Category: Statistics

BMC Infect Dis. 2021 May 7;21(1):428. doi: 10.1186/s12879-021-06128-1.

ABSTRACT

BACKGROUND: Since December 2019, the coronavirus disease 2019 (COVID-19) has spread quickly among the population and brought a severe global impact. However, considerable geographical disparities in the distribution of COVID-19 incidence existed among different cities. In this study, we aimed to explore the effect of sociodemographic factors on COVID-19 incidence of 342 cities in China from a geographic perspective.

METHODS: Official surveillance data about the COVID-19 and sociodemographic information in China’s 342 cities were collected. Local geographically weighted Poisson regression (GWPR) model and traditional generalized linear models (GLM) Poisson regression model were compared for optimal analysis.

RESULTS: Compared to that of the GLM Poisson regression model, a significantly lower corrected Akaike Information Criteria (AICc) was reported in the GWPR model (61953.0 in GLM vs. 43218.9 in GWPR). Spatial auto-correlation of residuals was not found in the GWPR model (global Moran’s I = – 0.005, p = 0.468), inferring the capture of the spatial auto-correlation by the GWPR model. Cities with a higher gross domestic product (GDP), limited health resources, and shorter distance to Wuhan, were at a higher risk for COVID-19. Furthermore, with the exception of some southeastern cities, as population density increased, the incidence of COVID-19 decreased.

CONCLUSIONS: There are potential effects of the sociodemographic factors on the COVID-19 incidence. Moreover, our findings and methodology could guide other countries by helping them understand the local transmission of COVID-19 and developing a tailored country-specific intervention strategy.

PMID:33962576 | DOI:10.1186/s12879-021-06128-1

BMC Infect Dis. 2021 May 7;21(1):430. doi: 10.1186/s12879-021-06033-7.

ABSTRACT

BACKGROUND: The upsurge in HIV infections among students is a matter of particular concern. However, few studies have explored the epidemiological characteristics including the risky sexual networking of HIV-infected students in Zhejiang province, China.

METHODS: Using the provincial surveillance data of HIV-infected students, we conducted a retrospective epidemiology study to describe the epidemiological characteristics of 628 newly diagnosed cases from 2011 to 2016 and detailed information of 124 cases from 2015 to 2016. Spatial analyses were conducted using ArcGIS software, and statistical analyses were performed using SPSS software.

RESULTS: A total of 628 cases of HIV/AIDS were diagnosed among students in Zhejiang Province, China between 2011 and 2016. The cases showed an overall increasing trend over time, while the proportions of students with HIV disease status, cases diagnosed by HIV voluntary counseling and testing (VCT), and cases of homosexual transmission remained stable over time. Significant spatial heterogeneity in the cases was seen at the county level. Detailed data on 124 HIV-positive individuals collected from the local Center for Disease Control and Prevention (CDC) from 2015 and 2016, showed that the majority of them (85.5%,) engaged in homosexual behavior, and 93.4% had sex with casual partners. These partners included not only social members, but also other students. Online dating applications represented the most common means of seeking and communicating with homosexual partners. The level of awareness regarding the risk of HIV infection, and the amount coverage of face-to-face education towards students were both low.

CONCLUSIONS: HIV infections among students were characterized by increasing trend and spatial clustering in Zhejiang Province between 2011 and 2016, with homosexual sexual activity being the main mode of infection. Interventions are urgently required to prevent HIV infection in this population by increasing awareness of the disease. HIV testing programs and information regarding disease prevention specifically through online dating applications are needed.

PMID:33962557 | DOI:10.1186/s12879-021-06033-7

J Complement Integr Med. 2021 May 7. doi: 10.1515/jcim-2020-0377. Online ahead of print.

ABSTRACT

OBJECTIVES: A healthy lifestyle is one, where the individual adapts it aiming at prevention from ailments. Unhealthy lifestyle is a behavioral risk factor for non-communicable diseases (NCDs). Arogya Raksha Panchatantra (five principles of healthy living), is a Naturopathy and Yoga lifestyle practice proposed by an eminent Indian Naturopath Dr. B. Venkat Rao, observed to modify the behavioral risk factors. The main objective of this study is to observe the changes in Hematological parameters and Anthropometric measures by practicing this Naturopathic lifestyle.

METHODS: The study adapted one group Pretest – Posttest quasi experimental design, with a total of nine healthy student volunteers between age group 18-20 years. Hematological parameters such as total blood cells count, hemoglobin concentration, MCV, MCH, PCV, and anthropometric measurements such as weight, body circumferences (waist, hip) and changes in blood pressure were measured at baseline and after practice at 25th day.

RESULTS: There was a statistically significant difference observed in weight, waist and hip circumference, hematological indices except with MCV and MCH, and blood pressure (p<0.05), with no significant changes in waist-hip ratio and blood counts.

CONCLUSIONS: The findings of the study indicate that adapting Naturopathy and Yoga lifestyle based on proposed lifestyle practices may be beneficial in reducing the risk factors for non-communicable diseases. The study does not attribute the effects observed to any particular lifestyle practiced in this study; rather it is combination of healthy practices as observed in the study and it needs further longitudinal observations whether the beneficial effect of Naturopathy lifestyle practices is sustained for longer period of time.

PMID:33962498 | DOI:10.1515/jcim-2020-0377

J Osteopath Med. 2021 May 7. doi: 10.1515/jom-2020-0040. Online ahead of print.

ABSTRACT

CONTEXT: Asthma is a leading cause of pediatric chronic illness, and poor disease control can lead to decreased quality of life and impaired academic performance. Although osteopathic manipulative treatment (OMT) has been shown to have positive effects on pulmonary function in adult patient populations, less is known about its impact in children.

OBJECTIVES: To evaluate changes in pulmonary function testing (PFT) in pediatric patients on the same day they received OMT compared with PFT in those who received usual care.

METHODS: We recruited patients between the ages of 7-18 years with a diagnosis of asthma who were receiving routine care at a primary care asthma clinic and had undergone baseline spirometry. Patients were excluded if they met any of the following criteria: clinical indication for pre- and postbronchodilator spirometry on the day of their visit, albuterol use in the last 8 hours, oral steroid use in the previous 2 weeks, or diagnosis of asthma exacerbation in the previous 4 weeks. Eligible patients were then randomized to either an OMT or a control group. Patients in the OMT group were treated with rib raising and suboccipital release in addition to standard asthma care, while control group patients received standard care only. A second PFT was performed for patients in both groups at the end of the visit. OMT was performed by multiple osteopathic pediatric residents specifically trained for this study. Change in spirometry results (forced vital capacity [FVC], forced expiration volume in 1 second [FEV1], FVC/FEV1, and forced expiratory flow 25-75%) were then compared.

RESULTS: The study population included 58 patients: 31 (53.4%) were assigned to the OMT group and 27 (46.6%) were assigned to the standard of care group. Patients who received OMT had greater improvement in all spirometry values compared to the usual group; however, these changes were not statistically significant.

CONCLUSIONS: The benefits of OMT on short term spirometry results in pediatric asthma patients remain unclear.

PMID:33962511 | DOI:10.1515/jom-2020-0040

Cochrane Database Syst Rev. 2021 May 7;5:CD010876. doi: 10.1002/14651858.CD010876.pub3.

ABSTRACT

BACKGROUND: The impact of exercise-based cardiac rehabilitation (CR) following heart valve surgery is uncertain. We conducted an update of this systematic review and a meta-analysis to assess randomised controlled trial evidence for the use of exercise-based CR following heart valve surgery.

OBJECTIVES: To assess the benefits and harms of exercise-based CR compared with no exercise training in adults following heart valve surgery or repair, including both percutaneous and surgical procedures. We considered CR programmes consisting of exercise training with or without another intervention (such as an intervention with a psycho-educational component).

SEARCH METHODS: We searched the Cochrane Central Register of Clinical Trials (CENTRAL), in the Cochrane Library; MEDLINE (Ovid); Embase (Ovid); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO); PsycINFO (Ovid); Latin American Caribbean Health Sciences Literature (LILACS; Bireme); and Conference Proceedings Citation Index-Science (CPCI-S) on the Web of Science (Clarivate Analytics) on 10 January 2020. We searched for ongoing trials from ClinicalTrials.gov, Clinical-trials.com, and the World Health Organization International Clinical Trials Registry Platform on 15 May 2020.

SELECTION CRITERIA: We included randomised controlled trials that compared exercise-based CR interventions with no exercise training. Trial participants comprised adults aged 18 years or older who had undergone heart valve surgery for heart valve disease (from any cause) and had received heart valve replacement or heart valve repair. Both percutaneous and surgical procedures were included.

DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data. We assessed the risk of systematic errors (‘bias’) by evaluating risk domains using the ‘Risk of bias’ (RoB2) tool. We assessed clinical and statistical heterogeneity. We performed meta-analyses using both fixed-effect and random-effects models. We used the GRADE approach to assess the quality of evidence for primary outcomes (all-cause mortality, all-cause hospitalisation, and health-related quality of life).

MAIN RESULTS: We included six trials with a total of 364 participants who have had open or percutaneous heart valve surgery. For this updated review, we identified four additional trials (216 participants). One trial had an overall low risk of bias, and we classified the remaining five trials as having some concerns. Follow-up ranged across included trials from 3 to 24 months. Based on data at longest follow-up, a total of nine participants died: 4 CR versus 5 control (relative risk (RR) 0.83, 95% confidence interval (CI) 0.26 to 2.68; 2 trials, 131 participants; GRADE quality of evidence very low). No trials reported on cardiovascular mortality. One trial reported one cardiac-related hospitalisation in the CR group and none in the control group (RR 2.72, 95% CI 0.11 to 65.56; 1 trial, 122 participants; GRADE quality of evidence very low). We are uncertain about health-related quality of life at completion of the intervention in CR compared to control (Short Form (SF)-12/36 mental component: mean difference (MD) 1.28, 95% CI -1.60 to 4.16; 2 trials, 150 participants; GRADE quality of evidence very low; and SF-12/36 physical component: MD 2.99, 95% CI -5.24 to 11.21; 2 trials, 150 participants; GRADE quality of evidence very low), or at longest follow-up (SF-12/36 mental component: MD -1.45, 95% CI -4.70 to 1.80; 2 trials, 139 participants; GRADE quality of evidence very low; and SF-12/36 physical component: MD -0.87, 95% CI -3.57 to 1.83; 2 trials, 139 participants; GRADE quality of evidence very low). AUTHORS’ CONCLUSIONS: Due to lack of evidence and the very low quality of available evidence, this updated review is uncertain about the impact of exercise-CR in this population in terms of mortality, hospitalisation, and health-related quality of life. High-quality (low risk of bias) evidence on the impact of CR is needed to inform clinical guidelines and routine practice.

PMID:33962483 | DOI:10.1002/14651858.CD010876.pub3

Immunohematology. 2021 Mar;37(1):25-32. doi: 10.21307/immunohematology-2021-006.

ABSTRACT

Determination of accurate anti-A/-B titers is important for treatment selection in ABO-incompatible stem cell and solid-organ transplants. The standard method for ABO antibody titration is the conventional tube test (CTT). Dithiothreitol (DTT) is commonly used to inactivate the IgM antibody component. The aim of this study was to compare six different methods for ABO antibody titration and to observe the effectiveness of DTT on antibody estimation. A total of 90 healthy voluntary blood donors were enrolled in this study, including 30 each for blood groups A, B, and O. Antibody titrations were performed and tested using the CTT-immediate spin (IS), CTT-antihuman globulin (AHG) with and without DTT, column agglutination technology (CAT)-IS, and CAT-AHG with and without DTT methods. Bead-CAT was used, and the positive cutoff value was set to 1+ for each method to determine the endpoint of the titer. The median values of anti-A/-B titers by IS were found to be higher than those values by AHG in CTT and CAT among group B and A individuals, whereas no statistically significant differences were observed in values from group O individuals for IS and AHG anti-A/-B titers, estimated by each method. Although there was positive correlation between the anti-A/-B titer results obtained using the CTT and CAT in all blood groups, testing using AHG showed poor agreement with and without DTT pretreatment (kappa value of 0.11 and 0.20, respectively). Moderate agreement was observed between CTT-IS and CAT-IS (kappa value of 0.46). Median anti-A/-B AHG titers were reduced by the use of DTT in all blood group samples. Significant differences in the interpretability of anti-A/-B titers were observed among different methods. A uniform approach for selecting the method for ABO antibody titration is highly recommended, and DTT pretreatment of plasma to neutralize IgM activity should be considered to obtain precise values of IgG anti-A/-B titers. Immunohematology 2021;37:25-32 .

Determination of accurate anti-A/-B titers is important for treatment selection in ABO-incompatible stem cell and solid-organ transplants. The standard method for ABO antibody titration is the conventional tube test (CTT). Dithiothreitol (DTT) is commonly used to inactivate the IgM antibody component. The aim of this study was to compare six different methods for ABO antibody titration and to observe the effectiveness of DTT on antibody estimation. A total of 90 healthy voluntary blood donors were enrolled in this study, including 30 each for blood groups A, B, and O. Antibody titrations were performed and tested using the CTT-immediate spin (IS), CTT-antihuman globulin (AHG) with and without DTT, column agglutination technology (CAT)-IS, and CAT-AHG with and without DTT methods. Bead-CAT was used, and the positive cutoff value was set to 1+ for each method to determine the endpoint of the titer. The median values of anti-A/-B titers by IS were found to be higher than those values by AHG in CTT and CAT among group B and A individuals, whereas no statistically significant differences were observed in values from group O individuals for IS and AHG anti-A/-B titers, estimated by each method. Although there was positive correlation between the anti-A/-B titer results obtained using the CTT and CAT in all blood groups, testing using AHG showed poor agreement with and without DTT pretreatment (kappa value of 0.11 and 0.20, respectively). Moderate agreement was observed between CTT-IS and CAT-IS (kappa value of 0.46). Median anti-A/-B AHG titers were reduced by the use of DTT in all blood group samples. Significant differences in the interpretability of anti-A/-B titers were observed among different methods. A uniform approach for selecting the method for ABO antibody titration is highly recommended, and DTT pretreatment of plasma to neutralize IgM activity should be considered to obtain precise values of IgG anti-A/-B titers. Immunohematology 2021;37:25–32 .

PMID:33962486 | DOI:10.21307/immunohematology-2021-006

Pneumologie. 2021 May 7. doi: 10.1055/a-1481-0037. Online ahead of print.

ABSTRACT

Use of social media and the Internet has changed the information-seeking behaviour and exchange of experience and information by patients. Passive observation of such online interaction between patients (social media listening) is conducted in order to understand the burden of the disease, symptom perception, and expectations from a patient perspective. For most conditions, it remains to be established how representative the social media user community is for the overall patient population. In this study, we describe internet and social media use in a population of 570 COPD patients from Germany and Switzerland. This study population is a good representation of the overall patient population in Germany and Switzerland with regards to socioeconomic data. Patients were analyzed in an exploratory fashion whether usage of the Internet to obtain disease-specific information and exchanging on COPD via social media is associated with or is independent from certain socioeconomic criteria. About three-fourths of patients indicated using the Internet to search information about COPD and about a third of patients indicated using social media to exchange with others about their disease. Results indicated that among the patients using the Internet to seek information and among those sharing information via social media, patients with very severe COPD (GOLD stage 4) were overrepresented versus milder forms of the disease. Similarly, patients with more advanced educational background were also overrepresented in the groups using social media and Internet in relation to COPD. Differences in mean age were statistically significant, but surprisingly small between social media users and non-users. No relationship with regards to social media and Internet use for COPD were observed for domiciling situation and sex.

PMID:33962479 | DOI:10.1055/a-1481-0037

Biol Reprod. 2021 May 7:ioab091. doi: 10.1093/biolre/ioab091. Online ahead of print.

ABSTRACT

Embryo survival and pregnancy success is increased among animals that exhibit estrus prior to fixed time artificial insemination (AI), but there are no differences in conceptus survival to d16. The objective of this study was to determine effects of preovulatory estradiol on uterine transcriptomes, select trophectoderm transcripts, and uterine luminal fluid (ULF) proteins. Beef cows/heifers were synchronized, artificially inseminated (d0), and grouped into either high (highE2) or low (lowE2) preovulatory estradiol. Uteri were flushed (d16); conceptuses and endometrial biopsies (n = 29) were collected. RNA sequencing was performed on endometrium. Real-Time PCR (RT-PCR) was performed on trophectoderm (TE; n = 21) RNA to measure relative abundance of IFNT, PTGS2, TM4SF1, C3, FGFR2, and GAPDH. Uterine fluid was analyzed using 2D LC-MS/MS based iTRAQ method. RT-PCR data were analyzed using the MIXED procedure in SAS. There were no differences in mRNA abundances in TE, but there were 432 differentially expressed genes (DEGs) (253 downregulated, 179 upregulated) in highE2/conceptus versus lowE2/conceptus groups. There were also 48 differentially expressed proteins (DEPs; 19 upregulated, 29 downregulated), 6 of these were differentially expressed (FDR < 0.10) at the mRNA level. Similar pathways for mRNA and proteins included: calcium signaling, protein kinase A signaling, and corticotropin releasing hormone (CRH) signaling. These differences in uterine function, may be preparing the conceptus for improved likelihood of survival after d16 among highE2 animals.

PMID:33962467 | DOI:10.1093/biolre/ioab091

Biol Reprod. 2021 May 7:ioab088. doi: 10.1093/biolre/ioab088. Online ahead of print.

ABSTRACT

Extracellular vesicles (EVs) play a crucial role in feto-maternal communication and provide an important paracrine signaling mechanism in pregnancy. We hypothesize that fetal cells-derived exosomes and microvesicles (MVs) under oxidative stress carry unique cargo and traffic through feto-maternal interface, which cause inflammation in uterine cells associated with parturition. Exosomes and MVs, from primary amnion epithelial cell (AEC) culture media under normal or oxidative stress (OS)-induced conditions, were isolated by optimized differential centrifugation method followed by characterization for size (nanoparticle tracking analyzer), shape (transmission electron microscopy), and protein markers (western blot and immunofluorescence). Cargo and canonical pathways were identified by mass spectroscopy and Ingenuity Pathway Analysis. Myometrial, decidual, and cervical cells were treated with 1×107 control/OS-derived exosomes/MVs. Pro-inflammatory cytokines were measured using a Luminex assay. Statistical significance was determined by paired T-test (p < 0.05). AEC produced cup-shaped exosomes of 90-150 nm and circular MVs of 160-400 nm. CD9, HSP-70, and Nanog were detected in exosomes while OCT-4, HLA-G, and calnexin were found in MVs. MVs, but not exosomes, were stained for phosphatidylserine. The protein profiles for control versus OS-derived exosomes and MVs were significantly different. Several inflammatory pathways related to OS were upregulated that were distinct between exosomes and MVs. Both OS-derived exosomes and MVs significantly increased pro-inflammatory cytokines (GMCSF, IL-6, and IL-8) in maternal cells compared to control (p < 0.05). Our findings suggest that fetal-derived exosomes and MVs under OS exhibited distinct characteristics and a synergistic inflammatory role in uterine cells associated with the initiation of parturition.

PMID:33962471 | DOI:10.1093/biolre/ioab088

J Am Acad Audiol. 2021 May 7. doi: 10.1055/s-0041-1722985. Online ahead of print.

ABSTRACT

BACKGROUND: Contralateral noise masking is an important aspect of auditory brainstem response (ABR) measurements.

PURPOSE: The primary aim of this study is to determine how contralateral white noise (WN) masking influences the amplitude and the latency of V wave generated during ABR measurements, using tone burst (TB), in adult ears with normal hearing (NH). The secondary aim of this study is to ascertain the need of contralateral masking in ABR measurements with the TB stimuli using a 3A insertion earphone, and to propose the applicability of WN masking in unilateral sensorineural hearing loss (USNHL).

RESEARCH DESIGN: It is a cross-sectional observational and descriptive study.

STUDY SAMPLE: Experiment 1: Thirty individuals, without any otologic, psychological, or neurological dysfunction, were selected. Experiment 2: Fifteen individuals with previous audiological diagnoses of severe and profound USNHL were considered.

INTERVENTION: The study involves ABR TB at specific frequencies of 0.5, 1, 2, and 4 kHz.

DATA COLLECTION AND ANALYSIS: Experiment 1: The evaluation was performed at the fixed intensity of 80 dB nHL (decibel normalized hearing level) on the tested ear, followed by the application of simultaneous masking to the nontested ear, intensity ranged from 0 to 80 dB. Experiment 2: ABR threshold measurements were first performed on the ear with hearing loss (HL) at the frequencies of 1, 2, and 4 kHz. The results were subsequently confirmed using contralateral masking.

RESULTS: Experiment 1: At any given frequency, there were no statistically significant differences in the amplitude and latency of V wave with increase in the intensities of WN masking. Experiment 2: Cross-hearing was observed at least once in all frequencies analyzed through the occurrence of V wave.

CONCLUSION: In conclusion, the contralateral WN masking at the maximum intensity of 80 dB does not affect the amplitude and latency of V wave of the ABR TB at 1, 2, and 4 kHz. Contralateral masking for the ABR TB presented using 3A insertion earphones is necessary at 1, 2, and 4 kHz in individuals with severe or profound degrees of USNHL and at intensities of 15, 20, and 10 dB above the ABR threshold of the nontested ear.

PMID:33962478 | DOI:10.1055/s-0041-1722985