Category: Statistics

Am J Epidemiol. 2021 Dec 7:kwab285. doi: 10.1093/aje/kwab285. Online ahead of print.

ABSTRACT

There are unique challenges to identifying causes and developing strategies for prevention of rare cancers, driven by the difficulty in estimating incidence, prevalence, and survival due to their small numbers. Using a Poisson modeling approach, Salmerón et al. (Am J Epidemiol. 2021) built upon their previous work to estimate incidence rates of rare cancers in Europe using a Bayesian framework, establishing a uniform prior for a measure of variability for country-specific incidence rates. They offer a methodology with potential transferability to other settings with similar cancer surveillance infrastructure. However, the approach does not consider the spatio-temporal correlation of rare cancer case counts and other, potentially more appropriate, non-normal probability distributions. In this commentary, we discuss the implications of future work from cancer and spatial epidemiology perspectives. We describe the possibility of developing prediction models tailored to each type of rare cancer; incorporating the spatial heterogeneity in at-risk populations, surveillance coverage, and risk factors in these predictions; and considering a modeling framework to address the inherent spatio-temporal components of these data. We note that extension of this methodology to estimate sub-country rates at provincial, state, or smaller levels of geography would be useful but pose additional statistical challenges.

PMID:34875003 | DOI:10.1093/aje/kwab285

PLoS One. 2021 Dec 7;16(12):e0261002. doi: 10.1371/journal.pone.0261002. eCollection 2021.

ABSTRACT

Somatic mutations have a central role in cancer but their role in other diseases such as common autoimmune disorders is not clear. Previously we and others have demonstrated that especially CD8+ T cells in blood can harbor persistent somatic mutations in some patients with multiple sclerosis (MS) and rheumatoid arthritis. Here we concentrated on CD8+ cells in more detail and tested (i) how commonly somatic mutations are detectable, (ii) does the overall mutation load differ between MS patients and controls, and (iii) do the somatic mutations accumulate non-randomly in certain genes? We separated peripheral blood CD8+ cells from newly diagnosed relapsing MS patients (n = 21) as well as matched controls (n = 21) and performed next-generation sequencing of the CD8+ cells’ DNA, limiting our search to a custom panel of 2524 immunity and cancer related genes, which enabled us to obtain a median sequencing depth of over 2000x. We discovered nonsynonymous somatic mutations in all MS patients’ and controls’ CD8+ cell DNA samples, with no significant difference in number between the groups (p = 0.60), at a median allelic fraction of 0.5% (range 0.2-8.6%). The mutations showed statistically significant clustering especially to the STAT3 gene, and also enrichment to the SMARCA2, DNMT3A, SOCS1 and PPP3CA genes. Known activating STAT3 mutations were found both in MS patients and controls and overall 1/5 of the mutations were previously described cancer mutations. The detected clustering suggests a selection advantage of the mutated CD8+ clones and calls for further research on possible phenotypic effects.

PMID:34874980 | DOI:10.1371/journal.pone.0261002

PLoS One. 2021 Dec 7;16(12):e0260632. doi: 10.1371/journal.pone.0260632. eCollection 2021.

ABSTRACT

Strategies adopted globally to mitigate the threat of COVID-19 have primarily involved lockdown measures with substantial economic and social costs with varying degrees of success. Morbidity patterns of COVID-19 variants have a strong association with age, while restrictive lockdown measures have association with negative mental health outcomes in some age groups. Reduced economic prospects may also afflict some age cohorts more than others. Motivated by this, we propose a model to describe COVID-19 community spread incorporating the role of age-specific social interactions. Through a flexible parameterisation of an age-structured deterministic Susceptible Exposed Infectious Removed (SEIR) model, we provide a means for characterising different forms of lockdown which may impact specific age groups differently. Social interactions are represented through age group to age group contact matrices, which can be trained using available data and are thus locally adapted. This framework is easy to interpret and suitable for describing counterfactual scenarios, which could assist policy makers with regard to minimising morbidity balanced with the costs of prospective suppression strategies. Our work originates from an Irish context and we use disease monitoring data from February 29th 2020 to January 31st 2021 gathered by Irish governmental agencies. We demonstrate how Irish lockdown scenarios can be constructed using the proposed model formulation and show results of retrospective fitting to incidence rates and forward planning with relevant “what if / instead of” lockdown counterfactuals. Uncertainty quantification for the predictive approaches is described. Our formulation is agnostic to a specific locale, in that lockdown strategies in other regions can be straightforwardly encoded using this model.

PMID:34874981 | DOI:10.1371/journal.pone.0260632

PLoS One. 2021 Dec 7;16(12):e0260388. doi: 10.1371/journal.pone.0260388. eCollection 2021.

ABSTRACT

INTRODUCTION: The burden of IgE-mediated food allergy in Australian born children is reported to be among the highest globally. This illness shares risk factors and frequently coexists with asthma, one of the most common noncommunicable diseases of childhood. Findings from a case-control study suggest that compared to immunisation with acellular pertussis vaccine, early priming of infants with whole-cell pertussis vaccine may be associated with a lower risk of subsequent IgE-mediated food allergy. If whole-cell vaccination is protective of food allergy and other atopic diseases, especially if protective against childhood asthma, the population-level effects could justify its preferential recommendation. However, the potential beneficial effects of whole-cell pertussis vaccination for the prevention of atopic diseases at a population-scale are yet to be investigated.

METHODS AND ANALYSIS: Analyses of population-based record linkage data will be undertaken to compare the rates of admissions to hospital for asthma in children aged between 5 and 15 years old, who were born in Western Australia (WA) or New South Wales (NSW) between 1997 and 1999 (329,831) when pertussis immunisation in Australia transitioned from whole-cell to acellular only schedules. In the primary analysis we will estimate hazard ratios and 95% confidence intervals for the time-to-first-event (hospital admissions as above) using Cox proportional hazard models in recipients of a first dose of whole-cell versus acellular pertussis-containing vaccine before 112 days old (~4 months of age). Similarly, we will also fit time-to-recurrent events analyses using Andersen-Gill models, and robust variance estimates to account for potential within-child dependence. Hospitalisations for all-cause anaphylaxis, food anaphylaxis, venom, all-cause urticaria and atopic dermatitis will also be examined in children who received at least one dose of pertussis-containing vaccine by the time of the cohort entry, using analogous statistical methods. Presentations to the emergency departments will be assessed separately using the same statistical approach.

PMID:34874968 | DOI:10.1371/journal.pone.0260388

PLoS One. 2021 Dec 7;16(12):e0260926. doi: 10.1371/journal.pone.0260926. eCollection 2021.

ABSTRACT

INTRODUCTION: The attitudes of healthcare staff towards patients’ safety, including awareness of the risk for adverse events, are significant elements of an organization’s safety culture.

AIM OF RESEARCH: To evaluate nurses and physicians’ attitudes towards factors influencing hospitalized patient safety.

MATERIALS AND METHODS: The research included 606 nurses and 527 physicians employed in surgical and medical wards in 21 Polish hospitals around the country. The Polish adaptation of the Safety Attitudes Questionnaire (SAQ) was used to evaluate the factors influencing attitudes towards patient safety.

RESULTS: Both nurses and physicians scored highest in stress recognition (SR) (71.6 and 80.86), while they evaluated working conditions (WC) the lowest (45.82 and 52,09). Nurses achieved statistically significantly lower scores compared to physicians in every aspect of the safety attitudes evaluation (p<0.05). The staff working in surgical wards obtained higher scores within stress recognition (SR) compared to the staff working in medical wards (78.12 vs. 73.72; p = 0.001). Overall, positive working conditions and effective teamwork can contribute to improving employees’ attitudes towards patient safety.

CONCLUSIONS: The results help identify unit level vulnerabilities associated with staff attitudes toward patient safety. They underscore the importance of management strategies that account for staff coping with occupational stressors to improve patient safety.

PMID:34874957 | DOI:10.1371/journal.pone.0260926

PLoS One. 2021 Dec 7;16(12):e0260488. doi: 10.1371/journal.pone.0260488. eCollection 2021.

ABSTRACT

Analysis of consumer preferences and willingness-to-pay (WTP) for sustainable foods produced using new agri-food technologies is required to enhance the uptake of innovations that accelerate the transition towards sustainable food systems. Consumers’ willingness to buy new food products, with no or limited consumption experience, mainly depends on their food choice motivational orientations (promotion- vs prevention-orientation). The objective of this study was to elicit consumers’ WTP for foods that are produced with microbial applications during the plant production phase with the aim to reduce the use of synthetic chemicals in crop farming, as well as to understand the associations of food choice motives, personal and socio-demographic factors with the WTP. We used contingent valuation to elicit consumers’ WTP for three food products (wheat bread, consumer potatoes and tomato sauce) through online surveys. Data were collected from 291 consumers, primarily from Italy, Germany and the Netherlands. Descriptive statistics, latent variable modelling and logistic regression were used to analysis data. Results show that more than two-third of the respondents are willing to pay premiums of at least 0.11 euro per kg of food products for reductions in synthetic chemical use by at least 50% due to microbial applications. The amount of WTP increases with the level of reductions in synthetic chemical use. The majority of the respondents are promotion-oriented consumers in relation to their food involvement, and are more likely to pay premiums for the sustainably produced food products. Environmentally concerned consumers are also more likely to pay premiums, whereas health concerned consumers are not. This study contributes to understanding of consumers’ attitude and perceived health risks towards foods obtained using microbial applications, and the heterogeneity of their preferences. Results provide insights for identifying potential buyers of foods produced using microbial applications, and to set prices according to the levels of consumers’ WTP.

PMID:34874958 | DOI:10.1371/journal.pone.0260488

PLoS One. 2021 Dec 7;16(12):e0260258. doi: 10.1371/journal.pone.0260258. eCollection 2021.

ABSTRACT

OBJECTIVE: Despite those efforts in expanded programs of immunization, nearly one fifth of children in developing countries miss out basic vaccines. Moreover, many children who started vaccination fail to complete immunization.Identifying associated factorswhich is scarce in the study area, is crucial for interventions. This study assessed full-immunization and associated factors among children aged 12-23 months in Somali region, Eastern Ethiopia.

METHODS: A community-based cross-sectional study design was conducted from October 1-30, 2018, in selected rural and urban kebeles in Somali regionamong 612 children. Cluster sampling was employed and data was collected using structured questionnaire. Full-immunization was measured by maternal recall and vaccination card.Data entry and analysis was done by EpiData3.1 and SPSSversion.20 respectively. Binary logistic regression with Bivariate and Multivariable model was usedto identify predictors of full-immunization. Odd ratios were computed and P-value <0.05 was considered as statistically significant.

RESULTS: Based on maternal recall plus vaccination card 249(41.4%) of children were completed immunization, while vaccination only by card was 87(29.7%). Only 238(39.5%) of participants had good knowledge about vaccination. Not knowing to come back for next visits 197(55.8%) were the major reason for dropout. Residing in urban (AOR = 2.0, 95%CI: 1.0, 3.9),primary educated mothers(AOR = 2.2, 95%CI: 1.0, 5.0), married mothers (AOR = 4.2, 95%CI:1.0, 18), higher average monthly income (AOR = 2.5, 95%CI 1.1, 5.2)and delivered at health facilities (AOR = 3.8, 95%CI 1.9, 7.3)were significantly associated with full-immunization.

CONCLUSION: Coverage of full immunization was found to be low compared to the targets set in the Global Vaccine Action Plan(2011-2020).Two-third of the participants has poor knowledge about vaccination. Urban residence, mother education, higher family income, male child and institutional delivery were factors. This study suggests that awareness creation, behaviour change on vaccination and enhancing utilization of maternal health service including delivery service, should be stressed.

PMID:34874949 | DOI:10.1371/journal.pone.0260258

PLoS One. 2021 Dec 7;16(12):e0260751. doi: 10.1371/journal.pone.0260751. eCollection 2021.

ABSTRACT

BACKGROUND: Hypertension is the major public health concern; leading to cardiovascular disease. It is associated with alteration in hematological parameters which may lead to end-organ damage. Thus, this study aimed to compare hematological parameters between hypertensive and normotensive adult groups in Harar, eastern Ethiopia.

METHODS: A comparative cross-sectional study was conducted from January to March, 2020 at Jugel and Hiwotfana Specialized University hospital, Harar, eastern Ethiopia. Convenient sampling technique was used to recruit 102 hypertensive patients from the two hospitals and 102 apparently healthy blood donors. Participant’s socio-demographic and clinical information were collected using pre-tested structured questionnaire. Blood sample were collected and analyzed by Beckman Coulter DxH 500 analyzer for complete blood count. The data were entered and analyzed using SPSS version 23. Independent t-test and Mann Whitney u-test was used for comparison between groups. Spearman’s correlation was used for correlation test. P values less than 0.05 was considered as statistically significant.

RESULT: 102 hypertensive and 102 healthy controls were enrolled in this study. The median ± IQR value of white blood cell (WBC) count, hemoglobin (Hgb), hematocrit (HCT), red cell distribution width (RDW) and mean platelet volume (MPV) were significantly higher in hypertensive group compared to apparently healthy control group. Additionally, RBC (red blood cell) count, HCT and RDW showed statistically significant positive correlations with systolic and diastolic blood pressure. WBC count and RDW were significantly and positively correlated with body mass index (BMI). Platelet (PLT) count had a significant but negative correlation (r = -0.219, P = 0.027) with duration of hypertension illness while MPV showed positive and significant correlation (r = 0.255, P = 0.010).

CONCLUSION: The median values of WBC, Hgb, HCT, RDW and MPV were significantly higher in hypertensive patient compared to apparently healthy individuals. Hence, it is important to assess hematological parameters for hypertensive individuals which may help to prevent complications associated with hematological aberrations. However, further studies are required to understand hypertensive associated changes in hematological parameters.

PMID:34874952 | DOI:10.1371/journal.pone.0260751

PLoS One. 2021 Dec 7;16(12):e0260132. doi: 10.1371/journal.pone.0260132. eCollection 2021.

ABSTRACT

Understanding how textual information impacts financial market volatility has been one of the growing topics in financial econometric research. In this paper, we aim to examine the relationship between the volatility measure that is extracted from GARCH modelling and textual news information both publicly available and from subscription, and the performances of the two datasets are compared. We utilize a latent Dirichlet allocation method to capture the dynamic features of the textual data overtime by summarizing their statistical outputs, such as topic distributions in documents and word distributions in topics. In addition, we transform various measures representing the popularity and diversity of topics to form predictors for a rolling regression model to assess the usefulness of textual information. The proposed method captures the statistical properties of textual information over different time periods and its performance is evaluated in an out-of-sample analysis. Our results show that the topic measures are more useful for predicting our volatility proxy, the unexplained variance from the GARCH model than the simple moving average. The finding indicates that our method is helpful in extracting significant textual information to improve the prediction of stock market volatility.

PMID:34874945 | DOI:10.1371/journal.pone.0260132

Med Oral Patol Oral Cir Bucal. 2021 Dec 7:24836. doi: 10.4317/medoral.24836. Online ahead of print.

ABSTRACT

BACKGROUND: to analyse the potential risk factors of tongue lesions, comparing the results with a control group.

MATERIAL AND METHODS: An observational, case-control study was designed. The study included a case group comprising 336 patients with tongue lesions and 336 sex and age-matched controls. We recorded tobacco/alcohol habits, presence of dentures, allergies, medical conditions, and medications. Statistical analysis was performed via logistic regression models to estimate the odds ratio (OR) adjusted for gender, age, tobacco, and alcohol using propensity score-matching analysis (PSM).

RESULTS: According to the final PSM model, patients with tongue lesions were more likely to suffer from allergies (OR 2.13; 1.27-3.66) or medical conditions (OR 2.14; 1.19-3.85), and more likely to take medication (OR 1.99; 1.11-3.57). Elderly individuals were more prone to hairy tongue (OR 3.82; 1.53-10.47). Smoking was associated with coated tongue (OR 2.05; 1.12-3.63), hairy tongue (OR 3.77; 1.52-9.22) and median rhomboid glossitis (OR 40.49; 5.84-860.43). Allergic individuals were more likely to exhibit sublingual varices (OR 1.73; 1.02-2.88). Medical conditions increased the chances of having coated tongue (OR 2.44; 1.36-4.64) or crenated tongue (OR 2.70; 1.42-5.30). Arterial hypertension was associated with median rhomboid glossitis (OR 5.85; 1.08-34.18). Individuals on medication showed a higher risk of fissured tongue (OR 1.87; 1.20-2.94) and varices (OR 2.42; 1.58-3.80). Agents acting on the alimentary tract and metabolism increased the probability of fissured tongue (OR 2.31; 1.42-3.79).

CONCLUSIONS: As far as we are aware, this is the first study on lingual pathology to include a PSM analysis. The results suggest that a history of allergies, the presence of medical conditions, and the use of medication are associated with increased probability of tongue lesions. The analysis of diseases and medications by subgroups requires studies matched by habits with larger sample sizes, in order to corroborate our observations.

PMID:34874926 | DOI:10.4317/medoral.24836