Binomial Regression Methods Research Articles

Air Quality Perceptions, Awareness, and Associated Behaviors Among U.S. Adults With and Without Heart Disease

IntroductionExposure to ambient air pollution can worsen cardiovascular disease and increase the risk of stroke, myocardial infarction, and cardiovascular disease mortality. Strategies to reduce air pollution exposure can therefore help prevent cardiovascular morbidity and mortality. This study was conducted to assess awareness among U.S. adults of the effect of air pollution on cardiovascular health and actions individuals can take to reduce their air pollution exposure. MethodsIn May–July 2022, 4,156 adults responded to the summer wave of the 2022 ConsumerStyles survey and self-reported their heart disease status and perceptions, awareness, and behaviors about ambient air pollution and health. In 2023, the data were analyzed to generate weighted population estimates representative of noninstitutionalized U.S. adults. Associations between heart disease and responses about perceptions, awareness, and behaviors were estimated using binomial and multinomial regression methods for weighted data. ResultsOverall, 90% of the weighted population estimate of U.S. adults reported that air pollution can impact a person's health and 44% reported that air pollution can cause or worsen heart disease. Percentages of adults reporting that air pollution can impact a person's health (prevalence ratio=1.09, 95% CI=1.06, 1.12) and that air pollution can cause or worsen heart disease (prevalence ratio=1.28, 95% CI=1.08, 1.51) were higher among adults with than without heart disease. ConclusionsLess than half of U.S. adults are aware that air pollution affects heart disease. Improvements in awareness of the effect of air pollution on cardiovascular health and strategies to reduce exposure could help protect individuals with heart disease.

The Effect of ICT on the Development of Bank Branches in the WAEMU Zone: An Application of Negative Binomial Regression

The main objective of this study is to analyze the effect of ICT on the number of bank branches in the WAEMU. Based on the total of eight (08) member countries of the union, from 1995 to 2022, it employs the negative binomial (BN) regression method for the estimations. The results of the study show that among the ICT variables selected, only mobile and fixed-line telephone subscriptions have a statistically significant and positive effect on the number of bank branches in the union. The Internet and the number of ATMs have no significant effect on the number of branches, although they remain negatively correlated with the number of bank branches. On the other hand, the number of banking institutions and the size of these banks encourage the opening of new bank branches.

ANALISIS PENGARUH FAKTOR RISIKO PENYAKIT PNEUMONIA TERHADAP ANGKA MORTALITAS BAYI DAN BALITA MENGGUNAKAN REGRESI POISSON DAN REGRESI BINOMIAL NEGATIF (Studi Kasus : Provinsi Jawa Barat)

Pneumonia is an acute infectious disease that attacks lungs caused by viruses, bacteria or fungi. This infection can be life-threatening for anyone, especially infants, children and people aged 65 years. In 2020 in West Java Province infant and toddler deaths due to pneumonia reached 122 cases. This study aims to analyze the factors that influence infant and under-five mortality rates by comparing Poisson regression and negative binomial regression, as well as modeling significant factors. The handling of overdispersion cases in Poisson regression can be done with alternative methods, one of which is the negative binomial regression method. This study uses secondary data obtained from the Health Profile of West Java Province 2020. The results of the study show that negative binomial regression handles overdispersion cases in data on the number of infant and under-five deaths due to pneumonia in West Java Province in 2020. Factors that influence infant mortality rates and toddlers due to pneumonia are low birth weight babies (X2) and population density (X4).

Invisible Publications: A Study of Academic Productivity in the Web of Science Database

The present study aims to outline the profile of uncited or rarely cited articles indexed in the Web of Science database between 2017 and 2021. We used stratified random sampling of 14,425 journals to extract our study sample of 373 journals. The dependent variable was defined as the number of citations, with independent variables being the JCR index, maturity, quartile, language of publication, and whether the research was funded. Descriptive statistics were used to characterize the sample according to field of research and variable. A negative binomial regression method was used to estimate which variables influence the number of citations received by articles in the sample. We found that of the 256,524 articles that make up the research corpus, 39,469 (15.39%) received no citations and 91,963 articles (35.85%) received up to four citations. The variables that positively influenced estimates of the number of citations were maturity (0.481), JCR index (0.159), and funding (0.020), while quartile (-0.170) and language (-1.032) had a negative influence on number of citations. We conclude that the pressures of academic productivism create a vicious cycle in which studies are referenced based on their ranking in the struggle for privileged editorial space, with articles in higher quartile journals being more prone to citation.

Analysis of Risk Factors for Dengue Hemorrhagic Fever in Riau Province using Negative Binomial Regression

Dengue Hemorrhagic Fever (DHF) is a serious threat in Riau province, Indonesia. To better understand and control the spread of dengue fever, this research aims to analyze the factors that cause dengue fever. This study aims to identify significant risk factors that influence the spread of dengue fever in Riau Province. The Negative Binomial Regression Method was used to identify factors associated with the increase in dengue fever cases in Riau. The variables evaluated include population density of the Aedes aegypti vector , level of environmental cleanliness, prevention practices, and socio-economic factors. In addition, the best model was selected to overcome overdispersion in the data. The results of the analysis show that factors such as population density of the Aedes aegypti vector , environmental cleanliness, and the level of public understanding about dengue prevention practices have a significant influence on the spread of dengue fever in Riau. The best model used to overcome overdispersion in the 2021 dengue fever case data in Riau is Negative Binomial Regression. This research provides a deeper understanding of the factors causing dengue fever in Riau and selects an appropriate statistical model for analyzing data that experiences overdispersion. Negative Binomial Regression proved to be more appropriate in overcoming the problem of overdispersion in the data. These results can be used as a basis for designing more effective dengue prevention and control strategies and provide guidance for more targeted interventions in fighting dengue fever in this region.

The Influence of Governance and Political Support on Corrupt Practices in Aceh Province

The study investigates how governance and political support affect the level of corruption in Aceh Province. To measure the level of corruption, the number of corrupt individuals involved in corruption cases that the court handled between 2019 and 2021 was taken into consideration. The governance aspect was evaluated based on the achievements of Monitoring Control for Prevention (MCP) and performance accountability, while political support was assessed by the support provided by political parties in the legislature to regional leaders. The negative binomial panel regression method with a fixed-effect approach was used to analyze the data collected from 24 local governments (provincial and district/city) in Aceh Province. The results indicate that governance has a significant negative impact on corruption. Therefore, it is crucial to consistently improve governance by enhancing MCP achievements and performance accountability in local governments to combat corruption in Aceh Province. Improvement efforts can be made to optimize the role of APIP in overseeing the implementation of government, especially state financial management to be more effective and efficient

Assessing the relationship of recommended diarrhea case management practices with the nutritional status of children aged between 0 to 59.9 months.

Background Paediatric diarrhoea and malnutrition have a bidirectional relationship, which in turn augments the presence of each other. The diarrhoeal diseases in children can be prevented by using oral rehydration solution (ORS) and oral zinc sulfate. The relationship between paediatric diarrhoea treatment guidelines with the nutritional status is not yet investigated, and this study primarily aims to examine the relationship of recommended diarrhoea case management practices with paediatric undernutrition (wasting, stunting and underweight) among children aged between 0 to 59 months. Methods Data from Pakistan Demographic & Health Surveys (PDHS) conducted in 2012–2013 and 2017–2018 were used in this study to investigate the relationship between paediatric diarrhoea treatment adherence with the various forms of paediatric undernutrition. Data from children with complaints of acute watery non-dysenteric diarrhoea was used in this study, whereas data from those children presented with complaints of either dysentery, and/or severe dehydration, and/or incomplete anthropometry were excluded. Children were classified as complete adherent, partial adherent and non-adherent based on ORS and oral zinc sulfate consumption. The relationship of diarrhoea case management practices with different types of nutritional status was assessed using a binomial logistic regression method. Results The malnutrition in children with acute non-dysenteric diarrhoea is 54.2% in 2012–2013, which decreased to 48.2% in the succeeding survey of 2017–2018. Only 6.2% (1% in 2012–2013 ~ 10% in 2017–2018) children of Pakistan received appropriate treatment for managing their diarrhoea. However, no relationship between the diarrhoea case management and paediatric undernutrition was observed. Conclusion This study found did not demonstrate a significant connection of diarrhoea case management strategies with paediatric undernutrition. This highlights the complexity of addressing both diarrhoea and malnutrition in children. Future research should emphasize the identification and resolution of the multifactorial factors, which contribute to paediatric undernutrition, integrating both diarrhoea management and nutritional improvement strategies.

Elranatamab Exposure-Efficacy Analysis in Patients with Relapsed or Refractory Multiple Myeloma: Insights from Pooled Magnetismm Studies

BACKGROUND Elranatamab (ELRA) is a heterodimeric humanized full-length bispecific antibody comprised of one B-cell Maturation Antigen (BCMA) binding arm and one cluster of differentiation 3 (CD3) binding arm paired through hinge mutation technology. Results from the MagnetisMM-3 (NCT04649359) study indicated deep and durable responses in patients with relapsed or refractory multiple myeloma (RRMM). The current analysis was conducted a) to characterize the relationship between free (ie, unbound) and total (ie, unbound and bound to soluble BCMA - sBCMA) ELRA exposure and objective response rate (ORR), b) to evaluate the effect of potential covariates in the ELRA exposure-response (E-R) relationship with ORR, and c) to characterize the relationship between ELRA exposure and duration of response (DOR). METHODS Data from ELRA monotherapy from the MagnetisMM-1 (first-in-human Ph1, NCT03269136), MagnetisMM-2 (Japan Ph1, NCT04798586), MagnetisMM-3 (Ph2 with pivotal Cohort A in BCMA-naïve patients and Cohort B with BCMA-exposed patients), and MagnetisMM-9 (Ph1/2, NCT05014412) studies were pooled for analyses. The dataset included a wide dose range from 0.1 µg/kg IV to 1000 µg/kg / 76 mg SC weekly (QW) dosing. Free and total exposure metrics (C ave,Day28, ie, average ELRA concentration on Day 28) and (C ave,Event, ie, average ELRA concentration up to the time of first response or progression/end of treatment) were obtained using the individual post-hoc pharmacokinetic (PK) parameters from the population PK model 1. The E-R relationship for the efficacy endpoint ORR by Investigator and the effects of various baseline demographic and disease risk factors (eg, age, sex, baseline sBCMA level, cytogenetics, extramedullary disease [EMD], and number of prior lines of therapy) were characterized using binomial logistic regression method. A Cox proportional hazard model was used to quantify the effects of C ave,Day28 and C ave,Event and the reduction of the dosing intensity from QW to once every two weeks (Q2W) on DOR. The relationship between tertiles and DOR was also explored using Kaplan-Meier (KM) analysis. The analyses were performed with R software. RESULTS A significant E-R relationship was identified between both total and free ELRA C ave,Day28 and C ave,Event and ORR. Higher ELRA exposure was associated with higher ORR. For the total ELRA PK analysis, lower baseline sBCMA level was associated with higher ORR. For both total and free ELRA E-R relationships, number of prior lines of therapy ≤ 5 and absence of baseline EMD were associated with higher ORR. None of the other covariates were significant predictors of ORR. The models developed using either C ave,Day28 or C ave,Event identified same set of significant covariates. Figure 1 shows the results of free ELRA C ave,Day28 E-R analysis. The Cox proportional hazard analysis and KM plots of DOR by tertiles of exposure revealed no significant association between ELRA exposure, Q2W switch, and DOR. CONCLUSION The efficacy endpoint ORR demonstrated E-R relationships with total and free ELRA exposures. Patients with higher ELRA exposure, lower number of prior lines of therapy, , were more likely to achieve objective responses. Lower sBCMA was also a significant predictor of ORR in the total PK analysis. The findings supported the 76 mg QW ELRA, which is the highest tested dose in the MagnetisMM-1 study. This regimen is projected to provide meaningful clinical benefit in the majority of RRMM patients, including those with relatively high baseline sBCMA levels. The identified covariates are known prognostic factors for RRMM, yet the ORR achieved in these subgroups is clinically meaningful. There was no significant association between total or free ELRA exposures, Q2W switch and DOR, which further supports the maintenance of responses with Q2W switch for the RRMM population.

Spatial Distribution and the Influence of Surface Temperature and Green Area on Sea Turtle Nesting Sites in Peninsular Malaysia

Malaysia is home to four of the seven sea turtles in the world, with Malaysian islands being one of the potential areas for sea turtle landing and nesting. However, sea turtles are classified as endangered species because they face extinction mainly due to land use changes, human marine activities, and environmental factors. As a result, they are now among the most important resources for ecotourism. Green turtles are the most prevalent species (endangered), while the hawksbill turtle is one of the world’s most seriously endangered marine turtle species today. Hence, considering the importance of improving turtle habitat in Malaysia, this study investigated the sea turtle’s nesting site preference in Peninsular Malaysia using spatial analysis. The objectives of this study are (1) to map sea turtle nesting sites in Peninsular Malaysia for five years (from 2017-2021) and (2) to identify the influence of surface temperature and landscape characteristics on sea turtle nesting habitats. This study used the binomial regression method to determine the significant environmental factors such as temperature, distance from the green area and the coastal line that could influence the preference for sea turtle habitat. The results show a positive relationship between temperature and that more sea turtles will nest and land in the area with the higher temperature. Also, more sea turtles prefer to land and nest near green areas. These findings confirmed the influence of green areas in turtle nesting sites in Peninsular Malaysia. It could assist the authorities in further understanding the importance of green areas in turtle nesting site preference and developing a mitigation plan to protect sea turtle habitat.

Perbandingan Metode KNN, Naive Bayes, dan Regresi Logistik Binomial dalam Pengklasifikasian Status Ekonomi Negara

The classification of a country's economic status as developed or developing often involves factors such as life expectancy and its underlying variables. This research aims to compare the performance of three machine learning algorithms, namely KNN (K-Nearest Neighbors), naive Bayes, and binomial logistic regression, in classifying the economic status of countries as developed or developing. The data used in this study is "Life Expectancy (WHO) Fixed," obtained from the Kaggle website. The first statistical analysis conducted was Principal Component Analysis (PCA) using 16 predictor variables. PCA resulted in three principal components capable of explaining 71.41% of the variance, which were subsequently used in the KNN, naive Bayes, and binomial logistic regression methods. The analysis results from the KNN, naive Bayes, and binomial logistic regression methods produced F1-scores of 100\%, 98.19%, and 97.36%, respectively.

Utilization of Telemedicine among Medicare beneficiaries undergoing Hepatopancreatic Surgery during the COVID-19 Pandemic

IntroductionTelemedicine may serve as an important avenue to address disparities in access to cancer care. We sought to define factors associated with telemedicine use among Medicare beneficiaries who underwent hepatopancreatic (HP) surgery, as well as characterize trends in telemedicine usage relative to community vulnerability based on the enactment of the Medicare telemedicine coverage waiver. MethodsPatients who underwent HP surgery between 2013–2020 were identified from the Medicare Standard Analytic Files (SAF). Telemedicine utilization was assessed pre- versus post- implementation of the Medicare telemedicine coverage waiver; the county-level social vulnerability index (SVI) was obtained from the Center for Disease Control. Interrupted time series analysis with negative binomial and multivariable logistic regression methods were used to assess changes in telemedicine utilization after the implementation of the Medicare telemedicine coverage waiver relative to SVI. ResultsPre-waiver telemedicine visits were scarce among 16,690 patients (0.2%, n = 28), while post-waiver telemedicine adoption was substantial among 3,301 patients (45.8%, n = 1,388). Post-waiver, the median patient age was 70 years (IQR, 66–74) with the majority of patients being age 65–69 (n = 994, 32.8%); 1,599 (52.8%) were female. Most patients self-identified as White (n = 2641, 87.1%), while a minority of patients self-identified as Black (n = 190, 6.3%), Asian (n = 18, 0.6%), Hispanic (n = 35, 1.2%), or Other/unknown (n = 147, 4.9%). On multivariable regression analysis, patients who lived in highly vulnerable counties (referent Low SVI; moderate SVI: OR 1.09, 95% CI 0.86–1.39, p = 0.449; high SVI: OR 0.72, 95% CI 0.55–0.94, p = 0.001) and individuals with advancing age (referent 18–64; 65–69, OR 0.68, 95%CI 0.54–0.86; 70–74, OR 0.56, 95%CI 0.44–0.71; 75–79, OR 0.57, 95%CI 0.44–0.75; 80–84, OR 0.43, 95%CI 0.30–0.61; 85 + , OR 0.25, 95%CI 0.13–0.49) had lower odds of utilizing telemedicine. In contrast, Black patients (referent White; OR 2.26, 95% CI 1.65–3.10) and patients with a higher CCI score > 2 (referent ≤ 2; OR 1.49, 95% CI 1.28–1.71) were more likely to use telemedicine (all p < 0.001). ConclusionsMedicare beneficiaries residing in counties with extreme vulnerability, as well as elderly individuals, were markedly less likely to use telemedicine services related to HP surgical episodes of care. The lower utilization of telemedicine in areas of high social vulnerability was attributable to concomitant lower rates of internet access in these areas.

Effect of the COVID-19 Pandemic on the Psychological Health of Patients Who Underwent Liver Transplantation Due to Hepatocellular Carcinoma

The primary aim of this study was to compare liver transplant (LT) recipients with and without hepatocellular carcinoma (HCC) in terms of COVID-19-related depression, anxiety, and stress. A total of 504 LT recipients with (HCC group; n = 252) and without HCC (non-HCC group; n = 252) were included in the present case-control study. Depression Anxiety Stress Scales (DASS-21) and Coronavirus Anxiety Scale (CAS) were used to evaluate the depression, stress, and anxiety levels of LT patients. DASS-21 total and CAS-SF scores were determined as the primary outcomes of the study. Poisson regression and negative binomial regression models were used to predict the DASS and CAS scores. The incidence rate ratio (IRR) was used as a coefficient. Both groups were also compared in terms of awareness of the COVID-19 vaccine. Poisson regression and negative binomial regression analyses for DASS-21 total and CAS-SF scales showed that the negative binomial regression method was the appropriate model for both scales. According to this model, it was determined that the following independent variables increased the DASS-21 total score: non-HCC (IRR: 1.26; p = 0.031), female gender (IRR: 1.29; p = 0.036), presence of chronic disease (IRR: 1.65; p < 0.001), exposure to COVID-19 (IRR: 1.63; p < 0.001), and nonvaccination (IRR: 1.50; p = 0.002). On the other hand, it was determined that the following independent variables increased the CAS score: female gender (IRR:1.75; p = 0.014) and exposure to COVID-19 (IRR: 1.51; p = 0.048). Significant differences were found between the HCC and non-HCC groups in terms of median DASS-21 total (p < 0.001) and CAS-SF (p = 0.002) scores. Cronbach's alpha internal consistency coefficients of DASS-21 total and CAS-SF scales were calculated to be 0.823 and 0.783, respectively. This study showed that the variables including patients without HCC, female gender, having a chronic disease, being exposed to COVID-19, and not being vaccinated against COVID-19 increased anxiety, depression, and stress. High internal consistency coefficients obtained from both scales indicate that these results are reliable.

The role of environmental justice reform in corporate green transformation: Evidence from the establishment of China’s environmental courts

Purpose: The establishment of environmental courts in China provides a good opportunity to explores the economic effects of environmental justice reform. This paper investigates how the environmental justice reform can influence corporate green transformation from the perspective of green technology innovation and explores the potential mechanisms of how the environmental courts affect green technology innovation. The heterogeneous effects of environmental courts are also considered.Methodology: Using the establishment of environmental courts in China as a quasi-natural experiment, this paper adopts a difference-in-difference (DID) method to conduct empirical test based on data on Chinese listed A-shared firms from 2004 to 2019. Moreover, this paper use propensity score matching (PSM), tobit and negative binomial regression method to address possible estimation bias.Findings: The establishment of environmental courts significantly enhances green technology innovation among enterprises. The more effective judicial enforcement and better public awareness of the environment brought by the environmental courts will increase the cost of illegality and external supervision pressure for firms, which will lead firms to innovate in green technology. Furthermore, the positive and significant effect of environmental courts on green technology innovation is more pronounced in state-owned enterprises (SOEs) and enterprises located in regions where local protectionism is more serious or regions with more ideal environmental legal system.

Pemodelan Faktor-Faktor yang Mempengaruhi Jumlah Kasus Diabetes Melitus di Jawa Timur Menggunakan Geographically Weighted Generalized Poisson Regression dan Geographically Weighted Negative Binomial Regression

Diabetes mellitus is a chronic disease of metabolic disorders characterized by blood-sugar levels exceeding normal limits. The province contributing the largest number of cases of diabetes mellitus in Indonesia in 2019 is East Java Province. To know the factors that affect the number of cases of diabetes mellitus is used approach with Geographically Weighted Generalized Poisson Regression (GWGPR) and graphically Weighted Negative Binomial Regression (GWNBR) methods. The highest number of people with diabetes mellitus in East Java is in Surabaya with 94076 cases and the lowest is in Batu City which is 3344 cases. GWGPR and GWNBR modeling both resulted in 4 groups for significants variables in each district/city. The AICc value comparison of the GWGPR and GWNBR models shows almost the same value. Sehingga menunjukkan bahwa model GWGPR dan GWNBR sudah sesuai. So, it shows that the GWGPR and GWNBR models are appropriate. The GWGPR model has a smaller AICc value than the GWNBR model, so the GWGPR method is best suited to model the number of cases of diabetes mellitus in districts/cities in East Java compared to GWNBR method.

The influence of the two-tier network of a regional innovation system on knowledge emergence

PurposeThis paper aims to focus on the characteristics of a two-tier network featuring internal subject cooperation and external embedded cooperation in the context of regional innovation systems (RISs) and explore the influence of network characteristics on knowledge emergence.Design/methodology/approachUsing social network analysis, a two-tier internal and external cooperation network of a RIS is constructed. A negative binomial regression method is used to explore the effects of the characteristics of these two-tier internal and external networks on knowledge emergence, the moderating effect of the cooperation knowledge base in this context is investigated and grouping and quantile regressions are used to conduct heterogeneity analysis.FindingsThe scale of the internal cooperation network has a positive effect on knowledge emergence, and the betweenness centralization of the internal cooperation network has an inverted U-shaped effect on knowledge emergence. The scale and structural holes of the external embedded network have an inverted U-shaped effect on knowledge emergence. Furthermore, the internal cooperation knowledge base weakens the influence of the external embedded network on knowledge emergence.Practical implicationsThis research may enlighten policymakers with respect to improving the scale and structure of the RIS cooperation network and matching the embedded network based on the internal cooperation knowledge base to promote knowledge emergence.Originality/valueThis research contributes to the study of knowledge emergence by exploring the influence of a two-tier network structure and scale characteristics on knowledge emergence in RISs. This paper also extends the framework of relevant research by integrating the internal cooperation knowledge base into the analysis of externally embedded cooperation and knowledge emergence.

Exploring the clinical translation intensity of papers published by the world's top scientists in basic medicine.

The online version contains supplementary material available at 10.1007/s11192-023-04634-4.

Determinants of Multidrug-Resistant Pulmonary Tuberculosis in Indonesia: A Spatial Analysis Perspective

Tuberculosis is caused by Mycobacterium Tuberculosis (MT). MT usually attacks the lungs and causes pulmonary-tuberculosis. Tuberculosis cases in Indonesia keep increasing over the years. The presence of Multidrug-Resistant Tuberculosis (MDR-TB) has been one of the main obstacles in eradicating tuberculosis because it couldn’t be cured using standard drugs. In fact, the success rate of MDR-TB treatment in 2019 at the global level was only 57 percent. Research on MDR-TB can be related to the spatial aspect because this disease can be transmitted quickly. This study aims to obtain an overview and model the number of Indonesia’s pulmonary MDR-TB cases in 2019 using the Geographically Weighted Negative Binomial Regression (GWNBR) method. The independent variables used in the model are population density, percentage of poor population, health center ratio per 100 thousand population, the ratio of health workers per 10 thousand population, percentage of smokers, percentage of the region with PHBS policies, and percentage of BCG immunization coverage. The finding reveals that the model forms 12 regional groups based on significant variables where GWNBR gives better results compared to NBR. The significant spatial correlation implies that the collaboration among regional governments plays an important role in reducing the number of pulmonary MDR-TB.

Test on the law protection of minority investors in China: Perspective of misrepresentation in securities market

AbstractUnder the background of effectively building the legal system of the capital market and strengthening investor protection, an evaluation of whether China's legal system's reformations have improved investor protection is of great significance. Based on the lawsuits of 663 listed companies from 1997 to 2021, this paper finds the average annual proportion of listed companies punished by the China Securities Regulatory Commission and prosecuted by the investors is 40%, and since 2017, it has stabilized at around 70%. This paper also finds the “head effect” of the number of investors and claims in the misrepresentation cases over the years and the advantages of China Securities Investor Services Center's support in investor protection. Then, the negative binomial regression method is used to empirically find that investor protection gets better and better with the reformation of China's laws. Reformations in the legal system and key provisions have all led to an increase in the number of sued investors and claims. However, the time of legal proceedings only depends on the reform of the entire legal system. Finally, to reduce litigation costs and make all investors actually receive compensation after being infringed, we should establish the class action mechanism in the future reformation of China's legal system.

Índice cronotrópico y eventos adversos a largo plazo en insuficiencia cardiaca con fracción de eyección conservada

Introduction and objectivesLittle is known about the usefulness of heart rate (HR) response to exercise for risk stratification in heart failure with preserved ejection fraction (HFpEF). Therefore, this study aimed to assess the association between HR response to exercise and the risk of total episodes of worsening heart failure (WHF) in symptomatic stable patients with HFpEF. MethodsThis single-center study included 133 patients with HFpEF (NYHA II-III) who performed maximal cardiopulmonary exercise testing. HR response to exercise was evaluated using the chronotropic index (CIx) formula. A negative binomial regression method was used. ResultsThe mean age of the sample was 73.2± 10.5 years; 56.4% were female, and 51.1% were in atrial fibrillation. The median for CIx was 0.4 [0.3-0.55]. At a median follow-up of 2.4 [1.6-5.3] years, a total of 146 WHF events in 58 patients and 41 (30.8%) deaths were registered. In the whole sample, CIx was not associated with adverse outcomes (death, P=.319, and WHF events, P=.573). However, we found a differential effect across electrocardiographic rhythms for WHF events (P for interaction=.002). CIx was inversely and linearly associated with the risk of WHF events in patients with sinus rhythm and was positively and linearly associated with those with atrial fibrillation. ConclusionsIn patients with HFpEF, CIx was differentially associated with the risk of total WHF events across rhythm status. Lower CIx emerged as a risk factor for predicting higher risk in patients with sinus rhythm. In contrast, higher CIx identified a higher risk in those with atrial fibrillation.

Chronotropic index and long-term outcomes in heart failure with preserved ejection fraction

Introduction and objectivesLittle is known about the usefulness of heart rate (HR) response to exercise for risk stratification in heart failure with preserved ejection fraction (HFpEF). Therefore, this study aimed to assess the association between HR response to exercise and the risk of total episodes of worsening heart failure (WHF) in symptomatic stable patients with HFpEF. MethodsThis single-center study included 133 patients with HFpEF (NYHA II-III) who performed maximal cardiopulmonary exercise testing. HR response to exercise was evaluated using the chronotropic index (CIx) formula. A negative binomial regression method was used. ResultsThe mean age of the sample was 73.2± 10.5 years; 56.4% were female, and 51.1% were in atrial fibrillation. The median for CIx was 0.4 [0.3-0.55]. At a median follow-up of 2.4 [1.6-5.3] years, a total of 146 WHF events in 58 patients and 41 (30.8%) deaths were registered. In the whole sample, CIx was not associated with adverse outcomes (death, P=.319, and WHF events, P=.573). However, we found a differential effect across electrocardiographic rhythms for WHF events (P for interaction=.002). CIx was inversely and linearly associated with the risk of WHF events in patients with sinus rhythm and was positively and linearly associated with those with atrial fibrillation. ConclusionsIn patients with HFpEF, CIx was differentially associated with the risk of total WHF events across rhythm status. Lower CIx emerged as a risk factor for predicting higher risk in patients with sinus rhythm. In contrast, higher CIx identified a higher risk in those with atrial fibrillation.