Tag: statistics

Environ Sci Pollut Res Int. 2021 Mar 21. doi: 10.1007/s11356-021-13046-x. Online ahead of print.

ABSTRACT

Investment in capitals is sacrosanct to launch a country to a greater path of sustainable development. Notwithstanding, its deleterious impacts on environment are equally incontestable. In light of this stark reality, this paper examines the threshold effects of capital investments on carbon emissions in G20 economies over the period, 1992-2014, for which data are available. The study uses both exogenously determined and endogenously determined thresholds to uncover the relationship. While the former relies on median approach to determining the threshold on the one hand, the latter uses both the fixed effects panel threshold model proposed by (Hansen J Econ 93:345-368, 1999) and the bootstrap method by (Hansen Econometrica 68:575-603, 2000) to assess the statistical relevance of the threshold effects on the other hand. The results of the exogenously determined thresholds show higher statistical significant environmental impacts of capital investments at a median threshold of above 3.068 than when it is lesser. The findings of the latter approach indicate the relationship between capital investments and carbon emissions to be non-linear for the G20 countries. More specifically, this study establishes a single-threshold level of capital investment on carbon emissions for the group of countries. The threshold estimator of 3.434 is established at the 95% confidence interval. Beyond this point, the environmental impacts of capital investments are imaginable. On the policy front, keeping to the limit set by threshold effects would go a long way to stemming environmental pollution and mitigating climatic change impacts.

PMID:33745025 | DOI:10.1007/s11356-021-13046-x

Eur J Cancer. 2021 Mar 17;148:124-133. doi: 10.1016/j.ejca.2021.02.022. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to report the uptake of hysterectomy and/or bilateral salpingo-oophorectomy (BSO) to prevent gynaecological cancers (risk-reducing surgery [RRS]) in carriers of pathogenic MMR (path_MMR) variants.

METHODS: The Prospective Lynch Syndrome Database (PLSD) was used to investigate RRS by a cross-sectional study in 2292 female path_MMR carriers aged 30-69 years.

RESULTS: Overall, 144, 79, and 517 carriers underwent risk-reducing hysterectomy, BSO, or both combined, respectively. Two-thirds of procedures before 50 years of age were combined hysterectomy and BSO, and 81% of all procedures included BSO. Risk-reducing hysterectomy was performed before age 50 years in 28%, 25%, 15%, and 9%, and BSO in 26%, 25%, 14% and 13% of path_MLH1, path_MSH2, path_MSH6, and path_PMS2 carriers, respectively. Before 50 years of age, 107 of 188 (57%) BSO and 126 of 204 (62%) hysterectomies were performed in women without any prior cancer, and only 5% (20/392) were performed simultaneously with colorectal cancer (CRC) surgery.

CONCLUSION: Uptake of RRS before 50 years of age was low, and RRS was rarely undertaken in association with surgical treatment of CRC. Uptake of RRS aligned poorly with gene- and age-associated risk estimates for endometrial or ovarian cancer that were published recently from PLSD and did not correspond well with current clinical guidelines. The reasons should be clarified. Decision-making on opting for or against RRS and its timing should be better aligned with predicted risk and mortality for endometrial and ovarian cancer in Lynch syndrome to improve outcomes.

PMID:33743481 | DOI:10.1016/j.ejca.2021.02.022

Comput Methods Programs Biomed. 2021 Mar 12;203:106046. doi: 10.1016/j.cmpb.2021.106046. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the importance of stroke volume readings in understanding the work of the cardiovascular system in patients, its routine daily measurement outside of a hospital in the absence of special equipment presents a problem for a comprehensive assessment of the heart performance.

OBJECTIVE: The purpose of this study was to develop a new non-invasive technique for measuring a stroke volume based on the relationship between time skin warming and a blood flow.

METHODS: . Ninety two randomly selected volunteers (54 males, aged 30.1 ± 11.9 years old, and 38 females, aged 35.8 ± 12.4 years old) were recruited for this study. The time skin warming was determined by applying on the wrist above the arterial pulsation a thermoelectric cooler using the Peltier effect. During recording the participants were in the supine position. Blood pressure was measured by sphygmomanometer. Heart performance was assessed by Murata ballistocardiographic sensor, detecting displacement of the whole body during each cardiac ejection of blood. The data provided by this sensor included heart rate, respiratory rate, heart rate variability and a stroke volume. Linear, non-linear statistical regression models and fuzzy logic were used to analyse the degree of interrelation between BCG-measured stroke volume and the time skin warming.

RESULTS: Comparative analysis of results indicated that the generic-fuzzy logic model demonstrated a high level of dependency (R = 0.803) between input (participants’ time skin warming, pulse pressure and age) and output (ballistocardiographic stroke volume) parameters.

CONCLUSIONS: The method described in the paper offers a simple, portable, and low-cost solution that can even be used in a home setting to measure the stroke volume. The principle of the proposed method is based on the interrelation between time skin warming and blood flow. The latter, corrected by corresponding age and pulse pressure, expresses the participant’s stroke volume. Adopting the genetic-fuzzy model significantly improved the accuracy of stroke volume’s measurement and made the proposed method reliable for assessing of the cardiovascular system. This daily practice technique would help healthcare provider get an early diagnosis of cardiac dysfunctions and track heart changes during stress, e.g., in sport.

PMID:33743490 | DOI:10.1016/j.cmpb.2021.106046

Med Image Anal. 2021 Mar 4;70:102020. doi: 10.1016/j.media.2021.102020. Online ahead of print.

ABSTRACT

Representing an object by a skeletal structure can be powerful for statistical shape analysis if there is good correspondence of the representations within a population. Many anatomic objects have a genus-zero boundary and can be represented by a smooth unbranching skeletal structure that can be discretely approximated. We describe how to compute such a discrete skeletal structure (“d-s-rep”) for an individual 3D shape with the desired correspondence across cases. The method involves fitting a d-s-rep to an input representation of an object’s boundary. A good fit is taken to be one whose skeletally implied boundary well approximates the target surface in terms of low order geometric boundary properties: (1) positions, (2) tangent fields, (3) various curvatures. Our method involves a two-stage framework that first, roughly yet consistently fits a skeletal structure to each object and second, refines the skeletal structure such that the shape of the implied boundary well approximates that of the object. The first stage uses a stratified diffeomorphism to produce topologically non-self-overlapping, smooth and unbranching skeletal structures for each object of a population. The second stage uses loss terms that measure geometric disagreement between the skeletally implied boundary and the target boundary and avoid self-overlaps in the boundary. By minimizing the total loss, we end up with a good d-s-rep for each individual shape. We demonstrate such d-s-reps for various human brain structures. The framework is accessible and extensible by clinical users, researchers and developers as an extension of SlicerSALT, which is based on 3D Slicer.

PMID:33743355 | DOI:10.1016/j.media.2021.102020

J Infect Public Health. 2020 Dec 30;14(4):504-507. doi: 10.1016/j.jiph.2020.12.026. Online ahead of print.

ABSTRACT

There is a serious concern over the variation of case fatality of COVID-19 patients that reflects the preparedness of the medical care system in response to the surge of pneumonia patients. We aimed to quantify the disease spectrum of COVID-19 on which we are based to develop a key indicator on the probability of progression from pneumonia to acute respiratory disease syndrome (ARDS) for fatal COVID-19. The retrospective cohort on 12 countries that have already experienced the epidemic of COVID-19 with available open data on the conformed cases with detailed information on mild respiratory disease (MRD), pneumonia, ARDS, and deaths were used. The pooled estimates from three countries with detailed information were 73% from MRD to pneumonia and 27% from MRD to recovery and the case-fatality rate of ARDS was 43%. The progression from pneumonia to ARDS varied from 3% to 63%. These key estimates were highly associated with the case fatality rates reported for each country with a statistically significant positive relationship (adjusted R² = 95%). Such a quantitative model provides key messages for the optimal medical resources allocation to a spectrum of patients requiring quarantine and isolation at home, isolation wards, and intensive care unit in order to reduce deaths from COVID-19.

PMID:33743372 | DOI:10.1016/j.jiph.2020.12.026

Ecotoxicol Environ Saf. 2021 Mar 17;215:112145. doi: 10.1016/j.ecoenv.2021.112145. Online ahead of print.

ABSTRACT

The toxicity of heavy metals is one of the major public health issues leading to hazardous effects on humans. Many studies focus on the adverse effects on people who were working in or living near E-waste recycling. However, little is known to the sustaining effects of E-waste exposure on human health after the recycling factories were shut down. In the present study, we collected the blood of people living near E‑waste recycling facilities after the recycling factories were closed for 2 years. Eight heavy metals were examined in all blood samples. The results revealed that the blood levels of lead (Pb), nickel (Ni), cobalt (Co), mercury (Hg) were significantly higher in the exposed group than in the reference group, and no difference was observed for copper (Cu), zinc (Zn), stannum (Sn), cadmium (Cd). Transforming growth factor-β (TGF-β) and alpha-smooth muscle actin (α-SMA) were analyzed as the important indicators of fibrosis, which were statistically significantly higher in the exposed group than in the reference group. 8-isoprostane (8-I) and malondialdehyde (MDA) as the biomarkers of oxidative stress (OS) were elevated in the exposed group. Furthermore, both Spearman correlation and multiple linear regression showed that Co was positively correlated with TGF-β, α-SMA and 8-I in the exposed group. Accordingly, we speculate that high concentrations of Co dissolved in the blood may increase the risk of tissue fibrosis through stimulating myofibroblast activation and OS involve in the process, which may provide some potential new hints for the intervention for tissue fibrosis in the future.

PMID:33743401 | DOI:10.1016/j.ecoenv.2021.112145

J Environ Manage. 2021 Mar 17;287:112352. doi: 10.1016/j.jenvman.2021.112352. Online ahead of print.

ABSTRACT

Agricultural activities such as row-cropping and grazing, have accelerated stream bank erosion. Accelerated stream bank erosion increases nonpoint source pollutants in aquatic ecosystems, significantly degrading them. Mitigating stream bank erosion is a priority worldwide, especially in agricultural watersheds. The objective of this study was to analyze the impacts of riparian land-use management on stream bank erosion and deposition, along with analyzing its temporal and spatial patterns. The study was conducted in three regions of Iowa (central, northeast and southeast) along 30 stream reaches adjacent to seven different riparian land-uses. The riparian land-uses were riparian forest buffers, grass filters, pastures with the cattle excluded from the stream, intensive rotational grazing, rotational grazing, continuous grazing and row crop fields. Seasonal erosion and deposition data (Spring, Summer and Autumn) were collected along these reaches for 5 years and yearly for the following two years. To analyze the data, conventional statistical methods (ANOVA and Tukey’s test) along with innovative techniques (percentile plots, cumulative erosion curves and bubble charts) were utilized. Based on the analysis, of this extensive in time (seven years) and large in size (1500 pins measured 17 times in three regions) field dataset, major results were obtained in regard to stream bank erosion in Iowa, USA. Stream banks exhibited high year-to-year variation in erosion and deposition showcasing the need for long-term datasets to better understand stream bank erosion and deposition. Seasonal erosion, also had high variability with Spring recording the most erosion followed by Summer and Autumn. Certain seasons exhibited high stream bank erosion indicating that managers need to focus on these seasons, to reduce erosion effectively. In addition, seasonal measurements can highlight depositional events that might be masked with annual measurements. Riparian land-uses significantly impacted stream bank erosion. Riparian forest buffers and grass filters significantly mitigated stream bank erosion while traditional agricultural practices like continuous grazing and row-crop agriculture had accelerated stream bank erosion. Finally, the percentile plots, cumulative erosion curves and bubble charts captured some stream bank responses that would have been unnoticed using conventional statistical methods, allowing decision makers, stakeholders and the general public, to support and approve measures to mitigate this environmental problem. Nature-based solutions utilizing riparian perennial vegetation can sustainably mitigate stream bank erosion.

PMID:33743416 | DOI:10.1016/j.jenvman.2021.112352

Clin Nutr. 2021 Feb 23;40(4):1562-1570. doi: 10.1016/j.clnu.2021.02.021. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: The degradation of muscle mass and loss of functional proteins due to catabolism are associated with adverse outcomes in critically ill patients. While an adequate supply of protein within a medical nutrition concept is suggested to minimize proteolysis, the specificities on appropriate dosage and timing are still under debate. The current study aimed to evaluate the effect of two different quantities of protein as part of a standardized energetically controlled nutrition therapy for the preservation of muscle mass in the later phase of critical illness.

METHODS: A randomized controlled trial was conducted in 42 critically ill patients (age 65 ± 15; 12 females; SAPS 45 ± 11; TISS 20 ± 7; SOFA-score 7 ± 3). The subjects were randomly assigned to either the intervention (1.8 g protein/kg body weight [BW]/d) or standard (1.2 g protein/kg BW/d) group. Nutrient supply via enteral and/or parenteral nutrition was calculated based on the individual energy expenditure measured by indirect calorimetry and target protein content. Quadriceps muscle layer thickness (QMLT) was observed through sonography at inclusion, and during the follow-up period, two and four weeks after inclusion. The measurement points were fixed on two sides at the midpoint and two-thirds between the anterior superior iliac spine and top of the patella. The data were analyzed descriptively wherein chi-squared tests or unpaired two-samle t-tests checked group differences. Daily changes in muscle mass were estimated using a linear mixed model. All data are shown as the mean ± standard deviation (SD).

RESULTS: Actual protein intake reached 1.5 ± 0.5 g and 1.0 ± 0.5 g/kg BW/d in the intervention and standard group, respectively. Mean values of all measurements of QMLT at inclusion (day 13 ± 2 after ICU admission) were 13.5 ± 7.4 mm and 13.4 ± 7.1 mm in the intervention and standard group, respectively (P = 0.967). In both the groups, QMLT decreased over time (P < 0.001), while the estimated mean values of daily QMLT changes were -0.15 ± 0.08 mm (intervention) and -0.28 ± 0.08 mm (standard) without significant between-group differences (intervention effect, P = 0.368; time x intervention effect, P = 0.242). Illness scores and clinical outcomes showed no group differences.

CONCLUSION: In this single-center trial the increased amounts of protein (1.5 g vs. 1.0 g/kg BW/d) provided through medical nutrition therapy in the late phase of critical illness did not achieve a statistically significant impact on the loss of muscle mass in long-term immobilized ICU patients. Larger multi-center trials are needed to evaluate whether observed numerical differences in muscle mass could be a true finding, and will translate into improved clinical outcomes.

TRIAL REGISTRATION: German Clinical Trials Register (http://www.drks.de/), DRKS-ID: DRKS00013594.

PMID:33743292 | DOI:10.1016/j.clnu.2021.02.021

Diagn Microbiol Infect Dis. 2021 Feb 19;100(2):115351. doi: 10.1016/j.diagmicrobio.2021.115351. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the accuracy of the rapid diagnostic test for malaria diagnosis in children under 5 years of age.

METHODS: As of August 31, 2020, PubMed, Web of Science and Cochrane Library databases had been systematically searched. Relevant data were extracted and meta-analysis was carried out. A random effects model was used for subgroup analysis.

RESULTS: According to the inclusion criteria, a total of 26 studies were included in this meta-analysis. The pooled sensitivity and specificity were 0.92 (95% confidence interval 0.83-0.96) and 0.92 (0.86-0.95), the parasite-specific lactate dehydrogenase-based test were 0.96 (0.85-0.98) and 0.93 (0.86-0.95), the histidine-rich protein 2-based test were 0.94 (0.84-0.98) and 0.86 (0.77-0.91).

CONCLUSIONS: This meta-analysis showed that rapid diagnostic test had good accuracy in diagnosing malaria in children under 5 years of age. And the diagnostic performance of parasite-specific lactate dehydrogenase test was better than that of the histidine-rich protein 2 test.

PMID:33743294 | DOI:10.1016/j.diagmicrobio.2021.115351

J Pediatr Nurs. 2021 Mar 17;61:34-39. doi: 10.1016/j.pedn.2021.03.011. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to examine patterns of health and developmental outcomes in children with prenatal opioid exposure (POE) and neonatal abstinence syndrome (NAS) compared to children without exposure during the first three years of life.

DESIGN AND METHODS: This was a secondary data analysis of the Maternal and Infant Data Hub (MIDH), a de-identified dataset originating from the Midwest region of the United States, consisting of newborn billing records and corresponding maternal and child electronic medical records. For these analyses, the repository included data on more than 20,000 children born between 2013 and 2019. Diagnoses were identified with International Classification of Diseases, ninth and tenth Revision, Clinical Modification codes (ICD-9/10-CM). Firth logistic regression was used to assess whether incidence of each diagnosis code differed by exposure group.

RESULTS: Among 20,389 children in the dataset, 13,173 were unexposed; 455 were POE, and 199 were POE + NAS. There were significant differences in frequency of diagnoses between groups, specifically regarding growth and development, infection, mental health, musculoskeletal, neonatal, sensory, and social issues. When comparing exposed groups, children with POE + NAS experienced more negative health outcomes than children with only POE across all years.

CONCLUSIONS: This study implicates POE as a significant variable associated with many health and developmental outcomes of children during the first three years of life.

PRACTICE IMPLICATIONS: It is crucial to understand and identify health risks observed more frequently in exposed children during such a critical period of growth and brain development.

PMID:33743318 | DOI:10.1016/j.pedn.2021.03.011