Category: Statistics

Updates Surg. 2023 Dec 26. doi: 10.1007/s13304-023-01730-1. Online ahead of print.

ABSTRACT

Concerning the perioperative outcomes of patients diagnosed with COVID-19 who underwent emergency laparotomy, more data must be collected. Because COVID-19 can affect multiple organs, cause various complications, and act as a risk factor for surgery, in this study, we aimed to compare the outcomes of emergency laparotomy between SARS-CoV-2 infected and uninfected patients. This retrospective cohort study was conducted on patients who underwent emergency laparotomy from December 2021 to December 2022. Postoperative outcomes were compared between patients with and without confirmed perioperative SARS-CoV-2 infection. The primary outcome was 30-day mortality. Secondary outcomes were postoperative intensive care unit admission, hospital length of stay, re-operation, and postoperative complications. Data were analyzed by SPSS statistic version 27. In this study, 50 patients in the COVID-19 group and 91 patients in the non-COVID-19 group were assessed. The 30-day mortality in the COVID-19 group was significantly higher than in the non-COVID-19 group (34% vs. 12.1%, respectively, P = 0.004). Postoperative complications were significantly higher in the COVID-19 group (64% vs. 26.4%, P < 0.001). The frequency of ICU admission and need for re-operation were significantly higher in the COVID-19 group (P = 0.003 and P = 0.039, respectively). Length of hospital stay was significantly lower in the non-COVID-19 group (P = 0.021). In patients with confirmed COVID-19, emergency laparotomy is associated with increased postoperative morbidity and mortality. Additionally, emergency laparotomy is associated with increasing postoperative complications, length of hospital stay, intensive care admission, and additional surgery requirement.

PMID:38147291 | DOI:10.1007/s13304-023-01730-1

J Endocrinol Invest. 2023 Dec 26. doi: 10.1007/s40618-023-02263-5. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess and compare the immunogenicity of recombinant Insulin Aspart [manufactured by BioGenomics Limited (BGL-ASP)] with its originator NovoRapid® (manufactured by Novo Nordisk) in adult patients with type 2 diabetes mellitus.

RESEARCH DESIGN AND METHODS: BGL-IA-CTP301 study was a randomized, open label, parallel group, multicenter phase-III clinical study to compare the efficacy and safety of recombinant Insulin Aspart 100 U/mL [manufactured by BioGenomics Limited (BGL-ASP)] with its reference medicinal product (RMP); NovoRapid® [manufactured by Novo Nordisk], in adult patients with Type 2 diabetes mellitus (T2DM). The primary objective of the study was to compare the immunogenicity of BGL-ASP and RMP; NovoRapid® in patient serum samples collected from phase-III clinical study. Immunogenicity was studied as the incidence of patients positive for anti-insulin Aspart (AIA) antibodies, developed against BGL-ASP/RMP at baseline, end of 12 week and end of 24 week of the treatment period. The changes in incidence of patients positive for AIA antibodies post-baseline were also studied to assess and compare the treatment-emergent antibody response (TEAR) between the treatment groups (BGL-ASP and RMP). Statistical evaluation was done by Fisher’s exact test to compare the overall incidence of patients positive for AIA antibodies and the TEAR positives observed post-baseline in both the treated groups. An in-vitro neutralizing antibody assay (Nab assay) was also performed to study the effect of AIA antibodies in neutralizing the biological activity/metabolic function of the insulin. The neutralizing potential of AIA was studied by its effect on %glucose uptake. We also evaluated the association between AIA antibody levels and its impact on biological activity by studying the correlation between them.

RESULTS: Analysis of immunogenicity data suggested that the percentage of patients positive for AIA antibodies until week 24 was similar and comparable in both the treatment groups, BGL-ASP and RMP; NovoRapid®. The changes in incidence of patients positive for AIA post-baseline in terms of TEAR positives were also similar and comparable between the treatment groups. The results of the Nab assay with confirmed positive AIA samples from BGL-ASP- and RMP-treated groups did not have any negative impact on %glucose uptake by the cells in Nab assay, confirming the absence of neutralizing antibodies in both the treatment groups. The correlation studies also showed absence of association between AIA antibody levels and percentage glucose uptake in both BGL-ASP and RMP-NovoRapid® treatment groups^. CONCLUSIONS: The immunogenicity assessment based on the overall incidence of patients positive for AIA, changes in incidence of patients positive for AIA post-baseline, TEAR rates and absence of neutralizing antibodies, were found to be apparently similar and comparable in both the treatment groups (BGL-ASP and RMP). We conclude from our studies that the immunogenicity of BGL-ASP is similar and comparable to RMP and the observed immunogenicity in terms of anti-insulin Aspart antibody levels had no impact on the biological activity of insulin.

PMID:38147290 | DOI:10.1007/s40618-023-02263-5

Environ Monit Assess. 2023 Dec 26;196(1):88. doi: 10.1007/s10661-023-12257-8.

ABSTRACT

Small island ecosystems and their inhabitants face a significant threat from global warming, jeopardizing their sustainability. These communities are particularly vulnerable to the impact of climate change, as they heavily rely on natural resources for their livelihoods and are more vulnerable than mainland regions. Therefore, it is essential to take urgent action to address the challenges small island states face and promote their resilience in the face of climate change. To preserve the coastal ecosystems in Karimunjawa Islands, Indonesia, this study proposes an alternative spatial plan through micro-zonation analysis. The study conducted literature reviews and field surveys to collect data and develop recommendations for the current spatial plans through spatial, descriptive statistics, and comparative analysis. The findings show that the sea surface temperatures of Karimunjawa and Kemujan Island have increased by 1-2 ℃. Stress levels were found for coral reefs at the bleaching warning position for all Karimunjawa Island marine areas, including Kemujan Island. Legon Lele and Tanjung Gelam were found to have suspended sediment traces and indications of heavy metal contamination, making them the research focus. The Karimunjawa micro-zonation boundaries were obtained, especially in the Legon Lele and Tanjung Gelam areas, with an area of 640.63 and 817.45 ha, respectively. The proposed micro-zonation for Karimunjawa National Park refers to watershed-sedimentary cells, making it an example of implementing integrated coastal management (ICM) spatial boundaries in Karimunjawa and other nations. By applying this micro-zonation, coastal ecosystem rehabilitation efforts can be carried out precisely.

PMID:38147264 | DOI:10.1007/s10661-023-12257-8

Environ Sci Pollut Res Int. 2023 Dec 26. doi: 10.1007/s11356-023-31494-5. Online ahead of print.

ABSTRACT

As part of their pursuit to succeed the Sustainable Development Goals (SDGs), European Union (EU) countries have placed great importance on realizing SDG 11, which aims to create sustainable cities and communities. The relationship between environmental quality and municipal solid waste remains understudied despite its significant impact on achieving SDG-11. Consequently, this study seeks to peruse municipal solid waste, renewable energy consumption, human capital, and natural resources impact on load capacity as a comprehensive measure of environmental quality. By utilizing the CS-ARDL approach, this study reveals the inadequacy of municipal solid waste conversion in EU countries and highlights the favorable effect of human capital and renewable energy on enhancing environmental quality. Moreover, this study provides concrete evidence that natural resources contribute to environmental corruption. EU economies should adopt policies to bolster municipal solid waste conversion to improve environmental quality.

PMID:38147253 | DOI:10.1007/s11356-023-31494-5

Environ Sci Pollut Res Int. 2023 Dec 26. doi: 10.1007/s11356-023-31588-0. Online ahead of print.

ABSTRACT

Policy adjustments can help strike a balance between economic growth and environmental sustainability, which has increasingly been the heart to nations and regions throughout the World. This paper examines how public investment affects economic growth, energy consumption, and CO2 emissions in eight ASEAN countries: Cambodia, Myanmar, Malaysia, Indonesia, the Philippines, Singapore, Thailand, and Vietnam. Extension of a Cobb-Douglas production function and application of panel cointegration techniques reveal bidirectional Granger causation between public investment and both private development and CO2 emissions from 1980 to 2019. Public investment Granger causes energy usage, the opposite does not hold statistically. More findings from pooled mean group estimations show a mean-reversion dynamic that corrects disequilibria by 14% yearly. State investment crowds in private sector growth, energy use, and carbon footprint. It also finds an inverted U-shaped relationship between public investment and energy consumption, and a U-shaped relationship between public investment and CO2 emissions, indicating complex regional interactions. It is suggested the implementation of public investment policies that enrich green infrastructure projects to foster growth while minimizing environmental impacts, and encourage a strategic approach to public investment for prioritizing environmental sustainability and thus, achieving Sustainable Development Goals 7 to 9 and 11 to 13 in this region.

PMID:38147250 | DOI:10.1007/s11356-023-31588-0

Infection. 2023 Dec 26. doi: 10.1007/s15010-023-02148-y. Online ahead of print.

ABSTRACT

BACKGROUND: Interstitial lung disease (ILD) is a new risk category for pneumocystis pneumonia (PCP) with a high mortality rate. The definite diagnostic criteria of PCP in ILD patients have not been established until now. The aims of this study were to identify potential risk factors of PCP in patients with ILD, and to evaluate the performance of metagenomic next-generation sequencing (mNGS), CD4 + T cell count, (1-3)-β-D-Glucan (BG) and lactate dehydrogenase (LDH) in the diagnosis of PCP in ILD patients.

METHODS: This is a retrospective, single-center, case-control study. ILD patients who underwent mNGS from December 2018 to December 2022 were included in the study. Based on the diagnosis criteria of PCP, these patients were divided into PCP-ILD and non-PCP-ILD groups. The potential risk factors for PCP occurrence in ILD patients were analysed via logistic regression. The diagnostic efficacy of mNGS was compared with serological biomarkers.

RESULTS: 92 patients with ILD were enrolled, 31 of which had a definite PCP and were assigned to the PCP-ILD group while 61 were to the non-PCP-ILD group. The infection rate of PJ in ILD patients was 33.7% (31/92). The history of glucocorticoid therapy, CD4 + T cell count, BG level and traction bronchiectasis on HRCT were associated with PCP occurrence in ILD patients. LDH level did not reach statistical significance in the logistic regression analysis. mNGS was confirmed as the most accurate test for PCP diagnosis in ILD patients.

CONCLUSION: ILD is a new risk group of PCP with high PCP prevalence. Clinicians should pay close attention to the occurrence of PCP in ILD patients who possess the risk factors of previous glucocorticoid therapy, decreased CD4 + T cell count, increased BG level and absence of traction bronchiectasis on HRCT. mNGS showed the most excellent performance for PCP diagnosis in ILD patients. Peripheral blood CD4 + T cell count and BG level are alternative diagnostic methods for PCP in ILD patients. However, the diagnostic value of serum LDH level was limited in ILD patients.

PMID:38147199 | DOI:10.1007/s15010-023-02148-y

Environ Monit Assess. 2023 Dec 26;196(1):91. doi: 10.1007/s10661-023-12268-5.

ABSTRACT

The analysis of animal hair is a useful and non-invasive investigation method for monitoring metal content, whose beginning dates to a few decades ago. This study addresses the issue of wildlife mortality in Piedmont and Aosta Valley by linking the evidence to the characteristics of the territories and to hair elemental profile. The considered animal species were badger, fox, marten, and wolf. The quantitative data for 11 trace metals and 16 lanthanides were evaluated considering animal location and death causes regarding impacts, whose relevant number was confined to the Turin province and to the badger and fox species. The evaluation of the analytical results was performed after the out of bounds sample identification by mean of statistics. For trace metals, some areas have thus been identified, mainly in Turin province, in which the large excess of As, Cd, and Pb was related to district pollution. Moreover, the lower contents of Fe, Mn, and Al in Aosta Valley badgers’ hair seem influenced by the different characteristics of the subsoil, in comparison to Piedmont, and a relationship with the living environment and the habits was suggested. Regarding lanthanides, Biella province represents an area in which environmental contamination and abundance of rare-earth elements was recorded.

PMID:38147193 | DOI:10.1007/s10661-023-12268-5

Clin Oral Investig. 2023 Dec 26;28(1):30. doi: 10.1007/s00784-023-05457-6.

ABSTRACT

OBJECTIVES: This follow-up study aimed to report the 24- and 30-month outcomes of a cohort previously enrolled in a randomized clinical trial on surgical reconstructive treatment of peri-implantitis.

METHODS: Twenty-four patients were diagnosed with peri-implantitis and treated with surgical reconstructive therapy with or without the adjunctive use of Er:YAG laser. Within-group and between-group comparisons were tested with mixed model with repeated measures.

RESULTS: Regarding peri-implant pocket depth (PPD) reduction (control vs. laser test group) between 6 months (- 1.85 vs. – 2.65 mm) and 30 months (- 1.84 vs. – 3.04 mm), the laser group showed statistically significant changes but not the control group. In terms of radiographic marginal bone loss (RMBL) at 6 months (- 1.1 vs. – 1.46 mm) to 24 months (- 1.96 vs. – 2.82 mm), both groups showed statistical difference compared to baseline. The six explanted implants all were featured by severe peri-implantitis and mostly with no or limited keratinized tissue (< 2 mm) at baseline and membrane exposure after surgery. Among the 15 retained cases, eight cases achieved more than 50% peri-implant bone level gain.

CONCLUSIONS: Within the limitation and follow-up time frame of this trial, the outcome of the surgical reconstructive therapy sustained or improved in most of the cases. However, 25% of the implants with severe peri-implantitis failed 2 years after the surgical reconstructive therapy. The use of Er:YAG laser favors PPD reduction in the longer term up to 30 months.

CLINICAL RELEVANCE: Longer-term follow-up on reconstructive therapy of peri-implantitis revealed sustained or improved stability in certain cases, but the survival of implants with severe peri-implantitis has its limitation, especially when there is limited keratinized tissue (< 2 mm or no KT).

TRIAL REGISTRATION: Clinical Trials Registration Number: NCT03127228 and HUM00160290.

PMID:38147180 | DOI:10.1007/s00784-023-05457-6

Environ Geochem Health. 2023 Dec 26;46(1):14. doi: 10.1007/s10653-023-01782-7.

ABSTRACT

Arsenic contamination in the groundwater occurs in various parts of the world due to anthropogenic and natural sources, adversely affecting human health and ecosystems. The current study intends to examine the groundwater hydrogeochemistry containing elevated arsenic (As), predict As levels in groundwater, and determine the aptness of groundwater for drinking in the Vehari district, Pakistan. Four hundred groundwater samples from the study region were collected for physiochemical analysis. As levels in groundwater samples ranged from 0.1 to 52 μg/L, with an average of 11.64 μg/L, (43.5%), groundwater samples exceeded the WHO 2022 recommended limit of 10 μg/L for drinking purposes. Ion-exchange processes and the adsorption of ions significantly impacted the concentration of As. The HCO₃^– and Na⁺ are the dominant ions in the study area, and the water types of samples were CaHCO₃, mixed CaMgCl, and CaCl, demonstrating that rock-water contact significantly impacts hydrochemical behavior. The geochemical modeling indicated negative saturation indices with calcium carbonate and other salt minerals, encompassing aragonite, calcite, dolomite, and halite. The dissolution mechanism suggested that these minerals might have implications for the mobilization of As in groundwater. A combination of human-induced and natural sources of contamination was unveiled through principal component analysis (PCA). Artificial neural networks (ANN), random forest (RF), and logistic regression (LR) were used to predict As in the groundwater. The data have been divided into two parts for statistical analysis: 20% for testing and 80% for training. The most significant input variables for As prediction was determined using Chi-squared analysis. The receiver operating characteristic area under the curve and confusion matrix were used to evaluate the models; the RF, ANN, and LR accuracies were 0.89, 0.85, and 0.76. The permutation feature and mean decrease in impurity determine ten parameters that influence groundwater arsenic in the study region, including F^–, Fe²⁺, K⁺, Mg²⁺, Ca²⁺, Cl^–, SO₄^2-, NO₃^–, HCO₃^–, and Na⁺. The present study shows RF is the best model for predicting groundwater As contamination in the research area. The water quality index showed that 161 samples represent poor water, and 121 samples are unsuitable for drinking. Establishing effective strategies and regulatory measures is imperative in Vehari to ensure the sustainability of groundwater resources.

PMID:38147177 | DOI:10.1007/s10653-023-01782-7

Clin Oral Investig. 2023 Dec 26;28(1):20. doi: 10.1007/s00784-023-05419-y.

ABSTRACT

OBJECTIVES: This study aimed to determine the degree of similarity and symmetry in the anatomy of contralateral mandibular incisors. Three-dimensional (3D) models of extracted teeth were obtained from microtomography (micro-CT) scans. Qualitative and quantitative assessments of the morphology and comparison of contralateral pairs were made. The null hypothesis was that contralateral mandibular incisors could not be considered identical in simple morphometric measurements.

METHODS: Sixty pairs of mandibular incisors were extracted from 30 patients and scanned with micro-CT. Virtual models of the cemento-enamel junction to the root apex were rendered. Parameters such as length, canal width, dentinal thicknesses, tortuosity, centerline length, accessory canals, root canal configurations, and root canal orifice cross-sections were used to compare the teeth. Width and thickness comparisons between paired teeth in the same individual were made by paired t-test (Wilcoxon signed-rank test for variables not normally distributed). An online randomization tool generated randomized pairs (independent of the individual/patient). Subsequently, an unpaired t-test (or Mann-Whitney U test for non-normally distributed parameters) and a correlation analysis were conducted. Canal configurations were classified according to preexisting classification schemes. The number and location of accessory canals and apical foramina were registered and compared.

RESULTS: Utilizing advanced imaging techniques and quantitative analyses, our study establishes that contralateral mandibular incisors exhibit a remarkable degree of symmetry in multiple morphological parameters, including length, canal width, and dentinal thicknesses. The apical third showed a high degree of inter-variability for the contralateral pairs. The rigorous statistical analysis of the normalized parameters by Z-score showed no statistically significant differences between the contralateral mandibular incisors. Comparisons between central and lateral teeth revealed differences in root length but no significant disparity in the distribution of accessory canals. Central teeth, on average, were longer, while accessory canals were distributed relatively evenly between central and lateral teeth.

CONCLUSIONS: The findings of this study further establish the significant similarities between contralateral mandibular incisors, reinforcing their suitability as a reliable substrate for root canal comparison studies.

CLINICAL RELEVANCE: The absence of statistically significant differences between contralateral pairs in normalized parameters underscores their potential as a reliable reference point for root canal comparison studies in clinical dentistry. Furthermore, our findings emphasize the importance of individualized treatment planning, considering the natural symmetry in mandibular incisors to enhance clinical decision-making. This research contributes valuable insights to the field of endodontics, offering a standardized approach to sample selection and enriching the understanding of dental anatomy.

PMID:38147175 | DOI:10.1007/s00784-023-05419-y