Tag: statistics

Proc Natl Acad Sci U S A. 2023 Jul 11;120(28):e2304981120. doi: 10.1073/pnas.2304981120. Epub 2023 Jul 5.

ABSTRACT

How the behavior of cells emerges from their constituent subcellular biochemical and physical parts is an outstanding challenge at the intersection of biology and physics. A remarkable example of single-cell behavior occurs in the ciliate Lacrymaria olor, which hunts for its prey via rapid movements and protrusions of a slender neck, many times the size of the original cell body. The dynamics of this cell neck is powered by a coat of cilia across its length and tip. How a cell can program this active filamentous structure to produce desirable behaviors like search and homing to a target remains unknown. Here, we present an active filament model that allows us to uncover how a “program” (time sequence of active forcing) leads to “behavior” (filament shape dynamics). Our model captures two key features of this system-time-varying activity patterns (extension and compression cycles) and active stresses that are uniquely aligned with the filament geometry-a “follower force” constraint. We show that active filaments under deterministic, time-varying follower forces display rich behaviors including periodic and aperiodic dynamics over long times. We further show that aperiodicity occurs due to a transition to chaos in regions of a biologically accessible parameter space. We also identify a simple nonlinear iterated map of filament shape that approximately predicts long-term behavior suggesting simple, artificial “programs” for filament functions such as homing and searching space. Last, we directly measure the statistical properties of biological programs in L. olor, enabling comparisons between model predictions and experiments.

PMID:37406100 | DOI:10.1073/pnas.2304981120

J Infect Dev Ctries. 2023 Jun 30;17(6):846-853. doi: 10.3855/jidc.17284.

ABSTRACT

INTRODUCTION: The analysis of factors associated with multibacillary leprosy is important for the development of strategies to mitigate the disease, which persists as a public health problem in Brazil and the world. The objective of this study was to verify the associations between sociodemographic and clinical-epidemiological variables and multibacillary leprosy in the state of northeastern Brazil.

METHODOLOGY: This is a cross-sectional, analytical, and retrospective study, with a quantitative approach, carried out in 16 municipalities in the southwest of Maranhão State, northeastern Brazil. All cases of leprosy reported between January 2008 and December 2017 were considered. Sociodemographic and clinical-epidemiological variables were analyzed using descriptive statistics. The identification of the risk factors associated with multibacillary leprosy was conducted using Poisson regression models. The prevalence ratios and respective 95% confidence intervals were estimated using regression coefficients at a 5% significance level.

RESULTS: A total of 3,903 leprosy cases were analyzed. Individuals older than 15 years, males, with less than 8 years of education, with level I, II, or “not evaluated” disability, and with type 1 or 2 or both reactional states were more likely to have multibacillary leprosy. Therefore, these characteristics may be considered risk factors. No protective factors were identified.

CONCLUSIONS: The investigation revealed important associations between risk factors and multibacillary leprosy. The findings can be considered during the creation of strategies to control and combat the disease.

PMID:37406066 | DOI:10.3855/jidc.17284

J Infect Dev Ctries. 2023 Jun 30;17(6):840-845. doi: 10.3855/jidc.17897.

ABSTRACT

INTRODUCTION: Blood transfusion saves millions of lives year around the world; it is the most important life-saving option for blood recipients. However, this act is not without risks as contaminated blood may be the source of transfusion-transmissible infections (TTI). This is a retrospective and comparative study on the prevalence of acquired human immunodeficiency syndrome, viral hepatitis B, C and syphilis in blood donors from Bejaia province (Algeria).

METHODOLOGY: This study is designed to estimate the risk of TTIs among blood donors and the demographic associated factors. It was carried out in the serology laboratories of Bejaia blood transfusion center and Khalil Amrane university hospital. Data were collected from the archived results of screening tests for HBV, HCV, HIV and syphilis, mandatory for all blood donations, from January 2010 to December 2019. The association was considered statistically significant at p < 0.05.

RESULTS: Among 140,168 donors from Bejaia province, 78,123 represent the urban population and 62,045 the rural population. Over 10 years, results of serological tests revealed a prevalence of 0.077%, 0.083%, 0.102%, and 0.132%, respectively for HIV, HCV, HBV, and Treponema pallidum. Trends of hepatitis B and syphilis were decreasing; however, hepatitis C was increasing.

CONCLUSIONS: HIV and syphilis prevalence have been variable, with significant peaks in 2013 and 2014, respectively. Globally, the low rates reported in this study confirm the effectiveness of the preventive policy applied by the health authorities. However, among the rural population, special attention is required to stem any resurgence of hepatitis C and syphilis.

PMID:37406062 | DOI:10.3855/jidc.17897

J Infect Dev Ctries. 2023 Jun 30;17(6):832-839. doi: 10.3855/jidc.17221.

ABSTRACT

INTRODUCTION: We compared the diagnostic values of individual and composite biomarkers used in the prediction of bacteremia in adult emergency department patients.

METHODOLOGY: First-hour blood levels of C- reactive protein, procalcitonin, interleukin-6, lactate, lipopolysaccharide-binding protein and white blood cell count were collected from a 30-person control group and 47 adult patients. Patients included in this study were admitted to the emergency department on suspicion of sepsis. We categorized patients according to presence/absence of sepsis and bacteremia. Our control group was categorized as S-B -, septic patients with bacteremia were S+B+, and septic patients without bacteremia were S+B-.

RESULTS: All biomarkers showed a statistically significant elevation when S+B- and S+B+ groups were compared with the S-B-. When S+B+ group was compared with the S+B- group only procalcitonin and lactate levels had statistically significant elevation (p < 0.005). Regression analysis demonstrated that lactate and procalcitonin were independently associated with having bacteremia in the state of sepsis and Hosmer-Lemeshow score was 0.772. The areas under the curve (AUC) values of biomarkers procalcitonin, lactate, C-reactive protein, combined 1 (procalcitonin+ lactate), and combined 2 (procalcitonin + lactate + C-reactive protein) were 0.773, 0.744, 0.523, 0.806, and 0.829 respectively.

CONCLUSIONS: Combination of tests such as combined 1 or combined 2 were highly predictive of bacteremia in adult septic patients. Combined 2 demonstrated the best predictive performance and could be utilized as a tool to assist diagnosis of bacteremia before culture results are available.

PMID:37406061 | DOI:10.3855/jidc.17221

J Infect Dev Ctries. 2023 Jun 30;17(6):782-790. doi: 10.3855/jidc.17911.

ABSTRACT

INTRODUCTION: Several previous studies have suggested a link between autoimmune activation and SARS-CoV-2 infection. This study aims to evaluate the excessive immune response via laboratory and radiological findings, treatment options, and previous acute phase reactants in patients with mild and moderate coronavirus disease 2019 (COVID-19) to identify the possible interaction between autoimmune response and SARS-CoV-2 infection.

METHODOLOGY: A total of 345 hospitalized patients with a diagnosis of definitive COVID-19 were evaluated retrospectively in terms of their clinical, laboratory, and radiological data, comorbidities, treatment options, and the values of C-reactive protein (CRP) of all patients in the last year before COVID-19 during admission to the hospital for any reason.

RESULTS: 162 (47%) of the patients were female and 183 (53%) were male. The mean age was 51.08 ± 15.52 years. Of all patients, 235 (68.1%) had mild disease and 110 (31.9%) had a moderate disease. There was a statistically significant difference between the two groups in terms of age, gender, the values of leukocytes, lymphocytes, and hemoglobin, the levels of AST, LDH, Na, Cl, Ca, CRP, ferritin and fibrinogen, duration of hospitalization, medical treatments as well as the CRP value of the patients in the last year. Male gender, shortness of breath, duration of hospitalization, the value of lymphocytes, and the levels of LDH, CRP, and fibrinogen were independent predictive factors for the severity of COVID-19.

CONCLUSIONS: The SARS-CoV-2 infection could act as a triggering factor for developing autoimmune and/or autoinflammatory dysregulation in genetically predisposed individuals.

PMID:37406059 | DOI:10.3855/jidc.17911

Immunohematology. 2023 Jul 5;39(2):55-60. doi: 10.21307/immunohematology-2023-009. eCollection 2023 Jun 1.

ABSTRACT

The aim of this study was to define risk factors for jaundice and anemia in newborns with a positive direct antiglobulin test (DAT) and/or with an incompatible crossmatch due to ABO incompatibility between mother and newborn. ABO incompatibility has become a more significant cause of hemolytic disease of the fetus and newborn since the introduction of effective anti-D prophylaxis. The condition is common and, if clinically significant at all, causes only mild jaundice, which can be treated with phototherapy (PT). However, rare and serious presentations, requiring transfusion therapy, have been noted. Clinical, laboratory, and immunohematologic data were collected retrospectively from medical records of ABO-incompatible newborns and their mothers over a 5-year period (2016-2020) from University Hospital Centre Zagreb. Two groups of newborns were compared: those who needed medical intervention because of hyperbilirubinemia or anemia and those who did not. Within the group of newborns requiring intervention, we also compared those with A and B blood groups. Over the 5-year period, 72 of 184 (39%) newborns required treatment. The treatment was PT in 71 (38%) newborns and erythrocyte transfusion in 2 (1%). In 112 (61%) newborns, ABO incompatibility was an accidental finding while performing blood group typing; these newborns did not require any therapy. In conclusion, we found a statistical, but not clinically significant, difference between the groups of treated and untreated newborns, related to the mode of delivery and DAT positivity within hours of delivery. There were no statistically significant differences in characteristics between the groups of treated newborns, except for two newborns with blood group A who received erythrocyte transfusions.

PMID:37405847 | DOI:10.21307/immunohematology-2023-009

Arch Med Sadowej Kryminol. 2022;72(4):183-199. doi: 10.4467/16891716AMSIK.22.021.17621.

ABSTRACT

The problems with obtaining expert opinions from court-appointed physicians in Poland have been known for a long time and are well-diagnosed. The reasons for this state of affairs are: an overall insufficient number of physicians compared to the general needs, uncompetitive remuneration levels, and the difficulty of reconciling professional and court-appointed expert duties, while taking into consideration the availability expected of experts. The ongoing generational transition may further exacerbate these problems. The purpose of this study was to investigate the latter phenomenon by comparing the age profile of court-appointed physicians with that of physicians in general. Information on the age of court-appointed physicians was obtained from the presidents of regional courts and the Central Register of Physicians, while general statistics on physicians were also acquired from the latter. Research allowed us to formulate the following conclusions: only 0.8% of all physicians in Poland serve a court-appointed expert function. Almost two-thirds of court-appointed physicians belong to the Baby Boomer generation (born in 1946-1964), nearly one-third to Generation X (1965-1980), and only one-sixteenth (6.10%) to Generation Y (1981-1996), or Millennials. The results obtained, as well as data from the literature, suggest that the current bad state of affairs regarding access to the opinions of court-appointed physicians will further deteriorate in the coming years due to generational changes, i.e., the replacement of Baby Boomers and Generation X, currently dominant among court-appointed experts, by Generation Y, i.e., Millennials, with a different attitude to life.

PMID:37405839 | DOI:10.4467/16891716AMSIK.22.021.17621

Eur J Neurol. 2023 Jul 5. doi: 10.1111/ene.15965. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the most sensitive combination of tests to detect peri-personal unilateral neglect (UN) after stroke.

METHODS: The present study is a secondary analysis of a previously reported multicentric study of 203 individuals with right hemisphere damage (RHD), mainly subacute stroke, 11 weeks post onset on average, and 307 healthy controls. A battery of 7 tests, providing 19 age and education adjusted z scores were given: the bells test, line bisection, figure copying, clock drawing, overlapping figures test, reading and writing. Statistical analyses used a logistic regression and a ROC after adjustment on demographic variables.

RESULTS: A combination of 4 z-scores based on the following three tests provided a good discrimination of patients with RHD from matched healthy controls: the starting point and the difference between the number of omissions on left and right sides from the Bells test, rightward deviation in bisection of long lines (20 cm), and left-sided omissions in a reading task. The area under the ROC curve was 0.865 (95%CI: 0.83-0.901) with a sensitivity= 0.68; a specificity = 0.95, an accuracy =0.85, a PPV= 0.90, and a NPV=0.82.

DISCUSSION / CONCLUSION: The most sensitive and parsimonious combination of tests to detect UN after stroke relies on 4 scores from 3 simple tests (bells test, line bisection and reading). Future study is warranted to assess its ability to account for the functional difficulties of UN in daily life in the patient’s actual environment.

PMID:37405828 | DOI:10.1111/ene.15965

JMIR Public Health Surveill. 2023 Jul 5;9:e46289. doi: 10.2196/46289.

ABSTRACT

BACKGROUND: Comorbidity of psychiatric disorders such as depression and anxiety is very common among children and adolescents. Few studies have examined how comorbid anxiety and depression are associated with health risk behaviors (HRBs) in adolescents, which could inform preventative approaches for mental health.

OBJECTIVE: We evaluated the association between HRBs and comorbid anxiety and depression in a large adolescent cohort.

METHODS: We used data from 22,868 adolescents in the National Youth Cohort (China). Anxiety and depression symptoms were assessed using the 9-item Patient Health Questionnaire scale and the 7-item Generalized Anxiety Disorder scale, respectively. Comorbidity was determined by the coexistence of anxiety and depression. HRBs including poor diet, smoking, physical inactivity, and poor sleep, as well as the above HRB scores, were added to obtain the total HRB score (HRB risk index). Based on single and total HRB scores, we divided participants into low-, medium-, and high-risk groups. Potential confounders included gender, presence of siblings, regional economic level, educational status, self-rated health, parental education level, self-reported family income, number of friends, learning burden, and family history of psychosis. Correlation analysis was used to explore associations between single risk behaviors. Binary logistic regression estimated the association between HRBs and anxiety-depression comorbidity before and after adjusting for potential confounders.

RESULTS: The comorbidity rate of anxiety and depression among Chinese adolescents was 31.6% (7236/22,868). There was a statistically significant association between each HRB (P<.05), and HRBs were positively associated with comorbid anxiety and depression in the above population. For single HRBs, adolescents with poor diet, smoking, and poor sleep (medium-risk) were more prone to anxiety-depression comorbidity after adjusting for confounders compared to low-risk adolescents. However, adolescents with all high-risk HRBs were more likely to have comorbid anxiety and depression after adjusting for confounders (poor diet odds ratio [OR] 1.50, 95% CI 1.39-1.62; smoking OR 2.17, 95% CI 1.67-2.81; physical inactivity OR 1.16, 95% CI 1.06-1.28; poor sleep OR 1.84, 95% CI 1.70-2.01). Moreover, in both unadjusted (medium risk OR 1.79, 95% CI 1.56-2.05; high risk OR 3.09, 95% CI 2.72-3.52) and adjusted (medium risk OR 1.57, 95% CI 1.37-1.80; high risk OR 2.33, 95% CI 2.03-2.68) models, HRB risk index, like clustered HRBs, was positively associated with anxiety-depression comorbidity, and the strength of the association was stronger than for any single HRB. In addition, we found that compared to girls, the association between clustered HRBs and anxiety-depression comorbidity was stronger in boys after adjustment.

CONCLUSIONS: We provide evidence that HRBs are related to comorbid anxiety and depression. Interventions that decrease HRBs may support mental health development in adolescence, with the potential to improve health and well-being through to adulthood.

PMID:37405826 | DOI:10.2196/46289

J Trauma Acute Care Surg. 2023 Jul 5. doi: 10.1097/TA.0000000000004019. Online ahead of print.

ABSTRACT

BACKGROUND: The coagulopathy of traumatic brain injury (TBI) remains poorly understood. Contradictory descriptions highlight the distinction between systemic and local coagulation, with descriptions of systemic hypercoagulability despite intracranial hypocoagulopathy. This perplexing coagulation profile has been hypothesized to be due to tissue factor release. The objective of this study was to assess the coagulation profile of TBI patients undergoing neurosurgical procedures. We hypothesize that dura violation is associated with higher tissue factor and conversion to a hypercoagulable profile and unique metabolomic and proteomic phenotype.

METHODS: This is a prospective, observational cohort study of all adult TBI patients at an urban, level-1 trauma center who underwent a neurosurgical procedure from 2019 to 2021. Whole blood samples were collected before and then one hour following dura violation. Citrated rapid and tissue plasminogen activator (tPA) thrombelastography (TEG) were performed, in addition to measurement of tissue factory activity, metabolomics, and proteomics.

RESULTS: Overall, 57 patients were included. The majority (61%) were male, the median age was 52 years, 70% presented after blunt trauma, and the median Glasgow Coma Score was 7. Compared to pre-dura violation, post-dura violation blood demonstrated systemic hypercoagulability, with a significant increase in clot strength (maximum amplitude of 74.4 mm versus 63.5 mm, p < 0.0001) and a significant decrease in fibrinolysis (LY30 on tPA-challenge TEG of 1.4% versus 2.6%, p = 0.04). There were no statistically significant differences in tissue factor. Metabolomics revealed notable increases in metabolites involved in late glycolysis, cysteine and one carbon metabolites, and metabolites involved in endothelial dysfunction/arginine metabolism/responses to hypoxia. Proteomics revealed notable increase in proteins related to platelet activation and fibrinolysis inhibition.

CONCLUSION: A systemic hypercoagulability is observed in TBI patients, characterized by increased clot strength and decreased fibrinolysis and a unique metabolomic and proteomics phenotype independent of tissue factor levels.

LEVEL OF EVIDENCE: n/a (basic science).

PMID:37405823 | DOI:10.1097/TA.0000000000004019