Approximating Partial Likelihood Estimators via Optimal Subsampling

With the growing availability of large-scale biomedical data, it is often time-consuming or infeasible to directly perform traditional statistical analysis with relatively limited computing resources at hand. We propose a fast and stable subsampling method to effectively approximate the full data maximum partial likelihood estimator in Cox's model, which reduces the computational burden when analyzing massive survival data. We establish consistency and asymptotic normality of a general subsample-based estimator. The optimal subsampling probabilities with explicit expressions are determined via minimizing the trace of the asymptotic variance-covariance matrix for a linearly transformed parameter estimator. We propose a two-step subsampling algorithm for practical implementation, which has a significant reduction in computing time compared to the full data method. The asymptotic properties of the resulting two-step subsample-based estimator is established. In addition, a subsampling-based Breslow-type estimator for the cumulative baseline hazard function and a subsample estimated survival function are presented. Extensive experiments are conducted to assess the proposed subsampling strategy. Finally, we provide an illustrative example about large-scale lymphoma cancer dataset from the Surveillance, Epidemiology,and End Results Program

Psychological mechanisms of English academic stress and academic burnout: the mediating role of rumination and moderating effect of neuroticism

IntroductionAcademic stress is a significant and prevalent phenomenon among college students. According to the Demands-Resources Model, when individuals are unable to cope with stress that exceeds their capacity, burnout may occur. Although English courses hold a significant position in university education, there has been limited research on the mechanisms linking English academic stress to English academic burnout.MethodsThis study recruited 1,130 undergraduate students taking English courses. Participants completed online questionnaires assessing English academic stress, rumination, English academic burnout, and neuroticism traits. A moderated mediation model was constructed to examine the relationship among these variables.ResultsThe results indicate that (1) Rumination serves as a mediator in the relationship between English academic stress and burnout; (2) neuroticism significantly moderates the pathway between English academic stress and rumination. Specifically, students with high neuroticism tendencies are more prone to developing rumination when faced with high levels of English academic stress.ConclusionThese findings offer valuable insights into the psychological mechanisms underlying the association between English learning stress and academic burnout. They emphasize the importance of addressing rumination as a mediator and considering individuals’ levels of neuroticism in interventions aimed at preventing and alleviating academic burnout among university students

Comparison of the Optical Quality between Small Incision Lenticule Extraction and Femtosecond Laser LASIK

Purpose. To investigate the visual quality after SMILE and Femto-LASIK. Methods. About 123 eyes from 63 patients were enrolled in this study. The parameters were measured preoperatively and 1 week, 1 month, and 3 months postoperatively using Sirius System. Results. The MTF curve increase slightly from low to high frequency at 3 mm and 6 mm pupil diameter after SMILE surgery (P<0.05) during the follow-up time comparing with the preoperative values. And the SR has a significant increase at various pupil diameters as well (P<0.05). However, there was little increase for MTF at intermediate to high frequency at 3 mm pupil diameter after Femto-LASIK procedure (P<0.05). And the SR had only significant increase at 3 mm pupil diameter. Between SMILE and Femto-LASIK, there was no statistic difference both in MTF and SR (P>0.05) at 3 mm pupil diameter at vertical and horizontal meridian. However, significant difference was found in MTF at low to mediate frequency at 6 mm pupil diameter at vertical meridian at 1 week postoperatively (P<0.05). Conclusions. Both SMILE and Femto-LASIK show a great improvement in optical quality at small diameter. It was found that SMILE shows better optical quality than Femto-LASIK at larger pupil diameter, which might be good for the night vision

Developing a new treatment for superficial fungal infection using antifungal Collagen-HSAF dressing

Fungal pathogens are common causes of superficial clinical infection. Their increasing drug resistance gradually makes existing antifungal drugs ineffective. Heat stable antifungal factor (HSAF) is a novel antifungal natural product with a unique structure. However, the application of HSAF has been hampered by very low yield in the current microbial producers and from extremely poor solubility in water and common solvents. In this study, we developed an effective mode of treatment applying HSAF to superficial fungal infections. The marine-derived Lysobacter enzymogenes YC36 contains the HSAF biosynthetic gene cluster, which we activated by the interspecific signaling molecule indole. An efficient extraction strategy was used to significantly improve the purity to 95.3%. Scanning electron microscopy images revealed that the Type I collagen-based HSAF (Col-HSAF) has a transparent appearance and good physical properties, and the in vitro sustained-release effect of HSAF was maintained for more than 2 weeks. The effective therapeutic concentration of Col-HSAF against superficial fungal infection was explored, and Col-HSAF showed good biocompatibility, lower clinical scores, mild histological changes, and antifungal capabilities in animals with Aspergillus fumigatus keratitis and cutaneous candidiasis. In conclusion, Col-HSAF is an antifungal reagent with significant clinical value in the treatment of superficial fungal infections

Genome-wide association meta-analysis in Chinese and European individuals identifies ten new loci associated with systemic lupus erythematosus

Systemic lupus erythematosus (SLE; OMIM 152700) is a genetically complex autoimmune disease. Genome-wide association studies (GWASs) have identified more than 50 loci as robustly associated with the disease in single ancestries, but genome-wide transancestral studies have not been conducted. We combined three GWAS data sets from Chinese (1,659 cases and 3,398 controls) and European (4,036 cases and 6,959 controls) populations. A meta-analysis of these studies showed that over half of the published SLE genetic associations are present in both populations. A replication study in Chinese (3,043 cases and 5,074 controls) and European (2,643 cases and 9,032 controls) subjects found ten previously unreported SLE loci. Our study provides further evidence that the majority of genetic risk polymorphisms for SLE are contained within the same regions across both populations. Furthermore, a comparison of risk allele frequencies and genetic risk scores suggested that the increased prevalence of SLE in non-Europeans (including Asians) has a genetic basis

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Language Shift Effect on Memory Generalization of Chinese-English Bilinguals

Language shift occurs when people learn information in one language but recall it in another language. This mismatch between encoding and retrieval language is found to impair memory accuracy when memory is tested immediately after learning. However, does the observed language shift effect still exist after a certain period of delay? Would it influence other aspects of memory, especially memory generalization? To address these two questions, we performed a memory experiment among unbalanced Chinese-English bilinguals. In the experiment, participants were required to read two stories (one in English, one in Chinese) and to retell the stories in Chinese from their memories afterward. Delay interval was manipulated in the experiment where participants either took memory recall tests immediately after story-reading or after 24 hours' delay. To analyze memory generalization, we coded the generalized words participants used to retell the stories. The results suggest that language shift (encoding in English and retrieving in Chinese) leads to a more generalized description in a memory recall task. However, the observed language shift effect disappears after 24 hours' delay. It can be concluded that language shift impacts bilingual learners' memory generalization in immediate recall tests, but such effect disappears after 24 hours' delay, which indicates the key role of delay interval in modulating language shift effect

Low-Carbon and Fundamental Properties of Eco-Efficient Mortar with Recycled Powders

Using recycled powders from solid waste is accepted as an effective strategy to realize the sustainable development of the construction industry. In our study, the cement was substituted by two kinds of recycled powders, i.e., spontaneous combustion gangue powder (SCGP) and recycled concrete powder (RCP), with a certain replacement ratio of 30%. The experimental variables were mainly the type of replacement powder (e.g., SCGP, RCP, and SCGP + RCP) and the grinding time of RCP (e.g., 25 min, 50 min, and 75 min). The fundamental properties, including mechanical properties, long-term properties, and carbon emission, were analyzed for all the mortar mixtures. Experimental results indicate that incorporation of RCP contributes to enhancing the toughness and dry shrinkage resistance of eco-efficient mortar, while SCGP positively affects the compressive strength and chloride resistance. The grinding process improves the activity of RCP to a certain extent, while a long grinding time leads to fusion and aggregation between powders. Investigation on CO2 emission demonstrates that carbon emission from cement production accounts for the largest proportion, 80~95%, in the total emission from mortar production. Combined with the AHP model, eco-efficient mortar containing 15% RCP ground for 50 min and 15% SCGP displays optimal fundamental properties