Random Effects Logistic Models Research Articles

Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, Senegal.

Artemisinin-based Combination Therapies (ACTs) are widely used in the treatment of uncomplicated malaria. Plasmodium falciparum infection is often accompanied by disturbances of hematological and biochemical parameters. The objective of this study was to evaluate the changes in biochemical and hematological parameters during uncomplicated malaria in patients treated with ACTs. Data from patient with uncomplicated Plasmodium falciparum malaria were pooled from different open-randomized trial evaluating the efficacy of Artesunate-Mefloquine (ASMQ), Artesunate-Amodiaquine (ASAQ), Artemether-Lumefantrine (AL), and Dihydro-artemisinin-Piperaquine (DHAPQ) combinations. Biochemical (transaminases, creatinine, and bilirubin) and hematological (hemoglobin and platelet levels) parameters were performed at baseline (D0) and at day 7 after treatment (D7). Data were analyzed as both continuous and categorical variables with 95% confidence interval. Risks and trends were calculated using multivariate logistic random effect models. A total of 720 patients with completed biological data were included in the analysis (320 in the AL arm, 160 in the ASMQ arm, 120 in the DHAPQ arm, and 88 in the ASAQ arm). The mean age of the patients was 9.43 ± 9.1 years. Male subjects represented 58.47% (sex ratio was 1.4 for males). The mean hemoglobin level at inclusion (D0) was 9.79 g/dl and anemia (Hb < 11 g/dl) was 71.43% (aOR = 1.16 [0.68 - 1.98]p = 0.57). At D7, hemoglobin level was 9.63 g/dl and anemia was significantly more frequent (78.29% [p = 0.002]). The mean platelet count at day 0 was 154075.5 platelets/mm3 of blood and 339328.7 platelets/mm3 at day 7. Thrombocytopenia was about 53.61% and was associated with malaria (aOR = 3.4 [2.18 - 5.3]p < 10-3). 19.58% of patients had abnormal ALT and 40.28% had abnormal AST at D0. 27.22% of patients had normal bilirubin at D0. Renal function was normal in all patients in the study. Normalization of transaminases was noted between D0 and D7. The percentage of subjects with normal bilirubin increased between D0 and D7. Renal function did not vary significantly between D0 and D7. Results from this analysis showed that subjects with high parasitaemia had a greater risk of anemia and thrombocytopenia. Artemisinin combinations were well-tolerated as no major biological disturbances were noted. The effects of ACTs on hematologic and biochemical parameters were not different.

Modelling factors associated with therapeutic inertia in hypertensive patients: Analysis using repeated data from a hospital registry in West Africa.

The proportion of poorly controlled hypertensives still remains high in the general African population. This is largely due to therapeutic inertia (TI), defined as the failure to intensify or modify treatment in a patient with poorly controlled blood pressure (BP). The objective of this study was to identify the determinants of TI. We conducted a retrospective cohort study from March 2012 to February 2014 of hypertensive patients followed during 4 medical visits. The TI score was the number of visits with TI divided by the number of visits where a therapeutic change was indicated. A random-effects logistic model was used to identify the determinants of TI. A total of 200 subjects were included, with a mean age of 57.98 years and 67% men. The TI score was measured at 85.57% (confidence interval [CI] 95% = [82.41-88.92]). Measured individual heterogeneity was significantly significant (0.78). Three factors were associated with treatment inertia, namely the number of antihypertensive drugs (odd ratios [OR] = 1.27; CI = [1.02-1.58]), the time between consultations (OR = 0.94; CI = [0.91-0.97]), and treatment noncompliance (OR = 15.18; CI = [3.13-73.70]). The random-effects model performed better in predicting high-risk patients with TI than the classical logistic model (P value < .001). Our study showed a high TI score in patients followed in cardiology in Burkina Faso. Reduction of the TI score through targeted interventions is necessary to better control hypertension in our cohort patients.

Indoor environmental exposures and obstructive lung disease phenotypes among children with asthma living in poor urban neighborhoods

Air trapping is an obstructive phenotype that has been associated with more severe and unstable asthma in children. Air trapping has been defined using pre- and postbronchodilator spirometry. The causes of air trapping are not completely understood. It is possible that environmental exposures could be implicated in air trapping in children with asthma. We investigated the association between indoor exposures and air trapping in urban children with asthma. Children with asthma aged 5 to 17 years living in Baltimore and enrolled onto the Environmental Control as Add-on Therapy for Childhood Asthma study were evaluated for air trapping using spirometry. Aeroallergen sensitization was assessed at baseline, and spirometry was performed at 0, 3, and6 months. Air trapping was defined as an FVC z score of lessthan -1.64 or a change in FVC with bronchodilation of ≥10% predicted. Logistic normal random effects models were used to evaluate associations of air trapping and indoor exposures. Airborne and bedroom floor mouse allergen concentrations were associated with air trapping but not airflow limitation (odds ratio 1.19, 95% confidence interval 1.02-1.37, P= .02 per 2-fold increase in airborne mouse allergen; odds ratio 1.23, 95% confidence interval 1.07-1.41, P= .003 per 2-fold increase in bedroom floor mouse allergen). Other indoor exposures (cockroach, cat, dog, dust mite, particulate matter, and nicotine) were not associated with air trapping or airflow limitation. Mouse allergen exposure, but not other indoor exposure, was associated with air trapping in urban children with asthma.

Pain Response Rates after Conventional Radiation Therapy for Bone Metastases Assessed Using International Consensus Pain Response Endpoints: A Systematic Review and Meta-Analysis of Initial Radiation Therapy and Re-Irradiation

<h3>Purpose/Objective(s)</h3> Previous systematic reviews of conventional radiation therapy (RT) for painful bone metastases showed response rates of 72%<b>–</b>75% for initial RT and 68% for re-irradiation. However, the definition of pain response differed among studies included in these reviews. The International Consensus Pain Response Endpoints (ICPRE) was published in 2002 and revised in 2012 to unify evaluation methods for pain response internationally and has been used in many studies. We conducted a systematic review and meta-analysis to determine the pain response rates assessed by ICPRE for both initial RT and re-irradiation. <h3>Materials/Methods</h3> A literature search was conducted in PubMed and Scopus for articles published between 2002 and 2021. The inclusion criteria were as follows: (i) the study designs of randomized controlled trials (RCTs), prospective studies, or studies based on prospectively collected data; and (ii) studies in which pain response was assessed using ICPRE. Our primary outcomes of interest were overall response (OR) rates (sum of complete response rate and partial response rate) for both initial RT and re-irradiation. The following subgroup analyses were performed for OR rates of initial RT: RCT vs. non-randomized studies, with vs. without exclusion criteria for complicated bone metastases, with vs. without eligibility criteria for no change in analgesic use at enrollment, and timing of response assessment (≤1 month vs. >1 month). Random effects logistic models were used to estimate pooled response rates. <h3>Results</h3> Of the 6470 articles identified in our database search, 32 and 3 met the inclusion criteria for analysis of initial RT and re-irradiation, respectively. The OR rates of initial RT in evaluable patients (n = 4775) and intent-to-treat patients (n = 6775) were 60.4% (95% confidence interval [CI], 55.2–65.4) and 45.4% (95% CI, 38.7–52.4), respectively. The OR rates of re-irradiation in evaluable patients (n = 733) and intent-to-treat patients (n = 1085) were 70.8% (95% CI, 15.7–96.9) and 62.2% (95% CI, 5.3–98.0), respectively. Subgroup analyses of initial RT showed no significant differences in any of the comparisons, indicating similar response rates across different study designs. <h3>Conclusion</h3> We determined the pain response rates of initial RT for painful bone metastases assessed by ICPRE. The OR rate assessed by ICPRE was lower than previously reported. The present review may provide benchmarks for future RCTs and non-randomized studies. Regarding the response rate for re-irradiation, the wide range of the 95% CI warrants that the OR rate based on ICPRE requires further investigation.

Prenatal exposure to Nitrogen Oxides and Waist-to-Height Ratio (WHtR) as a cardiovascular risk factor in school-aged children participants of the POSGRAD Cohort

Prenatal exposure to Nitrogen Oxides and Waist-to-Height Ratio (WHtR) as a cardiovascular risk factor in school-aged children participants of the POSGRAD Cohort. Priscila Ceja Esparza¹, Albino Barraza Villarreal¹, Leticia Hernández Cadena¹ ¹ Department of Environmental Health, The National Institute of Public Health of Mexico (INSP) Background and Aim: Prenatal exposure to NOx may increase the risk of obesity and cardiovascular risk factors in children. This study aims to evaluate the relationship between prenatal exposure to NOx and its effect on the behavior of the WHtR in school-aged children from the ages of 7 to 12 years old and to determine if the prenatal supplementation with docosahexaenoic acid (DHA) influences the outcome. Methods: We included 642 mother-child from the POSGRAD cohort. Land use regression models were performed to estimate exposure to NOx (NO, NO2 and NOx) using the results of passive outdoor monitoring from a representative sample of participant households. Child anthropometrics were taken yearly and WHtR was calculated. The association between prenatal exposure to NOx and WHtR was measured through a logistic random-effects model by tertiles of exposure and considering the prenatal supplementation status. Results: We found a significant difference in the risk of having a WHtR &amp;#x3e;= 0.5, on the second tertile of exposure for NOx between the supplemented (OR= 0.59, IC 95%: 0.10-3.49, p = 0.56) and placebo (OR=13.74, IC 95%: 1.94-97.24, p=0.01) groups when compared with the lowest tertile; in the third tertile the ORs were bigger for both groups, however, these were not significant. Conclusions: Prenatal exposure to NOx can affect the WHtR outcome in children and prenatal supplementation with DHA can decrease this effect. The lack of protection of DHA at higher levels of exposure could suggest a need for higher doses of supplementation. Key Words: Prenatal, Waist-to-Height Ratio, Nitrogen Oxides, Cardiovascular Risk

Global Epidemiology of Gaucher Disease: an Updated Systematic Review and Meta-analysis.

Gaucher disease [GD], an autosomal recessive lysosomal storage disorder, is characterized by progressive lysosomal storage of glucocerebroside in macrophages predominantly in bone, bone marrow, liver, and spleen. Meta-analysis of global GD epidemiology was not available before this study. To provide a systematic review and meta-analysis of birth prevalence and prevalence of GD in multiple countries. MEDLINE and EMBASE databases were searched for original research articles on the epidemiology of GD from inception until July 21, 2021. Meta-analysis, adopting a random-effects logistic model, was performed to estimate the birth prevalence and prevalence of GD. Eighteen studies that were screened of 1874 records were included for data extraction. The studies that fulfilled the criteria for inclusion involved 15 areas/countries. The global birth prevalence of GD was 1.5 cases [95% confidence interval: 1.0 to 2.0] per 100,000 live births. The global prevalence of GD was 0.9 cases [95% confidence interval: 0.7 to 1.1] per 100,000 inhabitants. This is the first comprehensive systematic review that presented quantitative data of GD global epidemiology. Quantitative data on global epidemiology of GD could be the fundamental to evaluate the global efforts on building a better world for GD patients.

Corporate social responsibility and CEO dismissals: the dynamic role of average and above-average CSR on CEO dismissals

Considering the growing importance of Corporate Social responsibility (CSR) among various stakeholders, the present study investigates the association between corporate social responsibility (CSR) and CEO (Chief Executive Officer) dismissals. Based on a sample of Chinese listed firms from 2009 to 2019, this research study used a random effect logistic model. The findings of the study indicate that total CSR is positively associated with CEO dismissals. In further analysis, we decompose CSR and show that average CSR is negatively linked with CEO dismissals, indicating that CEOs mitigate career concerns by maintaining an optimal range of CSR investment. Moreover, above-average CSR is positively linked with CEO dismissals, indicating that when CSR investments deviate from their optimal range, CEOs’ risk of dismissal increases. Finally, we have validated our findings and show a U-shaped link between CSR and CEO dismissals. This research is helpful for policymakers in making CSR-related decisions.

IMPACT OF COMORBID CONDITIONS ON EOSINOPHILIA IN PATIENTS WITH SEVERE ASTHMA

TYPE: Abstract TOPIC: Obstructive Lung Diseases PURPOSE: With growing evidence for the importance of the peripheral blood eosinophil count (PBEC) in the management of asthma, understanding the impact of common comorbidities on repeat eosinophil draws is critical. METHODS: A retrospective chart review was conducted of patients seen at the Drexel Severe Asthma Clinic. We extracted information including with repeat PBECs, exacerbations, comorbid conditions, age, and sex of the patients. Patients who received systemic steroids within three weeks of the draw were excluded. Comorbid conditions included COPD, GERD, atopic dermatitis, and current maintenance treatment of HIV. A random effect logistic model was used to assess if the presence or absence of these comorbidities was significantly associated with differences in repeat eosinophil draws. RESULTS: There were 79 patients and 744 PBECs recorded (mean 9.4 + 4.3 counts over 7.1 + 2.9 years). Random effect logistic regression showed the presence or absence of COPD (p=0.92), GERD (p=0.95), atopic dermatitis (p=0.99), and current maintenance treatment of HIV (p=0.99) were not associated with differences in repeat PBECs within comorbid cohorts. Additionally, patient sex was not associated with differences in repeat PBECs (p=0.93). However, there was a statistically significant association between an elevated PBEC and patient reported exacerbation within three weeks (p=0.01). CONCLUSIONS: These results indicate that neither the presence or absence of the described comorbidities nor patient sex are associated with persistently elevated or depressed eosinophil measurements. However, PBEC elevations were found within three weeks of exacerbations in non-systemic steroid treated patients. CLINICAL IMPLICATIONS: We show an association between eosinophilia on repeat draws and exacerbations DISCLOSURE: Nothing to declare. KEYWORD: Eosinophils

The association between institutional delivery and neonatal mortality based on the quality of maternal and newborn health system in India

Over 600,000 newborns in India died in their first month of life in 2017 despite large increases in access to maternal health services. We assess whether maternal and newborn health system quality in India is adequate for institutional delivery to reduce neonatal mortality. We identified recent births from the cross-sectional 2015–2016 National Family Health Survey and used reported content of antenatal care and immediate postpartum care averaged at the district level to characterize health system quality for maternity and newborn services. We used random effect logistic models to assess the relationship between institutional delivery and neonatal (death within the first 28 days of life) and early neonatal (death within 7 days of live births) mortality by quintile of district maternal and newborn health system quality. Three quarters of 191,963 births were in health facilities; 2% of newborns died within 28 days. District-level quality scores ranged from 40 to 90% of expected interventions. Institutional delivery was not protective against newborn mortality in the districts with poorest health system quality, but was associated with decreased mortality in districts with higher quality. Predicted neonatal mortality in the highest quintile of quality would be 0.018 (95% CI 0.010, 0.026) for home delivery and 0.010 (0.007, 0.013) for institutional delivery. Measurement of quality is limited by lack of data on quality of acute and referral care. Institutional delivery is associated with meaningful survival gains where quality of maternity services is higher. Addressing health system quality is an essential element of achieving the promise of increased access to maternal health services.

Factors Contributing to Persistent Frequent Attendance in Primary Care Among the Oldest Old: Longitudinal Evidence From the AgeCoDe-AgeQualiDe Study.

ObjectiveSince there is a lack of longitudinal studies in this area, our aim was to identify the determinants of persistent frequent attendance in primary care among the oldest old in Germany.MethodsLongitudinal data (follow-up wave 7–9) were taken from the multicenter prospective cohort “Study on needs, health service use, costs, and health-related quality of life in a large sample of oldest-old primary care patients (85+)” (AgeQualiDe), covering primary care patients ≥ 85 years (FU7 n = 741, mean age 88.9 years (SD 2.9; 85–100)). Persistent frequent attenders of general practitioner (GP) services (the patients in the top decile of the number of GP consultations in two or more consecutive waves) were our main outcome of interest. Logistic random-effects models were used.ResultsOur analysis included 1,891 observations (766 individuals). Across three waves, we identified 56 persistent frequent attenders. Results of random-effects logistic regressions showed that the odds of being persistent frequent attender were higher for widowed individuals (OR = 4.57; 95% CI [1.07–19.45]). Moreover, a one-point increase in the frailty score and having one more chronic condition increased the odds of being a persistent frequent attender by 68% (OR =1.68; 95% CI [1.05–2.69]) and 23% (OR=1.23, 95% CI [1.05–1.44]), respectively.ConclusionOur study stressed the longitudinal association between frailty and widowhood as well as chronic diseases and persistent frequent attendance among the oldest old in Germany.

The prevalence and incidence of major depressive disorder in 8079 Chinese university freshmen before and during COVID-19

BackgroundCOVID-19 pandemic may impact the prevalence and incidence of depression in college students. However, there is no longitudinal study focusing on major depressive disorder (MDD) before and during COVID-19 pandemic. MethodsA cohort study was carried out among 8079 Chinese college freshmen. The baseline survey was conducted in 2018 (T0) and annual follow-ups were in 2019 (T1, before COVID-19) and in 2020 (T2, during COVID-19). CIDI-3.0 was used to diagnose MDD. Random effects logistic models of panel data analysis were used for the risk of MDD incidence. STATA 15.1 was used for all analysis. ResultsThe weighted 12-month prevalence of MDD at T2 (2.10%) was significantly lower than that at T1 (2.67%) (p < 0.001). However, among students who reported exposure to the COVID-19 events, the annual prevalence of MDD at T2 was higher than that at T1 (4.21% vs. 2.79%, p < 0.001). The incidence from T0 to T1, incidence from T1 to T2, and the 2-year incidence was 2.23%, 1.34% and 3.75%, respectively. Only 8.93% of MDD students had chosen to seek professional help during the COVID-19 pandemic period. LimitationsThe computer assisted CIDI may not be as sensitive and specific as the diagnosis made by a psychiatrist and may have caused report bias. ConclusionsAlthough the MDD incidence of college students was decreasing over time, the impact of the pandemic on student mental health may depend on exposure to COVID-19 events. Not seeking professional help in the Chinese college students is still an important issue.

Potential determinants of unfavourable healthcare utilisation trajectories during the last year of life of people with incident Alzheimer Disease or Related Syndromes: a nationwide cohort study using administrative data

people approaching the end-of-life frequently face inappropriate care. With Alzheimer Disease or Related Syndromes (ADRS), end-of-life is characterised by progressive decline, but this period remains difficult to identify. This leads to a lack of anticipation and sometimes with unfavourable healthcare utilisation trajectories (HUTs). to quantify unfavourable HUTs during the last year of life and identify their potential determinants in both community and nursing-home settings. nationwide cohort study using administrative database. French community and nursing-home residents. incident ADRS people identified in 2012, who died up to 31 December 2017. we used multidimensional clustering to identify 15 clusters of HUTs, using 11 longitudinal healthcare dimensions during the last year of life. Clusters were qualitatively assessed by pluri-disciplinary experts as favourable or unfavourable HUTs. Individual and contextual potential determinants of unfavourable HUTs were studied by setting using logistic random-effect regression models. 62,243 individuals died before 31 December 2017; 46.8% faced unfavourable end-of-life HUTs: 55.2% in the community and 31.8% in nursing-homes. Individual potential determinants were identified: younger age, male gender, ADRS identification through hospitalisation, shorter survival, life-limiting comorbidities, psychiatric disorders, acute hospitalisations and polypharmacy. In the community, deprivation and autonomy were identified as potential determinants. Contextual potential determinants raised mostly in the community, such as low nurse or physiotherapist accessibilities. Nearly half of people with ADRS faced unfavourable HUTs during their last year of life. Individual potential determinants should help anticipate advance care planning and palliative care needs assessment. Contextual potential determinants suggest geographical disparities and health inequalities.

Factors Leading to Institutionalization among the Oldest Old: Longitudinal Findings from the AgeCoDe-AgeQualiDe Study

Introduction: Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study was to examine the determinants of institutionalization among the oldest old longitudinally. Methods: Longitudinal data (follow-up [FU] wave 7–9) were gathered from a multicenter prospective cohort study (“Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+],” AgeQualiDe). At FU wave 7, in 2014, complete measures were available for 763 individuals. The average age was 88.9 (standard deviation 2.9) years (range 85–100), and 68% were female. Sociodemographic and health-related independent variables (e.g., depressive symptoms or functioning) were included in the regression model. Institutionalization (admission to assisted living home or nursing home) was used as an outcome measure. Logistic random-effects models were used. Results: Regressions revealed that among oldest old, the odds of being institutionalized were lower for men (odds ratio [OR] = 0.03; 95% confidence interval [CI] 0.00–0.16). Institutionalization was associated with an increased age (OR = 1.27; 95% CI 1.04–1.55). Additionally, widowed individuals (ref. non-widowed) had higher odds of being institutionalized (OR = 8.95; 95% CI 1.61–49.81). Institutionalization was also associated with functional decline (OR = 0.16; 95% CI 0.11–0.23), whereas it was not significantly associated with cognitive decline, depressive symptoms, and social support. Conclusion: Our findings stress the importance of gender, age, widowhood, and functional decline for institutionalization among the oldest old. Preventing or at least postponing functional decline might help to delay institutionalization as far as possible.

Analyzing Spatial Dependency of the 2016-2017 Korean HPAI Outbreak to Determine the Effective Culling Radius.

Highly pathogenic avian influenza (HPAI) outbreaks are a threat to human health and cause extremely large financial losses to the poultry industry due to containment measures. Determining the most effective control measures, especially the culling radius, to minimize economic impacts yet contain the spread of HPAI is of great importance. This study examines the factors influencing the probability of a farm being infected with HPAI during the 2016–2017 HPAI outbreak in Korea. Using a spatial random effects logistic model, only a few factors commonly associated with a higher risk of HPAI infection were significant. Interestingly, most density-related factors, poultry and farm, were not significantly associated with a higher risk of HPAI infection. The effective culling radius was determined to be two ranges: 0.5–2.2 km and 2.7–3.0 km. This suggests that the spatial heterogeneity, due to local characteristics and/or the characteristics of the HPAI virus(es) involved, should be considered to determine the most effective culling radius in each region. These findings will help strengthen biosecurity control measures at the farm level and enable authorities to quickly respond to HPAI outbreaks with effective countermeasures to suppress the spread of HPAI.

Factors Impacting Video Telehealth Appointment Completion During COVID-19 Pandemic Among People Living with HIV in a Community-Based Health System

As the threat of COVID-19 on vulnerable populations continues, mitigation protocols have escalated the use of telehealth platforms, secure 2-way video platforms with audio capabilities. The goal of the current study was to examine factors associated with successful completion of video telehealth appointments in HIV care. We utilized a random effects logistic model to assess characteristics of patient encounters that predicted completed telehealth visits. Results show that factors such as identifying as black (AOR = 0.30, 95% CI 0.23–0.40, p < 0.01), identifying as heterosexual (AOR = 0.40, 95% CI, 0.29–0.55, p < 0.01), identifying as Hispanic/Latinx (AOR = 0.67, 95% CI, 0.48–0.95), having public insurance (e.g., Ryan White funding, Medicare/Medicaid) (AOR = .25, 95% CI 0.19–0.33, p < .001), and having detectable viral load (AOR = .049, 95% CI, 0.31–0.76) are negatively associated with completion of telehealth appointments. Results suggest that greater efforts to address the digital divide are needed to increase access to video telehealth.

Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking

QuestionMental disorders typically start in childhood and persist, causing high individual and collective burdens. To inform policymaking to address children’s mental health in high-income countries we aimed to identify updated...

Global epidemiology of mucopolysaccharidosis type III (Sanfilippo syndrome): an updated systematic review and meta-analysis.

Mucopolysaccharidosis III, an autosomal recessive lysosomal storage disorder, is characterized by progressive mental retardation and behavioral problems. Meta-analysis of global mucopolysaccharidosis III epidemiology, which serves as a fundamental reference for public health decision-making, was not available prior to this study. To provide a systematic review and meta-analysis of birth prevalence of mucopolysaccharidosis III in multiple countries. MEDLINE and EMBASE databases were searched for original research articles on the epidemiology of mucopolysaccharidosis III from inception until 1st July, 2020. A checklist adapted from STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) was used to assess the quality of all studies involved. Meta-analysis, adopting a random effects logistic model, was performed to estimate pooled birth prevalence of mucopolysaccharidosis III and its subtypes. Twenty-five studies screened out of 1,826 records were included for data extraction. The pooled global mucopolysaccharidosis III birth prevalence was 0.76 cases (95% CI:0.57-0.96) per 100,000 live births. The pooled global birthprevalence of mucopolysaccharidosis III subtypes (A,B,and C) was 0.52 cases (95% CI: 0.33-0.72), 0.21 cases (95% CI: 0.12-0.30) and 0.01 cases (95% CI: 0.005-0.02) per 100,000 live births, respectively. Based on the global population size (7.8 billion) and the life span of patients, there would be 12-19 thousand mucopolysaccharidosis III patients worldwide. To our knowledge, this is the first comprehensive systematic review that presented quantitative data fundamental for evidence-based public health decision-making by evaluating global epidemiology of mucopolysaccharidosis III.

Facilitating or inhibiting charitable giving? Exploring the dual role of compulsory donations in China

ABSTRACT Charitable giving is often seen as voluntary prosocial behavior. However, compulsory donations are not uncommon in countries such as China. This paper explores this understudied phenomenon by examining the impact of compulsory donations on voluntary and total charitable giving. Building upon the previous literature from multiple perspectives and using panel data from the China Labor-force Dynamics Survey, this study proposes an integrated framework to explain how compulsory donations affect voluntary and total giving and empirically tests the possible impact. Results from random-effects logistic regressions and tobit models demonstrate the dual role of compulsory donations in China. On the one hand, making compulsory donations crowds out voluntary charitable giving, while on the other hand, the practice increases total charitable giving because of its imperfect crowding-out effect on voluntary giving.

The Bayesian Multiple Logistic Random Effects Model for Analysis of Clinical Trial Data

A prospective, multi-institutional and randomized surgical trial involving 724 early stage melanoma patients was conducted to determine whether excision margins for intermediate-thickness melanomas (1.0 to 4.0 mm) could be safely reduced from the standard 4-cm radius. Patients with 1- to 4-mm-thick melanomas on the trunk or proximal extremities were randomly assigned to receive either a 2- or 4-cm surgical margin with or without immediate node dissection (i.e. immediate vs. later -within 6 months). The median follow-up time was 6 years. Recurrence rates did not correlate with surgical margins, even among stratified thickness groups. The hospital stay was shortened from 7.0 days for patients receiving 4-cm surgical margins to 5.2 days for those receiving 2-cm margins (p = 0.0001). This reduction was largely due to reduced need for skin grafting in the 2cm group. The overall conclusion was that the narrower margins significantly reduced the need for skin grafting and shortened the hospital stay. Due to the adequacy of subject follow up, recently a statistical focus was on what prognostics factors usually called covariates actually determined recurrence. As was anticipated, the thickness of the lesion (p = 0.0091) and whether or not the lesion was ulcerated (p = 0.0079), were determined to be significantly associated with recurrence events using the logistic regression model. This type of fixed effect analysis is rather a routine. The authors have determined that a Bayesian consideration of the results would afford a more coherent interpretation of the effect of the model assuming a random effect of the covariates of thickness and ulceration. Thus, using a Markov Chain Monte Carlo method of parameter estimation with non informative priors, one is able to obtain the posterior estimates and credible regions of estimates of these effects as well as their interaction on recurrence outcome. Graphical displays of convergence history and posterior densities affirm the stability of the results. We demonstrate how the model performs under relevant clinical conditions. The conditions are all tested using a Bayesian statistical approach allowing for the robust testing of the model parameters under various recursive partitioning conditions of the covariates and hyper parameters which we introduce into the model. The convergence of the parameters to stable values are seen in trace plots which follow the convergence patterns This allows for precise estimation for determining clinical conditions under which the response pattern will change.

Using the Multilevel Random Effect Model to Analyze the Behavior of Carpool Users in Different Cities

The purpose of this study was to offer a comprehensive econometrical framework based on a multilevel random effect logistic model that could highlight important contributors to carpool users among different cities with various attributes. The data was collected from the three cities of Tucson, AZ, USA; El Paso, TX, USA; and Austin, TX, USA and was based on register-based travel trip data from the Metropia platform and American Community Survey information from 2016 to 2017. The empirical results indicated there were statistically significant differences among carpool users in different cities due to the transportation mode, number of vehicles available, total number of males driving alone, and number of single-parent households. The individual level result showed that incentives had a significant effect on the promotion of carpool passenger and driver behavior. In addition, the time of finding the parking space at work, living situation of the household, flexibility to change departure times, gender, and age could effectively increase the possibility of carpool usage. The results of this study give a better understanding of the events in the initial factors of carpooling behavior and can be used by the government or commercial company to design an effective solution for traffic congestion.