Tag: statistics

JAMA Cardiol. 2024 Jan 10. doi: 10.1001/jamacardio.2023.5095. Online ahead of print.

ABSTRACT

IMPORTANCE: The genetic basis of coronary heart disease (CHD) has expanded from a germline to somatic genome, including clonal hematopoiesis of indeterminate potential (CHIP). How CHIP confers CHD risk in East Asian individuals, especially those with small clones (variant allele fraction [VAF] 0.5%-2%) and different genetic backgrounds, was completely unknown.

OBJECTIVE: To investigate the CHIP profile in a general Chinese cohort by deep sequencing and further explore the association between CHIP and incident CHD considering germline predisposition.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from 3 prospective cohorts in the project Prediction for Atherosclerotic Cardiovascular Disease Risk in China. Participants without cardiovascular disease or cancer at baseline were enrolled in 2001 and 2008 and had a median follow-up of 12.17 years extending into 2021.

EXPOSURES: CHIP mutations were detected by targeted sequencing (mean depth, 916×). A predefined CHD polygenic risk score (PRS) comprising 531 variants was used to evaluate germline predisposition.

MAIN OUTCOMES AND MEASURES: The main outcome was first incident CHD.

RESULTS: Among 6181 participants, the median (IQR) age was 53.83 years (45.35-62.39 years); 3082 participants (49.9%) were female, and 3099 (50.1%) were male. A total of 1100 individuals (17.80%) harbored 1372 CHIP mutations at baseline. CHIP was independently associated with incident CHD (hazard ratio [HR], 1.42; 95% CI, 1.18-1.72; P = 2.82 × 10-4) and presented a risk gradient with increasing VAF (P = 3.98 × 10-3 for trend). Notably, individuals with small clones, nearly half of CHIP carriers, also demonstrated a higher CHD risk compared with non-CHIP carriers (HR, 1.33; 95% CI, 1.02-1.74; P = .03) and were 4 years younger than those with VAF of 2% or greater (median age, 58.52 vs 62.70 years). Heightened CHD risk was not observed among CHIP carriers with low PRS (HR, 1.02; 95% CI, 0.64-1.64; P = .92), while high PRS and CHIP jointly contributed a 2.23-fold increase in risk (95% CI, 1.51-3.29; P = 6.29 × 10-5) compared with non-CHIP carriers with low PRS. Interestingly, the diversity in CHIP-related CHD risk within each PRS group was substantially diminished when removing variants in the inflammatory pathway from the PRS.

CONCLUSIONS: This study revealed that elevated CHD risk attributed to CHIP was nonnegligible even for small clones. Inflammation genes involved in CHD could aggravate or abrogate CHIP-related CHD risk.

PMID:38198131 | DOI:10.1001/jamacardio.2023.5095

Clin Rheumatol. 2024 Jan 10. doi: 10.1007/s10067-023-06858-4. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the relation between cumulative intravenous methylprednisolone dose and disease activity, damage, and mortality among a group of Egyptian SLE patients.

PATIENTS AND METHODS: This is a post hoc analysis of a retrospective multicenter COMOSLE study. Cumulative pulse methylprednisolone dose was abstracted from COMOSLE database. Patients with cumulative pulse dose of ≤ 3.0 g (median dose) were compared to those with cumulative dose of > 3.0 g regarding demographic data, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and The Systemic Lupus International Collaborating Clinics/ACR Damage Index (SLICC) score as well as treatment received. Additionally, at 1.5, 3, 6, and 9 g of cumulative methylprednisolone, patients were compared regarding SLICC score and risk of mortality.

RESULTS: Patients who received > 3 g of methylprednisolone were statistically significantly younger at disease onset, had longer disease duration, higher SLEDAI score at last visit, and higher SLICC score (p = 003, p = 0.002, p = 0.004 and p = < 0.001, respectively). Additionally, with every gram increase in the cumulative methylprednisolone, there was a significant increase in SLICC score by 0.169 (B = 0.169, CI = 0.122-0.216, p-value = < 0.001) and an increased risk of mortality by 13.5% (hazard ratio (HR) = 1.135, CI = 1.091-1.180, p-value = 0.001). The best cutoff value of methylprednisolone dose at which damage may occur, ranged between 2.75 (with sensitivity of 81.4% and specificity of 33.9%) and 3.25 g (with sensitivity of 48.3% and specificity of 71.5%).

CONCLUSION: With every gram increase in the cumulative methylprednisolone, there may be increase in damage and mortality, especially in doses exceeding the range of 2.75-3.25 g. Key Points • Treatment of systemic lupus erythematosus should be with the least possible dose of steroids to decrease the risk of damage and mortality. • With every gram increase in the cumulative intravenous methylprednisolone there may be increase in damage and mortality.

PMID:38198114 | DOI:10.1007/s10067-023-06858-4

Environ Sci Pollut Res Int. 2024 Jan 10. doi: 10.1007/s11356-023-31819-4. Online ahead of print.

ABSTRACT

Asbestos has been used extensively in the construction industry for its superior insulation properties before its health hazards were discovered and its use eventually banned. It is likely that many residential buildings built before the 2000s in Turkey contain asbestos. Therefore, it is important to raise awareness of the potential danger of asbestos exposure during demolition work and to identify asbestos-containing materials and ensure their safe removal and disposal. This study is executed to determine the residential dwellings containing asbestos in Izmir, Turkey. The research included field studies to determine asbestos presence in the buildings that were damaged during the 2020 earthquake. Air measurements and bulk samples were taken from 50 buildings that would go through the demolition process. Eleven buildings were found to contain asbestos which corresponds to 22%. The detected asbestos type was 60% chrysotile (white asbestos). Results could be helpful for future demolition work, which are conducted in the same region that includes buildings with similar properties. Also, it is expected that the database created for this study could be useful in other studies in Turkey, where accurate statistical data related with asbestos measurements is essentially non-existent.

PMID:38198092 | DOI:10.1007/s11356-023-31819-4

Environ Sci Pollut Res Int. 2024 Jan 10. doi: 10.1007/s11356-023-31670-7. Online ahead of print.

ABSTRACT

Landslides are a natural threat that poses a severe risk to human life and the environment. In the Kumaon mountains region in Uttarakhand (India), Nainital is among the most vulnerable areas prone to landslides inflicting harm to livelihood and civilization due to frequent landslides. Developing a landslide susceptibility map (LSM) in this Nainital area will help alleviate the probability of landslide occurrence. GIS and statistical-based approaches like the certainty factor (CF), information value (IV), frequency ratio (FR) and logistic regression (LR) are used for the assessment of LSM. The landslide inventories were prepared using topography, satellite imagery, lithology, slope, aspect, curvature, soil, land use and land cover, geomorphology, drainage density and lineament density to construct the geodatabase of the elements affecting landslides. Furthermore, the receiver operating characteristic (ROC) curve was used to check the accuracy of the predicting model. The results for the area under the curves (AUCs) were 87.8% for logistic regression, 87.6% for certainty factor, 87.4% for information value and 84.8% for frequency ratio, which indicates satisfactory accuracy in landslide susceptibility mapping. The present study perfectly combines GIS and statistical approaches for mapping landslide susceptibility zonation. Regional land use planners and natural disaster management will benefit from the proposed framework for landslide susceptibility maps.

PMID:38198087 | DOI:10.1007/s11356-023-31670-7

Breast Cancer Res Treat. 2024 Jan 10. doi: 10.1007/s10549-023-07218-1. Online ahead of print.

ABSTRACT

PURPOSE: Polypharmacy is associated with negative health outcomes and decreased medication adherence. Polypharmacy is common in cancer populations, but few studies have evaluated the relationship between polypharmacy and aromatase inhibitor (AI) adherence. No studies have evaluated the relationship between over-the-counter (OTC) supplements and AI adherence. Our primary hypothesis was that polypharmacy would be associated with increased risk of premature AI discontinuation.

METHODS: This exploratory analysis used data from the Exemestane and Letrozole Pharmacogenetics (ELPh) trial, a prospective, multicenter, randomized controlled trial that enrolled participants from 2005 to 2009. Included patients were female, postmenopausal, with stage 0-III breast cancer, who had completed indicated chemotherapy, surgery, and radiation. Participants were randomized to adjuvant exemestane or letrozole and completed serial clinical examinations and questionnaires for two years. Concomitant medication data were collected prospectively. Cox proportion models were used for statistical analysis of the relationship between polypharmacy, OTCs, medication class, and AI adherence.

RESULTS: In the 490 analyzed participants, use of any prescription medications at baseline was associated with decreased risk of premature AI discontinuation (HR 0.56, p = 0.02). Use of selective serotonin reuptake inhibitors (SSRIs) or selective serotonin and norepinephrine reuptake inhibitors (SNRIs) at baseline was associated with decreased risk of premature AI discontinuation (HR 0.67, p = 0.04). Use of any OTCs was not associated with AI discontinuation.

CONCLUSION: Baseline use of prescription medications but not OTCs was associated with increased AI persistence. Future research is needed to understand how this can be utilized to promote AI adherence.

PMID:38198070 | DOI:10.1007/s10549-023-07218-1

Ophthalmol Ther. 2024 Jan 10. doi: 10.1007/s40123-023-00867-x. Online ahead of print.

ABSTRACT

INTRODUCTION: XTEND (NCT03939767) is a multicenter, observational, prospective study of patients with treatment-naïve neovascular age-related macular degeneration (nAMD) in routine clinical practice. The study aims to examine treatment outcomes of proactive intravitreal aflibercept (IVT-AFL) treatment regimens (fixed dosing or treat-and-extend) according to local marketing labels.

METHODS: Study eyes received IVT-AFL injections as per the local label. The mean changes in best-corrected visual acuity (BCVA) and central subfield thickness (CST) from baseline to month (M) 12 and M24 were measured and stratified by baseline factors. Treatment exposure and safety data were evaluated. Statistical analysis was descriptive.

RESULTS: Overall, 1466 patients from 17 countries were treated. For the overall population, the mean ± standard deviation (SD) age was 78.7 ± 8.5 (range 50-100) years, and 891 patients (60.8%) were female. The mean ± SD baseline BCVA was 54.3 ± 20.3 letters and CST was 374 ± 126 µm. At M12 and M24, mean (95% confidence interval [CI]) BCVA change was + 4.3 (3.4, 5.3) and + 2.3 (1.3, 3.3) letters, respectively. Mean (95% CI) CST was – 106 (- 114, – 99) μm and – 109 (- 117, – 102) μm at M12 and M24, respectively. At M24, 41.5% of patients had a BCVA ≥ 70 letters. Patients received a mean ± SD of 7.7 ± 2.7 injections by M12 and 10.8 ± 5.0 injections by M24 (3.1 injections between M12 and M24). Adverse events were consistent with the known safety profile of IVT-AFL.

CONCLUSION: The 24-month results indicate that, in routine clinical practice, a proactive IVT-AFL regimen achieves functional improvements in patients with treatment-naïve nAMD. The proportion of patients achieving ≥ 70 letters at M24 increased, and patients with baseline BCVA ≥ 70 letters maintained vision regardless of the followed IVT-AFL label.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03939767. A video abstract is available for this article. Supplementary file2 (MP4 364624 KB).

PMID:38198053 | DOI:10.1007/s40123-023-00867-x

Plant Foods Hum Nutr. 2024 Jan 10. doi: 10.1007/s11130-023-01138-7. Online ahead of print.

ABSTRACT

Consumers prefer food products that, in addition to nutritional properties, also have effects beneficial to health. Non-conventional food plants such as canary seed (Phalaris canariensis) constitute an alternative in the food industry due to nutritional properties, chemical, and bioactive potential. The aim of this research was to develop pancake formulations with the inclusion of canary seed flour to evaluate their proximate composition, overall score, taste and texture sensory acceptability, and glycemic index. Pancakes based on whole-wheat flour mixed with canary seed flour were developed at four substitution levels (control 0, 10, 30, and 50%). The formulations exhibited attractive nutritional properties, mainly due to the levels of protein (~ 8.7%), minerals (~ 5.1%), and total dietary fiber (4.7-5.9%). The overall score and taste showed a statistical difference (p < 0.05) between the formulations. The flours with 10 and 30% showed high sensory acceptability with scores of 6.22 and 6.67 respect to 7-point hedonic scale, between the categories “I like it” and “I like it a lot”. All formulations presented a low glycemic index (34-39%) that was significantly influenced (p < 0.05) as the level of substitution increased. The findings represent a new approach to the use of canary seed in the development of healthy food products.

PMID:38198039 | DOI:10.1007/s11130-023-01138-7

Environ Monit Assess. 2024 Jan 10;196(2):130. doi: 10.1007/s10661-024-12294-x.

ABSTRACT

Soil serves as a reservoir for organic carbon stock, which indicates soil quality and fertility within the terrestrial ecosystem. Therefore, it is crucial to comprehend the spatial distribution of soil organic carbon stock (SOCS) and the factors influencing it to achieve sustainable practices and ensure soil health. Thus, the present study aimed to apply four machine learning (ML) models, namely, random forest (RF), k-nearest neighbors (kNN), support vector machine (SVM), and Cubist model tree (Cubist), to improve the prediction of SOCS in the Srou catchment located in the Upper Oum Er-Rbia watershed, Morocco. From an inventory of 120 sample points, 80% were used for training the model, with the remaining 20% set aside for model testing. Boruta’s algorithm and the multicollinearity test identified only nine (9) factors as the controlling factors selected as input data for predicting SOCS. As a result, spatial distribution maps for SOCS were generated for all models, then compared, and further validated using statistical metrics. Among the models tested, the RF model exhibited the best performance (R² = 0.76, RMSE = 0.52 Mg C/ha, NRMSE = 0.13, and MAE = 0.34 Mg C/ha), followed closely by the SVM model (R² = 0.68, RMSE = 0.59 Mg C/ha, NRMSE = 0.15, and MAE = 0.34 Mg C/ha) and Cubist model (R² = 0.64, RMSE = 0.63 Mg C/ha, NRMSE = 0.16, and MAE = 0.43 Mg C/ha), while the kNN model had the lowest performance (R² = 0.31, RMSE = 0.94 Mg C/ha, NRMSE = 0.24, and MAE = 0.63 Mg C/ha). However, bulk density, pH, electrical conductivity, and calcium carbonate were the most important factors for spatially predicting SOCS in this semi-arid region. Hence, the methodology used in this study, which relies on ML algorithms, holds the potential for modeling and mapping SOCS and soil properties in comparable contexts elsewhere.

PMID:38198014 | DOI:10.1007/s10661-024-12294-x

Graefes Arch Clin Exp Ophthalmol. 2024 Jan 10. doi: 10.1007/s00417-023-06367-9. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effect of posterior keratometry (PK) on the accuracy of 10 intraocular lens (IOL) power calculation formulas using standard keratometry (K) and total keratometry (TK).

METHODS: This is a retrospective consecutive case-series study. The IOL power was calculated using K and TK measured by IOLMaster 700 in 6 new-generation formulas (Barrett Universal II, Emmetropia Verifying Optical (EVO) 2.0, RBF Calculator 3.0, Hoffer QST, Kane, and Ladas Super Formula) and 4 traditional formulas (Haigis, Hoffer Q, Holladay 1, and SRK/T). The arithmetic prediction error (PE) and mean absolute PE (MAE) were evaluated. The locally-weighted scatterplot smoothing was performed to assess the relationship between PE and PK.

RESULTS: A total of 576 patients (576 eyes) who underwent cataract surgery were included. Compared with using K, all formulas using TK showed a hyperopic shift in the whole group. Specifically, for eyes with PK exceeding -5.90 D, all formulas using TK exhibited a hyperopic shift (all P < 0.001), while eyes with PK less than -5.90 D showed a myopic shift (all P < 0.001). The MAE of new-generation formulas calculated with TK and K showed no statistical differences, while the MAE of traditional formulas with TK was larger (TK: 0.34 ~ 0.43 D; K: 0.33 ~ 0.42 D, all P < 0.05).

CONCLUSIONS: The prediction bias of formulas with TK increased as PK deviated from -5.90 D. TK did not improve the prediction accuracy of new-generation formulas, and even performed worse in traditional formulas.

PMID:38197993 | DOI:10.1007/s00417-023-06367-9

Endocrine. 2024 Jan 10. doi: 10.1007/s12020-023-03677-0. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The atherogenic index of plasma (AIP) is supposed to be associated with cardiovascular disease (CVD), but there is limited evidence on its longitudinal effect. Our study aimed to explore the associations between baseline and long-term AIP with the risk of stroke and its subtypes.

METHODS AND RESULTS: A total of 97,959 participants free of stroke at baseline were included in the Kailuan study. The AIP was calculated as the logarithm of the ratio of triglyceride to high-density lipoprotein cholesterol. The updated mean AIP was calculated as the average of the AIP from baseline to the first occurrence of outcome or the end of follow-up. The outcome was the first occurrence of stroke, including ischemic stroke (IS) and intracerebral hemorrhage (ICH). We used univariable and multivariable Cox proportional hazard models to explore the association between AIP and the risk of stroke. During a median follow-up of 12.79 years, a total of 6307 participants developed stroke, including 5482 IS and 1024 ICH. Compared with the 1st quartile of baseline AIP, the multivariate-adjusted HR in the 4th quartile was 1.12 (95% CI, 1.03-1.22, p for trend <0.001) for stroke risk. Same results were found in IS, but no significant association was found for ICH. The associations between updated mean AIP and stroke and its subtypes showed similar results.

CONCLUSIONS: Elevated levels of both baseline and long-term updated mean AIP were associated with the risk of stroke and IS but not ICH in the general population.

PMID:38197990 | DOI:10.1007/s12020-023-03677-0