Category: Statistics

J Thromb Thrombolysis. 2023 Aug 7. doi: 10.1007/s11239-023-02873-z. Online ahead of print.

ABSTRACT

BACKGROUND: Computed tomography pulmonary angiography (CTPA) yields indices, such as the right ventricular/left ventricular (RV/LV) ratio > 1.0, which are commonly used for risk stratification of patients with acute pulmonary embolism (APE). Although pulmonary artery elasticity (PAE) has been previously described, its relationship with right ventricular dysfunction (RVD) has not been explored. Here, we investigated whether PAE, measured using CTPA, is associated with RVD.

METHODS: Patients who underwent retrospective electrocardiogram-gated CTPA and had a definitive diagnosis of APE were included in the study. The subjects were classified into RVD and non-RVD groups according to the RVD on echocardiography. PAE, involving aortic distensibility (AD), aortic compliance (AC), and aortic stiffness (ASI), and right heart function indices were compared between the two groups, and their correlations were examined. Receiver operating characteristic (ROC) curves were generated to evaluate the specificity and sensitivity of the RVD prediction.

RESULTS: Thirty-five patients with APE were enrolled in the study (RVD: 18, non-RVD: 17). The groups showed no significant differences in age, sex, number of patients receiving thrombolysis, and number of high-risk conditions (P > 0.05). Regarding PAE parameters, AD was significantly reduced in the RVD group compared to that in the non-RVD group (P < 0.05), whereas AC and ASI were not statistically different (P > 0.05). The ratio of the maximum cross-sectional area of PA and AA (PA/AAmax),the ratio of the minimum cross-sectional area of PA and AA(PA/AAmin), diameter of the coronary sinus, RV/LV diameter, RV/Lvarea, the ratio of the end-diastolic volume of right ventricular and left ventricular (RV/LV_DV), the ratio of the end-systolic volume of right ventricular and left ventricular (RV/LV_SV) were significantly greater in the RVD group than in the non-RVD group (P < 0.05). Correlation analysis of AD and right heart function parameters showed that AD was negatively correlated with PA/AAmax, PA/AAmin, RV/LV diameter, RV/LV_DV, and PAE measured by ultrasound, with correlation coefficients ranging from – 0.336 to – 0.580 (P < 0.05). The ROC curves of AD and RV/LVdiameter to predict RVD had areas under the curve of 0.748 and 0.712, sensitivities of 82.35% and 70.59%, specificities of 66.67% and 72.22%, and cutoff values of 4.9433 and 1.1105, respectively.

CONCLUSION: AD obtained by retrospective ECG-gated CTPA may be helpful in assessing RVD in patients with APE while accurately diagnosing APE. It contributes to timely diagnosis and treatment and improves the prognosis of patients with APE.

PMID:37548900 | DOI:10.1007/s11239-023-02873-z

J Racial Ethn Health Disparities. 2023 Aug 7. doi: 10.1007/s40615-023-01709-z. Online ahead of print.

ABSTRACT

OBJECTIVES: To measure changes in cause of death dynamics in 2019 and 2020 and the relationship between the concurrent occurrence of the COVID-19 pandemic and mortality outcome by race and ethnicity.

PATIENTS AND METHODS: We used resident mortality data from the Minnesota Department of Health (MDH) to conduct a retrospective statistical analysis of deaths in Minnesota in 2019 relative to 2020 to assess changes in mortality in a pre-pandemic and pandemic period.

RESULTS: COVID-19 strongly contributed to ethnicity-related mortality disparities in Minnesota. Not only was there a greater proportion of COVID-19 decedents within Black and Hispanic populations, but their average decedent age was markedly lower relative to the White population. The Black population experienced a disproportionate increase in decedents with a 34% increase during 2020 compared to 2019.

CONCLUSIONS: This retrospective analysis of death dynamics and mortality outcomes in Minnesota from 2019 to 2020 demonstrated an increase in adverse mortality outcomes relative to the pre-pandemic period that disproportionately impacted Black and Hispanic minority populations.

PMID:37548856 | DOI:10.1007/s40615-023-01709-z

Environ Geochem Health. 2023 Aug 7. doi: 10.1007/s10653-023-01715-4. Online ahead of print.

ABSTRACT

Identifying the contamination and sources of potentially toxic elements (PTEs) in road-dust sediment (RDS) and the surrounding greenspace soil of urban environments and understanding their ecological-health risks are important for pollution management and public health. The contamination characteristics, ecological and probabilistic health risks, and source apportionment of eight PTEs (Cd, Pb, Cr, Cu, Ni, As, Zn, and Hg) in the Yellow River Custom Tourist Line of Lanzhou, which is the largest open urban riverfront scenic park in China, were investigated. The results showed that all the RDS PTE mean concentrations exceeded their soil background values, whereas for the surrounding greenspace soils, the concentrations of the PTEs, except for Cr and Ni, were also higher than their local background levels. Moreover, the RDS-soil system was mainly contaminated by Cd, Zn, Pb, Cu, and Hg to varying degrees, and the integrated ecological risks of PTEs in the RDS and soil were high and considerable at most sites, respectively. The probabilistic health risk assessment results demonstrated that the non-carcinogenic hazard risk for humans was negligible, but the total carcinogenic risks should be considered. Source apportionment using a positive matrix factorization model combined with multivariate statistical analyses revealed that Cr, Ni, and As in the RDS-soil system were from natural and industrial sources, Cd, Pb, Zn, Cu came from vehicle emissions and pesticide and fertilizer applications, and Hg was from natural and industrial sources and utilization of pesticides with fertilizers. This work provides scientific evidence for urban planning and human health protection in urban environments.

PMID:37548849 | DOI:10.1007/s10653-023-01715-4

Arch Osteoporos. 2023 Aug 7;18(1):108. doi: 10.1007/s11657-023-01317-8.

ABSTRACT

This meta-analysis including 10 randomised controlled trials suggests that exercise is associated with a statistically significant, but relatively mild, improvement effect on bone mineral density in middle-aged and older men, indicating that exercise has the potential to be a safe and effective way toavert bone loss in men.

PURPOSE: To determine the effect of exercise on bone mineral density (BMD) in middle-aged and older men.

METHODS: We searched three electronic databases up to March 21, 2022. A systematic review of the literature according to the PRISMA statement included (1) randomised controlled trials (RCTs), with (2) at least one exercise group as an intervention versus a control group, (3) men aged ≥ 45 years old, and (4) areal BMD of the lumbar spine (LS) and/or femoral neck (FN) and/or total hip (TH) and/or trochanter region. Mean differences (MD) for BMD changes at the LS, FN, TH, and trochanter were defined as outcome measures.

RESULTS: A total of 10 eligible RCTs were included (N = 555 participants). Exercise significantly improved BMD, and the summarised MD was 0.02 (95% CI: 0.00 to 0.05) for LS BMD, 0.01 (95% CI: 0.00 to 0.02) for FN BMD, 0.01 (95% CI: 0.00 to 0.01) for TH BMD, and 0.03 (95% CI: 0.00 to 0.05) for trochanter BMD. Subgoup analyses showed the improvement effect was statistically significant in trials with longer duration and higher intensity in LS (≥ 12 months: MD, 0.01, 95% CI:0.00 to 0.03; higher intensity: MD, 0.01, 95% CI:0.00 to 0.03) and FN (≥ 12 months: MD, 0.02, 95% CI:0.01 to 0.02; higher intensity: MD, 0.01, 95% CI:0.01 to 0.02).

CONCLUSION: Our results suggested a relatively mild, improvement effect of exercise on LS and proximal femur BMD. Exercise has the potential to be an effective way to avert bone loss in middle-aged and older men.

PMID:37548809 | DOI:10.1007/s11657-023-01317-8

Eur J Health Econ. 2023 Aug 7. doi: 10.1007/s10198-023-01624-4. Online ahead of print.

ABSTRACT

BACKGROUND: How different subtypes and stages of lung cancer affect morbidity- and mortality-associated productivity have not been investigated. This study quantified the losses of lifetime employment duration and productivity among patients with various subtypes and stages of lung cancer.

METHODS: We identified nationwide lung cancer patients diagnosed at the ages of 50-64 between 2011 and 2019. Monthly survival probabilities were weighted by monthly employed-to-population ratios and working salaries to estimate lifetime employment duration and productivity. We compared lifetime employment duration and productivity of patients with those of the age-, sex-, calendar year-matched general population for losses of lifetime employment duration and productivity, which were multiplied by pathology and stage shifts based on the first-round screening of Taiwan Lung Cancer Screening in Never Smoker Trial (TALENT) to calculate the savings of lifetime employment duration and productivity.

RESULTS: Lung cancer patients had shorter survival and employment duration than the referents. Patients with lung cancers other than adenocarcinoma experienced greater losses of lifetime employment duration and productivity as compared to adenocarcinoma patients. Applying the estimations of never-smoking patients to 100 lung cancer patients with pathology and stage shifts based on the TALENT, the savings of lifetime employment duration and productivity were 132.2 (95% prediction interval: 116.2-147.4) years and 3353 (95% prediction interval: 2914-3802) thousand US dollars, respectively.

CONCLUSIONS: Early diagnosis of lung cancer would save the losses of employment duration and lifetime productivity. Future evaluation of the cost-effectiveness of lung cancer screening could consider incorporating these societal impacts.

PMID:37548803 | DOI:10.1007/s10198-023-01624-4

Arch Womens Ment Health. 2023 Aug 7. doi: 10.1007/s00737-023-01362-9. Online ahead of print.

ABSTRACT

Fear of childbirth exists on a continuum of severity, and the most severe form is commonly referred to as tocophobia. Although a rare entity, tocophobia is a common reason for requesting an elective cesarean section. It is generally considered a specific phobia but is not recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a diagnostic entity. To improve the assessment and treatment of tocophobia, research is warranted to clarify its relationship with commonly occurring psychiatric disorders in pregnancy.

PMID:37548800 | DOI:10.1007/s00737-023-01362-9

Environ Sci Pollut Res Int. 2023 Aug 7. doi: 10.1007/s11356-023-28989-6. Online ahead of print.

ABSTRACT

One of the first environmental crises to attract interest in development initiatives and aid was the great drought of the 1970s in the Sahel. This study investigates the extent of damage caused by natural disasters from one of the most widely used databases-EM-DAT-with a sample size of 16 Sahelian countries over the period 1960-2020. These countries have been divided into three regions: Western Africa Sahel (WAS), Central Africa Sahel (CAS), and Eastern Africa Sahel (EAS). The analyses encompass four categories of natural hazards, namely, biological, climatological, hydrological, and meteorological. We used descriptive and test statistics to summarize the natural disaster records. Through this approach, we explore tendencies to identify the most frequently reported natural hazards; we examine their spatial distribution and evaluate their impacts in terms of socioeconomic damage and causalities. During the study period, a total of 1000 events were recorded in the database. The Western Africa Sahel (WAS) region had the highest number of disasters, with 476 events, followed by the Eastern Africa Sahel (EAS) region with 369 events. The most common hazards in the Sahel were hydrological (41.8%), mainly floods, and biological (39.5%) hazards. Approximately 300 million people in the Sahel were affected by natural hazards, with 59.17% in EAS, 36.48% in WAS, and 4.35% in CAS. Although droughts occurred less frequently (14%), they had a significant impact on the population, affecting 84% of those affected by natural hazards. In general, EAS experiences a higher impact from natural hazards, potentially influenced by the pastoral lifestyle of its population. However, WAS is also very vulnerable to natural hazards especially epidemics and nowadays floods. The uncontrolled urbanization in the area may contribute to this vulnerability.

PMID:37548790 | DOI:10.1007/s11356-023-28989-6

Environ Sci Pollut Res Int. 2023 Aug 7. doi: 10.1007/s11356-023-29029-z. Online ahead of print.

ABSTRACT

Establishing a reasonable cost-sharing and compensation mechanism for air pollution control is a prerequisite for realizing inter-regional cooperative treatment. Taking inter-provincial sulfur dioxide (SO₂) emissions in China from 2005 to 2019 as the research object, this paper proposes a data-driven approach to establish a cost-sharing index system of regional SO₂ treatment in four dimensions and construct a cost-sharing and compensation scheme using the entropy-TOPSIS method. The results revealed that there are significant spatial and temporal differences in the treatment cost of SO₂ emission, and the total SO₂ treatment costs at the national level increased first and then decreased during the study period, meanwhile, the regional SO₂ treatment costs are much higher in the less economically developed regions such as the central and western regions than in economically developed eastern coastal regions. The design of the cost-sharing and compensation mechanism of SO₂ treatment should consider the regional differences in abatement capacity, abatement potential, abatement responsibility, and development demands. The economically developed regions should share higher treatment costs according to their historical cumulative abatement responsibilities, and provide economic compensation and technical support to the less economically developed regions. Specifically, the marginal abatement cost in the more economically developed eastern region is much higher than that in the less economically developed central and western areas due to their large abatement responsibility and strong reduction capacity but insufficient abatement potential, so the eastern regions can transfer part of their abatement responsibility to the central and western regions using economic compensation. Reasonable cost sharing and horizontal compensation can help promote regional cooperation and synergistic management in air pollution abatement. Finally, corresponding policy recommendations are given to provide a decision basis for cross-regional cooperation in air pollution control.

PMID:37548789 | DOI:10.1007/s11356-023-29029-z

Clin Oral Investig. 2023 Aug 7. doi: 10.1007/s00784-023-05191-z. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aims to compare β-thalassemia major patients and healthy individuals in terms of anthropometric characteristics and changes in craniofacial profile.

SUBJECTS AND METHOD: Craniofacial anthropometric measurements were performed on a total of 422 subjects (199 β-thalassemia major patients and 223 healthy individuals) by using a millimetric caliper and tape measure on 19 anthropometric parameters (8 horizontal, 10 vertical, and 1 head circumference) in cranial, facial, nasal, orolabial, and orbital zones.

RESULTS: The difference between the orbital, nasal, and orolabial zone parameters of healthy subjects and β-thalassemia major patients was found to be statistically significant (p < 0.05). There was no statistically significant difference between the groups in terms of head circumference in the cranial zone and total facial height in facial zone (n-gn) values (p˃0.05). In intragroup comparison between females and males with β-thalassemia, statistically significant differences were found in forehead width (ft-ft), forehead height (tr-gl), right eye width (R ex-ex), and upper lip height (sn-stm) (p < 0.05).

CONCLUSION: Understanding the craniofacial profile changes in β-thalassemia major patients and increasing our knowledge about the relationship between the course and severity of disease and the level of these changes would contribute to the advancements in diagnoses to be made in facial and jaw zones of these patients and in the treatment plans.

CLINICAL RELEVANCE: We believe that the analysis and results of the craniofacial anthropometric data obtained in the study will contribute to the diagnosis and treatment processes of patients with β-thalassemia major in areas of expertise such as craniofacial surgery, orthodontics, and hemato-oncology.

PMID:37548765 | DOI:10.1007/s00784-023-05191-z

Support Care Cancer. 2023 Aug 7;31(9):508. doi: 10.1007/s00520-023-07977-z.

ABSTRACT

OBJECTIVE: The goal of this research was to review the literature from randomized controlled trials (RCTs) on the impacts of moxibustion on cancer-related fatigue (CRF) as well as provide credible evidence to guide clinical practice.

METHODS: Three English electronic medical databases (PubMed, Embase, and the Cochrane Library) and two Chinese databases (China National Knowledge Infrastructure and Wanfang) were searched. Only randomized controlled trials on the effect of moxibustion on CRF were included in this systematic review. Study selection, data extraction, and validation were all carried out independently by two reviewers. The revised Cochrane Risk of Bias tool was used to assess the quality of the RCTs (RoB 2.0). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was applied to assess effect sizes in individual RCTs and pooled effect sizes in meta-analyses. Data were meta-analyzed using Stata (version 14.0).

RESULTS: In a random-effects meta-analysis of 24 RCTs with 1894 participants, the aggregated standardized mean difference (SMD) revealed a statistically significant association between moxibustion and alleviation from cancer-related fatigue (SMD = – 1.66, 95% CI = – 2.05, – 1.28, p = 0.000). Pooled results, however, show significant heterogeneity (I² = 92.5%), and the evidence is insufficient to determine whether this association varies systematically by measuring tools and moxibustion modalities. Furthermore, evidence ranging from very low to low showed that moxibustion had an immediate positive effect on patients with CRF.

CONCLUSION: Moxibustion may have a therapeutic effect on cancer-related fatigue. However, further large-scale, multicenter, high-quality RCTs on moxibustion for fatigue relief and safety are still needed because of the handful of studies included and the low methodological quality.

PMID:37548752 | DOI:10.1007/s00520-023-07977-z