22389

Clin Cardiol. 2022 Jan 23. doi: 10.1002/clc.23749. Online ahead of print.

ABSTRACT

BACKGROUND: Acute myocardial infarction (AMI) is the main cause of death and disability in cardiovascular and cerebrovascular diseases. Both the Global Registry of Acute Coronary Events (Grace) score and high-sensitivity C-reactive protein (hs-CRP) were associated with prognosis in patients with AMI. However, whether the addition of the hs-CRP to Grace risk score could improve the predictive power of Grace risk score on the prognosis of patients with AMI is unclear.

HYPOTHESIS: We hypothesized that the inclusion of hs-CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in-hospital outcomes.

METHODS: We retrospectively enrolled 1804 patients with AMI in the final analysis. Patients were divided into four groups by hs-CRP quartiles. The relation between hs-CRP and Grace risk score was analyzed by Spearman rank correlation. Logistic regression was used to identify independent risk factors. The predictive value of hs-CRP add to Grace risk score was evaluated by C-statistic, net reclassification improvement (NRI), integrated differentiation improvement (IDI), calibration plot, and decision curve analysis.

RESULTS: The hs-CRP and Grace risk score had a significantly positive correlation (r = .191, p < .001). hs-CRP combined with Grace risk score could improve the ability of Grace risk score alone to correctly redistinguish the occurrence of in-hospital outcome (C-statistic = 0.819, p < .001; NRI = 0.05956, p = .007; IDI = 0.0757, p < .001).

CONCLUSION: Admission hs-CRP level was a significant independent risk factor for in-hospital outcomes in patients with AMI. The inclusion of hs-CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in-hospital outcomes.

PMID:35066901 | DOI:10.1002/clc.23749

Clin Cardiol. 2022 Jan 23. doi: 10.1002/clc.23777. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the association between brachial-ankle pulse wave velocity (baPWV) and cardiovascular and cerebrovascular disease (CVD) in different age groups.

METHODS: A total of 39 417 people, receiving Kailuan physical examination, completing baPWV examination from 2010 to 2017, with no history of CVD and atrial fibrillation, were selected as the observation objects. The population was categorized into one age group per 10 years, namely the <50, 50-59, 60-69, 70-79, and ≥80-year-old groups, and the total population, and each group was further assigned into three classes according to the triple quartiles of baPWV. Kaplan-Meier method helped to calculate the cumulative incidence of CVD in different age groups. The effect of baPWV on CVD in different age groups was evaluated using the Cox proportional hazards regression model.

RESULTS: Kaplan-Meier survival curve indicated statistical significance (p < .05) in the cumulative incidence of CVD among the whole population, <50, 50-59, and 60-69-year-old groups, while the cumulative incidence of end-point events among the baPWV subgroups of 70-79 and ≥80-year-old groups exhibited no statistical significance (p > .05). Compared with baPWV in the Q1 group, hazard ratio value (95% confidence interval [CI]) of CVD in the Q3 group was 4.14 (95% CI: 2.98-5.75) in the total population, 2.98 (95% CI: 1.08-8.21) in <50-year-old population, 4.49 (95% CI: 2.89-7.00) in 50-59-year-old population, 2.78 (95% CI: 1.76-4.39) in 60-69-year-old population, 1.39 (95% CI: 0.86-2.24) in 70-79-year-old population, and 1.15 (95% CI: 0.55-2.41) in ≥80-year-old population.

CONCLUSION: CVD risk attributed to increased arterial stiffness reduces with age.

PMID:35066888 | DOI:10.1002/clc.23777

J Anim Ecol. 2022 Jan 23. doi: 10.1111/1365-2656.13666. Online ahead of print.

ABSTRACT

Parasites that infect multiple species cause major health burdens globally, but for many, the full suite of susceptible hosts is unknown. Predicting undocumented host-parasite associations will help expand knowledge of parasite host specificities, promote the development of theory in disease ecology and evolution, and support surveillance of multi-host infectious diseases. Analysis of global species interaction networks allows for leveraging of information across taxa, but link prediction at this scale is often limited by extreme network sparsity and lack of comparable trait data across species. Here we use recently developed methods to predict missing links in global mammal parasite networks using readily available data: network properties and evolutionary relationships among hosts. We demonstrate how these link predictions can efficiently guide the collection of species interaction data and increase the completeness of global species interaction networks. We amalgamate a global mammal host-parasite interaction network (>29,000 interactions) and apply a hierarchical Bayesian approach for link prediction that leverages in formation on network structure and scaled phylogenetic distances among hosts. We use these predictions to guide targeted literature searches of the most likely yet undocumented interactions, and identify empirical evidence supporting many of the top “missing” links. We find that link prediction in global host-parasite networks can successfully predict parasites of humans, domesticated animals, and endangered wildlife, representing a combination of published interactions missing from existing global databases, and potential but currently undocumented associations. Our study provides further insight into the use of phylogenies for predicting host-parasite interactions, and highlights the utility of iterated prediction and targeted search to efficiently guide the collection of information on host-parasite interactions. These data are critical for understanding the evolution of host specificity, and may be used to support disease surveillance through a process of predicting missing links, and targeting research towards the most likely undocumented interactions.

PMID:35066873 | DOI:10.1111/1365-2656.13666

Environ Sci Pollut Res Int. 2022 Jan 23. doi: 10.1007/s11356-021-18104-y. Online ahead of print.

ABSTRACT

Even though the ecological transition is considered the next big challenge for Africa, few studies have examined its scope regardless of the massive financing that is required and the stakes on other sectors. This study analyzes the links between financial development, ecological transition, and economic growth in Sub-Saharan Africa from 1980 to 2019. The Dumitrescu and Hurlin causality tests, Pedroni and Westerlund cointegration, and the Augmented Mean Group algorithm are applied on a sample of forty-eight countries. The findings support that institutional quality and human capital are crucial, but their effects can only be observed in high-income and upper middle-income countries. The level of economic development matters, and there is a threshold beyond which the effects of renewable energies and human capital occur on the performance of the financial system. Trade openness and investments seem also to be positive and significant on ecological transition only in these countries. Furthermore, there is substitutability between non-renewable and renewable energy consumption in these countries, while in lower middle-income and low-income countries, there is complementarity. The study concludes by highlighting key policy recommendations to sustain ecological transition.

PMID:35066855 | DOI:10.1007/s11356-021-18104-y

Environ Sci Pollut Res Int. 2022 Jan 23. doi: 10.1007/s11356-021-18186-8. Online ahead of print.

ABSTRACT

Pregnant women are vulnerable to certain environmental agents, one of which is aflatoxin. As one of the most popular aflatoxins, Aflatoxin B1 (AFB1) has recently garnered increased attention concerning its potential association between exposure and adverse pregnancy outcomes. The aims of the study were to examine the associations between prenatal exposure to AFB1 and postpartum hemorrhage (PPH), and whether coagulation function has a mediating effect on their relationship. A total of 379 mother-infant pairs were included in the present study. Prenatal serum AFB1 albumin (AFB1-Alb) adduct levels in peripheral venous blood were detected by using an ELISA kit. Multiple linear and logistics regression models were applied to analyze the relationship between AFB1-Alb levels and PPH. We found mothers with high levels of AFB1-Alb adduct levels had significantly increased postpartum blood loss (partial regression coefficient (β) = 50.71, 95% confidence interval (CI) 3.48, 97.95). Mothers with high levels of AFB1-Alb adduct levels also had significantly increased risk of PPH (odds ratio (OR) = 4.81, 95% CI 1.01, 22.98). Moreover, concentrations of AFB1-Alb were positively associated with activated partial thromboplastin time (APTT) while negatively associated with fibrinogen (FIB). One-unit increase in APTT was correlated with a 6.62-ml (95% CI 3.04, 10.20) increase in postpartum blood loss. Mediation analysis suggested that the maternal blood APTT levels had a positive mediating effect in the association between AFB1-Alb adduct levels and postpartum blood loss (β = 0.32, 95% CI 0.04, 0.68). These results indicated that prenatal exposure to AFB1 was associated with increased postpartum blood loss, possibly by interfering with maternal APTT levels.

PMID:35066843 | DOI:10.1007/s11356-021-18186-8

Environ Sci Pollut Res Int. 2022 Jan 23. doi: 10.1007/s11356-021-18199-3. Online ahead of print.

ABSTRACT

Exposure to lead among children, as well as adults, is a major global health issue. With diverse routes of exposure (e.g., food, air, and water) either environmentally or occupationally, lead among children can cause mild, moderate, to severe health complications in the later stages of life. The average blood lead level reported by CDC in 2021 is 3.5 µg/dL, and the level of blood lead toxicity is ≥ 10 μg/dL. In this study, we planned to systematically analyze the association between blood lead levels (BLLs) (≥ 10 μg/dL and < 10 μg/dL) and the risk of anemia (hemoglobin level < 11 g/dL) among Indian children aged between ≥ 1 and ≤ 18 years. An online literature search of 5 databases, PubMed, Ovid, EMBASE, Web of Science, and Google Scholar was accomplished with a search updated until 8^th March 2021. Study designs included cohort, cross-sectional, and case-control studies that have evaluated the association of lead toxicity or exposure with anemia (Hb < 11 g/dL) reported in urban and/or rural Indian children. Meta-analysis was performed among a total of 864 children from 4 cross-sectional studies. The association between lead toxicity (BLLs ≥ 10 μg/dL) and the risk of being anemic was not statistically significant (RR = 1.15 (95% CI: 0.86-1.55, I² = 77%). The risks of bias in all included studies were low according to the Newcastle Ottawa Scale. Increased blood lead levels did not appear to be the major contributor to anemia in Indian Children. We need to focus primarily on improving the nutritional quality, fortified food supplements, and a balanced diet for children to reduce the anemia burden in India. Lead toxicity should be sought as an etiological factor only in areas of high environmental risk factors which were leaded paints, leaded batteries, a house near major road/traffic areas, and pesticide exposure.

PMID:35066849 | DOI:10.1007/s11356-021-18199-3

Environ Sci Pollut Res Int. 2022 Jan 23. doi: 10.1007/s11356-021-18139-1. Online ahead of print.

ABSTRACT

This study intends to test the presence of β-convergence in the global Environmental Performance (EP). For this purpose, spatial Green Solow model is used as the theoretical framework of the study. Data of 88 developed and developing countries for the periods 1978-2017 is used. The present study utilizes ecological footprint (EF) as a comprehensive Environmental Performance Indicator (EPI). For data analysis, spatial econometric techniques have been used. To explore the spatial dependence of EP, Moran’s I statistic was used. For regression analysis, this study has made the use of Spatial Durbin Model (SDM). Findings of the study indicate that there is positive spatial autocorrelation in the EP of the countries which means countries with similar EP are clustered together. Results of SDM confirm the existence of β-convergence in the global EP. Physical capital was found to degrade environment while break-even investment (BEI) was found to improve it.

PMID:35066827 | DOI:10.1007/s11356-021-18139-1