Categories
Nevin Manimala Statistics

Taxonomy of the Trichophyton mentagrophytes/T. interdigitale Species Complex Harboring the Highly Virulent, Multiresistant Genotype T. indotineae

Mycopathologia. 2021 Apr 13. doi: 10.1007/s11046-021-00544-2. Online ahead of print.

ABSTRACT

A severe outbreak of highly virulent and multi-resistant dermatophytosis by species in the Trichophyton mentagrophytes/T. interdigitale complex is ongoing in India. The correct identity of the etiologic agent is a much-debated issue. In order to define species limits, a taxonomic study was undertaken combining molecular, morphological, and physiological characteristics as evidence of classification. Molecular characteristics show that T. mentagrophytes s. str. and T. interdigitale s. str. can be distinguished with difficulty from each other, but are unambiguously different from the Indian genotype, T. indotineae by sequences of the HMG gene. The entities were confirmed by multilocus analysis using tanglegrams. Phenotypic characters of morphology and physiology are not diagnostic, but statistically significant differences are observed between the molecular siblings. These properties may be drivers of separate evolutionary trends. Trichophyton mentagrophytes represents the ancestral, homothallic cloud of genotypes with a probable geophilic lifestyle, while T. indotineae and T. interdigitale behave as anthropophilic, clonal offshoots. The origin of T. indotineae, which currently causes a significant public health problem, is zoonotic, and its emergence is likely due to widespread misuse of antifungals.

PMID:33847867 | DOI:10.1007/s11046-021-00544-2

Categories
Nevin Manimala Statistics

Systematic Review and Meta-Analysis of the Impact of Bariatric Surgery on Lower Urinary Tract Symptoms in Males

Obes Surg. 2021 Apr 13. doi: 10.1007/s11695-021-05403-z. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity is a chronic disease with multisystem morbidity. There are multiple studies reporting the effect of bariatric surgery on cardiovascular and metabolic disease, but few examine its impact on lower urinary tract symptoms. This article aims to perform a systematic review with meta-analysis, to determine the effects of bariatric surgery on lower urinary tract symptoms in male patients.

METHODS: Medline, Embase, conference proceedings, and reference lists were searched for studies reporting the quantitative measurement of lower urinary tract symptoms score pre- and postweight loss surgery. The primary outcome was International Prostate Symptom Score (IPSS) before and after bariatric surgery. Secondary outcomes were changed in body mass index (BMI) and total body weight (TBW). Weighted mean differences (MD) were calculated for continuous outcomes.

RESULTS: Seven studies were included in the analysis of 334 patients undergoing bariatric surgery. Mean study follow-up was between 3 and 36 months. IPSS score ranged from 3-12.7 preoperatively and 1.9-6.9 postoperatively. There was a statistically significant improvement in the IPSS score following bariatric surgery (MD 2.82, 95% CI 0.96 to 4.69, p=0.003). Bariatric surgery also resulted in statistically significant reduction of BMI and TBW.

CONCLUSION: Bariatric surgery produces a significant improvement on lower urinary tract symptoms in men with obesity. This may be due to improvement of insulin sensitivity, testosterone levels or lipid profile associated with weight loss.

PMID:33847876 | DOI:10.1007/s11695-021-05403-z

Categories
Nevin Manimala Statistics

Evaluating the impacts of on-site sanitation facilities and saltwater intrusion on shallow groundwater quality in peri-urban communities of Cape Coast, Ghana

Environ Monit Assess. 2021 Apr 13;193(5):264. doi: 10.1007/s10661-021-09059-1.

ABSTRACT

Populations in peri-urban communities of Sub-Saharan Africa frequently depend on shallow aquifers and on-site sanitation facilities concurrently. Routinely, domestic wells end up too close to toilet facilities, risking groundwater contamination. For coastal communities, saltwater intrusion adds to the risk of groundwater contamination. This study assessed both risks in five peri-urban communities of Cape Coast, Ghana. Groundwater samples collected from 40 domestic wells were analyzed for physicochemical and microbial constituents. Multivariate statistics including hierarchical cluster analysis (HCA) and principal component analysis (PCA) were used to classify and link contaminants to potential sources. Results indicate high enteric bacteria contamination in 98% of the samples, as well as high enrichment in physicochemical constituents, tied largely to impacts of on-site sanitation facilities. We found that wells located within 25 m of septic tanks/toilet facilities contained higher contaminant loads than those without such facilities within 25 m of their locations. Similarly, for wells located close to point sources, the closer the water table is below the land surface (within 2 m), the higher the contaminant loads. Lastly, using molar ratios of Cl/HCO3 and Na+/Cl with R-mode HCA, the study isolated a few wells, located within 2 km of the coastline, that are experiencing effects of saltwater intrusion. Overall, this study provides useful information for aiding groundwater quality mitigation policy, and the baseline data for aiding future investigations in the study area. It also has broader policy implications for other peri-urban settings throughout Ghana and the entire Sub-Saharan Africa.

PMID:33847837 | DOI:10.1007/s10661-021-09059-1

Categories
Nevin Manimala Statistics

Rainfall in Brazilian Northeast via in situ data and CHELSA product: mapping, trends, and socio-environmental implications

Environ Monit Assess. 2021 Apr 13;193(5):263. doi: 10.1007/s10661-021-09043-9.

ABSTRACT

Rainfall is a climatic variable that dictates the daily rhythm of urban areas in Northeastern Brazil (NEB) and, therefore, understanding its dynamics is fundamental. The objectives of the study were (i) to validate the CHELSA product with data in situ, (ii) assess the spatial-temporality of the rains, and (iii) assess the trends and socio-environmental implications in the Metropolitan Region of Maceió (MRM). The monthly rainfall data observed between 1960 and 2016 were flawed and were filled with the imputation of data. These series were subjected to descriptive and exploratory statistics, statistical indicators, and the Mann-Kendall (MK) and Pettitt tests. CHELSA product was validated for MRM, and all stations obtained satisfactory determination coefficients (R2) and Pearson correlation (r). The standard error of the estimate (SEE), root mean square error (RMSE), and mean absolute error (MAE) were satisfactory. The highest annual rainfall accumulated occurred near the Mundaú and Manguaba lagoons. The Pettitt test identified that abrupt changes occur in El Niño and La Niña years (strong and weak). The monthly rain boxplots showed high variability in the rainy season (April-July). Outliers have been associated with extreme rainfall at MRM. The drought period was 5 months in all MRM seasons, except in Satuba and Pilar. The Mann-Kendall test and the Sen method showed a tendency for a significant increase in rainfall in Satuba and not significant in the Pilar, while in the others, there was a tendency for a decrease in rainfall. The MRM rainfall depends on physiographic factors, multiscale meteorological systems, and the coastal environment. These results will assist in planning conservationist practices, especially in areas of socio-environmental vulnerability.

PMID:33847840 | DOI:10.1007/s10661-021-09043-9

Categories
Nevin Manimala Statistics

Lifetime occupational exposure proportion estimation methods: a sensitivity analysis in the general population

Int Arch Occup Environ Health. 2021 Apr 13. doi: 10.1007/s00420-021-01691-1. Online ahead of print.

ABSTRACT

OBJECTIVE: To present a sensitivity analysis of the most widely used means of estimating lifetime occupational exposure proportion (LOEP) and their respective impacts on LOEP and population-attributable fraction (PAF) estimates.

METHODS: A French population-based sample with full job history (N = 10,010) was linked with four Matgéné job-exposure matrices: flour, cement, silica and benzene. LOEP and the 95% confidence interval were estimated using four methods: the maximum exposure probability during the career (Proba_max), two methods subdividing careers into job-periods (job-period_M1, job-period_M2) and one into job-years (job-year). To quantify differences between methods, percentages of variation were calculated for proportion values and PAF, and compared with published results for France using cross-sectional proportion multiplied by a factor.

RESULTS: For each agent, LOEP estimated from the maximum probability during the career (Proba_max) was consistently lower than proportion taking account of job-periods or job-years. LOEP on Proba_max for flour, cement, silica and benzene were, respectively, 4.4% 95% CI (4.0-4.7), 4.3% (3.9-4.6), 6.1% (5.7-6.5) and 3.9% (3.6-4.2). Percentage of variation ranged from 0 to 55.8% according to the agent. The number of cancer cases varied by a twofold factor for exposure to silica and lung cancer and by a fourfold factor for exposure to benzene and acute myeloid lymphoma.

CONCLUSIONS: The present study provides a description of several LOEP estimation methods based on exposure assessment over the entire career and describes their impact on PAF. For health monitoring purposes, we recommend to report a range of LOEP with low and high estimates obtained using job-periods (job-period_M1 and job-period_M2).

PMID:33847787 | DOI:10.1007/s00420-021-01691-1

Categories
Nevin Manimala Statistics

Postmortem coronary artery calcium score in cases of myocardial infarction

Int J Legal Med. 2021 Apr 13. doi: 10.1007/s00414-021-02586-z. Online ahead of print.

ABSTRACT

Sudden cardiac death (SCD) related to atherosclerotic coronary artery disease (ACAD) resulting in myocardial infarction is the most prevalent cause of death in western countries. In clinical practice, coronary artery calcium score (CACS) is considered an independent predictor of coronary events, closely related to atherosclerotic burden and is quantified radiologically by the Agatston score being calculated through computed tomography. Postmortem computed tomography (PMCT) allows the visualization and quantification of coronary calcifications before the autopsy. However, it was reported that some patients who died from severe ACAD had a zero CACS in PMCT. In this study, a retrospective evaluation of CACS in adult’s myocardial infarction cases related to ACAD, with available CACS and histological slides of coronary arteries, was performed in order to gain a deeper understanding of coronary calcifications and their role in myocardial infarction cases. The CACS was calculated by using the software Smartscore 4.0 after the radiological examination on a 64-row CT unit using a specific cardiac protocol. Thirty-six cases were identified out of 582 autopsies, recorded during a 2-year study period (29 men, 7 women; age 56.3 ± 11.7). CACS was 0-10 in 5 cases (5 men, 44.8 ± 13.7), 11-100 in 8 cases (6 men, 2 women, 53.1 ± 7.7), 101-400 in 13 cases (11 men, 2 women, 57.4 ± 9.6), and > 400 in 10 cases (9 men, 1 woman, 63.1 ± 11.9). Coronary thrombosis was found in 28 cases, histologically identified as plaque erosions in 6 cases and as plaque ruptures in 22 cases. Statistical analyses showed that CACS increases significantly with age (p-value < 0.05) and does not show significant correlation with gender, body weight, body mass index, and heart weight. CACS was significantly higher in plaque ruptures than in plaque erosions (p-value < 0.01). Zero or low CACS on unenhanced PMCT cannot exclude the presence of myocardial infarction related to ACAD. This paradoxical discrepancy between imaging and autopsy findings can be explained considering the histological aspect of fatal coronary plaques.

PMID:33847801 | DOI:10.1007/s00414-021-02586-z

Categories
Nevin Manimala Statistics

Two people, one graph: the effect of rotated viewpoints on accessibility of data visualizations

Cogn Res Princ Implic. 2021 Apr 13;6(1):31. doi: 10.1186/s41235-021-00297-y.

ABSTRACT

In co-located, multi-user settings such as multi-touch tables, user interfaces need to be accessible from multiple viewpoints. In this project, we investigated how this goal can be achieved for depictions of data in bar graphs. We designed a laboratory task in which participants answered simple questions based on information depicted in bar graphs presented from differently rotated points of view. As the dependent variable, we measured differences in response onsets relative to the standard viewpoint (i.e., upright graphs). In Experiment 1, we manipulated graph and label orientation independently of each other. We observed that rotations of the labels rather than rotations of the graph itself pose a challenge for accessing depicted information from rotated viewpoints. In Experiment 2, we studied whether replacing word labels with pictographs could overcome the detrimental effects of rotated labels. Rotated pictographs were less detrimental than rotated word labels, but performance was still worse than in the unrotated baseline condition. In Experiment 3, we studied whether color coding could overcome the detrimental effects of rotated labels. Indeed, for multicolored labels, the detrimental effect of label rotation was in the negligible range. We discuss the implications of our findings for the underlying psychological theory as well as for the design of depicted statistical information in multi-user settings.

PMID:33847833 | DOI:10.1186/s41235-021-00297-y

Categories
Nevin Manimala Statistics

Squaring Things Up With R2: What it is, What it Can (and cannot) Tell You

J Anal Toxicol. 2021 Apr 13:bkab036. doi: 10.1093/jat/bkab036. Online ahead of print.

ABSTRACT

The coefficient of correlation (r) and the coefficient of determination (R2 or r2) have long been used in analytical chemistry, bioanalysis and forensic toxicology as figures demonstrating linearity of the calibration data in method validation. We clarify here what these two figures are and why they should not be used for this purpose in the context of model fitting for prediction. R2 evaluates whether the data are better explained by the regression model used than by no model at all (i.e., a flat line of slope = 0 and intercept $bar y$), and to what degree. Hopefully, in the context of calibration curves, the fact that a linear regression better explains the data than no model at all should not be a point of contention. Upon closer examination, a series of restrictions appear in the interpretation of these coefficients. They cannot indicate whether the dataset at hand is linear or not, because they assume that the regression model used is an adequate model for the data. For the same reason, they cannot disprove the existence of another functional relationship in the data. By definition, they are influenced by the variability of the data. The slope of the calibration curve will also change their value. Finally, when heteroscedastic data are analyzed, the coefficients will be influenced by calibration levels spacing within the dynamic range, unless a weighted version of the equations is used. With these considerations in mind, we suggest to stop using r and R2 as figures of merit to demonstrate linearity of calibration curves in method validations. Of course, this does not preclude their use in other contexts. Alternative paths for evaluation of linearity and calibration model validity are summarily presented.

PMID:33847757 | DOI:10.1093/jat/bkab036

Categories
Nevin Manimala Statistics

The effect of pessary treatment on puborectalis muscle function

Int Urogynecol J. 2021 Apr 13. doi: 10.1007/s00192-021-04766-2. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: The objective was to assess if puborectalis muscle (PRM) function changes in women with pelvic organ prolapse (POP) undergoing pessary treatment.

METHODS: This was a prospective cohort study of women with symptomatic POP choosing pessary treatment. An interview, clinical examination and 3D/4D transperineal ultrasound were performed at baseline and at 3-month follow-up. POP was assessed using the Pelvic Organ Prolapse Quantification system (POPQ). Parameters compared between baseline and follow-up were: hiatal area at rest (HArest), maximal contraction (HActx), and maximal Valsalva maneuver (HAVal), displacement in contraction (DISPL-ctx, i.e., relative difference between HArest and HActx), and displacement in Valsalva (DISPL-Val, i.e., relative difference between and HAVal and HArest). Parameters were compared in women with and those without complete avulsion.

RESULTS: A total of 162 women were assessed and 34 were included. Mean age was 64 years (SD 11.4), and mean BMI 24 kg/m2 (SD 3.1). Thirty-one women had a cystocele, 8 a uterine prolapse, and 12 had a posterior compartment prolapse. Twenty-one women (61.8%) had a POP stage II, and 13 (38.2%) a POP stage III. Ring pessaries were most frequently used (97%). In the entire group a statistically significant increase in DISPL-ctx was observed (mean difference 2.1%, p = 0.017). In the no avulsion group HArest and DISPL-ctx increased significantly (mean difference 4.1%, p = 0.016 and 2.7%, p = 0.016 respectively) and the increase in DISPL-ctx was higher than in the avulsion group (mean difference 2.7% vs 0.2%, p = 0.056).

CONCLUSION: Our results show that PRM function changes in women with POP undergoing pessary treatment and suggest that such change occurs mainly in the absence of complete avulsion.

PMID:33847771 | DOI:10.1007/s00192-021-04766-2

Categories
Nevin Manimala Statistics

The ratio and difference of urine protein-to-creatinine ratio and albumin-to-creatinine ratio facilitate risk prediction of all-cause mortality

Sci Rep. 2021 Apr 12;11(1):7851. doi: 10.1038/s41598-021-86541-3.

ABSTRACT

The role of the difference and ratio of albuminuria (urine albumin-to-creatinine ratio, uACR) and proteinuria (urine protein-to-creatinine ratio, uPCR) has not been systematically evaluated with all-cause mortality. We retrospectively analyzed 2904 patients with concurrently measured uACR and uPCR from the same urine specimen in a tertiary hospital in Taiwan. The urinary albumin-to-protein ratio (uAPR) was derived by dividing uACR by uPCR, whereas urinary non-albumin protein (uNAP) was calculated by subtracting uACR from uPCR. Conventional severity categories of uACR and uPCR were also used to establish a concordance matrix and develop a corresponding risk matrix. The median age at enrollment was 58.6 years (interquartile range 45.4-70.8). During the 12,391 person-years of follow-up, 657 deaths occurred. For each doubling increase in uPCR, uACR, and uNAP, the adjusted hazard ratios (aHRs) of all-cause mortality were 1.29 (95% confidence interval [CI] 1.24-1.35), 1.12 (1.09-1.16), and 1.41 (1.34-1.49), respectively. For each 10% increase in uAPR, it was 1.02 (95% CI 0.98-1.06). The linear dose-response association with all-cause mortality was only observed with uPCR and uNAP. The 3 × 3 risk matrices revealed that patients with severe proteinuria and normal albuminuria had the highest risk of all-cause mortality (aHR 5.25, 95% CI 1.88, 14.63). uNAP significantly improved the discriminative performance compared to that of uPCR (c statistics: 0.834 vs. 0.828, p-value = 0.032). Our study findings advocate for simultaneous measurements of uPCR and uACR in daily practice to derive uAPR and uNAP, which can provide a better mortality prognostic assessment.

PMID:33846379 | DOI:10.1038/s41598-021-86541-3