Tag: statistics

Sci Rep. 2024 Mar 16;14(1):6387. doi: 10.1038/s41598-024-56839-z.

ABSTRACT

A within-host and between-host hand, foot and mouth disease (HFMD) mathematical model is established and the affect of optimal control in its within-host part on HFMD transmission is studied. Through define two basic reproduction numbers, by using the fast-slow system analysis method of time scale, the global stabilities of the between-host (slow) system and within-host (fast) system are researched, respectively. An optimal control problem with drug-treatment control on coupled within-host and between-host HFMD model is formulated and analysed theoretically. Finally, the purposed optimal control measures are applied to the actual HFMD epidemic analysis in Zhejiang Province, China from April 1, 2021 to June 30, 2021. The numerical results show that the drug control strategies can reduce the virus load per capita and can effectively prevent large-scale outbreaks of HFMD.

PMID:38493254 | DOI:10.1038/s41598-024-56839-z

Commun Med (Lond). 2024 Mar 16;4(1):51. doi: 10.1038/s43856-024-00476-0.

ABSTRACT

BACKGROUND: Type 1 diabetes (T1D) simulators, crucial for advancing diabetes treatments, often fall short of capturing the entire complexity of the glucose-insulin system due to the imprecise approximation of the physiological models. This study introduces a simulation approach employing a conditional deep generative model. The aim is to overcome the limitations of existing T1D simulators by synthesizing virtual patients that more accurately represent the entire glucose-insulin system physiology.

METHODS: Our methodology utilizes a sequence-to-sequence generative adversarial network to simulate virtual T1D patients causally. Causality is embedded in the model by introducing shifted input-output pairs during training, with a 90-min shift capturing the impact of input insulin and carbohydrates on blood glucose. To validate our approach, we train and evaluate the model using three distinct datasets, each consisting of 27, 12, and 10 T1D patients, respectively. In addition, we subject the trained model to further validation for closed-loop therapy, employing a state-of-the-art controller.

RESULTS: The generated patients display statistical similarity to real patients when evaluated on the time-in-range results for each of the standard blood glucose ranges in T1D management along with means and variability outcomes. When tested for causality, authentic causal links are identified between the insulin, carbohydrates, and blood glucose levels of the virtual patients. The trained generative model demonstrates behaviours that are closer to reality compared to conventional T1D simulators when subjected to closed-loop insulin therapy using a state-of-the-art controller.

CONCLUSIONS: These results highlight our approach’s capability to accurately capture physiological dynamics and establish genuine causal relationships, holding promise for enhancing the development and evaluation of therapies in diabetes.

PMID:38493243 | DOI:10.1038/s43856-024-00476-0

BMC Palliat Care. 2024 Mar 16;23(1):75. doi: 10.1186/s12904-024-01405-7.

ABSTRACT

BACKGROUND: Symptom assessment is key to effective symptom management and palliative care for patients with advanced cancer. Symptom prevalence and severity estimates vary widely, possibly dependent on the assessment tool used. Are symptoms specifically asked about or must the patients add them as additional symptoms? This study compared the prevalence and severity of patient-reported symptoms in two different versions of a multi-symptom assessment tool. In one version, three symptoms dry mouth, constipation, sleep problems were among those systematically assessed, while in the other, these symptoms had to be added as an “Other problem”.

METHODS: This retrospective cross-sectional study included adult patients with advanced cancer at an inpatient palliative care unit. Data were collected from two versions of the Edmonton Symptom Assessment System (ESAS): modified (ESAS-m) listed 11 symptoms and revised (ESAS-r) listed 9 and allowed patients to add one “Other problem”. Seven similar symptoms were listed in both versions.

RESULTS: In 2013, 184 patients completed ESAS-m, and in 2017, 156 completed ESAS-r. Prevalence and severity of symptoms listed in both versions did not differ. In ESAS-m, 83% reported dry mouth, 73% constipation, and 71% sleep problems, but on ESAS-r, these symptoms were reported by only 3%, 15% and < 1%, respectively. Although ESAS-r severity scores for these three symptoms were higher than on ESAS-m, differences did not reach statistical significance.

CONCLUSION: We identified significant differences in patient symptom reporting based on whether symptoms like dry mouth, obstipation and sleep problems were specifically assessed or had to be added by patients as an “Other problem”.

PMID:38493155 | DOI:10.1186/s12904-024-01405-7

Nat Commun. 2024 Mar 16;15(1):2383. doi: 10.1038/s41467-024-46675-0.

ABSTRACT

Genetic effects on functionally related ‘omic’ traits often co-occur in relevant cellular contexts, such as tissues. Motivated by the multi-tissue methylation quantitative trait loci (mQTLs) and expression QTLs (eQTLs) analysis, we propose X-ING (Cross-INtegrative Genomics) for cross-omics and cross-context integrative analysis. X-ING takes as input multiple matrices of association statistics, each obtained from different omics data types across multiple cellular contexts. It models the latent binary association status of each statistic, captures the major association patterns among omics data types and contexts, and outputs the posterior mean and probability for each input statistic. X-ING enables the integration of effects from different omics data with varying effect distributions. In the multi-tissue cis-association analysis, X-ING shows improved detection and replication of mQTLs by integrating eQTL maps. In the trans-association analysis, X-ING reveals an enrichment of trans-associations in many disease/trait-relevant tissues.

PMID:38493154 | DOI:10.1038/s41467-024-46675-0

Cell Commun Signal. 2024 Mar 16;22(1):184. doi: 10.1186/s12964-024-01553-6.

ABSTRACT

BACKGROUND: Injury to contractile organs such as the heart, vasculature, urinary bladder and gut can stimulate a pathological response that results in loss of normal contractility. PDGF and TGFβ are among the most well studied initiators of the injury response and have been shown to induce aberrant contraction in mechanically active cells of hollow organs including smooth muscle cells (SMC) and fibroblasts. However, the mechanisms driving contractile alterations downstream of PDGF and TGFβ in SMC and fibroblasts are incompletely understood, limiting therapeutic interventions.

METHODS: To identify potential molecular targets, we have leveraged the analysis of publicly available data, comparing transcriptomic changes in mechanically active cells stimulated with PDGF and TGFβ. Additional Analysis of publicly available data sets were performed on SMC and fibroblasts treated in the presence or absence of the MYC inhibitor JQ1. Validation of in silico findings were performed with qPCR, immunoblots, and collagen gel contraction assays measure the effect of JQ1 on cytoskeleton associated genes, proteins and contractility in mechanically active cells. Likelihood ratio test and FDR adjusted p-values were used to determine significant differentially expressed genes. Student ttest were used to calculate statistical significance of qPCR and contractility analyses.

RESULTS: Comparing PDGF and TGFβ stimulated SMC and fibroblasts identified a shared molecular profile regulated by MYC and members of the AP-1 transcription factor complex. Additional in silico analysis revealed a unique set of cytoskeleton-associated genes that were sensitive to MYC inhibition with JQ1. In vitro validation demonstrated JQ1 was also able to attenuate TGFβ and PDGF induced changes to the cytoskeleton and contraction of smooth muscle cells and fibroblasts in vitro.

CONCLUSIONS: These findings identify MYC as a key driver of aberrant cytoskeletal and contractile changes in fibroblasts and SMC, and suggest that JQ1 could be used to restore normal contractile function in hollow organs.

PMID:38493137 | DOI:10.1186/s12964-024-01553-6

BMC Nephrol. 2024 Mar 16;25(1):100. doi: 10.1186/s12882-024-03533-x.

ABSTRACT

BACKGROUND: Chronic Kidney Disease (CKD) who receive social support can cope with the challenges. Therefore, this study determined the moderating role of social support in the relationship between death anxiety and resilience among dialysis patients in Qazvin City.

METHODS: This cross-sectional study used a descriptive-analytical approach on 347 dialysis patients in Qazvin City. The data collection tools included several questionnaires. The convenience sampling method was employed. The data were analyzed using SPSS software version 22 and mplus software version 7.2, employing descriptive statistics, such as mean and standard deviation for continuous variables and using counts and percentages for categorical/nominal variables. Regression analysis and tests were used to examine the relationships between variables. Structural Equation Modeling (SEM) analysis was employed to determine direct and indirect relationships between independent and dependent variables.

RESULTS: The prevalence of death anxiety was high (48.3%) among the patients. The mean resilience score was 62.59 ± 15.69, and the mean social support score was 52.23 ± 10.21. There was a significant association between resilience and social support (P < 0.001), as well as between resilience and death anxiety (P < 0.001). Furthermore, a significant relationship was observed between social support and death anxiety (p = 0.015). In the analysis of SEM, both the direct and indirect relationships between resilience and death anxiety were significant through the mediating variable of social support.

CONCLUSION: This study demonstrates that there is a relationship between death anxiety and resilience, and social support significantly moderates the relationship between death anxiety and resilience.

PMID:38493124 | DOI:10.1186/s12882-024-03533-x

BMC Med Educ. 2024 Mar 16;24(1):298. doi: 10.1186/s12909-024-05287-4.

ABSTRACT

BACKGROUND: A capstone course often serves as the final checkpoint of student readiness before the commencement of experiential training. The purpose of this study was to determine if the assessment components from the capstone course can serve as predictors of student performance during their Advanced Pharmacy Practice Experiences (APPEs).

METHODS: Student data was analyzed to observe the correlation between performance in the Pharmacy Curriculum Outcomes Assessment (PCOA), student performance in the capstone course, and the overall grade point average (GPA) earned during APPEs. Spearman rank correlation analysis, multiple linear regression, and Mann-Whitney U test were used for statistical analysis.

RESULTS: A statistically significant positive correlation was observed between the overall APPE GPA and students’ capstone course grade, top drug competency exam score, pharmacy calculation competency exam score, and PCOA exam score. A significant regression equation was obtained during the analysis: (F(5, 97) = 5.62, p < 0.001), with an R2 = 0.225 (adjusted R2 = 0.185). In the linear regression model, capstone GPA emerged as a significant predictor (β = 0.155; p = 0.019) of APPE GPA amongst the tested variables. Additionally, students scoring < 73% on the top drug competency exam in the capstone course or less than the reference group in the PCOA exam were found to have significantly lower GPA during their APPEs compared to other students.

CONCLUSION: Performance on the top drug competency exam and the PCOA exam can serve as potential predictors of success during APPEs.

PMID:38493122 | DOI:10.1186/s12909-024-05287-4

BMC Oral Health. 2024 Mar 16;24(1):340. doi: 10.1186/s12903-024-04121-z.

ABSTRACT

BACKGROUND: Investigation is to utilize decision trees in conjunction with orthopantomography (OPT) and lateral panoramic graphy (LPG) to diagnose unilateral anterior disc displacement (ADD) of the temporomandibular joint.

METHODS: In this study, 161 patients with images obtained through all three imaging methods, MRI, OPT, and LPG, were selected from the archives. The participants were categorized into two groups: the study group, comprising 89 patients with unilateral anterior disc displacement, and the control group, consisting of 72 healthy individuals. Measurements, including 2 angles (antero-posterior angle and superior-inferior angle) and 3 distance parameters (anterior joint space distance, superior joint space distance, and posterior joint space distance), were conducted on each imaging modality dataset. To assess the obtained measurement data within each patient, the differences from each measurement were calculated. Statistical analysis of the measurement differences between the control and study groups was carried out with independent t test, and decision trees were generated using the SPSS 25 decision tree module 5.0.

RESULTS: In ADD patients, it was statistically significantly found that the APA increased while the SIA decreased for angle measurements. But for linear measurements, AS increased while the SS and PS decreased in MRI, OPT, and LPG.

CONCLUSION: ADD can be diagnosed in OPT and LPG. The identification of the specific type of ADD that occurs in the temporomandibular joint is not feasible.

PMID:38493117 | DOI:10.1186/s12903-024-04121-z

BMC Pediatr. 2024 Mar 16;24(1):192. doi: 10.1186/s12887-024-04683-5.

ABSTRACT

BACKGROUND: The impact of vitamin D on type 1 diabetes has been a controversial topic in public health. Furthermore, significant differences in the proportion of vitamin D have been noted. The purpose of this systematic review was to determine the overall proportion of vitamin D deficiency in children/adolescents with type 1 diabetes (T1D).

METHODS: Based on six electronic databases (PubMed, Web of Science, Embase, Ovid Medline, ProQuest, and Cochrane Library), eligible studies since the databases’ inception up to April 2022 were searched. Reference lists were also manually searched to identify additional studies. Overall, studies with statistical information on vitamin D deficiency in children and adolescents with T1D were included, and a random effects model was applied for the meta-analysis. In addition, subgroup and sensitivity analyses were carried out to evaluate heterogeneity, and publication bias was evaluated by using Egger’s test.

RESULTS: A total of 45 studies involving 6,995 participants met the inclusion criteria; these included 25 countries covering Africa, Oceania, Europe, North America and Asia. The proportion of vitamin D deficiency in children/adolescents with T1D was 45% (95% confidence interval [CI] 37-54%, I² = 97.94%). Subgroup analysis further revealed that the publication year, study design, vitamin D classification, season and geographical region significantly contributed to the variation in the reported incidence of vitamin D deficiency.

CONCLUSIONS: The results of the meta-analysis showed that the proportion of vitamin D deficiency among T1D children/adolescents was 45%. In addition, the proportion remains higher, which has important implications for adapting health and social care systems.

PMID:38493103 | DOI:10.1186/s12887-024-04683-5

Womens Health Issues. 2024 Mar 15:S1049-3867(24)00006-9. doi: 10.1016/j.whi.2024.02.001. Online ahead of print.

ABSTRACT

BACKGROUND: Undocumented immigrants face many barriers in accessing pregnancy care, including language differences, implicit and explicit bias, limited or no insurance coverage, and fear about accessing services. With the national spotlight on maternal health inequities, the current literature on undocumented immigrants during pregnancy requires synthesis.

OBJECTIVE: We aimed to describe the literature on pregnancy care utilization, experiences, and outcomes of undocumented individuals in the United States.

METHODS: We performed a scoping review of original research studies in the United States that described the undocumented population specifically and examined pregnancy care utilization, experiences, and outcomes. Studies underwent title, abstract, and full-text review by two investigators. Data were extracted and synthesized using descriptive statistics and content analysis.

RESULTS: A total of 5,940 articles were retrieved and 3,949 remained after de-duplication. After two investigators screened and reviewed the articles, 29 studies met inclusion criteria. The definition of undocumented individuals varied widely across studies. Of the 29 articles, 24 showed that undocumented status and anti-immigrant policies and rhetoric are associated with decreased care utilization and worse pregnancy outcomes, while inclusive health care and immigration policies are associated with increased prenatal and postnatal care utilization as well as improved pregnancy outcomes.

CONCLUSIONS: The small, heterogeneous literature on undocumented immigrants and pregnancy care is fraught with inconsistent definitions, precluding comparisons across studies. Despite areas in need of further research, the signal among published studies is that undocumented individuals experience variable access to pregnancy care, heightened fear and stress regarding their status during pregnancy, and worse outcomes compared with other groups, including documented immigrants.

PMID:38493075 | DOI:10.1016/j.whi.2024.02.001