Category: Statistics

Breast Cancer. 2023 Apr 27. doi: 10.1007/s12282-023-01459-0. Online ahead of print.

ABSTRACT

OBJECTIVE: We aim to use the SEER database to discuss the effect of various surgical methods of primary foci and other influencing factors on the nonregional lymph node (NRLN) metastasis in invasive ductal carcinoma (IDC) patients.

METHODS: Clinical information of IDC patients used in this study was obtained from the SEER database. The statistical analyses used included a multivariate logistic regression model, the chi-squared test, log-rank test and propensity score matching (PSM).

RESULTS: 243,533 patients were included in the analysis. 94.3% of NRLN patients had a high N positivity (N3) but an equal distribution in T status. The proportion of operation type, especially BCM and MRM, differed significantly between the N0-N1 and N2-N3 groups in the NRLN metastasis group and nonmetastasis group. Age > 80 years, positive PR, modified radical mastectomy (MRM)/radical mastectomy (RM) and radiotherapy for primary tumor were shown to be protective factors for NRLN metastasis, and higher N positivity was the most significant risk factors. N2-N3 patients receiving MRM had a lower metastasis to NRLN than those receiving BCM (1.4% vs 3.7%, P < 0.001), while this relevance was not discovered in N0-N1 patients. In N2-N3 patients, a better OS was observed in MRM group than BCM group (P < 0.001).

CONCLUSION: MRM exerted a protective effect on NRLN metastasis compared to BCM in N2-N3 patients but not N0-N1 patients. This implies the need for more consideration when choosing the operation methods of primary foci in patients with high N positivity.

PMID:37103742 | DOI:10.1007/s12282-023-01459-0

Environ Sci Pollut Res Int. 2023 Apr 27. doi: 10.1007/s11356-023-27190-z. Online ahead of print.

ABSTRACT

This paper focuses on the spatiotemporal evolution characteristics, as well as the driving factors, of carbon emissions in the prefecture-level cities in the Yellow River Basin (YB). The paper’s findings will aid in promoting ecological conservation and high-quality development in the region. The initiatives undertaken in the YB are a significant national strategy towards achieving carbon peaking and carbon neutrality. To fully investigate the spatiotemporal evolution process, as well as the typical characteristics of their carbon emissions, conventional, and spatial Markov transition probability matrices were developed utilizing YB’s panel data for 55 prefecture-level cities from 2003 to 2019. The generalized Divisia index decomposition method (GDIM) cleverly uses this data to conduct a complete analysis of the dynamics and driving processes influencing the change in carbon emissions in these cities. However, the evolution of carbon emissions in prefecture-level cities has reached a point of stability that maintains the original state, making it challenging to make meaningful short-term progress. The data indicates that prefecture-level cities in the YB are emitting more carbon dioxide on average. Neighborhood types in these cities significantly influence the transformation of carbon emissions. Low-emission areas can encourage a reduction in carbon emissions, whereas high-emission areas can encourage an increase. The spatial organisation of carbon emissions exhibits a “high-high convergence, low-low convergence, high-pulling low, low-inhibiting high” club convergence phenomenon. Carbon emissions rise with per capita carbon emissions, energy consumed, technology, and output scale, whereas it falls with carbon technology intensity and output carbon intensity. Hence, instead of enhancing the role of increase-oriented variables, prefecture-level cities in the YB should actively engage these reduction-oriented forces. The YB’s key pathways for lowering carbon emissions include boosting research and development, promoting and applying carbon emission reduction technologies, lowering output carbon intensity and energy intensity, and improving energy use effectiveness.

PMID:37103708 | DOI:10.1007/s11356-023-27190-z

Environ Sci Pollut Res Int. 2023 Apr 27. doi: 10.1007/s11356-023-27147-2. Online ahead of print.

ABSTRACT

An understanding of the vertical variations in hydrogeochemical processes in various aquifers and quality suitability assessment is crucial for the utilization of groundwater in the Ningtiaota coalfield of Ordos Basin, Northwestern China. Based on 39 water samples collected from surface water (SW), Quaternary pore water (QW), weathered fissure water (WW), and mine water (MW), we conducted self-organizing maps (SOM) algorithm, multivariate statistical analysis (MSA), and classical graphical methods to elucidate the mechanisms controlling the vertical spatial variations in SW and groundwater chemistry and conducted a health risk assessment. The findings indicated that the hydrogeochemical type showed a transition from the HCO₃^–-Na⁺ type in SW to the HCO₃^–-Ca²⁺ type in QW, then to the SO₄^2--Mg²⁺ type in WW, and back to HCO₃^–-Na⁺ type in MW. Water-rock interaction, silicate dissolution, and cation exchange were the main hydrogeochemical processes in the study area. Additionally, groundwater residence time and mining operations were critical external factors that affect water chemistry. Contrary to phreatic aquifers, confined aquifers featured greater circulation depth, water-rock interactions, and external interventions leading to worse quality and higher health risks. Water quality surrounding the coalfield was poor, causing it to be undrinkable, with excessive SO₄^2-, arsenic (As), and F^–, etc. Approximately 61.54% of SW, all of QW, 75% of WW, and 35.71% of MW can be used for irrigation.

PMID:37103707 | DOI:10.1007/s11356-023-27147-2

Sleep Breath. 2023 Apr 27. doi: 10.1007/s11325-023-02835-y. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to examine the relationship between plasma metabolites (biochemical parameters) and comorbid illnesses with sleep quality in individuals with coronary heart disease (CHD).

METHODS: This descriptive cross-sectional study was conducted between 2020 and 2021 at a university hospital. Hospitalized patients with a diagnosis of CHD were analyzed. The Personal Information Form’ and Pittsburgh Sleep Quality Index (PSQI) were used to collect data. Laboratory findings including plasma metabolites were examined.

RESULTS: Of 60 hospitalized patients with CHD, 50 (83%) had poor sleep quality. A positive and statistically significant correlation was found between the plasma metabolite blood urea nitrogen and poor sleep quality (r = 0.399; p = 0.002). The presence of CHD and additional chronic diseases (especially diabetes mellitus, hypertension, and chronic kidney disease) are important parameters associated with the risk of poor sleep quality (p = 0.040 < 0.05).

CONCLUSION: Increases in blood urea nitrogen level in individuals with CHD are associated with worse sleep quality. Additional chronic diseases coexisting with CHD correlate with increased risk of poor sleep quality.

PMID:37103681 | DOI:10.1007/s11325-023-02835-y

Clin Exp Med. 2023 Apr 27. doi: 10.1007/s10238-023-01073-6. Online ahead of print.

ABSTRACT

Idiopathic inflammatory myopathy (IIM) are heterogeneous autoimmune diseases that primarily affect the proximal muscles. IIM subtypes include dermatomyositis (DM), polymyositis (PM), and anti-synthetase syndrome (ASS). Metabolic disturbances may cause irreversible structural damage to muscle fibers in patients with IIM. However, the metabolite profile of patients with different IIM subtypes remains elusive. To investigate metabolic alterations and identify patients with different IIM subtypes, we comprehensively profiled plasma metabolomics of 46 DM, 13 PM, 12 ASS patients, and 30 healthy controls (HCs) using UHPLC-Q Exactive HF mass spectrometer. Multiple statistical analyses and random forest were used to discover differential metabolites and potential biomarkers. We found that tryptophan metabolism, phenylalanine and tyrosine metabolism, fatty acid biosynthesis, beta-oxidation of very long chain fatty acids, alpha-linolenic acid and linoleic acid metabolism, steroidogenesis, bile acid biosynthesis, purine metabolism, and caffeine metabolism are all enriched in the DM, PM, and ASS groups. We also found that different subtypes of IIM have their unique metabolic pathways. We constructed three models (five metabolites) to identify DM, PM, ASS from HC in the discovery and validation sets. Five to seven metabolites can distinguish DM from PM, DM from ASS, and PM from ASS. A panel of seven metabolites can identify anti-melanoma differentiation-associated gene 5 positive (MDA5 +) DM with high accuracy in the discovery and validation sets. Our results provide potential biomarkers for diagnosing different subtypes of IIM and a better understanding of the underlying mechanisms of IIM.

PMID:37103652 | DOI:10.1007/s10238-023-01073-6

Clin Exp Med. 2023 Apr 27. doi: 10.1007/s10238-023-01082-5. Online ahead of print.

ABSTRACT

The role of anti-thyroid peroxidase antibodies (anti-TPO Abs) in the development of abnormal thyroid function tests (DYSTHYR) during treatment with immune checkpoint inhibitors (ICIs) is not fully understood; moreover, controversial data exist about the relationship between ICI-related thyroid dysfunction (TD) and survival. We retrospectively analyzed the onset or the worsening of DYSTHYR in patients treated with programmed cell death protein-1 (PD-1) or its ligand (PD-L1) inhibitors between 2017 and 2020. In patients without previous TD, we focused on the association between baseline anti-TPO Abs level and DYSTHYR. Furthermore, the relationship between DYSTHYR and progression-free survival (PFS) or overall survival (OS) was explored. We included 324 patients treated with anti PD-1 (95.4%) or anti PD-L1 inhibitors. After a median of 3.3 months, DYSTHYR was registered in 24.7%, mostly hypothyroidism alone (17%). Patients with pre-existing TD (14.5% of the sample) were at higher risk of DYSTHYR compared to patients without previous TD (adjusted OR 2.44; 95% IC 1.26-4.74). In patients without known previous TD, high anti-TPO Abs level, even below the positivity cut-off, was a risk factor for developing DYSTHYR (adjusted OR 5.52; 95% IC 1.47-20.74). DYSTHYR was associated with a longer 12-month OS (87.3% vs 73.5%, p = 0.03); no statistically significant difference in terms of PFS was observed between the DYSTHYR+ and DYSTHYR- group. DYSTHYR is common during anti PD-1/anti PD-L1 treatment, especially in patients with pre-existing TD. In subjects without known previous TD, high anti-TPO Abs level at baseline can be a predictive biomarker of DYSTHYR. An improved OS is observed in patients with anti PD-1/anti PD-L1-induced DYSTHYR.

PMID:37103651 | DOI:10.1007/s10238-023-01082-5

Arch Orthop Trauma Surg. 2023 Apr 27. doi: 10.1007/s00402-023-04899-7. Online ahead of print.

ABSTRACT

INTRODUCTION: Previous reports using cadaveric knees and musculoskeletal computer simulation have shown that kinematically aligned (KA) total knee arthroplasty (TKA) provides more natural and physiological tibiofemoral kinematic patterns than mechanically aligned (MA) TKA. These reports suggested that the modification of joint line obliquity improve the knee kinematics. This study aimed to determine whether joint line obliquity change the intraoperative tibiofemoral kinematics in TKA candidates with knee osteoarthritis.

METHODS: Thirty consecutive knees with varus osteoarthritis that underwent TKA using a navigation system were evaluated. Two types of trial components were prepared: (1) MA TKA model: component trial in which articulating surface was parallel to the bone cut surface (2) KA TKA model: the femoral component trial, which mimicked the KA TKA method of Dossett et al. was designed 3° valgus and 3° internal rotation to the femoral bone cut surface, and the tibial component trial was designed 3° varus to the tibial bone cut surface. These two trials were set on the same knees during the operation, and the tibiofemoral rotational kinematics and varus-valgus laxity were measured from 0° to 120° of knee flexion using a navigation system.

RESULTS: The joint gap was 20 ± 2 mm and 3° ± 1° varus in extension and 20 ± 2 mm and 3° ± 1°varus in flexion. The differences in femoral component rotation between KA TKA and MA TKA were not statistically significant for any knee flexion angle. The differences in varus-valgus laxity between KA TKA and MA TKA were also not statistically significant for any knee flexion angle.

CONCLUSION: Although the degree of joint line obliquity varies widely in various KA TKA methods, this study, which mimicked the method of Dossett et al. showed that the modification of joint line obliquity did not change the tibiofemoral kinematics and stability of the knee joint in TKA candidates with knee osteoarthritis.

PMID:37103606 | DOI:10.1007/s00402-023-04899-7

Environ Monit Assess. 2023 Apr 27;195(5):618. doi: 10.1007/s10661-023-11195-9.

ABSTRACT

Climate change is of paramount importance for ecosystems, especially in arid and semi-arid areas. The major aim of the current study is to monitor vegetation and land use changes, and run drought assessment using field and satellite data. The main precipitation proportions in the studied region are influenced by the Westerlies, meaning that any variations in these precipitation systems significantly impact the region. The utilized data entailed MODIS images for 16- and 8-day intervals between 2000 and 2013, TM and OLI sensor images recorded in 1985 and 2013, precipitation network data of TRMM satellite between 2000 and 2013, and synoptic data 32-year period. The Mann-Kendall (MK) test was used to monitor temporal changes in meteorological station data in annual and seasonal scales. The results indicated that there was a downward trend in 50% of the meteorological stations in the annual scale. This falling trend was statistically significant at the level of 95%. At the end, drought was assessed using PCI, APCI, VSWI, and NVSWI. The results showed that vegetation, forest, pasture, and agriculture areas recorded the strongest correlations with initial precipitation at the beginning of the study. Based on interactions among various factors influencing vegetation indices, reduction in green vegetation, especially the area of oak forests in the studied period, is around 95,744 hectares, which is attributed to lower precipitation rate. Increasing of agricultural land and water zones during the studied years is the result of human management and depends on how surface and underground water resources are exploited.

PMID:37103605 | DOI:10.1007/s10661-023-11195-9

G Ital Cardiol (Rome). 2023 May;24(5):373-379. doi: 10.1714/4026.40011.

ABSTRACT

BACKGROUND: Update data regarding acute myocardial infarction (AMI)-related mortality in Italy remain scant. We assessed AMI-related mortality and time trends in Italy from 2007 to 2017 by using the Eurostat Mortality Database.

METHODS: The vital registration data of Italy from the publicly free-available OECD Eurostat website database were analyzed for the period between January 1, 2007 and December 31, 2017. Deaths reporting the codes I21 and I22 were extracted and analyzed according to the International Classification of Diseases 10th revision (ICD-10) coding system. Joinpoint regression was used to calculate nationwide annual trends in AMI-related mortality, determining the average annual percent change with 95% confidence intervals (CIs).

RESULTS: During the study period, 300 862 (132 368 men and 168 494 women) AMI-related deaths were recorded in Italy. Among 5-year age groups, AMI-related mortality increased with a seemingly exponential distribution. However, joinpoint regression analysis demonstrated a statistically significant linear decrease in age-standardized AMI-related mortality of -5.3 (95% CI -5.6, -4.9, p<0.0001) deaths per 100 000 individuals. A further sub-analysis, stratifying the population by gender, confirmed yielded results both in men (-5.7; 95% CI -6.3, -5.2, p<0.0001) and in women (-5.4; 95% CI -5.7, -4.8, p<0.0001).

CONCLUSIONS: The Italian age-adjusted mortality rates for AMI decreased over time, both in men and women.

PMID:37102350 | DOI:10.1714/4026.40011

J Neuroendocrinol. 2023 Apr;35(4):e13269. doi: 10.1111/jne.13269.

ABSTRACT

Pancreatic metastases (PMs) from neuroendocrine neoplasms (NENs) are rare but the increased sensitivity of new diagnostic tools such as ⁶⁸ Ga-DOTATATE PET/CT has resulted in their increased recognition at initial diagnosis or follow-up. A retrospective analysis of the data of patients from six tertiary referral centres was performed in order to identify the characteristics and the prognostic significance of PMs in patients with NENs. We used a control group of 69 age-, sex- and primary tumour – matched NEN patients from the same cohort with stage IV disease but no PMs. Overall survival (OS) was assessed using the Kaplan-Meier method log-rank analysis was used to assess the impact of various clinical and histopathological variables in OS. We identified 25 patients (11 females) with PMs with a median age at diagnosis of 60 years. The small intestine was the most common primary (80%) with a prevalence of 4.2% PMs (21/506). Fourteen patients presented with synchronous PMs whereas 11 developed metachronous PMs after a median time of 28 months (range: 7-168 months). Grading was available in 24 patients; 16 patients had G1 tumours, four G2, two atypical lung carcinoid, one typical and one atypical thymic carcinoid. Most patients had other concomitant metastases (12 hepatic, 4 lung and 6 bone) while five patients exhibited peritoneal carcinomatosis. Median OS in the PMs group was not reached compared with 212 months in the control group (95% CI: 26-398). The univariate analysis identified no prognostic factors statistically significantly associated with the OS. In conclusion, PMs are encountered with a low prevalence among NEN patients mostly developing in patients with advanced metastatic disease. The presence of PMs does not seem to be associated with a negative prognostic impact in OS.

PMID:37102337 | DOI:10.1111/jne.13269