Tag: statistics

PLoS One. 2021 Nov 11;16(11):e0259780. doi: 10.1371/journal.pone.0259780. eCollection 2021.

ABSTRACT

Amazonia and the Northeast region of Brazil exhibit the highest levels of climate vulnerability in the country. While Amazonia is characterized by an extremely hot and humid climate and hosts the world largest rainforest, the Northeast is home to sharp climatic contrasts, ranging from rainy areas along the coast to semiarid regions that are often affected by droughts. Both regions are subject to extremely high temperatures and are susceptible to many tropical diseases. This study develops a multidimensional Extreme Climate Vulnerability Index (ECVI) for Brazilian Amazonia and the Northeast region based on the Alkire-Foster method. Vulnerability is defined by three components, encompassing exposure (proxied by seven climate extreme indicators), susceptibility (proxied by sociodemographic indicators), and adaptive capacity (proxied by sanitation conditions, urbanization rate, and healthcare provision). In addition to the estimated vulnerability levels and intensity, we break down the ECVI by indicators, dimensions, and regions, in order to explore how the incidence levels of climate-sensitive infectious and parasitic diseases correlate with regional vulnerability. We use the Grade of Membership method to reclassify the mesoregions into homoclimatic zones based on extreme climatic events, so climate and population/health data can be analyzed at comparable resolutions. We find two homoclimatic zones: Extreme Rain (ER) and Extreme Drought and High Temperature (ED-HT). Vulnerability is higher in the ED-HT areas than in the ER. The contribution of each dimension to overall vulnerability levels varies by homoclimatic zone. In the ER zone, adaptive capacity (39%) prevails as the main driver of vulnerability among the three dimensions, in contrast with the approximately even dimensional contribution in the ED-HT. When we compare areas by disease incidence levels, exposure emerges as the most influential dimension. Our results suggest that climate can exacerbate existing infrastructure deficiencies and socioeconomic conditions that are correlated with tropical disease incidence in impoverished areas.

PMID:34762688 | DOI:10.1371/journal.pone.0259780

PLoS One. 2021 Nov 11;16(11):e0259577. doi: 10.1371/journal.pone.0259577. eCollection 2021.

ABSTRACT

BACKGROUND: Emergency department (ED) crowding is a frequent situation. To decrease this overload, patients without a life-threating condition are transferred to wards that offer ED support. This study aimed to evaluate if implementing a rapid response team (RRT) triggered by the modified early warning score (MEWS) in high-risk wards offering ED support is associated with decreased in-hospital mortality rate.

METHODS: A before-and-after cross-sectional study compared in-hospital mortality rates before and after implementation of an RRT triggered by the MEWS ≥4 in two wards of a tertiary hospital that offer ED support.

RESULTS: We included 6863 patients hospitalized in these wards before RRT implementation from July 2015 through June 2017 and 6944 patients hospitalized in these same wards after RRT implementation from July 2018 through June 2020. We observed a statistically significant decrease in the in-hospital mortality rate after intervention, 449 deaths/6944 hospitalizations [6.47% (95% confidence interval (CI) 5.91%- 7.07%)] compared to 534 deaths/6863 hospitalizations [7.78% (95% CI 7.17-8.44)] before intervention; with an absolute risk reduction of -1.31% (95% CI -2.20 –0.50).

CONCLUSION: RRT trigged by the MEWS≥4 in high-risk wards that offer ED support was found to be associated with a decreased in-hospital mortality rate. A further cluster-randomized trial should evaluate the impact of this intervention in this setting.

PMID:34762677 | DOI:10.1371/journal.pone.0259577

PLoS One. 2021 Nov 11;16(11):e0259793. doi: 10.1371/journal.pone.0259793. eCollection 2021.

ABSTRACT

With the development of economic integration, Beijing has become more closely connected with surrounding areas, which gradually formed the Beijing metropolitan area (BMA). The authors define the scope of BMA from two dimensions of space and time. BMA is determined to be the built-up area of Beijing and its surrounding 10 districts. Designed questionnaire survey the personal characteristics, family characteristics, and travel characteristics of residents from 10 districts in the surrounding BMA. The statistical analysis of questionnaires shows that the supply of public transportation is insufficient and cannot meet traffic demand. Further, the travel mode prediction model of Softmax regression machine learning algorithm for BMA (SRBM) is established. To further verify the prediction performance of the proposed model, the Multinomial Logit Model (MNL) and Support Vector Machine (SVM), model are introduced to compare the prediction accuracy. The results show that the constructed SRBM model exhibits high prediction accuracy, with an average accuracy of 88.35%, which is 2.83% and 18.11% higher than the SVM and MNL models, respectively. This article provides new ideas for the prediction of travel modes in the Beijing metropolitan area.

PMID:34762681 | DOI:10.1371/journal.pone.0259793

PLoS One. 2021 Nov 11;16(11):e0259139. doi: 10.1371/journal.pone.0259139. eCollection 2021.

ABSTRACT

An understanding of the types of shocks that disrupt and negatively impact urban household food security is of critical importance to develop relevant and targeted food security emergency preparedness policies and responses, a fact magnified by the current COVID-19 pandemic. This gap is addressed by the current study which draws from the Hungry Cities Partnership (HCP) city-wide household food insecurity survey of Nairobi city in Kenya. It uses both descriptive statistics and multilevel modelling using General Linear Mixed Models (GLMM) to examine the relationship between household food security and 16 different shocks experienced in the six months prior to the administration of the survey. The findings showed that only 29% of surveyed households were completely food secure. Of those experiencing some level of food insecurity, more experienced economic (55%) than sociopolitical (16%) and biophysical (10%) shocks. Economic shocks such as food price increases, loss of employment, and reduced income were all associated with increased food insecurity. Coupled with the lack of functioning social safety nets in Nairobi, households experiencing shocks and emergencies experience serious food insecurity and related health effects. In this context, the COVID-19 pandemic is likely to have a major negative economic impact on many vulnerable urban households. As such, there is need for new policies on urban food emergencies with a clear emergency preparedness plan for responding to major economic and other shocks that target the most vulnerable.

PMID:34762674 | DOI:10.1371/journal.pone.0259139

PLoS One. 2021 Nov 11;16(11):e0259377. doi: 10.1371/journal.pone.0259377. eCollection 2021.

ABSTRACT

This study establishes a new method for estimating the monthly Average Population Present (APP) in Australian regions. Conventional population statistics, which enumerate people where they usually live, ignore the significant spatial mobility driving short term shifts in population numbers. Estimates of the temporary or ambient population of a region have several important applications including the provision of goods and services, emergency preparedness and serve as more appropriate denominators for a range of social statistics. This paper develops a flexible modelling framework to generate APP estimates from an integrated suite of conventional and novel data sources. The resultant APP estimates reveal the considerable seasonality in small area populations across Australia’s regions alongside the contribution of domestic and international visitors as well as absent residents to the observed monthly variations. The modelling framework developed in the paper is conceived in a manner such that it can be adapted and re-deployed both for use with alternative data sources as well as other situational contexts for the estimation of temporary populations.

PMID:34762671 | DOI:10.1371/journal.pone.0259377

Panminerva Med. 2021 Nov 11. doi: 10.23736/S0031-0808.21.04573-0. Online ahead of print.

ABSTRACT

BACKGROUND: Few studies compared paclitaxel-coated balloon (PCB) versus sirolimus-coated balloon (SCB) in the treatment of drug-eluting stent (DES) instent restenosis (ISR).

METHODS: Between November 5 2009 and October 14 2020, in our centre 212 patients with first DES-ISR were treated with PCB (Restore®; Cardionovum GmbH, Bonn, Germany), whereas 230 patients were treated with SCB (Devoir®; MINVASYS SAS, Gennevilliers, France). Following a propensity matching, 186 patients were included into PCB group (PCB group), and in the SCB group (SCB group). The primary purpose of the study was the 1-year target lesion failure (TLF) rate, including cardiac death, target vessel-related myocardial infarction, and repeated target lesion or target vessel revascularization.

RESULTS: Procedural success occurred in all cases. Fully optimal predilation (that is, balloon-to-stent ratio >0.91, time of DCB inflation >60 sec. and residual percent diameter stenosis after lesion preparation <20%) was observed more often in the SCB group (126 [68%] patients versus 106 [57%] patients; p = 0.042). One year TLF occurred in 29 (15.5%) patients in the SCB group and in 32 (17%) patients in the PCB group (OR = 1.12 [0.65-1.95]; p = 0.78). By logistic Cox regression analysis fully optimal predilation (OR = 0.06; 95% confidence interval = 0.01-0.21; p <0.001) but not DCB type (OR = 0.74; 95% confidence interval = 0.41-1.31; p = 0.29) was independent predictor of 1-year TLF.

CONCLUSIONS: The current study suggests that 1-year TLF is not statistically and clinically different in patients with DES ISR treated with a PCB and a SCB.

PMID:34761888 | DOI:10.23736/S0031-0808.21.04573-0

Minerva Med. 2021 Nov 11. doi: 10.23736/S0026-4806.21.07665-5. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of the present study was to investigate the possible correlation between various inflammation-nutritional scores to histological determined Non-Alcoholic Steatohepatitis (NASH) and other liver injury suggestive for Non-Alcoholic Fatty Liver Disease (NAFLD) in a bariatric population.

METHODS: We evaluated consecutively and retrospectively all the patients referred to the department of bariatric surgery in Trieste, Italy. Inflammation-nutritional scores were calculated starting from pre-operative hematologic data. Liver biopsy was performed at the time of bariatric surgery (sleeve gastrectomy or gastric bypass) and pathological assessment was performed using Kleiner-Brunt staging system (NAS score).

RESULTS: Glasgow Prognostic Score/modified Glasgow Prognostic Score (GPS/ mGPS) and Prognostic Index (PI) were associated to the diagnosis of NASH (p= 0,024 and p=0,03 respectively). The presence of perisinusoidal and/or periportal fibrosis was correlated to Prognostic Nutritional Index (PNI) and Platelet-to-Lymphocyte ratio (PLR) values (p=0,02 and p=0,009 respectively).

CONCLUSIONS: GPS/mGPS and PI are statistically associated to the histological diagnosis of NASH. Further studies on large series are needed to better understand the relationship between these serum markers and liver injury in obese patients.

PMID:34761883 | DOI:10.23736/S0026-4806.21.07665-5

Minerva Med. 2021 Nov 11. doi: 10.23736/S0026-4806.21.07894-0. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiac involvement significantly contributes to coronavirus disease 2019 (COVID-19)mortality.12-lead electrocardiogram (ECG) represents a fast, cheap, and easy to perform exam with the adjunctive advantage of the remote reporting possibility. In this study, we sought to investigate if electrocardiographic parameters are able to identify patients, deemed at low-risk at admission,who will face in-hospital unfavourable course.

METHODS: From March 1, 2020 through March 30, 2021, 384 consecutive patients with confirmed low-risk COVID-19 were hospitalized at the AziendaOspedalieroUniversitariaPoliclinico di Bari (Italy). Criteria for low-risk were: admission to the division of Pneumology or Infectious Diseases, no need for immediate (within 24 hours from admission) transfer to Intensive Care Unit or for respiratory support with invasive mechanical ventilation (IMV) or for circulation support (either mechanical or pharmacological). Admission ECGs were reviewed and interpreted by two expert cardiologists. The primary outcomes were in-hospital death and the composite outcome of in-hospitaldeath and IMV.

RESULTS: In low-risk COVID-19 patients, atrial fibrillation (AF), poor R wave progression (PRWP), tachycardia, and right bundle branch block (RBBB) resulted as statistically significant and independent predictors of in-hospital all-cause mortality; AF, PRWP, Tachycardia, RBBB, and corrected QT interval showed to be statistically significant and independent risk factors for the occurrence of the composite endpoint of death and IMV.

CONCLUSIONS: Our study demonstrated for the first time that RBBB and PRWP, assessed upon admission with ECG, are associated with unfavourable clinical course in a baseline low-risk population hospitalized for COVID-19.

PMID:34761885 | DOI:10.23736/S0026-4806.21.07894-0

Aust N Z J Public Health. 2021 Nov 11. doi: 10.1111/1753-6405.13159. Online ahead of print.

ABSTRACT

OBJECTIVE: This study assessed the effectiveness of a school-based intervention in reducing adolescents’ sugar-sweetened beverage (SSB) consumption and percentage of energy from SSBs. Secondary outcomes were SSB consumption within school, average daily energy intake, and body mass index z-scores.

METHODS: Six secondary schools located in New South Wales, Australia were recruited to participate in a six-month pilot randomised controlled trial (1:1). The intervention included components targeting the school nutrition environment, curricula and community. Outcomes were collected via online surveys, observations, anthropometric measurements and project records. Between-group differences were assessed via linear mixed models.

RESULTS: At the six-month intervention endpoint (n=862) there were no statistically significant differences between students in intervention or control schools for mean daily intake of SSBs (8.55mL; CI -26.77, 43.87; p=0.63), percentage daily energy from SSBs (0.12% kJ; CI -0.55, 0.80; p=0.72), or for secondary outcomes. Acceptability of the school-based strategies were high, however intervention fidelity varied across schools.

CONCLUSION: While acceptable, improving fidelity of implementation and increasing the duration or intensity of the intervention may be required to reduce SSB intake. Implications for public health: Engaging parents and education stakeholders in the development phase to co-design interventions may prove beneficial in improving intervention fidelity and enhance behavioural outcomes.

PMID:34761854 | DOI:10.1111/1753-6405.13159

Am J Bot. 2021 Nov 11. doi: 10.1002/ajb2.1803. Online ahead of print.

ABSTRACT

PREMISE OF THE STUDY: Relict species provide valuable insights into the origin and formation of extant vegetation. Here, we aimed to elucidate the genetic structure and diversity of a riparian relic Acer miyabei in Japan; this species used to have a wide distribution but now occurs in three isolated regions. The most northern regional group is located at low elevation on Hokkaido Island, whereas the southern group is at high elevation in a mountainous landscape. This contrastive distribution enables us to examine the effects of climate oscillations on genetic diversity in relation to topographic variation.

METHODS: We collected 604 individuals of A. miyabei from 43 sites. Their genetic structure and diversity were analyzed using 12 microsatellite markers and cpDNA sequences.

KEY RESULTS: According to STRUCTURE analyses, ∆K statistic was lowest at K = 2; the clustering essentially separated many of the individuals in the most northern regional group from the others. In contrast, the two southern groups were not clearly differentiated from each other, despite their geographic discontinuity. The proportion of private alleles was high in populations from mountain terrain in the southern group although the number of extant populations is limited.

CONCLUSIONS: Genetic clustering of A. miyabei is not perfectly congruent with the current patterns of geographic distribution. We infer that disjunction of the two southern groups occurred more recently than that between these groups and the northern group. Mountainous landscape in the most southern region likely provided multiple refugia and contributed to the retention of distinctive genetic variation. This article is protected by copyright. All rights reserved.

PMID:34761814 | DOI:10.1002/ajb2.1803