Tag: statistics

PLoS One. 2022 Feb 25;17(2):e0264441. doi: 10.1371/journal.pone.0264441. eCollection 2022.

ABSTRACT

INTRODUCTION: In 2014, the Joint United Nations Programme on HIV/AIDS set an ‘ambitious’ 90-90-90 target for 2020. By 2016, there were disparities observed among countries in their progress towards the targets and some believed the targets were not achievable. In this report, we present the results of data from the Ethiopia Population-based HIV Impact Assessment survey analyzed to assess progress with the targets and associated factors.

METHODS: We conducted a nationally representative survey in urban areas of Ethiopia. Socio-demographic and behavioural data were collected from consenting participants using a structured interview. HIV testing was done following the national HIV rapid testing algorithm and seropositivity confirmed using a supplemental laboratory assay. HIV viral suppression was considered if the viral load was <1,000 RNA copies/ml. Screening antiretroviral drugs was done for efavirenz, lopinavir, and tenofovir, which were in use during the survey period. In this analysis, we generated weighted descriptive statistics and used bivariate and logistic regression analysis to examine for associations. The 95% confidence interval was used to measure the precision of estimates and the significance level set at p<0.05.

RESULTS: Of 19,136 eligible participants aged 15-64 years, 614 (3% [95% CI: 0.8-3.3]) were HIV-positive, of which 79.0% (95% CI: 4.7-82.7) were aware of their HIV status, and 97.1% (95% CI: 95.0-98.3 were on antiretroviral therapy, of which 87.6% (95% CI: 83.9-90.5) achieved viral load suppression. Awareness about HIV-positive status was significantly higher among females (aOR = 2.8 [95% CI: 1.38-5.51]), significantly increased with age, the odds being highest for those aged 55-64 years (aOR = 11.4 [95% CI: 2.52-51.79]) compared to those 15-24 years, and was significantly higher among those who used condom at last sex in the past 12 months (aOR = 5.1 [95% CI: 1.68-15.25]). Individuals with secondary education and above were more likely to have achieved viral suppression (aOR = 8.2 [95% CI: 1.82-37.07]) compared with those with no education.

CONCLUSION: Ethiopia made encouraging progress towards the UNAIDS 90-90-90 targets. The country needs to intensify its efforts to achieve the targets. A particular focus is required to fill the gaps in knowledge of HIV-positive status to increase case identification among population groups such as males, the youth, and those with low education.

PMID:35213668 | DOI:10.1371/journal.pone.0264441

Hum Reprod. 2022 Feb 25:deac038. doi: 10.1093/humrep/deac038. Online ahead of print.

ABSTRACT

STUDY QUESTION: Which success rates do female and male IVF patients expect, what determines their expectations and do patients reconsider their expectations after receiving a personal IVF prognosis at the expense of anxious reactions?

SUMMARY ANSWER: Female and male IVF patients have unrealistic high expectations which are positively associated with their dispositional optimism, and which are only reconsidered by patients receiving a less than average IVF prognosis, which leads to more anxious reactions in females.

WHAT IS KNOWN ALREADY: Female patients undergoing IVF are known to have unrealistic expectations of the success of their own IVF cycle. The available evidence suggests women expect above average performance of their fertility clinic and (family) reproductive systems. The association of gender and personality trait dispositional optimism, with expectations of IVF success and the impact of providing couples with their IVF prognosis have not been studied previously.

STUDY DESIGN, SIZE, DURATION: A total of 148 partnered individuals participated in this prospective survey at two separate points in treatment: following oocyte aspiration (T1) and embryo transfer (T2) (2019-2020, participation rate = 85%). At the time of embryo transfer, gynaecologists provided couples with their IVF prognosis, calculated with the Adapted van Loendersloot model. Women and their male partners completed questionnaires independently and immediately following oocyte aspiration and embryo transfer.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Dispositional optimism (‘LOT-R’ questionnaire) and expectations of IVF success (numerical rating scale) were assessed in eligible couples commencing a 2nd-6th IVF cycle on T1. Expectations of IVF success and anxiety (‘Spielberger State-Anxiety Inventory’) were (re)assessed on T2. The inter-partner correlation of expectations of IVF success was examined. Linear mixed models examined hypothesized determinants of expectations of IVF success (T1) and explored (determinants of) whether participants reconsidered their expectations after receiving their IVF prognosis (T1-T2) and whether couple’s IVF prognosis was associated with anxious reactions (T2).

MAIN RESULTS AND THE ROLE OF CHANCE: The mean of the IVF success rates expected by patients immediately after oocyte aspiration was 59.1% (±20.0), irrespective of gender (P = 0.077). Partners expectations of IVF success were moderately correlated (r = 0.483; P < 0.001). Expectations of IVF success were positively associated with the participant’s dispositional optimism (P < 0.001) but were not associated with their partner’s dispositional optimism, women’s age and their previous (un)successful IVF experiences. Gynaecologists gave couples their calculated IVF prognosis ranging from 4.8% to 69.2% (mean = 30.9%) at the time of embryo transfer. Gender did not influence whether participants reconsidered their expectations after receiving their prognosis. In contrast to the subgroup (n = 78), who received at least an average IVF prognosis and that did not reconsider their expectations of IVF success, the subgroup (n = 70) receiving a below average IVF prognosis lowered their expectations of IVF success (interaction effect: P < 0.001) from 55% to 46%. A below average IVF prognosis was associated with anxious reactions in women but not in men (interaction effect: P = 0.011).

LIMITATIONS, REASONS FOR CAUTION: The study design and sample size were more optimal for examining hypothesized determinants of patient’s expectations of IVF success than for studying the impact of sharing prognoses with patients. Whether (reconsidering) expectations influences IVF discontinuation rates and achieved live birth rates has yet to be followed-up.

WIDER IMPLICATIONS OF THE FINDINGS: Clinics are advised to offer patients the opportunity of receiving their IVF prognosis. Providing prognoses is in line with patient preferences and tempers the unrealistic high expectations of both partners in couples with a less than average prognosis. A sensitive communication style is indicated, as lower prognoses are associated with mild anxious reactions in women.

STUDY FUNDING/COMPETING INTEREST(S): E.A.F.D. holds a postdoctoral fellowship of the Research Foundation-Flanders (12H9819N) and this study was funded by the Research Council of the KU Leuven (C14/18/106; project of J.V., K.P. and E.A.F.D.) and as an investigator sponsored study of K.P. and E.A.F.D. by Merck nv/sa Belgium, an affiliate of Merck KGaA, Darmstadt, Germany. The authors declare no conflict of interest related to this study.

TRIAL REGISTRATION NUMBER: N/A.

PMID:35213695 | DOI:10.1093/humrep/deac038

PLoS One. 2022 Feb 25;17(2):e0264455. doi: 10.1371/journal.pone.0264455. eCollection 2022.

ABSTRACT

The pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) took the world by surprise. Following the first outbreak of COVID-19 in December 2019, several models have been developed to study and understand its transmission dynamics. Although the spread of COVID-19 is being slowed down by vaccination and other interventions, there is still a need to have a clear understanding of the evolution of the pandemic across countries, states and communities. To this end, there is a need to have a clearer picture of the initial spread of the disease in different regions. In this project, we used a simple SEIR model and a Bayesian inference framework to estimate the basic reproduction number of COVID-19 across Africa. Our estimates vary between 1.98 (Sudan) and 9.66 (Mauritius), with a median of 3.67 (90% CrI: 3.31-4.12). The estimates provided in this paper will help to inform COVID-19 modeling in the respective countries/regions.

PMID:35213645 | DOI:10.1371/journal.pone.0264455

PLoS One. 2022 Feb 25;17(2):e0264504. doi: 10.1371/journal.pone.0264504. eCollection 2022.

ABSTRACT

BACKGROUND: The predictive role of hematological indexes of mean platelet volume (MPV) and red cell distribution width (RDW) has been demonstrated in cardiovascular disease concomitant with psoriasis. This meta-analysis is intended to assess whether MPV and RDW can also serve as biomarkers for the early diagnosis and disease severity assessment of psoriasis.

MATERIAL AND METHODS: 13 studies which enrolled 1331 psoriasis patients and 919 healthy volunteers were included after screening the search results from PubMed, Embase and the Cochrane Library since inception to Mar 14, 2020. MPV of psoriasis participants and their counterparts was assessed in 10 studies, and RDW was evaluated in 4 studies, while the disease severity was measured by the Psoriasis Area and Severity Index (PASI) in 11 studies. Random-effect model analysis was applied to calculate pooled standard mean difference (SMD) with 95% confidence interval (95% CI).

RESULTS: Associations of MPV and RDW with the presence of psoriasis were demonstrated (MPV: SMD = 0.503, 95% CI: 0.242-0.765; RDW: SMD = 0.522, 95% CI: 0.228-0.817), but no statistically significant correlation of MPV and disease severity of psoriasis was found in meta-regression analysis (p = 0.208). Subgroup analysis revealed that the diagnosis value of MPV and RDW was consistent regardless of PASI and study type. Heterogeneity analysis between studies was implemented by chi-squared test and I2 statistics. Begg’s and Egger’s test were utilized for the evaluation of publication bias. The sensitivity analysis revealed no significant alteration no matter which study was excluded.

CONCLUSION: MPV and RDW could serve as promising predictive diagnostic biomarkers of psoriasis.

PMID:35213665 | DOI:10.1371/journal.pone.0264504

PLoS One. 2022 Feb 25;17(2):e0264410. doi: 10.1371/journal.pone.0264410. eCollection 2022.

ABSTRACT

The economic, environmental and social sustainability of Dutch dairy farms have attracted increasing societal concern in the past decades. In this paper, we propose a recently developed dynamic Luenberger indicator based on the by-production model to measure dynamic productivity growth in the economic, environmental and social dimensions of sustainability of Dutch dairy farms. Subsequently, we investigate the statistical associations between productivity growth and socio-economic factors using the OLS bootstrap regression model. We find that dairy farms have suffered a decline in dynamic sustainable productivity growth, especially in the environmental dimension where it is more pronounced than in the economic and social dimensions. Furthermore, we find that both technical and scale inefficiency change contribute to the decline of environmental productivity growth. Specialization and government support are associated with a higher economic and environmental sustainability productivity growth, and with, a decreased growth of social sustainable productivity. We found no significant association between the age of the oldest entrepreneur, financial structure, farm size or cost of advisory service and dynamic productivity growth in the three sustainability dimensions. The results provide insights into potential pathways towards improving the three pillars of sustainability.

PMID:35213644 | DOI:10.1371/journal.pone.0264410

PLoS One. 2022 Feb 25;17(2):e0264538. doi: 10.1371/journal.pone.0264538. eCollection 2022.

ABSTRACT

BACKGROUND AND OBJECTIVE: Most Asian patients with atrial fibrillation (AF) who undergo percutaneous coronary intervention (PCI) receive only dual antiplatelet therapy (DAPT) without oral anticoagulants (vitamin K antagonists [VKA] or non-VKA oral anticoagulants [NOAC]). However, it has not been fully investigated whether the DAPT results in better clinical outcomes in the early period after PCI than the standard triple therapy with VKA or NOAC.

METHODS: We analyzed the claims records of 11,039 Korean AF population who had PCI between 2013 and 2018. Patients were categorized according to the post-PCI antithrombotic therapy as VKA-based triple therapy (VKA-TT), NOAC-based triple therapy (NOAC-TT), and DAPT groups. After baseline adjustment using inverse probability weighting, we compared the risks of ischemic endpoints (ischemic stroke, myocardial infarction, and all-cause mortality) and major bleeding at 3 months post-PCI.

RESULTS: Ischemic stroke, MI, and all-cause mortality occurred in 105, 423, and 379 patients, respectively, and 138 patients experienced major bleeding. The DAPT group was associated with a lower risk of ischemic stroke and major bleeding (hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.37-0.84) compared to the VKA-TT group, despite no significant differences in the risks of MI and all-cause mortality. In contrast, the DAPT group demonstrated no significant difference in the risks for ischemic endpoints compared to the NOAC-TT group. Additionally, the DAPT group had a numerically lower risk of major bleeding than the NOAC-TT group but this was not statistically significant (HR 0.69, 95% CI 0.45-1.07).

CONCLUSIONS: An outcome benefit of DAPT was observed in the early period after PCI compared to the VKA-TT, but not against NOAC-TT users among the Asian AF population. Given the potential long-term benefits of NOACs, greater efforts should be made to increase compliance in clinical practice with proper combination therapy with NOAC after PCI.

PMID:35213632 | DOI:10.1371/journal.pone.0264538

PLoS One. 2022 Feb 25;17(2):e0264269. doi: 10.1371/journal.pone.0264269. eCollection 2022.

ABSTRACT

The sucrose synthase (SS) is an important enzyme family which play a vital role in sugar metabolism to improve the fruit quality of the plants. In many plant species, the members of SS family have been investigated but the detailed information is not available in legumes particularly and Glycine max specifically. In the present study, we found thirteen SS members (GmSS1-GmSS13) in G. max genome. High conserved regions were present in the GmSS sequences that may due to the selection pressure during evolutionary events. The segmental duplication was the major factor to increase the number of GmSS family members. The identified thirteen GmSS genes were divided into Class I, Class II and Class III with variable numbers of genes in each class. The protein interaction of GmSS gave the co-expression of sucrose synthase with glucose-1-phosphate adenylyltransferase while SLAC and REL test found number of positive sites in the coding sequences of SS family members. All the GmSS family members except GmSS7 and few of class III members, were highly expressed in all the soybean tissues. The expression of the class I members decreased during seed development, whireas, the class II members expression increased during the seed developing, may involve in sugar metabolism during seed development. Solexa sequencing libraries of acidic condition (pH 4.2) stress samples showed that the expression of class I GmSS genes increased 1- to 2-folds in treated samples than control. The differential expression pattern was observed between the members of a paralogous. This study provides detailed genome-wide analysis of GmSS family in soybean that will provide new insights for future evolutionary and soybean breeding to improve the plant growth and development.

PMID:35213642 | DOI:10.1371/journal.pone.0264269

PLoS One. 2022 Feb 25;17(2):e0264283. doi: 10.1371/journal.pone.0264283. eCollection 2022.

ABSTRACT

The CUSUM control chart is suitable for detecting small to moderate parameter shifts for processes involving autocorrelated data. The average run length (ARL) can be used to assess the ability of a CUSUM control chart to detect changes in a long-memory seasonal autoregressive fractionally integrated moving average with exogenous variable (SARFIMAX) process with underlying exponential white noise. Herein, new ARLs via an analytical integral equation (IE) solution as an analytical IE and a numerical IE method to test a CUSUM control chart’s ability to detect a wide range of shifts in the mean of a SARFIMAX(P, D, Q, r)s process with underlying exponential white noise are presented. The analytical IE formulas were derived by using the Fredholm integral equation of the second type while the numerical IE method for the approximate ARL is based on quadrature rules. After applying Banach’s fixed-point theorem to guarantee its existence and uniqueness, the precision of the proposed analytical IE ARL was the same as the numerical IE method. The sensitivity and accuracy of the ARLs based on both methods were assessed on a CUSUM control chart running a SARFIMAX(P, D, Q, r)s process with underlying exponential white noise. The results of an extensive numerical study comprising the examination of a wide variety of out-of-control situations and computational schemes reveal that none of the methods outperformed the IE. Specifically, the computational scheme is easier and can be completed in one step. Hence, it is recommended for use in this situation. An illustrative example based on real data is also provided, the results of which were found to be in accordance with the research results.

PMID:35213619 | DOI:10.1371/journal.pone.0264283

PLoS One. 2022 Feb 25;17(2):e0264393. doi: 10.1371/journal.pone.0264393. eCollection 2022.

ABSTRACT

Chronic kidney disease (CKD) is a major public health problem in low- and middle-income countries (LMICs). Although CKD prevalence has been rapidly increasing in LMICs, particularly in Asia, quantitative studies on the current epidemiology of CKD in this region are limited. This study aimed to identify the prevalence of CKD stages 3-5 in LMICs in Asia, by subregion, country economy classification, identification of CKD, traditional and non-traditional risk factors. A systematic review and meta-analysis of observational studies was conducted through a literature search of seven electronic databases and grey literature search published until November 2021. The Newcastle-Ottawa quality assessment scale (NOS) was used to assess the risk of bias of each study. A random-effects model was used to estimate pooled prevalence. The protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42019120519). Of 4,548 potentially relevant records, 110 studies with moderate and high quality were included with 4,760,147 subjects. The average prevalence (95% CI) of CKD stages 3-5 in 14 LMICs in Asia was 11.2% (9.3-13.2%). The prevalence of CKD stages 3-5 was varied among subregions and country economic classification. CKD prevalence was 8.6% (7.2-10.2%) in east Asia, 12.0% (7.7-17.0%) in south-east Asia, 13.1% (8.7-18.2%) in western Asia, and 13.5% (9.5-18.0%) in south Asia. CKD prevalence was 9.8% (8.3-11.5%) in upper-middle-income countries and 13.8% (9.9-18.3%) in lower-middle-income countries. Prevalence of CKD stage 3-5 in LMICs in Asia is comparable to global prevalence. High level of heterogeneity was observed. Study of factors and interventions that lead to the delay of CKD progression is needed.

PMID:35213610 | DOI:10.1371/journal.pone.0264393

PLoS One. 2022 Feb 25;17(2):e0264343. doi: 10.1371/journal.pone.0264343. eCollection 2022.

ABSTRACT

OBJECTIVE: After stratifying for age, sex and multimorbidity at baseline, our aim is to analyse time trends in incident multimorbidity and polypharmacy in the 15-year clinical trajectories of individual patients in a family medicine setting.

METHODS: This study was carried out using data from the Registration Network Family Medicine in the South of the Netherlands. The clinical trajectories of 10037 subjects during the 15-year period (2000-2014) were analyzed in a repeated measurement of using a generalized estimating equations model as well as a multilevel random intercept model with repeated measurements to determine patterns of incident multimorbidity and polypharmacy. Hierarchical age-period-cohort models were used to generate age and cohort trajectories for comparison with prevalence trends in multimorbidity literature.

RESULTS: Multimorbidity was more common in females than in males throughout the duration of the 15-year trajectory (females: 39.6%; males: 33.5%). With respective ratios of 11.7 and 5.9 between the end and the beginning of the 15-year period, the youngest female and male groups showed a substantial increase in multimorbidity prevalence. Ratios in the oldest female and male groups were 2.2 and 1.9 respectively. Females had higher levels of multimorbidity than males in the 0-24-year and 25-44-year age groups, but the levels converged to a prevalence of 92.2% in the oldest male and 90.7% in the oldest female group. Similar, albeit, moderate differences were found in polypharmacy patterns.

CONCLUSIONS: We sought to specify the progression of multimorbidity from an early age. As a result, our study adds to the multimorbidity literature by specifying changes in chronic disease accumulation with relation to polypharmacy, and by tracking differences in patient trajectories according to age and sex. Multimorbidity and polypharmacy are common and their prevalence is accelerating, with a relatively rapid increase in younger groups. From the point of view of family medicine, this underlines the need for a longitudinal approach and a life course perspective in patient care.

PMID:35213615 | DOI:10.1371/journal.pone.0264343