573 research outputs found
Bayesian SAR model with stochastic volatility and multiple time-varying weights
A novel spatial autoregressive model for panel data is introduced, which
incorporates multilayer networks and accounts for time-varying relationships.
Moreover, the proposed approach allows the structural variance to evolve
smoothly over time and enables the analysis of shock propagation in terms of
time-varying spillover effects. The framework is applied to analyse the
dynamics of international relationships among the G7 economies and their impact
on stock market returns and volatilities. The findings underscore the
substantial impact of cooperative interactions and highlight discernible
disparities in network exposure across G7 nations, along with nuanced patterns
in direct and indirect spillover effects
Spatial clustering of non-transported cardiac decedents: the results of a point pattern analysis and an inquiry into social environmental correlates
<p>Abstract</p> <p>Background</p> <p>People who die from heart disease at home before any attempt at transport has been made may represent missed opportunities for life-saving medical intervention. In this study, we undertook a point-pattern spatial analysis of heart disease deaths occurring before transport in a large metropolitan area to determine whether there was spatial clustering of non-transported decedents and whether there were significant differences between the clusters of non-transported cardiac decedents and the clusters of transported cardiac decedents in terms of average travel distances to nearest hospital and area socioeconomic characteristics. These analyses were adjusted for individual predictors of transport status.</p> <p>Methods</p> <p>We obtained transport status from the <it>place of death </it>variable on the death certificate. We geocoded heart disease decedents to residential street addresses using a rigorous, multistep process with 97% success. Our final study population consisted of 11,485 adults aged 25-74 years who resided in a large metropolitan area in west-central Florida and died from heart disease during 1998-2002. We conducted a kernel density analysis to identify clusters of the residential locations of cardiac decedents where there was a statistically significant excess probability of being either transported or not transported prior to death; we controlled for individual-level covariates using logistic regression-derived probability estimates.</p> <p>Results</p> <p>The majority of heart disease decedents were married (53.4%), male (66.4%), white (85.6%), and aged 65-74 years at the time of death (54.7%), and a slight majority were transported prior to death (57.7%). After adjustment for individual predictors, 21 geographic clusters of non-transported heart disease decedents were observed. Contrary to our hypothesis, clusters of non-transported decedents were slightly closer to hospitals than clusters of transported decedents. The social environmental characteristics of clusters varied in the expected direction, with lower socioeconomic and household resources in the clusters of non-transported heart disease deaths.</p> <p>Conclusions</p> <p>These results suggest that in this large metropolitan area unfavorable household and neighborhood resources played a larger role than distance to hospital with regard to transport status of cardiac patients; more research is needed in different geographic areas of the United States and in other industrialized nations.</p
Threshold for Onset of Injury in Chinook Salmon from Exposure to Impulsive Pile Driving Sounds
The risk of effects to fishes and other aquatic life from impulsive sound produced by activities such as pile driving and seismic exploration is increasing throughout the world, particularly with the increased exploitation of oceans for energy production. At the same time, there are few data that provide insight into the effects of these sounds on fishes. The goal of this study was to provide quantitative data to define the levels of impulsive sound that could result in the onset of barotrauma to fish. A High Intensity Controlled Impedance Fluid filled wave Tube was developed that enabled laboratory simulation of high-energy impulsive sound that were characteristic of aquatic far-field, plane-wave acoustic conditions. The sounds used were based upon the impulsive sounds generated by an impact hammer striking a steel shell pile. Neutrally buoyant juvenile Chinook salmon (Oncorhynchus tshawytscha) were exposed to impulsive sounds and subsequently evaluated for barotrauma injuries. Observed injuries ranged from mild hematomas at the lowest sound exposure levels to organ hemorrhage at the highest sound exposure levels. Frequency of observed injuries were used to compute a biological response weighted index (RWI) to evaluate the physiological impact of injuries at the different exposure levels. As single strike and cumulative sound exposure levels (SELss, SELcum respectively) increased, RWI values increased. Based on the results, tissue damage associated with adverse physiological costs occurred when the RWI was greater than 2. In terms of sound exposure levels a RWI of 2 was achieved for 1920 strikes by 177 dB re 1 µPa2⋅s SELss yielding a SELcum of 210 dB re 1 µPa2⋅s, and for 960 strikes by 180 dB re 1 µPa2⋅s SELss yielding a SELcum of 210 dB re 1 µPa2⋅s. These metrics define thresholds for onset of injury in juvenile Chinook salmon
Proton Pump Inhibitor Use, Fatigue, and Health-Related Quality of Life in Kidney Transplant Recipients:Results From the TransplantLines Biobank and Cohort Study
RATIONALE & OBJECTIVE: Prior studies report that the use of proton-pump inhibitors (PPIs) can adversely affect gut microbiota and gastrointestinal uptake of micronutrients, in particular iron and magnesium, and are used frequently by kidney transplant recipients (KTR). Altered gut microbiota, iron deficiency, and magnesium deficiency have been implicated in the pathogenesis of chronic fatigue. Therefore, we hypothesized that PPI use may be an important and underappreciated cause of fatigue and reduced health-related quality of life (HRQoL) in this population.STUDY DESIGN: Cross-sectional study.SETTING & PARTICIPANTS: KTR (≥1 year after transplantation) enrolled in the TransplantLines Biobank and Cohort Study.EXPOSURE: PPI use, PPI type, PPI dosage, and duration of PPI use.OUTCOMES: Fatigue and HRQoL, assessed using the validated Checklist Individual Strength 20 Revised questionnaire and Short Form-36 questionnaire.ANALYTICAL APPROACH: Logistic and linear regression.RESULTS: We included 937 KTR (mean age 56±13 years, 39% female) at a median of 3 [1-10] years after transplantation. PPI use was associated with fatigue severity (regression coefficient 4.02, 95%CI 2.18 to 5.85, p<0.001), a higher risk of severe fatigue (OR 2.05, 95%CI 1.48 to 2.84, p<0.001), lower physical HRQoL (regression coefficient -8.54, 95%CI -11.54 to -5.54, p<0.001), and lower mental HRQoL (regression coefficient -4.66, 95%CI -7.15 to -2.17, p<0.001). These associations were independent of potential confounders including age, time since transplantation, history of upper gastrointestinal disease, antiplatelet therapy, and the total number of medications. They were present among all individually assessed PPI types and were dose-dependent. Duration of PPI exposure was only associated with fatigue severity.LIMITATIONS: Residual confounding and inability to assess causal relationships CONCLUSIONS: PPI use is independently associated with fatigue and lower HRQoL among KTR. PPI use might be an easily accessible target for alleviating fatigue and improving HRQoL among KTR. Further studies examining the effect of PPI exposure in this population are warranted.</p
Characteristics and Dysbiosis of the Gut Microbiome in Renal Transplant Recipients
Renal transplantation is life-changing in many aspects. This includes changes to the gut microbiome likely due to exposure to immunosuppressive drugs and antibiotics. As a consequence, renal transplant recipients (RTRs) might suffer from intestinal dysbiosis. We aimed to investigate the gut microbiome of RTRs and compare it with healthy controls and to identify determinants of the gut microbiome of RTRs. Therefore, RTRs and healthy controls participating in the TransplantLines Biobank and Cohort Study (NCT03272841) were included. We analyzed the gut microbiome using 16S rRNA sequencing and compared the composition of the gut microbiome of RTRs to healthy controls using multivariate association with linear models (MaAsLin). Fecal samples of 139 RTRs (50% male, mean age: 58.3 ± 12.8 years) and 105 healthy controls (57% male, mean age: 59.2 ± 10.6 years) were collected. Median time after transplantation of RTRs was 6.0 (1.5-12.5)years. The microbiome composition of RTRs was significantly different from that of healthy controls, and RTRs had a lower diversity of the gut microbiome (p < 0.01). Proton-pump inhibitors, mycophenolate mofetil, and estimated glomerular filtration rate (eGFR) are significant determinants of the gut microbiome of RTRs (p < 0.05). Use of mycophenolate mofetil correlated to a lower diversity (p < 0.01). Moreover, significant alterations were found in multiple bacterial taxa between RTRs and healthy controls. The gut microbiome of RTRs contained more Proteobacteria and less Actinobacteria, and there was a loss of butyrate-producing bacteria in the gut microbiome of RTRs. By comparing the gut microbiome of RTRs to healthy controls we have shown that RTRs suffer from dysbiosis, a disruption in the balance of the gut microbiome
Geographic and Sociodemographic Disparities in Drive Times to Joint Commission–Certified Primary Stroke Centers in North Carolina, South Carolina, and Georgia
Introduction: Timely access to facilities that provide acute stroke care is necessary to reduce disabilities and death from stroke. We examined geographic and sociodemographic disparities in drive times to Joint Commission–certified primary stroke centers (JCPSCs) and other hospitals with stroke care quality improvement initiatives in North Carolina, South Carolina, and Georgia. Methods: We defined boundaries for 30- and 60-minute drive-time areas to JCPSCs and other hospitals by using geographic information systems (GIS) mapping technology and calculated the proportions of the population living in these drive-time areas by sociodemographic characteristics. Age-adjusted county-level stroke death rates were overlaid onto the drive-time areas. Results: Approximately 55% of the population lived within a 30-minute drive time to a JCPSC; 77% lived within a 60-minute drive time. Disparities in percentage of the population within 30-minute drive times were found by race/ethnicity, education, income, and urban/rural status; the disparity was largest between urban areas (70% lived within 30-minute drive time) and rural areas (26%). The rural coastal plains had the largest concentration of counties with high stroke death rates and the fewest JCPSCs. Conclusion: Many areas in this tri-state region lack timely access to JCPSCs. Alternative strategies are needed to expand provision of quality acute stroke care in this region. GIS modeling is valuable for examining and strategically planning the distribution of hospitals providing acute stroke care
Correlated fragile site expression allows the identification of candidate fragile genes involved in immunity and associated with carcinogenesis
Common fragile sites (cfs) are specific regions in the human genome that are
particularly prone to genomic instability under conditions of replicative
stress. Several investigations support the view that common fragile sites play
a role in carcinogenesis. We discuss a genome-wide approach based on graph
theory and Gene Ontology vocabulary for the functional characterization of
common fragile sites and for the identification of genes that contribute to
tumour cell biology. CFS were assembled in a network based on a simple measure
of correlation among common fragile site patterns of expression. By applying
robust measurements to capture in quantitative terms the non triviality of the
network, we identified several topological features clearly indicating
departure from the Erdos-Renyi random graph model. The most important outcome
was the presence of an unexpected large connected component far below the
percolation threshold. Most of the best characterized common fragile sites
belonged to this connected component. By filtering this connected component
with Gene Ontology, statistically significant shared functional features were
detected. Common fragile sites were found to be enriched for genes associated
to the immune response and to mechanisms involved in tumour progression such as
extracellular space remodeling and angiogenesis. Our results support the
hypothesis that fragile sites serve a function; we propose that fragility is
linked to a coordinated regulation of fragile genes expression.Comment: 18 pages, accepted for publication in BMC Bioinformatic
- …