External validation of the Dat'AIDS score: A risk score for predicting 5-year overall mortality in people living with HIV aged 60 years or older.

OBJECTIVE: To perform an external validation of the Dat'AIDS score for predicting 5-year overall mortality among people with HIV (PWH) aged 60 years or older. METHODS: This was a multi-centre prospective cohort study at all sites participating in the Swiss HIV Cohort Study (SHCS). We calculated the Dat'AIDS score in PWH aged 60 years or older at their first visit between 1 January 2015 and 1 January 2020. People living with HIV-2 and those whose Dat'AIDS score could not be calculated were excluded. Patients were followed until 1 January 2020. The primary endpoint was all-cause mortality. Vital status was collected throughout the study period. We obtained population and score descriptive statistics and assessed the score's discrimination and calibration. RESULTS: We included 2205 participants (82% male) of median [interquartile range (IQR)] age 62.0 (60.3-67.0) years, mostly with viraemia <50 copies/mL (92.7%). Median follow-up time was 15.9 years and median (IQR) CD4 cell count at enrolment was 586 (420-782) cells/µL. In all, 152 deaths were recorded during a total follow-up period of 7147 patient-years. The median (IQR) observed Dat'AIDS score was 3 (0-8). Discriminative capacities were good as the C-statistic was 0.73 (95% CI: 0.69-0.77) and consistent across all subgroups. Comparison of observed and expected survival probabilities showed good calibration. CONCLUSIONS: External validation of the Dat'AIDS score in patients aged 60 years or older showed that it could be a useful tool not only for research purposes, but also to identify older patients at a higher mortality risk and to tailor the most appropriate interventions.

The cluster depth tests: Toward point-wise strong control of the family-wise error rate in massively univariate tests with application to M/EEG.

The cluster mass test has been widely used for massively univariate tests in M/EEG, fMRI and, recently, pupillometry analysis. It is a powerful method for detecting effects while controlling weakly the family-wise error rate (FWER), although its correct interpretation can only be performed at the cluster level without any point-wise conclusion. It implies that the discoveries of a cluster mass test cannot be precisely localized in time or in space. We propose a new multiple comparisons procedure, the cluster depth tests, that both controls the FWER while allowing an interpretation at the time point level. We show the conditions for a strong control of the FWER, and a simulation study shows that the cluster depth tests achieve large power and guarantee the FWER even in the presence of physiologically plausible effects. By having an interpretation at the time point/voxel level, the cluster depth tests make it possible to take full advantage of the high temporal resolution of EEG recording and give a precise timing of the start and end of the significant effects.

Accounting for stimulus and participant effects in event-related potential analyses to increase the replicability of studies.

BACKGROUND: Event-related potentials (ERPs) are increasingly used in cognitive science. With their high temporal resolution, they offer a unique window into cognitive processes and their time course. In this paper, we focus on ERP experiments whose designs involve selecting participants and stimuli amongst many. Recently, Westfall et al. (2017) highlighted the drastic consequences of not considering stimuli as a random variable in fMRI studies with such designs. Most ERP studies in cognitive psychology suffer from the same drawback. NEW METHOD: We advocate the use of the Quasi-F or Mixed-effects models instead of the classical ANOVA/by-participant F1 statistic to analyze ERP datasets in which the dependent variable is reduced to one measure per trial (e.g., mean amplitude). We combine Quasi-F statistic and cluster mass tests to analyze datasets with multiple measures per trial. Doing so allows us to treat stimulus as a random variable while correcting for multiple comparisons. RESULTS: Simulations show that the use of Quasi-F statistics with cluster mass tests allows maintaining the family wise error rates close to the nominal alpha level of 0.05. COMPARISON WITH EXISTING METHODS: Simulations reveal that the classical ANOVA/F1 approach has an alarming FWER, demonstrating the superiority of models that treat both participant and stimulus as random variables, like the Quasi-F approach. CONCLUSIONS: Our simulations question the validity of studies in which stimulus is not treated as a random variable. Failure to change the current standards feeds the replicability crisis.

Avoiding sedentary behaviors requires more cortical resources than avoiding physical activity: An EEG study.

Why do individuals fail to exercise regularly despite knowledge of the risks associated with physical inactivity? Automatic processes regulating exercise behaviors may partly explain this paradox. Yet, these processes have only been investigated with behavioral outcomes (i.e., based on reaction times). Here, using electroencephalography, we investigated the cortical activity underlying automatic approach and avoidance tendencies toward stimuli depicting physical activity and sedentary behaviors in 29 young adults who were physically active or physically inactive but with the intention of becoming physically active. Behavioral results showed faster reactions when approaching physical activity compared to sedentary behaviors and when avoiding sedentary behaviors compared to physical activity. These faster reactions were more pronounced in physically active individuals and were associated with changes during sensory integration (earlier onset latency and larger positive deflection of the stimulus-locked lateralized readiness potentials) but not during motor preparation (no effect on the response-locked lateralized readiness potentials). Faster reactions when avoiding sedentary behaviors compared to physical activity were also associated with higher conflict monitoring (larger early and late N1 event-related potentials) and higher inhibition (larger N2 event-related potentials), irrespective of the usual level of physical activity. These results suggest that additional cortical resources were required to counteract an attraction to sedentary behaviors. Data and Materials [https://doi.org/10.5281/zenodo.1169140]. Preprint [https://doi.org/10.1101/277988].