Elevated Scores Research Articles

Elevated metabolic score for visceral fat was associated with increased prevalence of gallstones in American adults: a cross-sectional study

Elevated metabolic score for visceral fat was associated with increased prevalence of gallstones in American adults: a cross-sectional study

Rates of socio-emotional difficulties among deaf and hard of hearing children in Ireland

ABSTRACT Higher rates of socio-emotional difficulties for deaf and hard of hearing (DHH) children have been reported compared with their typical hearing (TH) peers. Nonetheless, there has to date been limited examination on this issue internationally and no such examination in the Republic of Ireland. In this study, data was collected from parents using an online survey which included the Strengths and Difficulties Questionnaire to examine the socio-emotional development of 113 DHH children aged 5–16 in the Republic of Ireland. The results were compared with data from typically hearing (TH) children obtained from a large longitudinal study of childhood in Ireland – the Growing Up in Ireland study. The findings demonstrate that the prevalence of socio-emotional difficulties among this cohort of children is over three times that of the general population of children in Ireland, with 42% of the sample demonstrating clinically significant problem scores. Furthermore, DHH children had elevated subscale scores for the four problem scales in the SDQ when compared against the TH sample. These differences were statistically significant and had a range of effect sizes from small to large. The subscale of most concern was the peer problems subscale where the DHH sample had mean scores that were roughly double those of the TH sample, with a large effect size found. Finally, bivariate analysis revealed that several background variables were associated with elevated difficulty scores for DHH children, namely male gender, poorer communicative competency, and presence of an additional educational need.

Moving Beyond Systemic Inflammatory Response Syndrome and Bacteremia: Are Modern Critical Care Calculators Useful in Predicting Debridement, Antibiotics, and Implant Retention Treatment Outcomes in Periprosthetic Joint Infection?

BackgroundIn critically ill periprosthetic joint infection (PJI) patients, surgeons need to balance the need for aggressive, definitive treatment against the health state of a potentially unstable patient. A clear understanding of the association between treatment outcomes and assessment scores for sepsis would benefit clinical decision-making in these urgent cases. The current study evaluates the effect of critical illness on debridement, antibiotics, and implant retention (DAIR) outcomes, as defined by systemic inflammatory response syndrome (SIRS) and, for the first time, by contemporary markers quick Sequential Organ Failure Assessment (qSOFA) and Modified Early Warning Score (MEWS). MethodsWe retrospectively identified 253 patients who underwent DAIR for PJI at a single institution between 2017 and 2021. The SIRS, qSOFA, and MEWS scores were calculated based on variables on admission. A DAIR treatment failure, defined as reoperation or mortality, was measured at 90 days and two years. Univariate analysis was used to determine the association between elevated critical care scores and DAIR failure. ResultsThe DAIR treatment success was 59% at two years, with hip procedures and Charlson comorbidity index (CCI) ≥ 1 independently associated with higher odds of DAIR failure. There were 43 patients (16%) who presented with SIRS, however, only four (2%) had positive qSOFA scores. Neither SIRS nor qSOFA were predictive of DAIR failure. For knees only, elevated MEWS scores were predictive of 90-day DAIR failure (P = 0.019). ConclusionOver one in six patients undergoing DAIR for PJI presented with SIRS, while only one in 50 had a positive qSOFA. The SIRS and qSOFA scores were not predictive of DAIR failure. Elevated MEWS scores were associated with DAIR failure at 90 days postoperatively in knee PJIs only, and should be confirmed in a larger cohort. Our results suggest that SIRS is not predictive of DAIR outcomes, possibly because it overestimates the proportion of critically ill patients.

Increased bolus overrides and lower time in range: Insights into disordered eating revealed by insulin pump metrics and continuous glucose monitor data in Australian adolescents with type 1 diabetes

AimsTo determine the prevalence of disordered eating behaviors (DEB) in a population of Australian adolescents with T1D and to investigate clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) data trends, and psychological attributes associated with DEB. Methods50 participants (27 female, 23 male, average age 15.2 years, average duration of diabetes 6.2 years) were recruited. Diabetes Eating Problem Survey-Revised (DEPS-R) and Strengths and Difficulties Questionnaires were completed. Prevalence of disordered eating was reported, and associations with clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) metrics were assessed. ResultsTwenty-four participants (48 %) had an elevated DEPS-R score. Participants with elevated DEPS-R were more likely to be female (75 % vs 31.6 %, p = 0.004), have a higher HbA1c (8.2 %/67 mmol/mol vs. 6.9 %/51 mmol/mol, p < 0.002) and BMI Z-score (+1.28 SD vs +0.76 SD, p = 0.040). They had lower time in range, 3.9–10 mmol/L (50.3 % vs. 63.8 %, p = 0.01) and higher mean glucose (10.0 mmol/L vs. 8.3 mmol/L, p = 0.005). Of the 60 % using IPT, participants with elevated DEPS-R had increased meal bolus overrides (7.9 % vs 3.8 %, p = 0.047). Reported difficulties on SDQ were higher in the elevated DEPS-R group (18.3 vs 10.5, p < 0.002). ConclusionsDEB are common in Australian adolescents with T1D and associated with increased dysglycemia. Diabetes technology cannot be solely relied upon for detection of DEB and there remains a need for routine screening.

Cardiovascular Risk in Pediatric Renal Transplant Recipients.

The survival of pediatric chronic kidney disease (CKD) patients has improved in recent decades due to advances in dialysis and transplantation. However, cardiovascular disease (CVD) emerges as the main cause of mortality in patients with CKD. To estimate cardiovascular risk in children with CKD at least 1 year after kidney transplantation. In addition, the possible association of cardiovascular risk with classic biochemical markers and potential new markers of this outcome was investigated. An observational ambidirectional (retrospective capture of risk factors and prospective study of outcomes) research including 75 patients who underwent renal transplant between 2003 and 2013 with postoperative follow-up of at least 1 year was conducted. The outcome variables adopted were the LV mass Z-score and the presence of coronary calcification on computed tomography using calcium Agatston score. Only one patient had an elevated calcium score, and three children (4%) had an LV mass Z-score ≥ 2.0. After multivariable analysis, only gender, serum triglyceride, and serum renalase concentration remained significantly associated with LV mass. The low incidence of cardiovascular changes in the population studied confirms the benefit of transplantation for the cardiovascular health of children. Nevertheless, long-term follow-up of these patients is recommended, given the limited duration of kidney function provided by transplantation and the high likelihood of further dialysis and kidney transplants being required in these children.

Telehealth-delivered depression prevention: Short-term outcomes from a school-based randomized controlled trial.

To examine short-term (i.e., postintervention) outcomes from a randomized controlled trial comparing a school-based telehealth-delivered depression prevention program, Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), to services as usual (SAU). We expected IPT-AST would be acceptable and feasible and that IPT-AST adolescents would experience greater reductions in depression symptoms, anxiety symptoms, and impairment compared with SAU. Adolescents (N = 242; Mage = 14.80 years, SD = 0.70; 65% female; 21% Black; 13% Hispanic/Latinx) with elevated scores on the Center for Epidemiologic Studies Depression Scale (Radloff, 1977) at screening provided data at baseline, 2-month (midpoint of IPT-AST), and 3-month (postintervention) assessments. They reported depression symptoms on the Center for Epidemiologic Studies Depression Scale, anxiety symptoms on the Screen for Child Anxiety Related Emotional Disorders (Birmaher et al., 1997), and impairment on the Columbia Impairment Scale (Bird et al., 1993). Baseline depression diagnosis was examined as a moderator. Hierarchical linear models showed that adolescents reported significant reductions in depression symptoms and impairment across conditions. IPT-AST adolescents reported significantly greater reductions in anxiety symptoms than SAU adolescents, d = .39, 95% CI [.05, .72], p = .003. Depression diagnosis moderated outcomes (ds = .33-.34, ps ≤ .05), such that IPT-AST adolescents without a diagnosis at baseline showed greater improvements in depression and anxiety symptoms than SAU adolescents. Adolescents in SAU with a depression diagnosis at baseline showed greater improvements in impairment compared with IPT-AST. Attendance and satisfaction data demonstrated the feasibility and acceptability of telehealth-delivered IPT-AST. Results support telehealth-delivered IPT-AST as a promising intervention for improving short-term outcomes among adolescents with depression symptoms but without a depression diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence and risk factors for postpartum depression and stress among mothers of preterm and low birthweight infants admitted to a neonatal intensive care unit in Accra, Ghana.

To determine the prevalence of postpartum depression (PPD) and postpartum stress (PPS) and identify associated risk factors among mothers of preterm and low birth weight (LBW) infants. We conducted a secondary analysis of data collected from 255 mothers with preterm and LBW infants admitted to the neonatal intensive care unit (NICU) at Korle-Bu Teaching Hospital, Accra, Ghana. A standardized interviewer-administered questionnaire collected data on maternal, pregnancy, birth, and infant characteristics. The questionnaire also included the Patient Health Questionnaire-9 (PHQ-9) and the Perceived Stress Scale-4 (PSS-4) to assess PPD and PPS, respectively. Simple and multivariable linear regression analyses were performed to identify factors associated with PPD and PPS. The prevalence of moderate to moderately severe PPD was 3.9%, and that of PPS was 43.5%. The multivariable linear regression analysis showed that an increased number of prenatal care visits (β-estimate = 0.26; 95% confidence interval [CI] 0.08-0.43; P < 0.01) was positively associated with higher scores on the PHQ-9, whereas gestational age at birth (β = -0.21; 95% CI -0.40 to -0.03; P = 0.02) was inversely associated with PHQ-9 scores. Moreover, a longer gestational period at the first prenatal care visit (β = 0.25; 95% CI 0.05-0.45; P = 0.01) and following the Islamic religion were associated with elevated scores on the PSS-4 (β = 0.95; 95% CI 0.11-1.80; P = 0.011). Our findings underscore the presence of moderate PPD levels and high PPS levels among mothers. Active screening, diagnosis, and treatment for mothers at risk of mental health disorders during the peripartum period could enhance coping mechanisms for mothers navigating the challenging NICU environment and transitioning to the home environment.

The Paradox of Physical Activity and Coronary Artery Calcification: Implications for Cardiovascular Risk

The introduction of CT scans and the subsequent Agatston score in the 1990s drastically improved our ability to detect coronary artery calcification (CAC). This led to its incorporation into cardiovascular risk assessment guidelines set forth by organizations such as the American Heart Association (AHA) and the American College of Cardiology (ACC). Over time, these guidelines have evolved significantly, reflecting an increasing understanding of CAC. Physical activity has become a key factor in the management of cardiovascular disease. However, the relationship between physical activity and CAC remains complex. Although physical activity is generally beneficial for cardiovascular health, paradoxically, high levels of physical activity have been associated with elevated CAC scores. However, these higher CAC levels may indicate the presence of more stable, calcified plaques that provide protection against plaque rupture. These contradictory findings call for balanced interpretations that acknowledge the cardiovascular benefits of physical activity. This review examines the historical development of clinical guidelines for CAC, the paradoxical relationship between physical activity and CAC, and potential underlying mechanisms. It emphasizes the need for future research to utilize objective measures and consistent methodologies to better understand the relationship between physical activity and CAC.

Edinburgh postnatal depression scale score elevation in caregivers of infants with cystic fibrosis.

The diagnosis of cystic fibrosis (CF) can impact the mental health of caregivers. This study aimed to explore prevalence of postpartum depression (PPD) symptoms in caregivers of infants with CF or CFTR-related metabolic syndrome (CRMS). This prospective, observational study was conducted in a CF clinic at a tertiary hospital over 4 years. Caregivers of infants with CF/CRMS completed serial surveys over the first year of life. Surveys included the Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). A control group of healthy infant caregivers was used for comparative analysis of EPDS scores. Analyses were conducted on 55 caregivers of 42 infants with CF/CRMS and 915 caregivers of healthy infants. Caregivers of infants with CF/CRMS had a significantly higher prevalence of elevated EPDS scores and higher mean EPDS scores for visit 1 (age 1-2mo) and visit 3 (age 6-9mo) compared to healthy controls (p < 0.001 for both). There was a higher prevalence of caregivers identifying thoughts of self-harm in the CF/CRMS cohort (8.3%) compared to caregivers of healthy controls (1.2%) at visit 1 (p = 0.015) and at visit 3 (CF/CRMS 8.8%; control 1.7%; p = 0.030). EPDS scores correlated with PHQ-9 and GAD-7 scores, particularly earlier in the infant's life. Caregivers of infants with CF/CRMS may be at higher risk of PPD and thoughts of self-harm when compared to healthy controls. Given what is known about the impact of PPD on mental and physical health of children, early identification is vital for this population.

An Elevated FIB-4 Score is associated with the severity of heart failure

Abstract Background Liver disease and heart failure (HF) are known to be closely associated. Non-invasive tests (NIT), such as the FIB-4 score, have been recommended by different guidelines to rule out advanced liver fibrosis and to stratify the risk of liver-related outcomes in patients with chronic liver diseases. Purpose Thus, our goal was to evaluate the connection between the FIB-4 index, heart failure, associated comorbidities, and cardiological biomarkers that predict the risk of liver fibrosis in patients with heart failure. Methods HF patients hospitalized in the cardiology department were divided into a group with an FIB-4 index &amp;lt;1.3 (indicating a low risk of liver fibrosis) (n=53) and a group with an FIB-4 index ≥1.3 (indicating intermediate and high risk of fibrosis) (n=59). Clinical examinations, laboratory results, echocardiography with Vivid E95-GE Healthcare, non-invasive body mass analysis with Body Composition Analyzer (Tanita Pro), and measurements of NT-proBNP, growth differentiation factor 15 (GDF-15), galectin-3, fatty acid-binding protein (FABP), copeptin, and vascular endothelial growth factor (VEGF) concentrations were performed. Results The patients with an FIB-4 index ≥1.3 had significantly higher: left ventricular volume index (LAVI) (p=0.004), E/E’ ratio (p=0.004) and lower left ventricular ejection fraction (p=0.003) compared to group with low risk of liver fibrosis. There were no differences in body mass compartments between groups except for ECW/TBW (%) - an index of body water distribution, which was lower in low-risk liver fibrosis group (p=0.0002). Patients with an FIB-4 index ≥1.3 had also lower: GFR MDRD (median 59.95 vs 85.1 mL/min/1.73 m²; p&amp;lt;0.001), total cholesterol (116.5 vs 15 mg/dL; p=0.002), LDL cholesterol (median 56 vs 93 mg/dL; p&amp;lt;0.0001) and HDL cholesterol (median 39 vs 47 mg/dL; p=0.03). Regarding heart failure biochemical biomarkers, patients with low risk of liver fibrosis had significantly lower level of NT-proBNP (median 37 vs 161 pg/ml; p&amp;lt;0.0001), GDF-15 (median 399.6 vs 898.9 pg/ml; p&amp;lt;0.0001) and FABP (median 101 vs 264,7 pg/ml; p=0.04). In a multiple logistic regression model the factors that were independently associated with the risk of liver fibrosis in HF patients based on an FIB-4 index were GDF-15 &amp;gt;724 pg/ml (OR 33.7, 95%CI: 6.5-174.2; p=0.0001), and NT-proBNP &amp;gt;129 pg/ml (OR 19.9, 95% CI: 3.8-103; p=0.0001) (Figure 1) Conclusion Our study suggests association between an elevated FIB-4 score and heart functions, and kidney impairment with fluid overload but not with higher total and low density cholesterols fractions or percentage of fat. Higher GDF-15 and NT-proBNP levels are independently associated with the risk of liver fibrosis based on an FIB-4 index. FIB-4 index in HF patients is an easy method to monitor the risk of liver fibrosis and might help to predict the HF progression and CVD complications.

Forecasting Psychological Distress Across Waves Of The COVID-19 Pandemic: A Multi-country Longitudinal Study

Abstract The current study used a longitudinal multi-country cohort survey (N = 8013 at baseline; age (M) = 40.3, SD = 15; female 76%) to investigate whether psychological distress assessed at five waves (May-June 2020; September-October 2020; December 2020-January 2021; March-April 2021 and March-May 2022) during the COVID-19 outbreak can be forecasted by a variety of socio-demographic and psychological- and COVID-related factors assessed at baseline. Psychological distress was defined by elevated depression and/or anxiety scores (PHQ-9 and GAD-7 &amp;gt; = 10). Predictors included demographic characteristics (e.g., gender, age, education), infections with COVID-19, loss of income, substance abuse, domestic violence, contamination fear, basic value orientations, social support and coping strategies. A Random Forest (RF) prediction model within a machine learning context was used to estimate the association between the independent variables and the presence of psychological distress among respondents completing all waves (N = 1052). Preliminary RF results showed that psychological distress at multiple waves, both during the initial phases (2020) as well as the more protracted phases (2021 and 2022), was adequately forecasted by scores on a number of basic value orientations (e.g., lower tradition and conformity, higher security and predictability), by demographic characteristics (e.g., younger age), by the fear of being contaminated, and by lower levels of social support and higher levels of loneliness. It is concluded that during a pandemic, certain personal values may elicit more vulnerability for psychological distress than others. Effective psychological intervention strategies should encompass personal traits and values and factors such as low social support levels and feelings of loneliness to mitigate distress. These insights can help in accurately pinpointing high-risk groups for heightened distress in future public health crises.

Assessing stroke and mortality risk in heart failure: the CHA2DS2-VASc score's prognostic value in patients with and without atrial fibrillation - a systematic review and meta analysis

Abstract Background Heart failure (HF) is a common cardiovascular disorder that is linked to substantial morbidity and mortality. The CHA2DS2-VASc score, originally designed to assess the risk of stroke in patients with atrial fibrillation, has demonstrated potential as a prognostic indicator for adverse outcomes in patients with heart failure. This systematic review and meta-analysis aimed to assess the predictive accuracy of the CHA2DS2-VASc score in determining the occurrence of stroke and increased mortality rates in patients with heart failure. Methods A thorough search of electronic databases, such as PubMed, EMBASE, and the Cochrane Library, was performed to find pertinent papers published until the search cutoff date. Included studies examined the correlation between the CHA2DS2-VASc score and the likelihood of stroke or death in patients with heart failure. The assessment of the quality of the included studies was conducted using recognized criteria, and data were collected for quantitative synthesis. Findings The meta-analysis encompassed four studies (45864 patients), revealing a consistent and substantial correlation between elevated CHA2DS2-VASc scores and heightened risks of both stroke and mortality in heart failure patients. More precisely, patients with CHA2DS2-VASc scores ≥4 had a greater risk of stroke compared to those with scores &amp;lt;4 (odds ratio 0.38, 95% confidence interval 0.33-0.43, p-value &amp;lt; 0.00001). The combined data showed homogeneity (p-value = 0.24, I2 = 29%). Similarly, patients with CHA2DS2-VASc scores ≥4 had a higher risk of mortality compared to those with scores &amp;lt;4 (OR 0.49, 95% CI 0.30-0.80, P = 0.05). However, the combined data showed significant heterogeneity (P &amp;lt; 0.00001, I2 = 96%). Conclusion The CHA2DS2-VASc score is a useful predictive tool for identifying heart failure patients who are hospitalized and at a high risk of both stroke and high mortality. The results of this study provide evidence for the practicality of using the CHA2DS2-VASc score for risk stratification in patients with heart failure. Additional investigation is necessary to confirm these findings and examine the incorporation of the CHA2DS2-VASc score into risk assessment algorithms for tailored patient management.Figure:Risk of strokeFigure:Risk of mortality

Perfusion metabolism mismatch predicts short-term complications in Takotsubo syndrome

Abstract Background Takotsubo syndrome (TTS) is a transient cardiac condition triggered by sudden emotional or physical stress characterized by LV dysfunction in the absence of obstructive epicardial coronary artery disease. 123I-BMIPP, an iodinated fatty acid analogue, can identify impaired myocardial metabolic activity. With the use of dual SPECT protocol, reduced uptake of 123I-BMIPP compared to perfusion which is called perfusion-metabolic mismatch is observed in apical regions in TTS. The mismatch may indicate jeopardized but viable myocardium, reflecting transient ischemic damage or metabolically stunned myocardium. However, the association between the perfusion metabolism mismatch in TTS and its complications remains underexplored. Purpose Our study aimed to analyze the degree of perfusion metabolism mismatch at the acute phase in TTS and investigate its association with short-term complications. Methods This retrospective study conducted between 2012 and 2024 at a single center included 82 patients diagnosed with TTS. Patients underwent dual SPECT imaging using 99mTc or 201 Tl and 123I-BMIPP within two weeks of admission. We applied quantitative analysis using QGS/QPS software from Cedars-Sinai. Total perfusion deficit ("TPD") was calculated based on sex-matched normal limits providing the extent of perfusion abnormality. Meanwhile, perfusion-metabolism mismatch scores ("worsen") were determined by comparing the total BMIPP counts to the total counts of perfusion. We then assessed the correlation of these imaging findings with biomarkers, regional wall motion abnormalities, and the occurrence of short-term complications. Short-term complications included heart failure, left ventricular outflow (LVOT) obstruction, mitral regurgitation, cardiac arrhythmia, cardiogenic shock, left ventricle (LV) rupture, and cardiac death during the hospitalization period. Results All study patients exhibited wall motion abnormalities seen in apical segments. The count of myocardial segments with regional wall motion abnormality was correlated with both TPD (r=0.34, p=0.002) and perfusion metabolic mismatch score (r=0.40, p&amp;lt;0.001). TPD had a moderate correlation coefficient with max CK-MB (r=0.44, p&amp;lt;0.001) and troponin T (r=0.40, p&amp;lt;0.001) levels. However, perfusion metabolic mismatch did not display correlations with max CK-MB (r=0.05, p=0.65), and Troponin T (r=0.12, p=0.28) levels. Among 82 patients, 37 patients experienced any short-term complications. Importantly, patients with short-term complications had elevated perfusion mismatch scores compared to those without short-term complications (14.0 [6.0-22.5] vs. 5.0 [3.0-10.0], p&amp;lt;0.001). However, no significant difference was observed in TPD between the two groups (9.0 [4.5-20.0] vs. 7.0 [3.0-12.0], p=0.130). Conclusions Our research highlights a significant association between perfusion-metabolism mismatch and an increased risk for short-term complications in patients with Takotsubo syndrome.

The influence of dark personality and pornography on sexual aggression beliefs

IntroductionViolence against women, particularly sexual violence, poses a significant public health concern. Predispositions toward perpetrating such acts often stem from the acceptance of myths that justify or deny these behaviours. This study aimed to explore how dark personality traits (narcissism, Machiavellianism, psychopathy, and sadism) and pornography consumption relate to the acceptance of these myths.MethodsSurveying 598 participants, the research employed Latent Profile Analyses (LPA) to identify distinct population profiles, Additionally, regression analyses were employed to further explore the relationships among variables.ResultsThree profiles emerged, showcasing varying degrees of acceptance of sexual aggression myths. The most concerning profile, encompassing 9.2% of participants, displayed the highest alignment with these myths, alongside elevated scores in dark personality traits and pornography consumption. Notwithstanding the three profiles showed significant differences in the acceptance of these myths. Interestingly, the regression analysis highlighted that Machiavellianism stood out as the primary predictor for accepting sexual aggression myths, overshadowing the influence of pornography consumption.ConclusionThis emphasizes the role of personality traits in influencing attitudes towards sexual aggression myths. Moreover, implications for tailored prevention strategies, focusing on high-risk profiles, are discussed, highlighting the potential for targeted interventions to address harmful beliefs and behaviours.

Higher dietary inflammatory index linked to increased risk of hypertension: a systematic review and dose-response meta-analysis.

The relationship between dietary inflammation index (DII) and the risk of hypertension is inconsistent across published epidemiological studies. This meta-analysis aimed to investigate the dose-response relationship between DII score and the risk of hypertension. A systematic search for relevant studies was conducted in PubMed, Web of Science, and Embase databases until January 9, 2024. After data extraction, the summarized relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated using the Der Simonian and Laird random effect model, and dose-response analyses were performed using restricted cubic splines. A total of six studies with 120,294 participants and 36,725 cases of hypertension were included. The pooled relative risk (RR) for hypertension risk was 1.15 (95% CI: 1.06, 1.26) for the highest DII score compared with the lowest, and 1.10 (95% CI: 1.03, 1.18) for higher DII score compared with the lower. The dose-response meta-analysis further demonstrated a positive association between elevated DII scores and hypertension risk. For each one-unit increase in the DII score, the incidence of hypertension increased by 4% (RR = 1.04, 95% CI: 1.00, 1.07). Pro-inflammation dietary increases the risk of hypertension. Therefore, reducing pro-inflammatory components in the diet may be beneficial for the prevention and control of hypertension.

Effect of a colorectal bundle in an entire health care region in Switzerland: Results from a prospective cohort study (EvaCol study).

Standardisation has the potential to serve as a measure to mitigate complication rates. The objective was to assess the impact of standardisation by implementing a colorectal bundle (CB), which comprises nine elements, on the complication rates in left-sided colorectal resections. This prospective, multicentre, observational, cohort trial was conducted in Switzerland at nine participating hospitals. During the control period, each patient was treated in accordance with the local standard protocol at their respective hospital. In the CB period, all patients were treated in accordance with the CB. The primary endpoint was the Comprehensive Complication Index (CCI) at 30 days. A total of 1141 patients were included (723 in the No CB group and 418 in the CB group). Median age was 66 years and 50.6% were female. Median CCI before and after CB implementation was 0.0 (Interquartile Range [IQR]: 0.0-20.9). A hurdle model approach was used for the analysis. The CB was not associated with the presence or severity of complications. Older age (Odds Ratio [OR] 1.02, 95% Confidence Intervall [CI]: 1.00-1.03), surgery for malignancy (OR 1.34, 95% CI: 1.01-1.92), emergency surgery (OR 2.19, 95% CI: 1.31-3.41), elevated nutritional risk score (OR 1.13, 95% CI: 1.01-1.24) and Body-Mass Index (OR 1.04, 95% CI: 1.00-1.06) were associated with higher odds of postoperative complications. In a supplementary per-protocol analysis, for each additional item of the CB fulfilled, the odds of anastomotic leakage (AL) were 24% lower (OR 0.76, 95% CI: 0.64-0.93). Dedicated teams can establish high quality colorectal services in a network of hospitals with a joint standard. The study can serve as a model for other healthcare settings to conduct and implement quality improvement programs. The consistent implementation of the CB items can reduce the occurrence of AL.

Schizotypy 17 years on: Prediction of schizotypic individual differences in midlife.

The picture for the long-term prediction of schizotypic individual difference features in relation to schizotypy assessed earlier in life remains opaque. Whereas schizotypy assessed earlier in life, typically during the late teen years, has been shown to predict nonaffective psychotic illness as well as the presence of nonaffective psychotic features (Chapman et al., 1994; Lenzenweger, 2021), the presence in midlife (mid-30s) of nonpsychotic schizotypic features in those assessed for schizotypy earlier in life remains to be demonstrated. The current study, which reports on a 17-year follow-up study, addresses this void in the schizotypy literature. Seventeen years after an initial psychometric assessment for schizotypy, in a sample of emerging adults (age = 18) with no prior history of psychotic illness, Perceptual Aberration Scale scores predicted elevated schizotypal personality features, increased schizophrenia-related personality disorder features (particularly schizotypal and paranoid), and elevated schizophrenia proneness scores at age 35. This pattern of associations was maintained even after the removal of participants with a diagnosis of nonaffective psychosis. The associations also remained largely unchanged net of state anxiety levels at initial and later assessments. These results support the emergence or maintenance of schizotypic psychopathology features consistent with a model that views schizotypy as the underlying liability for schizotypic psychopathology phenotypes. The results also provide additional support for both the construct validity of the initial psychometric schizotypy measure (Perceptual Aberration Scale) as well as the validity of the psychometric high-risk paradigm. Longitudinal research remains an illuminating and informative approach to understanding the nature of schizophrenia-related psychopathology by utilizing time as an essential scientific lever. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Value of preparticipation cardiovascular evaluation of master athletes by self-reported symptoms and cardiovascular risk-score

Purpose The risk of sudden cardiac death (SCD) is increased during endurance competitive sports. Coronary artery disease (CAD) is the most common cause of SCD in master athletes ≥ 35 years old (MAs). To reduce the risk of SCD self-assessment of symptoms by questionnaire, and evaluation of cardiovascular risk-score, are recommended as pre-participation cardiovascular evaluation (PCVE). We aimed to examine whether PCVE predicts CVD in MAs with or without increased risk as measured by validated score instruments. Methods We performed a single-site observational cohort study of healthy MAs based on findings at PCVE. They were allocated in two different groups: those MAs with reported symptoms on the questionnaire and/or with elevated cardiovascular risk score were allocated to a symptom group (SG), while MAs with no symptoms, nor raised risk score were defined as control group (CG). Thereafter, all were examined with extended examinations: resting-ECG, cardiorespiratory exercise testing and echocardiography. Results Total, 81 (18 women) MAs participated in the study. There were no differences at baseline between SG (n = 39) and CG (n = 42); sex (p = 0.11), age (55.0 ± 9.8 vs. 51.9 ± 11.1 years; p = 0.18), maximal oxygen uptake (49.8 ± 7.6 vs. 51.6 ± 7.0 ml/kg/min; p = 0.26), resting heart rate (61.4 ± 12.8 vs. 60.2 ± 11.0/min; p = 0.66), training hours/week (7.0 ± 3.2 vs. 7.1 ± 3.1; p = 0.88). After further examination, sixteen (20%) MAs were found with CVD: 12 in SG, 4 in CG (p = 0.024). The negative predictive value and specificity of the PCVE were 90% and 58%, respectively. Conclusion Negative findings on PCVE by questionnaire and cardiovascular risk-score may be a strategy to exclude subjects from preparticipation screening, thus saving resources.

Polygenic Landscape of Cryptogenic New-Onset Refractory Status Epilepticus: A Comprehensive Whole-Genome Sequencing Study.

Cryptogenic new-onset refractory status epilepticus (cNORSE) is a devastating condition with unclear pathogenesis. Here, we analyzed the genetic underprints of 31 cNORSE patients from an autoimmune encephalitis observational cohort through whole-genome sequencing. Compared to their controls, cNORSE patients exhibited elevated polygenic risk scores (PRS) for traits associated with autoimmune diseases. The individual PRS against these diseases were correlated with specific clinical phenotypes of cNORSE. The variants were enriched in genes expressed in the central nervous system and lymphocytes. These results suggest a shared genetic framework between cNORSE and other autoimmune/autoinflammatory diseases, and its involvement in the disease pathogenesis. ANN NEUROL 2024.

Contrast enhancement after mechanical thrombectomy: clinical correlations and impact on outcomes.

Contrast enhancement (CE) after mechanical thrombectomy (MT) remains a subject of investigation, with a reported prevalence ranging from 31 to 88%. We examined our patients to identify predictors of CE and its impact on outcomes, an aspect that remains understudied. We retrospectively analyzed 106 patients who underwent MT at our hospital between 2018 and 2022. The inclusion criteria involved patients who underwent two head CT scans: one immediately after the procedure and a repeat scan within 24h. This study compared demographic, clinical, laboratory, neuroimaging, and procedure-related variables between patients with CE and those without hyperdensity. Regression analysis was employed to determine the associations between CEs and significant variables. Among the analyzed patients, 32.1% had CE. Hyperlipidemia was more prevalent in the CE group. CE correlated with an increase in the National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 within 24h, intracerebral hemorrhage (ICH) incidence, elevated NIHSS score, and a decreased rate of modified Rankin scale (mRS) 0-3 upon discharge. The adjusted model demonstrated a significant association between CE and the incidence of hyperlipidemia and ICH, with an increase in NIHSS score ≥ 4 within 24h of ICH and a lower mRS score of 0-3 upon discharge. CE is associated with hyperlipidemia, ICH, early neurological deterioration, and poor functional outcomes upon discharge. However, no similar association was shown for long-term outcomes. Further studies are required to clarify the pathophysiology of CE and its implications for optimizing stroke care.