Profile Score Research Articles

Characteristics and nutrient profiles of foods and beverages on online food delivery systems.

Recently, there has been an emerging trend of purchasing foods and beverages via online food delivery systems but there is scarce evidence on the healthfulness of these items, particularly in Southeast Asian countries such as Malaysia. This study aimed to evaluate the characteristics and nutrient profiles of foods and beverages available via online food delivery systems in Malaysia. This cross-sectional study was conducted from September 2022 to March 2023 to identify foods and beverages available on the Grab Food and Foodpanda mobile applications. The healthfulness of selected foods and beverages was determined based on the Food Standards Agency Nutrient Profiling System. The present study included 3729 foods and 1882 beverages. Most of the foods were cereal-based dishes (37.4%), followed by cereals with protein-based dishes (12.8%) and meat or poultry-based dishes (12.0%), while most of the beverages were local handcrafted beverages (27.8%), followed by bubble milk tea (15.0%) and Western handcrafted beverages (14.6%). For protein dishes, deep-frying or battered-frying was the most common preparation method (33.8%) while most of the cereal-based dishes were stir-fried (76.7%). Out of 23 common foods, 15 foods (65%) were categorised as less healthy based on the nutrient profile score while 19 out of 24 (79%) common beverages were categorised as less healthy. The online food delivery systems feature predominantly local foods and beverages that are less healthy, potentially contributing to the development of an obesogenic environment.

Genetic evidence of the causal relationships between psychiatric disorders and cardiovascular diseases.

Our primary objective is to investigate the causal relationships between 12 psychiatric disorders (PDs) and atrial fibrillation (AF), coronary artery disease (CAD), myocardial infarction (MI), and heart failure (HF). Firstly, we used linkage disequilibrium score regression to calculate the genetic correlations between 12 PDs and 4 cardiovascular diseases (CVDs). Subsequently, we performed two-sample and bidirectional Mendelian randomization (MR) analyses of phenotypes with significant genetic correlations to explore the causal relationships between PDs and CVDs. Inverse variance weighted with modified weights (MW-IVW), Robust Adjusted Profile Score, Inverse Variance Weighted, weighted median and weighted mode were used to evaluate causal effects, with MW-IVW being the main analysis method. And to validate the MR results, we conducted the replicate analyses using data from the FinnGen database. Conducting MR analyses in phenotypes with significant genetic correlations, we identified bidirectional causal relationships between depression (DEP) and MI (DEP as exposure: OR=1.1324, 95% confidence interval (CI): 1.0984-1.1663, P<0.0001; MI as exposure: OR=1.0268, 95% CI: 1.0160-1.0375, P<0.0001). Similar relationships were observed in Attention Deficit/Hyperactivity Disorder (ADHD) and HF (ADHD as exposure: OR=1.0270, 95% CI: 1.0144-1.0395, P<0.0001; HF as exposure: OR=1.0980, 95% CI: 1.0502-1.1458, P<0.0001). In our study, we conducted the comprehensive analyses between 12 PDs and CVDs. By bidirectional MR analysis, we observed significant causal relationships between MI and DEP, HF and ADHD. These findings suggest possible complex causal relationships between PDs and CVDs.

Fetal cardiac function in pregnancy affected by congenital heart disease: protocol for a multicentre prospective cohort study

BackgroundCongenital heart disease (CHD) is the most common fetal malformation, and it can result first in cardiac remodeling and dysfunction and later in cardiac failure and hydrops. A limited number of studies have evaluated cardiac function in fetuses affected by CHD. Functional parameters could potentially identify fetuses at risk of cardiac failure before its development. However, these techniques have not translated from research to clinical settings, due to a lack of standardization and poor repeatability. We seek to evaluate whether application of automated techniques to a cohort with fetal pathology could overcome these factors.MethodsA multicenter cohort study will be carried out in eight teaching hospitals across Europe, Australia, and Middle East. Based on a previous observed standard deviation, a total sample of 381 pregnancies is required to achieve 80% power to detect a difference of 0.03 in mean myocardial performance index (MPI) with a two-sided type I error rate of 5%. After adjustments allowing for patient exclusions or incomplete datasets, a total of 330 healthy singleton pregnancies and 165 diagnosed with CHD will be recruited. Two fetal cardiac function evaluations at 19 + 6–28 + 6 and 32 + 6–36 + 6 weeks will be offered assessing automated pulsed wave doppler (PWD) MPI, spatio-temporal image correlation (STIC) annular and septal plane excursion (TAPSE, MAPSE and SAPSE), alongside cardiac morphometric and Doppler evaluations of flow across the valves. A secondary nested case–control study will evaluate fetuses with hydrops compared to those without. Differences in functional parameters between cases and controls and over time will be assessed using generalized linear mixed models. Logistic regression will estimate the association between cardiac parameters and hydrops’ incidence.DiscussionThis study will provide evidence as to whether automated functional parameters could be significantly different in pregnancy affected by CHD versus healthy pregnancies. The primary objective is to compare automated PWD-MPI and STIC TAPSE, MAPSE and SAPSE in fetuses affected by CHD versus healthy. The secondary objective is to estimate whether these automated parameters could improve the predictive value of the classical cardiovascular profile score in case of hydrops.Trial registrationThe study protocol has been registered in the ClinicalTrials.gov Protocol Registration System, identification number NCT05698277.

American alligators (Alligator mississippiensis) as wetland ecosystem carbon stock regulators

Blue carbon refers to organic carbon sequestered by oceanic and coastal ecosystems. This stock has gained global attention as a high organic carbon repository relative to other ecosystems. Within blue carbon ecosystems, tidally influenced wetlands alone store a disproportionately higher amount of organic carbon than other blue carbon systems. North America harbors 42% of tidally influenced global wetland area, which has been identified as a critical carbon stock in the context of climate change mitigation. However, quantified associations between vertebrate biota and carbon sequestration within ecosystems are in their infancy and have been incidental, given that microbial trophic levels are thought to drive nutrient dynamics. Here, we assess the relationship between American alligator (Alligator mississippiensis) demography and tidally influenced wetland soil carbon stock among habitats at continental, biogeographically-relevant, and local scales. We used soil core profile data from the Smithsonian’s Coastal Carbon Network and filtered for continuous core profiles in tidally influenced wetland areas along the Gulf and Atlantic Coasts of the United States. Results indicate that American alligator presence is positively correlated with soil carbon stock across habitats within their native distribution. Further, American alligator demographic variables are positively correlated with soil carbon stock at local scales. These conclusions are concordant with previous findings that apex predators, through trophic cascade theory, play a key role in regulating soil carbon stock and that alligators are functional apex predators in carbon dynamics and a key commercialized natural resource.

Botulinum toxin-A is ineffective in premature ejaculation treatment: insights from a meta-analysis of randomised controlled trials.

The ejaculatory reflex consists of emission and expulsion, with the latter involving rhythmic muscular contractions that propel seminal fluid. Botulinum toxin, through its inhibitory effects, has been hypothesized to improve premature ejaculation (PE). This study evaluates high-quality evidence on botulinum toxin-A injections into the bulbospongiosal muscle as a treatment for PE. We conducted a systematic review and meta-analysis of randomised-controlled trials (RCTs) following PRISMA guidelines. Outcomes included intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) scores, and complications. Data were analysed using Microsoft Excel and R. ROB-2, Eggers test, and GRADE assessed risk of bias, publication bias, and certainty of evidence (CoE). Three RCTs were eligible, and covered data from 228 patients with (1:1) randomisation into intervention and control arms (100 units of botulinum toxin-A in 10 mLs versus 10 mLs of 0.9% NaCl). IELT increases were noted with averages of 39.6, 11.5, and 2.4 s at 1, 3, and 6 months of follow up, respectively. Likewise, PEP scores demonstrated improvements of 1.54, 1.08, and 0.36 units at the same follow up intervals. however, statistical significance was not achieved in both outcomes of interest. Post-procedural complications were recorded in 11 patients (9.6%) with 10 in the intervention group. The majority of patients had voiding difficulties (n = 5) & mild erectile dysfunction (n = 4), however, all adverse events (AEs) were self-resolving and did not require active treatment. Given our findings, current high-quality evidence does not support using Botulinum Toxin-A in the management of PE. Larger scale & standardised RCTs are recommended to conclusively outline its clinical benefits.

Improved Items for Estimating SF-36 Profile and Summary Component Scores: Construction and Validation of an 8-item QOL General (QGEN) Survey.

Comprehensive health-related quality of life (QOL) assessment under severe respondent burden constraints requires improved single-item scales for frequently surveyed domains. This article documents how new single-item-per-domain (SIPD) QOL General (QGEN-8) measures were constructed for domains common to SF-36 and results from the first psychometric tests comparing scores for the new measure in relation to those for the SF-36 profile and summary components. Online NORC surveys of adults, ages 19-93 (mean=52y) representing the US population in 2020 (N=1648) included QGEN-8 and SF-36 items measuring physical (PF), social (SF), role physical (RP) and role emotional (RE) functioning and feelings of bodily pain (BP), vitality (VT), and mental health (MH). QGEN-8 items were constructed with response categories increasing score ranges for functioning (PF, SF, RP, RE) and directly measuring first-order factors for feelings (BP, VT, and MH). Analyses compared ceiling effects, convergent-discriminant correlations, classic and confirmatory factor analysis (CFA) testing for higher-order physical and mental components, and validity in discriminating across groups differing in comorbid condition severity. QGEN-8 reduced response times by 75% and lowered ceiling effect percentages (-2.2% to -27.8%, median=-14%) in comparison with SF-36. Their common measurement model was supported by: (1) substantial convergent correlations (r=0.576-0.778, median r=0.721) between methods for all domains; (2) lower discriminant correlations between different domains; (3) patterns of factor loadings equivalent to previous studies and adequate CFA model fit; (4) high correlations between methods for physical (r=0.813) and mental (r=0.761) component scores; and (5) equivalent average declines across groups reporting worse comorbid conditions. Overall, results support the use of QGEN-8 to reduce respondent burden and ceiling effects while maintaining convergent and discriminant validity sufficient to estimate group-level SF-36 physical (PCS) and mental (MCS) summary scores. To facilitate its use, QGEN-8 has been made available in multiple languages from the non-profit Mapi Research Trust at https://eprovide.mapi-trust.org.

Causal association between circulating α-Klotho levels and venous thromboembolism: a two-sample Mendelian randomization study

Backgroundα-Klotho may involve in the occurrence and development of venous thromboembolism (VTE). However, the underlying relationship between circulating α-Klotho levels and VTE is still unclear.MethodsThis two-sample Mendelian Randomization (MR) study aims to explore the causal associations of circulating α-Klotho levels with different types of venous thromboembolism. Data of exposure and outcomes were extracted from the genome-wide association study (GWAS) of the MRC Integrative Epidemiology Unit (MRC-IEU). The fixed inverse variance weighted (IVW), MR-Egger, MR-Robust Adjusted Profile Score (RAPS) and the weighted-median methods were utilized to investigate the causal associations of circulating α-Klotho levels with different types of VTE. The effect size was expressed as odds ratios (ORs) and 95% confidence intervals (CIs), and the False Discovery Rate (FDR) test was used for correction. The MR scatter plot and leave-one-out test were used for sensitivity analysis. In addition, reverse causal associations were assessed.ResultsIVW estimates suggested that an elevated circulating α-Klotho level was associated with lower odds of deep vein thrombosis (DVT) of lower extremities (OR = 0.992, 95%CI: 0.986–0.998, P = 0.0074), pulmonary embolism (PE) (OR = 0.474, 95%CI: 0.255–0.881, P = 0.0183), and DVT of lower extremities combined with PE (OR = 0.984, 95%CI: 0.971–0.997, P = 0.0175). However, after the FDR correction, only negatively causal association between circulating α-Klotho level and increased odds of lower-extremity DVT was statistically significant (FDR P = 0.0296). Also, there were no reverse causal associations between the circulating α-Klotho levels and different types of VTE (all P > 0.05). Additionally, both the MR scatter plots and leave-one-out test results showed that these causal associations were relatively robust.ConclusionAn elevated circulating α-Klotho levels was associated with lower risk of DVT of lower extremities, PE, and DVT of lower extremities combined with PE, indicating α-Klotho has the potential to act as a target for early screening or treatment for VTE. However, the specific mechanism that α-Klotho influencing the occurrence of VTE still needed further exploration.Graphical

Are Electromyography Data a Fingerprint for Patients with Cerebral Palsy (CP)?

This study aimed to first investigate changes in electromyography (EMG) patterns after multilevel surgical treatment in patients with cerebral palsy (CP) and then to assess the connection between the measure of EMG and motor control indices and surgery outcomes. We analyzed retrospective EMG and gait data from 167 patients with CP before and after surgery and from 117 typically developed individuals as a reference group. The patients underwent at least one soft tissue surgery on their shank and foot muscles. Using Repeated Measures ANOVA, we examined the norm-distance (ND) of the kinematics, kinetics, and EMG patterns, in addition to the Kerpape-Rennes EMG-based Gait Index (EDI), EMG Profile Score (EPS), and Walking Dynamic Motor Control Index (DMC) before and after surgery. Participants were divided into different response groups (poor, mild, and good gait quality) according to their pre- and post-treatment Gait Deviation Index (GDI), using the K-means-PSO clustering algorithm. The gait and EMG indices were compared between the responders using the nonparametric Mann–Whitney test. The ND for all kinematics and kinetics parameters significantly improved (p-value &lt; 0.05) after the surgery. Regarding EMG, a significant reduction was only observed in the ND of the rectus femoris (p-value &lt; 0.001) and soleus (p-value = 0.006). Among the indices, DMC was not altered post-operatively (p-value = 0.88). Although EDI and EPS were consistent across responders with a similar pre-treatment gait, a higher DMC was significantly associated with a greater improvement, particularly in patients with poor gait (p-value &lt; 0.05). These findings indicate systematic changes in the EMG of patients with CP following surgery, which can also be demonstrated through indices. DMC is a measure that can potentially serve as a partial predictor of outcomes, particularly in patients with poor pre-operative gait. Future research should investigate the effects of different surgical strategies on the improvement of these patients.

Unconventional polycyclic aromatic compounds distribution profiles in sediment cores collected from Todos os Santos Bay, Northeastern Brazil.

Polycyclic aromatic compounds (PACs) include conventional polycyclic aromatic hydrocarbons (PAHs) and nitrated (NHPAs), oxygenated (OHPAs), heterocyclic polycyclic aromatic sulfur (PASHs) derivatives, considered unconventional. Sediment cores were collected at four Todos os Santos Bay sites (BTS, Northeastern Brazil). Eighteen NPAHs, six OPAHs, seven PASHs, and nineteen PAHs were determined. The total concentrations of NPAHs, PASHs, and PAHs increased from the bottom towards the top of the cores, ranging from <LOD to 444 ng g-1 dw, <LOD to 104 ng g-1 dw, <LOD to 1160 ng g-1 dw and 10.6-1825 ng g-1 dw. Higher levels of NPAHs, PASHs, and PAHs were observed within the Port area associated with maritime and industrial activities, while 9,10-anthraquinone and low molecular weight PAH levels were elevated near a refinery. Principal Component Analysis revealed a mixture of emission sources in the top sediment layers in the western part of the bay, fossil fuel combustion in the Port area, and petrogenic sources near a refinery. The occurrence of PACs in bottom sediment cores near the river mouth and refinery (dating back to the 1850s) suggests sources from the sugar cane industry and petrogenic natural reserves. High PAC levels in a core near a refinery indicated the impact of BTS industrialization.

Kamchatka (southeastern Siberia) ice core records of dicarboxylic acids, oxocarboxylic acids and α-dicarbonyls since 1690s: A signal for the tropospheric oxidizing capacity.

There has been much interest about how to identify an ice core signal for oxidizing capacity of the troposphere. This study broadly explains the air-snow transfer/deposition process using ice core records of dicarboxylic (DCAs), ω-oxocarboxylic as well as pyruvic acids and α-dicarbonyls, which are potentially formed by atmospheric oxidation of aromatic hydrocarbons from the continent, incloud-oxidation of isoprene and unsaturated fatty acids from the western North Pacific. An ice core (~152m long, 304years) was collected at an ice cap on the Gorshkov crater at the summit of Ushkovsky (56° 04'N, 160° 28'E, altitude: 3903m) in the Kamchatka Peninsula from southeastern Siberia. Molecular distributions of DCAs showed a predominance of oxalic (C2) or succinic (C4) acid, followed by malonic (C3) acid. ω-Oxoacids are characterized by the predominance of glyoxylic acid (ωC2) followed by 8-oxooctanoic (ωC8) or 9-oxononanoic (ωC9) and then 4-oxobutanoic acid (ωC4). These molecular distributions (C2≅C4>C3 and ωC2>ωC8=ωC9>ωC4) in this ice core are different than those from Greenland Site-J and Alaskan Aurora Peak ice cores. The concentration profiles of these DCAs showed significant correlation (R=0.78, p<0.01) with the Dalton solar minimum (~1790s-1830s). Diagnostic ratios of these DCAs have clear signal of the Pacific and North Atlantic decadal oscillation with increases in the recent periods, suggesting that the ice core profiles of organic compounds are involved with past biogenic emission from marine biota and incloud-isoprene oxidation. This study reveals the multidecadal variability of the lower tropospheric oxidizing capacity in the North Pacific rim. SYNOPSIS: Polar organic compounds preserved in snow and ice are concomitant with recent climate changes in the western North Pacific rim. SIGNIFICANCE STATEMENTS.

Snoring as a Possible Protective Factor for Temporomandibular Joint Disorders

ABSTRACTBackgroundPrevious studies have linked sleep quality to temporomandibular joint disorders (TMD), suggesting a role for snoring in this association. However, the directionality of this relationship remains a subject of debate. This investigation aimed to elucidate the connections between snoring and TMD.MethodsThis research employed a two‐sample Mendelian randomization (MR) approach, leveraging publicly available large‐scale genome‐wide association study (GWAS) data on snoring and TMD. We utilised a suite of analytical methods, including the inverse variance weighted (IVW) method, maximum likelihood estimation, adjusted profile score, weighted median, MR–Egger regression, and a series of sensitivity analyses, to rigorously assess the existence of relationships.ResultsOur findings indicate that a greater genetic predisposition to snoring is significantly associated with a reduced risk of TMD (IVW method; odds ratio [OR] = 0.156, 95% confidence interval [CI] = 0.028–0.843, p = 0.0309). Conversely, the analysis did not support a potential influence of TMD on snoring susceptibility (IVW method; 95% CI = 0.990 to 1.002, p = 0.1926). Additionally, our sensitivity analyses did not reveal any significant pleiotropy that could bias these findings.ConclusionThis MR study provides limited but novel genetic evidence supporting a potential causal link between snoring and a decreased risk of developing TMD. On the other hand, it does not substantiate an effect of TMD on the likelihood of snoring.

Immune biomarkers in cases of recurrent pregnancy loss and recurrent implantation failure.

Reproductive failures, such as recurrent pregnancy loss (RPL) and recurrent implantation failures (RIF) are a major challenge for reproductive medicine. The current management of RPL and RIF cases identifies some causes for unsuccessful pregnancy in up to half of patients. Several studies have suggested that immune disorders are responsible for an important portion of unexplained cases of RPL and RIF. Moreover, the immune abnormalities responsible for reproductive failures can be classified into disorders related to autoimmunity and changes in cellular immunity. Antiphospholipid syndrome (APS), testing for antiphospholipid (aPL) antibodies, antinuclear antibodies, and antithyroid antibodies are identified as biomarkers of autoimmunity that can predict reproductive failure. The cellular immune response in cases of RPL and RIF can be investigated through the study of natural killer (NK) cells (uterine and peripheral blood) and T lymphocytes (T helper [Th]-1, Th-2, regulatory T and Th-17 cells). Several types of laboratory assays have been used to evaluate the endometrial immune microenvironment, such as the endometrial immune profile and decidualization score. However, the effectiveness of the treatment of RPL and RIF with immunomodulatory drugs has not yet been confirmed. Recently, a group of experts from the International Federation of Gynecology and Obstetrics and the European Society of Human Reproduction and Embryology recommended the investigation of some immune factors and treatment with immunosuppressants in women with RPL. In conclusion, it is important to consider immune abnormalities when managing women with RPL and RIF. The use of immunotherapies must be personalized and based on a specific diagnosis to obtain favorable outcomes.

Efficacy of combined electroacupuncture and moxibustion for treatment of neurogenic bladder after spinal cord injury: A retrospective analysis.

This retrospective study evaluates the clinical efficacy of combined electroacupuncture and moxibustion for the treatment of neurogenic bladder in patients with spinal cord injury. Ninety patients with neurogenic bladder after spinal cord injury who were admitted to the hospital between January 2021 and August 2023 were included. The patients were divided into the study and control groups (n = 45 each) using a random number table method. The study group was treated with electroacupuncture combined with moxibustion, while the control group was treated with electroacupuncture alone. The variables evaluated to assess the clinical efficacy of each treatment included number of cases in which bladder function reached a balanced state, initial bladder capacity sensation, maximum detrusor pressure before versus after treatment, maximum urine flow rate, maximum renal pelvic separation width, urine white blood cell count, and subjective quality of life profile score. In the study group, bladder pressure, residual urine volume, frequency of urination, and subjective quality of life profile score increased after versus before treatment (P < .05), whereas the maximal renal pelvis separation width and urinary white blood cell count decreased after versus before treatment (P < .05). Moreover, the study group exhibited significantly greater improvement than the control group (P < .05). The efficacy rates in the study and control groups were 75.6% and 95.6%, respectively; this difference was statistically significant (P < .05). Compared to electroacupuncture alone, electroacupuncture combined with moxibustion reduced the incidence of urinary tract infection, reduced residual urine volume, increased bladder capacity, and achieved balanced bladder function in patients with neurogenic bladder.

Histopathologic Features and Transcriptomic Signatures Do Not Solve the Issue of Magnetic Resonance Imaging-Invisible Prostate Cancers: A Matched-Pair Analysis.

Multiparametric magnetic resonance imaging (mpMRI) is pivotal in prostate cancer (PCa) diagnosis, but some clinically significant (cs) PCa remain undetected. This study aims to understand the pathological and molecular basis for csPCa visibility at mpMRI. We performed a retrospective matched-pair cohort study, including patients undergoing radical prostatectomy (RP) for csPCa (i.e., ISUP grade group ≥ 2) from 2015 to 2020, in our tertiary-referral center. We screened for inclusion in the "mpMRI-invisible" cohort all consecutive men (N = 45) having a negative preoperative mpMRI. The "mpMRI-visible" cohort was matched based on age, PSA, prostate volume, ISUP grade group. Included patients underwent radiological and pathological open-label revisions and characterization of the tumor mRNA expression profile (analyzing 780 gene transcripts, signaling pathways, and cell-type profiling). We compared the clinical-pathological variables and the gene expression profile between matched pairs. The analysis was stratified according to histological characteristics and lesion diameter. We included 34 patients (17 per cohort); mean age at RP and PSA were 70.5 years (standard deviation [SD] = 7.7), 7.1 ng/mL (SD = 3.3), respectively; 65% of men were ISUP 2. Overall, no significant differences in histopathological features, tumor diameter and location, mRNA profile, pathways, and cell-type scores emerged between cohorts. In the stratified analysis, an upregulation of cell adhesion and motility, of extracellular matrix remodeling and of metastatic process pathways was present in specific subgroups of mpMRI-invisible cancers. No PCa pathological or gene-expression hallmarks explaining mp-MRI invisibility were identified. Aggressive features can be present both in mpMRI-invisible and -visible tumors.

Does COVID-19 impact the QT interval prolongation? Answers from genetic causal inference.

During the COVID-19 pandemic, there has been heightened interest in the QT interval, a crucial indicator of ventricular electrical activity. Mendelian randomization (MR) is used here to investigate the genetic causation between QT interval alterations and COVID-19. Genetic proxies representing three COVID-19 phenotypes-severe, hospitalized, and COVID-19-were identified in over 1,000,000 individuals of European ancestry. Univariate two-sample Mendelian randomization (TSMR) and multi-exposure-adjusted multivariate Mendelian randomization (MVMR) were used to assess genetic causal associations between COVID-19 and QT intervals in 84,630 UK Biobank participants. The MR-robust adjusted profile score (MR-RAPS) method and radial MR frame were utilized for effect robustness and outlier variant detection, with sensitivity analyses conducted to identify horizontal pleiotropy. For every COVID-19 phenotype, univariate TSMR analysis revealed non-significant causal estimates between COVID-19 and the QT interval [COVID-19: βIVW (95% CI): -0.44 (-1.72, 0.84), P = 0.50; hospitalization: βIVW: 0.12 (-0.57, 0.80), P = 0.74; severe case: βIVW: 0.11 (-0.29, 0.51), P = 0.58]. MR-RAPS and outlier-corrected radial MR analyses further supported this null causal estimation. In confounder-adjusted MVMR analysis, this nonsignificant causality was independent of BMI, smoking, and alcohol consumption [βBMI+Alcohol+Smoking (95% CI): -0.77 (-2.44, 0.91), P = 0.37]. Sensitivity analyses did not detect any evidence of bias from horizontal pleiotropy, abnormal data distribution, or weak instruments. These findings suggest that COVID-19 does not directly causally prolong the QT interval. Inconsistent findings in observational research may be attributed to residual confounding.

Comparison of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment intensive care unit scoring system as mortality predictors in intensive care unit patients with sepsis

Background: Sepsis is a life-threatening organ dysfunction caused by a deregulated host response to infection. It is one of the leading causes of in-hospital mortality and morbidity among patients. It also results in significant morbidity and financial burden. Aims and Objectives: (1) To study the etiological profile of patients admitting with sepsis to ICU. (2) To compare between APACHE II and SOFA ICU scoring system of patients with sepsis at admission and at 24 h in predicting the 5th-day mortality. Materials and Methods: This was a single center hospital based prospective, observational, study conducted in patients in ICUs of ESICMC PGIMSR and Model Hospital Rajajinagar, Bangalore. Patients over age 18 years admitted in ICU who have fulfilled the criteria for sepsis were included in our study. Their clinical profile, APACHE II and SOFA scores were evaluated and followed up to 5th day of admission and data were compared with respect to patients’ outcome in the form of survival. Results: In this study, out of 53 patients the maximum number of patients belong to the age groups of &gt;60 years (23 patients). Male-to-female distribution in this study noted was 30 and 23 patients, respectively. Aspiration Pneumonitis (17%) and Community-Acquired Pneumonia (17%) were the most common causes of septic. Out of 53 patients, 31 patients did not survive. In this study, it was observed that the SOFA scoring had the highest specificity (87.10%) and APACHE II had the highest sensitivity (96.77%) at admission. However at 24 h of admission, both the highest sensitivity and highest specificity was more for APACHE II score. The most area under the Receiver-operating characteristic curve was better for SOFA score (AUROC=58.0%) at admission than APACHE II score with AUROC of 53.7%, however AUROC of both SOFA and APACHE II score calculated at 24 h of admission were equally good in predicting 5th-day mortality. Conclusion: We found that the SOFA score outperformed APACHE II scores in predicting survival in septic shock patients at admission. SOFA and APACHE II calculated at 24 h of admission and both scores provided equal efficacy in predicting 5th-day mortality in patients with sepsis.

Comparison of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment intensive care unit scoring system as mortality predictors in intensive care unit patients with sepsis

Background: Sepsis is a life-threatening organ dysfunction caused by a deregulated host response to infection. It is one of the leading causes of in-hospital mortality and morbidity among patients. It also results in significant morbidity and financial burden. Aims and Objectives: (1) To study the etiological profile of patients admitting with sepsis to ICU. (2) To compare between APACHE II and SOFA ICU scoring system of patients with sepsis at admission and at 24 h in predicting the 5th-day mortality. Materials and Methods: This was a single center hospital based prospective, observational, study conducted in patients in ICUs of ESICMC PGIMSR and Model Hospital Rajajinagar, Bangalore. Patients over age 18 years admitted in ICU who have fulfilled the criteria for sepsis were included in our study. Their clinical profile, APACHE II and SOFA scores were evaluated and followed up to 5th day of admission and data were compared with respect to patients’ outcome in the form of survival. Results: In this study, out of 53 patients the maximum number of patients belong to the age groups of &gt;60 years (23 patients). Male-to-female distribution in this study noted was 30 and 23 patients, respectively. Aspiration Pneumonitis (17%) and Community-Acquired Pneumonia (17%) were the most common causes of septic. Out of 53 patients, 31 patients did not survive. In this study, it was observed that the SOFA scoring had the highest specificity (87.10%) and APACHE II had the highest sensitivity (96.77%) at admission. However at 24 h of admission, both the highest sensitivity and highest specificity was more for APACHE II score. The most area under the Receiver-operating characteristic curve was better for SOFA score (AUROC=58.0%) at admission than APACHE II score with AUROC of 53.7%, however AUROC of both SOFA and APACHE II score calculated at 24 h of admission were equally good in predicting 5th-day mortality. Conclusion: We found that the SOFA score outperformed APACHE II scores in predicting survival in septic shock patients at admission. SOFA and APACHE II calculated at 24 h of admission and both scores provided equal efficacy in predicting 5th-day mortality in patients with sepsis.

Examining the Readability of AtlasGPT, The Premiere Resource for Neurosurgical Education

AtlasGPT represents an innovative generative pretrained transformer, trained using neurosurgery literature. Its ability to construct its response according to the training level of the user is unique; however, whether its responses can be comprehended at each user's training level remains unknown. This study aimed to analyze the readability of responses provided by AtlasGPT. Ten queries were presented to AtlasGPT across its 4 user profiles (i.e., surgeon, resident, medical student, patient). A readability analysis was performed using multiple instruments on Readability Studio. Readability scores of user-specific responses were compared using one-way analysis of variance testing and post hoc pairwise t-tests with Bonferroni correction. P value <0.05 was considered to be significant. Across the readability instruments that were leveraged, significant differences in reading ease were observed across all user profiles on comparisons to the patient (P<0.005). Readability scores for the medical student profile tended to show greater reading ease than the surgeon and resident profiles; these differences, however, were not significant. The mean grade levels for patient responses across multiple instruments ranged from 8.8 to 11.51. Only one output via the New Dale-Chall assessment was written at the level of fifth-sixth grade. AtlasGPT-generated content demonstrates readability variations according to the user profile selected; however, the readability of patient content still exceeds recommendations set by United States departmental agencies, necessitating a call to action.

Health utility attributable to oral conditions in Japanese adults.

Utility values enable relative comparisons across various health conditions, providing information for efficient allocation of healthcare resources. This study aimed to (1) quantify the utility values attributable to oral health-related quality of life (OHRQoL) in Japanese adults and (2) develop models for converting the 14-item Oral Health Impact Profile (OHIP-14) scores into EuroQoL 5-dimension 5-level (EQ-5D-5L)-based utility values. This was a cross-sectional study. Data from a large-scale Internet survey of Japanese adults conducted in 2022 (n = 28 405; mean age 48.2 years) were analysed. Multiple linear regression models were fitted to investigate the association between OHIP-14 scores and EQ-5D-5L-based utility values, adjusting for confounders. Conversion models were developed using a random half of the participants, and the observed and predicted utility values in the other half were compared to evaluate the model performance. Among the participants, 55.2% scored 0, 20.9% scored 1-5 and 23.9% scored 6-56 on the OHIP-14, corresponding mean utility values of 0.93, 0.90 and 0.84, respectively. A one-point increase in the OHIP-14 score was associated with a lower utility value (coefficient: -0.0053; 95% confidence interval:health-related quality of life -0.0056, -0.0051). The estimated utility value attributable to OHIP-14 was -23.3 per 1000 individuals, greater than that for other prevalent chronic conditions, including hypertension and diabetes (-2.9 and -7.1 per 1000 individuals, respectively). The conversion model incorporated the OHIP-14 total score, age, sex and self-rated health, predicted utility scores on average and captured differences according to the number of teeth lost. However, there was a discrepancy between predicted and observed utility values in the lower utility value groups. OHRQoL substantially impacted utility values at the population level. The OHIP-14 holds the potential as a valuable tool for predicting average utility values based on oral health conditions; however, the prediction performance was relatively low for individuals with a lower health-related quality of life.

Elucidating the Causal Impact of Dietary Factors on Rheumatoid Arthritis: Insights From Multivariable Mendelian Randomization Analysis.

Rheumatoid arthritis (RA) is a common chronic autoimmune disorder with an incompletely elucidated pathogenesis. Emerging research indicates that dietary factors may significantly influence the onset and progression of RA. Nevertheless, the causal relationship between dietary habits and RA remains ambiguous. This investigation employed a multivariable Mendelian randomization (MVMR) methodology to rigorously assess the potential causal effects of various dietary factors on RA risk. This study utilized genome-wide association study (GWAS) summary-level data, encompassing dietary preferences (n = 113,425-159,579), and RA data (n = 302,614) from the most recent FinnGen database. The primary causal analysis was conducted using inverse-variance weighting (IVW), complemented by MR-Egger, weighted median, Bayesian weighted Mendelian randomization, and Robust Adjusted Profile Score (RAPS) methodologies. Sensitivity analyses incorporated Cochran's Q test, MR-Egger intercept test, MR-PRESSO, and leave-one-out analysis. Steiger tests were employed to evaluate the identified dietary preferences. MVMR was utilized to assess the direct impact of dietary factors on RA. The study identified significant associations between RA and nine dietary preferences: F-lentils/beans liking (Fle), chips liking (Chips), coffee difference liking (CD), coffee with sugar liking (CWS), milk chocolate liking (MC), coriander liking (Coriander), pollock liking (Pollock), soft cheese liking (SC), and blue cheese liking (BC). The MVMR analysis indicated that genetically predicted coriander and MC have a direct impact on RA, independent of other dietary factors. This study presents novel causal evidence suggesting that dietary preferences may impact the risk of RA. Specifically, a reduction in the consumption of milk chocolate and coriander may contribute to the prevention and alleviation of RA. However, additional research is required to elucidate the underlying mechanisms and to validate these findings across diverse populations.