Multivariate state space methods for official statistics and climate modelling

This thesis explores how state space models, which are a type of econometric models designed to analyse time series data, can be employed to achieve more accurate and realistic estimates of official statistics, and to model and forecast regional concentrations of air pollutants. Specifically, a novel approach is presented, which incorporates survey-based, claimant counts and Google Trends data in order to provide more timely and accurate estimates of Dutch unemployment, over only employing survey-based data. A new method is proposed to model the relationship between the latter and claimant counts data as time-varying, which allows us to promptly tackle changes in such relationship and therefore achieve more realistic real-time estimates of Dutch unemployment. Time-varying relationships can potentially be modelled with other, already existing, econometric techniques, than the one proposed in this thesis, and the reasons why they have not been considered further are here documented. Finally, a novel spatial type of state space model is employed in order to model regional concentrations of nitrogen dioxide (NO2) in the Netherlands. The (time-varying) effects on this air pollutant of meteorological conditions, traffic intensity and geographical location of the Dutch regions, are accounted for in the model. The latter is further used to forecast regional NO2 concentrations for different scenarios of traffic intensity, and can therefore be potentially employed for evaluation of pollution-reduction policies

A dynamic factor model approach to incorporate Big Data in state space models for official statistics

In this paper we consider estimation of unobserved components in state space models using a dynamic factor approach to incorporate auxiliary information from high-dimensional data sources. We apply the methodology to unemployment estimation as done by Statistics Netherlands, who uses a multivariate state space model to produce monthly figures for the unemployment using series observed with the labour force survey (LFS). We extend the model by including auxiliary series of Google Trends about job-search and economic uncertainty, and claimant counts, partially observed at higher frequencies. Our factor model allows for nowcasting the variable of interest, providing reliable unemployment estimates in real-time before LFS data become available

Sex differences in the efficacy and safety of SARS-CoV-2 vaccination in residents of long-term care facilities: insights from the GeroCovid Vax study

Despite the reported sex-related variations in the immune response to vaccination, whether the effects of SARS-CoV-2 vaccination differ by sex is still under debate, especially considering old vulnerable individuals, such as long-term care facilities (LTCFs) residents. This study aimed to evaluate COVID-19 infections, adverse events, and humoral response after vaccination in a sample of LTCF residents. A total of 3259 LTCF residents (71% females; mean age: 83.4 +/- 9.2 years) were enrolled in the Italian-based multicenter GeroCovid Vax study. We recorded the adverse effects occurring during the 7 days after vaccine doses and COVID-19 cases over 12 months post-vaccination. In a subsample of 524 residents (69% females), pre- and post-vaccination SARS-CoV-2 trimeric S immunoglobulin G (Anti-S-IgG) were measured through chemiluminescent assays at different time points. Only 12.1% of vaccinated residents got COVID-19 during the follow-up, without any sex differences. Female residents were more likely to have local adverse effects after the first dose (13.3% vs. 10.2%, p = 0.018). No other sex differences in systemic adverse effects and for the following doses were recorded, as well as in anti-S-IgG titer over time. Among the factors modifying the 12-month anti-S-IgG titers, mobility limitations and depressive disorder were more likely to be associated with higher and lower levels in the antibody response, respectively; a significantly lower antibody titer was observed in males with cardiovascular diseases and in females with diabetes or cognitive disorders. The study suggests that, among LTCF residents, SARS-CoV-2 vaccination was effective regardless of sex, yet sex-specific comorbidities influenced the antibody response. Local adverse reactions were more common in females

Humoral immunity induced by mRNA COVID-19 vaccines in Nursing Home Residents previously infected with SARS-CoV-2

Background: Nursing home (NH) residents suffered the greatest impact of the COVID-19 pandemic. Limited data are available on vaccine-induced immunity and on the protection ensured by a prior infection in this population. Aims: The present study aims to monitor antibody levels and their persistence over a 6-month period in NH residents according to the history of prior SARS-CoV-2 infection. Methods: We measured anti-trimeric Spike IgG antibody levels in a sample of 395 residents from 25 NHs in 6 Italian Regions at study enrolment (prior to the first dose of vaccine, T0) and then after 2 (T1) and 6 months (T2) following the first vaccine dose. All participants received mRNA vaccines (BNT162b2 or mRNA-1273). Analyses were performed using log-transformed values of antibody concentrations and geometric means (GM) were calculated. Results: Superior humoral immunity was induced in NH residents with previous SARS-CoV-2 infection. (T0: GM 186.6 vs. 6.1 BAU/ml, p < 0.001; T1: GM 5264.1 vs. 944.4 BAU/ml, p < 0.001; T2: GM 1473.6 vs. 128.7 BAU/ml, p < 0.001). Residents with prior SARS-CoV-2 infection receiving two vaccine doses presented significantly higher antibody concentration at T1 and T2. A longer interval between previous infection and vaccination was associated with a better antibody response over time. Discussion: In a frail sample of NH residents, prior SARS-CoV-2 infection was associated with a higher humoral response to vaccination. Number of vaccine doses and the interval between infection and vaccination are relevant parameters in determining humoral immunity. Conclusions: These findings provide important information to plan future immunization policies and disease prevention strategies in a highly vulnerable population

Research Article Evaluation of the Potential Nephroprotective and Antimicrobial Effect of Camellia sinensis Leaves versus Hibiscus sabdariffa (In Vivo and In Vitro Studies)

Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Green tea and hibiscus are widely consumed as traditional beverages in Yemen and some regional countries. They are relatively cheap and the belief is that they improve health state and cure many diseases. The aim of this study was to evaluate the potential protective and antibacterial activity of these two famous plants in vitro through measuring their antibacterial activity and in vivo through measuring nonenzymatic kidney markers dysfunction after induction of nephrotoxicity by gentamicin. Gram positive bacteria like MRSA (methicillin resistant Staphylococcus aureus) were isolated from hospitalized patients ’ different sources (pus and wound) and Gram negative bacteria including E. coli and P. aeruginosa were used in vitro study. In addition, the efficacy of these plants was assessed in vivo through measuring nonenzymatic kidney markers including S. creatinine and S. urea. Green tea was shown antimicrobial activity against MRSA with inhibition zone 19.67 ± 0.33mm and MIC 1.25 ± 0.00mg/mL compared with standard reference (vancomycin) 18.00 ± 0.00mg/mL.Hibiscus did not exhibit a similar effect. BothHibiscus- and green tea-treated groups had nephroprotective effects as they reduced the elevation in nonenzymatic kidney markers. We conclude that green tea has dual effects: antimicrobial and nephroprotective. 1

Polypharmacy and Antibody Response to SARS-CoV-2 Vaccination in Residents of Long-Term Care Facilities: The GeroCovid Vax Study

Background and objective: Polypharmacy is common in older adults, particularly among those living in long-term care facilities. This condition represents a marker of clinical complexity and might directly affect the immunological response. However, there are limited data on the association of polypharmacy with vaccine immunogenicity. This study evaluated the immune response to anti-SARS-CoV-2 vaccines in older residents of long-term care facilities as a function of the number of medications used. Methods: In 478 long-term care facility residents participating in the GeroCovid Vax study, we assessed SARS-CoV-2 trimeric S IgG levels through chemiluminescent assays before the vaccination and after 2, 6, and 12 months. A booster dose was administered between 6- and 12-month assessments. Sociodemographic information and data on chronic diseases and medications were derived from medical records. Based on the number of daily medications, residents were classified into the no polypharmacy (zero to four medications), polypharmacy (five to nine medications), and hyperpolypharmacy (ten or more medications) groups. Results: In the sample (mean age 82.1 years, 69.2% female), 200 (41.8%) residents were taking five or fewer medications/day (no polypharmacy), 229 (47.9%) had polypharmacy, and 49 (10.3%) had hyperpolypharmacy. Using linear mixed models adjusted for potential confounders, we found that hyperpolypharmacy was associated with a steeper antibody decline after 6 months from the first vaccine dose administration (β = - 0.29, 95% confidence interval - 0.54, - 0.03, p = 0.03) than no polypharmacy, while no significant differences were observed at 12 months. Conclusions: The humoral immune response to SARS-CoV-2 vaccination of older residents showed only slight changes as a function of the number of medications taken. Although it seemed less durable among older residents with hyperpolypharmacy, the booster dose administration equalized such a difference

Diabetes mellitus Affects Antibody Response to SARS-CoV-2 Vaccination in Older Residents of Long-Term Care Facilities: Data from the GeroCovid Vax Study

   ABSTRACT OBJECTIVE: Type 2 Diabetes mellitus may affect the humoral immune response following vaccinations, but data concerning COVID-19 vaccines are scarce. We evaluated the impact of diabetes mellitus on antibody response to the SARS-CoV-2 vaccination in older long-term care facilities (LTCF) residents and tested for differences according to anti-diabetic treatment. RESEARCH DESIGN AND METHODS: 555 older LTCF residents participating in the GeroCovid Vax study were included for this analysis. SARS-CoV-2 trimeric S Immunoglobulin G (anti-S-IgG) concentrations using chemiluminescent assays were tested before the first dose and after 2- and 6-months. The impact of diabetes on anti-S-IgG levels was evaluated using linear mixed models, which included the interaction between time and the presence of diabetes. A second model considered also diabetes treatment: no insulin therapy (including dietary only or use of oral anti-diabetic agents) and insulin therapy (alone or in combination with oral anti-diabetic agents). RESULTS: The sample's mean age was 82.1 years, 68.1% were women and 25.2% were diabetic. In linear mixed models, the presence of diabetes mellitus was associated with lower anti-S-IgG levels 2 (β=-0.20, 95%CI:-0.34,-0.06) and 6 months (β=-0.22, 95%CI:-0.37,-0.07) after the first vaccine dose. Compared to those without diabetes, diabetic residents not using insulin had lower IgG levels at 2- and 6-month assessments (β=-0.24, 95%CI:-0.43,-0.05, and β=-0.30, 95%CI:-0.50,-0.10, respectively), while no differences were observed for those under insulin.  CONCLUSION: Older LTCF residents with diabetes tended to have weaker antibody response to COVID-19 vaccination. Insulin treatment might buffer this effect and establish a humoral immunity similar to non-diabetic individuals.</p

Gut Microbiota Signatures Are Associated With Psychopathological Profiles in Patients With Ulcerative Colitis: Results From an Italian Tertiary IBD Center

Lay Summary Psychiatric disorders are more prevalent in IBD patients than in general population. In this prospective cohort study, we found a correlation between active UC, peculiar psychiatric distress (anxiety and depression above all), and specific taxonomic gut microbiota signatures.Background Several patients with ulcerative colitis (UC) suffer from psychiatric disorders, such as major depressive disorder, anxiety, or bipolar disorder, and show specific personality traits. Despite this, there are few data about personality profiles' characterization in UC patients and about correlation of their psychopathological profile with their intestinal microbiota. The aim of our study is to analyze the psychopathological and personality profile of UC patients and correlate it with specific signatures of their gut microbiota. Methods This is a prospective interventional longitudinal cohort study. We enrolled consecutive patients affected by UC attending to the IBD Unit of Center for Digestive Disease of "A. Gemelli" IRCCS Hospital in Rome and a group of healthy subjects, matched for specific characteristics. Each patient was evaluated by a gastroenterologist and a psychiatrist. Moreover, all participants underwent psychological tests and a collection of stool samples. Results We recruited 39 UC patients and 37 healthy subjects. Most patients showed high level of alexithymia, anxiety symptoms, depressive symptoms, as well as neuroticism and hypochondria, with obsessive-compulsive features at the behavioral level, which significantly impaired their quality of life and abilities at work. Gut microbiota analysis in UC patients demonstrated an increase in actinobacteria, Proteobacteria and Saccharibacteria (TM7), with a reduction in verrucomicrobia, euryarchaeota and tenericutes. Conclusions Our study confirmed the presence of high levels of psycho-emotional distress in UC patients, alongside alterations of the intestinal microbiota, and highlighted some families and genera of bacteria (Enterobacteriaceae, Streptococcus, Veillonella, Klebsiella, and Clostridiaceae) as potential markers of an altered gut-brain axis in these patients