Regression Coefficients Research Articles

Association between Life's Essential 8 and risk of heart failure: findings from the Kailuan study.

The impact of Life's Essential 8 (LE8) on heart failure (HF) remains poorly understood. We examined the associations between three forms of LE8 measurements and HF. A total of 35 896 participants without a prior history of HF from the Kailuan community were included. The LE8 status was measured in 2014. A latent mixture model was employed to identify the trajectories of LE8 during 2006 to 2014. The LE8 annual change rate was defined as the slope of the linear regression equation fitted by five LE8 measurements. Cox proportional hazards models were used to assess the risk of HF associated with LE8, after adjusting for potential confounding variables. The predictive performance was quantified and compared using the C-index. Five distinct LE8 trajectories were identified. 461 HF events documented during follow-up. The LE8 trajectories presenting an upward trend in LE8 were associated with a reduced risk of HF, even when the initial LE8 level was low [HR (95% confidence interval) for moderate-increasing vs. moderate-decreasing trajectory was 0.43 (0.34, 0.55)]. The LE8 status was inversely associated with HF risk. A higher LE8 annual increase was associated with a lower risk of HF. The LE8 trajectory was more accurate in predicting the risk of HF compared with LE8 status. LE8 was inversely associated with HF risk. Individuals with initially low LE8 levels experienced a reversal in HF risk upon improvement. Both LE8 trajectories and status are practicable in identifying individuals at high risk of HF, LE8 trajectories may provide added prognostic information.

Long-term Effect of Tillage, Residue and Biofertilizer on Soil Microbial Biomass Carbon and Dehydrogenase Activity under Rice-wheat Cropping System in Terai Agro-ecological Region of West Bengal

As a major supply of staple foods, the rice-wheat cropping system is crucial to global food security. However, continuous cultivation of these crops has led to several soil-related environmental problems, including the gradual decline in soil health and quality. In this context, maintaining soil health necessitates the adoption of conservation agriculture. This study assessed the effect of tillage, residue and biofertilizer management practices on soil dehydrogenase activity (SDHA) and soil microbial biomass carbon (SMBC) of post wheat soils at various soil depth (0-5 cm, 5-10 cm, 10-20 cm and 20-40 cm). The research was conducted as part of a long-term field experiment initiated in 2006 in rice-wheat cropping system under a factorial randomized block design with three replications in the Terai agro-ecological regions of West Bengal. The results revealed that the SDHA and SMBC were increased by the influence of long-term zero tillage, bio fertilizer & residue addition at the most of the soils depths under study except at 20-40 cm. The highest short-term change of SDHA (213.19%) in compared to the initial soil status was observed in conventionally tilled soil with biofertilizer addition treatment combination. Since SDHA and SMBC are critical indicators of soil health and quality, this study also explored their relationship. Positive good regression coefficient of 0.74, 0.65 and 0.67 at 0-5 cm, 5-10 cm and 10-20 cm soil depth were observed respectively. These findings highlight the strong association between the two parameters. With growing future demand of foods, conservation agriculture must be practiced to ensure the long-term sustainability of soil productivity. The study provides evidence that implementing zero tillage along with residue and biofertilizer addition significantly improves these key soil health parameters.

Going beyond hawks and doves - Measuring degrees of examiner misalignment in OSCEs.

Minimising examiner differences in scoring in OSCEs is key in supporting the validity of the assessment outcomes. This is particularly true for common OSCE designs where the same station is administered across parallel circuits, with examiners nested within these. However, the common classification of extreme examiners as 'hawks' or 'doves' can be overly simplistic. Rather, it is the difference in patterns of scoring across circuits that better indicates poor levels of agreement between examiners that can unfairly advantage particular groups of candidates in comparison with others in different circuits. In this paper, a new measure of differences in examiner scoring is presented that quantifies the different combined patterns of scoring in global grades and checklist/domain scores for pairs of examiners assessing in the same station but in different circuits. Based on calculating the area between separate examiners' individual borderline regression lines, this measure can be used as a post hoc metric to provide a broad range of validity evidence for the assessment and its outcomes. In challenging the 'hawks'/'doves' paradigm, this work presents a detailed empirical analysis of a new misalignment metric in a particular high-stakes context and gives a range of evidence of its contribution to overall OSCE quality control processes and of improved fairness to candidates over time. The paper concludes with comments on developing the metric to contexts where there are multiple parallel circuits which will allows its practical application to a broader set of OSCE contexts.

Comparison of ERG signal-to-noise ratios in simultaneous recordings with skin electrodes and contact lens electrodes.

To compare signal-to-noise levels in ERG recordings obtained with contact lens electrodes and adhesive skin electrodes. 23 subjects were studied. Full-field ERGs were recorded according to ISCEV standards simultaneously with ERG-jet corneal contact lens electrodes and LKC Technologies Sensor Strip adhesive skin electrodes. B-wave amplitude or peak-to-peak amplitude was used as a measure of signal strength. Noise was estimated using the " ± averaging method." Comparisons between signal strength, absolute noise levels, and signal-to-noise ratios between contact lens and skin electrodes were performed by linear regression. Comparisons of signal strength for LA 3, 30-Hz, DA 0.01, and DA 3 responses, yielded regression coefficient ß values of 0.37, 0.39, 0.39, and 0.35, respectively. For the entire data set, the regression coefficient ß value was 0.36 (95% confidence limits 0.34 - 0.38). The grand average ERG noise for all ERG stimuli was 13.8µV for contact lens electrodes and 13.0µV for skin electrodes (not significant: p = 0.66 for paired t-test). For signal-to-noise ratios, regression ß coefficients for contact lens and adhesive skin electrodes for LA 3, 30-Hz, DA 0.01, and DA 3 stimuli were 0.25, 0.39, 0.50, and 0.36 respectively. The ß coefficient for the amalgamated data set was 0.33 (95% confidence limits 0.30- 0.36). Overall ERG amplitudes obtained with skin electrodes were 1/3 those obtained with contact lens electrodes. Absolute noise levels were similar. Signal-to-noise levels with skin electrodes were 1/3 those seen with contact lens electrodes. Implications for signal-averaging in clinical applications are discussed.

Factors Enabling Access to Affordable, Reliable, Sustainable and Modern Energy in the European Union

By 2050, Europe will become the first climate-neutral continent according to the vision of the European Union (EU). To tackle this challenge, the EU has scheduled the accomplishment of the 17 goals of the United Nations’s 2030 Agenda, with Goal 7 addressing the energy sector. The role of public policies is fundamental in this case; however, it is insufficient in some areas, e.g., when adopting green energy technologies. The purpose of this article is to identify the economic factors that are necessary to achieve Goal 7 of Agenda 2030. To realize the aim of this study and identify economic factors that are significant for implementing the targets of Goal 7 of the 2030 Agenda, two statistical methods were used: the Pearson linear correlation coefficient and linear regression modeling with a scatter plot to present the relationships. The results of this study confirm that in the EU, the possibility of achieving Goal 7 is dependent on the three economic determinants analyzed, i.e., GDP per capita, unemployment rate, and gross domestic spending on research and development. The analysis revealed that the impact of single economic factors on the realization of all SDG 7 targets is small because no economic factor correlates with even half of SDG 7 indicators.

Exploring the Relationship Between Disability and Children’s Household Chores in Selected Low- and Middle-Income Countries

Studies on disability and unpaid domestic and care work (UDCW) in low- and middle-income countries are rare. This paper contributes to a nascent body of literature by exploring how children’s unpaid workloads at home are affected by the disability status of their primary caregiver and of younger children within the household in 34 low- and middle-income countries and areas. We constructed ordinary least-squares regression models for the pooled data using country-fixed effects and for each country and area separately. Random effects models are included as a test of robustness. Our analysis of the pooled data revealed that when a household included a child aged 2–4 with a disability, the time dedicated to UDCW by children aged 5–17 rose by approximately 10 percent, on average. While we did not find an association between the disability status of the caregiver and the time children dedicated to UDCW in the pooled regressions, in the country-specific regressions, having a caregiver with a disability was associated with changes in the time spent on UDCW in certain countries, signaling the heterogeneity of country experience. As such, there is reason to devote additional attention to understanding the implications of disability on the amount of time children spend on UDCW and to consider what types of support might be needed in households with diverse disability profiles.

Physiological Characteristics of Young (9-12 Years) and Adolescent (≥13 Years) Rhythmic, Acrobatic, and Artistic Female Gymnasts.

Elite gymnasts are exposed to high levels of physical stress, during both childhood and adolescence, with significantly late maturation and high injury prevalence. Here, we compare the physiological characteristics of female gymnasts in 2 age groups: young (9-12 years) and adolescent (≥13 years) in 3 disciplines of competitive gymnastics. Participants' physiological characteristics will differ by age group and by gymnastic discipline. Cohort study. Level 2. The study included 274 gymnasts, aged 11.8 ± 1.9 years. Data collection included anthropometric measures, Tanner stage, and menarche age; ultrasound assessments were used to assess bone properties, including bone strength, skeletal age, and final-height prediction. Univariate analysis of variance showed age × discipline interactions for body mass index (BMI) percentiles (F(2, 266) = 4.379; P = 0.01), skeletal age (F(2, 241) = 3.808; P = 0.02), and final-height prediction (F(2, 240) = 3.377, P = 0.04). Moreover, in both age groups, artistic gymnasts exhibited significantly higher BMI percentiles than rhythmic gymnasts (P < 0.05). In the adolescent group, final-height prediction for rhythmic gymnasts was significantly greater than that of artistic gymnasts (P < 0.05). Finally, in adolescent gymnasts, regression lines showed that skeletal age was lower than chronological age (P < 0.05). Artistic gymnasts were shorter than rhythmic and acrobatic gymnasts. Despite similar BMI and body fat, maturity patterns, and training-volume history, artistic gymnasts had lower bone-strength than rhythmic and acrobatic gymnasts. Combined with their high-impact and intensive training, this could increase their risk of musculoskeletal injuries. The current study may help athletic trainers and medical teams define "norms" for different age groups and gymnastic disciplines, based on what may be expected during the athletes' early and late maturation. This knowledge can be used to modify, individualize, and optimize training programs.

Contact and Non-Contact Measurements of Chlorophyll-a in Water Based on Laser Spectroscopy

Chlorophyll-a fluorescence detection is an important technique for monitoring water quality. In this paper, we proposed an approach that employs the ratio of fluorescence to Raman obtained from contact and non-contact laser-induced fluorescence detection methods as the key for the detection of Chlorophyll-a in water. At first, extracted Chlorophyll-a solutions were prepared, and each sample was tested using two detection methods. The true values of the samples were measured in the laboratory using spectrophotometry. Then, the detection system was calibrated through the linear fitting of Chlorophyll-a and the fluorescence–Raman ratio. The linear correlation coefficients of contact and non-contact detection were 0.9453 and 0.9401, respectively. Finally, we tested the actual water samples in two ways, and compared the test results with the value measured using the national standard method. The root mean square error (RMSE) of contact and non-contact detection was 0.16 and 0.23, respectively. The results show that the two detection methods have high accuracy and sensitivity, and preliminary preparation of samples is not required. Compared with contact detection, the non-contact detection results had higher accuracy and stronger anti-interference, but the maintenance cost was higher because the probe is vulnerable to wear. The advantage of non-contact detection is that it avoids sample contamination and is easy to apply over large areas of water. In the future, it can be used for the real-time monitoring of algal biomass in water by selecting the appropriate detection method according to the requirements of the application.

Vaginal oxygen plus hyaluronic acid on lower urinary tract symptoms in breast cancer survivors

Objective This study aimed to evaluate the effect of vaginal oxygen and hyaluronic acid on lower urinary tract symptoms (LUTS) in breast cancer survivors. Method A prospective trial was conducted at a university hospital’s Menopause Outpatient Clinic. Breast cancer patients experiencing LUTS received intravaginal natural oxygen for 15 min, coupled with a 2% hyaluronic acid solution during the last 5 min. This treatment was performed five times at 15-day intervals. Assessments were repeated at each application and 60 days after the last application. Scores on the Urogenital Distress Inventory-6 (UDI-6) short form and its single items assessing different LUTS aspects were determined. Results Treatment in 85 breast cancer patients decreased the UDI-6 total score (from 24.8 ± 19.9 to 17.5 ± 16.2; p < 0.001) and subscales evaluating irritative (p = 0.001), stress (p = 0.006) and obstructive discomfort (p = 0.001) symptoms. In multivariate analysis, aromatase inhibitors were independently associated with a greater improvement of LUTS (coefficient of regression [CR] − 8.05, 95% confidence interval [CI] –13.41, –2.64; p = 0.004)). The use of a gonadotrophin-releasing hormone (GnRH) analog was associated with a greater improvement of irritative symptoms (CR −2.42, 95% CI −4.75, –0.08; p = 0.042), while tamoxifen reduced the improvement of stress symptoms (CR 2.49, 95% CI 0.10, 4.90; p = 0.041). Conclusion Short-term treatment with vaginal oxygen and hyaluronic acid appeared to improve LUTS of breast cancer patients.

Quantifying Geomagnetic Activity's Contribution to the Global E‐Region Electron Density's Day‐To‐Day Variability Using Spire Radio Occultation Observations

AbstractUsing the unprecedented sampling of the Spire Radio Occultation (RO) data set, this paper statistically estimates geomagnetic dependencies of the global E‐region Electron Density's (Ne) day‐to‐day variability. To assesses how much Spire RO‐observed variabilities are consistent with known Physics, comparison is made with the Specified Dynamics–Whole Atmosphere Community Climate Model with Ionosphere/Thermosphere eXtension (SD‐WACCM‐X), a first principles Physics‐based model. Results show that the largest geomagnetic dependency on Spire and SD‐WACCM‐X E‐region Ne occurs at night over the auroral latitudes with coefficients of determination at around 49% and 80%, respectively. Their regression coefficients are both between +10%/Kp index to +16%/Kp index. On the other hand, Spire and SD‐WACCM‐X substantially disagree on the geomagnetic dependencies during day‐time. These results suggest that Spire RO's observations of E‐region Ne geomagnetic dependencies may only be substantially explained by known physics at night and not during the day.

Validation of a Demography-Based Adaptive QT Correction Formula Using Pediatric and Adult Datasets Acquired From Humans and Guinea Pigs.

QT correction (QTc) formulae are widely used in clinical and research settings but often underperform, possibly due to demographic influences on the QT-heart rate (HR) relationship. To address this limitation, we developed an adaptive QTc (QTcAd) formula, which adjusts for demographic factors like age, and compared its efficacy to other standard formulae. The QTcAd formula was tested across diverse age groups with different HR in both humans and guinea pigs. Using retrospective ECG data from 1819 pediatric patients at Children's National Hospital and 2400 subjects from the Pediatric Heart Network database, alongside in vivo (n=55) and ex vivo (n=66) guinea pig ECG recordings, we evaluated the formula's effectiveness. Linear regression fit parameters of QTc-HR (slope and R²) were utilized for performance assessment. To evaluate the accuracy of the predicted QTc, we acquired epicardial electrical and optical voltage data from Langendorff-perfused guinea pig hearts. In both human subjects and guinea pigs, the QTcAd formula (QTcAd=QT+(|m|×(HR-HRmean)) consistently outperformed other formulae across all age groups. For instance, in a 20-year-old human group, the QTcAd formula successfully nullified the inverse QT-HR relationship (R²=5.1×10-10, slope=-3.5×10-5), whereas the Bazett formula failed to achieve comparable effectiveness (R²=0.21, slope=0.91). Moreover, the QTcAd formula exhibited better accuracy than the age-specific Benatar QTc formula, which overcorrected QTc (1-week human QT: 263.8±14.8 ms, QTcAd: 263.8±7.3 ms, P=0.62; Benatar QTc: 422.5±7.3 ms, P<0.0001). The optically measured pseudo-QT interval (143±22.5 ms, n=44) was better approximated by QTcAd (180.6±17.0 ms) compared with all other formulae. Furthermore, we demonstrated that the QTcAd formula was not inferior to individual-specific QTc formulae. The demography-based QTcAd formula showed superior performance across human and guinea pig age groups, which may enhance the efficacy of rate-corrected QTc for cardiovascular disease diagnosis, risk stratification, and drug safety testing in children and adults.

Assessment of myocardial deformation by CMR tissue tracking reveals left ventricular subclinical myocardial dysfunction in patients with gynecologic cancer undergoing chemotherapy

BackgroundChemotherapy-induced cardiotoxicity is a concern for patients with gynecologic cancer. This study aimed to assess left ventricular (LV) myocardial deformation in patients with gynecologic cancer undergoing chemotherapy and to investigate the association between myocardial deformation and chemotherapy factors.MethodsCardiac magnetic resonance (CMR) was performed to assess LV deformation parameters using CMR tissue tracking based on cine images. Serum myocardial injury biomarker were measured. Deformation parameters were compared between healthy controls and patients. Changes in deformation were assessed as chemotherapy progressed. Correlations between LV deformation parameters, clinical characteristics, and serum myocardial injury biomarkers were also analyzed.ResultsA total of 86 patients with gynecologic cancer and 30 normal controls were included. Among the patients, 41 completed CMR follow-up with a median interval of 6 months. Compared to the controls, patients exhibited lower absolute value of global radial strain (GRS) (37.30 ± 8.94% vs. 44.32 ± 8.44%), global circumferential strain (GCS) (-22.12 ± 3.05% vs. -24.08 ± 2.13%) and global longitudinal strain (GLS) (median -15.72% [IQR-17.13 to -13.58%] vs. -17.51 ± 2.00 %) (all p &amp;lt; 0.05). Patients with preserved LV ejection fraction (LVEF) also showed impaired global strain (all p &amp;lt; 0.05). GRS (39.71 ± 8.09% vs. median 30.56% [IQR 26.52 to 38.15%]; p = 0.001), GCS (-23.45 ± 2.09% vs. median -19.71% [IQR -21.71 to -19.10%]; p &amp;lt; 0.001) and GLS (-16.17 ± 2.42% vs. median -12.12% [IQR -14.10 to -8.53%]; p&amp;lt; 0.001) further decreased as the number of chemotherapy cycles increased during follow-up (all p &amp;lt; 0.05). Multivariate analysis showed that GCS was independently associated with the number of chemotherapy regimens (Standard regression coefficient [β] = 0.397, p &amp;lt; 0.001).ConclusionsMyocardial deformation is more sensitive than LVEF in detecting subclinical left ventricular dysfunction in patients with gynecologic cancer undergoing chemotherapy. GCS was associated with the number of chemotherapy regimens.

Multi-centre data harmonisation applied to heart-to-mediastinum quantification in parkinsonism (ITA-MIBG): a cross-calibration phantom study with tube and bottle

Abstract Purpose Planar cardiac scintigraphy with [123I]I-mIBG is widely used to image myocardial sympathetic activity. In multicentre studies, different γ-cameras can cause variability in quantitative parameters. This study aimed to harmonise multicentre [123I]I-mIBG data using a custom-designed phantom and to assess its feasibility and acceptability. Methods A ‘tube and bottle’ phantom was designed to standardise the heart-to-mediastinum (H/M) ratio across 15 centres. Each centre prepared three versions of the phantom (A, B, and C) with varying pertechnetate ([99mTc]Tc-O4-) activities, acquired static images using their own γ-camera, and uploaded DICOM data to a shared platform. In the phantom, the tube and bottle represent the heart and mediastinum, respectively, with the tube-to-bottle (T/B) ratio simulating the H/M ratio. The reference centre analysed the images and calculated the T/B ratios, applying linear regression for data harmonisation. A survey was conducted to assess the phantom’s usability. Results The harmonised T/B ratios for versions A and B were 20.46 ± 0.78 and 6.19 ± 0.39, respectively. The average slope and intercept of the regression line across the participating centres resulted in 1.07 ± 0.38 and − 0.82 ± 4.95. Survey feedback indicated high feasibility and acceptability, with all centres recommending the phantom for multicentre harmonisation. Conclusions The custom-made phantom effectively harmonised experimental data across different centres, supporting its use in multicentre studies to improve data consistency.

Effect of bottom ash powder replacement rate, water cement ratio and sand cement ratio on alkali activated slag mortar

The main objective of this study is to clarify the effect of bottom ash (BA) powder replacement rate, water-cement ratio, and sand-cement ratio on alkali-activated slag mortar (AASM) by comprehensively investigating the following parameters: fluidity, consistency, setting time, pH, compressive strength, and flexural strength, as well as observing the microstructure by XRD and SEM. Finally, the relationship between the parameters was explored by means of correlation coefficient heatmaps in concert with scatter plots (including quadratic polynomial linear fitting). The results show that it is feasible to use up to 60% of BA powder to replace slag for AASM. Meanwhile, it is suggested that the AASM with a water-cement ratio of 0.44 and a sand-cement ratio of 2.6 can obtain better workability, mechanical properties, and a denser microstructure. The incorporation of BA powder produces the unique hydration product Magadiite. In addition, the mechanical models of compressive strength and flexural strength of AASM were proposed . This study provides a reference for the application of BA powder in the alkali-activated system, which is beneficial for resource recycling.

On the performance of QTP functionals applied to second-order response properties.

Correlated orbital theory (COT) is an exact one-particle treatment that adds essential electron correlation into its molecular orbitals, potentially reducing correlated treatments of response properties to one-particle coupled-perturbed Hartree-Fock- or Kohn-Sham-like calculations. Such a computation is vastly simpler than the usual abinitio correlated approach that would add correlation typically with EOM-CC after a perturbed mean-field solution. The question then is, how well can this be accomplished via the Quantum Theory Project (QTP) exchange-correlation (XC) functionals that are meant to emulate the rigorous COT framework? This paper addresses this question for response properties by making comparisons between such orbital-specific calculations and those from well-correlated EOM-CC solutions for static polarizabilities, nuclear magnetic resonance coupling constants, and chemical shifts. The simple orbital-specific version provides an accurate realization of the correlated EOM-CC results, but now in a mode that facilitates an orbital-by-orbital interpretation. Here, we compare 33 XC functionals from the different Jacob's ladder rungs always against the EOM-CCSD results. Thus, the smallest mean absolute deviation for the static polarizability comes from LC-QTP XC, 0.28a.u. Regarding the total nuclear spin-spin coupling constants, QTP01 performs best, %Error = 10.63% (QTP02 and LC-QTP are second and third best). Finally, the XC that stood out in the chemical shift analysis was TPSS0, which presented the best result for the majority of the chemical shifts. However, considering the overall performances based on linear fitting of all isotope data points, five functionals are recommended for a chemical shift study: TPSS0, ωB97X, QTP00, QTP01, and QTP02, all presenting R2 = 0.96.

A Semismooth Newton-Based Augmented Lagrangian Algorithm for the Generalized Convex Nearly Isotonic Regression Problem

The generalized convex nearly isotonic regression problem addresses a least squares regression model that incorporates both sparsity and monotonicity constraints on the regression coefficients. In this paper, we introduce an efficient semismooth Newton-based augmented Lagrangian (Ssnal) algorithm to solve this problem. We demonstrate that, under reasonable assumptions, the Ssnal algorithm achieves global convergence and exhibits a linear convergence rate. Computationally, we derive the generalized Jacobian matrix associated with the proximal mapping of the generalized convex nearly isotonic regression regularizer and leverage the second-order sparsity when applying the semismooth Newton method to the subproblems in the Ssnal algorithm. Numerical experiments conducted on both synthetic and real datasets clearly demonstrate that our algorithm significantly outperforms first-order methods in terms of efficiency and robustness.

Pengaruh Live Shopping Shop Tokopedia @Npureofficial Terhadap Keputusan Pembelian Produk Skincare

This research aims to determine the influence of Shop Tokopedia live shopping on purchasing decisions for N'Pure Skincare. The theory used is AIDA (Attention, Interest, Desire, Action) by Elias St. Elmo Lewis. The research method use is a quantitative method with data collection in the form of a questionnaire distributed to followers of the TikTok account @npureofficial with a sample size of 100 respondents. The sampling technique uses non-probability sampling with a purposive sampling method. The data analysis methods used include normality test, simple linear regression test, partial test (t), and coefficient of determination test (R2). The data was tested using IBM SPPS Statistics 30 software. The research results show that Shop Tokopedia live shopping has a significant influence on purchasing decisions for N'Pure skincare products by 61.9% and the remaining 38.1% is influenced by other factors.

Acetabular component position significantly influences the rebalancing of pelvic sagittal inclination following total hip arthroplasty in patients with Crowe type III/IV developmental dysplasia of the hip.

Sagittal lumbar pelvic alignment alters with posterior pelvic tilt (PT) following total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH). The individual value of pelvic sagittal inclination (PSI) following rebalancing of lumbar-pelvic alignment is unknown. In different populations, PT regresses in a linear relationship with pelvic incidence (PI). PSI and PT have a direct relationship to each other via a fixed individual angle ∠γ. This study aimed to investigate whether the new PI created by acetabular component positioning during THA also has a linear regression relationship with PT/PSI when lumbar-pelvic alignment rebalances postoperatively in patients with Crowe type III/IV DDH. Using SPINEPARA software, we measured the pelvic sagittal parameters including PI, PT, and PSI in 61 patients with Crowe III/IV DDH. Both PSI and PT represent the pelvic tilt state, and the difference between their values is ∠γ (PT = PSI + ∠γ). The regression equation between PI and PT at one year after THA was established. By substituting ∠γ, the relationship between PI and PSI was also established. The Bland-Altman method was used to evaluate the consistency between the PSI calculated by the linear regression equation (ePSI) and the actual PSI (aPSI) measured one year postoperatively. The mean PT and PSI changed from preoperative values of 7.0° (SD 6.5°) and -8.0° (SD 6.7°), respectively, to 8.4° (SD 5.5°) and -4.5° (SD 5.9°) at one year postoperatively. This change shows that the pelvis tilted posteriorly following THA. In addition, when lumbar-pelvic alignment rebalanced, the linear regression equation between PI and PT was PT = 0.45 × PI - 10.5°, and PSI could be expressed as PSI = 0.45 × PI - 10.5° - ∠γ. The absolute difference between ePSI and aPSI was less than 5° in 55 of 61 patients (90.16%). The new PI created by the positioning of the acetabular component significantly affects the PSI when lumbar-pelvic alignment changes and rebalances after THA in patients with Crowe III/IV DDH.

Hospitalizations in people with down syndrome across age groups: a population-based cohort study in Switzerland.

People with Down syndrome suffer from multiple associated diseases. However, knowledge on rates and causes of hospitalizations is limited. This population-based cohort study used national hospital claims data in Switzerland between January 1, 2012 and December 31, 2020. Included were hospitalizations of people aged 0-90 years. People with Down syndrome were identified using ICD-10-GM code Q90 and were compared to the general population. The primary outcome was the hospitalization rate. Secondary outcomes were the primary reasons for hospitalizations, secondary diagnoses, and in-hospital outcomes. Analyses were stratified by three age groups: neonates and infants (0-12 months), children and adolescents (1-17 years), and adults (18-90 years). We calculated incidence rates, risk ratios (RR), and regression coefficients with corresponding 95% confidence intervals (CI). Among 9,992,538 hospitalizations, 5697 were identified for people with Down syndrome. Hospitalization rate for people with Down syndrome was highest in the first two years of life. In the total general population, it was highest in adults beyond 60 years. Primary reasons for hospitalization among people with Down syndrome were classified as diagnoses of the circulatory system (neonates and infants: RR 13.3 [95% CI 12.0-14.6], children and adolescents: RR 3.3 [95% CI 2.7-3.9]), and infectious diseases (adults: RR 4.0 [95% CI 3.7-4.2]). At birth, individuals with Down syndrome typically had an average of six diagnoses, a number that the general population reaches, on average, by the age of 69. People with Down syndrome experienced worse in-hospital outcomes, including longer stays in both the hospital and intensive care unit by a factor of 1.7 and a higher all-cause in-hospital mortality by an overall rate difference of 1.9%. The findings underscore the medical complexity of hospitalized people with Down syndrome and emphasize the need for a comprehensive, age-inclusive approach to improve in-hospital outcomes and anticipate emergency hospitalizations across age groups. Kantonsspital Aarau AG.

Ex Vivo Endocytoscopic Evaluation of Pancreatobiliary Cancers: A Step Toward Real-time In Vivo Diagnosis.

Endocytoscopy (EC) enables real-time diagnosis at extremely high magnification. The aim of the present study was to assess the potential of EC for the prediction of biliary malignancy. In total, 23 surgically resected cases with biliary tract cancer (BTCA, n=6), pancreatic head cancer (PCA, n=13), and non-cancerous bile duct lesion (NCBL, n=4) were enrolled in the study. The extrahepatic bile duct mucosa of the resected materials was examined ex vivo using EC. In cases of BTCA and PCA with bile duct invasion, several independent findings were identified as predictors of cancerous areas using multivariate analysis. These include, extravasation [odds ratio (OR)=15.91; 95% confidence interval (CI)=2.05-123.46], absence of fine network (OR=6.16; 95%CI=1.88-20.19), vascular dilatation (OR=4.87; 95%CI=1.56-15.25) in direct view. Additional predictors observed under methylene blue staining include anisonucleosis (OR=27.77; 95%CI=6.85-112.56), absence of large glands (OR=27.77; 95%CI=6.85-112.56), obscured nuclei (OR=7.63; 95%CI=2.23-26.17), and absence of uniform glands and small/irregular glands (OR=6.18; 95%CI=2.25-16.98). There were no differences in EC findings of non-cancerous areas between BTCA/PCA and NCBL. EC score for predicting the cancerous area (ECS-CA) was established by summing the scores (regression coefficients) of the eight EC findings described above. In the receiver operating characteristic curve analysis, the area under the curve for predicting cancerous areas using the ECS-CA was 0.960 (optimal cut-off ECS-CA, 6.1; sensitivity 91.5%; specificity, 93.6%). ECS-CA is valuable for assisting in the real-time diagnosis of biliary malignancy in vivo.