Tag: statistics

Trans R Soc Trop Med Hyg. 2022 Feb 26:trac008. doi: 10.1093/trstmh/trac008. Online ahead of print.

ABSTRACT

BACKGROUND: Thrombocytopenia is a marker of severity in dengue, and its resolution predicts clinical improvement. The objective was to evaluate mean platelet volume (MPV) trajectories as a predictor of platelet count (PC) recovery in dengue patients.

METHODS: An observational, longitudinal and analytical study was conducted at Fundación Valle del Lili (Cali, Colombia). Patients diagnosed with dengue during 2016-2020 were included. The association between PC and the covariates was evaluated using simple linear, quadratic and non-parametric spline smoothing regression models. A longitudinal linear mixed model was adjusted and then validated for PC measurements.

RESULTS: A total of 71 patients were included. The median age was 27 y, 38.5% were women and half had dengue with warning signs. A statistically significant PC decrease was observed when MPV was 13.87 fL and 4.46 d from the onset of symptoms, while PC displayed a significant constant increase with neutrophils count. Then, PC recovery was achieved with an MPV of 13.58 fL, 4.5 d from the onset of symptoms and a minimum neutrophils count of 150 μL.

CONCLUSION: MPV may be a predictor of PC recovery in dengue patients. PC recovery is expected when a patient has an MPV of 13.58 fL, an onset time of 4.5 d and a neutrophils count of 150 μL.

PMID:35220437 | DOI:10.1093/trstmh/trac008

Hum Reprod. 2022 Feb 27:deac032. doi: 10.1093/humrep/deac032. Online ahead of print.

ABSTRACT

STUDY QUESTION: In a country with supportive funding for medically assisted reproduction (MAR) technologies, what is the proportion of MAR births over-time?

SUMMARY ANSWER: In 2017, 6.7% of births were conceived by MAR (4.8% ART and 1.9% ovulation induction (OI)/IUI) with a 55% increase in ART births and a stable contribution from OI/IUI births over the past decade.

WHAT IS KNOWN ALREADY: There is considerable global variation in utilization rates of ART despite a similar infertility prevalence worldwide. While the overall contribution of ART to national births is known in many countries because of ART registries, very little is known about the contribution of OI/IUI treatment or the socio-demographic characteristics of the parents. Australia provides supportive public funding for all forms of MAR with no restrictions based on male or female age, and thus provides a unique setting to investigate the contribution of MAR to national births as well as the socio-demographic characteristics of parents across the different types of MAR births.

STUDY DESIGN, SIZE, DURATION: This is a novel population-based birth cohort study of 898 084 births using linked ART registry data and administrative data including birth registrations, medical services, pharmaceuticals, hospital admissions and deaths. Birth (a live or still birth of at least one baby of ≥400 g birthweight or ≥20 weeks’ gestation) was the unit of analysis in this study. Multiple births were considered as one birth in our analysis.

PARTICIPANTS/MATERIALS, SETTING, METHODS: This study included a total of 898 084 births (606 488 mothers) in New South Wales and the Australian Capital Territory, Australia 2009-2017. We calculated the prevalence of all categories of MAR-conceived births over the study period. Generalized estimating equations were used to examine the association between parental characteristics (parent’s age, parity, socio-economic status, maternal country of birth, remoteness of mother’s dwelling, pre-existing medical conditions, smoking, etc.) and ART and OI/IUI births relative to naturally conceived births.

MAIN RESULTS AND THE ROLE OF CHANCE: The proportion of MAR births increased from 5.1% of all births in 2009 to 6.7% in 2017, representing a 30% increase over the decade. The proportion of OI/IUI births remained stable at around 2% of all births, representing 32% of all MAR births. Over the study period, ART births conceived by frozen embryo-transfer increased nearly 3-fold. OI/IUI births conceived using clomiphene citrate decreased by 39%, while OI/IUI births conceived using letrozole increased 56-fold. Overall, there was a 55% increase over the study period in the number of ART-conceived births, rising to 56% of births to mothers aged 40 years and older. In 2017, almost one in six births (17.6%) to mothers aged 40 years and over were conceived using ART treatment. Conversely, the proportion of OI/IUI births was similar across different mother’s age groups and remained stable over the study period. ART children, but not OI/IUI children, were more likely to have parents who were socio-economically advantaged compared to naturally conceived children. For example, compared to naturally conceived births, ART births were 16% less likely to be born to mothers who live in the disadvantaged neighbourhoods after accounting for other covariates (adjusted relative risk (aRR): 0.84 [95% CI: 0.81-0.88]). ART- or OI/IUI-conceived children were 25% less likely to be born to immigrant mothers than births after natural conception (aRR: 0.75 [0.74-0.77]).

LIMITATIONS, REASONS FOR CAUTION: The social inequalities that we observed between the parents of children born using ART and naturally conceived children may not directly reflect disparities in accessing fertility care for individuals seeking treatment.

WIDER IMPLICATIONS OF THE FINDINGS: With the ubiquitous decline in fertility rates around the world and the increasing trend to delay childbearing, this population-based study enhances our understanding of the contribution of different types of MARs to population profiles among births in high-income countries. The parental socio-demographic characteristics of MAR-conceived children differ significantly from naturally conceived children and this highlights the importance of accounting for such differences in studies investigating the health and development of MAR-conceived children.

STUDY FUNDING/COMPETING INTEREST(S): This study was funded through Australian National Health and Medical Research Council (NHMRC) grant: APP1127437. G.M.C. is an employee of The University of New South Wales (UNSW) and Director of the National Perinatal Epidemiology and Statistics Unit (NPESU), UNSW. The NPESU manages the Australian and New Zealand Assisted Reproduction Database with funding support from the Fertility Society of Australia and New Zealand. C.V. is an employee of The University of New South Wales (UNSW), Director of Clinical Research of IVFAustralia, Member of the Board of the Fertility Society of Australia and New Zealand, and Member of Research Committee of School of Women’s and Children’s Health, UNSW. C.V. reports grants from Australian National Health and Medical Research Council (NHMRC), and Merck KGaA. C.V. reports consulting fees, and payment or honoraria for lectures, presentations, speakers, bureaus, manuscript, writing or educational events or attending meeting or travel from Merck, Merck Sparpe & Dohme, Ferring, Gedon-Richter and Besins outside this submitted work. C.V. reported stock or stock options from Virtus Health Limited outside this submitted work. R.J.N. is an employee of The University of Adelaide, and Chair DSMC for natural therapies trial of The University of Hong Kong. R.J.N. reports grants from NHMRC. R.J.N. reports lecture fees and support for attending or travelling for lecture from Merck Serono which is outside this submitted work. L.R.J. is an employee of The UNSW and Foundation Director of the Centre for Big Data Research in Health at UNSW Sydney. L.R.J. reports grants from NHMRC. The other co-authors have no conflict of interest.

TRIAL REGISTRATION NUMBER: N/A.

PMID:35220435 | DOI:10.1093/humrep/deac032

Int J Health Policy Manag. 2022 Feb 20. doi: 10.34172/ijhpm.2022.6127. Online ahead of print.

ABSTRACT

BACKGROUND: Front-of-pack nutrition labels (FoPLs) aim at increasing transparency and consumers’ awareness of the nutritional composition of pre-packed food products in order to improve the nutritional quality of their food choices. Nevertheless, the legitimacy of the Nutri-Score – the FoPL officially adopted in France and several other European countries – is subject to both technical and political controversy, particularly in Italy. In this study, we investigated how and by whom the legitimacy of the Nutri-Score, recognized by several institutional authorities, could be deconstructed within a specific system of norms, values and beliefs among Italian stakeholders.

METHODS: A netnography completed with qualitative interviews with eight Italian and French nutrition and public health experts were carried out to highlight the dimensions (pragmatic, normative and cognitive) in which the Nutri-Score’s legitimacy is being challenged among the stakeholders involved in FoPLs’ implementation in Italy. The degree of influence and the position of these stakeholders on the debate around the Nutri-Score were assessed through the Stakeholder Theory (SHT), using their respective level of power, legitimacy and urgency. Furthermore, we compared the Italian and the French contexts on the issue.

RESULTS: The direct implication of political parties and media outlets in framing the Italian debate around Nutri-Score as well as the high influence of corporate unions, led to a different political outcome than in France. Results also show that the deconstruction of the legitimacy of the Nutri-Score in Italy pertained mainly to its pragmatic dimension according to the Italian public health experts. Nevertheless, its two other dimensions (normative and cognitive) are also questioned by high-influence stakeholders.

CONCLUSION: Due to the limited mobilization of scientific expertise over the issue, the debate in Italy stayed centered around the “attack” of the Nutri-Score to the Italian way of life, mixing up concepts such as Made in Italy products and the Mediterranean diet.

PMID:35219283 | DOI:10.34172/ijhpm.2022.6127

Psychiatry Res. 2022 Feb 20;310:114466. doi: 10.1016/j.psychres.2022.114466. Online ahead of print.

ABSTRACT

BACKGROUND: Epidemiological studies have linked prenatal tobacco and alcohol exposures to internalizing behaviours in children and adolescents with inconsistent findings. Dearth of epidemiological studies have investigated the associations with the risk of experiencing symptoms of anxiety in young adulthood.

METHODS: Study participants (N = 1190) were from the Raine Study, a population-based prospective birth cohort based in Perth, Western Australia. Data on prenatal tobacco and alcohol exposures were available for the first and third trimesters of pregnancy. Experiencing symptoms of anxiety in young adulthood at age 20 years was measured by a short form of the Depression Anxiety Stress Scale (DASS 21). Relative risk (RR) of experiencing symptoms of anxiety in young adulthood for prenatal tobacco and alcohol exposures were estimated with log binomial regression.

RESULTS: After adjusting for potential confounders, we observed increased risks of experiencing symptoms of anxiety in young adults exposed to prenatal tobacco in the first trimester [RR = 1.52, 95% CI: 1.12-2.06, p-value < 0.01] and third trimester [RR = 1.53, 95% CI: 1.10-2.13, p-value = 0.02]. However, we found insufficient statistical evidence for an association between first trimester [RR = 1.01, 95% CI: 0.76-1.22, p-value = 0.90] and third trimester [RR = 1.03, 95% CI: 0.80-1.34, p-value = 0.91] prenatal exposure to alcohol and the risk of experiencing symptoms of anxiety in young adults. There was a dose response association between prenatal tobacco exposure and increasing anxiety symptoms in offspring.

CONCLUSION: The findings of this study suggest that an association between prenatal tobacco exposure and risk of anxiety symptoms remains apparent into young adulthood.

PMID:35219268 | DOI:10.1016/j.psychres.2022.114466

Spectrochim Acta A Mol Biomol Spectrosc. 2022 Feb 19;273:121063. doi: 10.1016/j.saa.2022.121063. Online ahead of print.

ABSTRACT

The realm of spectrophotometric analysis has witnessed a remarkable progress in inventing faster and simpler resolution techniques for spectrally overlapping drug mixtures. Eco-friendly and progressive spectrophotometric methods were firstly developed in this work, for the simultaneous determination of Dutasteride (DUT) and Silodosin (SLD) in their newly-marketed dosage form. The proposed methods focused on the unique spectral features of this mixture including spectral extension of SLD over DUT spectrum as well as existence of iso-absorptive points. By such way, the methods were classified into two categories; the first one was “fingerprint resolution techniques” including constant extraction coupled with spectrum subtraction and ratio subtraction coupled with constant multiplication methods. The former represented a new modification to the classical constant extraction method where one divisor and lower steps were manipulated instead. The second category was “iso-absorptive resolution techniques”, such as absorptivity centering, absorbance subtraction and amplitude modulation methods. Different solvents were investigated where ethanol was found to be the optimum one regarding drugs solubility, signal sensitivity and environmental, health & safety (EHS) score. Validity of the suggested methods was assessed as per ICH-guidelines and found to be linear over concentration ranges of 5.0-90.0 µg/mL for DUT and 5.0-120.0 µg/mL for SLD. The methods were successfully applied for quantifying the cited drugs in their combined dosage form and evaluating their content uniformity. Moreover, the insignificant statistical difference between the proposed methods and official HPLC ones encourages the utilization of such spectrophotometric methods as greener and faster candidates, especially in modest quality control laboratories. Methods’ greenness profile was finally guaranteed through several assessment tools, namely; national environmental methods index (NEMI), analytical eco-scale, green analytical procedure index (GAPI) and analytical greenness (AGREE) metric.

PMID:35219273 | DOI:10.1016/j.saa.2022.121063

Diabetes Metab Syndr. 2022 Feb 18;16(3):102428. doi: 10.1016/j.dsx.2022.102428. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Underweight and overweight/obesity is a critical public health problem among women in South Asian countries. This study aimed to find the prevalence of underweight and overweight/obesity and discover its associated factors among women of reproductive age in four South Asian countries.

METHODS: Population-representative cross-sectional latest Demographic and Health Survey data from four South Asian countries, considering Bangladesh (2017-18), Maldives (2016-17), Nepal (2016), and Pakistan (2017-18), were pooled for this study. To investigate the factors related with underweight and overweight/obesity in women, a multivariate multinomial logistic regression model was deployed.

RESULTS: The overall prevalence of underweight and overweight/obesity among reproductive-age women in four South Asian countries was 11.8% and 36.3%, respectively. According to adjusted multivariate multinomial logistic regression analysis, women who lived in Pakistan, were older, had a better education, were from the wealthiest home, were currently in union and had media exposure had a considerably decreased probability of being underweight. In contrast, families with a large number of members had a considerably increased risk of becoming underweight. Additionally, women from the Maldives, older age, secondary education, a higher number of children, women from the richest household, currently in the union, the family had media exposure, and pregnant women have been found significantly positively associated with overweight/obesity. However, Nepalese women, large family members, rural residence, and work involvement were significantly negatively associated with overweight/obesity.

CONCLUSION: The problem of being underweight and overweight/obesity still exists in South Asian countries. Focusing on women’s age, education, wealth index, and media exposure, different public health intervention approaches are imperative to reduce unhealthy weight conditions.

PMID:35219260 | DOI:10.1016/j.dsx.2022.102428

Waste Manag. 2022 Feb 23;143:35-45. doi: 10.1016/j.wasman.2022.02.018. Online ahead of print.

ABSTRACT

Municipal solid waste (MSW) composting is one of the most effective strategies for MSW management but detrimental litter such as plastic and glass debris must be discarded elsewhere. Well-segregated wastes are necessary in this context. A compost bin is a waste collection tool for source separation. To date, the deployment of compost bins for source separation has received scant investigation. This study investigated the effects of compost bin design in terms of user design preferences, waste collection and sorting execution, and segregation behavior. The study comprised a survey and an on-site experiment. Design preferences of nine designed compost bins were evaluated by surveying 400 respondents using the pairwise comparison method. It was revealed that design preference was determined by bin shape and slot position. On-site experiments were conducted to establish collection rate, contamination rate, capture rate, and effective capture rate under different conditions. Under the experimental conditions, better segregation rates were observed in comparison with the control condition. The contamination rate was reduced by 55.9%. The capture rate and the effective capture rate were increased by 8.90%, and 53.4%, respectively. The significant effects of design preferences, physical designs, visual prompts, and past behavior were identified via statistical methods. Source-separated waste collection can be improved through preferred compost bin adoption, enhanced design, appropriate visual prompts, and experience in waste segregation. Therefore, the findings of this study will help to generate effective source-separated collection and allow compost bins to be placed in public areas for integrated and sustainable waste management.

PMID:35219254 | DOI:10.1016/j.wasman.2022.02.018

Ecotoxicol Environ Saf. 2022 Feb 23;233:113332. doi: 10.1016/j.ecoenv.2022.113332. Online ahead of print.

ABSTRACT

Petrochemical industry is a key industry of soil pollution, which presents great effects on human health and the ecological environment. It is of great significance to achieve rapid, economic and efficient health risk identification for petrochemical industry in China. In this work, an efficient method was developed based on extreme gradient boosting (XGBoost) algorithm for human health risk identification, which is different from the traditional health risk assessment with complicated procedures. In this methodology, an index system of 13 indicators was established from the perspective of “sources – pathways – receptors” for risk identification. The 10-fold cross validation was used to assess the generalization performance, and the accuracy, precision and recall were employed to evaluate the performance of the algorithms. Wilcoxon signed-rank test was conducted to analyze the differences between XGBoost and other models for statistical support. The results showed that XGBoost significantly presented a better performance for health risk identification over multilayer perceptron neural network with error backpropagation training (BPNN), support vector machine (SVM), gradient boosting decision tree (GBDT) and light gradient boosting machine (LightGBM), with an accuracy of 0.783. The most important features contributing to the risk identification were determined with the sequence of site location (in the industrial zone or not), site planning and production period. Great attention should be given to the petrochemical sites that are not located in the industrial zone with long production period and sensitive receptors in the health risk identification. This method has important reference significance for relevant departments to carry out soil contamination screening and health risk assessment of petrochemical sites.

PMID:35219256 | DOI:10.1016/j.ecoenv.2022.113332

J Surg Res. 2022 Feb 23;275:35-42. doi: 10.1016/j.jss.2022.01.018. Online ahead of print.

ABSTRACT

INTRODUCTION: Multiple factors signifying higher social vulnerability, including lower socioeconomic status and minority race, have been associated with presentation with complicated appendicitis (CA). In this study, we compared the Social Vulnerability Index (SVI) of our population by appendicitis severity (uncomplicated appendicitis [UA] versus CA). We hypothesized that SVI would be similar between patients with UA and CA presenting to our institution, a safety-net hospital in a state with high healthcare insurance coverage.

METHODS: We included all patients at our hospital aged 18 y and older who underwent appendectomy for acute appendicitis between 2012 and 2016. SVI values were determined based on the 2010 census data using ArcMap software. We used nonparametric univariate statistics to compare the SVI of patients with CA versus UA and multivariable regression to model the likelihood of operative CA.

RESULTS: A total of 997 patients met inclusion criteria, of which 177 had CA. The median composite SVI score for patients with CA was lower than for patients with UA (80% versus 83%, P = 0.004). UA was associated with higher socioeconomic (83% versus 80%, P = 0.007), household/disability (68% versus 55%, P = 0.037), and minority/language SVI scores (91% versus 89%, P = 0.037). On multivariable analysis controlling for age, sex, ethnicity, insurance status, relevant comorbidities, and chronicity of symptoms, there was an inverse association between SVI and the likelihood of CA (odds ratio 0.59, 95% confidence interval 0.4-0.87, P = 0.008).

CONCLUSIONS: In the setting of high healthcare insurance and a medical center experienced in caring for vulnerable populations, patients presenting with UA have a higher composite SVI, and thus greater social vulnerability, than patients presenting with CA.

PMID:35219249 | DOI:10.1016/j.jss.2022.01.018

Mult Scler Relat Disord. 2022 Feb 19;60:103692. doi: 10.1016/j.msard.2022.103692. Online ahead of print.

ABSTRACT

BACKGROUND: Cognitive impairment is frequent in multiple sclerosis (MS), but reliable, sensitive and individualized monitoring in clinical practice is still limited. Smartphone-adapted tests may enhance the assessment of function as tests can be performed more frequently and within the daily living environment. The objectives were to prove reproducibility of a smartphone-based Symbol Digit Modalities Test (sSDMT), its responsiveness to relevant change in clinical cognitive outcomes, and develop an individual-based monitoring method for cognition.

METHODS: In a one-year cohort study with 102 patients with MS, weekly sSDMTs were performed and analyzed on reproducibility parameters: the standard error of measurement (SEM) and smallest detectable change (SDC). Responsiveness of the sSDMT to relevant change in the 3-monthly clinically assessed SDMT (i.e. 4-point change) was quantified with the area under the receiver operating characteristic curve (AUC). Curve fitting of the weekly sSDMT scores of individual patients was performed with a local linear trend model to estimate and visualize the de-noised cognitive state and 95% confidence interval (CI). The optimal assessment frequency was determined by analyzing the CI bandwidth as a function of sSDMT assessment frequency.

RESULTS: Weekly sSDMT showed improved reproducibility estimates (SEM=2.94, SDC=8.15) compared to the clinical SDMT. AUC-values did not exceed 0.70 in classifying relevant change in cSDMT. However, utilizing weekly sSDMT measurements, estimated state curves and the 95% CI were plotted showing detailed changes within individuals over time. With a test frequency of once per 12 days, 4-point changes in sSDMT can be detected.

CONCLUSION: A local linear trend model applied on sSDMT scores of individual patients increases the signal-to-noise ratio substantially, which improves the detection of statistically reliable changes. Therefore, this fine-grained individual-based monitoring approach can be used to complement current clinical assessment to enhance clinical care in MS.

TRIAL REGISTRATION: Netherlands Trial Register NL7070; https://www.trialregister.nl/trial/7070.

PMID:35219240 | DOI:10.1016/j.msard.2022.103692