Category: Statistics

Environ Monit Assess. 2024 Aug 15;196(9):815. doi: 10.1007/s10661-024-12958-8.

ABSTRACT

This study aims to comprehensively understand the Gosikhurd Dam ecosystem (GDE) ecosystem by employing the Ecopath with Ecosim software (version 6.6.5) to construct a trophic mass balancing model. This model consisted of 16 functional groups of organisms, and their interactions and trophic levels were explored. The study focuses on various performance indicators to assess the ecosystem’s maturity and complexity. To achieve these objectives, monthly fish samples were collected from June 2022 to May 2023. Performance indicators such as the connectance index (CI), system omnivory index (SOI), Finn’s cycling index (FCI), mean path length (FML), ascendency, overhead, and Shannon diversity index were calculated to assess ecosystem maturity and complexity. The Finn’s cycling index (FCI) and the mean path length (FML) were calculated as 1.81 and 2.20, respectively, indicating the ecosystem’s responsiveness to environmental changes and overall system health and stability. Ascendency and overhead values were also analysed, with ascendency being relatively higher (41.58%), reflecting a system that utilises less than half of its total capacity. The overhead value (58.42%) indicated that the ecosystem is relatively stable and capable of adapting to external perturbations. Furthermore, the Shannon diversity index was 1.67, illustrating less diversity and validating the ecosystem’s immaturity. The study identifies critical species and their roles in shaping the ecosystem dynamics, highlighting the importance of zooplankton, zoobenthos, and tilapia as keystone species. These indices propound that GDE is in its developmental stage and lacks complexity compared to mature ecosystems. The findings provide valuable insights into the current state of the ecosystem and can guide future management and conservation efforts.

PMID:39145842 | DOI:10.1007/s10661-024-12958-8

Lasers Med Sci. 2024 Aug 15;39(1):217. doi: 10.1007/s10103-024-04161-5.

ABSTRACT

This in vitro study aimed to investigate potential changes in the color and roughness of dental enamel resulting from the use of different toothpaste formulations during bleaching with violet LED light (405 nm). Sixty specimens of bovine incisors, each measuring 6 × 6 × 3 mm, were segregated into six distinct experimental groups based on their respective treatments (n = 10): C + VL: Brushing with Colgate^® Total 12 + bleaching with violet LED; LB + VL: Brushing with Colgate^® Luminous White Brilliant + bleaching with violet LED; LI + VL: Brushing with Colgate^® Luminous White Instant + violet LED bleaching; C: Brushing with Colgate^® Total 12; LB: Brushing with Colgate^® Luminous White Brilliant; LI: Brushing with Colgate^® Luminous White Instant. The examined variables included alterations in color (∆L*, ∆a*, ∆b*, ∆Eab, and ∆E00), surface roughness (Ra), and scanning electron microscopy observations. No statistically significant distinctions emerged in total color variations (∆E00 and ∆E) among the groups under scrutiny. Notably, the groups that employed Colgate^® Luminous White Instant displayed elevated roughness values, irrespective of their association with violet LED, as corroborated by scanning electron microscopy examinations. It can be concluded that whitening toothpastes associated to violet LED do not influence the color change of dental enamel in fifteen days of treatment. Toothpastes with a higher number of abrasive particles showed greater changes in enamel roughness, regardless of the use of violet LED.

PMID:39145805 | DOI:10.1007/s10103-024-04161-5

Graefes Arch Clin Exp Ophthalmol. 2024 Aug 15. doi: 10.1007/s00417-024-06608-5. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the changes in posterior segment hemodynamics caused by horizontal rectus muscle surgeries using the optic coherence tomography angiography (OCTA).

METHODS: Patients who underwent at least one horizontal rectus recession, resection, or combination surgery were included. The patients were evaluated with an OCTA preoperatively and 30 days postoperatively. Postoperative changes in superficial capillary plexus (SCP)-vessel density (VD), deep capillary plexus (DCP)-VD, foveal avascular zone (FAZ) area and choriocapillaris (CC)-flow area parameters were examined. The mean differences (Δ) for the parameters in which significant changes were detected in the whole operated eyes group were compared between the single- and two-muscle surgery groups.

RESULTS: Twenty-five eyes of 24 patients with an average age of 16.40 ± 6.75 years (5-29) were included. Of the eyes, 10 underwent single muscle recession surgery. Two-muscle surgeries were performed in 15 eyes. SCP-VD in the superior parafoveal region increased significantly postoperatively (53.23 ± 4.11% vs. 54.54 ± 3.67%, p = 0.032). For DCP-VD, there was a statistically significant increase in all zones, except the superior hemisphere and fovea regions (p < 0.05 for all). FAZ area did not change significantly (p = 0.207). There was a significant increase in the CC-flow area (2.171 ± 0.146 mm² vs. 2.232 ± 0.115 mm², p = 0.013). There was a significant difference between the two groups only for the Δ SCP-VD/parafovea superior value (-0.62 ± 0.98 vs. 1.57 ± 3.07, p = 0.019).

CONCLUSIONS: Conventional horizontal rectus muscle surgeries may cause alterations in posterior segment hemodynamics. The number of muscles incised does not seem to greatly affect the magnitude of changes that occur.

KEY MESSAGES: What is known • After conventional horizontal rectus muscle surgeries, the anterior ciliary arteries are not recanalized, instead, anterior segment blood flow is maintained by increasing the flow in the long posterior ciliary arteries. • Previous studies using Doppler ultrasonography have shown increased flow in the ophthalmic artery, central retinal artery and long posterior ciliary arteries. What is new • In this study, significant increases were observed in superficial and deep capillary plexus-vessel density and choriocapillaris-flow area parameters in the first postoperative month with optic coherence tomography angiography device. • Hemodynamic increases in both retinal and choroidal vasculature were detected in the early period after conventional horizontal rectus muscle surgeries. • The number of muscles incised does not seem to greatly affect the magnitude of changes that occur.

PMID:39145793 | DOI:10.1007/s00417-024-06608-5

Osteoporos Int. 2024 Aug 15. doi: 10.1007/s00198-024-07224-z. Online ahead of print.

ABSTRACT

PURPOSE: To identify the optimal statistical approach for predicting the risk of fragility fractures in the presence of competing event of death.

METHODS: We used real-world data from the Dubbo Osteoporosis Epidemiology Study that has monitored 3035 elderly participants for bone health and mortality. Fragility fractures were ascertained radiologically. Mortality was confirmed by the State Registry. We considered four statistical models for predicting fracture risk: (i) conventional Cox’s proportional hazard model, (ii) cause-specific model, (iii) Fine-Gray sub-distribution model, and (iv) multistate model. These models were fitted and validated in the development (60% of the original sample) and validation (40%) subsets, respectively. The model performance was assessed by discrimination and calibration analyses.

RESULTS: During a median follow-up of 11.3 years (IQR: 7.2, 16.2), 628 individuals (34.5%) in the development cohort fractured, and 630 (34.6%) died without a fracture. Neither the discrimination nor the 5-year prediction performance was significantly different among the models, though the conventional model tended to overestimate fracture risk (calibration-in-the-large index = – 0.24; 95% CI: – 0.43, – 0.06). For 10-year risk prediction, the multistate model (calibration-in-the-large index = – 0.05; 95% CI: – 0.20, 0.10) outperformed the cause-specific (- 0.23; – 0.30, – 0.08), Fine-Gray (- 0.31; – 0.46, – 0.16), and conventional model (- 0.54; – 0.70, – 0.39) which significantly overestimated fracture risk.

CONCLUSION: Adjustment for competing risk of death has minimum impact on the short-term prediction of fracture. However, the multistate model yields the most accurate prediction of long-term fracture risk and should be considered for predictive research in the elderly, who are also at high mortality risk. Fracture risk assessment might be compromised by the competing event of death. This study, using real-world data found a multistate model was superior to the current competing risk methods in fracture risk assessment. A multistate model is considered an optimal statistical method for predictive research in the elderly.

PMID:39145778 | DOI:10.1007/s00198-024-07224-z

Glob Health Action. 2024 Dec 31;17(1):2377828. doi: 10.1080/16549716.2024.2377828. Epub 2024 Aug 15.

ABSTRACT

BACKGROUND: Injuries, often preventable, prompted urgent action within the United Nations’ 2030 Agenda for Sustainable Development Goals (SDGs) to improve global health. South Africa (SA) has high rates of injury mortality, but accurate reporting of official national data is hindered by death misclassification.

OBJECTIVE: Two nationally representative surveys for 2009 and 2017 are utilised to assess SA’s progress towards SDG targets for violence and road traffic injuries, alongside changes in suicide and under-5 mortality rates for childhood injuries, and compare these estimates with those of the Global Burden of Disease for SA.

METHODS: The surveys utilised multi-stage, stratified cluster sampling from eight provinces, with mortuaries as primary sampling units. Post-mortem files for non-natural deaths were reviewed, with additional data from the Western Cape. Age-standardised rates, 95% confidence intervals (CIs), and incidence rate ratios (IRRs) were calculated for manner of death rate comparisons and for age groups.

RESULTS: The all-injury age-standardised mortality rate decreased significantly between 2009 and 2017. Homicide and transport remained the leading causes of injury deaths, with a significant 31% decrease in road traffic mortality (IRR = 0.69), from 36.1 to 25.0 per 100 000 population.

CONCLUSIONS: Despite a reduction in SA’s road traffic mortality rate, challenges to achieve targets related to young and novice drivers and male homicide persist. Achieving SA’s injury mortality SDG targets requires comprehensive evaluations of programmes addressing road safety, violence reduction, and mental well-being. In the absence of reliable routine data, survey data allow to accurately assess the country’s SDG progress through commitment to evidence-based policymaking.

PMID:39145429 | DOI:10.1080/16549716.2024.2377828

Pharmacoepidemiol Drug Saf. 2024 Aug;33(8):e5871. doi: 10.1002/pds.5871.

ABSTRACT

PURPOSE: Metadata for data dIscoverability aNd study rEplicability in obseRVAtional studies (MINERVA), a European Medicines Agency-funded project (EUPAS39322), defined a set of metadata to describe real-world data sources (RWDSs) and piloted metadata collection in a prototype catalogue to assist investigators from data source discoverability through study conduct.

METHODS: A list of metadata was created from a review of existing metadata catalogues and recommendations, structured interviews, a stakeholder survey, and a technical workshop. The prototype was designed to comply with the FAIR principles (findable, accessible, interoperable, reusable), using MOLGENIS software. Metadata collection was piloted by 15 data access partners (DAPs) from across Europe.

RESULTS: A total of 442 metadata variables were defined in six domains: institutions (organizations connected to a data source); data banks (data collections sustained by an organization); data sources (collections of linkable data banks covering a common underlying population); studies; networks (of institutions); and common data models (CDMs). A total of 26 institutions were recorded in the prototype. Each DAP populated the metadata of one data source and its selected data banks. The number of data banks varied by data source; the most common data banks were hospital administrative records and pharmacy dispensation records (10 data sources each). Quantitative metadata were successfully extracted from three data sources conforming to different CDMs and entered into the prototype.

CONCLUSIONS: A metadata list was finalized, a prototype was successfully populated, and a good practice guide was developed. Setting up and maintaining a metadata catalogue on RWDSs will require substantial effort to support discoverability of data sources and reproducibility of studies in Europe.

PMID:39145406 | DOI:10.1002/pds.5871

Pharmacoepidemiol Drug Saf. 2024 Aug;33(8):e5887. doi: 10.1002/pds.5887.

ABSTRACT

BACKGROUND: The Medicines Intelligence (MedIntel) Data Platform is an anonymised linked data resource designed to generate real-world evidence on prescribed medicine use, effectiveness, safety, costs and cost-effectiveness in Australia.

RESULTS: The platform comprises Medicare-eligible people who are ≥18 years and residing in New South Wales (NSW), Australia, any time during 2005-2020, with linked administrative data on dispensed prescription medicines (Pharmaceutical Benefits Scheme), health service use (Medicare Benefits Schedule), emergency department visits (NSW Emergency Department Data Collection), hospitalisations (NSW Admitted Patient Data Collection) plus death (National Death Index) and cancer registrations (NSW Cancer Registry). Data are currently available to 2022, with approval to update the cohort and data collections annually. The platform includes 7.4 million unique people across all years, covering 36.9% of the Australian adult population; the overall population increased from 4.8 M in 2005 to 6.0 M in 2020. As of 1 January 2019 (the last pre-pandemic year), the cohort had a mean age of 48.7 years (51.1% female), with most people (4.4 M, 74.7%) residing in a major city. In 2019, 4.4 M people (73.3%) were dispensed a medicine, 1.2 M (20.5%) were hospitalised, 5.3 M (89.4%) had a GP or specialist appointment, and 54 003 people died. Anti-infectives were the most prevalent medicines dispensed to the cohort in 2019 (43.1%), followed by nervous system (32.2%) and cardiovascular system medicines (30.2%).

CONCLUSION: The MedIntel Data Platform creates opportunities for national and international research collaborations and enables us to address contemporary clinically- and policy-relevant research questions about quality use of medicines and health outcomes in Australia and globally.

PMID:39145404 | DOI:10.1002/pds.5887

Endocrinol Diabetes Metab. 2024 Sep;7(5):e514. doi: 10.1002/edm2.514.

ABSTRACT

BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve cardiovascular (CV) outcomes in patients with or without Type 2 diabetes and heart failure (HF). However, studies have shown conflicting evidence regarding their efficacy in patients following acute myocardial infarction (MI). We conducted a pilot systematic review and meta-analysis to synthesise the available evidence regarding the effectiveness of SGLT2 inhibitors in MI.

METHODS: A systematic literature search was conducted using PubMed/MEDLINE, the Cochrane Library and Embase databases to identify randomised controlled trials (RCTs) that compared clinical outcomes of SGLT2 inhibitors with placebo following MI. We conducted the statistical analysis using RevMan, version 5.4 and pooled risk ratios (RRs) along the corresponding 95% confidence interval (CI) for all outcomes.

RESULTS: Five RCTs reporting data for 11,211 patients were included in our study. The mean follow-up duration was 43.8 weeks. Our pooled analysis showed that SGLT2 inhibitors significantly reduced the risk of hospitalisations for heart failure (HHF) (RR = 0.76, 95% CI: 0.61-0.88, p = 0.001) in patients with MI. However, the risk of all-cause mortality (RR = 1.05, 95% CI: 0.78-1.41, p = 0.76), CV mortality (RR = 1.04, 95% CI = 0.84-1.29, p = 0.73) and all-cause hospitalisations (RR = 1.06, 95% CI: 0.96-1.17, p = 0.25) remained comparable across the two groups.

CONCLUSION: SGLT2 inhibitors reduce HHF without affecting all-cause mortality, CV mortality and all-cause hospitalisations. However, further evidence is required to reach a definitive conclusion.

PMID:39145401 | DOI:10.1002/edm2.514

Pharmacoepidemiol Drug Saf. 2024 Aug;33(8):e5855. doi: 10.1002/pds.5855.

ABSTRACT

PURPOSE: Hypertension (HT), dyslipidemia (DL), and diabetes mellitus (DM) are major risk factors for cardiovascular diseases. Despite the wide availability of medications to reduce this risk, poor adherence to medications remains an issue. The aim of this study is to evaluate medication adherence of prevalent users in these disease medications (HT, DL, DM) using claims data. Factors associated with non-adherence were also examined.

METHODS: Of 7538 participants of the Tsuruoka Metabolomics Cohort Study, 3693 (HT: 2702, DL: 2112, DM: 661) were identified as prevalent users of these disease medications. Information on lifestyle was collected through a questionnaire. Adherence was assessed by a proportion of days covered (PDC) and participants with PDC ≥0.8 were defined as adherent. Predictors of non-adherence were determined by performing multivariable logistic regression.

RESULTS: Medication adherence differed by treatment status. Among those without comorbidities, those with HT-only showed the highest adherence (90.2%), followed by those with DM-only (81.2%) and those with DL-only (80.8%). Factors associated with non-adherence in each medication group were skipping breakfast and poor understanding of medications among those with HT medications, females, having comorbidities, having a history of heart disease, and drinking habit among those with DL medications, and good sleep quality and skipping breakfast among those with DM medications.

CONCLUSION: While participants showed high medication adherence, differences were observed across medication groups. The identified predictors of non-adherence could help target those in need of adherence support.

PMID:39145400 | DOI:10.1002/pds.5855

Clin Otolaryngol. 2024 Aug 15. doi: 10.1111/coa.14213. Online ahead of print.

ABSTRACT

PURPOSE: The primary objective of this study was to explore the potential disparity in postoperative fistula occurrence rates between patients who undergo (partial) lateral parotidectomy and those who undergo the extracapsular dissection technique for the management of benign parotid gland tumours.

METHODS: A consecutive series of 363 patients treated with (partial) lateral parotidectomy and extracapsular dissection technique for benign parotid gland tumours at one tertiary centre between 2018 and 2022 were included. To evaluate the impact of the surgical technique and possible other risk factors (tumour location, tumour size, Body Mass Index, age, smoking, diabetes mellitus, arterial hypertension) for the development of fistulas, multivariate logistic regression analyses using backward lection were applied to estimate odds ratios (ORs) and 95%-confidence intervals (CIs).

RESULTS: In 363 patients, 21 patients (5.8%) developed a fistula. Patients who underwent (partial) lateral parotidectomy had three times higher chance of developing a fistula compared to patients who were operated using the extracapsular dissection technique (OR_adjusted = 2.6, 4.1% vs. 12.5%, p = 0.044). In the multivariate analyses, no other risk factors for the development of fistulas were statistically significant in this cohort. The incidence of facial nerve paralysis was not significantly different between the extracapsular dissection and lateral parotidectomy group (5/73 = 6.8% vs. 11/290 = 3.8%, p = 0.333).

CONCLUSION: Fistulas occur more often in patients treated by means of a (partial) lateral parotidectomy approach compared to patients treated using the extracapsular dissection technique. Therefore, surgeons should be vigilant about postoperative fistula risks in lateral parotidectomy and consider preventive measures.

PMID:39145398 | DOI:10.1111/coa.14213