Category: Statistics

J Artif Organs. 2023 Dec 11. doi: 10.1007/s10047-023-01421-z. Online ahead of print.

ABSTRACT

PURPOSE: We developed a method to measure the extracellular and intracellular fluid volumes using the kinetics of uric acid in the bodies of Japanese patients undergoing dialysis. In this research, we aimed to assess the prognosis of vascular events using this uric acid kinetic model method.

METHODS: We conducted a retrospective cohort study of 1,298 patients who were undergoing hemodialysis or predilution online hemodiafiltration at the end of December 2019 at 13 institutions in Japan. Information on vascular events was acquired in 2020. Vascular event prognosis was defined as the new incidence of one or more of the following four types of vascular events: myocardial infarction, cerebral infarction, cerebral hemorrhage, or limb amputation. We measured the extracellular fluid volume and intracellular fluid volume after dialysis using the uric acid kinetic model method and determined the association between ECV, ICV, and vascular event risk.

RESULTS: A high extracellular volume was substantially linked to an increased risk of vascular events. In addition, while a crude analysis revealed that a high intracellular volume was associated with a low risk of vascular events, this was not statistically significant after multifactorial adjustment. This result was partly affected by the low measurement accuracy of the serum urea nitrogen level used for the intracellular volume calculation.

CONCLUSIONS: Extracellular volume calculated using the uric acid kinetic model method is a prognostic factor for vascular events in patients undergoing hemodialysis.

PMID:38079049 | DOI:10.1007/s10047-023-01421-z

Environ Sci Pollut Res Int. 2023 Dec 11. doi: 10.1007/s11356-023-31356-0. Online ahead of print.

ABSTRACT

Due to the advancement of digital technology, the digital economy has developed rapidly, profoundly changing human production and lifestyles, thereby promoting the dual digital transformation of the energy supply and demand sides and having a profound impact on energy utilization efficiency. Based on measuring the total factor energy efficiency (TFEE) of 268 cities in China from 2011 to 2019, we analyze the total and indirect effects of the digital economy on TFEE using a mediated effects model and examine the effects of urban heterogeneity from the perspectives of geographical location, city size, and resource endowment. The results show that the digital economy has a significant positive contribution to TFEE. In addition, the digital economy can promote TFEE through industrial structure upgrading, technological innovation, and environmental regulation. The test results of the subsample show that there is significant heterogeneity in the impact and mechanism of action of the digital economy on TFEE in different geographical locations, city sizes, and resource endowments. By understanding how the digital economy impacts TFEE, policymakers can formulate effective policies to simultaneously accelerate digital economy development and improve TFEE.

PMID:38079047 | DOI:10.1007/s11356-023-31356-0

AMB Express. 2023 Dec 11;13(1):142. doi: 10.1186/s13568-023-01645-5.

ABSTRACT

Most antibiotics now used in clinical practice are cephalosporins. Acremonium (A.) chrysogenum W42-I is an intermediate strain out of W42 strain improvement program whose productivity is above that of the wild-type strain to produce the broad-spectrum antibacterial cephalosporin C (CPC). As a result, fermentation process optimization is considered because it offers the ideal environment for strains to reach their full potential. Our research aimed to combine a rational design to regulate the fermentation process environment and culture media as well as to develop mutants with high productivity. Different media were tested to obtain maximum CPC production. To maximize the production of CPC, some environmental parameters were experimentally optimized via the Box-Behnken design used for response surface methodology (RSM). There were 17 tests conducted, and each experiment’s reaction was recorded. Improvement of the CPC production was further achieved via mutagenesis using gamma radiation. Results revealed that a pH of 4, an incubation period of 4 days, and an inoculum size of 1% v/v using the optimized media (CPC2) were the optimum conditions for enhancing the CPC production by 4.43-fold. In addition, gamma irradiation further enhanced production to reach 3.46-fold using an optimum dose of 2 KGy. In conclusion, in comparison to initial production levels, CPC production increased 4.43-fold because of nutritional and environmental optimization. The mutant AC8 demonstrated a roughly 3.46-fold increase in activity against its parent type. Moreover, subsequent AC8 mutant culture demonstrated excellent genetic stability.

PMID:38079030 | DOI:10.1186/s13568-023-01645-5

J Assoc Res Otolaryngol. 2023 Dec 11. doi: 10.1007/s10162-023-00920-3. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Tinnitus would benefit from an objective biomarker. The goal of this study is to identify plasma biomarkers of constant and chronic tinnitus among selected circulating inflammatory proteins.

METHODS: A case-control retrospective study on 548 cases with constant tinnitus and 548 matched controls from the Swedish Tinnitus Outreach Project (STOP), whose plasma samples were examined using Olink’s Inflammatory panel. Replication and meta-analysis were performed using the same method on samples from the TwinsUK cohort. Participants from LifeGene, whose blood was collected in Stockholm and Umeå, were recruited to STOP for a tinnitus subtyping study. An age and sex matching was performed at the individual level. TwinsUK participants (n = 928) were selected based on self-reported tinnitus status over 2 to 10 years. Primary outcomes include normalized levels for 96 circulating proteins, which were used as an index test. No reference standard was available in this study.

RESULTS: After adjustment for age, sex, BMI, smoking, hearing loss, and laboratory site, the top proteins identified were FGF-21, MCP4, GDNF, CXCL9, and MCP-1; however, these were no longer statistically significant after correction for multiple testing. Stratification by sex did not yield any significant associations. Similarly, associations with hearing loss or other tinnitus-related comorbidities such as stress, anxiety, depression, hyperacusis, temporomandibular joint disorders, and headache did not yield any significant associations. Analysis in the TwinsUK failed in replicating the top candidates. Meta-analysis of STOP and TwinsUK did not reveal any significant association. Using elastic net regularization, models exhibited poor predictive capacity tinnitus based on inflammatory markers [sensitivity = 0.52 (95% CI 0.47-0.57), specificity = 0.53 (0.48-0.58), positive predictive value = 0.52 (0.47-0.56), negative predictive values = 0.53 (0.49-0.58), and AUC = 0.53 (0.49-0.56)].

DISCUSSION: Our results did not identify significant associations of the selected inflammatory proteins with constant tinnitus. Future studies examining longitudinal relations among those with more severe tinnitus and using more recent expanded proteomics platforms and sampling of cerebrospinal fluid could increase the likelihood of identifying relevant molecular biomarkers.

PMID:38079022 | DOI:10.1007/s10162-023-00920-3

Dysphagia. 2023 Dec 11. doi: 10.1007/s00455-023-10636-4. Online ahead of print.

ABSTRACT

The older population is growing exponentially causing greater demands on healthcare. Malnutrition, dysphagia, sarcopenia and weakness are highly prevalent diseases in the older population. Previous research (Byun et al. in BMC Geriatr 19(356):1-7, 2019; Fujishima et al. in Geriatr Gerontol Int 19:91-97, 2019; Hernandez et al. in Nutr Hosp 32(4):1830-1836, 2015; Nagano et al. in J Nutr Health Aging 23(3):256-265.5, 2019; Nishioka et al. in Clin Nutr 36(4):1089-1096, 2017; Robinson et al. in Clin Nutr 37(4):1121-1132, 2018, https://doi.org/10.1016/j.clnu.2017.08.016 ) has shown that these disorders are frequently associated, in many cases, preventable using screenings and intervention. This study utilized the National Hospital Discharge Survey of 2008 from the National Center of Health Statistics as secondary data to examine the associations amongst these four variables as well as possible correlations with age, days of care in the acute care hospital setting and frequency of rehabilitative and nutritional interventions received by these patients. Out of 165,630 cases, a sample size of 59,029 cases ages 65 and above were filtered by the researchers for desired diagnoses and procedure codes. After this, all neurological diagnoses were filtered and excluded by the researchers, resulting in 2458 cases. Using the Chi square test of independence, findings revealed significant associations between the variables of malnutrition and dysphagia (χ² (1) = 1882.618, p = 0.001), dysphagia and weakness (χ² (1) = 21.069, p = 0.001) and malnutrition weakness (χ² (1) = 88.434, p = 0.001). The point biserial correlation coefficient was calculated to examine possible associations between these four conditions and age as well as days of care. A significant negative correlation was found between malnutrition and age (rpb (2456) = – 0.043, p = 0.05). In addition, days of care were significantly correlated with malnutrition (r(2456) = 0.138, p = 0.001) and inversely significantly correlated with dysphagia (r(2456) = – 110, p = 0.001), weakness (r(2456) = – 0.060, p = 0.001) and sarcopenia (r(2456) = – 0.041, p = 0.05). Lastly, the study found a large disparity between cases that received rehabilitative and nutritional intervention and those that didn’t.

PMID:38078983 | DOI:10.1007/s00455-023-10636-4

Tech Coloproctol. 2023 Dec 11;28(1):9. doi: 10.1007/s10151-023-02874-3.

ABSTRACT

BACKGROUND: Laparoscopic and now robotic colorectal surgery has rapidly increased in prevalence; however, little is known about how uptake varies by region and sociodemographics. The aim of this study was to quantify the uptake of minimally invasive colorectal surgery (MIS) over time and variations by region, sociodemographics and ethnicity.

METHODS: Retrospective analysis of routinely collected healthcare data (Clinical Practice Research Datalink linked to Hospital Episode Statistics) for all adults having elective colorectal resectional surgery in England from 1 January 2006 to 31 March 2020. Sociodemographics between modalities were compared and the association between sociodemographic factors, region and year on MIS was compared in multivariate logistic regression analysis.

RESULTS: A total of 93,735 patients were included: 52,098 open, 40,622 laparoscopic and 1015 robotic cases. Laparoscopic surgery surpassed open in 2015 but has plateaued; robotic surgery has rapidly increased since 2017, representing 3.2% of cases in 2019. Absolute differences up to 20% in MIS exist between regions, OR 1.77 (95% CI 1.68-1.86) in South Central and OR 0.75 (95% CI 0.72-0.79) in the North West compared to the largest region (West Midlands). MIS was less common in the most compared to least deprived (14.6% of MIS in the most deprived, 24.8% in the least, OR 0.85 95% CI 0.81-0.89), with a greater difference in robotic surgery (13.4% vs 30.5% respectively). Female gender, younger age, less comorbidity, Asian or ‘Other/Mixed’ ethnicity and cancer indication were all associated with increased MIS.

CONCLUSIONS: MIS has increased over time, with significant regional and socioeconomic variations. With rapid increases in robotic surgery, national strategies for procurement, implementation, equitable distribution and training must be created to avoid worsening health inequalities.

PMID:38078978 | DOI:10.1007/s10151-023-02874-3

Eur J Nucl Med Mol Imaging. 2023 Dec 11. doi: 10.1007/s00259-023-06526-4. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the feasibility of reducing the acquisition time for continuous dynamic positron emission tomography (PET) while retaining acceptable performance in quantifying kinetic metrics of 2-[¹⁸F]-fluoro-2-deoxy-D-glucose ([¹⁸F]FDG) in tumors.

METHODS: In total, 78 oncological patients underwent total-body dynamic PET imaging for ≥ 60 min, with 8, 20, and 50 patients receiving full activity (3.7 MBq/kg), half activity (1.85 MBq/kg), and ultra-low activity (0.37 MBq/kg) of [¹⁸F]FDG, respectively. The dynamic data were divided into 21-, 30-, 45- and ≥ 60-min groups. The kinetic analysis involved model fitting to derive constant rates (V_B, K₁ to k₃, and Ki) for both tumors and normal tissues, using both reversible and irreversible two-tissue-compartment models. One-way ANOVA with repeated measures or the Freidman test compared the kinetic metrics among groups, while the Deming regression assessed the correlation of kinetic metrics among groups.

RESULTS: All kinetic metrics in the 30-min and 45-min groups were statistically comparable to those in the ≥ 60-min group. The relative differences between the 30-min and ≥ 60-min groups ranged from 12.3% ± 15.1% for K₁ to 29.8% ± 30.0% for V_B, and those between the 45-min and ≥ 60-min groups ranged from 7.5% ± 8.7% for Ki to 24.0% ± 24.3% for V_B. However, this comparability was not observed between the 21-min and ≥ 60-min groups. The significance trend of these comparisons remained consistent across different models (reversible or irreversible), administrated activity levels, and partial volume corrections for lesions. Significant correlations in tumor kinetic metrics were identified between the 30-/45-min and ≥ 60-min groups, with Deming regression slopes > 0.813. In addition, the comparability of kinetic metrics between the 30-min and ≥ 60-min groups were established for normal tissues.

CONCLUSION: The acquisition time for dynamic PET imaging can be reduced to 30 min without compromising the ability to reveal tumor kinetic metrics of [¹⁸F]FDG, using the total-body PET/CT system.

PMID:38078950 | DOI:10.1007/s00259-023-06526-4

Acta Vet Hung. 2023 Dec 11. doi: 10.1556/004.2023.00878. Online ahead of print.

ABSTRACT

Calprotectin (CP) is an inflammatory marker. The aim of the current study was to investigate oxidative stress and changes in CP in cattle with traumatic reticuloperitonitis (TRP). The study was divided into two groups, experimental (TRP) and healthy control group, with 10 animals in each group. Total leucocyte count, neutrophil and lymphocyte counts were higher in the TRP group compared to the control group and this increase was statistically significant (P < 0.001). The level of malondialdehyde (MDA) in TRP group was statistically significantly higher than the control group (P < 0.001). The level of glutathione (GSH) in the TRP group was statistically significantly lower than in the control group (P < 0.001). Serum Amyloid A (SAA) and CP values were higher in the TRP group and this difference was statistically significant (P < 0.001). It was concluded as a result of ROC analysis that CP, which has similar values with SAA, can be used diagnostically to confirm the inflammatory status in cattle with TRP.

PMID:38078926 | DOI:10.1556/004.2023.00878

Endocr Connect. 2023 Dec 1:EC-23-0363. doi: 10.1530/EC-23-0363. Online ahead of print.

ABSTRACT

OBJECTIVE: Pituitary dysfunction following mild traumatic brain injury can have serious physical and psychological consequences making diagnosis and treatment essential. To the best of our knowledge, this study is the first to study the prevalence of pituitary dysfunction following mild traumatic brain injury in an all-female population following detailed endocrinological work up after screening for pituitary dysfunction in female athletes.

DESIGN: Retrospective cohort study.

METHODS: Hormone screening blood tests, including serum blood values for thyroid-stimulating hormone, free thyroxin, insulin-like growth factor 1, prolactin, cortisol, follicle stimulating hormone, luteinizing hormone, oestrogen, and progesterone were taken in 133 female athletes. Results were repeatedly outside the reference value in 88 women necessitating further endocrinological evaluation. Two of those were lost to follow up and further endocrinological evaluation was performed in 86 participants.

RESULTS: Six women (4.6%, n = 131) were diagnosed with hypopituitarism, four (3.1%) with central hypothyroidism and two with growth hormone deficiency (1.5%). Ten women (7.6%) had hyperprolactinemia, four (3.1%) of them had prolactinoma. Medical treatment was initiated in 13 (9.9%) women. Significant prognostic factors were not found.

CONCLUSIONS: As 12.2% of female athletes with a history of mild traumatic brain injury had pituitary dysfunction (hypopituitarism 4.6%, hyperprolactinemia 7.6%), we conclude that pituitary dysfunction is an important consideration in post-concussion care. Hyperprolactinemia in the absence of prolactinoma may represent pituitary or hypothalamic injury following mild traumatic brain injury.

PMID:38078923 | DOI:10.1530/EC-23-0363

Traffic Inj Prev. 2023 Dec 11:1-9. doi: 10.1080/15389588.2023.2287405. Online ahead of print.

ABSTRACT

Objective: Develop corridor-level network screening models to identify high-risk corridors where safety improvements could be implemented to reduce fatal and injury (FI) crashes. Methods: A novel corridor definition focused on context classification and lane count was developed and applied to urban and suburban four-lane divided arterial roadways in Florida. Negative binomial regression models were developed for multi- and single-vehicle crashes using 80% of the corridors (training set). Crash frequency predictions were obtained from the developed corridor models and similar site-level models from the Highway Safety Manual (HSM) models for the remaining 20% of the corridors (testing set). Results from all models were adjusted using the empirical Bayes (EB) method. Results: A total of 130 corridors were identified across seven counties. These corridors contained approximately 349 km (217 miles) of roadway and experienced 11,437 multi-vehicle and 746 single-vehicle crashes that resulted in fatalities or injuries from 2017 to 2021. After applying the HSM site-level models and the developed corridor-level models to the testing set (both with and without EB adjustments), the corridor-level models with EB adjustments were the most accurate for corridor crash prediction. Applying the corridor-level models with EB adjustments to the testing set gave a predicted value of 386.44 crashes/year, which was the closest to the observed crash frequency of 383.20 crashes/year. From the corridor-level models, a 3.48-km (2.16-mile) high-risk corridor in Miami-Dade County was identified and analyzed site-by-site using the HSM methodology to identify specific sites within the corridor where safety improvements could provide the most FI crash reductions. Conclusions: The corridor-level models were more accurate and statistically reliable than similar HSM models while being less data intensive. They also only required corridor-level data rather than data for each intersection and segment. By using readily available data, the methods in this paper can be easily replicated by agencies to develop their own network screening corridor-level models and expedite the identification of corridors in need of safety improvements to reduce FI crashes. Existing site-level network screening methods can be used to supplement the developed corridor-level methodology by identifying high-risk sites within identified high-risk corridors.

PMID:38078886 | DOI:10.1080/15389588.2023.2287405