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Nevin Manimala Statistics

Daily ambient temperature and mortality in Thailand: Estimated effects, attributable risks, and effect modifications by greenness

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

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Nevin Manimala Statistics

Deforestation drivers in the Brazilian Amazon: assessing new spatial predictors

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

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Nevin Manimala Statistics

The geographic distribution of bioavailable strontium isotopes in Greece – A base for provenance studies in archaeology

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

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Both pH and salinity shape the microbial communities of the lakes in Badain Jaran Desert, NW China

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, CO32- 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

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Diagnostic accuracy of the interferon-gamma release assay (IGRA) for cases of feline mycobacteriosis

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

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Quantitative study of preoperative staging of gastric cancer using intravoxel incoherent motion diffusion-weighted imaging as a potential clinical index

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 T4a+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

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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 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

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The anxiolytic effects of exercise for people with anxiety and related disorders: An update of the available meta-analytic evidence

Psychiatry Res. 2021 Jun 11;302:114046. doi: 10.1016/j.psychres.2021.114046. Online ahead of print.

ABSTRACT

Exercise as a treatment option for people with mental disorders is a field of growing interest. The increased number of published randomized controlled trials (RCTs) evaluating the effects of exercise in the treatment of anxiety and related disorders in recent years calls for an update of the available meta-analytic evidence. Electronic databases (PubMed, CINAHL, PSYCArticles, and Embase) were searched up to 17.2.2021, for RCTs evaluating the effects of exercise on anxiety and stress symptoms in adults with anxiety and related disorders. A random effects meta-analysis was conducted. A total of 13 RCTs comprising 731 adult participants (exercise n=376; control n=355) were included. Exercise had a small, bordering medium, but statistically significant effect on decreasing anxiety symptoms compared to control condition (standardized mean difference=-0.425, 95%CI -0.67 to -0.17; I2 = 47.9%) in people with anxiety and related disorders. Our meta-analysis updates the existing evidence supporting exercise as an efficacious intervention for anxiety and related disorders. Although the updated meta-analytic evidence is less heterogenous than previously reported, future research is still needed to explore the factors moderating the effects of exercise on outcome such as frequency, intensity, duration of the sessions, and type of exercise and qualification of the provider in more detail.

PMID:34126464 | DOI:10.1016/j.psychres.2021.114046

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Language profiles of Welsh-English bilingual children with Down syndrome

J Commun Disord. 2021 Jun 1;93:106126. doi: 10.1016/j.jcomdis.2021.106126. Online ahead of print.

ABSTRACT

PURPOSE: Given that children with Down syndrome (DS) have language learning difficulties, concerns have been raised about the capacity of these children to acquire two (or more) languages. This research examines the language profiles of bilingual children with DS and typically developing (TD) children in comparison to monolinguals, with a view towards identifying the factors associated with language abilities within these populations.

METHOD: Four groups of children were recruited: Welsh-English bilinguals with DS (n=10), English monolinguals with DS (n=10), TD Welsh-English bilinguals (n=10) and TD English monolinguals (n=10). Children were individually matched on nonverbal cognitive ability (NVCA) to each child in the bilingual DS group and the four groups were matched on socioeconomic status and gender. Bilinguals were matched on current and lifetime exposure to Welsh and age of first exposure to their L2. Within DS and TD groups, chronological age was statistically controlled for. Language abilities were assessed via standardised assessments and specially designed tasks. Bilinguals were assessed in both of their languages.

RESULTS: Results show no effect of language status on measures of expressive and receptive language abilities or phonological awareness. Language impairments were evident for both DS groups, particularly for expressive morphosyntax. Welsh receptive vocabulary scores of the bilinguals with DS were comparable to the TD bilinguals. Working memory, phonological awareness and chronological age were the strongest predictors of receptive language outcomes in both DS groups, explaining 90% of the variability.

CONCLUSIONS: In conclusion, we report no adverse outcomes on language development for bilinguals with DS. To our knowledge, this is the first group study of bilingualism in children with DS within the UK. Findings align with and add to the growing body of literature that reports that bilingualism does not negatively impact the language development of children with developmental disabilities. Clinical and educational implications are discussed.

PMID:34126402 | DOI:10.1016/j.jcomdis.2021.106126

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Deep learning for tracing esophageal motility function over time

Comput Methods Programs Biomed. 2021 Jun 1;207:106212. doi: 10.1016/j.cmpb.2021.106212. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Esophageal high-resolution manometry (HRM) is widely performed to evaluate the representation of manometric features in patients for diagnosing normal esophageal motility and motility disorders. Clinicians commonly assess esophageal motility function using a scheme termed the Chicago classification, which is difficult, time-consuming and inefficient with large amounts of data.

METHODS: Deep learning is a promising approach for diagnosing disorders and has various attractive advantages. In this study, we effectively trace esophageal motility function with HRM by using a deep learning computational model, namely, EMD-DL, which leverages three-dimensional convolution (Conv3D) and bidirectional convolutional long-short-term-memory (BiConvLSTM) models. More specifically, to fully exploit wet swallowing information, we establish an efficient swallowing representation method by localizing manometric features and swallowing box regressions from HRM. Then, EMD-DL learns how to identify major motility disorders, minor motility disorders and normal motility. To the best of our knowledge, this is the first attempt to use Conv3D and BiConvLSTM to predict esophageal motility function over esophageal HRM.

RESULTS: Test experiments on HRM datasets demonstrated that the overall accuracy of the proposed EMD-DL model is 91.32% with 90.5% sensitivity and 95.87% specificity. By leveraging information across swallowing motor cycles, our model can rapidly recognize esophageal motility function better than a gastroenterologist and lays the foundation for accurately diagnosing esophageal motility disorders in real time.

CONCLUSIONS: This approach opens new avenues for detecting and identifying esophageal motility function, thereby facilitating more efficient computer-aided diagnosis in clinical practice.

PMID:34126411 | DOI:10.1016/j.cmpb.2021.106212