Statistical Analysis System Institute Research Articles

A Comparative American Board of Surgery In-Training Examination (ABSITE) Performance Analysis Between International vs. Domestic Graduates and Doctor of Medicine (MD) vs. Doctor of Osteopathic Medicine (DO) Medical Degrees.

Introduction The American Board of Surgery (ABS) plays a pivotal role in certifying surgeons in the United States, with the American Board of Surgery In-Training Examination (ABSITE) serving as a critical assessment tool for general surgery residents aspiring for certification. The aim of this study is to compare the performance of international medical graduates (IMGs) to their domestic counterparts and assess the impact of different medical degrees on ABSITE scores. Notably, ABSITE scores often dictate the trajectory of a surgical career, including opportunities for fellowship placements in specialized fields such as plastic surgery. Methods This study focused on general surgery residents enrolled at Marshall University from 2014 to 2022. Data encompassing ABSITE scores, TrueLearn quiz percentages, and TrueLearn mock exam results were collected for analysis. Descriptive statistics summarized sample characteristics, and linear mixed models were employed to address correlations. Statistical analyses were conducted using the Statistical Analysis System (SAS) (version 9.4; SAS Institute Inc., Cary, NC, USA), with significance defined by a two-sided test with p < 0.05. Results Among the 48 participants, comprising 24 non-international medical graduates (nIMGs) and 24IMGs, IMGs demonstrated superior performance across various metrics. They exhibited higher quiz percentages (67% vs. 61%; p = 0.0029), mock Exam 1 scores (64% vs. 58%; p = 0.0021), mock Exam 2 scores (66% vs. 58%; p = 0.0015), ABSITE scores (560 vs. 505; p = 0.010), and ABSITE percentages (74% vs. 68%; p = 0.0077) compared to nIMGs. Analysis between Doctor of Osteopathic Medicine (DO) and Doctor of Medicine (MD) participants revealed no statistically significant differences in performance metrics, highlighting the comparability of these medical degrees in the context of ABSITE scores and related assessments. Discussion/conclusion This study underscores the superior performance of IMGs over nIMGs in ABSITE examinations, shedding light on the critical role of ABSITE scores in shaping surgical careers. Higher scores correlate with enhanced opportunities for coveted fellowship placements, particularly in specialized fields like plastic surgery. Understanding these dynamics is crucial for resident training and navigating the competitive landscape of surgical sub-specialization. Future research endeavors can delve deeper into the factors influencing ABSITE performance, thereby facilitating the development of targeted interventions to support residents in achieving their career aspirations.

Time Delay in Motor Vehicle Accident Arrival: A Critical Analysis of Trauma Team Activation.

Introduction This research aims to investigate the role of time since trauma (TST) in refining trauma team activation (TTA) criteria within a level I trauma center. We analyze the association between TST and post-emergency department (ED) disposition, proposing new insights for the enhancement of TTA criteria. Methods A retrospective analysis was conducted on a dataset comprising 3,693 patients presenting to a level I trauma center following motor vehicle accidents (MVAs) from 2016 to 2021. Data from a trauma registry, encompassing time of injury, time of ED arrival, TTA status, and post-ED disposition, were utilized. TST was calculated as the difference between the time of injury and the time of ED arrival. Patients that received TTA, full or partial, were categorized based on TST (less than one hour, one to two hours, and two or more hours). Statistical analyses, including chi-square tests, were performed using the Statistical Analysis System (SAS) (version 3.8, SAS Institute Inc., Cary, NC). Results Of the 1,261 patients meeting the criteria, 98.3% received TTA, with decreasing TTA rates observed with increasing TST (p = 0.0076). A significant association was found between TST and post-ED disposition for patients who received TTA (p = 0.0007). Compared to the other TST groups, a higher proportion of patients with a TST of two or more hours were admitted,sent to the intensive care unit (ICU), and sent to the operating room (OR). Conclusion The study indicates a statistically significant relationship between TST and TTA rates, challenging our assumptions about the decreased need for TTA over time. While a longer TST was associated with a lower percentageof TTA, patients with a TST of two or more hours demonstrated increased rates of admission, ICU utilization, and surgical interventions. This suggests that TTA criteria may benefit from refinement to include patients with longer TST. Acknowledging study limitations, such as a small sample size and retrospective design, this research contributes valuable insights into potential considerations for optimizing trauma care protocols.

EVALUATION OF SOIL CHEMICAL PROPERTIES AND CARROT PERFORMANCE AS INFLUENCED BY INTEGRATED APPLICATION OF POULTRY MANURE AND COCOA POD HUSK IN THE RAINFOREST AGROECOLOGICAL ZONE OF NIGERIA

The high cost of inorganic fertilizer, difficulties involved in its use, its scarcity, coupled with its adverse effects associated with its continuous use on soil quality prompted the need to research into cheap, locally available organic materials to combat soil fertility problems. Field experiments were conducted in 2019 and 2020 to evaluate the effects of the integrated application of poultry manure (PM) and cocoa pod husk (CPH) on soil chemical properties, growth, leaf nutrients content and yield of carrot at Igba in the rainforest ecology of southwest Nigeria. The treatments consisted of PM and CPH each at three levels (0, 5, 10 t ha-1) in a 2 x 3 factorial experiment laid into randomized complete block design with three replicates. Data were collected on soil chemical properties, growth parameters, leaf nutrients content and yield parameters. Data collected were subjected to analysis of variance using Statistical Analysis System Institute Package (SAS, 2000). The soil was slightly acidic (pH 5.5.), low in nitrogen (0.12g kg), available phosphorus (8 mg kg-1). Integrated application of PM and CPH significantly (P&lt; 0.05) improved soil pH, organic carbon, total N, available P, exchangeable bases and lowered exchangeable acidity. Plots with integrated application of PM and CPH had higher values of soil pH, exchangeable bases, ECEC, total N, total organic carbon, available P and lower values of exchangeable acidity and micronutrients than the plots with their sole applications. There were reductions in soil pH, exchangeable bases, ECEC, total N and organic carbon in the control plots in the second cropping seasons. Growth parameters were better enhanced in plots with the integrated application of PM and CPH than either of their sole. There were significant improvements in plant height, leaf length and shoot diameter in the second cropping season in plots amended with PM, CPH and their integrations as against control plots where reductions in the growth characteristics were obtained. The leaf content of N, P, K and Ca were significantly (P&lt; 0.05) enhanced in plots with integrated application of PM and CPH than the plots with their sole application. Carrot root yield characteristics were significantly (P &lt; 0.05) enhanced in plots with the integrated application of PM and CPH than plots with the sole application of PM or CPH. Root yield was increased in the second cropping season in plots treated with the sole application of PM, CPH and their integrations, while there were reductions in root yield parameters in the control plots. Improvements in soil nutrients status, growth, leaf nutrients content and root yield of carrot in both cropping season in the amended plots when compared to the control plots, imply that integrated use of PM and CPH could be used in the enhancement of production of carrot on sustainable basis in the study area.

Racial Disparities In In-Hospital Mortality of Children and Adolescents Under 20 Years With Type 1 Diabetes Mellitus.

In the United States, racial disparities in health outcomes continue to be a major problem with far-reaching effects on equity in healthcare and public health. Children and teenagers with type 1 diabetes are a disadvantaged demographic that has particular difficulties in managing their condition and getting access to healthcare. Despite improvements in the treatment of diabetes, little study has examined how much racial disparities in in-hospital mortality affect this particular demographic. By examining racial differences in in-hospital mortality rates among children and adolescents with type 1 diabetes in the United States, this study seeks to close this gap. This cross-sectional study utilized data from the Healthcare Cost and Utilization Project's (HCUP) Kids' Inpatient Database (KID) for 2012. The KID is a nationally representative sample of pediatric discharges from US hospitals. A total of 20,107 patients who were admitted with type 1 diabetes were included in this study. The primary outcome was the patient's in-hospital mortality status. The primary predictor variable was the race of the patient. Six potential confounders were chosen based on previous literature: age, sex, hospital location, obesity, weight loss, electrolyte disorders status, and median household income. Descriptive statistics and bivariate analyses were done. Multivariate analysis was conducted while controlling for potential confounders. Odd ratios with a 95% confidence interval and probability value were reported. Statistical Analysis System (SAS) version 9.4 for Windows (SAS Institute Inc., Cary, NC, USA) was used for the statistical analysis. A total of 20,107 patients were included in this study. Of the patients included, 78.6%, 5.3%, 5.9%, and 10.2% were of age groups <4, 5-9, 10-14, and 15-18, respectively. Among the patients,64.3% were female. Whites stood at 54.3%, while Hispanic, Black, and other races accounted for 17.2%, 21.8%, and 6.7% respectively. After adjusting for all other variables, children, and young adults of Asian and Pacific Islanders (OR=1.948; 95% CI 1.015,3.738) had 94% higher odds of in-hospital mortality compared to their White counterparts. Children and young adults aged 5-9 (OR=0.29; 95% CI 0.13,0.649) had 71% lower odds of in-hospital mortality compared to those aged 4 or under. Those aged 10-14 (OR=0.155; 95% CI 0.077,0.313) had 85% lower odds of in-hospital mortality compared to those aged 4 or under, while those aged 15-19 (OR=0.172; 95% CI 0.100,0.296) had 83% lower odds of in-hospital mortality compared to those aged 4 or under.Children and young adults who had weight loss (OR=4.474; 95% CI 2.557,7.826) had almost five times higher odds of in-hospital mortality compared to those without weight loss, while children and young adults who had electrolyte disorders (OR=5.131; 95% CI 3.429,7.679) had five times higher odds of in-hospital mortality compared to those without electrolyte disorders. The results show young adults of Asian and Pacific Islanders have higher odds of in-hospital mortality compared to their White counterparts and this study highlights the urgent need for focused measures designed to lessen these inequalities and enhance health equity. The implementation of culturally sensitive healthcare practices, addressing social determinants of health, and enhancing access to high-quality diabetes care should all be priorities.

The importance of social risk factors for patients diagnosed with opioid use disorder

BackgroundOpioid Use Disorder (OUD) is a major public health concern, with mortality rates in individuals who use opioid medications being up to 30 times greater than those of individuals who do not use such medications. Social risk factors influence one’s ability to make healthy choices and pose challenges for individuals recovering from OUD. ObjectiveThis study aimed to explore the relationship between OUD and social risk factors for patients who have been prescribed opioid medications. MethodsData for this retrospective cohort study were obtained from a health care system’s comprehensive data warehouses consisting of electronic health records (EHR) with Social Determinants of Health (SDoH) screening information, and medical and prescription claims data. The study compared patients 18 years of age or older with an opioid prescription who were considered users of opioids to patients who had a documented diagnosis of OUD in the EHR. All patients were screened for SDoH. The analyses were performed using Statistical Analysis System (SAS) (SAS Institute Inc, Cary, NC). ResultsThe study included patients with an outpatient visit at one of the health care system’s primary care or oncology facilities between January 1, 2017 and December 31, 2018. There were 5003 patients with an opioid prescription who were considered users of opioids, and 209 patients with an opioid prescription as well as a diagnosis of OUD. Compared to the opioid use group, patients with OUD were more likely to have a lower educational attainment, encounter financial hardship, or be food insecure. Being female, older than 40, and having a higher Charlson Comorbidity Index score were factors associated with lower rates of opioid misuse. ConclusionIdentifying social risk factors and providing appropriate services to individuals with OUD is essential in mitigating challenges to recovery and promoting overall health for these individuals.

Cysteamine Supplementation In Vitro Remarkably Promoted Rumen Fermentation Efficiency towards Propionate Production via Prevotella Enrichment and Enhancing Antioxidant Capacity.

Cysteamine (CS) is a vital antioxidant product and nutritional regulator that improves the productive performance of animals. A 2 × 4 factorial in vitro experiment was performed to determine the effect of the CS supplementation levels of 0, 20, 40, and 60 mg/g, based on substrate weight, on the ruminal fermentation, antioxidant capacity, and microorganisms of a high-forage substrate (HF, forage:corn meal = 7:3) in the Statistical Analysis System Institute. After 48 h of incubation, the in vitro dry matter disappearance and gas production in the LF group were higher when compared with a low-forage substrate (LF, forge hay:corn meal = 3:7), which was analyzed via the use of the MIXED procedure of the HF group, and these increased linearly with the increasing CS supplementation (p &lt; 0.01). With regard to rumen fermentation, the pH and acetate were lower in the LF group compared to the HF group (p &lt; 0.01). However, the ammonia N, microbial crude protein, total volatile fatty acids (VFA), and propionate in the LF group were greater than those in the HF group (p &lt; 0.05). With the CS supplementation increasing, the pH, ammonia N, acetate, and A:P decreased linearly, while the microbial crude protein, total VFA, and propionate increased linearly (p &lt; 0.01). Greater antioxidant capacity was observed in the LF group, and the increasing CS supplementation linearly increased the superoxide dismutase, catalase, glutathione peroxidase, total antioxidant capacity, glutathione, and glutathione reductase, while it decreased the malondialdehyde (p &lt; 0.05). No difference occurred in the ruminal bacteria alpha diversity with the increasing CS supplementation, but it was higher in the LF group than in the HF group (p &lt; 0.01). Based on the rumen bacterial community, a higher proportion of Bacteroidota, instead of Firmicutes, was in the LF group than in the HF group. Furthermore, increasing the CS supplementation linearly increased the relative abundance of Prevotella, norank_f_F082, and Prevotellaceae_UCG-001 under the two substrates (p &lt; 0.05). Prevotella, norank_f_F082, and Prevotellaceae_UCG-001 were positively correlated with gas production, rumen fermentation, and antioxidant capacity in a Spearman correlation analysis (r &gt; 0.31, p &lt; 0.05). Overall, a CS supplementation of not less than 20 mg/g based on substrate weight enhanced the rumen fermentation and rumen antioxidant capacity of the fermentation system, and it guided the rumen fermentation towards glucogenic propionate by enriching the Prevotella in Bacteroidetes.

Contributing Factors to Operating Room Delays Identified from an Electronic Health Record: A Retrospective Study.

The operating room (OR) is considered a major cost center and revenue generator for hospitals. Multiple factors contribute to OR delays and impact patient safety, patient satisfaction scores, and hospital financial performance. Reducing OR delays allows better utilization of OR resources and staffing and improves patient satisfaction while decreasing operating costs. Accurate scheduling can be the basis to achieve these goals. The objective of this initial study was to identify factors not normally documented in the electronic health record (EHR) that may contribute to or be indicators of OR delays. Materials and Methods. A retrospective data analysis was performed analyzing 67,812 OR cases from 12 surgical specialties at a small university medical center from 2010 through the first quarter of 2017. Data from the hospital's EHR were exported and subjected to statistical analysis using Statistical Analysis System (SAS) software (SAS Institute, Cary, NC). Results. Statistical analysis of the extracted EHR data revealed factors that were associated with OR delays including, surgical specialty, preoperative assessment testing, patient body mass index, American Society of Anesthesiologists (ASA) physical status classification, daily procedure count, and calendar year. Conclusions. Delays hurt OR efficiency on many levels. Identifying those factors may reduce delays and better accommodate the needs of surgeons, staff, and patients thereby leading to improved patient's outcomes and patient satisfaction. Reducing delays can decrease operating costs and improve the financial position of the operating theater as well as that of the hospital. Anesthesiology teams can play a key role in identifying factors that cause delays and implementing mitigating efficiencies.

Dietary total antioxidant capacity is associated in Polish men and women with the prevalence of cardiovascular diseases and their risk factors

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiovascular diseases (CVD) are the main cause of mortality in the Polish population. Improper diet and lifestyle are among the risk factors for CVD. Previous studies have suggested that dietary total antioxidant capacity (DTAC) is a measure of diet quality. Purpose The aim of the study was to investigate the relationship between diet quality measured by DTAC and the prevalence of CVD and CVD risk factors in the representative sample of men and women in Poland. Methods The study evaluated participants (2594 men, 3136 women) of the population-based cross-sectional Polish National Multicenter Health Examination Survey (WOBASZ II), which was conducted in 2013-2014. Dietary data were collected using a single 24-hour dietary recall method. The database on dietary antioxidants was compiled from published and own experimental data. DTAC was calculated taking into account the antioxidant capacity of individual foods and the amount of food intake. Men and women were divided into quartiles of CVD prevalence and its risk factors (diabetes; hypertension; BMI≥25; central obesity, CO; low level of leisure-time physical activity, LTPA) according to DTAC. Statistical calculations were performed using the Statistical Analysis System (SAS), version 9.4 (SAS Institute Inc., Cary, NC, USA). Results DTAC in men ranged from 0.47 to 95.69 mmol/day, while in women it was 0.32-191.82 mmol/day. In men, the prevalence of CVD was 23.7% in the lowest DTAC quartile (Q1) versus 14.9% in the highest quartile (Q4) (p&amp;lt;0.0001), while in women it was 23.4% (Q1) and 17.4% (Q4), respectively (p&amp;lt;0.0002). In women, but not in men, DTAC was inversely associated with diabetes (p&amp;lt;0.0002), hypertension (p&amp;lt;0.0001), CO (p&amp;lt;0.02) and low LTPA (p&amp;lt;0.0006). Conclusions DTAC is inversely related to the prevalence of CVD in both genders. In women, but not in men, there is a significant inverse association of DTAC with CVD risk factors such as metabolic diseases, central obesity and lower physical activity. In order to reduce the risk of CVD, Polish men and women should be advised to improve the quality of their diet by increasing the dietary intake of antioxidants.

Maltitol based sugar-free chocolates may not promote dental caries: An open-label clinical study

Background: Sugar substitutes like maltitol are reported to be noncariogenic ingredients and may not lead to the development of dental caries (DC), in contrast to sugars and other fermentable carbohydrates. The current study aimed to investigate the effects of maltitol-based sugar-free chocolates on factors associated with DC. Methods: This was an open-label study involving healthy human volunteers. A total of 15 healthy human subjects were screened and enrolled in the study after obtaining their signed informed consent. The subjects were administered the test product, maltitol-based sugar-free chocolate, which contains no added sugar (sucrose). Sucrose was completely replaced with the sweeteners maltitol (minimum 45%) and steviol glycoside (0.05%). Salivary pH was measured using a digital pH meter at baseline and 0 h, 1 h, 2 h, and 4 h after test product consumption. The saliva samples were collected for measurement of Streptococcus mutans colonies at baseline and at 0 h and 4 h after test product consumption. The data were subjected to two-sided tests, at a 5% level of significance using Statistical Analysis System (SAS) 9.4 software (SAS Institute Inc., NC Cary). Results: A statistically significant increase in the salivary pH level from the baseline at 0 h measurement (p = 0.0181) and a reduction in S. mutans formation from baseline to 0 h and 4 h, respectively (p = 0.0001) were noted. Conclusion: Maltitol-based sugar-free chocolates were found to be safe for consumption and were devoid of cariogenic potential.

Outcomes of multiple gestation births compared to singleton: analysis of multicenter KID database

BackgroundThe available data regarding morbidity and mortality associated with multiple gestation births is conflicting and contradicting.ObjectiveTo compare morbidity, mortality, and length of stay (LOS) outcomes between multiple gestation (twin, triplet and higher-order) and singleton births.MethodsData from the national multicenter Kids’ Inpatient Database of the Healthcare Cost and Utilization Project from the years 2000, 2003, 2006, 2009, 2012, and 2016 were analyzed using a complex survey design using Statistical Analysis System (SAS) 9.4 (SAS Institute, Cary NC). Neonates with ICD9 and ICD10 codes indicating singletons, twins or triplets, and higher-order multiples were included. Mortality was compared between these groups after excluding transfer outs to avoid duplicate inclusion. To analyze LOS, we included inborn neonates and excluded transfers; who died inpatient and any neonates who appear to have been discharged less than 33 weeks PMA. The LOS was compared by gestational age groups.ResultsA total of 22,853,125 neonates were analyzed for mortality after applying inclusion-exclusion criteria; 2.96% were twins, and 0.13% were triplets or more. A total of 22,690,082 neonates were analyzed for LOS. Mean GA, expressed as mean (SD), for singleton, twins and triplets, were 38.30 (2.21), 36.39 (4.21), and 32.72 (4.14), respectively. The adjusted odds for mortality were similar for twin births compared to singleton (aOR: 1.004, 95% CI:0.960–1.051, p = 0.8521). The adjusted odds of mortality for triplet or higher-order gestation births were higher (aOR: 1.33, 95% CI: 1.128–1.575, p = 0.0008) when compared to the singleton births. Median LOS (days) was significantly longer in multiple gestation compared to singleton births overall (singletons: 1.59 [1.13, 2.19] vs. twins 3.29 [2.17, 9.59] vs. triplets or higher-order multiples 19.15 [8.80, 36.38], p < .0001), and this difference remained significant within each GA category.ConclusionMultiple gestation births have higher mortality and longer LOS when compared to singleton births. This population data from multiple centers across the country could be useful in counseling parents when caring for multiple gestation pregnancies.

Meat quality of lambs fed phytogenic additives

The study was developed in the Sheep Production Laboratory of the Department of Animal Science, College of Agricultural and Veterinary Sciences, São Paulo State University, Jaboticabal, SP, Brazil. Thirty-two non-castrated Ile de France lambs weighing 20.0 ± 0.2 kg received 4 diets with a roughage: concentrate ratio of 40: 60. The experimental treatments consisted of D1: corn silage + concentrate; D2: corn silage + concentrate + 30 mg rosemary extract kg body weight1; D3: corn silage + concentrate + 30 mg green tea extract kg body weight-1; and D4: corn silage + concentrate + 30 mg oregano extract kg body weight-1, up to 35.0 ± 0.2 kg body weight. The objectives were to evaluate rib eye area, cholesterol content, lipid oxidation, qualitative parameters, as well as perform sensory analysis, centesimal composition, and fatty acid profile of the meat. The experimental design was completely randomized with four treatments and eight replicates. The treatments were compared by Tukey’s test through the SAS software (Statistical Analysis System Institute [SAS], 2003). Inclusion of phytogenic additives into the diets did not affect the qualitative parameters cholesterol content, lipid oxidation, and centesimal composition (except for protein content, which was lower in D2, 22.57%, compared to D1, 25.62%), as well as meat fatty acid profile (except for C18: 1n7 cis-vaccenic). The use of phytogenic additives provided suitable qualitative parameters.

Inflammatory Markers in Workers Occupationally Exposed to Petrol and Petroleum Products

Place and Duration of Study: Sample: Abia State University Teaching Hospital, Aba, Abia State and Laboratory Department, JAROS Inspection Services Limited, Port Harcourt, Rivers State, between April 2018 and June 2018.&#x0D; Methodology: A total of 204 samples comprising of 123 auto-mechanics and 81 non -auto-mechanics were assayed. Detailed information of the bio-data of the subjects including age, gender, medical history, health information and lifestyle were obtained from each participant. Blood samples were collected from for the analysis of inflammation markers, IL-6, TNF-α and CRP were determined using standard methods and techniques. The effect of age and duration of exposure on the inflammation parameters were considered. Statistical Analysis System (SAS), STAT 15.1, developed by SAS Institute, North Carolina State University, USA was used for statistical analysis. Data were presented as Mean ± SEM, comparison of means of groups that are more than two was done using Analysis of Variance (ANOVA), and the Tukey test of multiple comparison was used to test for variance within and across groups.&#x0D; Results: There was significant increase in the means of IL-6, TNF-α and CRP in the exposed subjects (p &lt;0.05) compared with the control subjects There was no significant difference (p &gt;0.05) in the means of IL-6, TNF-α and C-reactive protein (CRP) between the age groups of the exposed and the control subjects. Similarly, there was no significant difference between the groups, based on duration of exposure. This suggests that the toxic effect does not depend on the age or duration of exposure but on other factors for the automechanics in Aba. &#x0D; Conclusion: This study shows that the exposure of automechanics may significantly increase the serum IL-6 TNF-α and Hs-CRP levels. Increase in the serum levels of the inflammation markers is predictive of the danger of future pathology in automechanics compared with non automechanics in Aba metropolis. Age and duration did not influence significant variation in the automechanics.

Dietary intake of plant sterols in cardiovascular diseases: a population-based study of Polish adults

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Cardiology, Warsaw, Poland Introduction. Cardiovascular diseases (CVD) are a major cause of premature mortality and disability in developed countries. Among various risk factors, disorders of lipid metabolism are prevalent. Scientific evidence shows that plant sterols have a positive effect on dyslipidemia. The primary mechanism of hypolipemic effect of plant sterols is inhibition of cholesterol absorption in the small intestine, and this effect depends on the dose. Purpose. The aim of the study was to determine the intake of plant sterols, which was never studied in the Polish population. Methods. In total, 5690 participants of the population-based cross-sectional Polish National Multicenter Health Examination Survey WOBASZ II (2013-2014), aged 20+, were evaluated in the study (1). Nutritional data were collected using a single 24-hour dietary recall method. A dietary plant sterol database was compiled from available experimental data including total and individual plant sterols such as β-sitosterol, campesterol and stigmasterol. Plant sterol intakes were calculated taking into account plant sterol contents in individual food products and the volume of food consumption. Statistical calculations were performed using Statistical Analysis System (SAS), version 9.4 (SAS Institute Inc., Cary, NC, USA). Results. The dietary plant sterol intake (DPSI) for the general population, 283 mg/day, was dependent on the age and gender. The intake of sterols among people over 65 years of age (264 mg/day in men and 208 mg/day in women) was lower than in younger age groups (20-44 years) of participants (343 mg/day in men and 259 mg/day in women). The main dietary plant sterol for both genders was β-sitosterol (∼62% of intake), followed by campesterol (∼21%) and stigmasterol (∼9%). Overall, men and women with cardiovascular disease had significantly lower DPSI (p &amp;gt; 0.002) than men and women without cardiovascular disease, 298.6 and 237.8 vs. 326.1 and 255.9 mg/d, respectively, and men but not women with diabetes had significantly (p &amp;gt; 0.04) lower DPSI than men without diabetes, 301.7 vs. 323.3, respectively. Conclusions. In the view of current recommendations to lower cholesterol, this research confirms findings for other populations, that the dietary intake of plant sterols in the Polish population is insufficient to beneficially modulate lipid metabolism, especially in CVD and diabetic patients.

Evaluation of Effective Microorganisms (EM®) against Root-Knot Nematode (Meloidogyne javanica) in Tomato

Introduction: Plant-parasitic nematodes cause significant yield losses in a wide range of crops (Nicol et al. 2011). Root-knot nematodes (Meloidogyne spp.) are the most important plant-parasitic nematodes, because they widely distributed all around the world and have wide host range (Chapuis-Lardy et al. 2015). Chemical nematicide is one of the primary means of control for plant-parasitic nematodes. Due to negative impact of synthetic nematicides, it will be necessary to develop other management strategies for plant-parasitic nematodes which are safe for the environment and humans (Huang et al., 2016). Latest interest in organic farming lead to substitution for conventional nematicides by low-risk compounds such as natural products derived from plants (Oka et al. 2006). Also, biological control is an interesting option to control these nematodes (Mosahaneh et al. 2020). Effective microorganisms (EM®) consist of a mixture of live cultures of microorganisms such as photosynthetic bacteria, which they are reported to reduce the incidence of pathogenic microorganisms (Condor et al., 2007). Materials and Methods: In the present study, the aerial parts of the marigold (Tagetes erecta) were collected from Shiraz, Iran. Marigold leaves dried in shade and finely grinded using an electric grinder and a stock solution (10% w/v) was prepared. Seeds of tomato (cv. Early-Urbana) were sown in plastic pots containing 1500 g of a sterilized mixture of farm soil (sandy loam soil) and cow manure. The pots were kept under greenhouse conditions with 16:8 h light to dark photoperiod and 27 ± 4 °C. Four-leaf stage seedlings were soil-drenched (50 ml per plant) with EM® or a mixture of equal amount of EM®+ marigold leaf extract at the rate of 5, 10, 15 and 20% and simultaneously inoculated with a suspension of M. javanica (6000 eggs per pot). The experiment was carried out in a completely randomized design with five replications. Sixty days after nematode inoculation, plants were harvested and the vegetative indices including shoots length, shoot fresh and dry weight and root fresh weight and the nematode population indices including the number of eggs as described by Hussey and Barker (1973), number of galls and egg masses per root system as described by Taylor and Sasser (1978) and the number of second stage juveniles (J2s) in the pot were recorded. Finally, the reproduction factor calculated as described by Sasser and Taylor (1978). Data were subjected to one-way analysis of variance (ANOVA) for plant growth parameters and two-way ANOVA for nematode population indices using SAS 9.1 program (Statistical Analysis System Institute Inc., USA). Treatment means were compared using least significance differences (LSD) at p<0.01.Results and Discussion: Results showed that soil drenching of EM® and EM®+ marigold leaf extract increased the plant growth parameters on inoculated and non-inoculated plants as compared to control. The treatment with EM®+ marigold leaf extract at the rate of 20% was the most effective treatment and increased shoot length, shoot fresh weight and shoot dry weight of non-inoculated plants by 33, 39 and 11% respectively, as compared to non-inoculted control plants. In the case of inoculated plants, shoot length, shoot fresh weight, shoot dry weight and root fresh weight of treated plats with EM®+ marigold leaf extract at the rate of 20% were 34, 31, 15 and 11% higher than inoculated control plants. The number of eggs and egg masses per root system and the reproduction factor were significantly reduced in treated plants with EM®+ marigold leaf extract at the rate of 15 and 20%. EM®+ marigold leaf extract at the rate of 20% reduced the number of eggs, galls, egg masses per root system and the reproduction factor by 28, 40, 37 and 27% respectively, as compared to control. The lowest numbers of eggmasses were observed in the root system of tomato plants treated with EM®+ marigold leaf extract at the rate of 20%. It had significant difference than other treatments, except EM® at the rate of 20%. These data for the first time in Iran, suggest that EM® might have utility in controlling root-knot nematodes. A mixture of EM® and marigold leaf extract was more effective than alone application of EM® for control of M. javanica. Findings from this study, suggest that a mixture of equal amount of EM® and marigold leaf extract at the rate of 20% reduced M. javanica reproduction rates in tomato plants grown in greenhouse.

Outcomes of Open, Laparoscopic, and Percutaneous Drainage of Infected Walled-Off Pancreatic Necrosis: A Nationwide Inpatient Sample Study.

BackgroundWalled-off pancreatic necrosis (WOPN) represents an encapsulated collection of necrotic pancreatic or peripancreatic tissue that tends to develop four weeks after the onset of acute necrotizing pancreatitis. When infected, it is managed initially by antibiotic therapy before drainage by endoscopic, percutaneous, or surgical means. This study aims to describe the morbidity, mortality, length of stay (LOS), and cost of care associated with open surgical, laparoscopic, and radiology-guided percutaneous drainage in adult patients with infected WOPN.MethodsUsing the Nationwide Inpatient Sample (NIS), patients aged 18 years and older discharged with the diagnosis of WOPN between January 1, 2016 and December 31, 2016 who underwent open, laparoscopic, or percutaneous drainage were included. Patients’ characteristics including age, gender, and body mass index were reported. The primary endpoints were the mortality rate as well as length and cost of stay in each group. The secondary endpoint was the rate of procedural complications in each arm. Endpoints were reported and compared with studies assessing similar outcomes. Statistical Analysis System (SAS) statistical software (SAS Institute Inc., Cary, NC, USA) was used to perform the analysis.ResultsA total of 229 patients with the diagnosis of acute pancreatitis with infected necrosis were identified. Of these 229 patients, 27, 15, and 20 underwent open, laparoscopic, and percutaneous drainage, respectively. A total of eight studies were used for comparison of outcome variables. Mortality rate was found to be similar among comparison studies. LOS and costs varied widely among studies. There were significantly fewer pancreatic fistula and significantly more multi-organ failure complications as a result of open necrosectomy in the NIS study sample.ConclusionOverall, in analyzing the outcomes of patients undergoing intervention for infected WOPN through the 2016 NIS database, it appears that the database is representative of the majority of outcomes seen in similar clinical trials.

Farming largemouth bass (Micropterus salmoides) with lettuce (Lactuca sativa) and radicchio (Cichorium intybus) in aquaponics: effects of stocking density on fish growth and quality, and vegetable production

Submitted 2020-06-30 | Accepted 2020-09-01 | Available 2020-12-01 https://doi.org/10.15414/afz.2020.23.mi-fpap.79-87 The present study assessed the effects of two initial stocking densities (low – LD, 4.23 kg m-3, moderate – MD, 8.05 kg m-3) on growth, health and fillet quality of largemouth bass (Micropterus salmoides), and on yield of lettuce (Lactuca sativa) and radicchio (Cichorium intybus group Rubifolium) produced in a low-tech recirculating aquaponic system. A total of 104 largemouth bass (initial body weight: 236 ± 38 g) were randomly stocked in eight 500 L tanks (four per stocking density) and monitored during a 70-day period. Vegetables yield was similar in LD and MD groups. Lettuce yield (6.33 kg m-2) was in line with typical values, whereas radicchio showed a negligible yield (1.34 kg m-2). Likewise, fish final weight (263 g, on average), specific growth rate (0.17% d-1), feed conversion ratio (2.72), and mortality (4.8%) did not differ between treatments. Fish morphometric indices, slaughter results and fillet quality were not affected by stocking density. In conclusion, the production of lettuce was successful in the tested system, whereas the production of radicchio did not achieve satisfactory results. Growth performances of the largemouth bass were poor and further investigations are required to optimize the rearing of this fish species in low-tech aquaponic systems. Keywords: largemouth bass, lettuce, radicchio, water quality, flesh quality References BAßMANN, B. et al. (2017). Stress and welfare of African catfish (Clarias gariepinus Burchell, 1822) in a coupled aquaponic system. Water, 9(7), 504. https://doi.org/10.3390/w9070504 BROWN, T. G. et al. (2009). Biological synopsis of largemouth bass (Micropterus salmoides). Canadian Manuscript Report of Fisheries and Aquatic Sciences, 2884, v + 27 p. CHAVES-POZO, E. et al. (2019). An overview of the reproductive cycle of cultured specimens of a potential candidate for Mediterranean aquaculture, Umbrina cirrosa. Aquaculture, 505, 137–149. https://doi.org/10.1016/j.aquaculture.2019.02.039 CHEN, Y. et al. (2020). Effects of dietary fish oil replacement by soybean oil and L-carnitine supplementation on growth performance, fatty acid composition, lipid metabolism and liver health of juvenile largemouth bass, Micropterus salmoides. Aquaculture, 516, 734596. https://doi.org/10.1016/j.aquaculture.2019.734596 PANTANELLA, E. et al. (2012). Aquaponics vs. hydroponics: production and quality of lettuce crop. Acta Horticulturae, 927, 887-893. https://doi.org/10.17660/ActaHortic.2012.927.109 RAHMAN, M. M (2015). Role of common carp (Cyprinus carpio) in aquaculture production systems. Frontiers in Life Science, 8(4), 399–410. https://doi.org/10.1080/21553769.2015.1045629 RAKOCY, J. E. (2012). Aquaponics: integrating fish and plant culture. In: Tidwell J.H. (Ed), Aquaculture production systems. India: Wiley-Blackwell (pp. 343–386). https://doi.org/10.1002/9781118250105.ch14 SAS (Statistical Analysis System). 2013. SAS/STAT(R) 9.2 User’s Guide, second ed. SAS Institute Inc., Cary, NC, USA. Retrieved May 10, 2020 from http://support.sas.com/documentation/cdl/en/statug/63033/HTML/default/viewer.htm#glm_toc.htm SOMERVILLE, C. et al. (2014). Small-scale aquaponic food production. Integrated fish and plant farming. Rome: FAO Fisheries and Aquaculture Technical Paper No. 589. Retrieved May 15, 2020 from http://www.fao.org/3/a-i4021e.pdf SUÁREZ, M. D. et al. (2014). Influence of dietary lipids and culture density on rainbow trout (Oncorhynchus mykiss) flesh composition and quality parameter. Aquaculture Engineering, 63, 16–24. http://dx.doi.org/10.1016/j.aquaeng.2014.09.001 SUN, J.-L. et al. (2020). Interactive effect of thermal and hypoxia on largemouth bass (Micropterus salmoides) gill and liver: Aggravation of oxidative stress, inhibition of immunity and promotion of cell apoptosis. Fish &amp; Shellfish Immunology, 98, 923–936. https://doi.org/10.1016/j.fsi.2019.11.056 TIDWELL, J. H. et al. (2000). Species profile – Largemouth bass. Southern Regional Aquaculture Center 722. Retrieved May 20, 2020 from http://aquaculture.ca.uky.edu/aquaculture-publications/12 TIDWELL, J. H. et al. (2007). Effect of stocking density on growth and water quality for largemouth bass Micropterus salmoides growout in ponds. Journal of the World Aquaculture Society, 29, 79–83. https://doi.org/10.1111/j.1749-7345.1998.tb00302.x TYSON, R. V. et al. (2004). Reconciling water quality parameters impacting nitrification in aquaponics: the pH levels. In: Proceedings of the Florida State Horticultural Society 117, 79–83. Retrieved May 20, 2020 from https://journals.flvc.org/fshs/article/view/858557_11 VITULE, J. R. S. et al. (2006). Introduction of the African catfish Clarias gariepinus (Burchell, 1822) into Southern Brazil. Biological Invasions, 8, 677–681. https://doi.org/10.1007/s10530-005-2535-8 WANG, Y. et al. (2019). Effect of stocking density on growth, serum biochemical parameters, digestive enzymes activity and antioxidant status of largemouth bass, Micropterus salmoides. Pakistan Journal of Zoology, 51(4), 1509–1517. http://dx.doi.org/10.17582/journal.pjz/2019.51.4.1509.1517 WATTS, C. et al. (2016). Evaluation of stocking density during second‐year growth of largemouth bass, Micropterus salmoides, raised indoors in a recirculating aquaculture system. Journal of the World Aquaculture Society, 47(4), 538–543. https://doi.org/10.1111/jwas.12315 YILDIZ, H. Y. et al. (2017). Fish welfare in aquaponic systems: its relation to water quality with an emphasis on feed and faeces—A review. Water, 9(1), 13. https://doi.org/10.3390/w9010013 YUAN, J. et al. (2019). Analysis of the growth performances, muscle quality, blood biochemistry and antioxidant status of Micropterus salmoides farmed in in-pond raceway systems versus usual-pond systems. Aquaculture, 511, 734241. https://doi.org/10.1016/j.aquaculture.2019.734241 Â

Excellent Outcome of Protocol-Based Treatment of Motivated Type 2 Diabetes Mellitus (T2DM) Patients: A Real World Follow-Up for 11 Years

Introduction and aimTo evaluate the real-world clinical outcome of guideline-based treatment among adherent and committed type 2 diabetes mellitus (T2DM) patients.MethodsThe study reports the outcomes of an 11-year clinic-based standard care regime, based on the American Diabetes Association (ADA) guidelines and implemented in the authors’ practices. Records of 145 T2DM patients, who were regularly followed up, were reviewed. Descriptive and inferential statistical analysis was carried out with the Statistical Analysis System (SAS) (SAS Institute Inc., Cary, NC, USA) and with Statistical Package for Social Sciences (SPSS) (IBM Corp., Armonk, NY, USA), with Microsoft Word and Excel to generate graphs and tables.ResultsApart from a significant increase of body weight (but not of body mass index, BMI) and a significant decrease of diastolic blood pressure (DBP), there were insignificant changes in all major biochemical parameters, fasting plasma glucose (FPG), postprandial plasma glucose (PPG), glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), creatinine, estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (ACR), over the 11 years of follow-up.ConclusionADA guideline-based management effectively maintained treatment goals among treatment adherent and committed T2DM patients over 11 years. Glycemic parameters (FPG, PPG, and HbA1c) and renal parameters (serum creatinine, eGFR, and ACR levels) remained stable. Our outcomes data were better than those recorded in the landmark United Kingdom Prospective Diabetes Study (UKPDS) and Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE).

Factors associated with Chinese pregnant women's preference for a cesarean section based on the theory of planned behaviour.

Cesarean delivery on maternal request is one of the important public health issues in China. Our study aimed to apply the theory of planned behaviour to comprehensively determine the factors regarding pregnant women's preference for cesarean section and to provide references for establishing measures to reduce cesarean delivery on maternal request. This cross-sectional analysis was conducted in four women's and children's hospitals in China from May to June 2018. Eligible women arriving for routine antenatal visits at these hospitals were recruited to answer a structured questionnaire. A total of 1853 pregnant women consented to participate in the investigation, with a response rate of 88.75%. Finally, 1677 pregnant women (984 nulliparae and 693 multiparae) were involved in the analysis. Descriptive statistics and logistic regression analyses were used. Of the study participants, 20.39% preferred cesarean section. For both nulliparae and multiparae, those who had lower scores of attitudes towards vaginal delivery, lower scores of childbirth self-efficacy and higher scores of subjective norms were more likely to prefer cesarean section. Pregnant women's birth preferences were significantly associated with their attitudes towards the delivery mode, childbirth self-efficacy and subjective norms, which is consistent with the theory of planned behaviour. Interventions to reduce cesarean delivery on maternal request can be developed based on the theory of planned behaviour.

Microbial Ecology of Retail Ready-to-Eat Escarole and Red Chicory Sold in Palermo City, Italy

Background: Ready-To-Eat (RTE) foods include any edible food that is commonly consumed raw. This study aimed at evaluation of microbial ecology of retail RTE escarole and red chicory sold in Palermo city, Italy. Methods: A total of 32 mono-varietal RTE samples, including escarole (n=16) and red chicory (n=16) samples were obtained from Palermo, Italy. Both RTE vegetables at expiry date were analyzed to quantify spoilage bacteria, pathogenic bacteria, and yeast. All different colonies were isolated and identified on the basis of phenotypic characteristics and genetic polymorphisms by random amplification of polymorphic DNA-Polymerase Chain Reaction (PCR) and further genotype by sequencing the 16S rRNA gene. The statistical analysis was conducted with SAS 9.2 software (Statistical Analysis System Institute Inc., Cary, NC, USA). Results: The level of Listeria monocytogenes and coagulase-positive staphylococci were below the detection. Total microbial counts were above 8 log10 colony forming unit/g in RTE red chicory, while they were about 1 log cycle lower in escarole. In general, escarole showed lower levels for all microbial groups than red chicory with the exception of the total yeast. A total of 13 strains were identified into ten species belonging to six genera as Bacillus, Erwinia, Pantoea, Pseudomonas, Microbacterium, and Rahnella. The most numerous identified genera were Pseudomonas and Pantoea. Conclusion: This work pointed out the relevance of implementing good hygiene practices during processing in order to prolong quality parameters and acceptability of mono-varietal salads.

Fatty acid composition of maize silages from different hybrids

Fatty acid composition of maize silages from different hybrids