Category: Statistics

Sci Total Environ. 2021 Jun 18;793:148483. doi: 10.1016/j.scitotenv.2021.148483. Online ahead of print.

ABSTRACT

Climate change is increasing winter temperatures across the planet, altering snowmelt hydrology. This study addresses a gap in snow research in non-alpine areas by examining changes to snow and winter and spring streamflow across most of the eastern US using daily observations from weather stations and stream gages from water years 1960-2019. These daily data were aggregated across drainage basins and classified winters with similar temperatures; differences between winters and both seasonal and annual trends were statistically quantified. Winters were classified as “warm” or “cool” in each drainage basin relative to the 60-year mean; analysis of the data indicates that warm winters occur more frequently in recent decades from an average of 0.39 to 3.96 warm winters/decade from the 1960’s to the 2010’s respectively. Those classifications were then used to examine changes in snowpack over the same period, which shows that warmer winters have on average 50.1 cm less annual snowfall, a reduced maximum snowpack depth by 14.4 cm, and 34 more bare ground days. These changes correlate with shifts to higher winter streamflows as well as peak basin yields that are 0.02 cm lower and occur three days earlier in warm winters. In addition to altered soil moisture and stream ecosystem dynamics, these snow and streamflow changes may have negative infrastructure and economic implications including impacts to winter tourism and agriculture.

PMID:34182450 | DOI:10.1016/j.scitotenv.2021.148483

In Vivo. 2021 Jul-Aug;35(4):2187-2196. doi: 10.21873/invivo.12490.

ABSTRACT

BACKGROUND/AIM: To date, multiple different surgical techniques have been established for hallux valgus surgery, with each technique having its unique advantages and limitations. The open distal chevron osteotomy is widely accepted, but increasing patient demands have led several minimally invasive (MIS) techniques to be described in recent years. The aim of this study was to compare outcomes after minimally invasive (MIS) distal chevron osteotomy and the minimally invasive Reverdin-Isham method.

PATIENTS AND METHODS: We assessed clinical and radiographic outcomes after MIS chevron osteotomy in 57 feet of 49 consecutive patients with a mean follow-up of 58.9 (range=39.0-85.4) months. Outcomes after MIS Reverdin-Isham osteotomy were analyzed by means of a systematic literature review with a minimum follow-up of 6 months.

RESULTS: Radiographic outcomes were significantly better in the MIS chevron cohort for intermetatarsal angle (p<0.001), hallux valgus angle and distal metacarpal articular angle (p<0.05). Concerning clinical outcomes, both methods provided comparable improvement.

CONCLUSION: MIS distal chevron osteotomy in mild to moderate hallux valgus deformity correction results in superior radiographic outcomes compared to the MIS Reverdin-Isham osteotomy. Sufficient correction of IMA cannot be achieved with the MIS Reverdin-Isham osteotomy.

PMID:34182496 | DOI:10.21873/invivo.12490

Environ Pollut. 2021 Jun 23;287:117643. doi: 10.1016/j.envpol.2021.117643. Online ahead of print.

ABSTRACT

The solar ultraviolet radiation (UVR) at national, provincial and county levels in Iran during 2005-2019 were determined based on Ozone Monitoring Instrument (OMI) dataset. The temporal (annual and monthly) trends and spatial distributions of the UVR in terms of erythemally weighted daily dose (EDD), erythemally weighted irradiance at local solar noon time (EDR), and UV index and the major factors influencing the spatiotemporal trends were analyzed. The population-weighted average values of EDD, EDR, and UV index in Iran were respectively 3631 J/m², 176.3 mW/m², 7.1 in 2005 and rose by 0.22% per year to 3744 J/m², 181.7 mW/m², and 7.3, respectively in 2019, but the annual trend was not statistically significant. The EDD in Iran during the study period exhibited the highest monthly average value in June (6339 J/m²) and the lowest one in December (1263 J/m²). The solar UVA/UVB ratios at the national level during 2005-2019 were considerably lower in summer. The EDD provincial average values in the study period were in the range of 2717 (Gilan) to 4424 J/m² (Fars). The spatiotemporal variations of the solar UVR parameters were well described by the linear models as a function of cloud optical thickness (COT), ozone column amount, surface albedo, latitude, and altitude (R² > 0.961, p value < 0.001) and the temporal changes of the solar UVR parameters were mainly caused by the COT. The results indicated that non-burning exposure to solar UVR in summer can be more efficient for vitamin D synthesis due to higher contribution of UVB in the solar UVR. The spatial distributions and temporal trends should be considered to determine the optimal duration, time and condition of exposure to the solar UVR for the public and occupational training and public health measures.

PMID:34182400 | DOI:10.1016/j.envpol.2021.117643

Eur J Obstet Gynecol Reprod Biol. 2021 Jun 20;263:117-126. doi: 10.1016/j.ejogrb.2021.06.021. Online ahead of print.

ABSTRACT

Women pregnant with a breech-presenting fetus at term are at an increased risk of adverse outcomes. Although the most common intervention is planned delivery by caesarean section, this is not always possible or desirable. Comparing alternative interventions is difficult due to heterogeneity in reported outcomes and their measurements. Additionally, the evidence, particularly for women in labour with a breech-presenting fetus, is very low quality, with several outcomes viewed as critical and important to decision-making not reported at all. There is a need to develop a core outcome set of minimum outcomes in all studies evaluating the effectiveness of interventions to improve outcomes associated with term breech birth (Breech-COS). Our objectives were to (1) identify outcomes currently reported in effectiveness studies of breech birth at term using a systematic review of the literature; (2) assess the methodological quality of outcome reporting in the included studies; and (3) engage with members of an established Patient and Public Involvement (PPI) group about the results, to help frame our understanding from the perspective of service users. We searched three databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials) for all effectiveness studies associated with vaginal breech birth published in English between 2000 and 2020. Two reviewers independently screened and extracted the data. Outcomes were categorised into neonatal, maternal, features of labour, and long-term maternal and hierarchy of outcome classification (primary, secondary, part of composite, or undesignated). Frequency of reporting was calculated for each. An adapted methodological assessment was done for each study investigating whether primary and secondary objectives were clearly stated and defined. The results of the systematic review were then discussed with a PPI group to consider importance and relevance to service users. A total of 211 outcomes were extracted from 108 included studies, comprising of short (43) and long-term (39) neonatal, short (54) and long-term (39) maternal and features of labour (36) outcomes. The most frequently reported outcome in each category was: APGAR score at 5 min, developmental vulnerability/neurological morbidity, maternal mortality, urinary incontinence, and actual mode of birth respectively. Long-term outcomes were infrequently reported in the included studies, with outcomes for future pregnancies not reported at all, although these were each deemed important by service users. There was a lack of consensus in definition and measurement of outcomes, with only 36% of the included studies having clearly stated primary and secondary objectives. The observed heterogeneity in reported outcomes, lack of consensus in definition and measurement, as well as desire expressed by service users to have robust risk statistics for outcomes important to them highlights the need to develop a core outcome set for evaluating effectiveness studies of breech birth at term. A Breech-COS will enable useful synthesis of evidence and contribute to supported decision-making for women pregnant with a breech-presenting fetus at term.

PMID:34182405 | DOI:10.1016/j.ejogrb.2021.06.021

Eur J Obstet Gynecol Reprod Biol. 2021 Jun 15;263:127-131. doi: 10.1016/j.ejogrb.2021.06.011. Online ahead of print.

ABSTRACT

OBJECTIVE: Short-term postoperative voiding dysfunction (POVD) is common in women undergoing surgery for pelvic organ prolapse. It results in increased catheter burden for patients and health services, and catheter-associated urinary tract infections (CAUTIs), thereby escalating the overall cost of treatment. Our aim was to determine the risk factors for voiding dysfunction following surgery for POP in our unit.

STUDY DESIGN: A retrospective case-control study conducted in a tertiary center in the U.K. The study cohort included all women who underwent surgery for pelvic organ prolapse between March 2017 and March 2019 and had a failed trial without catheter (TWOC). The control group comprised consecutive women on the surgical database who passed TWOC. Relevant data, including demographic details, past medical history, intraoperative and postoperative factors, were collected. We used the Chi-square test to calculate the statistical significance and multiple logistic regression analysis using SPSS software to identify the risk factors.

RESULTS: 286 surgeries were performed. After exclusion, 43 patients were included in each group. Baseline demographics were similar in both groups. The incidence of POVD was 15%, and none of our patients had long-term voiding problems. Logistic regression analysis identified five risk factors – advanced pelvic organ prolapse (OR = 2.654, p = 0.029), comorbidities (OR = 4.583, p = 0.019), preoperative anticholinergics and/or antidepressants (OR = 4.440, p = 0.004), sacrospinous hysteropexy/colpopexy (OR = 2.613, p = 0.041) and postoperative opioid use (OR = 3.529, p = 0.004).

CONCLUSION: We identified five risk factors to recognize the women who would benefit from advanced counseling and management plan following surgery for pelvic organ prolapse.

PMID:34182406 | DOI:10.1016/j.ejogrb.2021.06.011

Drug Alcohol Depend. 2021 Jun 24;225:108826. doi: 10.1016/j.drugalcdep.2021.108826. Online ahead of print.

ABSTRACT

BACKGROUND: Prenatal alcohol exposure (PAE) remains a potentially preventable, but pervasive risk factor to neurodevelopment. Yet, evidence is lacking on the impact of alcohol on brain development in toddlers. This study aimed to investigate the impact of PAE on brain white matter integrity in 2-3-year-old children.

METHODS: Children (n = 83, 30-37 months old) of the Drakenstein Child Health Study birth cohort, underwent diffusion MRI on a 3 T Siemens scanner during natural sleep. Parameters were extracted in children with PAE (n = 25, 56 % boys) and unexposed controls (n = 58, 62 % boys) using Tract-based Spatial Statistics, and compared by group. The contribution of maternal tobacco smoking to white matter differences was also explored.

RESULTS: Children with PAE had altered fractional anisotropy, radial diffusivity and axial diffusivity in brain stem, limbic and association tracts compared to unexposed controls. Notably lower fractional anisotropy was found in the uncinate fasciculus, and lower mean and radial diffusivity were found in the fornix stria terminalis and corticospinal tract (FDR corrected p < 0.05). There was a significant interaction effect of PAE and prenatal tobacco exposure which lowered mean, radial and axial diffusivity in the corticospinal tract significantly in the PAE group but not controls.

CONCLUSION: Widespread altered white matter microstructural integrity at 2-3 years of age is consistent with findings in neonates in the same and other cohorts, indicating persistence of effects of PAE through early life. Findings also highlight that prenatal tobacco exposure impacts the association of PAE on white matter alterations, amplifying effects in tracts underlying motor function.

PMID:34182371 | DOI:10.1016/j.drugalcdep.2021.108826

J Commun Disord. 2021 Jun 17;93:106138. doi: 10.1016/j.jcomdis.2021.106138. Online ahead of print.

ABSTRACT

INTRODUCTION: Studies have shown that many children with early language difficulties also have delays in social-emotional competencies as well as social-emotional and behavioral problems. It is unclear if these conditions are causally related, if they share a common underlying etiology, or if there are bidirectional effects. Studies investigating these associations have mostly involved children who are already using words to communicate, but it is important to know whether delays in preverbal communication and language development have any effects on these associations. The aim of the present study was to examine associations between preverbal communication and early verbal skills in infancy and subsequent social-emotional competencies and ensuing social-emotional and behavioral problems in early toddlerhood. The role of background factors known to influence early language development was also examined.

METHODS: The sample consisted of 395 children (51.6% boys) from the Finnish Steps Study cohort. Language was assessed at age 13 months (+ 1 month) with the MacArthur Communicative Development Inventory for Infants (CDI-I), and the social-emotional domain was assessed at age < 17 months with the Brief Infant-Toddler Social and Emotional Assessment (BITSEA).

RESULTS: Infants with lower preverbal gestural communication and receptive language skills had a higher risk of delays in social-emotional competencies in toddlerhood than children with better communication skills, but not of elevated social-emotional and behavioral problems.

CONCLUSIONS: The results indicate that lower early communication skills can predict delays in the development of social-emotional competencies, which has been found to be a risk factor for later development of social-emotional and behavioral problems. It is important to monitor early communication skills to provide guidance to parents in supporting early pragmatic communication and language development in infancy, if needed.

PMID:34182379 | DOI:10.1016/j.jcomdis.2021.106138

Sleep Med. 2021 Jun 11;84:259-267. doi: 10.1016/j.sleep.2021.06.002. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review and meta-analysis were conducted to study the prevalence and pattern of sleep disturbances in children and adolescents during the COVID-19 pandemic.

METHODS: MEDLINE, EMBASE, and Web of Science were searched for original studies describing sleep abnormalities in children and adolescents with or without pre-existing neurobehavioral disorders during the COVID-19 pandemic. The pooled estimates for various sleep abnormalities were calculated using a random-effect model.

RESULTS: Of 371 articles screened, 16 studies were included. Among these, five studies were in preschool children, two were in children with pre-existing neurobehavioral disorders and the remaining were in school going children and adolescents. The outcome measures used for sleep were markedly heterogeneous across the studies. The pooled prevalence of any sleep disturbance in children during the pandemic was 54%(95%CI:50-57%). Interestingly, the prevalence in pre-school children was lower than pre-pandemic times (RR = 0.87; 95% CI:0.58-1.30) but this was not statistically significant. The pooled prevalence of children not meeting sleep recommendation was 49% (95%CI: 39-58%).

CONCLUSION: The prevalence of sleep problems in children and adolescents during the COVID-19 pandemic is alarming. Pre-school children had a trend towards relatively fewer sleep disturbances due to home confinement measures in comparison with pre-pandemic times. Sleep duration recommendations were not met in nearly half of healthy children. However, these conclusions need to be seen in light of limited literature on the topic, few included studies done in heterogenous populations, and dubious quality of inferences drawn from these studies which were predominantly online surveys.

PROSPERO REGISTRATION ID: CRD42020213788.

PMID:34182354 | DOI:10.1016/j.sleep.2021.06.002

Food Chem. 2021 Jun 23;364:130434. doi: 10.1016/j.foodchem.2021.130434. Online ahead of print.

ABSTRACT

This study aimed to investigate the effects of polysaccharide from Artocarpus heterophyllus Lam. pulp (JFP-Ps) on gut microbiota composition and short-chain fatty acids production in mice. The microbial communities of V3 and V4 region 16S rRNA gene was amplified by PCR, then sequenced on an Illumina MiSeq PE250 platform and analyzed by multivariate statistical methods. The concentrations of short-chain fatty acids (SCFAs) were measured using gas chromatography (GC) equipped with a flame ionization detector (FID). The results showed that JFP-Ps significantly affected the levels of intestinal bacteria, including Bacteroidetes, Firmicutes, Proteobacteria, Cyanobacteria, Actinobacteria, Tenericutes, Deferribacteres and TM7. The concentrations of acetic acid, propionic acid, n-butyric acid and total SCFAs in mouse feces were significantly increased by treatment with JFP-Ps for 2 weeks. These results indicate that JFP-Ps is beneficial to the gut health and can be developed as a functional ingredient in relation to gut health.

PMID:34182368 | DOI:10.1016/j.foodchem.2021.130434

J Vet Emerg Crit Care (San Antonio). 2021 Jun 28. doi: 10.1111/vec.13088. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the relationship between various physical and clinicopathologic parameters and the capillary refill time (CRT) using a standard method; to evaluate the influence of emergency room (ER) versus ICU hospital location on CRT; and to identify latent subgroups among the CRT distribution.

DESIGN: Prospective, observational study.

SETTING: University teaching hospital.

ANIMALS: Client-owned dogs in the ER (n = 40) and ICU (n = 71).

INTERVENTIONS: The CRT was defined as the duration required for the oral mucosa of the upper lip to return to its original color after blanching for 4 seconds. The CRT was recorded in seconds to the 10ths place by a single observer using an automated recording device.

MEASUREMENTS AND MAIN RESULTS: Median CRT for all dogs was 1.1 seconds (ER, 1.2 s; ICU, 1.1 s; P = 1.000). The CRT was significantly associated with rectal temperature (P = 0.004), systolic blood pressure (P = 0.028), body weight (P = 0.031), mucous membrane color (P = 0.007), skin turgor (P = 0.039), and acute patient physiologic and laboratory evaluation mentation score (P = 0.019) for all dogs. The CRT was related to a greater number of variables in the ER than in the ICU patient population. In general, the total population of dogs had CRTs belonging to 1 of 2 groups: either ≤1.2 or ≥1.7 seconds. A statistically significant association was found between body weight CRT ≥1.3 seconds (P = 0.02).

CONCLUSIONS: A CRT following blanching for 4 seconds may provide insight into the hydration status and hemodynamic stability of canine patients. Further research into its clinical application is warranted.

PMID:34181819 | DOI:10.1111/vec.13088