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Nevin Manimala Statistics

Application of Multiple Occupational Health Risk Assessment Models for Metal Fumes in Welding Process

Biol Trace Elem Res. 2023 Jun 22. doi: 10.1007/s12011-023-03717-w. Online ahead of print.

ABSTRACT

Welding fumes have an important role to create the adverse health effects. So, the aim of this study was to use of multiple occupational health risk assessment models for metal fumes in welding process. This cross-sectional study was conducted among welding workers. Sampling of heavy metals such as Sn, Zn, Al, Fe, Cd, Pb, Cu, Mn, Ni, Cr, and As was provided based on the National Institute for Occupational Safety and Health (NIOSH) method 7300 and analyzed by inductively coupled plasma mass spectroscopy (ICP-MS). Risk assessment was managed by four methods including Malaysia’s method, Control of Substances Hazardous to Health Essentials (COSHH model), Chinese OHRA standard (GBZ/T 298-2017), and EPA method. Also, Monte Carlo simulation was used to examine the uncertainties by using the Crystal Ball tool. To compare the models, the risk levels of each model were converted into the risk ratio and the SPSS 22.0 software was used to the statistical analysis. The consistency of the two occupational health risk assessment models was examined by Cohen’s Kappa. Risk ration was the highest level for Cr (VI) fumes in all models. Also, carcinogenic risk was unacceptable for all examined fumes. Moreover, non-carcinogenic risk was the highest (HI > 1) for As fumes. Mont Carlo simulations suggested that exposure time (ET) had a significant effect on the risk. Also, there was a good consistency between Malaysia method/GBZ/T 298-2017 and COSHH model/GBZ/T 298-2017. Therefore, it is recommended that the engineering and administrative controls should be provided to reduce exposure.

PMID:37347403 | DOI:10.1007/s12011-023-03717-w

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Smoking during pregnancy and gestational diabetes mellitus: a systematic review and meta-analysis

Endocrine. 2023 Jun 22. doi: 10.1007/s12020-023-03423-6. Online ahead of print.

ABSTRACT

PURPOSE: To investigate whether maternal cigarette smoking during pregnancy is a risk factor for developing GDM.

METHODS: MEDLINE, Scopus, CENTRAL and Google Scholar databases were searched from inception to December 2022 to identify eligible original articles. A systematic review and meta-analysis (weighted data, random-effects model) were performed. The primary outcome was the development of GDM in pregnant women. The results were expressed as odds ratios (OR) with 95% confidence interval (CI) (inverse variance method). Subgroup analysis was planned according to the maternal smoking status and GDM diagnostic criteria. Statistical heterogeneity was checked with the Chi-squared (Chi2) test and the I2 index was used to quantify it. The studies were evaluated for publication bias.

RESULTS: Thirty-five studies, including 23,849,696 pregnant women, met the inclusion criteria. The pooled OR of smoking during pregnancy compared with non-smoking (never smokers and former smokers) was 1.06 (95% CI 0.95-1.19), p = 0.30; I2 = 90%; Chi2 = 344; df=34; p < 0.001. Subgroup analysis was performed according to the two-step Carpenter-Coustan diagnostic criteria, due to the high heterogeneity among the other applied methods. The pooled OR for the Carpenter-Coustan subgroup was 1.19 (95% CI 0.95-1.49), p = 0.12; I2 = 63%; Chi2 = 27; df=10; p < 0.002. Further subgroup analysis according to maternal smoking status was not performed due to missing data.

CONCLUSION: There is no evidence to support an association between maternal cigarette smoking during pregnancy and the risk for GDM. Universally accepted diagnostic criteria for GDM must be adopted to reduce heterogeneity and clarify the association between smoking and GDM.

PMID:37347387 | DOI:10.1007/s12020-023-03423-6

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Pathways between verbal bullying and oral conditions among school children

Eur Arch Paediatr Dent. 2023 Jun 22. doi: 10.1007/s40368-023-00818-x. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the direct and indirect pathways between verbal bullying and adverse oral conditions among school-aged children.

METHODS: A cross-sectional survey was conducted with 8- to 10-year-old children, enrolled in public schools in Southern Brazil. Verbal bullying was collected by self-reports. Independent variables included sociodemographic characteristics (sex, age, household income, and caregivers’ educational level) and oral conditions (anterior open bite, anterior teeth crowding, upper anterior diastema, large overjet, untreated dental caries, and PUFA index). The pathways between verbal bullying and the independent variables were analysed through structural equation modelling.

RESULTS: 1369 children were included. The prevalence of verbal bullying was 26.2% (95% confidence interval [CI] 23.9-28.6%). Verbal bullying was directly influenced by large overjet (standard coefficient [SC] 0.13, P < 0.01), untreated dental caries (SC 0.63, P = 0.01) and PUFA index (SC 0.75, P = 0.02). Sex (SC – 0.005, P = .04) and age (SC – 0.006, P < 0.01) indirectly influenced verbal bullying via untreated dental caries.

CONCLUSIONS: Verbal bullying was directly influenced by large overjet, untreated dental caries and PUFA index. Sex and age indirectly impacted verbal bullying through untreated dental caries.

PMID:37347383 | DOI:10.1007/s40368-023-00818-x

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Implications of a Reduced Length of Postpartum Hospital Stay on Maternal and Neonatal Readmissions, an Observational Study

Matern Child Health J. 2023 Jun 22. doi: 10.1007/s10995-023-03667-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Reducing the Length Of postpartum Stay (LOS) is associated with lower hospital costs, a major reason for initiating federal projects in Belgium. Disadvantages following the reduction of LOS are the risks of maternal and neonatal readmissions. This study compares readmissions with or without reduced LOS, by introducing the KOZI&Home program in the university hospital Brussels.

METHODS: This is an observational study comparing the readmission rates of the length of postpartum hospital stay between two groups: the non-KOZI&Home group (> 2 days for vaginal birth and > 4 days for caesarean section) and KOZI&Home group (≤ 2 days for vaginal birth and ≤ 4 days for caesarean section). A follow-up period of 16 weeks was set up.

RESULTS: The maternal readmission rate was 4,8% for the non-KOZI&Home group (n = 332) and 3.3% for the KOZI&Home group (n = 253). Neonatal readmission rates were 7.2% and 15.9% respectively. After controlling influencing factors in a multivariate model for maternal and neonatal readmissions, there were no statistical significant differences. Factors negatively affecting neonatal readmissions are (1) dismissal period October-January (OR:3.22;95% CI 1.10-9.42) and (2) low education level (OR:3.44;95% CI 1.54-7.67), for maternal readmissions it concerns whether or not LOS is known (OR:3.26;95% CI 1.21-8.81).

DISCUSSION: There is no effect of the KOZI&Home program on maternal nor neonatal readmission rates. Systematically informing about postpartum LOS antenatally will enforce preparation and is important to reduce maternal readmissions. Personalized information should be given to women discharged in the period October-January and to those with a lower education level, in order to reduce neonatal readmissions.

PMID:37347379 | DOI:10.1007/s10995-023-03667-8

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Safety, Tolerability, Bioavailability, and Biological Activity of Inhaled Interferon-α2b in Healthy Adults: The IN2COVID Phase I Randomized Trial

Clin Drug Investig. 2023 Jun 22. doi: 10.1007/s40261-023-01278-3. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Interferons have been identified as a potential treatment alternative for coronavirus disease 2019. This study assessed the safety, tolerability, bioavailability, and biological activity of inhaled interferon-α2b (IFN)-α2b in healthy adults.

METHODS: A double-blind, randomized, phase I clinical trial was conducted with two cohorts of healthy subjects aged 18-50 years. The first cohort received 2.5 MIU of inhaled IFN-α2b twice daily for 10 days (n = 6) or placebo (n = 3); the second cohort received 5.0 MIU of inhaled IFN-α2b in a similar scheme (n = 6) or placebo (n = 3). The first two doses were administered in an emergency department, then participants completed their treatment at home. Safety was measured through vital signs, new symptoms, and laboratory tests. Tolerability was measured as participants’ treatment acceptability. Bioavailability and biological activity were measured from serum IFNα concentrations and real-time quantitative polymerase chain reaction of interferon-induced genes in blood before and after treatments.

RESULTS: Exposure to inhaled IFN-α2b at 2.5-MIU or 5-MIU doses did not produce statistically significant changes in participant vital signs, or elicit new symptoms, and standard hematological and biochemical blood measurements were comparable to those recorded in individuals who received placebo. A total of 58 adverse events were observed. All were mild or moderate and did not require medical care. All participants reported very high tolerability towards a twice-daily nebulized treatment for 10 days (98.0, 97.0, and 97.0 in the placebo, 2.5-MIU, and 5-MIU groups, respectively, on a 0- to 100-mm visual analog scale). A dose-dependent mild increase in serum IFN-α concentrations and an increase in serum RNA expression of IFN-induced genes were observed 11 days after treatment (p < 0.05 for all between-group comparisons).

CONCLUSIONS: Inhaled IFN-α2b was preliminarily safe and well tolerated, and induced systemic biological activity in healthy subjects.

CLINICAL TRIAL REGISTRATION: The trial was registered in ClinicalTrials.gov (NCT04988217), 3 August, 2021.

PMID:37347370 | DOI:10.1007/s40261-023-01278-3

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Racial and regional disparities in deaths in breast cancer

Med Oncol. 2023 Jun 22;40(7):210. doi: 10.1007/s12032-023-02083-w.

ABSTRACT

Breast cancer is the second most diagnosed malignancy in American women with a lifetime occurrence of 1 in 8 women in the United States. There has been a dearth of research focusing on regional differences in breast cancer mortality with respect to race in the US. It is crucial to identify regions that are lagging to uplift the outreach of breast cancer care to certain races. Data for this study were obtained from the 2016-2018 Nationwide Inpatient Sample. In-hospital mortality, race and hospital regions for the patients with the primary diagnosis of Malignant Neoplasms of Breast were studied. Baseline characteristics of participants were summarized using descriptive statistics. The patient population was stratified as per race, hospital region, gender, therapy received and family history. Logistic regression was performed to derive the odds ratio while adjusting for different variables. 99, 543 patients with metastatic breast cancer were identified. African Americans (AAs) were found to have the highest reported deaths at 5.54%, followed by Asians and Pacific Islanders at 4.80% and Caucasians 4.09% (p < 0.0001). The odds of dying were significantly higher in the AA population when compared to Caucasian population (OR 1.391 (1.286-1.504)), and the odds were consistently higher across all regions of the US. In terms of regional disparities with respect to race, AA’s had highest mortality in the south whereas all other races had the highest mortality in the west. It was seen that races identifying as “others” had significantly higher odds of dying in the Northeast. It is crucial to identify racial differences in the various regions across the US in order to implement appropriate outreach strategies to tackle these disparities.

PMID:37347351 | DOI:10.1007/s12032-023-02083-w

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Role of lncRNAs in Remodeling of the Coronary Artery Plaques in Patients with Atherosclerosis

Mol Diagn Ther. 2023 Jun 22. doi: 10.1007/s40291-023-00659-w. Online ahead of print.

ABSTRACT

INTRODUCTION: Cardiovascular diseases (CVDs) are the leading cause of death worldwide according to World Health Organization (WHO) data. Atherosclerosis is considered as a chronic inflammatory disease that develops in response to damage to the vascular intima-media layer in most cases. In recent years, epigenetic events have emerged as important players in the development and progression of CVDs. Since noncoding RNA (ncRNAs) are important regulators in the organization of the pathophysiological processes of the cardiovascular system, they have the potential to be used as therapeutic targets, diagnostic and prognostic biomarkers. In this study long noncoding RNA (lncRNA) and mRNA gene expression were compared between coronary atherosclerotic plaques (CAP) and the internal mammary artery (IMA) which has the same genetic makeup and is exposed to the same environmental stress conditions with CAP in the same individual.

METHODS: lncRNA and mRNA gene expressions were determined using the microarray in the samples. Microarray results were validated by RT-qPCR. Differentially expressed genes (DEGs; lncRNAs and mRNAs) were determined by GeneSpring (Ver 3.0) [p values < 0.05 and fold change (FC) > 2]. DAVID bioinformatics program was used for Gene Ontology (GO) annotation and enrichment analyses of statistically significant genes between CAP and IMA tissue.

RESULTS AND CONCLUSIONS: In our study, 345 DEGs were found to be statistically significant (p < 0.05; FC > 2) between CAP and IMA. Of these, 65 were lncRNA and 280 were mRNA. Thirty-three lncRNAs were upregulated, while 32 lncRNAs were downregulated. Some of the important mRNAs are SPP1, CYP4B1, CHRDL1, MYOC, and ALKAL2, while some of the lncRNAs are LOC105377123, LINC01857, DIO3OS, LOC101928134, and KCNA3 between CAP and IMA tissue. We also identified genes that correlated with statistically significant lncRNAs. The results of this study are expected to be an important source of data in the development of new genetically based drugs to prevent atherosclerotic plaque. In addition, the data obtained may contribute to the explanation of the epigenetic mechanisms that play a role in the pathological basis of the process that protects the IMA from atherosclerosis.

PMID:37347334 | DOI:10.1007/s40291-023-00659-w

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Modelling extreme risks for green bond and clean energy

Environ Sci Pollut Res Int. 2023 Jun 22. doi: 10.1007/s11356-023-27071-5. Online ahead of print.

ABSTRACT

Value at Risk and Expected Shortfall are two traditional tools used to measure extreme risk in financial markets. However, there is little research on measuring extreme risk in emerging markets such as green bonds and clean energy. This paper uses both semi-parametric models with simultaneous excitation functions and traditional models to estimate extreme risk in SP500 Green Bond (GB) and Global Clean Energy (GCE), selecting Expected Shortfall (ES) and Value at Risk (VaR) as the indices of extreme risk. Then, the paper uses a breakpoint scan of the predictions of the different types of models. The results find that the green bond market was relatively stable while the global clean energy market experienced sharp fluctuations after the COVID-19 pandemic outbreak. Representative models in GCE have at least two breakpoints, but those for GB have no breakpoints. The GARCH model with normal innovations performs the best among all target models, and the GARCH-FZ model fits the best among all semi-parametric candidates. Our research could help governments, companies, and investors with risk management and improve model accuracy and mechanisms for measuring extreme risks.

PMID:37347333 | DOI:10.1007/s11356-023-27071-5

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Micro-CT analysis and leakage of bioceramic retrofillings after ultrasonic and Er:YAG laser cavity preparations: an in vitro study

Lasers Med Sci. 2023 Jun 22;38(1):145. doi: 10.1007/s10103-023-03809-y.

ABSTRACT

The purpose of the study was to determine the influence of preparation techniques on marginal adaptation and sealing of Biodentine™ and TotalFill® RRM bioceramic retrograde fillings. Fifty-two single-root teeth extracted for periodontal reasons were used. Root canals were instrumented using Reciproc Blue #25 and obturated using a single cone technique with an AH Plus® root canal sealer. Retrograde cavities were prepared with Piezomed device (Piezo), Er:YAG laser in short-pulse(SP) and quantum square pulse(QSP) modes and filled with Biodentine™ (BD) or TotalFill® RRM (TF). There were 6 groups (n=8): (1) Piezo BD, (2) Piezo TF, (3) SP BD, (4) SP TF, (5) QSP BD, and (6) QSP TF, and positive and negative controls (n=2). Micro-CT analysis was performed on two samples from each group. Percentage volumes of internal and external voids in apical 1.5 mm were determined. Rhodamine B dye leakage was done on six samples. The samples were cut longitudinally and examined under a stereomicroscope. Digital recordings were analyzed in ImageJ software. The deepest penetration of color in mm was recorded. The data were statistically analyzed using ANOVA and Duncan’s test at the level of significance α=0.05. TotalFill® RRM performed significantly better than Biodentine™ in terms of sealing (p<0.05) and marginal adaptation, as evaluated by micro-CT. Sealing was significantly better in SP compared to QSP mode preparations (p<0.05). Differences between Piezomed and laser modes were not significantly different (p>0.05). Sealing was statistically significantly better with TotalFill® RRM compared to Biodentine™ and in Er:YAG SP preparations compared to Er:YAG QSP.

PMID:37347307 | DOI:10.1007/s10103-023-03809-y

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Analysing medical predictors for the outcome of infertility treatment: a 5-year follow-up survey

Arch Gynecol Obstet. 2023 Jun 22. doi: 10.1007/s00404-023-07097-3. Online ahead of print.

ABSTRACT

PURPOSE: For many couples, bearing children is a common life goal; however it cannot always be fulfilled. Undergoing infertility treatment does not always guarantee pregnancies and live births. Couples experience miscarriages and even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified.

METHODS: To further our understanding, a cross-sectional 5-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women’s Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). In addition, chi-square tests were used to examine differences in the outcome depending on the number of risk factors being present.

RESULTS: In the binary logistic regression models for clinical pregnancies, live births and drop outs were statistically significant only for the maternal age, whereas the maternal and paternal BMI, smoking, infertility diagnoses and infections showed no significant predicting effect on any of the outcome variables. A correlation between the number of risk factors and the outcome of infertility treatment could not be excluded.

CONCLUSION: The results confirm that maternal age has an effect on infertility treatment, whereas the relevance of other possible medical predictors remains unclear. Further large-scale studies should be considered to increase our knowledge on their predictive power.

PMID:37347283 | DOI:10.1007/s00404-023-07097-3