Tag: statistics

Int J Hyg Environ Health. 2021 Jul 23;237:113811. doi: 10.1016/j.ijheh.2021.113811. Online ahead of print.

ABSTRACT

Legionnaires Disease incidence has risen in the Netherlands in recent years. For the majority of the cases, the source of infection is never identified. Two Dutch wastewater treatment plants (WWTPs) have previously been identified as source of outbreaks of Legionnaires Disease (LD) among local residents. The objective of this study is to examine if LD patients in the Netherlands are more exposed to aerosols originating from WWTPs than controls.

METHODS: An atmospheric dispersion model was used to generate nationwide exposure maps of aerosols from 776 WWTPs in the Netherlands. Municipal sewage treatment plants and industrial WWTPs were both included. Exposure of LD cases and controls at the residential address was compared, in a matched case-control design using a conditional logistic regression. Cases were notified LD cases with onset of disease in the period 2013-2018 in the Netherlands (n = 1604).

RESULTS: Aerosols dispersed over a large part of the Netherlands, but modelled concentrations are estimated to be elevated in close proximity to WWTPs. A statistically significant association was found between LD and the calculated annual average aerosol concentrations originating from WWTPs (odds-ratio: 1.32 (1.06-1.63)). This association remained significant when the two outbreak-related WWTPs were removed from the analysis (odds-ratio: 1.28 (1.03-1.58)).

CONCLUSION: LD cases were more exposed to aerosols from WWTPs than controls. This indicates that exposure to aerosols dispersed from WWTPs caused Legionnaires Disease in residents living near WWTPs in the period 2013-2018. In order to investigate which characteristics of WWTPs are associated with an increased LD risk, the WWTP database should be updated and more data is needed on the presence and survival of aerosolized Legionella bacteria to improve the Legionella dispersion modelling. Furthermore, it is recommended to further investigate how aerosol dispersion of WWTPs can effectively be reduced in order to reduce the potential health risk.

PMID:34311418 | DOI:10.1016/j.ijheh.2021.113811

Sci Total Environ. 2021 Jul 15;797:149063. doi: 10.1016/j.scitotenv.2021.149063. Online ahead of print.

ABSTRACT

The aim of this study is to utilize novel and powerful workflows with publicly available tools to efficiently process data and facilitate rapid acquisition of knowledge on environmental fate studies. Taking imatinib (IMA) as an example, we developed an efficient workflow to describe IMA biodegradation with activated sludge (AS) from wastewater treatment plants (WWTP). IMA is a cytostatic pharmaceutical; a selective tyrosine kinase inhibitor used to treat chronic myeloid leukemia. Its reported ecotoxic, endocrine and genotoxic effects imply high risk for aquatic wildlife and human health, however its fate in the environment is not yet well known. The study was conducted in a batch biotransformation setup, at two AS concentration levels and in presence and absence of carbon source. Degradation profiles and formation of IMA transformation products (TPs) were investigated using UHPLC-QqOrbitrap-MS/MS which showed that IMA is readily biodegradable. TPs were determined using multivariate statistical analysis. Eight TPs were determined and tentatively identified, six of them for first time. Hydrolysis of amide bond, oxidation, demethylation, deamination, acetylation and succinylation are proposed as major biodegradation pathways. TP235, the product of amide bond hydrolysis, was detected and quantified in actual wastewaters, at levels around 1 ng/L. This calls for more studies on the environmental fate of IMA in order to properly asses the environmental risk and hazard associated to IMA and its TPs.

PMID:34311367 | DOI:10.1016/j.scitotenv.2021.149063

Sci Total Environ. 2021 Jul 17;797:149040. doi: 10.1016/j.scitotenv.2021.149040. Online ahead of print.

ABSTRACT

The increasing release of nutrients to aquatic environments has led to great concern regarding eutrophication and the risk of unwanted algal blooms. Based on observational data of 20 water quality parameters measured on a monthly basis at 40 stations from 2011 to 2020, this study applied different Machine Learning (ML) algorithms to suggest the best option for algal bloom prediction in the Han River, a large river in South Korea. Eight different ML algorithms were categorized into several groups of statistical learning, regression family, and deep learning, and were then compared for their suitability to predict the chlorophyll-derived trophic index (TSI-Chla). ML algorithms helped identify the most important water quality parameters contributing to algal bloom prediction. The ML results confirmed that eutrophication and algal proliferation were governed by the complex interplay between nutrients (nitrogen and phosphorus), organic contaminants, and environmental factors. Of the models tested, the adaptive neuro-fuzzy inference system (ANFIS) exhibited the best performance owing to its consistent and outperforming prediction both quantitatively (i.e., via regression) and qualitatively (i.e., via classification), which was evidenced by the lowest value of mean absolute error (MAE) of 0.09, and the highest F1-score, Recall and Precision of 0.97, 0.98 and 0.96, respectively. In a further step, a representative web application was constructed to assist common users to predict the trophic status of the Han River. This study demonstrated that ML techniques are not only promising for highly accurate water quality modeling of urban rivers, but also reduce time and labor intensity for experiments, which decreases the number of monitored water quality parameters, providing further insights into the driving factors of water quality deterioration. They ultimately help devise proactive strategies for sustainable water management.

PMID:34311376 | DOI:10.1016/j.scitotenv.2021.149040

Lung Cancer. 2021 Jul 20;159:45-55. doi: 10.1016/j.lungcan.2021.06.024. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to compare the prognostic value of inflammatory biomarkers extracted from pretreatment peripheral blood and [18F]-FDG PET for estimating outcomes in non-small cell lung cancer (NSCLC) patients treated with first-line immunotherapy (IT) or chemotherapy (CT).

MATERIALS AND METHODS: In this retrospective multicenter study, we evaluated 111 patients with advanced NSCLC who underwent baseline [18F]-FDG PET/CT before IT or CT between 2016 and 2019. Several blood inflammatory indices were evaluated: derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP) and systemic immune-inflammation index (SII). FDG-PET inflammatory parameters were extracted from lymphoid tissues (BLR and SLR: bone marrow or spleen-to-Liver SUVmax ratios). Association with survival and relationships between parameters were evaluated using Cox prediction models and Spearman’s correlation respectively.

RESULTS: Overall, 90 patients were included (IT:CT) (51:39pts). Median PFS was 8.6:6.6 months and median OS was not reached:21.2 months. In the IT cohort, high dNLR (>3), high SII (≥1,270) and high SLR (0.77) were independent statistically significant prognostic factors for one-year progression-free survival (1y-PFS) and two-year overall survival (2y-OS) on multivariable analysis. In the CT cohort, high BLR (≥0.80) and high dNLR (>3) were associated with shorter 1y-PFS (HR 2.2, 95% CI 1.0-4.9) and 2y-OS (HR 3.4, 95CI 1.1-10.3) respectively, on multivariable analysis. Finally, BLR significantly but moderately correlated with most blood-based inflammatory indices (CRP, PLR and SII) while SLR was only associated with CRP (p < 0.01 for all).

CONCLUSION: In advanced NSCLC patients undergoing first-line IT or CT, pretreatment blood and inflammatory factors evaluating the spleen or bone marrow on [18F]-FDG PET/CT provided prognostic information for 1y-PFS and 2y-OS. These biomarkers should be further evaluated for potential clinical application.

PMID:34311344 | DOI:10.1016/j.lungcan.2021.06.024

Lung Cancer. 2021 Jul 21;159:56-65. doi: 10.1016/j.lungcan.2021.06.028. Online ahead of print.

ABSTRACT

OBJECTIVES: Veliparib is a potent poly(ADP)-ribose polymerase (PARP) 1 and 2 inhibitor that impedes repair of DNA damage induced by cytotoxic and radiation therapies. This phase 1 study evaluated veliparib in combination with chemoradiotherapy in patients with unresectable stage III non-small cell lung cancer (NSCLC).

MATERIALS AND METHODS: Patients received veliparib orally twice daily (BID) in escalating doses (60-240 mg, Day -3 to 1 day after last dose of radiation) combined with weekly carboplatin (area under the curve [AUC] 2 mg/mL/min), paclitaxel (45 mg/m²), and daily radiation therapy (60 Gy in 30 fractions), followed by two cycles of veliparib (120-240 mg BID, Days -2 through 5 of each 21-day cycle), carboplatin (AUC 6 mg/mL/min, Day 1 of each cycle), and paclitaxel (200 mg/m², Day 1 of each cycle) consolidation. Endpoints included veliparib maximum tolerated dose (MTD), recommended phase 2 dose (RP2D), pharmacokinetics, safety, and efficacy.

RESULTS: Forty-eight patients were enrolled. The MTD/RP2D of veliparib was 240 mg BID with chemoradiotherapy followed by 120 mg BID with consolidation. The most common any-grade adverse events (AEs) in this cohort for the whole treatment period were nausea (83%), esophagitis (75%), neutropenia (75%), and thrombocytopenia (75%). Dose-proportional pharmacokinetics of veliparib were observed. Median progression-free survival (mPFS) was 19.6 months (95% CI: 9.7-32.6). Median overall survival was estimated to be 32.6 months (95% CI: 15.0-not reached). In patients treated with the RP2D, mPFS was 19.6 months (95% CI: 3.0-not reached).

CONCLUSIONS: When combined with standard concurrent chemoradiotherapy and consolidation chemotherapy in patients with stage III NSCLC, veliparib demonstrated an acceptable safety profile and antitumor activity with an mPFS of 19.6 months.

PMID:34311345 | DOI:10.1016/j.lungcan.2021.06.028

J Biomech. 2021 Jul 10;126:110623. doi: 10.1016/j.jbiomech.2021.110623. Online ahead of print.

ABSTRACT

Temporomandibular joint (TMJ) disorders disproportionally affect females, with female to male prevalence varying from 3:1 to 8:1. Sexual dimorphisms in masticatory muscle attachment morphometry and association with craniofacial size, critical for understanding sex-differences in TMJ function, have not been reported. The objective of this study was to determine sex-specific differences in three-dimensional (3D) TMJ muscle attachment morphometry and craniofacial sizes and their impact on TMJ mechanics. Human cadaveric TMJ muscle attachment morphometry and craniofacial anthropometry (10Males; 11Females) were determined by previously developed 3D digitization and imaging-based methods. Sex-differences in muscle attachment morphometry and craniofacial anthropometry, and their correlation were determined, respectively using multivariate general linear and linear regression statistical models. Subject-specific musculoskeletal models of the mandible were developed to determine effects of sexual dimorphisms in mandibular size and TMJ muscle attachment morphometry on joint loading during static biting. There were significant sex-differences in craniofacial size (p = 0.024) and TMJ muscle attachment morphometry (p < 0.001). TMJ muscle attachment morphometry was significantly correlated with craniofacial size. TMJ contact forces estimated from biomechanical models were significantly, 23% on average (p < 0.001), greater for females compared to those for males when generating the same bite forces. There were significant linear correlations between TMJ contact force and both 3D mandibular length (R² = 0.48, p < 0.001) and muscle force moment arm ratio (R² = 0.68, p < 0.001). Sexual dimorphisms in masticatory muscle morphology and craniofacial sizes play critical roles in subject-specific TMJ biomechanics. Sex-specific differences in the TMJ mechanical environment should be further investigated concerning mechanical fatigue of TMJ discs associated with TMJ disorders.

PMID:34311291 | DOI:10.1016/j.jbiomech.2021.110623

Midwifery. 2021 Jul 14;103:103093. doi: 10.1016/j.midw.2021.103093. Online ahead of print.

ABSTRACT

OBJECTIVES: Explore what influenced women’s decision to exclusively formula feed, and their experiences with formula feeding within a maternity hospital environment.

DESIGN: This mixed methods study used a cross-sectional exploratory survey design. Short surveys were administered by telephone in the postpartum period. Content analysis revealed common themes for responses to open-ended questions on what influenced women’s choice and experience with formula feeding. Descriptive statistics were used for demographic characteristics, and frequencies conducted on some themes.

PARTICIPANTS AND SETTING: English-speaking women who chose to exclusively formula feed, and attended a tertiary maternity hospital in Australia were invited to participate; 102 women were interviewed.

FINDINGS: Themes that influenced women to choose exclusive formula feeding were: ‘Previous breastfeeding challenges’, ‘social and societal issues’ including convenience, comfort, and trust in formula, and ‘maternal health’ including medical issues and medications, breast physiology and mental health. Themes from the formula feeding experience in hospital were: ‘Supportive’ elements such as midwifery care, convenience, and resources, and ‘hindering’ elements such as a perceived breastfeeding agenda and systemic barriers.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Previous breastfeeding difficulties were a common influence on exclusive formula feeding in subsequent pregnancies, highlighting the importance of adequate support during the primary lactation/infant feeding experience. Greater comfort and confidence levels with formula feeding and a sense of trust in formula were also influential. Some maternal medications, conditions, or physiological circumstances were perceived by women as impacting breastfeeding or breastmilk, signposting the importance of antenatal screening and assessment to support women’s options and decisions regarding infant feeding. A perception of professional and organisational preferences for breastfeeding over formula feeding contributed to some women feeling judged for their choice. This reminds midwives to consider the complex intersection of factors that influence infant feeding decisions and ensure all mothers are respected and fully supported.

PMID:34311337 | DOI:10.1016/j.midw.2021.103093

J Environ Manage. 2021 Jul 23;297:113327. doi: 10.1016/j.jenvman.2021.113327. Online ahead of print.

ABSTRACT

The significant increase in illegal use of the synthetic opioid fentanyl is leading to unintentional overdose fatalities. Spills of fentanyl where it is abused or prepared for illegal distribution can result in persistent contamination of areas. Remediation can be attempted through physical removal but may benefit greatly from application of decontamination solutions that provide in-situ degradation of fentanyl. This work investigates the efficacy of decontamination technologies for degradation of fentanyl-HCl on indoor surfaces. Decontamination studies were conducted to evaluate the oxidative degradation of fentanyl based on percarbonate, hydrogen peroxide, peracetic acid, and chlorine (bleach) chemistries. This study utilized an experimental design relevant to field operations to provide direct information to first or hazardous materials responders and providers of environmental fentanyl remediation services, who may otherwise rely on unverified approaches. Across a range of nonporous indoor surfaces, results suggest that water (with or without detergent) spraying alone can physically remove 70-90% of fentanyl (with all fentanyl recovered in runoff). In nearly all cases, the spray application of peracetic acid or acetified bleach oxidants resulted in statistically significant degradation of fentanyl (>95% reduction), with noticeably lower efficacy for other oxidants (e.g., pH neutral bleach and OxiClean™). The decontamination efficacy was significantly reduced upon the addition of cutting agents that competed for oxidant demand.

PMID:34311256 | DOI:10.1016/j.jenvman.2021.113327

Food Chem. 2021 Jun 21;365:130430. doi: 10.1016/j.foodchem.2021.130430. Online ahead of print.

ABSTRACT

Liquid-liquid microextraction (LLME) combined with gas chromatography-olfactometry-mass spectrometry (GC-O-MS) was used to detect the variations in volatile compounds during the distillation process (head, heart, and tail) of raw Baijiu produced by different layers of fermented grains; 47 aroma compounds were sniffed and identified. Moreover, temperature-programmed headspace gas chromatography-ion mobility spectrometry (TP-HS-GC-IMS) was applied to characterize the Baijiu distillation process for the first time. The 3D fingerprint spectrum clearly showed a variation in volatile compounds from different distillation stages, and most compounds showed a downward trend. In addition, multivariate statistical analysis, including principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), etc., confirmed ten aroma active markers related to classification, indicating that these markers had a great influence on the flavor of raw Baijiu.

PMID:34311281 | DOI:10.1016/j.foodchem.2021.130430

Diabetes Metab Syndr. 2021 Jul 21;15(5):102227. doi: 10.1016/j.dsx.2021.102227. Online ahead of print.

ABSTRACT

AIMS: The aim is to assess the association and population attributable fraction (PAF) of multiple risk factors combination for diabetes and hypertension among adults in the Northeast region of India.

METHODS: Data used is from the Indian Demographic Health Survey conducted in 2015-16. The study comprised 107, 766 respondents (95,153 females and 12, 613 males) aged 15-49 years. We examined four modifiable risk factors: smoking, alcohol consumption, aerated drinks consumption, and overweight or obesity. PAF was calculated using the relative risk from the multivariable logistic regression models.

RESULTS: Overweight or obesity in conjunction with smoking was associated with 43.9 % of patients with diabetes. Smoking in conjunction with alcohol and overweight or obesity contributed to 53% of patients with diabetes (PAF = 53 %). The three risk factors combination (i.e., smoking, alcohol, and overweight or obesity) is associated with the most hypertension cases (PAF = 50.7 %). Experiencing all four risk factors is associated with 50.3 % of patients with hypertension. In women, the four-risk combination contributed the most hypertension cases (PAF = 46.8 %).

CONCLUSIONS: Overweight or obesity was the single most significant factor leading to hypertension and diabetes among the study population. Also, smoking, alcohol, and overweight or obesity together are prominent risk factors for hypertension and diabetes.

PMID:34311195 | DOI:10.1016/j.dsx.2021.102227