Category: Statistics

Aliment Pharmacol Ther. 2022 Aug 16. doi: 10.1111/apt.17191. Online ahead of print.

ABSTRACT

BACKGROUND: Autoimmune hepatitis (AIH) may coexist with metabolic syndrome-associated diseases (MSADs) given patients’ inherent need for corticosteroid therapy, as well as general population trends.

AIM: To examine the impact of MSAD risk factors on AIH or its treatment, and vice versa METHODS: This was a multi-centre retrospective cohort study of 552 patients with AIH diagnosed between January 2000 and December 2019. Data relating to demographic factors, laboratory values, AIH medications and MSADs were collected at diagnosis and at 1- and 3-year follow-up. Statistical relationships were analysed and reported.

RESULTS: We included 552 patients in the study cohort (median age 50 years, 76.1% female). All MSADs, including hypertension, dyslipidaemia, diabetes and a gain of BMI ≥3 kg/m² , increased within the AIH cohort over time. Initial treatment regimen impacted de novo diabetes but not other MSAD development. AIH biochemical remission was less frequent at 3 years post-diagnosis among patients with ≥1 MSAD. The incidence of new MSADs could be predicted by baseline factors in certain cases.

CONCLUSION: In the largest US-based cohort of patients newly diagnosed with AIH, there was a considerable burden of pre-existing and de novo MSADs that may affect AIH treatment outcomes. Identifying those at highest risk of co-morbid MSADs allows for an individualised approach to management to reduce its long-term sequelae in patients with AIH.

PMID:35971856 | DOI:10.1111/apt.17191

Allergy. 2022 Aug 16. doi: 10.1111/all.15480. Online ahead of print.

ABSTRACT

BACKGROUND: Asthma is a heterogeneous disease with several phenotypes, endotypes and severity degrees, in which different T cell subpopulations are involved. These cells express specific miRNAs (i.e., inflamma-miRs) that can be released to serum in exosomes after activation and be used as biomarkers of underlying inflammation. Thus, we aim to evaluate specific T cell miRNA signatures in serum exosomes from different subgroups of asthmatic patients.

METHODS: Samples from healthy donors (N=30) and patients (N=119) with different asthma endotypes (T2^high -Atopic/T2^high -Non atopic/T2^low ) and severity degrees (mild/MA and moderate-severe/MSA) were used. Demographic, clinical, haematological and biochemical characteristics were collected. Twelve miRNAs previously associated with different Th subsets were preselected and their levels in serum exosome samples were measured using RTqPCR.

RESULTS: We detected five miRNAs with high confidence in serum exosomes: miR-16-5p, miR-21-5p, miR-126-3p, miR146a-5p, and miR-215-5p. All of them, except miR-16-5p were upregulated in MSA patients compared to MA. A logistic regression model including each of these miRNAs was created to discriminate both conditions, rendering a ROC curve AUC of 0.896 (0.830-0.961). miR-21-5p and miR-126-3p, both involved in Th1/Th2 differentiation, were specifically augmented in T2^high -Atopic patients. Of note, all these changes were found in samples collected in autumn. On the other hand, IL-6^high patients with MSA, which were more obese, older, with higher neutrophil and basophil counts and TNF levels, displayed a decrease of miR-21-5p, miR-126-3p, and miR-146a-5p.

CONCLUSION: Immune-related miRNAs, including miR-21-5p, miR-126-3p, miR-146a-5p, and miR-215-5p can be used as clinically relevant non-invasive biomarkers of the phenotype/endotype and severity of asthma.

PMID:35971848 | DOI:10.1111/all.15480

Am Surg. 2022 Aug 16:31348221121547. doi: 10.1177/00031348221121547. Online ahead of print.

ABSTRACT

BACKGROUND: Frailty is associated with adverse surgical outcomes including post-operative complications, needs for post-acute care, and mortality. While multiple frailty screening tools exist, most are time and resource intensive. Here we examine the association of an automated electronic frailty index (eFI), derived from routine data in the Electronic Health Record (EHR), with outcomes in vascular surgery patients undergoing open, lower extremity revascularization.

METHODS: A retrospective analysis at a single academic medical center from 2015 to 2019 was completed. Information extracted from the EHR included demographics, eFI, comorbidity, and procedure type. Frailty status was defined as fit (eFI≤0.10), pre-frail (0.10<eFI≤0.21), and frail (eFI>0.21). Outcomes included length of stay (LOS), 30-day readmission, and non-home discharge.

RESULTS: We included 295 patients (mean age 65.9 years; 31% female), with the majority classified as pre-frail (57%) or frail (32%). Frail patients exhibited a higher degree of comorbidity and were more likely to be classified as American Society of Anesthesiologist class IV (frail: 46%, pre-frail: 27%, and fit: 18%, P = 0.0012). There were no statistically significant differences in procedure type, LOS, or 30-day readmissions based on eFI. Frail patients were more likely to expire in the hospital or be discharged to an acute care facility (31%) compared to pre-frail (14%) and fit patients (15%, P = 0.002). Adjusting for comorbidity, risk of non-home discharge was higher comparing frail to pre-frail patients (OR 3.01, 95% CI 1.40-6.48).

DISCUSSION: Frail patients, based on eFI, undergoing elective, open, lower extremity revascularization were twice as likely to not be discharged home.

PMID:35971786 | DOI:10.1177/00031348221121547

J Card Surg. 2022 Aug 16. doi: 10.1111/jocs.16840. Online ahead of print.

ABSTRACT

BACKGROUND: Outcomes of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in patients with aortic stenosis and bicuspid aortic valve (BAV) must be better investigated.

METHODS: A meta-analysis including studies published by January 2022 reporting immediate outcomes (in-hospital death, stroke, acute kidney injury [AKI], major bleeding, new permanent pacemaker implantation [PPI], paravalvular leakage [PVL]), mortality in the follow-up (with Kaplan-Meier curves for reconstruction of individual patient data).

RESULTS: Five studies met our eligibility criteria. No statistically significant difference was observed for in-hospital death, stroke, AKI, and PVL. TAVI was associated with lower risk of major bleeding (odds ratio [OR]: 0.29; 95% confidence interval [CI]: 0.12-0.69; p = .025), but higher risk of PPI (OR: 2.00; 95% CI: 1.05-3.77; p = .041). In the follow-up, mortality after TAVI was significantly higher in the analysis with the largest samples (HR: 1.24, 95% CI: 1.01-1.53, p = .043), but no statistically significant difference was observed with risk-adjusted populations (HR: 1.06, 95% CI: 0.86-1.32, p = .57). Landmark analyses suggested a time-varying risk with TAVI after 10 and 13 months in both largest and risk-adjusted populations (HR: 2.13, 95% CI: 1.45-3.12, p < .001; HR: 1.7, 95% CI: 1.11-2.61, p = .015, respectively).

CONCLUSION: Considering the immediate outcomes and comparable overall survival observed in risk-adjusted populations, TAVI can be used safely in selected BAV patients. However, a time-varying risk is present (favoring SAVR over TAVI at a later timepoint). This finding was likely driven by higher rates of PPI with TAVI.

PMID:35971783 | DOI:10.1111/jocs.16840

Huan Jing Ke Xue. 2022 Aug 8;43(8):4199-4211. doi: 10.13227/j.hjkx.202112133.

ABSTRACT

Taking the Jianghugongmi producing area as the research object, As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn in the soil of the study area were sampled and determined. The correlation of heavy metals was discussed using the multivariate statistical method, the spatial distribution interpolation analysis of heavy metals was carried out using ArcGIS 10.2, the quantitative source analysis of heavy metal pollution was carried out using the enrichment factor (EF) and PMF methods, and the potential ecological risk was evaluated. The results showed that the contents of the soil heavy metals As, Cd, Cu, Hg, Pb, and Zn were lower than the screening values specified in the standard for soil pollution risk control of agricultural land (GB 15618-2018), and the soil ecological environment risk was low; the maximum values of Cr and Ni exceeded the risk screening values, but the risk was low. The main distribution range of pH in the study area was 6.05-6.69, which was suitable for rice growth. The Mohe River indicated the spatial distribution of pH and heavy metals, which was closely related to the supergene geochemical characteristics of the elements. However, Hg and Cd showed different spatial distribution characteristics under human influence. Hg was distributed in the middle and high value distribution area along the west side of the river, and the spatial distribution of Cd was significantly different from north to south. The quantitative source analysis results based on the EF method and PMF showed that the main sources of heavy metals in the study area were agricultural sources, mixed sources, coal sources, and natural sources. The contribution rates of various sources accounted for 24.2%, 35.4%, 9.5%, and 30.9%, respectively. The medium strong ecological risk points of Hg in the study area were distributed along the west side of the Mohe River, whereas the moderate potential ecological risk points of Cd were concentrated in the cultivated land on both sides of the Mohe River, and the potential ecological risk index (E_r) of the other elements was<40. Cd and Hg were the main potential ecological risk elements in the study area, whereas Cd was still the main potential pollution element in the cultivated land soil in the study area.

PMID:35971717 | DOI:10.13227/j.hjkx.202112133

Huan Jing Ke Xue. 2022 Aug 8;43(8):4179-4189. doi: 10.13227/j.hjkx.202109180.

ABSTRACT

Shizuishan is a typical exhausted resources-based city in the northern area of the Ningxia Hui autonomous region in China. In order to develop the planting industry of selenium (Se)-rich agricultural products and promote green and sustainable urban development and transformation, investigations on the quality of Se-rich land were carried out in Shizuishan City, where 7399 surface soil (0-20 cm) samples of farmlands, 30 atmospheric precipitation samples, and nine parent rocks were collected. By means of semi variogram model construction by GS⁺, Kriging interpolation in ArcGIS and statistics via SPSS, such as correlation analysis and mean-value analysis, the content, spatial distribution, and enrichment factors of Se-soil were analyzed. Further, the enrichment characteristics of soil Se in alkaline conditions were summarized. The results indicated that ω(Se) in surface soil was (0.26±0.12) mg·kg^-1, and its spatial distribution was highly auto-correlated. The variation in Se content was related to natural factors. Along Helan Mountain, the content of Se in the surface soil was comparatively higher than that where coal mines were located. The parent rock was the principal factor that controlled the enrichment of soil Se. The physical and chemical properties of soil such as organic material, pH, and iron and manganese oxides had crucial effects on the enrichment of soil Se in a surficial environment. Compared to a strong alkaline environment, alkaline conditions were beneficial for the enrichment of Se in the surface soil.

PMID:35971715 | DOI:10.13227/j.hjkx.202109180

Huan Jing Ke Xue. 2022 Aug 8;43(8):4054-4063. doi: 10.13227/j.hjkx.202110174.

ABSTRACT

The pollution source identification methods based on traditional water quality monitoring and pollutant discharge loading typically require a high frequency of monitoring and generate a level of uncertainty in the identification results, owing to their limitations on the accurate and quantitative assessment of pollution source identification, migration, and transformation. This study combined multivariate statistical analysis and stable isotope technology to identify groundwater pollution sources in a typical multiple land-use area of the Chengdu Plain. A positive matrix factorization (PMF) model was adopted to reduce the interference of mass environmental factors on source identification and to determine the main factors influencing groundwater quality. Subsequently, a Bayesian stable isotope mixing model was developed to quantify the apportionment of each pollution source to groundwater nitrate (NO₃^–) with the consideration of hydro-chemical and land-use information. The results showed that the concentrations of NO₃^–, NO₂^–, NH₄⁺, Mn, Fe, SO₄^2-, and Cl^– in groundwater of the study area exceeded the standard to different extents, presenting spatial variation. The main form of inorganic nitrogen in groundwater was NO₃^–. In general, concentrations of groundwater NO₃^– were the highest in vegetable fields (9.29 mg·L^-1 on average), followed by livestock and poultry breeding farms (7.66 mg·L^-1) and arable land (7.09 mg·L^-1), whereas concentrations of groundwater NO₃^– in industrial areas were the lowest (2.20 mg·L^-1). Groundwater quality in the study area was affected by geological processes, agricultural activities, hydrogeochemical evolution, and domestic and industrial discharges. Agricultural activities were the main contributor to the increase in groundwater NO₃^– in the study area. Chemical fertilizer (32%) and soil nitrogen (25%) contributed greatly to groundwater NO₃^– in agricultural areas, whereas sewage (28%) and atmospheric precipitation (27%) contributed most groundwater NO₃^– in industrial areas. Thus, the combination of multivariate statistical analysis and stable isotope technology could identify groundwater pollution sources and their apportionment effectively, providing scientific support for the prevention and control of groundwater pollution.

PMID:35971703 | DOI:10.13227/j.hjkx.202110174

Huan Jing Ke Xue. 2022 Aug 8;43(8):4042-4053. doi: 10.13227/j.hjkx.202110065.

ABSTRACT

Based on the measured water quality data of Huangyuan County, Huzhu Tu Autonomous County, and Minhe Hui Tu Autonomous County in Hehuang Valley of Qinghai province in the normal and wet seasons, the effects of land use and land cover patterns on regional seasonal water quality were analyzed using remote sensing technology and mathematical statistics. The results showed that:① the concentrations of total nitrogen and total phosphorus in the surface water of Hehuang Valley were high. Water pollution areas (Class Ⅳ and Ⅴ) were mainly concentrated in the lower reaches of the river and the junction of tributaries. ② The explanation rate of land use to water quality in the normal season was higher than that in the wet season. The optimal scale was the 200 m buffer scale in the normal season, and farmland and towns were the main influencing factors. The optimal scale in the wet season was the 5 km buffer scale, and the main influencing factor was the forest. ③ In the normal season, the proportion of farmland was positively correlated with the concentration of total nitrogen and permanganate index but negatively correlated with the concentration of total phosphorus. The proportion of town area was positively correlated with the water quality index. The proportion of grassland area in the wet season was positively correlated with the permanganate index. The proportion of forestland area was negatively correlated with water quality index in both periods. Farmland, grassland, and town areas were the “source” landscape of pollutants, but farmland also played a role in intercepting pollutants to a certain extent. Forest land was the “sink” landscape of pollutants. ④ The pattern of forestland in the 200 m buffer zone in the normal season had a high explanatory rate for water quality, and the largest patch index (LPI) and patch density (PD) were the main factors. The study showed that it is an important measure to purify the surface water quality of Hehuang Valley by rationally planning the proportion of residential land and cultivated land and improving the coverage rate and aggregation degree of forestland around the riparian zone.

PMID:35971702 | DOI:10.13227/j.hjkx.202110065

Huan Jing Ke Xue. 2022 Aug 8;43(8):4008-4017. doi: 10.13227/j.hjkx.202111172.

ABSTRACT

As sediment is an essential component of rivers, the enrichment of heavy metals in sediment presents a serious threat to the aquatic environment. Many industrial cities are located along the Yellow River, and heavy metal pollution is a prominent problem in these areas. Thus, the study of heavy metal pollution in sediments of the Yellow River basin is of vital significance to the safety of the Yellow River basin ecosystem. In this study, we collected data on the concentrations of heavy metals (Pb, Cd, Cr, As, Zn, Cu, Ni, and Hg) in the sediments of the Yellow River basin from 2000 to 2020. We first analyzed the spatial distribution characteristics of heavy metals based on descriptive statistics and geostatistics and then used the Monte Carlo method to evaluate the probability of the ground accumulation index(I_geo), potential ecological risk, and toxicity units. Finally, the number of pollution sources and their contribution rates were determined by combining the positive definite matrix factor (PMF) decomposition model and Pearson correlation analysis. It was found that the mean values of ω(Pb), ω(As), ω(Zn), ω(Ni), ω(Cu), ω(Hg), ω(Cr), and ω(Cd) in the Yellow River basin sediments were 26.92, 11.78, 87.17, 31.13, 24.96, 0.07, 73.36, and 0.58 mg·kg^-1, which exceeded the mean soil background values in the Yellow River basin provinces by 1.27, 1.08, 1.26, 1.05, 1.09, 2.32, 1.14, and 5.95 times, respectively, among which Cd exceeded the standard by the largest factor and should be taken seriously. The I_geo was ranked as Cd>Hg>Cr>Cu>Pb>Zn>As>Ni, and Cd and Hg showed medium-severe pollution. The proportions of heavy ecological risk in sediments in the upper, middle, and lower reaches of the Yellow River basin were 18.6%, 15.7%, and 7.1%, respectively, with a decreasing trend. Heavy metals in the sediments of the Yellow River basin were in a low-toxicity state. The PMF-Pearson correlation analysis showed that the four sources of heavy metals in the Yellow River basin sediments were mining sources (42.2%), natural activities (38.3%), agricultural activities (11.6%), and electroplating wastewater (7.9%). The results of this study can provide a basis for developing relevant pollution prevention and control measures in the Yellow River basin.

PMID:35971699 | DOI:10.13227/j.hjkx.202111172

Huan Jing Ke Xue. 2022 Aug 8;43(8):3966-3976. doi: 10.13227/j.hjkx.202111145.

ABSTRACT

The ozone concentration characteristics of 13 cities in Beijing-Tianjin-Hebei regions from 2016 to 2020 were analyzed based on ecological environment monitoring and meteorological observation data. The influence of meteorological elements such as daily maximum temperature (T_max), daily average ground pressure (p), daily average ground relative humidity (RH), and daily average ground wind speed (v) on ozone concentration[ρ(O₃-8h)] and the exceeding standard rate of O₃-8h were discussed. The AQI, ozone concentration range, and ozone pollution level forecast accuracy rates were evaluated using the neural network statistical model. The results showed that the concentrations of O₃-8h-90per[ρ(O₃-8h-90per)] of 13 cities in the Beijing-Tianjin-Hebei region from 2016 to 2020 were 157.4, 177.2, 177.3, 190.6, and 175.6 μg·m^-3, respectively. The regional ozone concentration increased by 11.6% over the five years from 2016 to 2019. From 2016 to 2019, there was an overall upward trend in volatility, followed by a decline in 2020. Compared with that in 2016, the concentration of O₃-8h-90per in the other 10 cities increased by 6-45.5 μg·m^-3, except for in Beijing, Zhangjiakou, and Chengde, where it decreased slightly. The average value of ρ(O₃-8h) from April to September was higher than 100 μg·m^-3, and the highest monthly average concentration of O₃-8h was 158.10 μg·m^-3 in June. The range of the over standard rate of O₃-8h was 8.6%-19.2% in the 13 cities, and 97.8% of ozone concentrations exceeded the standard in the period from April to September. At the regional scale, the concentration of O₃-8h had the strongest correlation with the daily maximum temperature. Furthermore, when T_max was in the range of 25-28℃, the concentration of O₃-8h in the 13 cities began to exceed the standard concentration of 160 μg·m^-3. Additionally, the concentration of O₃-8h negatively correlated with p. When RH was below 60%, ozone concentration increased slowly with relative humidity in most cities. When RH was above 61%-70%, ozone concentration decreased with the increase in daily relative humidity in most cities. When ozone exceeded the standard concentration of 160 μg·m^-3, the dominant wind was mainly southerly wind, and the high ozone concentration in most cities tended to be concentrated in the low wind speed range of 2-3 m·s^-1 and below. Moreover, the correlation coefficient range of the statistical model of OPAQ 1-9 days in advance was 0.72-0.86, the average accuracy of AQI level forecasts was 67%-86%, and the average accuracy of O₃-8h concentration forecasts was 63%-84%. In April to September, when ozone exceeded the standard of 160 μg·m^-3, the accuracy rates of the model forecast of light ozone pollution and ozone exceeding the standard concentration of 160 μg·m^-3three days in advance were 69% and 66%, which can provide a reference for the management and control of ozone pollution.

PMID:35971695 | DOI:10.13227/j.hjkx.202111145