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1.
Proc Natl Acad Sci U S A ; 121(11): e2318365121, 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38451950

RESUMO

To construct a stochastic version of [R. J. Barro, J. Polit. Econ. 87, 940-971 (1979)] normative model of tax rates and debt/GDP dynamics, we add risks and markets for trading them along lines suggested by [K. J. Arrow, Rev. Econ. Stud. 31, 91-96 (1964)] and [R. J. Shiller, Creating Institutions for Managing Society's Largest Economic Risks (OUP, Oxford, 1994)]. These modifications preserve Barro's prescriptions that a government should keep its debt-gross domestic product (GDP) ratio and tax rate constant over time and also prescribe that the government insure its primary surplus risk by selling or buying the same number of shares of a Shiller macro security each period.


Assuntos
Governo , Produto Interno Bruto
2.
Brief Bioinform ; 25(4)2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38877886

RESUMO

Single-cell sequencing has revolutionized our ability to dissect the heterogeneity within tumor populations. In this study, we present LoRA-TV (Low Rank Approximation with Total Variation), a novel method for clustering tumor cells based on the read depth profiles derived from single-cell sequencing data. Traditional analysis pipelines process read depth profiles of each cell individually. By aggregating shared genomic signatures distributed among individual cells using low-rank optimization and robust smoothing, the proposed method enhances clustering performance. Results from analyses of both simulated and real data demonstrate its effectiveness compared with state-of-the-art alternatives, as supported by improvements in the adjusted Rand index and computational efficiency.


Assuntos
Neoplasias , Análise de Célula Única , Análise de Célula Única/métodos , Humanos , Neoplasias/genética , Neoplasias/patologia , Análise por Conglomerados , Algoritmos , Biologia Computacional/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Genômica/métodos
3.
Biostatistics ; 25(2): 521-540, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-36940671

RESUMO

The use of social contact rates is widespread in infectious disease modeling since it has been shown that they are key driving forces of important epidemiological parameters. Quantification of contact patterns is crucial to parameterize dynamic transmission models and to provide insights on the (basic) reproduction number. Information on social interactions can be obtained from population-based contact surveys, such as the European Commission project POLYMOD. Estimation of age-specific contact rates from these studies is often done using a piecewise constant approach or bivariate smoothing techniques. For the latter, typically, smoothness is introduced in the dimensions of the respondent's and contact's age (i.e., the rows and columns of the social contact matrix). We propose a smoothing constrained approach-taking into account the reciprocal nature of contacts-introducing smoothness over the diagonal (including all subdiagonals) of the social contact matrix. This modeling approach is justified assuming that when people age their contact behavior changes smoothly. We call this smoothing from a cohort perspective. Two approaches that allow for smoothing over social contact matrix diagonals are proposed, namely (i) reordering of the diagonal components of the contact matrix and (ii) reordering of the penalty matrix ensuring smoothness over the contact matrix diagonals. Parameter estimation is done in the likelihood framework by using constrained penalized iterative reweighted least squares. A simulation study underlines the benefits of cohort-based smoothing. Finally, the proposed methods are illustrated on the Belgian POLYMOD data of 2006. Code to reproduce the results of the article can be downloaded on this GitHub repository https://github.com/oswaldogressani/Cohort_smoothing.


Assuntos
Doenças Transmissíveis , Humanos , Simulação por Computador , Análise dos Mínimos Quadrados , Probabilidade , Fatores Etários
4.
Biostatistics ; 2024 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-39103178

RESUMO

The under-5 mortality rate (U5MR), a critical health indicator, is typically estimated from household surveys in lower and middle income countries. Spatio-temporal disaggregation of household survey data can lead to highly variable estimates of U5MR, necessitating the usage of smoothing models which borrow information across space and time. The assumptions of common smoothing models may be unrealistic when certain time periods or regions are expected to have shocks in mortality relative to their neighbors, which can lead to oversmoothing of U5MR estimates. In this paper, we develop a spatial and temporal smoothing approach based on Gaussian Markov random field models which incorporate knowledge of these expected shocks in mortality. We demonstrate the potential for these models to improve upon alternatives not incorporating knowledge of expected shocks in a simulation study. We apply these models to estimate U5MR in Rwanda at the national level from 1985 to 2019, a time period which includes the Rwandan civil war and genocide.

5.
Biostatistics ; 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38637995

RESUMO

Computed tomography (CT) has been a powerful diagnostic tool since its emergence in the 1970s. Using CT data, 3D structures of human internal organs and tissues, such as blood vessels, can be reconstructed using professional software. This 3D reconstruction is crucial for surgical operations and can serve as a vivid medical teaching example. However, traditional 3D reconstruction heavily relies on manual operations, which are time-consuming, subjective, and require substantial experience. To address this problem, we develop a novel semiparametric Gaussian mixture model tailored for the 3D reconstruction of blood vessels. This model extends the classical Gaussian mixture model by enabling nonparametric variations in the component-wise parameters of interest according to voxel positions. We develop a kernel-based expectation-maximization algorithm for estimating the model parameters, accompanied by a supporting asymptotic theory. Furthermore, we propose a novel regression method for optimal bandwidth selection. Compared to the conventional cross-validation-based (CV) method, the regression method outperforms the CV method in terms of computational and statistical efficiency. In application, this methodology facilitates the fully automated reconstruction of 3D blood vessel structures with remarkable accuracy.

6.
Biostatistics ; 25(3): 666-680, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38141227

RESUMO

With rapid development of techniques to measure brain activity and structure, statistical methods for analyzing modern brain-imaging data play an important role in the advancement of science. Imaging data that measure brain function are usually multivariate high-density longitudinal data and are heterogeneous across both imaging sources and subjects, which lead to various statistical and computational challenges. In this article, we propose a group-based method to cluster a collection of multivariate high-density longitudinal data via a Bayesian mixture of smoothing splines. Our method assumes each multivariate high-density longitudinal trajectory is a mixture of multiple components with different mixing weights. Time-independent covariates are assumed to be associated with the mixture components and are incorporated via logistic weights of a mixture-of-experts model. We formulate this approach under a fully Bayesian framework using Gibbs sampling where the number of components is selected based on a deviance information criterion. The proposed method is compared to existing methods via simulation studies and is applied to a study on functional near-infrared spectroscopy, which aims to understand infant emotional reactivity and recovery from stress. The results reveal distinct patterns of brain activity, as well as associations between these patterns and selected covariates.


Assuntos
Teorema de Bayes , Humanos , Estudos Longitudinais , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Interpretação Estatística de Dados , Modelos Estatísticos , Lactente , Análise Multivariada , Bioestatística/métodos
7.
BMC Bioinformatics ; 25(1): 30, 2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38233793

RESUMO

MOTIVATION: Within the frame of their genetic capacity, organisms are able to modify their molecular state to cope with changing environmental conditions or induced genetic disposition. As high throughput methods are becoming increasingly affordable, time series analysis techniques are applied frequently to study the complex dynamic interplay between genes, proteins, and metabolites at the physiological and molecular level. Common analysis approaches fail to simultaneously include (i) information about the replicate variance and (ii) the limited number of responses/shapes that a biological system is typically able to take. RESULTS: We present a novel approach to model and classify short time series signals, conceptually based on a classical time series analysis, where the dependency of the consecutive time points is exploited. Constrained spline regression with automated model selection separates between noise and signal under the assumption that highly frequent changes are less likely to occur, simultaneously preserving information about the detected variance. This enables a more precise representation of the measured information and improves temporal classification in order to identify biologically interpretable correlations among the data. AVAILABILITY AND IMPLEMENTATION: An open source F# implementation of the presented method and documentation of its usage is freely available in the TempClass repository, https://github.com/CSBiology/TempClass  [58].


Assuntos
Projetos de Pesquisa , Fatores de Tempo
8.
BMC Genomics ; 25(1): 73, 2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38233788

RESUMO

BACKGROUND: Long noncoding RNAs (lncRNAs) are integral to a plethora of critical cellular biological processes, including the regulation of gene expression, cell differentiation, and the development of tumors and cancers. Predicting the relationships between lncRNAs and diseases can contribute to a better understanding of the pathogenic mechanisms of disease and provide strong support for the development of advanced treatment methods. RESULTS: Therefore, we present an innovative Node-Adaptive Graph Transformer model for predicting unknown LncRNA-Disease Associations, named NAGTLDA. First, we utilize the node-adaptive feature smoothing (NAFS) method to learn the local feature information of nodes and encode the structural information of the fusion similarity network of diseases and lncRNAs using Structural Deep Network Embedding (SDNE). Next, the Transformer module is used to capture potential association information between the network nodes. Finally, we employ a Transformer module with two multi-headed attention layers for learning global-level embedding fusion. Network structure coding is added as the structural inductive bias of the network to compensate for the missing message-passing mechanism in Transformer. NAGTLDA achieved an average AUC of 0.9531 and AUPR of 0.9537 significantly higher than state-of-the-art methods in 5-fold cross validation. We perform case studies on 4 diseases; 55 out of 60 associations between lncRNAs and diseases have been validated in the literatures. The results demonstrate the enormous potential of the graph Transformer structure to incorporate graph structural information for uncovering lncRNA-disease unknown correlations. CONCLUSIONS: Our proposed NAGTLDA model can serve as a highly efficient computational method for predicting biological information associations.


Assuntos
Neoplasias , RNA Longo não Codificante , Humanos , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , Biologia Computacional/métodos , Neoplasias/genética , Algoritmos
9.
Am J Epidemiol ; 193(7): 1002-1009, 2024 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-38375682

RESUMO

This article introduces bayesian spatial smoothing models for disease mapping-a specific application of small area estimation where the full universe of data is known-to a wider audience of public health professionals using firearm suicide as a motivating example. Besag, York, and Mollié (BYM) Poisson spatial and space-time smoothing models were fitted to firearm suicide counts for the years 2014-2018. County raw death rates in 2018 ranged from 0 to 24.81 deaths per 10 000 people. However, the highest mortality rate was highly unstable, based on only 2 deaths in a population of approximately 800, and 80.5% of contiguous US counties experienced fewer than 10 firearm suicide deaths and were thus suppressed. Spatially smoothed county firearm suicide mortality estimates ranged from 0.06 to 4.05 deaths per 10 000 people and could be reported for all counties. The space-time smoothing model produced similar estimates with narrower credible intervals as it allowed counties to gain precision from adjacent neighbors and their own counts in adjacent years. bayesian spatial smoothing methods are a useful tool for evaluating spatial health disparities in small geographies where small numbers can result in highly variable rate estimates, and new estimation techniques in R software have made fitting these models more accessible to researchers.


Assuntos
Teorema de Bayes , Armas de Fogo , Suicídio , Humanos , Armas de Fogo/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Análise Espacial , Estados Unidos/epidemiologia , Modelos Estatísticos
10.
Cancer ; 130(1): 150-161, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37688396

RESUMO

BACKGROUND: This study investigated the influence of oral microbial features on the trajectory of oral mucositis (OM) in patients with squamous cell carcinoma of the head and neck. METHODS: OM severity was assessed and buccal swabs were collected at baseline, at the initiation of cancer treatment, weekly during cancer treatment, at the termination of cancer treatment, and after cancer treatment termination. The oral microbiome was characterized via the 16S ribosomal RNA V4 region with the Illumina platform. Latent class mixed-model analysis was used to group individuals with similar trajectories of OM severity. Locally estimated scatterplot smoothing was used to fit an average trend within each group and to assess the association between the longitudinal OM scores and longitudinal microbial abundances. RESULTS: Four latent groups (LGs) with differing patterns of OM severity were identified for 142 subjects. LG1 has an early onset of high OM scores. LGs 2 and 3 begin with relatively low OM scores until the eighth and 11th week, respectively. LG4 has generally flat OM scores. These LGs did not vary by treatment or clinical or demographic variables. Correlation analysis showed that the abundances of Bacteroidota, Proteobacteria, Bacteroidia, Gammaproteobacteria, Enterobacterales, Bacteroidales, Aerococcaceae, Prevotellaceae, Abiotrophia, and Prevotella_7 were positively correlated with OM severity across the four LGs. Negative correlation was observed with OM severity for a few microbial features: Abiotrophia and Aerococcaceae for LGs 2 and 3; Gammaproteobacteria and Proteobacteria for LGs 2, 3, and 4; and Enterobacterales for LGs 2 and 4. CONCLUSIONS: These findings suggest the potential to personalize treatment for OM. PLAIN LANGUAGE SUMMARY: Oral mucositis (OM) is a common and debilitating after effect for patients treated for squamous cell carcinoma of the head and neck. Trends in the abundance of specific microbial features may be associated with patterns of OM severity over time. Our findings suggest the potential to personalize treatment plans for OM via tailored microbiome interventions.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Microbiota , Estomatite , Humanos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Carcinoma de Células Escamosas/tratamento farmacológico
11.
Biostatistics ; 24(3): 562-584, 2023 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-34958093

RESUMO

Univariate spatio-temporal models for areal count data have received great attention in recent years for estimating risks. However, models for studying multivariate responses are less commonly used mainly due to the computational burden. In this article, multivariate spatio-temporal P-spline models are proposed to study different forms of violence against women. Modeling distinct crimes jointly improves the precision of estimates over univariate models and allows to compute correlations among them. The correlation between the spatial and the temporal patterns may suggest connections among the different crimes that will certainly benefit a thorough comprehension of this problem that affects millions of women around the world. The models are fitted using integrated nested Laplace approximations and are used to analyze four distinct crimes against women at district level in the Indian state of Maharashtra during the period 2001-2013.


Assuntos
Crime , Humanos , Feminino , Teorema de Bayes , Índia , Análise Espaço-Temporal
12.
Brief Bioinform ; 23(5)2022 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-35988924

RESUMO

Recently, N6-methylation (m6A) has recently become a hot topic due to its key role in disease pathogenesis. Identifying disease-related m6A sites aids in the understanding of the molecular mechanisms and biosynthetic pathways underlying m6A-mediated diseases. Existing methods treat it primarily as a binary classification issue, focusing solely on whether an m6A-disease association exists or not. Although they achieved good results, they all shared one common flaw: they ignored the post-transcriptional regulation events during disease pathogenesis, which makes biological interpretation unsatisfactory. Thus, accurate and explainable computational models are required to unveil the post-transcriptional regulation mechanisms of disease pathogenesis mediated by m6A modification, rather than simply inferring whether the m6A sites cause disease or not. Emerging laboratory experiments have revealed the interactions between m6A and other post-transcriptional regulation events, such as circular RNA (circRNA) targeting, microRNA (miRNA) targeting, RNA-binding protein binding and alternative splicing events, etc., present a diverse landscape during tumorigenesis. Based on these findings, we proposed a low-rank tensor completion-based method to infer disease-related m6A sites from a biological standpoint, which can further aid in specifying the post-transcriptional machinery of disease pathogenesis. It is so exciting that our biological analysis results show that Coronavirus disease 2019 may play a role in an m6A- and miRNA-dependent manner in inducing non-small cell lung cancer.


Assuntos
COVID-19 , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , MicroRNAs , Adenosina/metabolismo , Processamento Alternativo , COVID-19/genética , Humanos , Metilação , MicroRNAs/genética , MicroRNAs/metabolismo , RNA Circular , Proteínas de Ligação a RNA/metabolismo
13.
Brief Bioinform ; 23(3)2022 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-35380614

RESUMO

High-dimensional, localized ribonucleic acid (RNA) sequencing is now possible owing to recent developments in spatial transcriptomics (ST). ST is based on highly multiplexed sequence analysis and uses barcodes to match the sequenced reads to their respective tissue locations. ST expression data suffer from high noise and dropout events; however, smoothing techniques have the promise to improve the data interpretability prior to performing downstream analyses. Single-cell RNA sequencing (scRNA-seq) data similarly suffer from these limitations, and smoothing methods developed for scRNA-seq can only utilize associations in transcriptome space (also known as one-factor smoothing methods). Since they do not account for spatial relationships, these one-factor smoothing methods cannot take full advantage of ST data. In this study, we present a novel two-factor smoothing technique, spatial and pattern combined smoothing (SPCS), that employs the k-nearest neighbor (kNN) technique to utilize information from transcriptome and spatial relationships. By performing SPCS on multiple ST slides from pancreatic ductal adenocarcinoma (PDAC), dorsolateral prefrontal cortex (DLPFC) and simulated high-grade serous ovarian cancer (HGSOC) datasets, smoothed ST slides have better separability, partition accuracy and biological interpretability than the ones smoothed by preexisting one-factor methods. Source code of SPCS is provided in Github (https://github.com/Usos/SPCS).


Assuntos
Análise de Célula Única , Transcriptoma , Perfilação da Expressão Gênica/métodos , RNA , Análise de Sequência de RNA/métodos , Análise de Célula Única/métodos , Software
14.
Stat Med ; 43(10): 2007-2042, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38634309

RESUMO

Quantile regression, known as a robust alternative to linear regression, has been widely used in statistical modeling and inference. In this paper, we propose a penalized weighted convolution-type smoothed method for variable selection and robust parameter estimation of the quantile regression with high dimensional longitudinal data. The proposed method utilizes a twice-differentiable and smoothed loss function instead of the check function in quantile regression without penalty, and can select the important covariates consistently using the efficient gradient-based iterative algorithms when the dimension of covariates is larger than the sample size. Moreover, the proposed method can circumvent the influence of outliers in the response variable and/or the covariates. To incorporate the correlation within each subject and enhance the accuracy of the parameter estimation, a two-step weighted estimation method is also established. Furthermore, we prove the oracle properties of the proposed method under some regularity conditions. Finally, the performance of the proposed method is demonstrated by simulation studies and two real examples.


Assuntos
Algoritmos , Modelos Estatísticos , Humanos , Simulação por Computador , Modelos Lineares , Tamanho da Amostra
15.
Stat Med ; 43(7): 1372-1383, 2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38291702

RESUMO

The diagnostic accuracy of multiple biomarkers in medical research is crucial for detecting diseases and predicting patient outcomes. An optimal method for combining these biomarkers is essential to maximize the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC). Although the optimality of the likelihood ratio has been proven by Neyman and Pearson, challenges persist in estimating the likelihood ratio, primarily due to the estimation of multivariate density functions. In this study, we propose a non-parametric approach for estimating multivariate density functions by utilizing Smoothing Spline density estimation to approximate the full likelihood function for both diseased and non-diseased groups, which compose the likelihood ratio. Simulation results demonstrate the efficiency of our method compared to other biomarker combination techniques under various settings for generated biomarker values. Additionally, we apply the proposed method to a real-world study aimed at detecting childhood autism spectrum disorder (ASD), showcasing its practical relevance and potential for future applications in medical research.


Assuntos
Transtorno do Espectro Autista , Humanos , Criança , Transtorno do Espectro Autista/diagnóstico , Biomarcadores , Simulação por Computador , Funções Verossimilhança , Curva ROC , Área Sob a Curva
16.
Stat Med ; 43(19): 3578-3594, 2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-38881189

RESUMO

In health and clinical research, medical indices (eg, BMI) are commonly used for monitoring and/or predicting health outcomes of interest. While single-index modeling can be used to construct such indices, methods to use single-index models for analyzing longitudinal data with multiple correlated binary responses are underdeveloped, although there are abundant applications with such data (eg, prediction of multiple medical conditions based on longitudinally observed disease risk factors). This article aims to fill the gap by proposing a generalized single-index model that can incorporate multiple single indices and mixed effects for describing observed longitudinal data of multiple binary responses. Compared to the existing methods focusing on constructing marginal models for each response, the proposed method can make use of the correlation information in the observed data about different responses when estimating different single indices for predicting response variables. Estimation of the proposed model is achieved by using a local linear kernel smoothing procedure, together with methods designed specifically for estimating single-index models and traditional methods for estimating generalized linear mixed models. Numerical studies show that the proposed method is effective in various cases considered. It is also demonstrated using a dataset from the English Longitudinal Study of Aging project.


Assuntos
Modelos Estatísticos , Estudos Longitudinais , Humanos , Modelos Lineares , Simulação por Computador , Interpretação Estatística de Dados
17.
BMC Med Res Methodol ; 24(1): 44, 2024 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-38368350

RESUMO

BACKGROUND: The residual life of a patient with human immunodeficiency virus (HIV) is of major interest to patients and their physicians. While existing analyses of HIV patient survival focus mostly on data collected at baseline, residual life analysis allows for dynamic analysis based on additional data collected over a period of time. As survival times typically exhibit a right-skewed distribution, the median provides a more useful summary of the underlying distribution than the mean. In this paper, we propose an efficient inference procedure that fits a semiparametric quantile regression model assessing the effect of longitudinal biomarkers on the residual life of HIV patients until the development of dyslipidemia, a disease becoming more prevalent among those with HIV. METHODS: For estimation of model parameters, we propose an induced smoothing method that smooths nonsmooth estimating functions based on check functions. For variance estimation, we propose an efficient resampling-based estimator. The proposed estimators are theoretically justified. Simulation studies are used to evaluate their finite sample performances, including their prediction accuracy. We analyze the Korea HIV/AIDS cohort study data to examine the effects of CD4 (cluster of differentiation 4) cell count on the residual life of HIV patients to the onset of dyslipidemia. RESULTS: The proposed estimator is shown to be consistent and normally distributed asymptotically. Under various simulation settings, our estimates are approximately unbiased. Their variances estimates are close to the empirical variances and their computational efficiency is superior to that of the nonsmooth counterparts. Two measures of prediction performance indicate that our method adequately reflects the dynamic character of longitudinal biomarkers and residual life. The analysis of the Korea HIV/AIDS cohort study data shows that CD4 cell count is positively associated with residual life to the onset of dyslipidemia but the effect is not statistically significant. CONCLUSIONS: Our method enables direct prediction of residual lifetimes with a dynamic feature that accommodates data accumulated at different times. Our estimator significantly improves computational efficiency in variance estimation compared to the existing nonsmooth estimator. Analysis of the HIV/AIDS cohort study data reveals dynamic effects of CD4 cell count on the residual life to the onset of dyslipidemia.


Assuntos
Síndrome da Imunodeficiência Adquirida , Dislipidemias , Infecções por HIV , Humanos , Estudos de Coortes , HIV , Análise de Regressão , Simulação por Computador , Biomarcadores , República da Coreia/epidemiologia
18.
Health Econ ; 33(7): 1584-1617, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38499984

RESUMO

We study the welfare impacts of illness shocks on rural agricultural households in the semi-arid tropical and humid eastern regions of India. These regions are characterized by rainfed agriculture, missing markets for credit and insurance, and limited access to publicly funded healthcare infrastructure. We find that illness shocks increase households' medical expenditures and reduce wage income. However, aggregate non-medical, food, and non-food consumption expenditures are insensitive to illness shocks. Disaggregating illness by the age and the gender of the household members, we observe that illness in male children leads to the largest increase in medical expenditure, and illness in prime-aged adults leads to the largest decline in per-capita wage earnings. We also find illness shocks leading to changes in household dietary diversity, higher travel expenditures, and a compensating reduction in spending on education and entertainment. Analysis of risk-coping strategies reveals that households rely on transfers from kinship networks and loans from informal sources like local moneylenders to smooth consumption. While large landowners rely on gifts from kinship networks, landless and smallholders increase borrowings from informal sources.


Assuntos
Características da Família , Gastos em Saúde , Humanos , Masculino , Feminino , Índia , Adulto , Gastos em Saúde/estatística & dados numéricos , População Rural , Renda , Criança , Pessoa de Meia-Idade , Adolescente , Agricultura/economia , Pré-Escolar , Fatores Sexuais , Fatores Etários , Adulto Jovem , Fatores Socioeconômicos
19.
Skin Res Technol ; 30(4): e13672, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38591218

RESUMO

BACKGROUND: Hyaluronic acid (HA) is a widely used active cosmetic ingredient. Its multiple skin care benefits are modulated by its molecular weight. Low molecular weight (LMW) HA can penetrate the skin, but high molecular weight (HMW) HA remains at the surface. Here, we assessed how vectorization of HMW HA with bentonite clay-achieved with an innovative technology-enhances its cosmetic and hydrating properties. MATERIALS AND METHODS: The two HA forms were applied to skin explants; their penetration and smoothing effects were monitored by Raman spectroscopy and scanning electron microscopy. The two forms were biochemically characterised by chromatography, enzyme sensitivity assays, and analysis of Zeta potential. Cosmetics benefits such as, the smoothing effect of vectorised-HA was assessed in ex vivo experiments on skin explants. A placebo-controlled clinical study was finally conducted applying treatments for 28 days to analyse the final benefits in crow's feet area. RESULTS: Raman spectroscopy analysis revealed native HMW HA to accumulate at the surface of skin explants, whereas vectorised HMW HA was detected in deeper skin layers. This innovative vectorisation process changed the zeta potential of vectorised HMW HA, being then more anionic and negative without impacting the biochemical structure of native HA. In terms of cosmetic benefits, following application of vectorised HMW HA ex vivo, the skin's surface was visibly smoother. This smoothing was clinically confirmed, with a significant reduction in fine lines. CONCLUSION: The development of innovative process vectorising HMW HA allowed HMW HA penetration in the skin. This enhanced penetration extends the clinical benefits of this iconic cosmetic ingredient.


Assuntos
Ácido Hialurônico , Envelhecimento da Pele , Humanos , Ácido Hialurônico/farmacologia , Ácido Hialurônico/química , Argila , Peso Molecular , Pele
20.
BMC Public Health ; 24(1): 1893, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39010038

RESUMO

BACKGROUND: Fatal opioid-involved overdose rates increased precipitously from 5.0 per 100,000 population to 33.5 in Massachusetts between 1999 and 2022. METHODS: We used spatial rate smoothing techniques to identify persistent opioid overdose-involved fatality clusters at the ZIP Code Tabulation Area (ZCTA) level. Rate smoothing techniques were employed to identify locations of high fatal opioid overdose rates where population counts were low. In Massachusetts, this included areas with both sparse data and low population density. We used Local Indicators of Spatial Association (LISA) cluster analyses with the raw incidence rates, and the Empirical Bayes smoothed rates to identify clusters from 2011 to 2021. We also estimated Empirical Bayes LISA cluster estimates to identify clusters during the same period. We constructed measures of the socio-built environment and potentially inappropriate prescribing using principal components analysis. The resulting measures were used as covariates in Conditional Autoregressive Bayesian models that acknowledge spatial autocorrelation to predict both, if a ZCTA was part of an opioid-involved cluster for fatal overdose rates, as well as the number of times that it was part of a cluster of high incidence rates. RESULTS: LISA clusters for smoothed data were able to identify whether a ZCTA was part of a opioid involved fatality incidence cluster earlier in the study period, when compared to LISA clusters based on raw rates. PCA helped in identifying unique socio-environmental factors, such as minoritized populations and poverty, potentially inappropriate prescribing, access to amenities, and rurality by combining socioeconomic, built environment and prescription variables that were highly correlated with each other. In all models except for those that used raw rates to estimate whether a ZCTA was part of a high fatality cluster, opioid overdose fatality clusters in Massachusetts had high percentages of Black and Hispanic residents, and households experiencing poverty. The models that were fitted on Empirical Bayes LISA identified this phenomenon earlier in the study period than the raw rate LISA. However, all the models identified minoritized populations and poverty as significant factors in predicting the persistence of a ZCTA being part of a high opioid overdose cluster during this time period. CONCLUSION: Conducting spatially robust analyses may help inform policies to identify community-level risks for opioid-involved overdose deaths sooner than depending on raw incidence rates alone. The results can help inform policy makers and planners about locations of persistent risk.


Assuntos
Teorema de Bayes , Overdose de Opiáceos , Fatores Socioeconômicos , Análise Espacial , Humanos , Massachusetts/epidemiologia , Fatores de Risco , Overdose de Opiáceos/mortalidade , Overdose de Opiáceos/epidemiologia , Análise por Conglomerados , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Analgésicos Opioides/intoxicação , Feminino , Adulto , Masculino , Overdose de Drogas/mortalidade , Overdose de Drogas/epidemiologia
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