Category: Statistics

Environ Sci Pollut Res Int. 2022 Jan 27. doi: 10.1007/s11356-021-18247-y. Online ahead of print.

ABSTRACT

Up to now, information about biogeochemistry of many trace elements is scarce. Meanwhile, all the elements are always present in soil and plants. It may be suggested that the trace elements also play certain role in the biogeochemical processes. The aim of the research was to study bioaccumulation of poorly investigated trace elements (scandium, cerium, europium, hafnium, and tantalum) and well-known elements (chromium, iron, cobalt, zinc, and arsenic) in two crops, oats and barley, and examine how these elements interact with each other as they absorbed by plants. The plants were grown in the soils that differed in their parameters and in level of contamination. Although oats and barley are botanically similar and were grown under the same conditions, the plants differed in the ability to accumulate many elements. The uptake of the elements by the plants also depended on type of soil. For example, concentrations of Cr, Fe, Co, As, Sc, Ce, Eu, Hf, and Ta in roots of the oats grown in slightly contaminated soil were much higher as compared to the concentrations of the elements in roots of the barley grown in the same soil. In leaves of the oats grown in moderately contaminated soil, the concentrations of Cr, As, Ce, Eu, and Ta were statistically significantly higher than those in leaves of the barley grown in the soil. In soils and in plants, relationships between elements were both similar and different. A statistically significant correlation was found between the poorly investigated trace elements and well-studied elements.

PMID:35083671 | DOI:10.1007/s11356-021-18247-y

Environ Sci Pollut Res Int. 2022 Jan 27. doi: 10.1007/s11356-021-18196-6. Online ahead of print.

ABSTRACT

Epidemiological studies found that exposure to air pollution increases cardiovascular hospitalizations. However, studies on rural-urban differences in associations between hospitalizations for cardiovascular diseases and air pollution are limited. The generalized linear model (GLM) was applied to investigate the associations between cardiovascular hospitalizations and air pollution (SO₂, NO₂, PM_2.5, PM₁₀, CO, and O₃) in Guangxi, southwest China, in 2015 (January 1-December 31). The relative risk of pollutants (SO₂, NO₂) on cardiovascular hospital admissions was significantly different between urban and rural areas. The effect of SO₂ on cardiovascular hospitalizations was higher in urban areas than in rural areas at lag0 to lag3 and cumulative lag01 to lag03. In urban areas, there were positive associations between NO₂ and cardiovascular hospitalizations at lag0, lag1 and cumulative lag01, lag02. In contrast, the effect of NO₂ on cardiovascular hospitalizations was not significant in rural areas. Urban residents were more sensitive than rural residents to SO₂ and NO₂. Subgroup analyses showed statistically significant differences between rural and urban areas in the association between SO₂ and NO₂ and cardiovascular hospitalizations for males. For age groups, people aged ≥ 65 years appeared to be more vulnerable to SO₂ and NO₂ in urban areas. The effects of PM_2.5 PM₁₀, CO, and O₃ on cardiovascular hospitalizations were consistently negative for all groups. Our findings indicated that there were rural-urban differences in associations between cardiovascular hospitalizations and air pollutants. In rural areas, the risk of cardiovascular hospitalizations was mainly influenced by SO₂. Therefore, we expect to pay attention to protecting people from air pollution, particularly for those aged ≥ 65 years in urban areas.

PMID:35083669 | DOI:10.1007/s11356-021-18196-6

Psychiatr Q. 2022 Jan 27. doi: 10.1007/s11126-021-09970-3. Online ahead of print.

ABSTRACT

The United States (US) has a culturally diverse population. However, the percentage of underrepresented minorities (URMs) and women in healthcare does not fully reflect their current and future demographics. Our objective was to explore and forecast the gender and racial trends in the US addiction psychiatry fellowship programs. A retrospective analysis was performed using data from Accreditation Council for Graduate Medical Education (ACGME) Resource Books which encompassed US addiction psychiatry fellows from 2007 to 2020. Simple linear and multiple regression were used to predict the 2030 addiction psychiatry workforce. White (Non-Hispanic) and Asian/Pacific Islander had a relative change of -2.8% and -26.1% from 2011 to 2020, respectively. Black (non-Hispanic) had a relative change of + 5.2%. Hispanic and Native American/Alaskan had no relative change during this time. From 2007 to 2020, women’s representation relatively decreased by 10.9%. Statistically, these dynamic trends of the addiction psychiatry workforce will continue to exist in 2030. Women and URM addiction psychiatrists play an effective role in addressing substance use disorders (SUD). Unfortunately, the current gender and racial disparities in addiction psychiatry will exist in the future. Understanding the continued gender and racial bias in addiction psychiatry fellowships and devising appropriate recommendations can help mitigate the existing disparities.

PMID:35083646 | DOI:10.1007/s11126-021-09970-3

J Gen Intern Med. 2022 Jan 26. doi: 10.1007/s11606-021-07193-7. Online ahead of print.

ABSTRACT

BACKGROUND: Access to primary care was hindered by the coronavirus disease 2019 (COVID-19) pandemic.

OBJECTIVE: Evaluate changes in health screening rates before and during the pandemic.

DESIGN: Retrospective analysis of health maintenance and disease management screening rates among primary care patients before and during the pandemic.

PARTICIPANTS: Over 150,000 patients of a large, academic health system.

MAIN MEASURES: Six quality measures were analyzed: colon cancer, breast cancer, cervical cancer, diabetes Hgb A1C, diabetes eye, and diabetes nephropathy monitoring. Based on US Preventative Services Task Force screening guidelines, we determined which patients were due for at least one of the quality measures. We tracked completion rates during three time periods: pre-pandemic (January 1-March 3, 2020), stay-at-home (March 4-May 8, 2020), and phased reopening (May 9-July 8, 2020). Differences in quality measure completion rates were evaluated using mixed-effects logistic regression models.

KEY RESULTS: Compared to pre-pandemic rates, completion of all health screenings declined during the stay-at-home period: mammograms (OR: 0.34; 95% CI: 0.31-0.37), cervical cancer (OR: 0.83; 95% CI: 0.76-0.91), colorectal cancer (OR: 0.25; 95% CI: 0.23-0.28), diabetes eye (OR: 0.34; 95% CI: 0.29-0.41), diabetes Hgb A1c (OR: 0.41; 95% CI: 0.37-0.46), and diabetes nephropathy (OR: 0.46, 95% CI: 0.41-0.53). During phased reopening, completion of all quality measures increased compared to the stay-at-home period, except for cervical cancer screening (OR: 0.83; 95% CI: 0.76-0.92). There was a persistent reduction in completion of all quality measures, except for diabetic nephropathy monitoring (OR: 0.99; 95% CI: 0.89-1.09), during phased reopening compared to pre-pandemic.

CONCLUSIONS: Healthcare screening rates were reduced during the early part of the COVID-19 pandemic and did not fully recover to pre-pandemic rates by July 2020. Future research should aim to clarify the long-term impacts of delayed health screenings. New interventions should be considered for expanding remote preventative health services.

PMID:35083647 | DOI:10.1007/s11606-021-07193-7

Proteomics. 2022 Jan 26:e2100137. doi: 10.1002/pmic.202100137. Online ahead of print.

ABSTRACT

As the resident immune cells in the central nervous system, microglia play an important role in the maintenance of its homeostasis. Dysregulation of microglia has been associated with the development and maintenance of chronic pain. However, the relevant molecular pathways remain poorly defined. In this study, we used a mass spectrometry-based proteomic approach to screen potential changes of histone protein modifications in microglia isolated from the brain of control and cisplatin-induced neuropathic pain adult C57BL/6J male mice. We identified several novel microglial histone modifications associated with pain including statistically significantly decreased histone H3.1 lysine 27 mono-methylation (H3.1K27me1, 54.8% of control) and lysine 56 tri-methylation (7.5% of control), as well as a trend suggesting increased histone 3 tyrosine 41 nitration. We further investigated the functional role of H3.1K27me1 and found that treatment of cultured microglial cells for 4 consecutive days with 1-10 μM of NCDM-64, a potent and selective inhibitor of lysine demethylase 7A, an enzyme responsible for the demethylation of H3K27me1, dose-dependently elevated its levels with a greater than a 2-fold increase observed at 10 μM compared to vehicle-treated control cells. Moreover, pre-treatment of mice with NCDM-64 (10 or 25 mg/kg/day, i.p.) prior to cisplatin treatment prevented the development of neuropathic pain in mice. The identification of specific chromatin marks in microglia associated with chronic pain may yield critical insight into the contribution of microglia to the development and maintenance of pain, and opens new avenues for the development of novel non-opioid therapeutics for the effective management of chronic pain. This article is protected by copyright. All rights reserved.

PMID:35081661 | DOI:10.1002/pmic.202100137

Appl Clin Inform. 2022 Jan;13(1):123-131. doi: 10.1055/s-0041-1741479. Epub 2022 Jan 26.

ABSTRACT

BACKGROUND: Following the implementation of a new electronic health record (EHR) system at Columbia University Irving Medical Center (CUIMC), the demands of the novel coronavirus disease 2019 (COVID-19) pandemic forced an abrupt reallocation of resources away from EHR adoption. To assist staff in focusing on techniques for improving EHR utilization, an optimization methodology was designed referencing the Consolidated Framework for Implementation Research (CFIR) approach.

METHODS: The study was performed using a methodology that comprised of two primary components as follows: (1) analysis of qualitative and quantitative data and (2) participation of frontline staff in project work groups. Working groups mapped out the current state of the identified workflows, designed and implemented interventions, monitored the effectiveness of each intervention, and scaled the proposed changes.

RESULTS: As a result of the optimization methodology, clinical and operational workflows improved in the pilot department. Operationally, the pilot department increased enrollment of patients in the virtual patient portal by 20%, increased schedule utilization by 25%, and reduced average check-in time by 19%. Clinically, the pilot department had a statistically significant increase in dictation and NoteWriter tool note composition from their baseline month to their observed month. Compared with the control department, the pilot department had a statistically significant increase in SmartTool and dictation note composition. The control department showed smaller increases, and in some cases a decline in performance, in these areas of operational and clinical workflows.

CONCLUSION: The CFIR framework helped design an optimization methodology by applying a set of constructs to support effective organizational optimization, accounting for inner and outer settings. Through this methodology, the inner setting was supported in leading the identification and execution of interventions targeted to impact the outer setting. The phase-1 data at CUIMC suggest this strategy is effective in identifying opportunities, implementing interventions and creating a scalable process for continued organizational optimization.

PMID:35081654 | DOI:10.1055/s-0041-1741479

Z Geburtshilfe Neonatol. 2022 Jan 26. doi: 10.1055/a-1727-6309. Online ahead of print.

ABSTRACT

OBJECTIVE: Cystatin C (Cys-C) concentration has not been examined sufficiently among healthy newborn population, particularly in terms of reference values. This study aimed to establish gender-, postnatal age- and birth weight-specific Cys-C concentration for healthy term newborns. Its objective was also to examine if there were any differences between our measured concentration and the reference interval established by the CALIPER study.

METHODS: Serum samples from a total of 90 healthy term newborns were used to determine Cys-C concentration. Cys-C was measured within first three days of birth using particle-enhanced turbidimetric immunoassay (PETIA) on the Architect plus ci8200 analyzer.

RESULTS: Median concentration of the Cys-C was 2.05 mg/L. There were no statistically significant differences in Cys-C concentration regarding gender (p=0.779), birth weight (p=0.505), postnatal age (p=0.512) or Apgar score (p=0.799). The value of the 2.5th and 97.5th percentile for Cys-C concentrations for girls was 0.93-3.15 mg/L and for boys it was 1.5-3.36 mg/L.

CONCLUSION: Cys-C concentration in healthy term newborns does not depend on gender, birth weight, postnatal age, or Apgar score. Our measured concentration range of CyS-C in healthy newborns turned out to be slightly wider than the interval determined in the CALIPER study.

PMID:35081646 | DOI:10.1055/a-1727-6309

Rofo. 2022 Jan 26. doi: 10.1055/a-1717-2703. Online ahead of print.

ABSTRACT

PURPOSE: Evaluation of machine learning-based fully automated artery-specific coronary artery calcium (CAC) scoring software, using semi-automated software as a reference.

METHODS: A total of 505 patients underwent non-contrast-enhanced calcium scoring computed tomography (CSCT). Automated, machine learning-based software quantified the Agatston score (AS), volume score (VS), and mass score (MS) of each coronary artery [right coronary artery (RCA), left main (LM), circumflex (CX) and left anterior descending (LAD)]. Identified CAC of readers who annotated the data with semi-automated software served as a reference standard. Statistics included comparisons of evaluation time, agreement of identified CAC, and comparisons of the AS, VS, and MS of the reference standard and the fully automated algorithm.

RESULTS: The machine learning-based software correlated strongly with the reference standard for the AS, VS, and MS (Spearman’s rho > 0.969) (p < 0.001), with excellent agreement (ICC > 0.919) (p < 0.001). The mean assessment time of the reference standard was 59 seconds (IQR 39-140) and that of the automated algorithm was 5.9 seconds (IQR 3.9-16) (p < 0.001). The Bland-Altman plots mean difference and 1.96 upper and lower limits of agreement for all arteries combined were: AS 0.996 (1.33 to 0.74), VS 0.995 (1.40 to 0.71), and MS 0.995 (1.35 to 0.74). The mean bias was minimal: 0.964-1.0429. Risk class assignment showed high accuracy for the AS in total (weighed κ = 0.99) and for each individual artery (κ = 0.96-0.99) with corresponding correct risk group assignment in 497 of 505 patients (98.4 %).

CONCLUSION: The fully automated artery-specific coronary calcium scoring algorithm is a time-saving procedure and shows excellent correlation and agreement compared with the clinically established semi-automated approach.

KEY POINTS: · Very high correlation and agreement between fully automatic and semi-automatic calcium scoring software.. · Less time-consuming than conventional semi-automatic methods.. · Excellent tool for artery-specific calcium scoring in a clinical setting..

CITATION FORMAT: · Winkelmann MT, Jacoby J, Schwemmer C et al. Fully Automated Artery-Specific Calcium Scoring Based on Machine Learning in Low-Dose Computed Tomography Screening. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1717-2703.

PMID:35081651 | DOI:10.1055/a-1717-2703

J Trauma Acute Care Surg. 2022 Jan 25. doi: 10.1097/TA.0000000000003549. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to assess pain and Quality of Life (QoL) outcomes in patients with multiple painful displaced fractured ribs with and without operative fixation. Rib fractures are common and can lead to significant pain and disability. There is minimal level 1 evidence for rib fixation in non-ventilator dependent patients with chest wall injuries. We hypothesized that surgical stabilization of rib fractures (SSRF) would reduce pain and improve QoL over 6 months.

METHODS: A prospective multi-centre randomised controlled trial comparing rib fixation to non-operative management of non-ventilated patients with at least three consecutive rib fractures. Inclusion criteria were rib fracture displacement and/or ongoing pain. Pain (McGill Questionnaire) and QoL (Short Form 12) at 3 and 6 months post injury were assessed. Surgeons enrolled patients in whom they felt there was clinical equipoise. Patients who were deemed to need surgical fixation, or who were deemed to be too well to be randomized to rib fixation were not enrolled.

RESULTS: 124 patients were enrolled at four sites between 2017 and 2020. 61 patients were randomised to operative management and 63 to non-operative management. No differences were seen in the primary endpoint of Pain Rating Index at 3 months, nor in the QoL measures. Return-to-work rates improved between 3 and 6 months, favouring the operative group.

CONCLUSIONS: In this study no improvements in pain or QoL at 3 and 6 months in patients undergoing rib fixation for non-flail, non-ventilator dependent rib fractures have been demonstrated.

LEVELS OF EVIDENCE: Level 1 Therapeutic.

PMID:35081599 | DOI:10.1097/TA.0000000000003549

Am J Epidemiol. 2022 Jan 27:kwac006. doi: 10.1093/aje/kwac006. Online ahead of print.

ABSTRACT

Simplified drug regimens may improve retention in care for chronic diseases. In April 2013, South Africa adopted a once-daily single-pill HIV treatment regimen as standard-of-care, replacing a multiple-pill regimen. Because the regimens had similar biological efficacy, the shift to single-pill therapy offers a real-world test of the impact of simplified drug delivery mechanisms on patient behavior. Using a quasi-experimental regression discontinuity design, we assessed retention in care among patients starting HIV treatment just before and just after the guideline change. The study included 4484 patients starting treatment at a large public sector clinic in Johannesburg, South Africa. The share of patients prescribed a single-pill regimen increased by over 40 percentage points between March and April 2013. Initiating after the policy change was associated with 11.7 percentage points higher retention at 12 months (95% CI: -2.2, 29.4). Findings were robust to different measures of retention, different bandwidths, and different statistical models. Patients starting treatment early in HIV infection – a key population in the test-and-treat era – experienced the greatest improvements in retention from single-pill regimens.

PMID:35081613 | DOI:10.1093/aje/kwac006