Search results for: Rinaldo Bellomo

Authors: Laurence Weinberg, Dominic Walpole, Dong-Kyu Lee, Michael D’Silva, Jian W. Chan, Lachlan F. Miles, Bradley Carp, Adam Wells, Tuck S. Ngun, Siven Seevanayagam, George Matalanis, Ziauddin Ansari, Rinaldo Bellomo, Michael Yii

Abstract:

Background: There have been multiple recent advancements in the selection, optimization and management of cardiac surgical patients. However, there is limited data regarding the outcomes of nonagenarians undergoing cardiac surgery, despite this vulnerable cohort increasingly receiving these interventions. This study describes the patient characteristics, management and outcomes of a group of nonagenarians undergoing cardiac surgery in the context of contemporary peri-operative care. Methods: A retrospective observational study was conducted of patients 90 to 99 years of age (i.e., nonagenarians) who had undergone cardiac surgery requiring a classic median sternotomy (i.e., open-heart surgery). All operative indications were included. Patients who underwent minimally invasive surgery, transcatheter aortic valve implantation and thoracic aorta surgery were excluded. Data were collected from four hospitals in Victoria, Australia, over an 8-year period (January 2012 – December 2019). The primary objective was to assess six-month mortality in nonagenarians undergoing open-heart surgery and to evaluate the incidence and severity of postoperative complications using the Clavien-Dindo classification system. The secondary objective was to provide a detailed description of the characteristics and peri-operative management of this group. Results: A total of 12,358 adult patients underwent cardiac surgery at the study centers during the observation period, of whom 18 nonagenarians (0.15%) fulfilled the inclusion criteria. The median (IQR) [min-max] age was 91 years (90.0:91.8) [90-94] and 14 patients (78%) were men. Cardiovascular comorbidities, polypharmacy and frailty, were common. The median (IQR) predicted in-hospital mortality by EuroSCORE II was 6.1% (4.1-14.5). All patients were optimized preoperatively by a multidisciplinary team of surgeons, cardiologists, geriatricians and anesthetists. All index surgeries were performed on cardiopulmonary bypass. Isolated coronary artery bypass grafting (CABG) and CABG with aortic valve replacement were the most common surgeries being performed in four and five patients, respectively. Half the study group underwent surgery involving two or more major procedures (e.g. CABG and valve replacement). Surgery was undertaken emergently in 44% of patients. All patients except one experienced at least one postoperative complication. The most common complications were acute kidney injury (72%), new atrial fibrillation (44%) and delirium (39%). The highest Clavien-Dindo complication grade was IIIb occurring once each in three patients. Clavien-Dindo grade IIIa complications occurred in only one patient. The median (IQR) postoperative length of stay was 11.6 days (9.8:17.6). One patient was discharged home and all others to an inpatient rehabilitation facility. Three patients had an unplanned readmission within 30 days of discharge. All patients had follow-up to at least six months after surgery and mortality over this period was zero. The median (IQR) duration of follow-up was 11.3 months (6.0:26.4) and there were no cases of mortality observed within the available follow-up records. Conclusion: In this group of nonagenarians undergoing cardiac surgery, postoperative six-month mortality was zero. Complications were common but generally of low severity. These findings support carefully selected nonagenarian patients being offered cardiac surgery in the context of contemporary, multidisciplinary perioperative care. Further, studies are needed to assess longer-term mortality and functional and quality of life outcomes in this vulnerable surgical cohort.

Keywords: cardiac surgery, mortality, nonagenarians, postoperative complications

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Authors: Adji Achmad Rinaldo Fernandes

Abstract:

Regression analysis is a statistical method that is able to describe and predict causal relationships between individuals. Not all relationships have a known curve shape; often, there are relationship patterns that cannot be known in the shape of the curve; besides that, a cause can have an impact on more than one effect, so that between effects can also have a close relationship in it. Regression analysis that can be done to find out the relationship can be brought closer to the semiparametric regression of truncated spline biresponse. The purpose of this study is to examine the function estimator and determine the best model of truncated spline biresponse semiparametric regression. The results of the secondary data study showed that the best model with the highest order of quadratic and a maximum of two knots with a Goodness of fit value in the form of Adjusted R2 of 88.5%.

Keywords: biresponse, farmer attachment, farmer loyalty, truncated spline

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Authors: Adji Achmad Rinaldo Fernandes

Abstract:

The research was conducted to apply semiparametric SEM modeling to the timeliness of paying credit. Semiparametric SEM is structural modeling in which two combined approaches of parametric and nonparametric approaches are used. The analysis method in this research is semiparametric SEM with a nonparametric approach using a truncated spline. The data in the study were obtained through questionnaires distributed to Bank X mortgage debtors and are confidential. The study used 3 variables consisting of one exogenous variable, one intervening endogenous variable, and one endogenous variable. The results showed that (1) the effect of capacity and willingness to pay variables on timeliness of payment is significant, (2) modeling the capacity variable on willingness to pay also produces a significant estimate, (3) the effect of the capacity variable on the timeliness of payment variable is not influenced by the willingness to pay variable as an intervening variable, (4) the R^2 value of 0.763 or 76.33% indicates that the model has good predictive relevance.

Keywords: structural equation modeling semiparametric, credit bank, accuracy of payment time, willingness to pay

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Authors: Adji Achmad Rinaldo Fernandes

Abstract:

Path analysis is an analytical technique to study the causal relationship between independent and dependent variables. In this study, the integration of Clusters in the Ward Linkage method was used in a variety of clusters with path analysis. The variables used are character (x₁), capacity (x₂), capital (x₃), collateral (x₄), and condition of economy (x₄) to on time pay (y₂) through the variable willingness to pay (y₁). The purpose of this study was to compare the Ward Linkage method cluster integration in various clusters with path analysis to classify willingness to pay (y₁). The data used are primary data from questionnaires filled out by customers of Bank X, using purposive sampling. The measurement method used is the average score method. The results showed that the Ward linkage method cluster integration with path analysis on 2 clusters is the best method, by comparing the coefficient of determination. Variable character (x₁), capacity (x₂), capital (x₃), collateral (x₄), and condition of economy (x₅) to on time pay (y₂) through willingness to pay (y₁) can be explained by 58.3%, while the remaining 41.7% is explained by variables outside the model.

Keywords: cluster integration, linkage, path analysis, compliant paying behavior

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Authors: Usriatur Rohma, Adji Achmad Rinaldo Fernandes

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Nonparametric path analysis is a statistical method that does not rely on the assumption that the curve is known. The purpose of this study is to determine the best nonparametric truncated spline path function between linear and quadratic polynomial degrees with 1, 2, and 3-knot points and to determine the significance of estimating the best nonparametric truncated spline path function in the model of the effect of population migration and agricultural economic growth on rural poverty through the variable unemployment rate using the t-test statistic at the jackknife resampling stage. The data used in this study are secondary data obtained from statistical publications. The results showed that the best model of nonparametric truncated spline path analysis is quadratic polynomial degree with 3-knot points. In addition, the significance of the best-truncated spline nonparametric path function estimation using jackknife resampling shows that all exogenous variables have a significant influence on the endogenous variables.

Keywords: nonparametric path analysis, truncated spline, linear, quadratic, rural poverty, jackknife resampling

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Authors: Adji Achmad Rinaldo Fernandes

Abstract:

Path analysis tests the relationship between variables through cause and effect. Before conducting further tests on path analysis, the assumption of linearity must be met. If the shape of the relationship is not linear and the shape of the curve is unknown, then use a nonparametric approach, one of which is a truncated spline. The purpose of this study is to estimate the function and get the best model on the nonparametric truncated spline path of linear, quadratic, and cubic orders with 1 and 2-knot points and determine the significance of the best function estimator in modeling farmer loyalty through the jackknife resampling method. This study uses secondary data through questionnaires to farmers in Sumbawa Regency who use SP-36 subsidized fertilizer products as many as 100 respondents. Based on the results of the analysis, it is known that the best-truncated spline nonparametric path model is the quadratic order of 2 knots with a coefficient of determination of 85.50%; the significance of the best-truncated spline nonparametric path estimator shows that all exogenous variables have a significant effect on endogenous variables.

Keywords: nonparametric path analysis, farmer loyalty, jackknife resampling, truncated spline

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Authors: Rinaldo Diricchardi

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In this paper, author theoretically and empirically explores the ethnic identity of the descendants of the Indian travelers in Slovenia Sinti, who are in modern time, for the researchers, still a "tabula rasa". He investigates the extent to which Sinti ethnic particular identities (e.g. Sinti chiefs, Sinti’s individual political structure…), the Sinti language (dialect, which is topic and it is not allowed to be spoken in public), culture and habits still in the impact of anachronism, moreover, to what extent the community is still “tabula rasa” (to non–Sinti population). The relationships within the Sinti entity: "in se–intra se" is a mirror of duality of the relation of "extra se". Is it possible that the concepts of social/economical relationships are reflecting the Sinti community, moreover, the possible influence of minority from outside to inside? Is the stratification of their ethnicity and their language ethnicism? In addition, is the result of stratification of discourse still inherited and discounted the Indian caste system? In present article, author uses the word Gypsy with high respect and with a large measure of prudentiality, without negative connotations. At the first Gypsy World Congress in 1971 in London the Sinti did not accept unification with Romani, but Sinti and others Gypsies still keep the name Gypsy/Romanichals, Gypsy/Kale, Gypsy/Manouches, Gypsy/Manoesje, Gypsy/Xoraxano, Gypsy/Machaways and Gypsy/Kalderashe. In addition, all of the European documents taken into account respect and use the name Gypsy.

Keywords: Sinti, Gypsy, identity, stratification, inclusion, exclusion

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Authors: Adji Achmad Rinaldo Fernandes

Abstract:

SEM analysis is a complex multivariate analysis because it involves a number of exogenous and endogenous variables that are interconnected to form a model. The measurement model is divided into two, namely, the reflective model (reflecting) and the formative model (forming). Before carrying out further tests on SEM, there are assumptions that must be met, namely the linearity assumption, to determine the form of the relationship. There are three modeling approaches to path analysis, including parametric, nonparametric and semiparametric approaches. The aim of this research is to develop semiparametric SEM and obtain the best model. The data used in the research is secondary data as the basis for the process of obtaining simulation data. Simulation data was generated with various sample sizes of 100, 300, and 500. In the semiparametric SEM analysis, the form of the relationship studied was determined, namely linear and quadratic and determined one and two knot points with various levels of error variance (EV=0.5; 1; 5). There are three levels of closeness of relationship for the analysis process in the measurement model consisting of low (0.1-0.3), medium (0.4-0.6) and high (0.7-0.9) levels of closeness. The best model lies in the form of the relationship X1Y1 linear, and. In the measurement model, a characteristic of the reflective model is obtained, namely that the higher the closeness of the relationship, the better the model obtained. The originality of this research is the development of semiparametric SEM, which has not been widely studied by researchers.

Keywords: semiparametric SEM, measurement model, structural model, reflective model, formative model

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Authors: Edda E. Falcone, Cinzia Federico, Sergio Bellomo, Lorenzo Brusca, Manfredi Longo, Walter D’Alessandro

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Although trace metals are an essential element for living beings, they can become toxic at high concentrations. Their potential toxicity is related not only to the total content in the environment but mostly upon their bioavailability. Volcanoes are important natural metal emitters and they can deeply affect the quality of air, water and soils, as well as the human health. Trace metals tend to accumulate in the tissues of living organisms, depending on the metal contents in food, air and water and on the exposure time. Birds are considered as bioindicators of interest, because their feathers directly reflects the metals uptake from the blood. Birds are exposed to the atmospheric pollution through the contact with rainfall, dust, and aerosol, and they accumulate metals over the whole life cycle. We report on the first data combining the rainfall metal content in three different areas of Mt Etna, variably fumigated by the volcanic plume, and the metal contents in the feathers of pigeons, collected in the same areas. Rainfall samples were collected from three rain gauges placed at different elevation on the Eastern flank of the volcano, the most exposed to airborne plume, filtered, treated with HNO₃ Suprapur-grade and analyzed for Fe, Cr, Co, Ni, Se, Zn, Cu, Sr, Ba, Cd and As by ICP-MS technique, and major ions by ion chromatography. Feathers were collected from single individuals, in the same areas where the rain gauges were installed. Additionally, some samples were collected in an urban area, poorly interested by the volcanic plume. The samples were rinsed in MilliQ water and acetone, dried at 50°C until constant weight and digested in a mixture of 2:1 HNO₃ (65%) - H₂O₂ (30%) Suprapur-grade for 25-50 mg of sample, in a bath at near-to-boiling temperature. The solutions were diluted up to 20 ml prior to be analyzed by ICP-MS. The rainfall samples most contaminated by the plume were collected at close distance from the summit craters (less than 6 km), and show lower pH values and higher concentrations for all analyzed metals relative to those from the sites at lower elevation. Analyzed samples are enriched in both metals directly emitted by the volcanic plume and transported by acidic gases (SO₂, HCl, HF), and metals leached from the airborne volcanic ash. Feathers show different patterns in the different sites related to the exposure to natural or anthropogenic pollutants. They show abundance ratios similar to rainfall for lithophile elements (Ba, Sr), whereas are enriched in Zn and Se, known for their antioxidant properties, probably as adaptive response to oxidative stress induced by toxic metal exposure. The pigeons revealed a clear heterogeneity of metal uptake in the different parts of the volcano, as an effect of volcanic plume impact. Additionally, some physiological processes can modify the fate of some metals after uptake and this offer some insights for translational studies.

Keywords: bioindicators, environmental pollution, feathers, trace metals, volcanic plume

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Authors: Stéfani T. A. Dantas, Laura T. S. Takume, Bruna F. Rossi, Érika R. Bonsaglia, Ivana G. Castilho, José C. F. Pantoja, Ary Fernandes Júnior, Juliano L. Gonçalves, Marcos V. Santos, Rinaldo A. Mota, Vera L. M. Rall

Abstract:

Staphylococcus aureus is one of the main pathogens causing contagious bovine mastitis, being more frequently isolated from subclinical form, although the clinical form also occurs. Clinical mastitis cause visual signs, such as swelling, fever, hardening of the mammary gland, or any change in the characteristics of the milk. Considering the subclinical type, there are no visible signs in the animal nor changes in the milk. S. aureus has many important virulence factors for the establishment of its pathogenicity in animals, such as enterotoxins, which are also responsible for foodborne poisoning. Our objective is to perform a comparative analysis between 103 isolates of S. aureus, obtained from the milk of cows with clinical mastitis and 103 more, from subclinical type, in relation to the presence of these enterotoxins and verify if their presence plays an important role in the signs of illness. We will investigate all enterotoxins described till now, such as sea-see, seg-sez, sel26, sel 27, se01, and se02 (This study was approved by the Sao Paulo State University Animal Use Ethics Committee, No. 0136/2017). For the PCR assay, we used Illustra Bacteria Mini Spin Kit for bacterial DNA. At this moment, we have already tested sea-see, seg-ser, sew, and sex, and the results have already been submitted to Fisher Exact Probability Test or Chi-square Test. Considering the isolates obtained from clinical mastitis, the most frequent enterotoxins were selw (99%), selx (78%) and selh (50.5%), and sec, see, sej, sell, selp,and ser were absent. Among the subclinics, selw (82.5%) selm (15.5%) and selx (14.6%) were the most frequent, and sea-see, seg, sei-sel, sem-ser were absent. We have already observed statistically significant differences for seb, seg, seh, sei, selo, selu, selw and selx. Other interesting results were the low number of genes in each isolate from subclinical mastitis [0 genes: 14 (13.6%); 1 gene: 55 (53.4%); 2 genes: 33 (32%) or 3: 1 (0.97%)] compared to clinical isolates [1 gene: 5 (4.9%); 2 genes: 29 (28.1%); 3 genes: 38 (36.9%); 4 genes: 14 (13.6%); 5 genes: 5 (4.9%); 6 genes: 4 (3.9%); 7 genes: 5 (4.9%); 8 genes: 2 (1.9%) and 9 genes: 1 (1%)]. Based on these results, we can conclude that enterotoxins indeed play an important role in clinical signs in cattle with mastitis.

Keywords: mastitis, S. aureus, PCR, staphylococcal enterotoxin

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Authors: Ana Paula Almeida Castaldelli Maciel, Gabriela Medeiros, Amanda de Souza Machado, Maria Clara Pilatti, Ralpho Rinaldo dos Reis, Silvio Cesar Sampaio

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Sustainable agricultural systems are crucial to ensuring global food security and the long-term production of nutritious food. Comprehensive soil and water management practices, including nutrient management, balanced fertilizer use, and appropriate waste management, are essential for sustainable agriculture. Swine wastewater (SWW) treatment has become a significant focus due to environmental concerns related to heavy metals, antibiotics, resistant pathogens, and nutrients. In South America, small farms use soil to dispose of animal waste, a practice that is expected to increase with global pork production. The potential of SWW as a nutrient source is promising, contributing to global food security, nutrient cycling, and mineral fertilizer reduction. Short- and long-term studies evaluated the effects of SWW on soil and plant parameters, such as nutrients, heavy metals, organic matter (OM), cation exchange capacity (CEC), and pH. Although promising results have been observed in short- and medium-term applications, long-term applications require more attention due to heavy metal concentrations. Organic soil amendment strategies, due to their economic and ecological benefits, are commonly used to reduce the bioavailability of heavy metals. However, the rate of degradation and initial levels of OM must be monitored to avoid changes in soil pH and release of metals. The study aimed to evaluate the long-term effects of SWW application on soil fertility parameters, focusing on calcium (Ca), magnesium (Mg), and potassium (K), in addition to CEC and OM. Experiments were conducted at the Universidade Estadual do Oeste do Paraná, Brazil, using 24 drainage lysimeters for nine years, with different application rates of SWW and mineral fertilization. Principal Component Analysis (PCA) was then conducted to summarize the composite variables, known as principal components (PC), and limit the dimensionality to be evaluated. The retained PCs were then correlated with the original variables to identify the level of association between each variable and each PC. Data were interpreted using Analysis of Variance - ANOVA for general linear models (GLM). As OM was not measured in the 2007 soybean experiment, it was assessed separately from PCA to avoid loss of information. PCA and ANOVA indicated that crop type, SWW, and mineral fertilization significantly influenced soil nutrient levels. Soybeans presented higher concentrations of Ca, Mg, and CEC. The application of SWW influenced K levels, with higher concentrations observed in SWW from biodigesters and higher doses of swine manure. Variability in nutrient concentrations in SWW due to factors such as animal age and feed composition makes standard recommendations challenging. OM levels increased in SWW-treated soils, improving soil fertility and structure. In conclusion, the application of SWW can increase soil fertility and crop productivity, reducing environmental risks. However, careful management and long-term monitoring are essential to optimize benefits and minimize adverse effects.

Keywords: contamination, water research, biodigester, nutrients

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