Tag: statistics

Blood Transfus. 2022 Oct 18. doi: 10.2450/2022.0128-22. Online ahead of print.

ABSTRACT

BACKGROUND: Platelet concentrates have a limited shelf life due to room temperature storage and therefore, are not kept in regional centres where turnover is low. Cryopreserved platelets have been proposed as an alternative to platelet transfusion in austere circumstances and fibrinogen concentrate has improved thromboelastometry parameters in thrombocytopenia. This study compared the ability of stored haemostatic products and platelets to correct thromboelastometry parameters in thrombocytopenia.

MATERIALS AND METHODS: Blood from eight patients with severe thrombocytopenia was combined with platelet concentrates, cryoprecipitate, fibrinogen concentrate, factor VIII, factor XIII and cryopreserved platelets in ratios equivalent to transfusion. Tissue factor initiated thromboelastometry (EXTEM) was compared between the products.

RESULTS: EXTEM amplitude at 20 minutes (A20) improved by 13.1 mm with platelets (p<0.01). The 5mm increase in A20 seen with cryoprecipitate (p=0.06) was not statistically different from platelets (p=0.19). No improvement in A20 was observed with cryopreserved platelets or factor concentrates. EXTEM clotting times (CT) improved with cryopreserved platelets (19.4 s, p=0.001) and cryoprecipitate (24.1 s, p<0.05), but not fibrinogen, and both were superior to platelets (9.9 s, p<0.05). Clotting concentrates did not improve EXTEM parameters although further studies suggested the improvement in A20 was largely driven by higher fibrinogen concentrations in cryoprecipitate.

DISCUSSION: These results suggest that cryopreserved platelets enhance clot initiation but do not contribute to clot strength in thrombocytopenia. When platelets are not available for transfusion, cryoprecipitate may be of value, however this requires further clinical studies.

PMID:36346878 | DOI:10.2450/2022.0128-22

IEEE Rev Biomed Eng. 2022 Nov 8;PP. doi: 10.1109/RBME.2022.3220636. Online ahead of print.

ABSTRACT

The tools for spectrally analyzing heart rate variability (HRV) has in recent years grown considerably, with emphasis on the handling of time-varying conditions and confounding factors. Time-frequency analysis holds since long an important position in HRV analysis, however, this technique cannot alone handle a mean heart rate or a respiratory frequency which vary over time. Overlapping frequency bands represents another critical condition which needs to be dealt with to produce accurate spectral measurements. The present survey offers a comprehensive account of techniques designed to handle such conditions and factors by providing a brief description of the main principles of the different methods. Several methods derive from a mathematical/statistical model, suggesting that the model can be used to simulate data used for performance evaluation. The inclusion of a respiratory signal, whether measured or derived, is another feature of many recent methods, e.g., used to guide the decomposition of the HRV signal so that signals related as well as unrelated to respiration can be analyzed. It is concluded that the development of new approaches to handling time-varying scenarios are warranted, as is benchmarking of performance evaluated in technical as well as in physiological/clinical terms.

PMID:36346854 | DOI:10.1109/RBME.2022.3220636

PLoS One. 2022 Nov 8;17(11):e0277406. doi: 10.1371/journal.pone.0277406. eCollection 2022.

ABSTRACT

A broad set of factors are associated with falling (e.g., age, sex, physical activity, vision, health), but their co-occurrence is understudied. Our objectives were to quantify the number and pattern of co-occurring fall-related factors. Data were obtained from the U.S. National Health and Nutrition Examination Survey (N = 1,957, 60-85 years). Twenty fall-related factors were included (based on previous research), covering a wide range including cognitive, motor, sensory, health, and physical activity measures. The number and pattern of co-occurring fall-related factors were quantified with logistic regression and cluster analyses, respectively. Most participants (59%) had ≥4 fall-risk factors, and each additional risk factor increased the odds of reporting difficulty with falling by 1.28. The identified clusters included: (1) healthy, (2) cognitive and sensory impaired, and (3) health impaired. The mean number of co-occurring fall-related factors was 3.7, 3.8, and 7.2, for clusters 1, 2, and 3, respectively (p<0.001). These observations indicate that co-occurrence of multiple fall-risk factors was common in this national sample of U.S. older adults and the factors tended to aggregate into distinct clusters. The findings support the protective effect of physical activity on fall-risk, the association between gait speed and falls, and the detrimental effect of health-related factors on difficulty with falls (e.g., arthritis, prescription medications). Cluster analyses revealed a complex interplay between sex and BMI that may alter the role of BMI in the etiology of falls. Cluster analyses also revealed a large detrimental effect of health-related factors in cluster 3; it is important to extend current fall interventions (typically focused on balance, flexibility, strength, cognitive, fear factors) to include health-related interventions that target factors such as BMI and arthritis.

PMID:36346815 | DOI:10.1371/journal.pone.0277406

PLoS Comput Biol. 2022 Nov 8;18(11):e1010687. doi: 10.1371/journal.pcbi.1010687. Online ahead of print.

ABSTRACT

Epithelial to Mesenchymal Transition (EMT) and its reverse-Mesenchymal to Epithelial Transition (MET) are hallmarks of metastasis. Cancer cells use this reversible cellular programming to switch among Epithelial (E), Mesenchymal (M), and hybrid Epithelial/Mesenchymal (hybrid E/M) state(s) and seed tumors at distant sites. Hybrid E/M cells are often more aggressive and metastatic than the “pure” E and M cells. Thus, identifying mechanisms to inhibit hybrid E/M cells can be promising in curtailing metastasis. While multiple gene regulatory networks (GRNs) based mathematical models for EMT/MET have been developed recently, identifying topological signatures enriching hybrid E/M phenotypes remains to be done. Here, we investigate the dynamics of 13 different GRNs and report an interesting association between “hybridness” and the number of negative/positive feedback loops across the networks. While networks having more negative feedback loops favor hybrid phenotype(s), networks having more positive feedback loops (PFLs) or many HiLoops-specific combinations of PFLs, support terminal (E and M) phenotypes. We also establish a connection between “hybridness” and network-frustration by showing that hybrid phenotypes likely result from non-reinforcing interactions among network nodes (genes) and therefore tend to be more frustrated (less stable). Our analysis, thus, identifies network topology-based signatures that can give rise to, as well as prevent, the emergence of hybrid E/M phenotype in GRNs underlying EMP. Our results can have implications in terms of targeting specific interactions in GRNs as a potent way to restrict switching to the hybrid E/M phenotype(s) to curtail metastasis.

PMID:36346808 | DOI:10.1371/journal.pcbi.1010687

PLoS One. 2022 Nov 8;17(11):e0277254. doi: 10.1371/journal.pone.0277254. eCollection 2022.

ABSTRACT

BACKGROUND: More than one-third of reproductive aged women in Ethiopia use hormonal contraceptives to prevent conception. The present study aimed to compare the hematological parameters of reproductive-age women taking hormonal contraceptives at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia in 2021.

METHODS: A comparative cross-sectional study was conducted from April to June 2021. A total of 240 study participants were recruited by using a consecutive sampling technique. Data on socio-demographic variables and clinical data were collected through face-to-face interviews using a structured questionnaire and medical record reviews, respectively. Three milliliter venous blood was collected for complete blood count analysis using Unicel DxH 800 coulter hematology analyzer. Data was entered into Epi-data 4.4.3.1 version then exported to IBM SPSS v25 for analysis. Kruskal-Wallis H, Dunn-Bonferroni pairwise comparison test, and Spearman’s correlation analysis were used for inferential statistics. P<0.05 were considered statistically significant.

RESULT: The median and interquartile range of platelet count among combined oral contraceptive users was 285(238-332) which is significantly higher than that of depot medroxyprogesterone acetate users 246(220-226) (p = 0.010), implant user 247(221-297) (p = 0.034), and controls 256(224-278) (p = 0.015). The result also showed long-term use of implant negatively correlated with red blood cell count (p = 0.033).

CONCLUSION: This finding concludes that combined oral contraceptive users had a higher platelet counts than controls while long-term use of implants can result in low red blood cells count. Therefore, a baseline evaluation of complete blood count in women desiring contraceptive methods would also be recommended.

PMID:36346804 | DOI:10.1371/journal.pone.0277254

PLoS One. 2022 Nov 8;17(11):e0277280. doi: 10.1371/journal.pone.0277280. eCollection 2022.

ABSTRACT

To identify the role of digital skill in the skill-biased technological changes caused by artificial intelligence, this study estimates the impacts of displacement risk on occupational wage and employment and examines the moderation effects of digital skill through the occupational data from the U.S. Bureau of Labor Statistics through the methods of fixed-effects modeling, heterogeneity analyzing and moderation effect testing. The results highlight three main points that (1) the displacement risk by artificial intelligence has significantly negative effects on occupational wage and employment, (2) the heterogeneous effects across occupational characteristics are significant, and (3) the digital skill exerts a significant moderation effect to protect against displacement risk. The core policy implication is suggested to emphasize digital skill in education and training across occupations to accommodate job requirements in the future.

PMID:36346798 | DOI:10.1371/journal.pone.0277280

PLoS One. 2022 Nov 8;17(11):e0277309. doi: 10.1371/journal.pone.0277309. eCollection 2022.

ABSTRACT

BACKGROUND: Studies on insomnia in patients with ischemic stroke, particularly in the acute phase, are limited. The proportion of patients with sleep disturbance during the acute stroke period who are likely to develop insomnia in subacute and chronic stages of stroke is unknown. This study aimed to investigate the risk factors for sleep disturbance and the clinical course of the disease in patients with acute ischemic stroke.

METHODS: This prospective observational study included patients diagnosed with ischemic stroke between July 1, 2020, and October 31, 2021. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for insomnia and the eight-item Athens Insomnia Scale (CAIS-8) were used to diagnose insomnia. Beck Depression Inventory (BDI) was applied to evaluate the mood of patients. Patient reported their sleeping conditions, before stroke onset and during the acute (within 7 days) and chronic (3 months after presentation) stroke periods.

RESULTS: In total, 195 patients with ischemic stroke were included in this study. Of these, 34.3% (67), 37.4% (73), and 29.7% (58) presented with sleep disturbance before stroke onset and during the acute and chronic stroke periods, respectively. Of the 128 patients without insomnia before stroke onset, 15.6% (20/128) presented with insomnia symptoms 3 months after stroke onset. Moreover, 13 (12.7%) of the 102 patients without sleep disturbance during the acute stroke period developed insomnia 3 months after stroke onset. Of the 67 patients with insomnia before stroke onset 29 (43.3%) did not develop the condition 3 months after stroke onset. A higher risk of sleep disturbance was associated with atrial fibrillation, hypertension, and mood disturbance in the acute stroke period, and a higher risk of insomnia was associated with low education and mood disturbance in the chronic stroke period.

CONCLUSION: The prevalence rates of sleep disturbance before and during the acute and chronic stroke periods were 34.3%, 37.4%, and 29.7%, respectively. The incidence of stroke-related insomnia was 15.6%. Patients with insomnia before stroke may recover after the stroke. Atrial fibrillation, hypertension, and mood disturbance were associated with a higher risk of sleep disturbance in the acute stroke period, whereas low education and mood disturbance were associated with insomnia in the chronic stroke period.

PMID:36346797 | DOI:10.1371/journal.pone.0277309

PLoS One. 2022 Nov 8;17(11):e0277210. doi: 10.1371/journal.pone.0277210. eCollection 2022.

ABSTRACT

In this paper, we present evidence from a lab-in-the-field experiment of the effects of the Chinese one-child policy on adults in China who were born just before and after the introduction of the policy. We measure risk, uncertainty, and time preferences, as well as subjects’ preferences in the social domain, i.e., concerning competitiveness, cooperation, and bargaining. We sampled people from three Chinese provinces born both before and after the introduction of the policy in 1979. We utilize the fact that the one-child policy was introduced at different times and with different degrees of strictness in different provinces. Overall, we find a statistically significant effect only on risk and uncertainty aversion and not on any other preferences in the experiments: Those born after the introduction of the one-child policy are less risk and uncertainty averse. These results hold for various robustness checks and heterogeneity tests. Hence, our results do not confirm the general wisdom and stereotype of only-children in China being “little emperors.”

PMID:36346790 | DOI:10.1371/journal.pone.0277210

PLoS One. 2022 Nov 8;17(11):e0276813. doi: 10.1371/journal.pone.0276813. eCollection 2022.

ABSTRACT

INTRODUCTION: The receptor activator NF-κB ligand (RANKL) and Osteoprotegrin (OPG) single nucleotide polymorphisms (SNPs) have been associated with the risk of breast cancer to bone metastasis. This study was designed to investigate the association of RANKL and OPG gene polymorphisms with breast to bone metastasis in Pashtun population of Khyber Pakhtunkhwa, Pakistan.

MATERIALS AND METHODS: A total of 215 participants were enrolled containing 106 breast cancer patients, 58 breast to bone metastasis and 51 age and gender matched healthy controls. RANKL (rs9533156) and OPG (rs2073618, rs3102735) polymorphisms were genotyped in genomic DNA, using Tetra-ARMS PCR protocol. The results were analyzed among the three groups and P-value less then 0.05 were considered statistically significant.

RESULTS: Our results displayed significant association of OPG (rs3102735) risk allele and corresponding genotypes in breast cancer vs healthy controls, bone metastasis vs healthy controls and breast cancer vs breast to bone metastasis as a disease risk. However, there was no association observed for OPG (rs2073618) risk allele and corresponding genotypes with the diseases risk. Similarly, RANKL (rs9533156) risk allele and corresponding genotypes in breast cancer vs healthy controls, bone metastasis vs healthy controls and breast cancer vs breast to bone metastasis exhibited significant association except for the risk allele carrying genotypes in breast to bone metastasis.

CONCLUSION: OPG (rs3102735) and RANKL (rs9533156) exhibited significant association with breast to bone metastasis while OPG (rs2073618) didn’t show significant association with breast to bone metastasis in Pashtun population of Pakistan. However, this study unlocks more questions to investigate the exact scenario of genetic predisposition of breast to bone metastasis.

PMID:36346787 | DOI:10.1371/journal.pone.0276813

PLoS One. 2022 Nov 8;17(11):e0277340. doi: 10.1371/journal.pone.0277340. eCollection 2022.

ABSTRACT

Due to the high prevalence of patients attending with urinary tract infection (UTI) symptoms, the use of flow-cytometry as a rapid screening tool to avoid unnecessary cultures is becoming a widely used system in clinical practice. However, the recommended cut-points applied in flow-cytometry systems differ substantially among authors, making it difficult to obtain reliable conclusions. Here, we present FlowUTI, a shiny web-application created to establish optimal cut-off values in flow-cytometry for different UTI markers, such as bacterial or leukocyte counts, in urine from patients with UTI symptoms. This application provides a user-friendly graphical interface to perform robust statistical analysis without a specific training. Two datasets are analyzed in this manuscript: one composed of 204 urine samples from neonates and infants (≤3 months old) attended in the emergency department with suspected UTI; and the second dataset including 1174 urines samples from an elderly population attended at the primary care level. The source code is available on GitHub (https://github.com/GuillermoMG-HUVR/Microbiology-applications/tree/FlowUTI/FlowUTI). The web application can be executed locally from the R console. Alternatively, it can be freely accessed at https://covidiario.shinyapps.io/flowuti/. FlowUTI provides an easy-to-use environment for evaluating the efficiency of the urinary screening process with flow-cytometry, reducing the computational burden associated with this kind of analysis.

PMID:36346782 | DOI:10.1371/journal.pone.0277340