Tag: statistics

Sci Adv. 2023 Oct 6;9(40):eadh0761. doi: 10.1126/sciadv.adh0761. Epub 2023 Oct 4.

ABSTRACT

Laboratory evidence suggests a possibility of immune imprinting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We investigated the differences in the incidence of SARS-CoV-2 reinfection in a cohort of persons who had a primary Omicron infection, but different vaccination histories using matched, national, retrospective, cohort studies. Adjusted hazard ratio for reinfection incidence, factoring adjustment for differences in testing rate, was 0.43 [95% confidence interval (CI): 0.39 to 0.49] comparing history of two-dose vaccination to no vaccination, 1.47 (95% CI: 1.23 to 1.76) comparing history of three-dose vaccination to two-dose vaccination, and 0.57 (95% CI: 0.48 to 0.68) comparing history of three-dose vaccination to no vaccination. Divergence in cumulative incidence curves increased markedly when the incidence was dominated by BA.4/BA.5 and BA.2.75* Omicron subvariants. The history of primary-series vaccination enhanced immune protection against Omicron reinfection, but history of booster vaccination compromised protection against Omicron reinfection. These findings do not undermine the public health utility of booster vaccination.

PMID:37792951 | DOI:10.1126/sciadv.adh0761

Sci Adv. 2023 Oct 6;9(40):eadd9973. doi: 10.1126/sciadv.add9973. Epub 2023 Oct 4.

ABSTRACT

The Amazon rainforest is threatened by land-use change and increasing drought and fire frequency. Studies suggest an abrupt dieback of large parts of the rainforest after partial forest loss, but the critical threshold, underlying mechanisms, and possible impacts of forest degradation on the monsoon circulation remain uncertain. Here, we use a nonlinear dynamical model of the moisture transport and recycling across the Amazon to identify several precursor signals for a critical transition in the coupled atmosphere-vegetation dynamics. Guided by our simulations, we reveal both statistical and physical precursor signals of an approaching critical transition in reanalysis and observational data. In accordance with our model results, we attribute these characteristic precursor signals to the nearing of a critical transition of the coupled Amazon atmosphere-vegetation system induced by forest loss due to deforestation, droughts, and fires. The transition would lead to substantially drier conditions, under which the rainforest could likely not be maintained.

PMID:37792950 | DOI:10.1126/sciadv.add9973

Sci Adv. 2023 Oct 6;9(40):eadk5668. doi: 10.1126/sciadv.adk5668. Epub 2023 Oct 4.

ABSTRACT

People with booster vaccinations appear more prone to reinfection than those with primary series vaccination only; however, selection bias in the study design complicates interpretation.

PMID:37792936 | DOI:10.1126/sciadv.adk5668

J Child Psychol Psychiatry. 2023 Oct 4. doi: 10.1111/jcpp.13895. Online ahead of print.

ABSTRACT

BACKGROUND: Stress is a universal phenomenon and one of the most common precipitants of insomnia. However, not everyone develops insomnia after experiencing a stressful life event. This study aims to test aspects of Spielman’s ‘3P model of insomnia’ (during adolescence) by exploring the extent to which: (a) insomnia symptoms are predicted by polygenic scores (PGS); (b) life events predict insomnia symptoms; (c) the interaction between PGS and life events contribute to the prediction of insomnia symptoms; (d) gene-environment interaction effects remain after controlling for sex.

METHODS: The sample comprised 4,629 twins aged 16 from the Twin Early Development Study who reported on their insomnia symptoms and life events. PGS for insomnia were calculated. In order to test the main hypothesis of this study (a significant interaction between PGS and negative life events), we fitted a series of mixed effect regressions.

RESULTS: The best fit was provided by the model including sex, PGS for insomnia, negative life events, and their interactions (AIC = 26,158.7). Our results show that the association between insomnia symptoms and negative life events is stronger for those with a higher genetic risk for insomnia.

CONCLUSIONS: This work sheds light on the complex relationship between genetic and environmental factors implicated for insomnia. This study has tested for the first time the interaction between genetic predisposition (PGS) for insomnia and environmental stressors (negative life events) in adolescents. This work represents a direct test of components of Spielman’s 3P model for insomnia which is supported by our results.

PMID:37792459 | DOI:10.1111/jcpp.13895

J Med Internet Res. 2023 Oct 4;25:e48750. doi: 10.2196/48750.

ABSTRACT

BACKGROUND: Depression and anxiety are common comorbidities in cardiovascular clinic outpatients. Timely identification and intervention of these mental and psychological disorders can contribute to correct diagnosis, better prognosis, less medical expenses, and improved quality of life. The convenience of online doctor-patient communication platforms has increasingly attracted patients to online consultations. However, online health care and offline health care are very different. Research on how to identify psychological disorders in patients who engage in an online cardiology consultation is lacking.

OBJECTIVE: This study aimed to explore the feasibility of using a self-rating scale to assess mental illness among patients who consult with a cardiologist online and to compare the differences in anxiety and depression between online and offline patients.

METHODS: From June 2022 to July 2022, we conducted follow-up visits with 10,173 patients on the Haodf platform. We conducted detailed consultations with 286 patients who visited the same cardiologist in the outpatient department. We used the self-rated Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) scales to assess anxiety and depression, respectively. We analyzed the influencing factors related to the degree of coordination of online patients. We also compared the prevalence of anxiety or depression between online and offline patients and analyzed the factors related to anxiety or depression.

RESULTS: Of the 10,173 online consultation patients, only 186 (1.8%) responded effectively. The response rate of the offline consultation patients was 96.5% (276/286). Frequent online communication and watching live video broadcasts were significantly related to effective responses from online patients (P<.001). The prevalence of anxiety (70/160, 43.7% vs 69/266, 25.8%; P<.001) or depression (78/160, 48.7% vs 74/266, 27.7%; P<.001) in online consultation patients was significantly higher than that in offline patients. In bivariate analyses, the factors related to anxiety included female sex, unemployment, no confirmed cardiovascular disease, and the online consultation mode, while smokers and those who underwent COVID-19 quarantine were less likely to present with anxiety. The factors related to depression included female sex, divorced or separated individuals, and the online consultation mode. COVID-19 quarantine was related with a lower likelihood of depression. BMI was negatively correlated with depression. In multiple ordered logistic regression analysis, women were more likely than men to present with anxiety (odds ratio [OR] 2.181, 95% CI 1.365-3.486; P=.001). Women (OR 1.664, 95% CI 1.082-2.559; P=.02) and online patients (OR 2.631, 95% CI 1.305-5.304; P=.007) were more likely to have depression.

CONCLUSIONS: Online patients had more anxiety or depression than offline patients. Anxiety was more prevalent in women, the unemployed, and those without confirmed cardiovascular disease. Women and divorced or separated individuals were more prone to depression. Increasing the frequency of doctor-patient communication and participating in video interactions can help improve patient cooperation.

PMID:37792455 | DOI:10.2196/48750

Epileptic Disord. 2023 Oct 4. doi: 10.1002/epd2.20165. Online ahead of print.

ABSTRACT

OBJECTIVE: In the presurgical evaluation of patients with drug-resistant epilepsy (DRE), occasionally, patients do not experience spontaneous typical seizures (STS) during a stereo-electroencephalography (SEEG) study, which limits its effectiveness. We sought to identify risk factors for patients who did not have STS during SEEG and to analyze the clinical outcomes for this particular set of patients.

METHODS: We conducted a retrospective analysis of all patients with DRE who underwent depth electrode implantation and SEEG recordings between January 2013 and December 2018.

RESULTS: SEEG was performed in 155 cases during this period. Eleven (7.2%) did not experience any clinical seizures (non-STS group), while 143 experienced at least one patient-typical seizure during admission (STS group). No significant differences were found between STS and non-STS groups in terms of patient demographics, lesional/non-lesional epilepsy ratio, pre-SEEG seizure frequency, number of ASMs used, electrographic seizures or postoperative seizure outcome in those who underwent resective surgery. Statistically significant differences were found in the average number of electrodes implanted (7.0 in the non-STS group vs. 10.2 in STS), days in Epilepsy Monitoring Unit (21.8 vs. 12.8 days) and the number of cases that underwent resective surgery following SEEG (27.3% vs 60.8%), respectively. The three non-STS patients (30%) who underwent surgery, all had their typical seizures triggered during ECS studies. Three cases were found to have psychogenic non-epileptic seizures. None of the patients in the non-STS group were offered neurostimulation devices. Five of the non-STS patients experienced transient seizure improvement following SEEG.

CONCLUSION: We were unable to identify any factors that predicted lack of seizures during SEEG recordings. Resective surgery was only offered in cases where ECS studies replicated patient-typical seizures. Larger data sets are required to be able to identify factors that predict which patients will fail to develop seizures during SEEG.

PMID:37792454 | DOI:10.1002/epd2.20165

JMIR Hum Factors. 2023 Oct 4;10:e48220. doi: 10.2196/48220.

ABSTRACT

BACKGROUND: Previous studies have identified that the effective management of cyber security in large health care environments is likely to be significantly impacted by human and social factors, as well as by technical controls. However, there have been limited attempts to confirm this by using measured and integrated studies to identify specific user motivations and behaviors that can be managed to achieve improved outcomes.

OBJECTIVE: This study aims to document and analyze survey and interview data from a diverse range of health care staff members, to determine the primary motivations and behaviors that influence their acceptance and application of cyber security messaging and controls. By identifying these issues, recommendations can be made to positively influence future cyber security governance in health care.

METHODS: An explanatory sequential mixed methods approach was undertaken to analyze quantitative data from a web-based staff survey (N=103), with a concurrent qualitative investigation applied to data gathered via in-depth staff interviews (N=9). Data from both stages of this methodology were mapped to descriptive variables based on a modified version of the Technology Acceptance Model (TAM; TAM2). After normalization, the quantitative data were verified and analyzed using descriptive statistics, distribution and linearity measures, and a bivariate correlation of the TAM variables to identify the Pearson coefficient (r) and significance (P) values. Finally, after confirming Cronbach α, the determinant score for multicollinearity, and the Kaiser-Meyer-Olkin measure, and applying the Bartlett test of sphericity (χ²), an exploratory factor analysis (EFA) was conducted to identify the primary factors with an eigenvalue (λ) >1.0. Comments captured during the qualitative interviews were coded using NVivo software (QSR International) to create an emic-to-etic understanding, which was subsequently integrated with the quantitative results to produce verified conclusions.

RESULTS: Using the explanatory sequential methodology, this study showed that the perceived usefulness of security controls emerged as the most significant factor influencing staff beliefs and behaviors. This variable represented 24% of all the variances measured in the EFA and was also the most common category identified across all coded interviews (281/692, 40.6%). The word frequency analysis showed that systems, patients, and people represented the top 3 recurring themes reported by the interviewees.

CONCLUSIONS: To improve cyber security governance in large health care environments, efforts should be focused on demonstrating how confidentiality, integrity, availability, policies, and cloud or vendor-based controls (the main contributors of usefulness measured by the EFA) can directly improve outcomes for systems, staff, and patients. Further consideration also needs to be given to how clinicians should share data and collaborate on patient care, with tools and processes provided to support and manage data sharing securely and to achieve a consistent baseline of secure and normalized behaviors.

PMID:37792450 | DOI:10.2196/48220

Clin Cancer Res. 2023 Oct 4. doi: 10.1158/1078-0432.CCR-23-1340. Online ahead of print.

ABSTRACT

Since the first approval of a tumor-agnostic indication in 2017, a total of seven tumor-agnostic indications involving six drugs have received approval from the US Food and Drug Administration. In this paper, the master protocol subteam of the Statistical Methods in Oncology Scientific Working Group, Biopharmaceutical Session, American Statistical Association, provides a comprehensive summary of these seven tumor-agnostic approvals, describing their mechanisms of action; biomarker prevalence; study design; companion diagnostics; regulatory aspects, including comparisons of global regulatory requirements; and Health Technology Assessment approval. Also discussed are practical considerations relating to the regulatory approval of tumor-agnostic indications, specifically: (1) recommendations for the design stage to mitigate the risk that exceptions may occur if a treatment is initially hypothesized to be effective for all tumor types; and (2) because drug development continues after approval of a tumor-agnostic indication, recommendations for further development of tumor-specific indications in frontline patients in the setting of a randomized confirmatory basket trial, acknowledging the challenges in this area. These recommendations and practical considerations may provide insights for the future development of drugs for tumor-agnostic indications.

PMID:37792436 | DOI:10.1158/1078-0432.CCR-23-1340

J Med Food. 2023 Oct 4. doi: 10.1089/jmf.2023.0056. Online ahead of print.

ABSTRACT

The aim of this work was to evaluate the effect of blackberry juice consumption during pregnancy on the length of the brain, as well as on the cell density of the dentate gyrus in Wistar rat pups. Pregnant rats were divided into three groups: control (C), fed with standard diet and water ad libitum; BJ1, which received blackberry juice containing polyphenols (7.8 mg/kg) and anthocyanins (1.9 mg/kg); and BJ2, receiving blackberry juice containing polyphenols (9.3 mg/kg) and anthocyanins (3.54 mg/kg). On postnatal day 0, pups per litter, body weight, and length were measured, and cells in the dentate gyrus of male pups were quantified. Maternal body weight and pups per litter were statistically equal across experimental groups during pregnancy. Pups in BJ1 and BJ2 groups showed an increase in body weight (20%) and length (5%) when comparing to controls. An increase in brain length was observed in BJ2 group (8%) as compared to the control. A significant increase in the number of cells/mm² was observed in the dentate gyrus of the offspring in BJ1 (21.8%) and BJ2 (23.7%) groups when compared to the control group. Given the above, blackberry juice may be considered a potential functional food during pregnancy, while further research on prenatal and postnatal development must be done.

PMID:37792428 | DOI:10.1089/jmf.2023.0056

Biotechnol Prog. 2023 Oct 4:e3393. doi: 10.1002/btpr.3393. Online ahead of print.

ABSTRACT

Coffee is a crop of significant socioeconomic importance, and the reuse of agri-food by-products and biowaste has great potential across several industries. Coffee wastewater (CWW) is a valuable resource containing essential nutrients that can be utilized by Candida sorboxylosa for single-cell protein (SCP) production. This utilization contributes to mitigating the negative impacts of agro-industrial waste. The optimization of culture conditions using the design of experiments (DoE) technique is crucial in understanding the environmental factors influencing metabolite production. In our study, the DoE technique was employed to analyze culture conditions, including room temperature, pH 8.4, agitation at 200 rpm, a headspace of 60% (v/v), and an inoculum of 0.75 DO_600nm over 28-h period. This approach resulted in a remarkable SCP yield of 64.4% and dry cell weight (DCW) of 2.26 g/L. It is noteworthy that there is no literature reporting SCP production under alkaline pH conditions in yeast. Interestingly, our work demonstrated that an alkaline pH of 8.4 significantly influenced SCP production by C. sorboxylosa. The DoE technique proved to be an efficient statistical tool for optimizing culture conditions, offering several advantages, such as: (i) conducting cultures at room temperature to minimize unnecessary energy consumption; (ii) reducing the incubation time from 46 to 28 h, thereby enhancing overall productivity; (iii) achieving 1.7-fold increase in SCP yield compared to previous basal production levels.

PMID:37792408 | DOI:10.1002/btpr.3393