Tag: statistics

Environ Sci Pollut Res Int. 2023 Jun 1. doi: 10.1007/s11356-023-28004-y. Online ahead of print.

ABSTRACT

In present study, geophysical and geostatistical variability of ground water and agricultural soil investigated in the Jaipur region of Rajasthan (Western India) by applying the geographic information system (GIS), vertical electrical sounding (VES) ,and statistical analysis. Ground water and soil samples collected from different sites from the selected study area and variation pattern of quality parameters were assessed. A contour map analysis of distribution of metals and other contaminants in the samples was conducted using GIS. Maximum concentration of metals recorded in the soil samples in order of Fe, 11.25 mg kg^-1 > Mn, 8.6 mg kg^-1 > Zn, 7.2 mg kg^-1 > Cu, 0.455 mg kg^-1; however, maximum concentration of metals in the ground water samples was found as Zn, 2.64 mg L^-1 > Cu, 0.86 mg L^-1 > Fe, 0.39 mg L^-1 > Mn, 0.18 mg L^-1 > Pb, 0.065 mg L^-1 > Ni, 0.016 mg L^-1. Observed data emphasis variability in groundwater and soil quality parameter by PCA technique indicated 84.60% and 66.98% of variance, respectively. Soil quality index (SQI) value was observed as 0.482 indicating that 46% of soil sampling sites deteriorated and shown poor quality. Similarly, water quality index (WQI) value indicates good water quality at the sampling sites TW1, TW8, TW10, and TW12; however, TW3, TW4, TW6, TW19, TW20, and TW22 sites showed very poor water quality. The present study concludes that overexploitation of groundwater and unregulated discharge of wastewater leads to depletion of water and soil quality. Further, applying geographical and geostatistical techniques in assessing water and soil quality could be more effective tools in environmental monitoring and management for environmental and health safety.

PMID:37261695 | DOI:10.1007/s11356-023-28004-y

Environ Sci Pollut Res Int. 2023 Jun 1. doi: 10.1007/s11356-023-27821-5. Online ahead of print.

ABSTRACT

This study examined the impact of climate change on climate extreme indices in the Kaduna River basin, Nigeria. Large-scale atmospheric variables derived from the Global Climate Model (GCM), Coupled Model Intercomparison Project Phase 5 (CMIP5) (CanESM2) were used to develop a high-resolution climate using a Statistical Down Scaling Model. The adapted Caussinus-Mestre algorithm for homogenizing networks of temperature series and multivariate bias correction based on an N-dimension probability function were used to homogenize and correct the climate data, respectively. Fifteen climate extreme indices were computed using RClimdex. The coefficient of variance, Kruskal-Wallis test, and the modified Mann-Kendall test were used to assess the variation and trends. Wavelet analysis was used to determine the periodicities of the indices (1980-2020). The findings revealed a significant warming trend with low variability of temperature indices. The moderate variability with an insignificant decreasing trend was found for rainfall indices. Similarly, the future climate indices indicate a continuing positive trend in the temperature extreme indices. The majority of climate indices have a periodicity of less than or equal to 10 years for high frequency, except for PRCPTOT, R10MM, R20MM, Rx5day, SDII, TN90p, and TX90p for temperature indices. The findings conclude that the periodicity pattern of climate extreme indices is related to atmospheric phenomena (such as quasi-biennial oscillation, QBO), which indicate the impact of climate change. As a result, this can serve as an early warning for possible extreme event occurrences in the basin. The CMIP6 should be used to compare with the results of this study to provide a detailed assessment of the current implication of climate change on the catchment.

PMID:37261694 | DOI:10.1007/s11356-023-27821-5

J Patient Rep Outcomes. 2023 Jun 1;7(1):51. doi: 10.1186/s41687-023-00593-9.

ABSTRACT

BACKGROUND: The Respiratory Infection Intensity and Impact Questionnaire (RiiQ™) is a patient-reported outcome measure designed to assess symptoms and impacts of respiratory syncytial virus (RSV) infection. This study evaluated the construct validity, reliability, and responsiveness of the RiiQ™ Respiratory and Systemic Symptoms Scale scores.

METHODS: Prospective data were analyzed from a total of 1795 participants, including from non-hospitalized patients with acute respiratory infection (ARI) and no coinfections enrolled in a Phase 2b RSV vaccine study (RSV-positive: n = 60; RSV-negative: n = 1615), and two observational studies of patients hospitalized with RSV (n = 20; n = 100). Descriptive statistics, confirmatory factor analysis (CFA), test-retest intraclass correlation coefficients (ICCs), construct validity correlations (between a clinician-assessed clinical questionnaire and the RiiQ™ symptoms scale), known-groups validity, and responsiveness (correlations of change scores) were evaluated.

RESULTS: Mean patient age ranged from 66.5 to 71.5 years and the majority of patients were female. Initial assessments in the vaccine trial (ARI Day 1) were suggestive of less severe illness than in the observational studies with hospitalized patients. CFA loadings (> 0.40) supported summary scores. ICCs exceeding the recommended threshold of 0.70 supported test-retest reliability for Respiratory and Systemic Symptoms, except in the small observational study. At the scale level, correlations were moderate to strong (|r| ≥ 0.3) and positive between the Respiratory Symptoms Scale and the related clinical questionnaire scores, reflecting measurement of similar symptoms in support of convergent validity. Correlations with change in Patient Global Impression of Severity > 0.30 supported responsiveness.

CONCLUSIONS: Psychometric tests applied to the RiiQ™ Symptoms scales provide evidence of its reliability, construct validity, discriminating ability, and responsiveness for use in clinical studies to assess the onset and severity of RSV symptoms.

PMID:37261682 | DOI:10.1186/s41687-023-00593-9

Geroscience. 2023 Jun 1. doi: 10.1007/s11357-023-00825-2. Online ahead of print.

ABSTRACT

Balancing stroke prevention and risk of bleeding in patients with atrial fibrillation (AF) is challenging. Direct oral anticoagulants (DOACs) are by now considered standard of care for treating patients with AF in international guidelines. Our objective was to assess the safety of long-term intake of DOACs in older adults with AF. We included RCTs in elderly (≥ 65 years) patients with AF. A systematic search in MEDLINE and EMBASE was performed on 19 April 2022. For determination of risk of bias, the RoB 2 tool was applied. We pooled outcomes using random-effects meta-analyses. The quality of evidence was assessed using GRADE. Eleven RCTs with a total of 63,374 patients were identified. Two RCTs compared apixaban with either warfarin or aspirin, four edoxaban with either placebo, aspirin, or vitamin K antagonists (VKAs), two dabigatran with warfarin and three rivaroxaban with warfarin. DOACs probably reduce mortality in elderly patients with AF (HR 0.89 95%CI 0.77 to 1.02). Low-dose DOACs likely reduce bleeding compared to VKAs (HR ranged from 0.47 to 1.01). For high-dose DOACS the risk of bleeding varied widely (HR ranged from 0.80 to 1.40). We found that low-dose DOACs probably decrease mortality in AF patients. Moreover, apixaban and probably edoxaban are associated with fewer major or clinically relevant bleeding (MCRB) events compared to VKAs. For dabigatran and rivaroxaban, the risk of MCRB varies depending on dose. Moreover, subgroup analyses indicate that in the very old (≥ 85) the risk for MCRB events might be increased when using DOACs.Registration: PROSPERO: CRD42020187876.

PMID:37261677 | DOI:10.1007/s11357-023-00825-2

Clin Pharmacokinet. 2023 Jun 1. doi: 10.1007/s40262-023-01248-0. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: An important barrier to HIV prevention among transgender women (TGW) is the concern that oral pre-exposure prophylaxis (PrEP) negatively affects the efficacy of feminizing hormone therapy (FHT). We aimed to assess the impact of PrEP on FHT pharmacokinetics (PK) among TGW from Brazil.

METHODS: We performed a drug-drug interaction sub-study among TGW enrolled in a daily oral PrEP demonstration study (PrEParadas, NCT03220152). Participants had a first PK assessment (PK1) 15 days after FHT (estradiol valerate 2-6 mg plus spironolactone 100-200 mg) initiation and then started PrEP (tenofovir disoproxil fumarate 300 mg/emtricitabine 200 mg). A second PK evaluation was performed 12 weeks later (PK2). Blood samples were collected prior and after the directly observed dosing (0, 0.5, 1, 2, 4, 6, 8, and 24 hours). Pharmacokinetic parameters of estradiol, spironolactone, and metabolites were estimated by non-compartmental analysis (Monolix 2021R2, Lixoft^®) and compared as geometric mean ratios (GMRs, 90% confidence interval [CI]).

RESULTS: Among 19 TGW who completed the substudy, median age was 26 years (interquartile range: 23-27.5). Estradiol area under the plasma concentration-time curve (AUC_τ) and trough concentrations did not differ between PK1 and PK2 evaluations (GMR [90% CI]: 0.89 [0.76-1.04] and 1.06 [0.94-1.20], respectively). Spironolactone and canrenone AUC_τ were statistically lower at PK2 than PK1 (0.76 [0.65-0.89] and 0.85 [0.78-0.94], respectively). Canrenone maximum concentration was also lower at PK2 than PK1 (0.82 [0.74-0.91]).

CONCLUSION: Estradiol PK was not influenced by PrEP concomitant use. The small differences observed in some spironolactone and canrenone PK parameters should not prevent the concomitant use of estradiol-based FHT and PrEP.

TRIAL REGISTRATION: This trial (NCT03220152) was registered on July 18, 2017.

PMID:37261664 | DOI:10.1007/s40262-023-01248-0

J Cancer Surviv. 2023 Jun 1. doi: 10.1007/s11764-023-01408-y. Online ahead of print.

ABSTRACT

PURPOSE: Weight gain after breast cancer poses health risks. We aimed to identify factors associated with weight gain during adjuvant endocrine therapy (AET).

METHODS: Women initiating AET enrolled in a prospective cohort. Participants completed FACT-ES plus PROMIS pain interference, depression, anxiety, fatigue, sleep disturbance and physical function measures at baseline, 3, 6, 12, 24, 36, 48 and 60 months. Treatment-emergent symptoms were defined as changes in scores in the direction indicative of worsening symptoms that exceeded the minimal important difference at 3 and/or 6 months compared to baseline. We used logistic regression to evaluate associations of clinicodemographic features and treatment-emergent symptoms with clinically significant weight gain over 60 months (defined as ≥ 5% compared to baseline) in pre- and post-menopausal participants.

RESULTS: Of 309 participants, 99 (32%) were pre-menopausal. The 60 months cumulative incidence of clinically significant weight gain was greater in pre- than post-menopausal participants (67% vs 43%, p < 0.001). Among pre-menopausal participants, treatment-emergent pain interference (OR 2.49), aromatase inhibitor receipt (OR 2.8), mastectomy, (OR 2.06) and White race (OR 7.13) were associated with weight gain. Among post-menopausal participants, treatment-emergent endocrine symptoms (OR 2.86), higher stage (OR 2.25) and White race (OR 2.29) were associated with weight gain while treatment-emergent physical function decline (OR 0.30) was associated with lower likelihood of weight gain.

CONCLUSIONS: Weight gain during AET is common, especially for pre-menopausal women. Clinicodemographic features and early treatment-emergent symptoms may identify at risk individuals.

IMPLICATIONS FOR CANCER SURVIVORS: Patients at risk for weight gain can be identified early during AET.

GOV IDENTIFIER: NCT01937052, registered September 3, 2013.

PMID:37261654 | DOI:10.1007/s11764-023-01408-y

Hernia. 2023 Jun 1. doi: 10.1007/s10029-023-02813-z. Online ahead of print.

ABSTRACT

PURPOSE: There is a growing trend to expand Ambulatory Surgery (AS) criteria in abdominal wall surgery. No Admission (NOADS) circuit. The present study aimed to assess the impact of classification criteria on postoperative results and hospital stays in a NOADS versus a conventional admission circuit to throw some light on surgical circuit inclusion.

METHODS: A retrospective analysis of a prospective;y maintained database was performed comparing groin hernia’s interventions in a NOADS vs Admission circuit in our center in 2018-2021. A multiple regression predictive model followed by a retrospective retest were dessigned to assess the impact of each criterion on hospital stay. In total, 743 patients were included, 399 in the Admission circuit (ADC) and 344 in NOADS circuit (NOADS).

RESULTS: There were no statistical differences in complication or readmission rates (p = 0.343 and p = 0.563), nevertheless, a shorter hospital stay was observed in NOADS (p = 0.000). A hierarchical multiple regression predictive model proposed two opposite scenarios. The best scenario, not likely to need admission, was a female patient operated via the laparoscopic approach of a unilateral primary hernia (Estimated Postoperative Stay: 0.049 days). The worst scenario, likely to need admission, was a male patient operated via the open approach of a bilateral and recurrent hernia (Estimated Postoperative Stay: 1.505 Days).

CONCLUSION: Groin hernia patients could safely benefit from a No Admission (NOADS) circuit. Our model could be useful for surgical circuit decision-making, especially for best/worst scenarios.

PMID:37261641 | DOI:10.1007/s10029-023-02813-z

J Magn Reson Imaging. 2023 Jun 1. doi: 10.1002/jmri.28839. Online ahead of print.

ABSTRACT

BACKGROUND: Lenticulostriate artery (LSA) obstruction is a potential cause of subcortical infarcts. However, MRI LSA evaluation at 3T is challenging.

PURPOSE: To investigate middle cerebral artery (MCA) plaque characteristics and LSA morphology associated with subcortical infarctions in LSA territories using 7-T vessel wall MRI (VW-MRI) and time-of-flight MR angiography (TOF-MRA).

STUDY TYPE: Prospective.

POPULATION: Sixty patients with 80 MCA atherosclerotic plaques (37 culprit and 43 non-culprit).

FIELD STRENGTH/SEQUENCE: 7-T with 3D TOF-MRA and T1-weighted 3D sampling perfection with application-optimized contrast using different flip angle evolutions (SPACE) sequences.

ASSESSMENT: Plaque distribution (superior, inferior, ventral, or dorsal walls), LSA origin involvement, LSA morphology (numbers of stems, branches, and length), and plaque characteristics (normalized wall index, maximal wall thickness, plaque length, remodeling index, intraplaque hemorrhage, and plaque surface morphology (regular or irregular)) were assessed.

STATISTICAL TESTS: Least absolute shrinkage and selection operator regression, generalized estimating equations regression, receiver operating characteristic curve, independent t-test, Mann-Whitney U test, Chi-square test, Fisher’s exact test, and intra-class coefficient. A P value <0.05 was considered statistically significant.

RESULTS: Plaque irregular surface, superior wall plaque, longer plaque length, LSA origin involvement, fewer LSA stems, and shorter total and average lengths of LSAs were significantly associated with culprit plaques. Multivariable logistic analysis confirmed that LSA origin involvement (OR, 28.51; 95% CI, 6.34-181.02) and plaque irregular surface (OR, 8.32; 95% CI, 1.41-64.73) were independent predictors in differentiating culprit from non-culprit plaques. A combination of LSA origin involvement and plaque irregular surface (area under curve = 0.92; [95% CI, 0.86-0.98]) showed good performance in identifying culprit plaques, with sensitivity and specificity of 86.5% and 86.0%, respectively.

DATA CONCLUSION: 7-T VW-MRI and TOF-MRA can demonstrate plaque involvement with LSA origins. MCA plaque characteristics derived from 7-T VW-MRI showed good diagnostic accuracy in determining the occurrence of subcortical infarctions.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 3.

PMID:37259904 | DOI:10.1002/jmri.28839

J Obstet Gynaecol Res. 2023 Jun 1. doi: 10.1111/jog.15699. Online ahead of print.

ABSTRACT

AIM: To explore left ventricular structural/functional abnormalities in preeclampsia patients by using multimodal echocardiography and to analyze the cardiac impact in preeclampsia subtypes.

METHODS: A total of 103 individuals, including 64 preeclampsia patients and 39 healthy pregnant women were recruited for this study from 2019 to 2021. There were 34 patients with preeclampsia with severe features (SPE) patients and 30 with preeclampsia with nonsevere features (NSPE), including 9 with early-onset NSPE (EO-NSPE) patients, 27 early-onset SPE (EO-SPE) patients, 21 later-onset NSPE (LO-NSPE), and 7 with later-onset SPE (LO-SPE). All patients underwent multimodal echocardiography before treatment, including two-dimensional, Doppler, and speckle-tracking echocardiography, to evaluate left ventricular structure/function. Analysis of variance was used to determine statistical significance across groups.

RESULTS: EO-SPE patients showed decreased left ventricular ejection fractions, peak longitudinal systolic strain at apical four-chambers, peak circumferential, and radial systolic strain at the apical and mitral annular plane systolic excursion (MAPSE), and increased mitral regurgitation compared to other preeclampsia patients. Compared to LO-NSPE and EO-SPE patients, LO-SPE patients showed increased left ventricular mass indexed to height^2.7 and early diastolic left ventricular diastolic filling/mitral annular velocity, and decreased MAPSE and early/late diastolic mitral annular velocity.

CONCLUSION: EO-SPE patients were characterized by left ventricular injury and systolic function reduced. LO-SPE patients were characterized by left ventricular hypertrophy and reduced diastolic function. Multimodal echocardiography can detect myocardial injury in PE patients at an early stage.

PMID:37259850 | DOI:10.1111/jog.15699

Future Oncol. 2023 Jun 1. doi: 10.2217/fon-2023-0165. Online ahead of print.

ABSTRACT

Purpose: To evaluate the risk factors for young-onset advanced colorectal neoplasia. Methods: We performed a meta-analysis of 30 potential exposure risk factors from 28 original studies. Results: Several risk factors showed statistical significance, including male sex (odds ratio [OR]: 1.28; 95% CI: 1.12-1.47), metabolic syndrome (OR: 1.34; 95% CI: 1.25-1.44), hypertension (OR: 1.22; 95% CI: 1.17-1.28), diabetes (OR: 1.23; 95% CI: 1.15-1.32), inflammatory bowel disease (OR: 4.62; 95% CI: 1.12-17.54), obesity (OR: 1.23; 95% CI: 1.06-1.43), sedentary behavior (OR: 1.25; 95% CI: 1.06-1.48), smoking (OR: 1.19; 95% CI: 1.05-1.36), high alcohol consumption (OR: 1.37; 95% CI: 1.10-1.71), high intake of sugar (OR: 2.58; 95% CI: 1.61-4.13) and red meat (OR: 1.10; 95% CI: 1.04-1.16), and family history of colorectal cancer (OR: 3.14; 95% CI: 1.29-7.64). Conclusion: Our study identified potential risk factors for young-onset advanced colorectal neoplasms to help develop targeted primary prevention strategies.

PMID:37259811 | DOI:10.2217/fon-2023-0165