Category: Statistics

J Nephrol. 2024 Jun 24. doi: 10.1007/s40620-024-01984-x. Online ahead of print.

ABSTRACT

BACKGROUND: Although several risk factors of kidney cancer have already been well-addressed, many remain underappreciated, such as chronic exposure to air pollution. This systematic review and meta-analysis aims to assess the association between air pollutant exposure and the risk of kidney cancer.

METHODS: With an exhaustive search equation including keywords related to air pollution and kidney cancer on EMBASE, PubMed, Web of science, Cochrane Library and CINAHL database, we identified all relevant articles published before March 23rd, 2023 (Prospero registration number: CRD42020187956). Using random-effects meta-analysis, we present pooled hazard ratios (with their respective 95% confidence interval) associated with a 10 µg/m³ increase in each pollutant level. Heterogeneity was quantified by the I₂ statistic. Risks of methodological and publication bias were also both assessed using appropriate tools.

RESULTS: Of the 1919 records identified, our review included 19 articles (13 cohort, 5 registry-based and 1 case-control studies), of which 9 were suitable for the meta-analysis. We found a significantly increased risk of kidney cancer incidence for a 10 μg/m³ elevation of both particulate matter of less than 10 µm (PM₁₀) (HR = 1.29 [1.10; 1.51], I² = 0%, p = 0.002) and nitrogen dioxide (NO₂) (HR = 1.10 [1.03; 1.18], I² = 20%, p = 0.004). Secondary analyses also suggest an increased risk of kidney cancer-related morbidity-mortality associated with PM₁₀ exposure.

CONCLUSIONS: Overall, our findings suggest a potential association between exposure to increased levels of PM₁₀ and NO₂ and the risk of kidney cancer. These results should nonetheless be interpreted with caution due to the limited number of included studies and their significant risk of methodological bias.

PMID:38913266 | DOI:10.1007/s40620-024-01984-x

Environ Sci Pollut Res Int. 2024 Jun 24. doi: 10.1007/s11356-024-34060-9. Online ahead of print.

ABSTRACT

The health of humans, animals and the environment is interconnected. Adopting a One Health approach means intervening promptly to prevent the main diseases that affect animal health to guarantee the safety of livestock production. Exposure to toxic trace elements in sheep can lead to increased accumulation in different biological substrate, developing both acute and chronic diseases in humans and livestock. The aim of this study was to evaluate the bioaccumulation of arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg) in Sicilian Barbaresca sheep using the following biological substrates: milk, blood and fleece. An inductively coupled plasma mass spectrometer (ICP-MS) was used for As, Cd and Pb, and a direct mercury analyser (DMA-80) was used for Hg determination. In addition, the role of the haematological parameters as possible indicators of different biodistribution was evaluated. A statistically significant value was observed from our analysed metals in the substrates: arsenic (p < 0.001), cadmium (p < 0.01), lead (p < 0.001) and mercury (p < 0.0001). The correlation analysis showed a relationship between milk and blood for arsenic (p < 0.0001) and lead (p < 0.0001), and no correlation for the metals was observed between milk/blood and the haematological parameters analysed for the low concentration observed in the present study comforting the final consumer.

PMID:38913265 | DOI:10.1007/s11356-024-34060-9

J Epidemiol Glob Health. 2024 Jun 24. doi: 10.1007/s44197-024-00268-8. Online ahead of print.

NO ABSTRACT

PMID:38913257 | DOI:10.1007/s44197-024-00268-8

Braz J Microbiol. 2024 Jun 24. doi: 10.1007/s42770-024-01413-y. Online ahead of print.

ABSTRACT

The Yanomami are one of the oldest indigenous tribes in the Amazon and are direct descendants of the first people to colonize South America 12,000 years ago. They are located on the border between Venezuela and Brazil, with the Venezuelan side remaining uncontacted. While they maintain a hunter-gatherer society, they are currently experiencing contact with urbanized populations in Brazil. The human gut microbiota of traditional communities has become the subject of recent studies due to the Westernization of their diet and the introduction of antibiotics and other chemicals, which have affected microbial diversity in indigenous populations, thereby threatening their existence. In this study, we preliminarily characterized the diversity of the gut microbiota of the Yanomami, a hunter-gatherer society from the Amazon, experiencing contact with urbanized populations. Similarly, we compared their diversity with the population in Manaus, Amazonas. A metabarcoding approach of the 16 S rRNA gene was carried out on fecal samples. Differences were found between the two populations, particularly regarding the abundance of genera (e.g., Prevotella and Bacteroides) and the higher values of the phyla Bacteroidetes over Firmicutes, which were significant only in the Yanomami. Some bacteria were found exclusively in the Yanomami (Treponema and Succinivibrio). However, diversity was statistically equal between them. In conclusion, the composition of the Yanomami gut microbiota still maintains the profile characteristic of a community with a traditional lifestyle. However, our results suggest an underlying Westernization process of the Yanomami microbiota when compared with that of Manaus, which must be carefully monitored by authorities, as the loss of diversity can be a sign of growing danger to the health of the Yanomami.

PMID:38913252 | DOI:10.1007/s42770-024-01413-y

Eur Radiol. 2024 Jun 24. doi: 10.1007/s00330-024-10850-0. Online ahead of print.

ABSTRACT

OBJECTIVES: To establish normative values and identify potential factors influencing pancreatic iodine uptake using dual-energy CT (DECT).

MATERIALS AND METHODS: This retrospective study included participants without pancreatic diseases undergoing DECT at two institutions with different platforms. Their protocols both included arterial phase (AP), portal venous phase (PP), and equilibrium phase (EP), defined as 35 s-40 s, 60 s-70 s, and 150 s-180 s after injection of contrast agent, respectively. Both iodine concentration (IC) and normalised IC (NIC) were measured. Demographic features, local measurements of the pancreas and visceral fat area (VFA) were considered as potential factors influencing iodine uptake using multivariate linear regression analyses.

RESULTS: A total of 562 participants (median age 58 years [interquartile range: 47-67], with 282 men) were evaluated. The mean IC differed significantly between two institutions (all p < 0.001) across three contrast-enhanced phases, while the mean NIC showed no significant differences (all p > 0.05). The mean values of NIC were 0.22 at AP, 0.43 at PP and 0.45 at EP. NIC_AP was independently affected by VFA (β = 0.362, p < 0.001), smoking (β = -0.240, p = 0.001), and type-II diabetes (β = -0.449, p < 0.001); NIC_PP by VFA (β = -0.301, p = 0.017) and smoking (β = -0.291, p < 0.001); and NIC_EP by smoking (β = -0.154, p = 0.10) and alcohol consumption (β = -0.350, p < 0.001) with statistical power values over 0.81.

CONCLUSION: NIC values were consistent across institutions. Abdominal obesity, smoking, alcohol consumption, and diabetes are independent factors influencing pancreatic iodine uptake.

CLINICAL RELEVANCE STATEMENT: This study has provided reference normative values, influential factors and effective normalisation methods of pancreatic iodine uptake in multiphase dual-energy CT for future studies in this area as a new biological marker.

KEY POINTS: Evaluation of pancreatic iodine uptake measured by dual-energy CT is a promising method for future studies. Abdominal obesity, smoking, alcohol consumption, diabetes, and sex are independent factors influencing pancreatic iodine uptake. Utility of normalised iodine concentration is necessary to ensure the consistency across different institutions.

PMID:38913243 | DOI:10.1007/s00330-024-10850-0

Int Ophthalmol. 2024 Jun 24;44(1):267. doi: 10.1007/s10792-024-03196-5.

ABSTRACT

PURPOSE: To assist in surgical planning in endoscopic approaches, we analyzed the morphometric measurements of the superior orbital fissure (SOF) and optic canal (OC) by three-dimensional multislice computed tomography (3D MDCT) and evaluated them according to age, gender, and lateralization.

METHODS: The study analyzed 219 MDCT images (114 women, 105 men) from individuals aged 18-90. Measurements of SOF and OC were performed on 3D MDCT images in the axial plane and with 3D-Slicer software.

RESULTS: The distance between the infraorbital foramen and the anterior entrance of the maxillary sinus (CBW) (p < 0.001), the distance between the CBW and the lateral point of the SOF (p = 0.001), and the Angle 1 (p = 0.028) were higher in women than in men. While the SOF length and on 3D the SOF width were higher in women than men (p < 0.001 and (p = 0.001, respectively), the lateral wall length OC was higher in men than women (p = 0.045). According to SOF classification, SOF length was highest in type II and lowest in type VIII (p = 0.025), SOF width was highest in type I and lowest in type VI (p < 0.001). No significant difference was found based on age groups and lateralization in all parameters.

CONCLUSION: We found that as the SOF width increased, the SOF length also increased, and there was a statistically strong positive correlation. These findings can contribute to a more effective and safe operation by improving and updating surgeons’ knowledge about safe distances to SOF in endoscopic procedures from a 3D MDCT perspective.

PMID:38913238 | DOI:10.1007/s10792-024-03196-5

Nanoscale. 2024 Jun 24. doi: 10.1039/d4nr00589a. Online ahead of print.

ABSTRACT

We conduct all-atom molecular dynamics simulations to systematically investigate the underlying mechanisms governing ion transport through a sub-nanometer pore decorated with negative charges in a “Janus” MoSSe membrane. The charge imbalance between S and Se atoms on each side of the membrane induces different types of ion adsorption processes depending on the pore inner charge configuration, and the polarity of external biases, which leads to asymmetry in ionic I–V characteristics. Statistical analysis of the total translocation times including adsorption-desorption processes, and ion dwell times indicates that potassium ions predominantly remain adsorbed during their interaction with the membrane before undertaking a quick translocation through the pore. High applied biases suppress cation adsorption, which results in fast translocation with the current flow boosted by negative inner charges around the pore. We also show that in a membrane consisting of several “Janus” layers, the applied bias necessary to overcome the sub-nm pore barrier increases with the number of layers, providing control over the ionic current.

PMID:38912547 | DOI:10.1039/d4nr00589a

Resusc Plus. 2024 Jun 5;19:100683. doi: 10.1016/j.resplu.2024.100683. eCollection 2024 Sep.

ABSTRACT

INTRODUCTION: Emergency Medical Service (EMS) providers are essential for out-of-hospital cardiac arrest (OHCA) survival, however implementing high-performance CPR guidelines in developing EMS settings presents challenges. This study assessed the impact of Continuous Quality Improvement (CQI) initiatives on OHCA outcomes in a hospital-based EMS agency in Bangkok, Thailand.

METHODS: A before-and-after study design was utilized, utilizing data from a prospective OHCA registry spanning 2019 to 2023. CQI interventions included low-dose high-frequency training in advanced airway management, high-performance CPR, and post-debriefing with video recording (VDO). Data collection encompassed patient characteristics, EMS management, and survival outcomes. Quality CPR metrics were assessed using the mobile defibrillator and CPR code review software. Statistical analyses compared outcomes between the pre-intervention period in 2019 and the post-full CQI implementation period in 2023.

RESULTS: Among enrolled OHCA patients, with 88 cases occurring in 2019 and 91 cases in 2023. The bystander CPR rate was similar between both groups (47.73% in 2023 vs 53.85%, p = 0.413). In 2023, there was a significantly higher rate of prehospital intubation (93.40% vs 70.45%, p < 0.001) compared to 2019. Prehospital return of spontaneous circulation (ROSC) improved from 30.68% to 49.45% (p = 0.012), with an adjusted odds ratio (aOR) of 2.16 (95% CI: 1.14-4.07). Survival to discharge increased significantly from 2.27% in 2019 to 7.69% in 2023 (p = 0.27), with an aOR of 3.81 (95% CI: 0.46-31.79).

CONCLUSION: Tailored CQI initiatives in a developing EMS setting were significantly associated with improved prehospital ROSC but showed an insignificant increase in survival to discharge.

PMID:38912534 | PMC:PMC11192784 | DOI:10.1016/j.resplu.2024.100683

Resusc Plus. 2024 Jun 5;19:100684. doi: 10.1016/j.resplu.2024.100684. eCollection 2024 Sep.

ABSTRACT

AIMS: Previous research has reported racial disparities in out-of-hospital cardiac arrest (OHCA) interventions, including bystander CPR and AED use. However, studies on other prehospital interventions are limited. The primary objective of this study was to investigate race/ethnic disparities in out-of-hospital cardiac arrest (OHCA) interventions: EMS response times, medication administration, and decisions for intra-arrest transport. The secondary objective was to evaluate differences in the provision of Bystander CPR (CPR) and application of AED.

METHODS: We retrospectively analyzed data from the Salt Lake City Fire Department (2010-2023). We included adults 18 years or older with EMS-treated OHCA. Race/ethnicity was categorized as White people, Asian people, Black people, Hispanic people, and others. We employed multivariable regression analysis to evaluate the association between race/ethnicity and the outcomes of interest.

RESULTS: Unadjusted analyses revealed no significant differences across ethnic groups in EMS response, medication administration, bystander CPR, or intra-arrest transport decisions. However, significant ethnic disparities were observed in Automated External Defibrillator (AED) utilization, Black people having the lowest rate (6.5%) and Asian people the highest (21.8%). The adjusted analysis found no significant association between race/ethnicity and all OHCA intervention measures, nor between race/ethnicity and survival outcomes.

CONCLUSIONS: Our multivariable analysis found no statistically significant association between race/ethnicity and EMS response time, epinephrine administration, antiarrhythmic medication use, bystander CPR, AED intervention, or intra-arrest transport. These results imply regional variations in ethnic disparities in OHCA may not be consistent across all areas, warranting further research into disparities in other regions and additional influential factors like neighborhood conditions and socioeconomic status.

PMID:38912531 | PMC:PMC11190541 | DOI:10.1016/j.resplu.2024.100684

Ther Clin Risk Manag. 2024 Jun 17;20:373-379. doi: 10.2147/TCRM.S455332. eCollection 2024.

ABSTRACT

INTRODUCTION: The management of patients with COVID-19 infection has placed great pressure on the healthcare systems around the world. The aim of this study was to investigate the impact of the COVID-19 pandemic on the treatment outcomes of patients with rectal cancer by comparing them to those of patients with the same diagnosis in the pre-pandemic period.

METHODS: Retrospective data analysis of patients undergoing multimodal treatment for rectal cancer at the four university hospitals during the COVID-19 pandemic (2020-2021) and the 2-year pre-pandemic period (2018-2019).

RESULTS: A total of 693 patients (319 in the pre-pandemic period and 374 in the pandemic period) with rectal cancer were included in the study. The demographic and clinical characteristics of patients in both study periods were comparable, as was the spectrum of surgical procedures. Palliative surgery was more common in the pandemic period (18% vs 13%, p=0.084). The proportion of patients undergoing minimally invasive surgery was higher during the COVID-19 pandemic (p=0.025). There were no statistically significant differences between the study periods in the incidence/severity of post-operative complications, 30-day mortality and length of hospital stay. The number of positive resection margins was similar (5% vs 5%). Based on these results, COVID-19 had no effect on the postoperative morbidity and mortality in patients undergoing surgery for rectal cancer. Neoadjuvant treatment was more common in the pre-pandemic period (50% vs 45%). Long-course RT was predominantly offered in the pre-pandemic period, short-course RT during the pandemic. Significantly shorter “diagnosis-surgery” intervals were observed during the pandemic (23 days vs 33 days, p=0.0002). The “surgery-adjuvant therapy” interval was similar in both analysed study periods (p=0.219).

CONCLUSION: Our study showed, that despite concerns about the COVID-19 pandemic, multimodal treatment of rectal cancer was associated with unchanged postoperative morbidity rates, increased frequency of short-course neoadjuvant RT administration and shorter “diagnosis-surgery” intervals.

PMID:38912517 | PMC:PMC11192038 | DOI:10.2147/TCRM.S455332