Category: Statistics

Gait Posture. 2021 Jun 8;88:240-246. doi: 10.1016/j.gaitpost.2021.06.005. Online ahead of print.

ABSTRACT

BACKGROUND: Barriers to successful return to previous level of activity following Anterior Cruciate Ligament Reconstruction (ACLR) are multifactorial and recent research suggests that athletic performance deficits persist after completion of the rehabilitation course in a large percentage of patients.

RESEARCH QUESTION: Do technology-based biomechanical assessments reveal underneath differences in both recreational and competitive athletes in Return to Play after ACL-Reconstruction?

METHODS: Thirty soccer athletes (26.9 ± 5.7 years old, male) with ACL injury were surgically treated with all-inside technique and semitendinosus tendon autograft. Before 2 years from surgery, they were called back for clinical examination, self-reported psychological scores, and biomechanical outcomes (balance, strength, agility and velocity, and symmetry). Athletes were classified into recreational (n = 15) and competitive (n = 15) according to the self-reported Return to Play Level based on the TALS post-injury. Nonparametric statistical tests have been adopted for group comparisons in terms of age, concomitant presence of meniscus tear, injury on dominant leg, presence of knee laxity, presence of varus/valgus, body sides, and return to different levels of sports.

RESULTS: Competitive athletes showed better in terms of strength (45.3 ± 5.4 W kg^-1 vs 39.3 ± 3.4 W kg^-1, P ≤ 0.01) associated with good self-reported outcomes (TLKS, CRSQ) and low fear of reinjury (TSK). However, all the athletes had a functional deficit in at least one subtest, and a safe return to sports could not have been recommended. Our findings confirmed that demographics, physical function, and psychological factors were related to playing the preinjury level sport at mean 2 years after surgery, supporting the notion that returning to sport after surgery is multifactorial.

SIGNIFICANCE: A strict qualitative and quantitative assessment of athletes’ status should be performed at different follow-ups after surgery to guarantee a safe and controlled RTP.

PMID:34126566 | DOI:10.1016/j.gaitpost.2021.06.005

Appl Ergon. 2021 Jun 11;96:103494. doi: 10.1016/j.apergo.2021.103494. Online ahead of print.

ABSTRACT

Industrial passive low-back exoskeletons have gained recent attention as ergonomic interventions to manual handling tasks. This research utilized a two-armed experimental approach (single vs dual-task paradigms) to quantify neural and biomechanical tradeoffs associated with short-term human-exoskeleton interaction (HEI) during asymmetrical lifting in twelve healthy adults balanced by gender. A dynamic, electromyography-assisted spine model was employed that indicated statistical, but marginal, biomechanical benefits of the tested exoskeleton, which diminished with the introduction of the cognitive dual-task. Using Near Infrared Spectroscopy (fNIRS)-based brain connectivity analyses, we found that the tested exoskeleton imposed greater neurocognitive and motor adaptation efforts by engaging action monitoring and error processing brain networks. Collectively, these findings indicate that a wearer’s biomechanical response to increased cognitive demands in the workplace may offset the mechanical advantages of exoskeletons. We also demonstrate the utility of ambulatory fNIRS to capture the neural cost of HEI without the need for elaborate dual-task manipulations.

PMID:34126572 | DOI:10.1016/j.apergo.2021.103494

Sci Total Environ. 2021 Jun 5;791:148309. doi: 10.1016/j.scitotenv.2021.148309. Online ahead of print.

ABSTRACT

This study explored the sources, transformations of suspended particulate organic matter (POM), and the influence of landscape patterns on POM within the Beiyun River Watershed by applying the stable carbon and nitrogen isotope technique combined with multiple statistical analyses. The POM variables showed great spatial fluctuations under different urban development gradients. Analysis of multiple isotopes revealed that assimilation of phytoplankton might exist in the rainy season, while nitrification occurs in the dry season. SIAR modeling results indicated that the sewage debris and phytoplankton were the main sources of POM in both seasons, accounting for 52.58% and 38.39% in the rainy season, 33.17% and 31.95% in the dry season, respectively. Spatiotemporal variations of POM sources existed in the study watershed, probably due to urbanization and human disturbance. The multiple linear stepwise regression and redundant analysis results indicated that landscape metrics reflecting contagion and fragmentation at the class level correlated well with the POM variables over seasons. Interspersion and juxtaposition indices of grassland and water were negatively related to POM variables in the rainy season, whereas the landscape division index of buildup land showed negative correlations with POM parameters in the dry season. Increasing the adjacency of grassland and water to other land uses, while reducing the aggregation of buildup lands would be an efficient way for urban river water quality improvement.

PMID:34126488 | DOI:10.1016/j.scitotenv.2021.148309

Sci Total Environ. 2021 Jun 8;791:148373. doi: 10.1016/j.scitotenv.2021.148373. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, many previous studies have examined the association between ambient temperature and mortality in different parts of the world. However, very few studies have explored the mortality burden attributable to temperature, especially those in developing countries. This study aimed to quantify the burden of mortality attributable to non-optimum temperature in Thailand and explore whether greenness, using normalized difference vegetation index (NDVI) as indicator, alleviates the mortality contributed by non-optimum ambient temperature.

METHODS: Daily number of mortality (i.e., all-cause, cardiovascular and respiratory diseases) and daily meteorological data were obtained over 65 provinces in Thailand during 2010 to 2017. The two-stage statistical approach was applied to estimate the association between temperature and mortality. First, the time-stratified case-crossover analysis was performed to examine province-specific temperature-mortality association. Second, province-specific association was pooled to derive national estimates using multivariate meta-regression. Mortality burden attributable to temperature was then estimated, and the association between attributed mortality and NDVI was explored using multivariate meta-regression models.

RESULTS: A total of 2,891,407 all-cause of death was included over the study period, in which 403,450 and 264,672 deaths were accounted for cardiovascular and respiratory diseases, respectively. The temperature-mortality association at cumulative lag 0-7 days was non-linear with J-shaped curve for all-cause and respiratory mortality, whereas V-shaped curve was observed for cardiovascular mortality. Using minimum mortality temperature (MMT) as optimum temperature, 3.72% (95% empirical CI: 2.18, 5.21) of all-cause, 2.92% (0.55, 5.10) of cardiovascular and 3.00% (0.27, 5.49) of respiratory mortality were attributable to non-optimum temperature (both hot and cold effects). Higher level of NDVI was associated with alleviated impacts of non-optimum temperature, especially hot temperature.

CONCLUSION: Exposure to non-optimum temperature was associated with increased risks of mortality in Thailand. This finding is useful for planning the public health interventions to reduce health effects of non-optimum ambient temperature.

PMID:34126499 | DOI:10.1016/j.scitotenv.2021.148373

J Environ Manage. 2021 Jun 11;294:113020. doi: 10.1016/j.jenvman.2021.113020. Online ahead of print.

ABSTRACT

Researches on the deforestation of the Amazon have gained prominence in the last recent years, mainly with the change in the policy regarding the facing of this phenomenon by the Brazilian government. Therefore, an understanding about the causes that pressure the occurrence of deforestation remains relevant and has a leading role in the world. Therefore, the aim of this study is to perform the analysis of the spatial variability of the reasons for the deforestation in the Amazon Biome, in Brazil, (2010-2019). To achieve this goal, 14 variables were selected, the choice and adjustment of the regression model were determined and a diagnosis was carried out in order to verify the most appropriate model. To achieve this purpose, a geographic database was structured in a geographic information system environment. The main results revealed that the adjusted R² of the Geographically Weighted Regression (GWR) was 0.96, that is, the GWR model explains 96% of the variations in deforestation. Therefore, it was observed a significant gain when using this model. In addition, it was also observed that the average variable of the number of oxen was, among those analyzed, the one that showed the highest correlation with deforestation. Thus, it was found that the livestock sector in southern Amazonia is the main economic agent that pressures large areas of deforestation, since stockfarming is practiced extensively. Finally, it was concluded that the municipalities with the largest areas of deforestation formed a cluster in the southern portion of the Amazon, in the arc of deforestation.

PMID:34126530 | DOI:10.1016/j.jenvman.2021.113020

Sci Total Environ. 2021 Jun 4;791:148156. doi: 10.1016/j.scitotenv.2021.148156. Online ahead of print.

ABSTRACT

Sr isotopes are a powerful tool used to reconstruct human mobility in archaeology. This requires extensive bioavailable ⁸⁷Sr/⁸⁶Sr baselines used as reference for deciphering potential areas of origin. We define the first extensive bioavailable Sr isotope baselines for the different geographical regions and surface lithologies of Greece by combining new Sr data with previously published bioavailable ⁸⁷Sr/⁸⁶Sr data. We present 82 new Sr concentrations and ⁸⁷Sr/⁸⁶Sr signatures of plants, soil leachates, surface waters and spring waters from Central Greece and combine these with published baseline values from all over Greece. We define individual baselines for ten of the thirteen geographical regions of Greece. We also provide soil leachate ⁸⁷Sr/⁸⁶Sr ratios from the two archaeological Bronze Age sites of Kirrha and Ayios Vasileios in Central and Southern Greece and demonstrate the validity and applicability of the new baselines for these sites. The bioavailable ⁸⁷Sr/⁸⁶Sr compositions of Central Greece define a narrow range of ⁸⁷Sr/⁸⁶Sr values between 0.70768 – 0.71021, with the widest range observed for the soil leachates. Sr derived from carbonate weathering appears to be the most important Sr source sampled by the proxies. There is an overall larger variability in baseline ranges of the different geographical regions, the narrowest is that for West Greece and the widest that for West Macedonia. In addition, we computed statistical Sr isotope ranges for the five main surface lithological groups characterising the sampling sites of the various proxies. Narrowly ranged, unradiogenic bioavailable Sr isotope signatures are typical of areas characterised by igneous outcrops as well as by Cenozoic and Mesozoic sediments. Areas, where Palaeozoic and Precambrian bedrock outcrops dominate, produce significantly wider ranges. Our study promotes the usefulness of multi-proxy baselines for geographical reference purposes and thus their promising applicability for future human mobility studies.

PMID:34126477 | DOI:10.1016/j.scitotenv.2021.148156

Sci Total Environ. 2021 Jun 6;791:148108. doi: 10.1016/j.scitotenv.2021.148108. Online ahead of print.

ABSTRACT

Badain Jaran Desert (BJD), characterized by extremely arid climate and tallest sand dunes in the world, is the second largest desert in China. Surprisingly, there are a large number of permanent lakes in this desert. At present, little is known about the composition and distribution of microbial communities in these desert lakes, which are an important bioresource and play a fundamental role in the elemental cycles of the lakes. In this study, the physicochemical characteristics and microbial communities of water samples from 15 lakes in BJD were comparatively investigated. The results showed that the lakes were rich in Na⁺, Cl^–, CO₃^2- and HCO₃^– while Ca²⁺ and Mg²⁺ were scarce, with pH 8.52-10.27 and salinity 1.05-478.70 g/L. Bacteria dominated exclusively in low saline lakes (salinity < 50 g/L) while archaea were predominant in hypersaline lakes (salinity > 250 g/L), which abundance increased along salinity gradient linearly. Genera Flavobacterium, Synechocystis and Roseobacter from phyla Bacteroidetes, Cyanobacteria, Alphaproteobacteria were the major members in low saline lakes whereas Halomonas, Aliidiomarina and Halopelagius from Gammaproteobacteria and Euryarchaeota were abundant in moderately saline lakes (salinity 50-250 g/L). The hypersaline lakes were predominated by extreme halophiles such as Halorubrum, Halohasta and Natronomonas from Euryarchaeota. The correlation among the microbes in the lakes was mainly positive, suggesting they can survive in the harsh environments through synergistic interactions. Statistical analyses indicated that physicochemical characteristics rather than spatial factors shaped the microbial communities in the desert lakes. The pH was the most important environmental factor controlling alpha diversity, while salinity was the major driver determining microbial community structure in BJD lakes. In contrast, geographic factors had no significant impact on the microbial community compositions.

PMID:34126487 | DOI:10.1016/j.scitotenv.2021.148108

Prev Vet Med. 2021 Jun 8;193:105409. doi: 10.1016/j.prevetmed.2021.105409. Online ahead of print.

ABSTRACT

The aim of this study was to evaluate the sensitivity and specificity of the interferon-gamma release assay (IGRA) for diagnosing infections with members of the Mycobacterium (M.) tuberculosis-complex (MTBC) and non-tuberculous mycobacteria (NTM) in domestic cats, and to generate defined feline-specific cut-off values using receiver operating characteristic (ROC) curve analysis to improve test performance. Records of 594 cats that had been tested by IGRA were explored to identify individuals that had a culture and/or polymerase chain reaction (PCR)-confirmed case of mycobacterial disease, and those that had a final diagnosis of non-mycobacterial disease. A total of 117 cats – 80 with mycobacterial disease and 37 diagnosed with a condition other than mycobacteriosis – were identified for further detailed analysis. This population was used to estimate test sensitivity and specificity, as well as likelihood ratios for the IGRA to correctly identify a cat with or without mycobacterial disease. Agreement between IGRA results and culture/PCR using current and proposed new cut-off values was also determined. ROC analysis of defined confirmed infected and non-mycobacterial disease control cats allowed an adjustment of current test cut-offs that increased the overall test sensitivity for MTBC infections from 83.1 % (95 % confidence interval [CI]: 71.5-90.5 %) to 90.2 % (95 % CI: 80.2-95.4%), and M. bovis infection from 43 % (95 % CI: 28.2-60.7%) to 68 % (95 % CI: 51.4-82.1%) while maintaining high test specificity (100 % in both cases). Overall agreement between IGRA results and culture/PCR, while recognising that neither culture nor PCR tests have perfect sensitivity, improved from weak (κ = 0.57) to moderate (κ = 0.71) using new proposed IGRA test cut-off values. Application of these results, based upon the statistical analysis of accumulated test data, can improve the diagnostic performance of the feline IGRA, particularly for identifying infections with M. bovis, without compromising specificity.

PMID:34126470 | DOI:10.1016/j.prevetmed.2021.105409

Eur J Radiol. 2021 Mar 4;141:109627. doi: 10.1016/j.ejrad.2021.109627. Online ahead of print.

ABSTRACT

PURPOSE: To determine the utility of intravoxel incoherent motion (IVIM) diffusion-weighted imaging in quantitative analysis of preoperative tumor (T) and node (N) stages of gastric cancer, and to quantify the diagnostic threshold of IVIM parameters for serosal invasion and lymphatic metastasis.

MATERIALS AND METHODS: From October 2016 to February 2020, 98 patients with gastric cancer who were receiving treatment in Zhongshan Hospital, China, were subject to an IVIM sequence imaging analysis. The IVIM sequence data were imported into software for post-processing of tumor regions of interest, and the IVIM parameters (the microvascular volume fraction (f), the molecular diffusion coefficient (D) and perfusion-related incoherent microcirculation (D*) were calculated. The variation of these IVIM parameters with different tumor-node metastasis (TNM) stages were analyzed by one-way analysis of variance. The IVIM parameters of serosal invasion and lymphatic metastasis were examined by receiver operating characteristic curve analysis and t-tests.

RESULTS: A total of 98 gastric cancer patients (65 males and 33 females) with an average age of 61.9 years were enrolled in this study. There were 14 patients in stage T1, 14 in stage T2, 10 in stage T3 and 60 in stage T4_a+b. There were 37 patients in stage N0, 19 in stage N1, 18 in stage N2 and 24 in stage N3. Statistically significant associations were found between the D values and T stages of gastric cancer. The D values of stage T4 cancers were significantly different from those of stage T2, T3 and T4 cancers. The D value decreased with increasing T stage. The mean D values of stages were 1.432 × 10^-3 mm²/s (T1), 1.225 × 10^-3 mm²/s (T2), 1.154 × 10^-3 mm²/s (T3) and 0.9468 × 10^-3 mm²/s (T4). The extent of the invasion of serosa was found to be significantly correlated with D value, with the diagnostic threshold for D being 1.107 × 10^-3 mm²/s. In addition, different pathological N stages of gastric cancer lesions showed statistically significantly variations in f values, but no correlation was found with different N stages. Finally, the extent of lymphatic metastasis was found to be correlated with D values, with the diagnostic threshold being 1.1739 × 10^-3 mm²/s. There was no statistically significant correlation between the IVIM MRI parameters and tumor size. The grade of tumor was found to be significantly correlated with D* value, with the diagnostic threshold for D* being 1.516 × 10^-2 mm²/s. There was no statistically significant correlation between the ADC value and tumor size. There was a significant difference in the ADC values among different T and N stage cancers. ADC value had statistically significant to distinguish gastric cancer with or without serosal invasion, its detection efficiency was not as high as that of D value, with an AUC of 0.628 and 0.830, respectively. The ADC value was not statistically significant in distinguishing gastric cancer with or without lymphatic metastasis (P ≥ 0.05). The ADC value had not statistically significant in distinguishing gastric cancer between low and medium-high grade (P ≥ 0.05).

CONCLUSION: We found that significant differences existed between whole-volume IVIM parameters of different T or N stages in gastric cancers, and were able to quantify different T or N stages of gastric cancer by the values of these parameters. The results of this quantitative study provide new tools for evaluating the prognosis of gastric cancer and will be valuable for the development of an new imaging method for determining the morphological stages of gastric cancer.

PMID:34126429 | DOI:10.1016/j.ejrad.2021.109627

Sex Med. 2021 Jun 11;9(4):100384. doi: 10.1016/j.esxm.2021.100384. Online ahead of print.

ABSTRACT

INTRODUCTION: Low intensity extracorporeal shock wave therapy (LIESWT) improves erectile function (EF) in men with vascular erectile dysfunction (ED) but longer-term outcomes remain unknown.

AIM: To evaluate the clinical outcomes of LIESWT at a minimum 5-year follow-up.

METHODS: This is an open-label single-arm prospective study involved men with vascular ED who received LIESWT.

MAIN OUTCOME MEASURE: Changes in patient demographics, IIEF-5 and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) scores, as well as overall satisfaction score (on a 5-point scale) were reviewed at 12, 24, 48, and 60 months after completion of LIESWT. A chi-square contingency analysis was used to examine the relationship between erectile function score and treatment satisfaction, with statistical significance set at 5%.

RESULTS: The mean follow-up period was 69.9 (63-82; median 76) months. The mean IIEF-5 scores for pretreatment and after treatment at 12, 24, 48, and 60 months were 14.8, 17.6, 16.8, 16.5, and 16.5 while the percentages of patients who reported an improvement in IIEF-5 score by 5 points were 60%, 45%, 40%, and 40%; and EDITS scores >50% were recorded in 70%, 55%, 50%, and 48% of patients at 12, 24, 48, and 60 months post-LIESWT. Ten patients required medical therapy and 2 patients opted for penile prosthesis implantation. The overall satisfaction rate appeared sustained subsequent follow-up (score 4 out of 5; 68% vs 50% vs 40% vs 40% at 12, 24, 48, and 60 months). There were minor time-limited, but no significant adverse event reported.

CONCLUSION: This long-term study showed the observed clinical improvement in EF continues to deteriorate but appears to plateau at 40% clinical efficacy at 48-60 months after completion of LIESWT. The absence of penile pain and deformity at 5-year follow-up supports the long-term safety data of LIESWT in men with ED. Chung E, Cartmill R. Evaluation of Long-Term Clinical Outcomes and Patient Satisfaction Rate Following Low Intensity Shock Wave Therapy in Men With Erectile Dysfunction: A Minimum 5-Year Follow-Up on a Prospective Open-Label Single-Arm Clinical Study. Sex Med 2021;XX:XXXXXX.

PMID:34126432 | DOI:10.1016/j.esxm.2021.100384