Omnibus Test Research Articles

Exploring household food security through institutional factors: A statistical and mathematical analysis

Achieving household food security is the tumbling issue of the century. This article explores the factors affecting household food security and solutions by utilizing a synergy of statistical and mathematical models. The methodology section is divided into two portions namely sociological and mathematical methods. Sociologically, 379 household heads were interviewed through structured questions and further analyzed in terms of descriptive and binary logistic regression. The study found that 4 independent variables (poverty, poor governance, militancy, and social stratification) showed a significant association (P = 0.000) to explain variations in the dependent variable (household FS). The Omnibus test value (χ2= 102.386; P = 0.000) demonstrated that the test for the entire model against constant was statistically significant. Therefore, the set of predictor variables could better distinguish the variation in household FS. The Nagelkerke’s R Square (R2 = .333) helps to interpret that the prediction variable and the group variables had a strong relationship. Moreover, 23% to 33% variation in FS was explained by the grouping variables (Cox and Snell R2 = 0.237 and Nagelkerke’s R2 = 0.333). The significant value of Wald test results for each variable confirmed that the grouping variables (poor governance P = 0.004, militancy P = 0.000, social stratification P = 0.021 and poverty P = 0.000) significantly predicted FS at the household level. Mathematically, all the statistics were validated further through the application of spherical fuzzy mathematics (TOPIS and MADM) to explore what factors are affecting household FS. Thus, the study found that F3 (poverty) > F2 (militancy) > F4 (social stratification) > F1 (poor governance) respectively. Thus, it could be concluded from these findings that the prevalence of poverty dysfunctional all the channels of household FS at the macro and micro levels. Therefore, a sound and workable model to eradicate poverty in the study area by ensuring social safety nets for the locals was put forward some of the policy implications for the government are the order of the day.

CSF β-Amyloid and Tau Biomarker Changes in Veterans With Mild Traumatic Brain Injury.

Moderate-to-severe traumatic brain injuries (TBI) have been reported to increase the risk of Alzheimer disease (AD). Whether mild TBI (mTBI) in veterans confers a similar increased risk of AD is less known. This study investigated early AD changes using CSF biomarkers in veterans with blast mTBI. This was a cross-sectional case-control study of veterans with mTBI and non-mTBI veterans and civilians from 2 study sources. Blast-mTBI veterans had at least 1 war zone blast or combined blast/impact mTBI meeting Veterans Affairs (VA) and Department of Defense (DoD) criteria for mTBI. Non-mTBI participants had no lifetime history of TBI. All participants underwent standardized clinical and neuropsychological assessments and lumbar puncture for collection of the CSF. CSF biomarkers were measured using MesoScale Discovery assays for Aβ40 and Aβ42 and INNOTEST ELISAs for phosphorylated tau181 (p-tau181) and total tau (t-tau). Our sample comprised 51 participants with mTBI and 85 non-mTBI participants with mean (SD) ages 34.0 (10.1) and 33.5 years (8.9), respectively. All participants but 1 (99%) were male. Differences in CSF AD biomarkers between mTBI and non-mTBI groups were age dependent and most pronounced at older ages (omnibus test p ≤ 0.08). At age 50 years, the mTBI group had lower mean [95% CI] CSF Aβ42 and Aβ40 than the non-mTBI group by 154 [-12 to 319] and 1864 [610-3,118] pg/mL, respectively. By contrast, CSF p-tau181 and t-tau mean levels remained relatively constant with age in participants with mTBI, while tending to be higher at older ages for the non-mTBI group. The mTBI group also demonstrated poorer cognitive performance at older ages (omnibus p < 0.08): at age 50 years, the mean TMT-B time was higher by 34 seconds [10-58] and the mean CVLT-II short-delay recall was lower by 4.2 points [1.9-6.6]. Poorer verbal memory and verbal fluency performance were associated with lower CSF Aβ42 (p ≤ 0.05) in older participants. CSF Aβ levels decreased in middle-aged veterans with blast-related mTBI. These data suggest that chronic neuropathologic processes associated with blast mTBI share properties in common with pathogenic processes known to portend AD onset, thus raising concern that veterans with blast-related mTBI may develop a dementing disorder later in life.

The presence of attentional and interpretation biases in patients with severe MS-related fatigue.

Severe fatigue is a prevalent and disabling symptom in multiple sclerosis (MS). This study tested if a fatigue- andphysical activity-related attentional bias (AB) and a somatic interpretation bias (IB) are present in severely fatigued patients with MS. Biases were compared to healthy controls and patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Severely fatigued patients with MS or ME/CFS and healthy controls completed a Visual Probe Task (VPT) assessing fatigue- and physical activity-related AB and an IB task that assesses the tendency to interpret ambiguous information in either a somatically threatening way or in a more neutral manner. The VPT was completed by 38 MS patients, 44 ME/CFS patients, and 46 healthy controls; the IB task was completed by 156, 40 and 46 participants respectively. ANOVA showed no statistically significant group differences in a fatigue-related AB or physical activity-related AB (omnibus test of interaction between topic × condition: F2,125 = 1.87; p = .159). Both patient groups showed a tendency to interpret ambiguous information in a somatically threatening way compared to healthy controls (F1,2 = 27.61, p < .001). This IB was significantly stronger in MS patients compared to ME/CFS patients. IB was significantly correlated with cognitive responses to symptoms in MS patients. MS patients tend to interpret ambiguous information in a somatically threatening way. This may feed into unhelpful ways of dealing with symptoms, possibly contributing to the perpetuation of severe fatigue in MS.

Establishment of morphological markers to differentiate male and female plants in Ailanthus excelsa Roxb. using multiple logistic regression

Ailanthus excelsa Roxb., belongs to the family Simaroubaceae, is a fast-growing multipurpose tree, and used mainly as a source of fodder and shade. It bears male, female, and hermaphrodite flowers on separate plants. It has been observed that male plant has more leaf biomass during April-May in semi-arid regions of India (Jaipur). In its vegetative state, the sex of the tree cannot be identified. The present study has therefore been designed to investigate if there is any difference in male and female plants based on morphological descriptors namely stomata number, stomata length, stomata diameter, trichome number, trichome length, and trichome diameter. 20 plants with male flowers and 20 plants with female flowers have been studied. The data revealed that male plants have lower trichome diameter (11.91 µm) than female (14.18 µm) plants. Other parameters do not show any statistically significant difference (P > 0.05). The Omnibus Tests of the Model Coefficient obtained for trichome diameter (0.042) is reliable in improving the model, implying that the model is the best fit. To test the validity of this model, the Hosmer and Lemeshow test was performed, and the p-value of chi-square (0.405 > 0.05) indicates that the logistic model obtained above is the best-fit model. Further studies of trichome diameter at the seedling stage and then confirmation of plant sex at maturity level will help in establishing morphological markers in A. excelsa for identification of sex.

Power analyses for measurement model misspecification and response shift detection with structural equation modeling

PurposeStatistical power for response shift detection with structural equation modeling (SEM) is currently underreported. The present paper addresses this issue by providing worked-out examples and syntaxes of power calculations relevant for the statistical tests associated with the SEM approach for response shift detection.MethodsPower calculations and related sample-size requirements are illustrated for two modelling goals: (1) to detect misspecification in the measurement model, and (2) to detect response shift. Power analyses for hypotheses regarding (exact) overall model fit and the presence of response shift are demonstrated in a step-by-step manner. The freely available and user-friendly R-package lavaan and shiny-app ‘power4SEM’ are used for the calculations.ResultsUsing the SF-36 as an example, we illustrate the specification of null-hypothesis (H0) and alternative hypothesis (H1) models to calculate chi-square based power for the test on overall model fit, the omnibus test on response shift, and the specific test on response shift. For example, we show that a sample size of 506 is needed to reject an incorrectly specified measurement model, when the actual model has two-medium sized cross loadings. We also illustrate power calculation based on the RMSEA index for approximate fit, where H0 and H1 are defined in terms of RMSEA-values.ConclusionBy providing accessible resources to perform power analyses and emphasizing the different power analyses associated with different modeling goals, we hope to facilitate the uptake of power analyses for response shift detection with SEM and thereby enhance the stringency of response shift research.

Effect of Testosterone on Progression From Prediabetes to Diabetes in Men With Hypogonadism

The effect of testosterone replacement therapy (TRT) in men with hypogonadism on the risk of progression from prediabetes to diabetes or of inducing glycemic remission in those with diabetes is unknown. To evaluate the efficacy of TRT in preventing progression from prediabetes to diabetes in men with hypogonadism who had prediabetes and in inducing glycemic remission in those with diabetes. This nested substudy, an intention-to-treat analysis, within a placebo-controlled randomized clinical trial (Testosterone Replacement Therapy for Assessment of Long-Term Vascular Events and Efficacy Response in Hypogonadal Men [TRAVERSE]) was conducted at 316 trial sites in the US. Participants included men aged 45 to 80 years with hypogonadism and prediabetes or diabetes who were enrolled in TRAVERSE between May 23, 2018, and February 1, 2022. Participants were randomized 1:1 to receive 1.62% testosterone gel or placebo gel until study completion. The primary end point was the risk of progression from prediabetes to diabetes, analyzed using repeated-measures log-binomial regression. The secondary end point was the risk of glycemic remission (hemoglobin A1c level <6.5% [to convert to proportion of total hemoglobin, multiply by 0.01] or 2 fasting glucose measurements <126 mg/dL [to convert to mmol/L, multiply by 0.0555] without diabetes medication) in men who had diabetes. Of 5204 randomized participants, 1175 with prediabetes (mean [SD] age, 63.8 [8.1] years) and 3880 with diabetes (mean [SD] age, 63.2 [7.8] years) were included in this study. Mean (SD) hemoglobin A1c level in men with prediabetes was 5.8% (0.4%). Risk of progression to diabetes did not differ significantly between testosterone and placebo groups: 4 of 598 (0.7%) vs 8 of 562 (1.4%) at 6 months, 45 of 575 (7.8%) vs 57 of 533 (10.7%) at 12 months, 50 of 494 (10.1%) vs 67 of 460 (14.6%) at 24 months, 46 of 359 (12.8%) vs 52 of 330 (15.8%) at 36 months, and 22 of 164 (13.4%) vs 19 of 121 (15.7%) at 48 months (omnibus test P = .49). The proportions of participants with diabetes who experienced glycemic remission and the changes in glucose and hemoglobin A1c levels were similar in testosterone- and placebo-treated men with prediabetes or diabetes. In men with hypogonadism and prediabetes, the incidence of progression from prediabetes to diabetes did not differ significantly between testosterone- and placebo-treated men. Testosterone replacement therapy did not improve glycemic control in men with hypogonadism and prediabetes or diabetes. These findings suggest that TRT alone should not be used as a therapeutic intervention to prevent or treat diabetes in men with hypogonadism. ClinicalTrials.gov Identifier: NCT03518034.

Intent to stay in nursing profession and predictors among nurses working in public hospitals of Eastern Ethiopia, a multi-center study

Backgroundthe desire to remain in the nursing field has become a serious problem across the globe, and a shortage of nurses shows gaps for the health care system in terms of cost, patients care cabability, and nursing care quality. The nursing profession is losing a lot of nurses. There is paucity of data on the degree and factors influencing intention to stay. ObjectiveTo asses the level of intent to stay in the nursing profession and associated factors among nurses employed at public hospitals of Eastern Ethiopia, a multi centere study. MethodsA cross-sectional study was conducted among 413 nurses employed at public hospitals of eastern Ethiopia from March 1 to 30, 2020. Participants were chosen via simple random sampling methods, with a lottery method. Data were gathered using standardised self-administered questionnaires that had been pre-tested and supervised by an interviewer. EpiData Version 4.6 was used to enter the data, which was then exported to SPSS Version 20 for analysis. Bivariable and multivariable analyses were used. An adjusted odds ratio with a 95% confidence interval was used to determine the association between the dependant and independent variables. Finally, factors were deemed statistically significant, if their p-value was less than 0.05. The Hosmer-Lemeshow statistic, with 0.254, and the omnibus test, with < 0.001, were used to assess the goodness of fit. ResultsPercentage of nurses intended to remain in nursing profession was 49.3 % (95 %CI: 46–55.9). Having dependent family members (AOR = 1.908, 95 %CI:1. 142–3.188), job satisfaction (AOR = 6.54, 95 %CI, 2.774–15.41), organizational commitment (AOR=0.301, 95 %CI, 0.127–0.713) and normative commitment (AOR = 3.617,95 %CI, 1.879–6.963) were all substantially correlated with the intention to stay. ConclusionThis study demonstrated that nurses had low level of intent to stay in their profession. Having dependent family members, job satisfaction, organizational commitment, and having a high normative commitment showed association with intent to stay. Such kind of unstability in profession altered quality nursing service. Therefore, strengthing nurses’ intent to stay requires enhancing their job happiness, autonomy, professional opportunity, and organizational commitment.

Understanding the Impacts of Electoral Technologies on Nigeria’s Electoral System

This study investigated the impacts of electoral technologies on Nigeria’s electoral system, with the aim of finding out the role of technology on having an improved electoral system in Nigeria. The study was carried out in the six (6) State offices of the Independent National Electoral Commission (INEC) in the southwest geopolitical zone of Nigeria (comprising Lagos, Oyo, Ogun, Osun, Ondo, and Ekiti states), and also at the national head office of INEC, Abuja. Primary data were collected using semi-structured key informant interviews, observation methods, and from 240 copies of structured questionnaires, administered in the Information and Communication Technology/Voter Registry (ICT/VR), and Electoral Operations (EOps) departments of the commission. The questionnaire elicited information on the impacts of electoral technologies on Nigeria’s electoral system, such as single voter registration, transmission speed, among others. Semi-structured key informant interviews of one of the top managers were carried out to assess the manager’s views about the impacts of electoral technologies on the electoral system in Nigeria. The binary logistic regression model (Cox &amp; Snell R2 of 0.662 and Nagelkerke’s R2 of 0.883, Model Coefficients Omnibus Test of 31.264) indicated that the predictors reliably predict Nigeria’s electoral system. It was evident that the Transmission Speed of electoral data and election results (β = 2.826, p&lt;0.05) and Single Voter Registration (β = 2.815, p&lt;0.05) among others, were positive, signifying significant impacts of electoral technologies on Nigeria’s electoral system. The study concluded that INEC should pursue an improved continuous use of electoral technologies.

Scabies prevalence and its associated factors among prisoners in southern Ethiopia: An institution-based analytical cross-sectional study.

Scabies is an ectoparasitic infestation that can easily spread during close human contact and in overcrowded areas such as prisons and public places where sanitation is a problem. Globally, as many as 300 million people are infested with scabies each year. Within Ethiopia, its burden in institutions like prisons is not well-studied. As a consequence, we sought to estimate the prevalence of scabies and also identify factors associated with it among prison inmates in southern Ethiopia. An institution-based analytical cross-sectional study design was employed. We used, a simple random sampling technique to select 422 prisoners. A pretested-structured questionnaire was used to collect the necessary information. EpiData version 4.2.0.0 and Statistical Packages for Social Science version 25 software were used for data entry and analysis respectively. Both descriptive and inferential statistics were computed. The model fitness was checked using the Hosmer-Lemeshow and omnibus tests. The association between the independent and outcome variables was presented in the form of a table showing the crude odds ratio and adjusted odds ratio (AOR) along with their 95% confidence interval (CI). The level of statistical significance was declared at P.value ≤ 0.05. A total of 418 prisoners were interviewed, yielding a 99.1% response rate. The age of the participants ranged from 17 to 60 years. As many as 381 (91.1%) participants were male. The prevalence of scabies was found to be 8.9%. A history of sexual contact in the past two months, before imprisonment (AOR: 9.92 (95% CI 3.07, 32.02), P <0.001), a period of stay less than two months duration in the prison (AOR: 4.54 (95% CI 1.51, 13.54), P = 0.007), poor ventilation (AOR: 3.36 (95% CI 1.07, 10.58), P = 0.038), lack of hygiene soap (AOR: 5.53 (95% CI 1.45, 21.17), P = 0.012), and sharing clothes among each other (AOR: 3.81 (95% CI (1.09, 13.29), P = 0.036) were factors independently associated with a scabies infestation. In this study, we found the prevalence of scabies was high among prison inmates in Wolaita Zone prison. Furthermore, scabies infestations were associated with a previous history of sexual contact, poorly ventilated rooms, lack of hygiene soaps for washing, and sharing clothes amongst the inmates. Prison administrations should be encouraged to improve sanitary and screening and isolation of prisoners during imprisonment.

"Knees Out" or "Knees In"? Volitional Lateral vs. Medial Hip Rotation During Barbell Squats.

Chiu, LZF. "Knees out" or "Knees in"? Volitional lateral versus medial hip rotation during barbell squats. J Strength Cond Res 38(3): 435-443, 2024-Medial or lateral hip rotation may be present during barbell squats, which could affect the hip frontal and transverse plane moments. Male (n = 14) and female (n = 18) subjects performed squats using their normal technique and with volitional medial and lateral hip rotation. Hip net joint moments (NJM) were calculated from 3-dimensional motion capture and force platform measurements. Statistical significance was set for omnibus tests (α = 0.05) and Bonferroni's corrected for pairwise comparisons (αt-test = 0.0056). Normal squats required hip extensor, adductor, and lateral rotator NJM. Lateral rotation squats had smaller hip extensor (p = 0.002) and lateral rotator (p < 0.001) NJM and larger hip adductor (p < 0.001) NJM than normal squats. Medial rotation squats had smaller hip extensor (p = 0.002) and adductor (p < 0.001) NJM and larger hip lateral rotator (p < 0.001) NJM than normal squats. These differences exceeded the minimum effects worth detecting. As gluteus maximus exerts hip extensor and lateral rotator moments, and the adductor magnus exerts hip extensor and adductor moments, these muscles combined would be required to meet these hip demands, supporting previous research that has established these muscles as the primary contributors to the hip extensor NJM. Lateral rotation squats reduce hip lateral rotator and increase hip adductor NJM, which may be hypothesized as preferentially loading adductor magnus. Medial rotation squats increase hip lateral rotator and decrease hip adductor NJM; therefore, this variant may shift loading to the gluteus maximus.

A nonparametric test for comparing survival functions based on restricted distance correlation

Abstract In this article, we propose an omnibus test for comparing two survival functions under non-proportional hazards. The test statistic is based on a product-limit estimate of the restricted distance correlation, which is closely related to the L 2 {L}_{2} distance between survival curves. The strong consistency is established under mild regularity conditions. Our simulation studies show that the new test has satisfactory power under proportional hazard and various non-proportional hazards settings including delayed treatment effect, diminishing effect, and crossing survival curves; therefore, it can be a competitive alternative to the existing omnibus tests such as Kolmogorov-Smirnov test, Cramer-von Mises test, two-stage test, and the maxCombo test based on weighted log-rank statistics. Two extensions of the new test to one-sided alternatives and a Gaussian kernel are also discussed.

Joint analysis of multiple phenotypes for extremely unbalanced case-control association studies using multi-layer network.

Genome-wide association studies is an essential tool for analyzing associations between phenotypes and single nucleotide polymorphisms (SNPs). Most of binary phenotypes in large biobanks are extremely unbalanced, which leads to inflated type I error rates for many widely used association tests for joint analysis of multiple phenotypes. In this article, we first propose a novel method to construct a Multi-Layer Network (MLN) using individuals with at least one case status among all phenotypes. Then, we introduce a computationally efficient community detection method to group phenotypes into disjoint clusters based on the MLN. Finally, we propose a novel approach, MLN with Omnibus (MLN-O), to jointly analyse the association between phenotypes and a SNP. MLN-O uses the score test to test the association of each merged phenotype in a cluster and a SNP, then uses the Omnibus test to obtain an overall test statistic to test the association between all phenotypes and a SNP. We conduct extensive simulation studies to reveal that the proposed approach can control type I error rates and is more powerful than some existing methods. Meanwhile, we apply the proposed method to a real data set in the UK Biobank. Using phenotypes in Chapter XIII (Diseases of the musculoskeletal system and connective tissue) in the UK Biobank, we find that MLN-O identifies more significant SNPs than other methods we compare with. https://github.com/Hongjing-Xie/Multi-Layer-Network-with-Omnibus-MLN-O.

A partial empirical test of the general strain theory on cyberbullying victimization among expatriate students

A partial empirical test of the general strain theory on cyberbullying victimization among expatriate students

IID Time Series Testing

Traditional white noise testing, for example the Ljung-Box test, studies only the autocorrelation function (ACF). Time series can be heteroscedastic and therefore not i.i.d. but still white noise (that is, with zero ACF). An example of heteroscedasticity is financial time series: times of high variance (financial crises) can alternate with times of low variance (calm times). Here, absolute values of time series terms are not white noise. We could test for white noise separately for original and absolute values, for example using Ljung-Box tests for both. In this article, we create an omnibus test which combines these two tests. Moreover, we create a general framework to create various i.i.d. tests. We apply tests to simulated data, both autoregressive linear and heteroscedastic.

Accelerated Brain Aging Mediates the Association Between Psychological Profiles and Clinical Pain in Knee Osteoarthritis

Chronic pain is driven by factors across the biopsychosocial spectrum. Previously, we demonstrated that magnetic resonance images (MRI)-based brain-predicted age differences (brain-PAD: brain-predicted age minus chronological age) were significantly associated with pain severity in individuals with chronic knee pain. We also previously identified four distinct, replicable, multidimensional psychological profiles significantly associated with clinical pain. The brain aging-psychological characteristics interface in persons with chronic pain promises elucidating factors contributing to their poor health outcomes, yet this relationship is barely understood. That is why we examined the interplay between the psychological profiles in participants having chronic knee pain impacting function, brain-PAD, and clinical pain severity. Controlling for demographics and MRI scanner, we compared the brain-PAD among psychological profiles at baseline (n = 164) and over two years (n = 90). We also explored whether profile-related differences in pain severity were mediated by brain-PAD. Brain-PAD differed significantly between profiles (ANOVA's omnibus test, P = .039). Specifically, participants in the profile 3 group (high negative/low positive emotions) had an average brain-PAD ∼4 years higher than those in profile- (low somatic reactivity), with P = .047, Bonferroni-corrected, and than those in profile 2 (high coping), with P = .027, uncorrected. Repeated measures ANOVA revealed no significant change in profile-related brain-PAD differences over time, but there was a significant decrease in brain-PAD for profile 4 (high optimism/high positive affect), with P = .045. Moreover, profile-related differences in pain severity at baseline were partly explained by brain-PAD differences between profile 3 and 1, or 2; but brain-PAD did not significantly mediate the influence of variations in profiles on changes in pain severity over time. PerspectiveAccelerated brain aging could underlie the psychological-pain relationship, and psychological characteristics may predispose individuals with chronic knee pain to worse health outcomes via neuropsychological processes.

Gene-based association study of rare variants in children of diverse ancestries implicates TNFRSF21 in the development of allergic asthma

BackgroundMost genetic studies of asthma and allergy have focused on common variation in individuals primarily of European ancestry. Studying the role of rare variation in quantitative phenotypes and in asthma phenotypes in populations of diverse ancestries can provide additional, important insights into the development of these traits. ObjectiveThe goal of this study was to examine the contribution of rare variants to different asthma- or allergy-associated quantitative traits in children with diverse ancestries and explore their role in asthma phenotypes. MethodsWe examined whole-genome sequencing (WGS) data from children participants in longitudinal studies of asthma (n=1,035; parent-identified as 67% Black and 25% Hispanic) to identify rare variants (minor allele frequency < 0.01). We assigned variants to genes and tested for associations using an omnibus variant-set test between each of 24,902 genes and eight asthma-associated quantitative traits. Combining our results with external data on predicted gene expression in humans and mouse knockout studies, three candidate genes were identified. A burden of rare variants in each gene and in a combined 3-gene score was tested for its associations with clinical phenotypes of asthma. Finally, published single cell gene expression data in lower airway mucosal cells after allergen challenge was used to assess transcriptional responses to allergen. ResultsRare variants in USF1 were significantly associated with blood neutrophil count (p=2.18x10-7); rare variants in TNFRSF21 with total IgE (p=6.47x10-6) and PIK3R6 with eosinophil count (p=4.10x10-5) reached suggestive significance. These three findings were supported by independent data from human and mouse studies. A burden of rare variants in TNFRSF21 and in a 3-gene score were associated with allergy-related phenotypes in cohorts of children with mild and severe asthma. Furthermore, TNFRSF21 was significantly upregulated in bronchial basal epithelial cells from adults with allergic asthma but not in adults with allergies (but not asthma) after allergen challenge. ConclusionWe report novel associations between rare variants in genes and allergic and inflammatory phenotypes in children with diverse ancestries, highlighting TNFRSF21 as contributing to the development of allergic asthma.

Speckle Tracking Echocardiography for the Diagnosis and Prognosis of Light Chain Cardiac Amyloidosis

Background Cardiac amyloidosis was thought to be a rare disease, but the data shows that its prevalence rate is increasing, and the light chain (AL) cardiac amyloidosis are the most common and worst [1]. Because of the lack of symptoms specificity in the preliminary stages of AL cardiac amyloidosis, resulting in underdiagnosis or severe delays in diagnosis, patients are often delayed in the optimal timing of treatment. A considerable proportion of patients are diagnosed after the onset of symptoms of heart failure which progresses rapidly and results in poor prognosis and high mortality. Patients have a mortality rate of up to 50% within 4-6 months after diagnosis of congestive heart failure and the median survival of these patients were less than 12 months [2]. Therefore, early diagnosis and treatment are particularly important for them. Speckle tracking echocardiography has a good imaging analysis of cardiac amyloidosis, which remains the most often used imaging tool. This study aimed to explore the use of speckle tracking echocardiographic parameters to build models which improve the diagnostic rate of patients with suspected AL cardiac amyloidosis and assess the prognosis of patients with AL cardiac amyloidosis. Methods We studied twenty-four patients of pathologically confirmed amyloidosis from March 2017 to February 2023 at the First Affiliated Hospital of Soochow University. According to the criteria for organ involvement, patients were divided into two groups based on whether the heart was involved or not and SPSS 26.0 was used to analyze data. The differences of characteristics and various parameters of Speckle tracking echocardiography between two groups were compared and the indicators with statistical difference were selected for single factor analysis and multivariate analysis. Statistically significant factors were used to establish diagnosis and prognosis assessment models as below. Result In this study, the rate of cardiac involvement was 62.5%. Until June 30 th, 2023, median follow-up time of twenty-four patients was 31 months, and the 5-year survival rate was 74% in CA group and 85.7% in non-CA group. Characteristics The results showed that CA group has lower baseline blood pressure, and the levels of NT-pro BNP and dFLC were significantly higher in the CA group compared to the non-CA group. In speckle tracking echocardiography parameters, CA group has significantly increased IVSd, LVPWd, RWT, E/e and decreased EF, interventricular septum e', lateral wall e' and left ventricular global strain. Diagnosis The results showed that CA group is more likely to be involved in the heart when monoclonal proteins are formed in the peripheral blood （OR=0.031, 95%CI 0.003-0.365, P=0.002）. In univariate analysis, E/e&amp;gt;10.85, interventricular septum e‘&amp;lt;5.25 cm/s, lateral wall e‘&amp;lt;6.05 cm/s, |left ventricular global strain|&amp;lt;16.3% and left ventricular diastolic function ≥Class II have the effect on CA group with statistically significant. Incorporating them into variables to construct a multivariate logistic regression model showed that: the model was built successfully (Omnibus test: P&amp;lt;0.001) and the goodness of fit model is well (Hosmer-Leme show test: P=1). 88.9% of the study subjects who were CA patients were predicted by the model to be CA patients, while 92.9% of the study subjects who were not CA patients were predicted by the model to be not CA patients, but the 5 factors had no significant effect on cardiac amyloidosis (P &amp;gt; 0.05). Prognosis assessment The result of the study shows that IVPWd&amp;gt;13.5mm, RWT&amp;gt; 0.51, NT pro-BNP&amp;gt;6614pg/mL and dFLC&amp;gt;142.35mg/L are elevated risk factors for prognosis with statistically significant. (Figure1). They were included in the variables to construct a multi-factor Cox proportional hazards model and it turns out: the model was built successfully (Omnibus test: P&amp;lt;0.05), but these 4 factors had no significant effect on cardiac amyloidosis (P &amp;gt; 0.05). Conclusion Speckle tracking echocardiography is of great value in the diagnosis and prognosis of patients with cardiac amyloidosis. The combined analysis of echocardiography parameters and serological abnormalities can help in the diagnosis and prognostic assessment of the disease, it also helps to identify patients with poor prognosis early and increasing the possibility of future treatment strategies based on risk stratification.

Sample Size Requirements to Test Subgroup-Specific Treatment Effects in Cluster-Randomized Trials

Cluster-randomized trials (CRTs) often allocate intact clusters of participants to treatment or control conditions and are increasingly used to evaluate healthcare delivery interventions. While previous studies have developed sample size methods for testing confirmatory hypotheses of treatment effect heterogeneity in CRTs (i.e., targeting the difference between subgroup-specific treatment effects), sample size methods for testing the subgroup-specific treatment effects themselves have not received adequate attention—despite a rising interest in health equity considerations in CRTs. In this article, we develop formal methods for sample size and power analyses for testing subgroup-specific treatment effects in parallel-arm CRTs with a continuous outcome and a binary subgroup variable. We point out that the variances of the subgroup-specific treatment effect estimators and their covariance are given by weighted averages of the variance of the overall average treatment effect estimator and the variance of the heterogeneous treatment effect estimator. This analytical insight facilitates an explicit characterization of the requirements for both the omnibus test and the intersection–union test to achieve the desired level of power. Generalizations to allow for subgroup-specific variance structures are also discussed. We report on a simulation study to validate the proposed sample size methods and demonstrate that the empirical power corresponds well with the predicted power for both tests. The design and setting of the Umea Dementia and Exercise (UMDEX) CRT in older adults are used to illustrate our sample size methods.

SOCIAL MEDIA AND ENTREPRENEURSHIP DEVELOPMENT NEXUS IN BENUE STATE NIGERIA: EVIDENCE FROM A BINARY LOGISTIC REGRESSION MODEL

This study carried out an analysis of social media and entrepreneurship development nexus in Benue State. The researcher used mainly primary data from a sample of three hundred entrepreneurs in Zone A, B &amp; C in Benue State Nigeria. The primary data was obtained using a structured questionnaire. The data collected were analyzed using logit regression to establish the relationship between social media and entrepreneurship development while principal component analysis was used to identify the most important factors that affects the use of social media in entrepreneurship development. The result of the binary logistic regression analysis indicates that Social Media added significantly to the model/prediction. This means that the logistic model was statistically significant at 5 percent level of significance. Increasing the use of social media was associated with an increased likelihood of entrepreneurship development in Benue State. The logistic regression model was statistically significant, using values from the Omnibus Test of Model Coefficient. The model explained of the variance in post harvest losses of orange in the studied areas and correctly classified of cases. Use of social media was 0.018 times more likely to bring about entrepreneurship development in the studied areas. It was concluded that social media have a positive and significant effect on entrepreneurship development in Benue State Nigeria. It was recommended among others that entrepreneurs in the study area should engage more qualified personnel who can create the right content needed to engage the diverse customers of the business. When this is done, the likelihood of the use of social media in bringing about entrepreneurship development in Benue State can be increased.

Ball divergence for the equality test of crossing survival curves.

It is a very common problem to test survival equality using the right-censored time-to-event data in clinical research. Although the log-rank test is popularly used in various studies, it may become insensitive when the proportional hazards assumption is violated. As follows, there have a variety of statistical methods being proposed to identify the discrepancy between crossing survival curves or hazard functions. The omnibus tests against general alternatives are usually preferred due to their wide applicability to complicated scenarios in real applications. In this paper, we propose two novel statistics to estimate the ball divergence using the right-censored survival data, and then implement them in the equality test on survival time in two independent groups. The simulation analysis demonstrates their efficiency in identifying the survival discrepancy. Compared to the existing methods, our proposed methods present higher power in situations with complex distributions, especially when there is a scale shift between groups. Real examples illustrate its advantage in practical applications.