Tag: statistics

JAMA Netw Open. 2024 Aug 1;7(8):e2426847. doi: 10.1001/jamanetworkopen.2024.26847.

ABSTRACT

IMPORTANCE: Seventeen states introduced COVID-19 vaccine mandates for health care workers (HCWs) in mid-2021. Prior research on the effect of these mandates was centered on the nursing home sector, and more evidence is needed for their effect on the entire HCW population.

OBJECTIVE: To examine the association between state COVID-19 vaccine mandates for HCWs and vaccine uptake in this population.

DESIGN, SETTING, AND PARTICIPANTS: This repeated cross-sectional study included biweekly, individual-level data for adults aged 25 to 64 years who were working or volunteering in health care settings obtained from the Household Pulse Survey between May 26 and October 11, 2021. Analyses were conducted between November 2022 and October 2023.

EXPOSURE: Announcement of a state COVID-19 vaccine mandate for HCWs.

MAIN OUTCOMES AND MEASURES: An indicator for whether a sampled HCW ever received a COVID-19 vaccine and an indicator for whether an HCW completed or intended to complete the primary COVID-19 vaccination series. Event study analyses using staggered difference-in-differences methods compared vaccine uptake among HCWs in mandate and nonmandate states before and after each mandate announcement. The sample was further stratified by the availability of regular COVID-19 testing in place of a vaccination (ie, a test-out option) and by the ages of HCWs (25-49 or 50-64 years) to examine heterogeneous associations.

RESULTS: The study sample included 31 142 HCWs (mean [SD] age, 45.5 [10.6] years; 72.1% female) from 45 states, 16 of which introduced COVID-19 vaccine mandates for HCWs. Results indicated a mandate-associated 3.46-percentage point (pp) (95% CI, 0.29-6.63 pp; P = .03) increase in the proportion of HCWs ever vaccinated against COVID-19 and a 3.64-pp (95% CI, 0.72-6.57 pp; P = .02) increase in the proportion that completed or intended to complete the primary vaccination series 2 weeks after mandate announcement from baseline proportions of 87.98% and 86.12%, respectively. In the stratified analyses, positive associations were only detected in mandate states with no test-out option and among HCWs aged 25 to 49 years, which suggested vaccination increases of 3.32% to 7.09% compared with baseline proportions.

CONCLUSIONS AND RELEVANCE: This repeated cross-sectional study found that state COVID-19 vaccine mandates for HCWs were associated with increased vaccine uptake among HCWs, especially among younger HCWs and those in states with no test-out option. These findings suggest the potential for vaccine mandates to further promote vaccinations in an already highly vaccinated HCW population, especially when no test-out option is in place.

PMID:39141387 | DOI:10.1001/jamanetworkopen.2024.26847

JAMA Netw Open. 2024 Aug 1;7(8):e2427683. doi: 10.1001/jamanetworkopen.2024.27683.

ABSTRACT

IMPORTANCE: Firearm violence is a major public health problem in the US. However, relatively little research has focused particular attention on firearm violence in rural areas, and few studies have used research designs that draw on exogenous variation in the prevalence of firearms to estimate the association between firearm presence and shootings.

OBJECTIVE: To investigate the association between the start of deer hunting season and shootings in rural counties in the US.

DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, data from all rural US counties in states with available data on the timing of deer hunting season were matched with data on shootings from the Gun Violence Archive from January 1, 2014, to December 31, 2021.

EXPOSURE: Shootings in the first 3 weeks of deer hunting season were compared with the week prior to the start of deer hunting season.

MAIN OUTCOMES AND MEASURES: The main outcome was daily total shootings. The association between the start of deer hunting season and shootings was estimated using Poisson regression models to analyze change within counties while controlling for relevant calendar year, month of year, and seasonal effects.

RESULTS: The sample included 854 rural counties with a mean (SD) population of 16 416 (18 329) per county and 5.4 (13.3) annual shootings per 100 000 people. The county fixed-effects specification analyzing the association between deer hunting season and shootings showed that relative to the week prior to deer hunting season, the incidence rate ratio for total shootings was 1.49 (95% CI, 1.13-1.95) for the first week of deer hunting season and 1.41 (95% CI, 1.02-1.94) for the second week of deer hunting season. Estimates remained consistent when excluding hunting accidents and were most pronounced in states with more hunting licenses per capita.

CONCLUSIONS AND RELEVANCE: In this cohort study of the association between the start of deer hunting season and firearm violence, results showed that the start of deer hunting season was associated with a substantial increase in shootings. The findings highlight the role of firearm prevalence in gun violence and suggest the need for focused policies designed to reduce firearm violence in areas with substantial hunting activity during the first weeks of deer hunting season.

PMID:39141384 | DOI:10.1001/jamanetworkopen.2024.27683

Ophthalmic Physiol Opt. 2024 Aug 14. doi: 10.1111/opo.13378. Online ahead of print.

ABSTRACT

PURPOSE: To assess the long-term stability of clinical measures of convergence (near point of convergence [NPC] and positive fusional vergence [PFV]) in participants enrolled in the Convergence Insufficiency Treatment Trial-Attention and Reading Trial (CITT-ART) who received 16 weeks of office-based vergence/accommodative therapy.

METHODS: A total of 310 children, 9-14 years old, with symptomatic convergence insufficiency were enrolled in CITT-ART. Some 270 completed both their 16-week primary outcome visit followed by a 1-year follow-up visit. Of those 270, 181 (67%) were randomised to the vergence/accommodative therapy. Of the 181 in the vergence/accommodative group, 121 (67%) reported not receiving any additional treatment after the 16-week primary outcome visit. The mean change in NPC, PFV and percentages of children classified by the predetermined success criteria of convergence (normal NPC [<6 cm] and/or improved by ≥4 cm; normal PFV [passing Sheard’s criterion and base-out break >15Δ] and/or improved by ≥10Δ) were compared at the 16-week primary outcome visit and 1 year later.

RESULTS: Of the 121 who returned for their 1-year follow-up visit, there was no significant change in mean adjusted NPC (reduction of -0.2 cm; 95% CI: -1.0 to 0.5 cm) at 1 year. There was a statistically significant decrease in mean-adjusted PFV (-4.7∆; 95% CI: -6.5 to -2.8Δ) at 1 year. There were similar percentages of participants classified as ‘normal’ (p = 0.30), ‘normal and/or improved’ (p > 0.50) and ‘normal and improved’ (p > 0.14) based on NPC and PFV at the 1-year visit compared with the 16-week primary outcome visit.

CONCLUSION: The improvements in NPC and PFV following 16 weeks of vergence/accommodative therapy (with no reported additional treatment thereafter) in children with symptomatic convergence insufficiency persisted 1-year post-treatment.

PMID:39141379 | DOI:10.1111/opo.13378

Transl Vis Sci Technol. 2024 Aug 1;13(8):27. doi: 10.1167/tvst.13.8.27.

ABSTRACT

PURPOSE: Epiretinal membranes (ERM) pose a common challenge in vitreoretinal pathology, often causing vision impairment in older adults. The Preceyes Surgical System (PSS) supports the surgical removal of ERM through robot-assisted membrane peeling (RA-MP). This study compares surgical times and iatrogenic hemorrhages between manual membrane peeling (MMP) and RA-MP using PSS.

METHODS: Nine patients underwent RA-MP with PSS, whereas 16 patients (18 eyes) underwent MMP for comparative analysis. Surgical durations were categorized into RA-MP, manual forceps utilization in PSS surgeries (mRA-MP), and traditional MMP. Cumulative manual manipulation duration (cMMP), instrument grasps, and intraoperative hemorrhages were statistically analyzed using the Mann-Whitney U test.

RESULTS: RA-MP showed significantly longer peeling times compared to MMP (P < 0.001). Flap initiation grasps were similar between methods (P = 0.86), RA-MP demonstrated a significant reduction in peeling grasps (P = 0.01) and mean grasps per minute (P < 0.001). Although RA-MP resulted in fewer hemorrhages, the difference did not reach statistical significance relative to MMP (P = 0.08).

DISCUSSION: Although RA-MP tended to extend surgical time, it offered advantages in reducing tissue trauma and intraoperative hemorrhages. Further research is needed to explore the learning curve for novice surgeons and evaluate the safety profile of RA-MP.

TRANSLATIONAL RELEVANCE: RA-MP may offer potential advantages over manual surgery, particularly in terms of reduced tissue trauma and intraoperative hemorrhages. Despite its longer duration compared with manual techniques, RA-MP may lead to fewer grasping maneuvers and lower rates of hemorrhages, thereby enhancing the safety and precision of vitreoretinal surgeries.

PMID:39141371 | DOI:10.1167/tvst.13.8.27

JAMA Dermatol. 2024 Aug 14. doi: 10.1001/jamadermatol.2024.2601. Online ahead of print.

ABSTRACT

IMPORTANCE: It is unknown whether germline genetic factors influence in situ melanoma risk differently than invasive melanoma risk.

OBJECTIVE: To determine whether differences in risk of in situ melanoma and invasive melanoma are heritable.

DESIGN, SETTING, AND PARTICIPANTS: Three genome-wide association study meta-analyses were conducted of in situ melanoma vs controls, invasive melanoma vs controls, and in situ vs invasive melanoma (case-case) using 4 population-based genetic cohorts: the UK Biobank, the FinnGen cohort, the QSkin Sun and Health Study, and the Queensland Study of Melanoma: Environmental and Genetic Associations (Q-MEGA). Melanoma status was determined using International Statistical Classification of Diseases and Related Health Problems codes from cancer registry data. Data were collected from 1987 to 2022, and data were analyzed from September 2022 to June 2023.

EXPOSURE: In situ and invasive cutaneous melanoma.

MAIN OUTCOMES AND MEASURES: To test whether in situ and invasive melanoma have independent heritable components, genetic effect estimates were calculated for single-nucleotide variants (SNV; formerly single-nucleotide polymorphisms) throughout the genome for each melanoma. Then, SNV-based heritability was estimated, the genetic correlation between melanoma subtypes was assessed, and polygenic risk scores (PRS) were generated for in situ vs invasive status in Q-MEGA participants.

RESULTS: A total of 6 genome-wide significant loci associated with in situ melanoma and 18 loci with invasive melanoma were identified. A strong genetic correlation (genetic r = 0.96; 95% CI, 0.76-1.15) was observed between the 2 classifications. Notably, loci near IRF4, KLF4, and HULC had significantly larger effects for in situ melanoma compared with invasive melanoma, while MC1R had a significantly larger effect on invasive melanoma compared with in situ melanoma. Heritability estimates were consistent for both, with in situ melanoma heritability of 6.7% (95% CI, 4.1-9.3) and invasive melanoma heritability of 4.9% (95% CI, 2.8-7.2). Finally, a PRS, derived from comparing invasive melanoma with in situ melanoma genetic risk, was on average significantly higher in participants with invasive melanoma (odds ratio per 1-SD increase in PRS, 1.43; 95% CI, 1.16-1.77).

CONCLUSIONS AND RELEVANCE: There is much shared genetic architecture between in situ melanoma and invasive melanoma. Despite indistinguishable heritability estimates between the melanoma classifications, PRS suggest germline genetics may influence whether a person gets in situ melanoma or invasive melanoma. PRS could potentially help stratify populations based on invasive melanoma risk, informing future screening programs without exacerbating the current burden of melanoma overdiagnosis.

PMID:39141363 | DOI:10.1001/jamadermatol.2024.2601

Proc Natl Acad Sci U S A. 2024 Aug 20;121(34):e2319077121. doi: 10.1073/pnas.2319077121. Epub 2024 Aug 14.

ABSTRACT

Successful implementation of the Kunming-Montreal Global Biodiversity Framework requires identifying a process for measuring and valuing changes in biodiversity that build on the recognition that economics and valuation must play a key role in “halting and reversing” biodiversity loss. Here, we discuss considerations for a practical path to valuing changes in biodiversity. Framing changes in the value of biodiversity as a summary of changes in certain natural assets enables leveraging existing approaches and international standards associated with environmental-economic accounting. We discuss why an approach that builds from individual species, evolutionary groups, or functional groups into a practical, hierarchical statistical classification system is better than the development of any one biodiversity index. We merge techniques from ecology and other natural sciences, national and environmental-economic accounting, and economics, which are all on the cusp of making measurement of the change in the value of biodiversity possible. The focus should be on scaling and integrating these approaches. The path forward appears to begin with imperfect but useful measures, grounded in robust concepts, while establishing ambition to further scale-up measurements-just like the past evolution of many other official statistical series.

PMID:39141347 | DOI:10.1073/pnas.2319077121

Vet Res Commun. 2024 Aug 14. doi: 10.1007/s11259-024-10490-1. Online ahead of print.

ABSTRACT

The cytokine context present in the reproductive tract of cows is closely involved in normal uterine functions, including the estrous cycle and the establishment and maintenance of pregnancy. However, the roles of some cytokines in the uterus, and their relation with reproductive performance remain to be elucidated. Thus, this study aimed to examine the protein expression of several cytokines such as TNFα, IL-6, IL-8, IFNγ, IL-4, and TGF-β₃ in endometrial biopsies previous to conception, to evaluate the possible association with delayed conception in dairy cows. Protein expression levels were evaluated by immunohistochemistry. Results showed that the protein expression levels of TNFα, IL-6, IL-4 and TGF-β₃ were not associated with the parturition-conception interval, whereas the high protein expression levels of IFNγ were associated with the parturition-conception interval. Finally, the low protein expression of IL-8 showed a statistical tendency to be associated with delayed conception. This is the first report about the protein expression of IFN-γ in the endometrium of dairy cows and also, this cytokine could enhance the favorable conditions to achieve an early pregnancy.

PMID:39141287 | DOI:10.1007/s11259-024-10490-1

Adv Ther. 2024 Aug 14. doi: 10.1007/s12325-024-02959-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the technological advancements in catheter ablation strategies, the recurrence of atrial fibrillation (AF) post-ablation remains a concern that requires further investigation. Glucagon-like peptide 1 (GLP-1) receptor agonists have shown a significant effect on weight reduction, which in turn is associated with freedom from AF recurrence in both patients who are obese and not obese undergoing ablation. Therefore, we aimed to summarize the available evidence on the efficacy of GLP-1 receptor agonists in maintaining sinus rhythm post-ablation.

METHODS: Medline, Cochrane Library, and Scopus were searched until June 9, 2024. Double-independent study selection, data extraction, and quality assessment were performed. Evidence was pooled using DerSimonian-Laird random effects meta-analysis.

RESULTS: Three propensity score-matched studies (n = 6031 participants) were analyzed. Over a 12-months follow-up, the use of GLP-1 receptor agonists was associated with a significant reduction in AF recurrence compared to controls, hazard ratio (HR) = 0.549, 95% confidence interval (CI) = [0.315, 0.956], P = 0.034; I² = 57%. No significant heterogeneity was observed (Q statistic = 4.6, heterogeneity P = 0.1).

CONCLUSION: The use of GLP-1 receptor agonists is associated with a lower risk of AF recurrence in patients receiving AF ablation therapy. Further large-scale randomized trials are necessary to explore the efficacy of GLP-1 receptor agonists in maintaining ablation outcomes over the long term.

PMID:39141282 | DOI:10.1007/s12325-024-02959-x

Clin Transl Oncol. 2024 Aug 14. doi: 10.1007/s12094-024-03656-5. Online ahead of print.

ABSTRACT

OBJECTIVE: High-grade gliomas are aggressive brain tumors with poor prognoses. Understanding the factors that influence their progression is crucial for improving treatment outcomes. This study investigates the prognostic significance of panimmune inflammation in patients diagnosed with high-grade gliomas.

MATERIALS-METHODS: Data from 89 high-grade glioma patients were analysed retrospectively. The Panimmune inflammation Value (PIV) of each patient meeting the eligibility criteria was calculated on the basis of platelet, monocyte, neutrophil, and lymphocyte counts obtained from peripheral blood samples taken on the first day of treatment. PIV is calculated using the following formula: PIV = T × M × N ÷ L. A receiver operating characteristic (ROC) analysis was employed to identify the optimal cut-off value for PIV about progression-free survival (PFS) and overall survival (OS) outcomes. The primary and secondary endpoints were the differences in OS and PFS between the PIV groups. The Kaplan‒Meier method was used for survival analyses.

RESULTS: The ROC analysis indicated that the optimal PIV threshold was 545.5, which exhibited a significant interaction with PFS and OS outcomes. Patients were subsequently divided into two groups based on their PIV levels: a low PIV (L-PIV) group comprising 45 patients and a high PIV (H-PIV) group comprising 44 patients. A comparative analysis of survival rates indicated that patients with elevated PIV had a shorter median PFS of 4.0 months compared to 8.0 months in the low PIV group (P = 0.797), as well as a reduced median OS of 19.0 months versus not available (NA) in the low PIV group (P = 0.215).

CONCLUSION: Our study results did not reveal a statistically significant association between H-PIV measurements and reduced PFS or OS. However, PIV effectively stratified newly diagnosed high-grade glioma patients into two distinct groups with significantly different PFS and OS outcomes.

PMID:39141278 | DOI:10.1007/s12094-024-03656-5

Environ Monit Assess. 2024 Aug 14;196(9):810. doi: 10.1007/s10661-024-12960-0.

ABSTRACT

Forest fires pose significant environmental and socioeconomic threats, particularly in regions such as Central India, where forest ecosystems are vital for biodiversity and local livelihoods. Understanding forest fire dynamics and identifying fire risk zones are crucial for effective mitigation. The current study explores the spatiotemporal dynamics of forest fires in the Khandwa and North Betul forest divisions in the Central Indian region over 22 years using Mann-Kendall and Sen’s slope tests on MODIS (Moderate Resolution Imaging Spectroradiometer) fire point data. We found a nonsignificant increase in forest fires in both divisions. Khandwa showed a nonsignificant slope rise of more than three events per year, while North Betul revealed an increase of around one event per year. The lack of statistical significance suggests that upward trends of forest fire events may result from random fluctuations rather than consistent patterns. Spatial autocorrelation analysis revealed significant clustering of fire incidents in both regions. Khandwa confirmed moderate clustering (Moran’s I = 0.043), whereas North Betul showed robust clustering (Moran’s I = 0.096). Kernel density estimation further identified high-risk clusters in both divisions, necessitating zonal-wise targeted fire management strategies. Fire risk zonation was developed using the analytic hierarchy process (AHP), combining 10 environmental and socioeconomic factors. The AHP model, validated using MODIS fire data, showed reliable accuracy. The results revealed many of both divisions in the high- to very high-risk categories. Approximately, 45% of the area of the Khandwa and nearly 50% of the area of North Betul fall under high to very high fire risk zones. Khandwa’s high-risk areas mainly lie in the northern and southeastern parts, while North Betul lies in the northwestern and north-eastern regions. The identified fire-prone areas indicate the pressing need for local or region-specific fire prevention and mitigation strategies. Thus, the findings of this study provide valuable insights into forest fire risk management and contribute to more focused research and methodological developments.

PMID:39141225 | DOI:10.1007/s10661-024-12960-0