Reference values for IGF-I serum concentration in an adult population: use of the VARIETE cohort for two new immunoassays

Context: Measurement of IGF-I is important in the management of patients with growth hormone disorders. Here we aim to establish normative data for two new IGF-I assay kits based on a large random sample of the French general adult population. Subjects and Methods: We measured IGF-I in 911 healthy adults (18–90 years) with two immunoassays (ROCHE Elecsys® and IMMULITE-2000 calibrated against the new IS 02/2547). We compared the data with those of the six immunoassays (iSYS, LIAISON XL, IMMULITE-2000 calibrated against the first IS 87/518, IGFI RIACT, Mediagnost ELISA, and Mediagnost RIA) that we reported previously. The pairwise concordance among the eight assays was assessed with Bland-Altman plots for both the IGF-1 raw data and the standard deviation scores (SDS), as well as with the percentage of observed agreement and the weighted Kappa coefficient for categorizing IGF-I SDS (ClinicalTrials.gov Identifier: NCT01831648). Results: The normative data included the range of values (2.5–97.5 percentiles) given by the two new IGF-I assays according to age group and sex. A formula for the SDS calculation is provided. For the previous six assays, the lower limits of the reference intervals of the two new assays were similar, but the upper limits varied markedly. The pairwise concordances were only moderate (kappa 0.57). Conclusions: Data obtained for these two new IGF-I immunoassays confirm that despite being obtained in the same large healthy population, the reference intervals of the eight commercial IGF-1 assay kits showed noteworthy differences. The agreement among the various methods was moderate to good.

Social inequalities in hostility toward vaccination against Covid-19

In recent decades, France has appeared as a country particularly hostile to vaccination in general. When asked in November 2020 about the intention to take the Covid-19 vaccine, the French public showed, once again, reluctance. Therefore, France appeared as an ideal case study to analyze whether the hostility toward the Covid-19 vaccine has its own reasons or whether it is related to the reluctance to the principle of vaccination itself. Our objective was to determine the specificity of the social determinants of the intention to get the Covid-19 vaccine. Thanks to the use of a large random sample of the general population in France (86,000 individuals), the reluctant to Covid-19 vaccine could be clearly distinguished from the hesitant and the convinced, and thereby thoroughly analyzed. Our analysis highlighted a gendered reluctance toward vaccination in general but even more so regarding vaccination against Covid-19. It might refer to women being more concerned about the possible effects of an injection in their body, especially at the age of maternity and a differentiated socialization making them more sensitive than men to long-term risks and more apprehensive toward rapid technological change. We also found that people at the bottom of the social hierarchy, in terms of level of education, financial resources, and immigration status, were more likely to refuse the Covid-19 vaccine. Nevertheless, this reluctance was less prominent than for vaccination in general, reflecting the actual spread of the epidemic in various social milieux. Finally, our analysis showed that trust in the government's actions was significantly associated with reluctance toward the Covid-19 vaccine, even more than toward vaccination in general. Specific campaigns should be thought beforehand to reach women and people at the bottom of the social hierarchy to avoid furthering social inequalities in terms of morbidity and mortality.

Early prognostication of COVID-19 to guide hospitalisation versus outpatient monitoring using a point-of-test risk prediction score

IntroductionRisk factors of adverse outcomes in COVID-19 are defined but stratification of mortality using non-laboratory measured scores, particularly at the time of prehospital SARS-CoV-2 testing, is lacking.MethodsMultivariate regression with bootstrapping was used to identify independent mortality predictors in patients admitted to an acute hospital with a confirmed diagnosis of COVID-19. Predictions were externally validated in a large random sample of the ISARIC cohort (N=14 231) and a smaller cohort from Aintree (N=290).Results983 patients (median age 70, IQR 53–83; in-hospital mortality 29.9%) were recruited over an 11-week study period. Through sequential modelling, a five-predictor score termed SOARS (SpO2, Obesity, Age, Respiratory rate, Stroke history) was developed to correlate COVID-19 severity across low, moderate and high strata of mortality risk. The score discriminated well for in-hospital death, with area under the receiver operating characteristic values of 0.82, 0.80 and 0.74 in the derivation, Aintree and ISARIC validation cohorts, respectively. Its predictive accuracy (calibration) in both external cohorts was consistently higher in patients with milder disease (SOARS 0–1), the same individuals who could be identified for safe outpatient monitoring. Prediction of a non-fatal outcome in this group was accompanied by high score sensitivity (99.2%) and negative predictive value (95.9%).ConclusionThe SOARS score uses constitutive and readily assessed individual characteristics to predict the risk of COVID-19 death. Deployment of the score could potentially inform clinical triage in preadmission settings where expedient and reliable decision-making is key. The resurgence of SARS-CoV-2 transmission provides an opportunity to further validate and update its performance.

Early prognostication of COVID-19 to guide hospitalisation versus outpatient monitoring using a point-of-test risk prediction score

ABSTRACTIntroductionRisk factors of adverse outcomes in COVID-19 are defined but stratification of mortality using non-laboratory measured scores, particularly at the time of pre-hospital SARS-CoV-2 testing, is lacking.MethodsMultivariate regression with bootstrapping was used to identify independent mortality predictors in a derivation cohort of COVID-19 patients. Predictions were externally validated in a large random sample of the ISARIC cohort (N=14,231) and a smaller cohort from Aintree (N=290).Results983 patients (median age 70, IQR 53-83; in-hospital mortality 29.9%) were recruited over an 11-week study period. Through sequential modelling, a 5-predictor score termed SOARS (SpO2, Obesity, Age, Respiratory rate, Stroke history) was developed to correlate COVID-19 severity across low, moderate and high strata of mortality risk. The score discriminated well for in-hospital death, with area under the receiver operating characteristic values of 0.82, 0.80 and 0.74 in the derivation, Aintree and ISARIC validation cohorts respectively. Its predictive accuracy (calibration) in both external cohorts was consistently higher in patients with milder disease (SOARS 0-1), the same individuals who could be identified for safe outpatient monitoring. Prediction of a non-fatal outcome in this group was accompanied by high score sensitivity (99.2%) and negative predictive value (95.9%).ConclusionThe SOARS score uses constitutive and readily assessed individual characteristics to predict the risk of COVID-19 death. Deployment of the score could potentially inform clinical triage in pre-admission settings where expedient and reliable decision-making is key. The resurgence of SARS-CoV-2 transmission provides an opportunity to further validate and update its performance.

Mindfully Scrolling: Rethinking Facebook After Time Deactivated

Many people express concern that Facebook’s users are overly connected. This article examines responses to survey questions asked after a large random sample of American Facebook users had been paid to deactivate Facebook. We find a recurring discourse of mind including, for example, references to mindfulness. Using iterative qualitative coding, we ask what meanings and practices are invoked in this discourse. Furthermore, we critically assess the potential of what respondents describe to address the problems of overconnection. We find explicit awareness of the automaticity of use, the value and content of Facebook, and how it makes users feel. We find that users came to practice disconnection at many nested levels of vernacular affordances. Ultimately, we argue that Facebook has become a landscape trap, altering daily life such that individual practices, such as mindful scrolling, cannot overcome the overconnection problems it may create. Mindfulness in this discourse may be power, but it is power to avoid elements of Facebook, not power to transform it.

The Price of Natural American Spirit Relative to Other Cigarette Brands

Introduction American Spirit cigarettes feature American Indian/Alaska Native (AI/AN) imagery in the branding and are marketed as environmentally friendly, without additives, and four varieties contain organic tobacco. This study is the first to examine retail price of American Spirit relative to other cigarette brands and to assess how its price varies by neighborhood demography. Methods In a random sample of licensed tobacco retailers (n = 1277), trained data collectors recorded availability and price of American Spirit, Pall Mall, Newport, Marlboro, and the cheapest cigarettes regardless of brand. Data were collected in January–March 2017 in California, the state with the largest AI/AN population. Paired t tests assessed prices (before sales tax) of American Spirit relative to others. Ordinary least squares regressions modeled prices as a function of neighborhood demography, adjusting for store type. Results American Spirit was sold in 77% of stores at an average price of $7.03 (SD = 0.66), which was $0.75–$1.78 (12.0%–34.4%) higher than Pall Mall, Newport, and Marlboro in the same stores. American Spirit costs significantly less in neighborhoods with a higher proportion of school-age residents; however, this pattern was not unique to that brand. Contrary to expectation, American Spirit did not cost less in neighborhoods with a higher proportion of AI/ANs. Conclusion This study is the first to document lower prices for American Spirit in neighborhoods with a higher proportion of school-age youth. Future research should consider whether the ultra-premium price of American Spirit contributes to misperceptions that the brand is organic and less harmful than other cigarettes. Implications In a large random sample of licensed tobacco retailers in California, American Spirit costs significantly more than other brands, 12.0%–34.4% more than Pall Mall, Newport, and Marlboro in the same stores. After controlling for store type, American Spirit price was significantly lower in neighborhoods with a higher proportion of school-age residents. Research about how an ultra-premium price contributes to misperceptions that all American Spirit varieties are organic and the brand is less harmful and less addictive than other cigarette brands would be informative for ongoing litigation and product regulation.

Us versus Them: The Responses of Managers to the Feminization of High-Status Occupations

What happens when more and more women enter high-status occupations that were previously male-dominated occupations? This article explores how the processes by which the entrance of women into high-status occupations has affected the hiring, income, and perceived competence of women. I present the results of a general population experiment conducted on a large, random sample of the U.S. population. The experiment was designed to explore the hiring, income, and perceived competence of all women when high-status occupations become predominantly female. I show that when male managers are exposed to information about high-status occupations’ becoming predominantly female, they evaluate women who work in other high-status occupations as less competent, tend to hire them less frequently, and offer them lower salaries. Female managers, however, tend to respond to such changes in the labor force by valuing women more highly.

Self-reported changes in alcohol use behavior among people living with HIV in China after receiving HIV positive diagnosis

Background: Alcohol use remains a significant challenge for treating people living with HIV (people living with HIV). We aimed to examine current use and retrospective self-reported changes in drinking behavior after HIV+ diagnosis in people living with HIV. Method: Survey data were collected from a large random sample of people living with HIV (N = 2964, mean age = 42.5, standard deviation = 12.8) in Guangxi, China. Results: The estimated prevalence rate of current alcohol use was 42.8%. Among current drinkers, 41.7% reported binge drinking and 10.4% reported hazardous drinking. Among the ever drinkers, 45.4% reported reductions in drinking and 19.5% reported quitting after HIV+ diagnosis. Older age, female gender, higher income, being employed, if currently on antiretroviral therapy, and having received an HIV+ diagnosis within a year were positively associated with quitting; and more education, lower income, currently on antiretroviral therapy, and having received an HIV+ diagnosis more than one year were associated with reduced drinking. Conclusion: The time period immediately following receiving an HIV+ diagnosis may represent a window of opportunity for alcohol use intervention in people living with HIV.

Comparison of liquidity based and financial performance based indicators in financial analysis

Research background: Since the turn of the 21st century financial statement manipulations became the center of attention for accountants, auditors and financial analysts. Since being classified by the regulators as fraudulent, earnings management has required a separate detection methodology. The majority of detection research is performed through the comparison of a large number of statements for the same company in order to find irregularities in earnings behavior. Shortening of the detection time and the amount of data becomes important. Purpose of the article: The goal was to compare the characteristics of M-Score and ∆P-∆R and to find their advantages and limitations. Applying both indicators to the different samples, the research attempted to determine the statistical connection between them and to set up the limits of their applicability. Since M-Score indicator is liquidity-based, this research attempted to determine to which extent M-Score and Z-Score are statistically related. Methods: The research paper compares the behavior of both indicators using various samples of financial data: the sample of companies, charged with fraud, the sample with exceptional liquidity, the large random sample and the sample from the emerging market economy. Based on the original observations, two other subsamples (one based on poor Z-Score and one based on exceptional Z-Score) were extracted from the main sample. For all samples ∆P-∆R, M-Score and Z-Score were statistically compared among and between themselves. Findings and value added: The research found the limitations of ∆P-∆R and M-Score in the stable markets and was able to connect them in the emerging market by using linear regression model (also including Z-Score). The research confirmed that M-Score can mistake exceptional performance for manipulations, resulted in Type I errors. ∆P-∆R appeared somewhat coarse and prone to Type II errors. The combined use of both in the emerging markets will provide the best approach.

Meta-assessment of bias in science

Numerous biases are believed to affect the scientific literature, but their actual prevalence across disciplines is unknown. To gain a comprehensive picture of the potential imprint of bias in science, we probed for the most commonly postulated bias-related patterns and risk factors, in a large random sample of meta-analyses taken from all disciplines. The magnitude of these biases varied widely across fields and was overall relatively small. However, we consistently observed a significant risk of small, early, and highly cited studies to overestimate effects and of studies not published in peer-reviewed journals to underestimate them. We also found at least partial confirmation of previous evidence suggesting that US studies and early studies might report more extreme effects, although these effects were smaller and more heterogeneously distributed across meta-analyses and disciplines. Authors publishing at high rates and receiving many citations were, overall, not at greater risk of bias. However, effect sizes were likely to be overestimated by early-career researchers, those working in small or long-distance collaborations, and those responsible for scientific misconduct, supporting hypotheses that connect bias to situational factors, lack of mutual control, and individual integrity. Some of these patterns and risk factors might have modestly increased in intensity over time, particularly in the social sciences. Our findings suggest that, besides one being routinely cautious that published small, highly-cited, and earlier studies may yield inflated results, the feasibility and costs of interventions to attenuate biases in the literature might need to be discussed on a discipline-specific and topic-specific basis.