Marginal Effect Research Articles

Availability and use of telehealth services among patients with ADRD enrolled in traditional Medicare vs. Medicare advantage during the COVID-19 pandemic.

The objective of this study was to examine differences in availability and use of telehealth services among Medicare enrollees according to Alzheimer's disease and related dementias (ADRD) status and enrollment in Medicare Advantage (MA) versus Traditional Medicare (TM) during the period surrounding the COVID-19 pandemic. This was a retrospective cross-sectional analysis of data from community-dwelling MA and TM enrollees with and without ADRD from the Medicare Current Beneficiary Survey (MCBS) Fall 2020 and Winter 2021 COVID-19 Supplement Public Use Files. We examined self-reported availability of telehealth service before and during the COVID-19 pandemic and use of telehealth services during COVID-19. We analyzed marginal effects under multivariable logistic regression. There were 13,700 beneficiaries with full-year enrollment in MA (6,046) or TM (7,724), 518 with ADRD and 13,252 without ADRD. Telehealth availability during COVID-19 was positively associated with having a higher income (2.81 pp. [percentage points]; 95% CI: 0.57, 5.06), having internet access (7.81 pp.; 95% CI: 4.96, 10.66), and owning telehealth-related technology (3.86; 95% CI: 1.36, 6.37); it was negatively associated with being of Black Non-Hispanic ethnicity (-8.51 pp.; 95% CI: -12.31, -4.71) and living in a non-metro area (-8.94 pp.; 95% CI: -13.29, -4.59). Telehealth availability before COVID-19 was positively associated with being of Black Non-Hispanic ethnicity (9.34 pp.; 95% CI: 3.74, 14.94) and with enrollment in MA (4.72 pp.; 95% CI: 1.63, 7.82); it was negatively associated having dual-eligibility (-5.59 pp.; 95% CI: -9.91, -1.26). Telehealth use was positively associated with being of Black Non-Hispanic ethnicity (6.47 pp.; 95% CI: 2.92, 10.01); it was negatively associated with falling into the age group of 75+ years (-4.98 pp.; 95% CI: -7.27, -2.69) and with being female (-4.98 pp.; 95% CI: -7.27, -2.69). Telehealth services were available to and used by Medicare enrollees with ADRD to a similar extent compared to their non-ADRD counterparts. Telehealth services were available to MA enrollees to a greater extent before COVID-19 but not during COVID-19, and this group did not use telehealth services more than TM enrollees during COVID-19.

SAR dynamical mechanism affected by diminishing marginal effect based on personal fashion psychology on multi-layer contacted network

People in complex systems exhibit varying capacities for social interaction because of differences in personal psychology, educational attainment, and social class. It is true that people often use different social networks and show different enthusiasm for obtaining information, but their interest in collecting information will decrease over time. Our study on Personal Fashion Psychology (PFP) has shown that when people get information, they behave in a way known as the Diminishing Marginal Effect (DME-PFP behavior). Next, we created a SAR propagation dynamics model on a multi-layer contact network to represent DME-PFP behavior using a threshold function. Then, to assess and uncover the transmission mechanism of individual behaviour, we use partition theory. A boundary phenomena is displayed by the propagation mode, as demonstrated by both theoretical analysis and simulated tests. The final size can exhibit either discontinuous first-order phase transitions or continuous second-order phase changes in individual DME-PFP behaviour. Meanwhile, through the unit transmission probability changed, the ideal DME-PFP parameters occur at the largest final adoption size. Moreover, the promotion of the propagation pattern and behaviour from continuous second-order to discontinuous first-order is facilitated by interpersonal contact. The numerical analysis and the actual models may eventually agree.

Assessing the effect of urban digital infrastructure on green innovation: mechanism identification and spatial-temporal characteristics

Under the background of digitization and greening in China, digital infrastructure offers new opportunities for developing green innovation. This paper investigates the effect of digital infrastructure on urban green innovation using panel data from 285 Chinese prefecture-level cities between 2011 and 2020, and explains the mechanism and its spatial-temporal dynamic effect. The results demonstrate that digital infrastructure promotes urban green innovation. Talent agglomeration, R&D investment increase, and industrial structure upgrading are crucial channels. Furthermore, depending on a city’s size, human capital, environmental regulations, and financial subsidies, digital infrastructure contributes to urban green innovation differently. Also, there is not only a positive spatial spillover effect of digital infrastructure but a threshold effect that presents a nonlinear trend of rising marginal effect. This study provides a new perspective for promoting digital infrastructure and urban green innovation, which makes a difference in facilitating its high-level development collaboratively.

Health utility among people who regularly use opioids in Australia.

Studies of health utilities among people who use opioids have mostly been based on in-treatment populations. We aim to report utility-based quality of life by participants' socio-demographic, drug and treatment characteristics, and to examine the determinants of health utility among people who use opioids regularly. Cross-sectional study of participants who used opioids regularly, recruited across New South Wales, Victoria and Tasmania in 2018-2019. Differences in European Quality of Life (EQ-5D-5L) heath utility scores between socio-demographic and clinical subgroups were assessed using non-parametric Kruskal-Wallis test by rank. To address the unique distribution of EQ-5D-5L health utility scores in the current sample, a two-part model was applied to assess factors associated with health utility. Among 402 participants enrolled in the study, 385 (96%) completed the EQ-5D-5L questionnaire. The mean health utility of the total sample was 0.63 (SD 0.29). Participants who previously received opioid agonist treatment [OAT] (adj marginal effect (ME) -0.11; 95% confidence interval [CI] -0.20 to -0.02) and those currently in OAT (adj ME -0.13; 95% CI -0.22 to -0.06) reported lower health utility than those who had never received OAT. Participants who used both pharmaceutical opioids and benzodiazepines had lower health utility compared to no pharmaceutical opioids and no benzodiazepines use (adj ME -0.17; 95% CI -0.28 to -0.07). Findings provide important health utility data for economic evaluations, useful for guiding allocation of resources for treatment strategies among people who use opioids. Lower health utilities among those using benzodiazepines and pharmaceutical opioids suggests interventions targeting these subgroups may be beneficial.

Micro-entrepreneurship, Institutional Environment and the COVID-19 Pandemic: A Comparison of Weaving Clusters in West Bengal, India

This article compares micro-enterprises’ performance and the entrepreneurial ability of weavers as perceived by the weavers themselves under two different institutional environments: one dominated by a cooperative society and the other dominated by private traders. Weavers in the private trader-dominated institutional environment are more likely to introduce new designs, develop new products and usher client satisfaction. However, the determinants of overall entrepreneurial ability reveal that after controlling for several factors, the weavers associated with a cooperative society seem to have significantly higher abilities. Analysing the marginal effects of the institutional environment, it is observed that the perceived quality of handlooms, weaver’s ability to bargain for returns and ability to efficiently manage business finances are much better in the cooperative-dominated cluster as compared to the private trader-dominated cluster. Furthermore, the resilience of enterprises during the COVID-19 pandemic was much higher in the cooperative-dominated business environment. Enterprises using more unpaid female household labour were more resilient than others during the pandemic.

Epistasis arises from shifting the rate-limiting step during enzyme evolution of a β-lactamase

Epistasis, the non-additive effect of mutations, can provide combinatorial improvements to enzyme activity that substantially exceed the gains from individual mutations. Yet the molecular mechanisms of epistasis remain elusive, undermining our ability to predict pathogen evolution and engineer biocatalysts. Here we reveal how directed evolution of a β-lactamase yielded highly epistatic activity enhancements. Evolution selected four mutations that increase antibiotic resistance 40-fold, despite their marginal individual effects (≤2-fold). Synergistic improvements coincided with the introduction of super-stochiometric burst kinetics, indicating that epistasis is rooted in the enzyme’s conformational dynamics. Our analysis reveals that epistasis stemmed from distinct effects of each mutation on the catalytic cycle. The initial mutation increased protein flexibility and accelerated substrate binding, which is rate-limiting in the wild-type enzyme. Subsequent mutations predominantly boosted the chemical steps by fine-tuning substrate interactions. Our work identifies an overlooked cause for epistasis: changing the rate-limiting step can result in substantial synergy that boosts enzyme activity.

Quantifying the impacts of management and herbicide resistance on regional plant population dynamics in the face of missing data

Abstract A key challenge in the management of populations is to quantify the impact of interventions in the face of environmental and phenotypic variability. However, accurate estimation of the effects of management and environment, in large‐scale ecological research is often limited by the expense of data collection, the inherent trade‐off between quality and quantity, and missing data. In this paper we develop a novel modelling framework, and demographically informed imputation scheme, to comprehensively account for the uncertainty generated by missing population, management, and herbicide resistance data. Using this framework and a large dataset (178 sites over 3 years) on the densities of a destructive arable weed (Alopecurus myosuroides) we investigate the effects of environment, management, and evolved herbicide resistance, on weed population dynamics. In this study we quantify the marginal effects of a suite of common management practices, including cropping, cultivation, and herbicide pressure, and evolved herbicide resistance, on weed population dynamics. Using this framework, we provide the first empirically backed demonstration that herbicide resistance is a key driver of population dynamics in arable weeds at regional scales. Whilst cultivation type had minimal impact on weed density, crop rotation, and earlier cultivation and drill dates consistently reduced infestation severity. Synthesis and applications: As we demonstrate that high herbicide resistance levels can produce extremely severe weed infestations, monitoring herbicide resistance is a priority for farmers across Western Europe. Furthermore, developing non‐chemical control methods is essential to control current weed populations, and prevent further resistance evolution. We recommend that planning interventions that centre on crop rotation and incorporate spring sewing and cultivation to provide the best reductions in weed densities. More generally, by directly accounting for missing data our framework permits the analysis of management practices with data that would otherwise be severely compromised.

Supportive Interventions of Chinese Police in Domestic Violence: Do Officer Knowledge and Training Matter?

Policing domestic violence (DV) poses significant challenges in China due to cultural, legal, and organizational complexities. Policing DV in China favors mediation over assertive interventions, complicating law enforcement's role. While previous research has focused on coercive interventions by Chinese police, there is limited information on non-coercive, supportive approaches. This study investigates the relationship between police officers' knowledge and training regarding the Anti-DV law and their willingness to provide supportive services to DV victims in China. It also considers various individual and organizational factors. The data used in this study are derived from the Policing DV in China project, with a sample of 1,353 respondents who had experience dealing with DV cases within the past 3 years. The study focuses on three dependent variables representing supportive approaches to DV cases: Referral, Counseling, and Protection orders. Independent variables include officers' knowledge of the Anti-DV law and agency training. Control variables include the use of body-worn cameras (BWC) and attitudes toward Violence Tolerance, Male Dominance, and Gender Equality. Additionally, demographic variables, working environment, length of service, and police rank are considered. The analytical approach involves a three-step strategy, incorporating descriptive, bivariate analyses, and regression analyses. The results are interpreted using odds ratios and average marginal effects, and statistical software such as SPSS by IBM and R by Open-Source Model is utilized for data analysis. Key findings indicate that more than half of the officers referred intimate partner violence survivors to shelters and assisted victims in filing protection orders. Counseling practices varied across provinces and between male and female officers. Agency training and the use of BWC were positively associated with non-coercive and supportive approaches, while knowledge of the DV Act, male dominance score, and gender equality score did not predict the use of such approaches. Demographic characteristics, including police rank, length of service, and province of employment, influenced the utilization of non-coercive and supportive approaches. This study examines the challenges faced by Chinese police officers when responding to DV cases and their willingness to provide supportive interventions. The study highlights the complexities surrounding the initiation of protection orders due to officers' legal knowledge and discretion. The study emphasizes the importance of police support in addressing DV in China and the role of agency training in promoting non-coercive responses. It highlights regional variations in police support and underscores the need for addressing disparities in service provision across different provinces.

Examining individuals’ adoption of flex route transit

ABSTRACT This study aims to comprehensively identify the contributing factors affecting the adoption of flex route transit. A survey was conducted in 2019, and a multiple indicators multiple causes (MIMIC) model was utilized to capture individuals’ preferences toward car, fixed route, and flex route transit. Subsequently, the multinomial logit model with attitudinal features is employed to identify the key factors influencing the shift from car or fixed route to flex route transit. Results indicate that several factors contribute to flex route transit adoption, with the top three being car restriction, travel cost, and age groups. Car restriction is positively associated with flex route transit adoption (marginal effects 11.67%). Travel costs (≥1.49 US$) and elderly groups also contribute to an increase in flex route transit adoption, with marginal effects of 9.18% and 8.01%, respectively. These findings provide insightful implications for decision-makers in identifying potential adopters and improving flex route transit adoption.

Stock Performance Analysis of PT. Kalbe Farma TBK (KLBF) in 2016-2020

When the World Health Organization (WHO) announced that COVID-19 was upgraded to pandemic status, investors began to reconsider their portfolio structure from risky assets such as stocks to gold. This study aims to determine the stock performance of PT. Kalbe Farma Tbk during the COVID-19 pandemic. A quantitative descriptive approach by linking company financial statement data with the phenomenon of the COVID-19 pandemic is the method used in this study. Based on the results of the research that has been done, it can be concluded that the performance of PT. Kalbe Farma Tbk before and during the COVID-19 pandemic on the dependent variable (stock return), namely the Current ratio, had a significant effect on Stock Return. However, based on the results of hypothesis testing regarding the effect of Earnings Per Share and Net profit margin on Stock Return partially, it can be concluded that these variables do not have a significant effect on Stock Return. Based on the conclusions above, the researcher recommends that the first company is expected to make the value of CR better in order to attract investors in investing their funds. Because if the company has a high CR value then the company can be said to have no constraints to pay its debts, thus many investors will be interested in investing in pharmaceutical sector companies and that can be very profitable for the company. Next is advice for those who want to invest in pharmaceutical companies, it is recommended to look at the CR owned by the company if investors want to make long-term investments.

Associations between employment and mental health of older workers with disparate conditions: Evidence from China

PurposeThis study aimed to examine associations between the employment of older people and mental health across demographic characteristics, socioeconomic conditions, and health status, with a focus on pensions. MethodsThis study included 4,512 participants aged 60–69 from the CLASS in 2014. A multiple linear regression was conducted to investigate the association between employment and mental health. A causal forest model was applied to estimate the heterogeneous treatment effects. ResultsEmployed individuals (n = 1,295) reported better mental health than their non-employed counterparts. This association displayed significant heterogeneity, primarily attributed to pensions. Those with lower pensions may be compelled to work due to financial reasons, thus offsetting the health-promotion effect of employment. ConclusionEmployment may benefit the mental health of older adults, which has a more significant marginal effect on those who are men, older, urban residents, without a spouse, below primary education, receiving more pensions, and less family and friend support.

Health care utilization and the associated costs attributable to cardiovascular disease in Ireland: a cross-sectional study.

Cardiovascular disease (CVD) is the leading cause of mortality and disability globally. We examined healthcare service utilization and costs attributable to CVD in Ireland in the period before the introduction of a major healthcare reform in 2016. Secondary analysis of data from 8113 participants of the first wave of The Irish Longitudinal Study on Ageing. CVD was defined as having a self-reported doctor's diagnosis of myocardial infarction, angina, heart failure, stroke, atrial fibrillation or transient ischaemic attack. Participants self-reported the utilization of healthcare services in the year preceding the interview. Negative binomial regression with average marginal effects (AME) was used to estimate the incremental number of general practitioner (GP) and outpatient department (OPD) visits, accident and emergency department attendances and hospitalisations in population with CVD relative to population without CVD. We calculated the corresponding costs at individual and population levels, by gender and age groups. The prevalence of CVD was 18.2% (95% CI: 17.3, 19.0) Participants with CVD reported higher utilization of all healthcare services. In adjusted models, having CVD was associated with incremental 1.19 (95% CI: 0.99, 1.39) GP and 0.79 (95% CI: 0.65, 0.93) OPD visits. There were twice as many incremental hospitalisations in males with CVD compared to females with CVD (AME (95% CI): 0.20 (0.16, 0.23) vs 0.10 (0.07, 0.14)). The incremental cost of healthcare service use in population with CVD was an estimated €352.2 million (95% CI: €272.8, €431.7), 93% of which was due to use of secondary care services. We identified substantially increased use of healthcare services attributable to CVD in Ireland. Continued efforts aimed at CVD primary prevention and management are required.

Digital economy, industrial structure upgrading, and residents' consumption: Empirical evidence from prefecture-level cities in China

In the context of promoting high-quality economic development, how to use digital technology to empower industrial transformation and upgrading, and then drive consumption growth, has become a critical issue that needs to be solved urgently. Based on the panel data of prefecture-level cities in China from 2011 to 2020, this paper has discussed the influence of the digital economy on residents' consumption and its internal mechanism. Theoretical analysis and empirical test results show that, firstly, the digital economy has a positive effect on residents' consumption, and this conclusion is still valid after the endogenous test and robustness test. Secondly, mechanism analysis results confirm that industrial structure upgrading is the main channel through which the positive mediating effect operates. Thirdly, the influence of the digital economy is only valid for rural areas rather than urban areas, and more significant for western regions than eastern and central regions, which indicates the development of the digital economy is beneficial to narrowing the consumption gap. Finally, the positive impact of the digital economy on residents' consumption is continuously strengthened with the upgrading of industrial structure, which is a significant non-linear characteristic of the marginal effect increasing. The above research conclusions can provide a theoretical basis for further improving the infrastructure of the digital economy, accelerating the integration of the digital economy with traditional industries, and building a consumer Internet.

Assessing the effects of geometry and non-geometry related factors in work-zone crashes

Objective Work zones are unique in geometry and traffic management, utilizing special traffic signs, standard channelizing devices, appropriate barriers, and pavement markings. These configurations can introduce unexpected driving conditions, potentially posing risks to drivers. This analysis aims to explore potential differences in contributing factors between work-zone crashes where geometry was identified as a factor and those where it was non-geometry factor. To gain insights into driver injury severities in single-vehicle work-zone crashes, this study analyzed work zone crash data from Florida. Method This study employed random parameters logit models, accommodating potential variations in parameter estimates’ means and variances. The dataset encompassed a wide array of factors known to influence driver injury severity, encompassing crash characteristics, vehicle attributes, roadway features, prevailing traffic volume, driver profiles, and spatial and temporal considerations. Results This analysis yielded significantly distinct parameters for work-zone crashes, distinguishing between geometry-related and non-geometry-related factors (primarily the human factors). This distinction suggests a complex interplay between these factors. Notably, the marginal effects of individual parameter estimates exhibited marked differences between these two categories – geometry and non-geometry factors. Conclusion These findings contribute to the growing body of research indicating that geometric restrictions within work zones introduce a distinct set of risk factors compared to non-geometry-related factors. Recognizing the significance of geometric restrictions, beyond typical driving conditions, holds the implications for enhancing safety within various work zone configurations and offers valuable insights for crash scene investigators to pinpoint contributing factors accurately.

Utilization of wollastonite, jarosite, and their blends for the sustainable development of concrete paver block mixes containing reclaimed asphalt pavement aggregates.

While several research studies considered the utilization of reclaimed asphalt pavement (RAP) aggregates for asphalt and concrete pavements, very few attempted its possible utilization for precast concrete applications like concrete paver blocks (CPBs). Moreover, few attempts made in the recent past to improve the strength properties of RAP inclusive concrete mixes by incorporating certain supplementary cementitious materials (SCMs) have reported an insignificant or marginal effect. The present study attempts to comprehensively investigate the utilization potential of some locally and abundantly available materials having suitable physicochemical properties to improve the performance of a zero-slump CPB mix containing 50% RAP aggregates. The studied filler materials, namely, wollastonite (naturally occurring calcium metasilicate mineral) and jarosite (hazardous zinc industry waste), were used to replace 5-15% and 10-20% by volume of Portland cement in the 50% RAP CPB mix. Apart from their individual effects, the efficacy of wollastonite-jarosite blends was also investigated. Considering the lack of indoor storage facilities and economic aspects of CPBs, the influence of water spray curing regime on the performance of the RAP CPB mixes was studied and compared to that of continuous water curing regime. Inclusion of the considered fillers was found to statistically and significantly enhance the flexural strength, tensile splitting strength, and abrasion resistance of the 50% RAP CPB mix; however, the compressive strength (in most cases), permeable voids, water absorption, and water permeability properties showed an insignificant improvement. Results of thermogravimetric analysis confirmed the occurrence of pozzolanic reactivity, and microstructure analysis revealed improvements in packing of concrete matrix and ITZ with filler inclusion qualitatively substantiating the improvements in strength and durability characteristics. The toxicity characteristics of heavy metals that may leach from the hazardous jarosite-based RAP CPB mixes were found to be within permissible limits. Based on the performance requirements specified by IS, IRC, and ASTM standards, all the RAP CPB mixes with filler inclusions fulfilled the acceptance criteria for heavy traffic applications, and water spray curing can enact as an alternate method for curing these mixes. However, to avail maximum performance benefits, it is recommended to use 5% wollastonite, 15% jarosite, and a combination of 10% wollastonite and 10% jarosite as a Portland cement substitute to produce sustainable eco-friendly RAP CPB mixes.

Current and future roles of meltwater–groundwater dynamics in a proglacial Alpine outwash plain

Abstract. Glacierized alpine catchments are rapidly evolving due to glacier retreat and consequent geomorphological and ecological changes. As more terrain becomes ice-free, reworking of exposed terrain by the river as well as thawing of the top layer may lead to an increase in surface and subsurface water exchanges, leading to potential changes in water storage and release, which in turn may impact ecological, geomorphological and hydrological processes. In this study, we aim to understand the current and future hydrological functioning of a typical outwash plain in a Swiss Alpine catchment. As with many other fluvial aquifers in alpine environments, this outwash plain is located at the valley bottom, where catchment-wide water and sediment fluxes tend to gather from multiple sources, may store water and provide specific habitats for alpine ecosystems. Their dynamics are however rarely studied in post Little Ice Age proglacial zones. Based on geophysical investigations as well as year-round stream and groundwater observations, we developed a simplified physically based 3D MODFLOW model and performed an optimized automatic calibration using PEST HP. We highlight the strong interactions between the upstream river and the aquifer, with stream infiltration being the dominant process of recharge. Groundwater exfiltration occurs in the lower half of the outwash plain, balancing out the amount of river infiltration at a daily timescale. We show that hillslope contributions from rain and snowmelt have little impact on groundwater levels. We also show that the outwash plain acts as a bedrock-dammed aquifer and can maintain groundwater levels close to the surface during dry periods lasting months, even in the absence of glacier meltwater, but may in turn provide only limited baseflow to the stream. Finally, we explore how new outwash plains may form in the future in this catchment due to glacier recession and discuss from a hydrological perspective which cascading impacts the presence of multiple outwash plains may have. For this case study, we estimate the total dynamic storage of future outwash plains to be about 20 mm, and we demonstrate their limited capacity to provide more stream water than that which they infiltrate upstream, except for very low river flows (<150 to 200 L s−1). Below this limit, they can provide limited baseflow on timescales of weeks, thus maintaining moisture conditions that may be beneficial for proglacial ecosystems. Their role in attenuating floods also appears limited, as less than 0.5 m3 s−1 of river water can be infiltrated. The studied outwash plain appears therefore to play an important role for alpine ecosystems but has a marginal hydrological effect on downstream river discharge.

Genome-wide epistasis analysis reveals gene–gene interaction network on an intermediate endophenotype P-tau/Aβ42 ratio in ADNI cohort

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the most common cause of dementia in the elderly worldwide. The exact etiology of AD, particularly its genetic mechanisms, remains incompletely understood. Traditional genome-wide association studies (GWAS), which primarily focus on single-nucleotide polymorphisms (SNPs) with main effects, provide limited explanations for the “missing heritability” of AD, while there is growing evidence supporting the important role of epistasis. In this study, we performed a genome-wide SNP–SNP interaction detection using a linear regression model and employed multiple GPUs for parallel computing, significantly enhancing the speed of whole-genome analysis. The cerebrospinal fluid (CSF) phosphorylated tau (P-tau)/amyloid-β42\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\beta _{42}$$\\end{document} (Aβ42\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\beta _{42}$$\\end{document}) ratio was used as a quantitative trait (QT) to enhance statistical power. Age, gender, and clinical diagnosis were included as covariates to control for potential non-genetic factors influencing AD. We identified 961 pairs of statistically significant SNP–SNP interactions, explaining a high-level variance of P-tau/Aβ42\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\beta _{42}$$\\end{document} level, all of which exhibited marginal main effects. Additionally, we replicated 432 previously reported AD-related genes and found 11 gene–gene interaction pairs overlapping with the protein-protein interaction (PPI) network. Our findings may contribute to partially explain the “missing heritability” of AD. The identified subnetwork may be associated with synaptic dysfunction, Wnt signaling pathway, oligodendrocytes, inflammation, hippocampus, and neuronal cells.

Telemedicine Reduces Missed Appointments but Disparities Persist

IntroductionMissed appointments also known as “no-shows” adversely affect clinical outcomes, clinic efficiency, and quality of care and have been attributed to barriers such as work schedule conflicts and lack of transportation. The widespread telemedicine implementation and adoption that has occurred as a consequence of the COVID-19 pandemic has the potential to address these barriers and improve missed appointment rates. This study aims to analyze the relationship between telemedicine and missed appointments. MethodsThis retrospective cohort study used electronic health records data from a safety-net academic health center with federally qualified clinics (March 2020 to December 2022). Bivariate and multivariable generalized estimating equations were used to analyze the relationship between no-show and appointment type (in-person versus telemedicine appointment). Stratified adjusted regression analyses were used to calculate the average change in the marginal effect of telemedicine appointments on no-shows across covariates. The data was analyzed from 09/2023-10/2023. ResultsHispanic patients accounted for 60% of the 474,212 appointments, followed by non-Hispanic White (22.5%), Non-Hispanic Black (13.3%), Asian (2.7%), Native American (1%) and “other race/ethnicity” patients (0.6%). The no-show rate for telemedicine appointments was 12% compared to 25% for in-person appointments. Multivariable analysis showed that telemedicine appointment was associated with a decreased likelihood of no-show compared to in-person appointments (OR:0.40; 95% CI:0.40, 0.41). The average change in the marginal effect of telemedicine appointments on the reduction of no-shows across race/ethnicity was greatest for Native American and non-Hispanic Black patients. ConclusionsTelemedicine appointments were associated with decreased likelihood of no-shows and the protective effect of telemedicine appointments on missed appointments was greatest for underserved groups. Strategies to increase telemedicine uptake especially for underserved groups are critical.

Combined Replacement of Fishmeal and Fish Oil by Poultry Byproduct Meal and Mixed Oil: Effects on the Growth Performance, Body Composition, and Muscle Quality of Tiger Puffer.

This study aimed to evaluate the effects of combined replacement of fishmeal (FM) and fish oil (FO) with poultry byproduct meal (PBM) and mixed oil (MO, poultry oil: coconut oil = 1 : 1) on growth performance, body composition and muscle quality of tiger puffer (Takifugu rubripes). Fish with an average initial body weight of 14.29 g were selected for the feeding experiment. FM accounting for 0%, 5%, and 10% of the diet was replaced by PBM. For each grade of FM replacement, 5% FO or MO was used as added oil. The six experimental diets were designated as FO-FM, MO-FM, FO-5PBM, MO-5PBM, FO-10PBM, and MO-10PBM, respectively. Each treatment was performed in triplicate with 30 fish per replicate. The feeding period was 45 days. There was no significant difference in growth performance among the groups. Dietary supplementation of both PBM and MO had marginal effects on whole-fish proximate composition, except that dietary MO supplementation significantly increased the liver moisture content. In serum, there were no significant differences in contents of triglyceride, total cholesterol, total bile acid, and protein carbonyl among groups, but the malondialdehyde content was reduced by MO. The fatty acid composition in fish mirrored those in the diets, but the omega-3 sparing effects of saturated and monounsaturated fatty acid in MO can still be observed. Dietary PBM and MO had marginal effects on free amino acid composition and texture of fish muscle, but exerted complicated effects on the muscle volatile flavor compound composition. In conclusion, combined fishmeal (10% of the diet) and fish oil (5% of the diet) replacement with poultry byproduct and mixed oil (poultry oil + coconut oil) had no adverse effects on the growth performance and body proximate composition of farmed tiger puffer. However, these replacements changed the muscle flavor compound profile.

Dietary patterns and the effect of long-term PM2.5 exposure on metabolic syndrome among Chinese adults: a cross-sectional study

Limited evidence exists regarding the causal effects of air pollution and metabolic syndrome (MetS), as well as the potential moderating effect of adherence to healthy dietary patterns. We recruited participants with accessible clinical characteristics, dietary patterns, and blood biomarkers data from the 2009 China Health and Nutrition Survey. Multi-biomarkers combined with physical examinations were used to determine the status of MetS. The fine particulate matter (PM2.5) concentration was calculated by the near-real-time historical data at the resolution of 1 km. The control function (CF) combined with probit model (CF-Probit) was used to determine the effect of long-term PM2.5 exposure on MetS risk, with wind speed serving as the instrument. We assessed the dietary patterns of each participant using the dietary balance index (DBI). The modification analyses were conducted to investigate the potential moderating role of dietary patterns. The study included 4,277 adult participants participated with a mean age of 50.18 years and an incidence of MetS of 22.38% (957/4277 cases). The mean score for the DBI was 40.23. The mean long-term PM2.5 level was 65.79 μg m−3. The CF-Probit marginal effects analysis showed significant causal effects of chronic PM2.5 exposure on MetS incidence, with a marginal effect of 0.013 (95% confidence interval (CI): 0.003–0.022), suggesting that the average partial effect of long-term PM2.5 level on the risk of MetS in adults is 1.3 percentage points. The modification analysis indicated that the average partial effect of PM2.5 level on the risk of MetS is higher for male compared to female (4.22 pencetage points, 95% CI: 2.12 percentage points, 6.35 percentage points) and greater associated with unhealthy dietary patterns (1 percentage point, 95% CI: 0.17 percentage points, 1.86 percentage points). This study found that long-term exposure to PM2.5 increases the risk of MetS, while a healthy dietary pattern can modulate this effect. The findings can provide scientific basis for health protection guidelines for air pollution and provide dietary recommendations for populations.