High Statistical Significance Research Articles

Human immunodeficiency virus cascade-continuum of care stages and outcomes in a hospital in southern Brazil.

The human immunodeficiency virus (HIV) continuum of care cascade illustrates the 90-90-90 goals defined by the Joint United Nations Program on HIV/acquired immunodeficiency syndrome (UNAIDS). The care cascade includes the following five steps: Diagnosis, linkage to care, retention in care, adherence to antiretroviral therapy (ART), and viral suppression. To elaborate the HIV cascade of patients diagnosed with HIV at the Nossa Senhora da Conceição Hospital (HNSC) and to determine possible local causes for the loss of patients between each step of the cascade. This retrospective cohort study included patients diagnosed with HIV infection from January 1, 2015 to December 31, 2016 and followed up until July 31, 2019. The data were analyzed by IBM SPSS software version 25, and Poisson regression with simple robust variance was used to analyze variables in relation to each step of the cascade. Variables with P < 0.20 were included in multivariable analysis, and P < 0.05 was considered significant. Pearson's χ 2 test was used to compare the groups of patients followed up at the HNSC and those followed up at other sites. The results were lower than those expected by the UNAIDS, with 94% of patients linked, 91% retained, 81% adhering to ART, and 84% in viral suppression. Age and site of follow-up were the variables with the highest statistical significance. A comparison showed that the cascade of patients from the HNSC had superior results than outpatients, with a significant difference in the last step of the cascade. The specialized and continued care provided at the HNSC was associated with better results and was closer to the goals set by the UNAIDS. The development of the HIV cascade using local data allowed for the stratification and evaluation of risk factors associated with the losses occurring between each step of the cascade.

Testing Cluster Membership of Planetary Nebulae with High-precision Proper Motions. I. HST Observations of JaFu 1 Near the Globular Cluster Palomar 6

If a planetary nebula (PN) is shown to be a member of a star cluster, we obtain important new constraints on the mass and chemical composition of the PN’s progenitor star, which cannot be determined for PNe in the field. Cluster membership can be tested by requiring the projected separation between the PN and cluster to be within the tidal radius of the cluster, and the objects to have nearly identical radial velocities (RVs) and interstellar extinctions, and nearly identical proper motions (PMs). In an earlier study, we used PMs to confirm that three PNe, which had already passed the other tests, are highly likely to be members of Galactic globular clusters (GCs). For a fourth object, the PN JaFu 1, which lies in the Galactic bulge near the GC Palomar 6 on the sky and has a similar RV, the available PM measurement gave equivocal results. We have now obtained new high-resolution images of the central star of JaFu 1 with the Hubble Space Telescope (HST), which, combined with archival HST frames taken 14 and 16 yr earlier, provide a high-precision PM. Unfortunately, we find that the PM of the central star differs from that of the cluster with high statistical significance. Nevertheless, JaFu 1 is of astrophysical interest because its nucleus appears to be a member of the rare class of “EGB 6-type” central stars, which are associated with compact emission-line knots.

A Tale of Many H0

▪The Hubble parameter, H 0, is not an univocally defined quantity: It relates redshifts to distances in the near Universe, but it is also a key parameter of the ΛCDM standard cosmological model. As such, H 0 affects several physical processes at different cosmic epochs and multiple observables. We have counted more than a dozen H 0s that are expected to agree if (a) there are no significant systematics in the data and their interpretation and (b) the adopted cosmological model is correct.▪With few exceptions (proverbially confirming the rule), these determinations do not agree at high statistical significance; their values cluster around two camps: the low (68 km s1 Mpc1) and high (73 km s1 Mpc1) camps. It appears to be a matter of anchors. The shape of the Universe expansion history agrees with the model; it is the normalizations that disagree.▪Beyond systematics in the data/analysis, if the model is incorrect, there are only two viable ways to “fix” it: by changing the early time (z ≳ 1,100) physics and, thus, the early time normalization or by a global modification, possibly touching the model's fundamental assumptions (e.g., homogeneity, isotropy, gravity). None of these three options has the consensus of the community.▪The research community has been actively looking for deviations from ΛCDM for two decades; the one we might have found makes us wish we could put the genie back in the bottle.

Are lithium-rich giants binaries? A radial velocity variability analysis of 1,400 giants

The existence of low-mass giants with large amounts of lithium (Li) in their surfaces has challenged stellar evolution for decades. One of the possibilities usually discussed in the literature to explain these Li-rich giants involves the interaction with a close binary companion, a scenario that predicts that, when compared against their non-enriched counterparts, Li-rich giants should preferentially be found as part of binary systems. We aim to assemble the largest possible sample of low-mass giants with well-measured Li abundances, to determine with high statistical significance the close binary fractions of Li-rich and Li-normal giants, and thus test the binary interaction scenario for the emergence of Li-rich giants. We developed a method that uses radial velocities (RVs) at three different epochs to quantify the degree of RV variability, which we used as a proxy for the presence of a close binary companion. The method was tested and calibrated against samples of known RV standard stars and known spectroscopic binaries. We then assembled a sample of 1418 giants with available RVs from RAVE, GALAH, and Gaia as well as stellar parameters and Li abundances from GALAH, to which we applied our variability classification. We could determine an evolutionary state for 1030 of these giants. We also compared the results of our RV variability analysis with binarity indicators from the Gaia mission. When applying our methodology to the control samples, we found that the accuracy of the classification is controlled by the precision of the RVs used in the analysis. For the set of RVs available for the giants, this accuracy is 80-85&lt;!PCT!&gt;. Consistent with seismic studies, the resulting sample of giants contains a fraction of Li-rich objects in the red clump (RC) that is twice as large as that in the first ascent red giant branch (RGB). Among RC giants, the fractions of Li-rich objects with a high RV variability and with no RV variability are the same as those for Li-normal objects, but we find some evidence that these fractions may be different for giants in the first-ascent RGB. Analysis of binary indicators in Gaia DR3 shows a smaller fraction of binary giants than our criteria, but no relation can be seen between Li enrichment and binarity either. Our RV variability analysis indicates that there is no preference for Li-rich giants in the RC to be part of binary systems, thus arguing against a binary interaction scenario for the genesis of the bulk of Li-rich giants at that evolutionary stage. On the other hand, Li-rich giants in the RGB appear to have a small but measurable preference for having close companions, something that deserves further scrutiny with more and better data. Additional measurements of the RVs of these giants at a higher RV precision would greatly help in confirming and more robustly quantifying these results.

Influential Psycholinguistic Factors in the Development of Linguistic Competence in English as a Foreign Language

This study investigated the influence of cognitive and metacognitive psycholinguistic factors on English linguistic competence among university students enrolled in a Language Center at a national university in Peru. The sample consisted of 153 students selected through convenience non-probabilistic sampling from a pre-intermediate level. A virtual form instrument was designed for data collection, which was validated through factorial analysis, showing a good model fit with two factors and good internal consistency. This study employed multiple linear regression (MLR) as the statistical method to investigate the relationship between psychosocial factors and linguistic competence. The results showed high statistical significance in the global model test, suggesting that the analyzed factors explain 21.8% of the variability in linguistic competence. The analysis of effect sizes, with ε² values of 0.161 and 0.023 for cognitive and metacognitive factors, respectively, supports the stronger influence of cognitive factors on linguistic competence. This study highlights the importance of considering psycholinguistic factors in developing linguistic competence and provides a basis for further research.

Phase-resolved Spectroscopy of Low-frequency Quasiperiodic Oscillations from the Newly Discovered Black Hole X-Ray Binary Swift J1727.8-1613

Low-frequency quasiperiodic oscillations (LFQPOs) are commonly observed in X-ray light curves of black hole X-ray binaries (BHXRBs); however, their origin remains a topic of debate. In order to thoroughly investigate variations in spectral properties on the quasiperiodic oscillation (QPO) timescale, we utilized the Hilbert–Huang transform technique to conduct phase-resolved spectroscopy across a broad energy band for LFQPOs in the newly discovered BHXRB Swift J1727.8–1613. This is achieved through quasi-simultaneous observations from Neutron Star Interior Composition Explorer, Nuclear Spectroscopic Telescope Array, and Hard X-ray Modulation Telescope. Our analysis reveals that both the nonthermal and disk–blackbody components exhibit variations on the quasiperiodic oscillation (QPO) timescale, with the former dominating the QPO variability. For the spectral parameters, we observe modulation of the disk temperature, spectral indices, and reflection fraction with the QPO phase with high statistical significance (≳5σ). Notably, the variation in the disk temperature is found to precede the variations in the nonthermal and disk fluxes by ∼0.4–0.5 QPO cycles. We suggest that these findings offer further evidence that the type-C QPO variability is a result of geometric effects of the accretion flow.

Factors affecting implementation of computer vision-based technologies adopted for monitoring buildings construction projects

Construction monitoring in dynamic construction site environments poses significant challenges for construction management. To overcome these challenges, the implementation of computer vision (CV) technologies for construction project monitoring has gained traction. This study focuses on investigating the factors influence the successful implementation of CV technologies in monitoring construction activities within building projects. A comprehensive methodology was employed, including a systematic review of CV technologies implemented in construction and qualitative surveys conducted with construction experts. Additionally, a quantitative questionnaire was developed, and the collected data was analysed using structural equation modelling. The findings reveal the presence of 10 factors categorized into four constructs. Notably, all 10 factors demonstrate high value factor loadings and statistical significance, and among the four constructs (device, jobsite, environment, human), device (0.82) has the highest impact on the implementation of CV-based technologies on the construction site, followed by jobsite condition (0.62), human (0.61), and environment (0.51) came in the last place. By addressing these influential factors and mitigating their effects, construction stakeholders can enhance the implementation of CV technologies for monitoring construction sites. This study contributes valuable insights that inform the implementation and optimization of CV technologies in construction projects, ultimately advancing the field of construction management.

Exploring the Influence of IL-8, IL-10, Patient-Reported Pain, and Physical Activity on Endometriosis Severity.

Endometriosis is known to be a chronic, debilitating disease. The pathophysiological mechanisms of endometriosis development include local chronic inflammation and a certain degree of local immune deficit. We investigated the relationship between the endometriosis severity, IL-8, IL-10, BDNF, VEGF-A serum and tissue levels, patient-related pain, and physical activity in a cohort of 46 patients diagnosed with endometriosis who underwent surgery. The same panel of biomarkers was investigated in a control group of 44 reproductive-aged patients with non-endometriotic gynecological pathology who underwent surgical intervention. Our data show a high statistical significance between tissue expression of IL-8, IL-10, patient-related pain, and the severity of endometriosis. No relationship was identified between serum or tissue levels of VEGF-A and BDNF and the severity of endometriosis. These results validate the presence of local chronic inflammation and immune deficit, thereby creating, alongside other studies in the field, an opportunity for the development of innovative and personalized treatment approaches in endometriosis.

Smoking and its Impact on Orthodontic Treatment/Management Modalities: A Systematic Review and Meta-Analysis

Background: We aimed to review studies that evaluated the effect of cigarette smoking on orthodontic treatment methods and determine whether the smoke affected appliances in a way that could impair the effectiveness of the overall treatment strategy. Methods: PubMed, Google Scholar, Cochrane Library, and Web of Science were scoured using pertinent keywords, reference searches, and citation searches in accordance with the PRISMA protocol regarding articles published from 2008 till 2022. Results: Ultimately, 7 papers were chosen for further analysis at the end of the selection protocol. Overall pooled odds ratio (OR) for the impact of cigarette smoking on orthodontic treatment was 0.25 (95% CI: 0.15, 0.43), with high statistical significance (P&lt;0.00001) but also high heterogeneity (I² = 81%). The relative risk (RR) was 0.50 (95% CI: 0.38, 0.66), indicating a 50% greater risk of noticeable impact, with high statistical significance (P&lt;0.00001) and high heterogeneity (I² = 79%), and the risk difference (RD), which was -0.33 (95% CI: -0.45, -0.21), suggesting a 33% higher risk of noticeable impact, with high statistical significance (P&lt;0.00001) and high heterogeneity (I² = 81%). The high heterogeneity in all measures indicates significant variability in the results across the included studies. Conclusion: All the 7 studies selected for our systematic review exhibited significant detrimental associations between smoking and orthodontic appliances and other modalities that were exposed to cigarette smoke. However, more studies need to be done in this regard, since the literature currently available on this relationship is quite poor and lacking in concrete evidence.

Comparative study of the efficacy of azathioprine, dapsone, and NB-UVB phototherapy as steroid-sparing modalities in generalised lichen planus.

Background Generalised lichen planus (GLP) is a chronic disease with an overall prevalence of 1% requiring longer treatment. Limited studies are available on GLP and its treatment in the literature, unlike oral lichen planus. Objective To determine the best steroid-sparing treatment modality for GLP by comparing the efficacy, response, safety, side effects, and remission with azathioprine, dapsone, and narrowband UV-B (NB-UVB) along with their impact on itching severity and life quality. Methodology Open-label, prospective, comparative, interventional study on generalised lichen planus patients treated with systemic steroids along with one of three steroid-sparing modalities. Totally 90 patients were studied including 30 patients each who received azathioprine (Group A), dapsone (Group B), and narrow band UVB (NB-UVB) (Group C), respectively, for 16 weeks. Itch severity index (ISI) and Dermatology life quality Index (DLQI) were assessed at baseline and week 24. All patients received oral prednisolone until there was no more active disease. Response was assessed in terms of occurrence of new lesions, flattening of lesions, post-inflammatory hyperpigmentation (PIH), and grading of lesions two weeks once for 6 months followed by six months of follow-up after treatment completion. Results Females outnumbered males in all 3 groups. Mean patient ages (34, 38, and 34) and the presence of one or more co-morbidities (50%, 42.3%, 37.5%) in Groups A, B, and C, respectively, were comparable. ISI and DLQI improvement at 24 weeks were greatest with NB-UVB, followed by azathioprine and dapsone in that order; the differences in improvement between groups showed high statistical significance. At week 24, occurrence of new lesions (0%, 0%, 3.8%), flattening (100% - all groups), PIH (100% - all groups), grade 3 lesions i.e. poor response, resolution of 20-50% of lesions (7.1%, 11.5%, 0%), grade 2 lesions i.e. partial response, resolution of 50-90% of lesions (35.7%, 76.9%, 8.3%) and grade 1 lesions i.e. complete response, resolution of >90% lesions (57.1%, 11.5%, 91.3%) were noted in Groups A, B and C, respectively; the differences in the extent of resolution of lesions between the groups were highly significant statistically. Remission was seen in 100%, 76.9%, and 87.5% in Groups A, B, and C, respectively, after six months. Limitations The sample size was small. Only 3 treatment options were compared in this study but many more options have been used for lichen planus. Long term follow-up is required. Conclusions NB-UVB with oral steroids showed a better response in terms of improvement in DLQI, ISI, disease control, and side effects than azathioprine and dapsone. Azathioprine showed a faster response and more prolonged remission. Dapsone showed poor response with multiple side effects.

Enhancing Biodegradation Efficiency of Reactive Black-5 Dye using Bacillus wiedmannii strain NAF4: Optimization of Degradation Parameters via Response Surface Methodology (RSM)

Reactive Black 5 (RB-5) dye is extensively used in industries such as textile, paper, and leather, raising environmental concerns due to its persistence and adverse effects. This study aimed to develop efficient and eco-friendly strategies for RB-5 dye removal from industrial wastewater. RB-5 dye-degrading bacteria, namely NAF1, NAF2, NAF3, and NAF4, were isolated from soil contaminated with textile effluents. Evaluation of their decolorization potential revealed NAF4 as the most effective, achieving a decolorization percentage of 89%, followed by NAF3 and the co-culture at 75% and 73%, respectively. NAF2 exhibited the lowest decolorization potential. The isolate NAF4 showed significant production of tyrosinase and laccase enzymes, with lower quantities of lignin peroxidase and azoreductase. Phylogenetic analysis confirmed the identities of the isolates as Bacillus, Pseudomonas, Escherichia, and Citrobacter. The decolorization potential exhibited by Bacillus wiedmannii NAF4 has instigated the investigation of its capacity to secrete degradative enzymes implicated in the breakdown of azo dyes. Substantial enzyme production was observed over a duration of 192 hours. The biodegradation potential of B. wiedmannii strain NAF4 for RB-5 dye was assessed using Surface Response Optimization (SRO) modeling. The optimized conditions for RB-5 degradation were determined to be an agitation speed of 115.777 rpm, pH of 7.449, inoculum size of 12.255, and temperature of 29.74°C. The SRO model exhibited high statistical significance with an F-value of 53.30 and low p-values (&lt;0.0001), as well as a correlation coefficient (R2) value of 0.9813. Validation studies confirmed the adequacy and precision of the model. The maximum RB-5 degradation achieved was 90.2291%. Three-dimensional plots visually represented the validated optimum conditions of variables and responses. The successful application of Response Surface Methodology (RSM) as an optimization tool highlights its effectiveness in enhancing degradation processes. This study provides insights into the potential applicability of RSM for optimizing degradation processes in various contexts. The developed eco-friendly strategies offer promising solutions for RB-5 dye removal from industrial wastewater, mitigating its environmental impact.In conclusion, the application of Response Surface Methodology (RSM) as an optimization tool proved effective in maximizing the degradation process by optimizing the degradation parameters. The success of this approach suggests its potential applicability in other contexts to enhance degradation processes.

Effectiveness of Circuit and Fartlek Exercises to Increase Aerobic Endurance in Adolescent Futsal Players

Aerobic endurance is an important component in futsal sports games, so it requires an exercise that can increase aerobic endurance. This study aims to evaluate the effectiveness of circuit training with fartlek exercises to increase aerobic endurance futsal players Bina Darma. The research method used was an experiment with the design of the control group pre-test post-test. The study population of 40 Bina Darma futsal players was divided evenly into two groups, namely the circuit training group and the fartlek training group consisting of 20 samples. Each group performed the exercises for 8 weeks with a frequency of 3 times a week. Aerobic endurance measurements were taken before and after the exercise program using the Bleep Test. Analysis Data obtained from VO2 max test will be analyzed using statistical software SPSS 23. Statistical analysis that will be used is an Paired Samples Test to compare the increase in aerobic endurance between circuit training group and fartlek exercise group. The results showed a significant increase in aerobic endurance in all groups after the exercise programme. The results of this study showed that the circuit training group was more significant than the fartlek training group with very high statistical significance (p&amp;lt; .001), showing that the difference between circuit training and fartlek training in improving aerobic endurance was significant. In conclusion, circuit training is a more effective option for improving aerobic endurance in Bina Darma futsal players. Choosing the right type of sport can increase the aerobic endurance of futsal players.

Experimental and Statistical Determination of Convective Heat and Mass Transfer Coefficients for Eucalyptus nitens Sawn Wood Drying

This study aimed to develop a model using experimentally obtained convective heat and mass transfer coefficients to predict the effect of temperature, humidity, and drying rate on wood drying. Tangential wood samples of Eucalyptus nitens (H. Deane &amp; Maiden) were used in the investigation. The experimental design consisted of two temperature levels (40 °C and 55 °C), two relative humidity levels (55% and 75%), and two air velocity settings (2 m·s−1 and 3 m·s−1). The experiments were conducted under a constant evaporation rate, spanning the maximum and critical moisture content in the wood. A statistical model using multivariate regression was created to predict the convective heat and mass transfer coefficients. The results indicated that the experimental data and empirical correlations exhibited an error margin of 37.77% and 37.86%, respectively. A significant positive correlation was found between the convective heat transfer coefficient and air velocity, temperature, and relative humidity, while the convective mass transfer coefficient showed a significant positive correlation only with air velocity and temperature. The model predicted the convective heat and mass transfer coefficients with high accuracy and statistical significance. Using the proposed method, we successfully obtained both convective coefficients, which enable accurate description of heat and mass flow during the convective drying of Eucalyptus nitens wood.

Diffusion-Weighted MRI for the Detection and Staging of Liver Fibrosis

Background/Aims: In this study, we aimed to evaluate the stage of liver fibrosis in patients with chronic hepatitis and cirrhosis due to HBV and HCV, with DWI-MRI instead of the liver biopsy, and to investigate whether ADC values can practically replace histological fibrosis staging. Methods: We included 46 cases with diagnosis of confirmed chronic hepatitis whose Ishaac fibrosis scoring were performed and 11 cases were assesed as normal according to radiological and clinical data.The ADC value of liver fibrosis patients and healthy controls was compared. The correlation of ADC value and liver fibrosis staging was analyzed. Results: The ADC values were demonstrated to be decreased with increasing fibrosis stage.Very high statistical significance was found between the mean liver ADC values (p

The Utility of Serum Procalcitonin Level as an Early Diagnostic Biomarker For COVID in Patients Presenting with ST-Elevation Myocardial Infarction Post Primary Percutaneous Coronary Intervention

Abstract Aim and Objectives The aim of the study was to detect if serum procalcitonin could be used as an early diagnostic marker for COVID in asymptomatic patients presenting with ST-segment elevation Myocardial infarction and if procalcitonin is related to the extent of myocardial injury after the infarction. Patients and Methods The study was carried out on 150 patients (age 53.39 ± 13.16) presenting to Ain shams university hospitals with ST-segment elevation Myocardial Infarction and received the standard of care management which is Primary PCI. The patients were assessed regarding the demographic data, presence of any symptoms and signs of infection, risk factors, echocardiography and laboratory measures. COVID PCR and Procalcitonin were withdrawn from all patients. Results Out of all the asymptomatic patients presenting with STEMI whose COVID PCR turned out to be positive, the procalcitonin was positive 24 and 48 hours post presentation with P value 0.000. Procalcitonin had no statistical significance with any demographical data, risk factors and comorbidities for cardiovascular disease, extent of myocardial injury and most laboratory findings. There was high statistical significance between positive procalcitonin and TLC count where there was a drop from a median of 11/mm3 with range (4.5– 19) /mm3 in negative procalcitonin to a median of 3.7 /mm3 with range (1.4 –12) /mm3 in procalcitonin positive patients. There was high statistical significance between positive procalcitonin and rise of CRP value where there was a rise from CRP median value from 12 mg/dL range (2– 40) mg/dL in negative procalcitonin patients to 47 mg/dL range (14– 163) mg/dL in positive procalcitonin patients. Conclusion Procalcitonin as an inflammatory marker has no relationship to myocardial infarction nor extent of myocardial injury. There was a strong relationship between procalcitonin and COVID infection in asymptomatic patients thus procalcitonin can be used as an early diagnostic biomarker for covid infection in patients presenting with myocardial infarction.

Fast supermassive black hole growth in the SPT2349--56 protocluster at z=4.3

Large-scale environment is one of the main physical drivers of galaxy evolution. The densest regions at high redshifts (i.e. $z&gt;2$ protoclusters) are gas-rich regions characterised by high star formation activity. The same physical properties that enhance star formation in protoclusters are also thought to boost the growth of supermassive black holes (SMBHs), most likely in heavily obscured conditions. We aim to test this scenario by probing the active galactic nucleus (AGN) content of SPT2349--56:\ a massive, gas-rich, and highly star-forming protocluster core at $z=4.3$ discovered as an overdensity of dusty star-forming galaxies (DSFGs). We compare our results with data on the field environment and other protoclusters We observed SPT2349--56 with Chandra (200 ks) and searched for X-ray emission from the known galaxy members. We also performed a spectral energy distribution fitting procedure to derive the physical properties of the discovered AGNs. In the X-ray band, we detected two protocluster members:\ C1 and C6, corresponding to an AGN fraction among DSFGs in the structure of $ This value is consistent with other protoclusters at $z=2-4$, but higher than the AGN incidence among DSFGs in the field environment. Both AGNs are heavily obscured sources, hosted in star-forming galaxies with $ M_ odot $ stellar masses. We estimate that the intergalactic medium in the host galaxies contributes to a significant fraction (or even entirely) to the nuclear obscuration. In particular, C1 is a highly luminous ($L_X=2 and Compton-thick ($N_H=2 cm^ $) AGN, likely powered by a $M_ BH M_ odot $ SMBH, assuming Eddington-limited accretion. Its high accretion rate suggests that it is in the phase of efficient growth that is generally required to explain the presence of extremely massive SMBHs in the centres of local galaxy clusters. Considering SPT2349--56 and DRC, a similar protocuster at $z=4$, and under different assumptions on their volumes, we find that gas-rich protocluster cores at $z enhance the triggering of luminous (log$ L_X lunit =45-46$) AGNs by three to five orders of magnitude with respect to the predictions from the AGN X-ray luminosity function at a similar redshift in the field environment. We note that this result is not solely driven by the overdensity of the galaxy population in the structures. Our results indicate that gas-rich protoclusters at high redshift boost the growth of SMBHs, which will likely impact the subsequent evolution of the structures. Therefore, they stand as key science targets to obtain a complete understanding of the relation between the environment and galaxy evolution. Dedicated investigations of similar protoclusters are required to definitively confirm this conclusion with a higher statistical significance.

P-575 Application of biomarkers in obese infertile women: a genetic tool for a personalized treatment

Abstract Study question Investigate CART and Leptin gene expression, FSH Receptor Asn680Ser polymorphism, and reproductive hormones in patients suffering from obesity under 40, facing infertility, undergoing bariatric surgery. Summary answer The present study proposes that variations in CART, leptin expressions, and the Polymorphism Asn680Ser on the FSH Receptor, may influence the response to IVF treatment. What is known already Obesity, presents a multifaceted challenge with profound implications for fertility, particularly concerning hormonal disruptions in reproductive hormones. Research has shown that Asn680Ser polymorphism of FSH Receptor has a pivotal role in infertility. Notably identified as a singular factor sufficient for infertility, this polymorphism influences the response of the FSH receptor to follicle-stimulating hormone (FSH). Leptin activates the expression of CART neuropeptide, indicating a significant interplay between these two regulatory factors. In ovarian granulosa cells (GCs) of obese patients, elevated CART levels have been observed, with leptin stimulation increasing CART expression and subsequently inhibiting GC aromatase expression and steroidogenesis. Study design, size, duration A total of 29 women were included in the study. An hormonal profile along with a detection of CART and Leptin gene expression was evaluated before and after bariatric surgery. Additionally, the presence or absence of Asn680Ser of FSHR gene was studied. Participants/materials, setting, methods Participants had suffer from obesity and experiencing infertility, with a body mass index (BMI) equal to or greater than 40 kg/m². Only women below 40 were included. Blood samples were collected from all women before surgery and 6 months later. Total RNA was extracted from blood samples. To assess the gene expression of Leptin and CART, we utilized Real-time Polymerase Chain Reaction (RT-PCR). The FSHR polymorphism was detected by using the RFLP method. Main results and the role of chance Following bariatric surgery, a mean reduction in BMI (16.03 kg/m²) was observed in all women, reaching high statistical significance (p &amp;lt; 0.001). The intervention also yielded significant differences (p &amp;lt; 0.001) in hormone levels and gene expressions post-surgery, with FSH, LH, E2, and AMH displaying noteworthy variations. Further investigations explored associations between CART and leptin gene expression before and after the intervention, coupled with the detection of the Polymorphism Asn680Ser on the FSH Receptor. Elevated CART expression before treatment correlated with lower expression after treatment (rs = 0.51, p = 0.005), and a similar significant correlation was noted for leptin (rs = 0.75, p &amp;lt; 0.001). Genetic analysis revealed that 27.6% of patients were homozygous for the polymorphism, 44.8% were heterozygous, and it was absent in 27.6%. An ongoing statistical analysis is realized to establish a potential relationship between the presence/absence of the polymorphism and CART and Leptin expression. Limitations, reasons for caution The study’s limitations encompass a small patient cohort, exclusively pre- and post-bariatric surgery assessments. Expanding the sample to include diverse groups—infertile women with lower BMI and high BMI women without fertility issues—would enhance validity. Furthermore, examining gene expression in all participants one year post-surgery could provide valuable insights. Wider implications of the findings Our results underscores the positive impact of bariatric surgery on BMI decrease and possible link between surgical intervention, genetic markers, and hormonal alterations and consequently with infertility issues. These significant correlations may be applied for personalized therapeutic approaches, offering a valuable genetic tool for improved fertility outcomes in obese individuals. Trial registration number not applicable

Workplace accidents, economic determinants and underreporting: an empirical analysis in Italy

PurposeThis paper proposes an analysis of occupational accidents in Italy at the regional level. For this purpose, our panel is composed of 20 regions over the 2010–2019 time span.Design/methodology/approachWe apply different econometric estimation techniques (pooled OLS model, panel fixed and random effects models and semiparametric fixed model) using INAIL and ISTAT data. Our models investigate workplace accidents at the regional level by accounting for socioeconomic, labour market and productive system variables and controlling for possible underreporting bias.FindingsOverall results reveal the existence of a relevant under-notification phenomenon of accidents at work with respect to moderate accidents, that is higher especially for the southern regions of Italy. However, when considering as outcome variable an alternative set of more severe workplace accidents our model specification remains highly jointly statistically significant. Among our main findings, the analysis shows that worker skills (blue collar) strongly affect the regional pattern of workplace accidents, i.e. an increase of 1% of low paid employees generates about an increase of 1.8 severe workplace accidents per thousand workers. Moreover, we provide evidence that the size of the firm is inversely related to the occupational accident rates. Finally, our results highlight a nonlinear relationship between GDP and occupational accidents for the Italian regional context, confirmed by the high statistical significance of the quadratic term in all the estimated linear models and by the semi-parametric analysis.Originality/valueA first element of originality of our study consists of investigating the macro determinants of occupation accidents at a regional Italian level. Second, the empirical literature (Boone and Van Ours, 2006) highlights the possible bias of underreporting behaviours on nonfatal accidents in contrast to fatal accidents that are always reported. From this perspective, we have identified a few analyses (namely, Boone et al., 2011) considering different accident sets characterised by different severity degrees. Thus, this paper contributes to the literature considering five alternative subsets of accidents stratified by degree of severity (i.e. moderate, severe, moderate plus severe, severe plus fatal and total accident rates) to test for possible underreporting bias affecting our econometric model.

Sounding the alarm regarding mental health of children and adolescents in relation to parenting style

BackgroundChildhood and adolescence are critical periods for physical and mental development. For that, sounding the alarm for the warning signs and red flags of children’s mental health disorders is important to promote good health and mental wellness throughout the lifespan. The aim of the study was to assess children’s and adolescents’ mental health in relation to parenting styles.MethodsThis study used a descriptive cross-sectional design. From early May 2022 until late October 2022, Zagazig University in Egypt hosted this investigation. Subjects: For this study, 400 parents of Zagazig University staff, employees, and workers who agreed to engage in the current study were gathered as a convenience sample. Tools: In order to get the required data, three tools were utilized. Tool I: A questionnaire for interviews to gather demographic information about the participating parents and their children. Tool II: Adapted Ontario Child Health Study Emotional Behavioural Scale: Parent Version (for children 4–17 years). Tool III: Parenting style scale.ResultsIt was found that criteria for conduct disorder constituted the highest followed by criteria for attention deficit hyperactivity disorder and major depression disorder with a mean and standard deviation of 15.10 ± 3.7, 12.83 ± 3.4, and 11.9 ± 2.8. Also, 66% of the participating parents practiced a permissive parenting style while 18% of them practiced the authoritative style and 16% for the authoritarian style.ConclusionIt was determined that criteria of conduct disorder were the most prevalent, followed by criteria of attention deficit hyperactivity disorder and major depressive disorder. Additionally, there was high statistical significance between mental health disorders, parenting styles, and parental educational level. In order to protect children’s and adolescents’ mental health, this study recommended alerting parents and teachers about red flags and warning signs of mental health disorders for early detection and management. Additionally, educate parents about effective parenting methods and how to behave correctly with their children. Psychological counseling centers for seeking help should be available everywhere and announced.

The Effect of Obesity on Repolarization and Other ECG Parameters.

Background: Overweight and obesity are important risk factors in the development of cardiovascular diseases. New repolarization markers, such as the Tpeak-Tend interval and JTpeak intervals, have not yet been profoundly studied in obese patients. The study aims to analyze whether, in patients with obesity and overweight, repolarization markers, including the Tpeak-Tend interval, are prolonged and simultaneously check the frequency of other ECG pathologies in a 12-lead ECG in this group of patients. Methods: A study group consisted of 181 adults (90 females and 91 males) with overweight and first-class obesity. The participants completed a questionnaire, and the ECG was performed and analyzed. Results: When analyzing the classic markers, only QT dispersion was significantly higher in obese people. The Tpeak-Tend parameter (97.08 ms ± 23.38 vs. 89.74 ms ± 12.88, respectively), its dispersion, and JTpeak-JTend parameters were statistically significantly longer in the obese group than in the controls. There were also substantial differences in P-wave, QRS duration, and P-wave dispersion, which were the highest in obese people. Tpeak-Tend was positively correlated with body mass and waist circumference, while JTpeak was with BMI, hip circumference, and WHR. Tpeak/JT was positively correlated with WHR and BMI. In backward stepwise multiple regression analysis for JTpeak-WHR, type 2 diabetes and smoking had the highest statistical significance. Conclusions: Only selected repolarization markers are significantly prolonged in patients with class 1 obesity and, additionally, in this group, we identified more pathologies of P wave as well as prolonged QRS duration.