Higher Z-score Research Articles

Technical and performance analysis by revisiting Altman’s Z-score over Mindtree and L&T post-merger synergy predictions

Mergers and acquisitions are an integral part of corporate finance and strategy. One of the most noteworthy mergers to have happened in recent times is the L&T Infotech Ltd. and Mindtree Ltd. merger. It was the first hostile takeover/acquisition of an IT company in Indian corporate history when Larsen & Toubro Limited, an engineering and construction conglomerate with a yearly turnover exceeding USD21 billion, completed the acquisition of Mindtree Limited by acquiring 60 percent of the stake in a phased manner until June 2019. In this research, the researcher have attempted to assess how successful this merger is, using technical analysis and Altman’s Z-score. In-depth analysis using the stock prices, and indicators such as relative strength index (RSI), moving average convergence/divergence (MACD), and Bollinger Bands have been deployed to get a better understanding of how both the companies reacted to certain market news throughout the past 5 years from 2017 to 2022. The Altman’s Z-score model application to test the financial distress of Indian companies reveals that comparatively healthy companies exhibit high Z-scores, indicating their financial soundness, while unhealthy firms exhibit low Z-scores, proving they are distressed (Korath & Nayak, 2022). The beta analysis for both companies has also been conducted to get a fair idea of how sensitive each company is to market volatility. The research has also attempted to gauge the various challenges that the newly merged company may face post the merger.

Empirical Analysis of the Relationship Between Altman’s Z-Score and Stock Performance Based on Airline Companies Listed in the United States

This research looks at any relevance between Altman’s Z-score and the stock market performance of airline companies in the United States (US). Nearly a thousand pieces of data on various aspects of operation and financial status from 81 airline companies in the US are available. Additionally, stock return is used as an indicator of firm stock performance in this paper. In order to satisfy the purpose of determining the relationship between Z-score and stock performance as well as what may be inferred from high stock returns with regard to Z-score, two different regression processes are carried out. The first regression tests the relationship between Z-score and stock return, while the second regression examines whether there is a difference in Z-scores between well-performing airline companies and poorly performing ones using dummy variables. The results reveal that there is a significant positive correlation between the Z-scores of US airline companies and their stock performance; besides, high stock returns potentially imply relatively high Z-scores and vice versa. Therefore, one of the crucial steps that US airline companies must make is to strengthen their balance sheets in order to draw investors to make investments in their businesses.

Corporate disclosures and financial distress in banks in India: the moderating role of competition

PurposeThis study aims to determine the association of Transparency and Disclosure (TD) with financial distress (FID) while the competition (as Lerner Index) moderates the association between the two.Design/methodology/approachThe panel data analysis (static model) is performed to examine the effect of disclosures on the bank's FID. A TD index is built to assess the level of TD. All three versions of Altman's Zscore are employed to measure a bank's FID (High Zscore is opposite of FID). The data of 34 banks running in India for the timeframe 2015–16 to 2018–19 is utilized. Lerner index (LI) is taken as the moderator. The bank-size, valuation and financial leverage are control variables.FindingsThere exists no linear connection between TD and FID. However, TD is positively associated with financial stability (opposite FID). It means TD initially reduces financial stability and improves it after TD crosses a threshold level. Competition (as LI, where the higher value of LI means reduced competition) negatively moderates the association of TD with financial stability. Hence, the findings of this study support the competition-fragility premise. Surprisingly, the negatively significant interaction term of LI and TD implies either high competition and high TD or low competition with low TD, which helps in the bank's financial stability.Originality/valueThe findings provide input to a long-term policy of disclosures and competition in the banking sector, keeping in view the financial stability of the banks. Therefore, findings are novel and carry immense value to the existing knowledge on the topic.

Sleep duration and risk of high blood pressure in Thai adolescents: the Thai National Health Examination Survey V, 2014 (NHES-V)

BackgroundSleep duration has been proposed to be associated with high blood pressure. However, nationwide studies regarding this association in adolescents remain limited. This study aimed to explore the national prevalence of high blood pressure among Thai adolescents and to determine the association between sleep duration and high blood pressure.MethodsData from adolescents aged 10–19 years from the Thai National Health and Examination Survey V were included. We collected demographic data (including age and gender), height, weight, waist circumference, blood pressure, fasting blood chemistries and sleep duration data. Sleep durations were categorized as short, normal or long for each age group based on the United States National Sleep Foundation’s recommendations. High blood pressure was diagnosed using the 2017 guidelines of the American Academy of Pediatrics. Factors associated with high blood pressure were analyzed using multivariate logistic regression.ResultsA total of 3505 adolescents (1785 female) were included. The prevalence of high blood pressure was 9.4% (95% CI 8.5–10.4%). The high blood pressure group had higher BMI z-score, LDL-C, triglyceride and lower HDL-C than the normotensive group. In the multivariate analysis, BMI z-score, LDL-C and HDL-C were independently associated with high blood pressure. However, there was no association between sleep duration and high blood pressure.ConclusionsHigh blood pressure risk was increased in adolescents with high BMI z-score. Neither short nor long sleep duration was associated with an increased risk of high blood pressure.

Exploration of mitochondrial defects in sarcopenic hip fracture patients

Severe cases of age-related loss of muscle function and mass are clinically unique to sarcopenia. Mitochondrial dysfunction has been associated with aging and sarcopenia, but the causal connection in this context is not well eluded. Here we investigated different aspects of mitochondrial respiration in sarcopenia. Open muscle biopsies were taken from a total of 31 hip fracture patients, older than 70 years. Patients were assigned a sarcopenia Z-score based on EWGSOP2 criteria. Primary myoblast cultures were generated from the muscle tissue samples and used for real time metabolic measurement. Muscle and serum samples showed correlation of high Z-scores with reduced mitochondrial complex I activity, increased tricarboxylic acid cycle (TCA) metabolites, reduced vitamin D3 levels, and signs of an altered iron metabolism. Primary myoblast cultures gained from the same muscle biopsies did not show significant mitochondrial defects. We hypothesize that a sum of external consequences, including vitamin D3 deficiency and iron deficiency caused by disturbances in the iron metabolism, result in complex I deficiency, which in turn affects the TCA and contributes to muscle weakness and loss.

P-023: 2,3-DIPHOSPHOGLYCERATE DETECTION VIA DIRECT INFUSION HIGH RESOLUTION MASS SPECTROMETRY CORRELATES WITH QUANTITATIVE DETECTION IN BLOOD OF PATIENTS WITH SICKLE CELL DISEASE

Purpose: Sickle cell disease (SCD) is a hereditary and chronic life-threatening disorder, characterized by haemolytic anaemia. Increased 2,3-diphosphoglycerate (2,3-DPG) concentrations, along with decreased oxygen affinity of hemoglobin, may be related to the variability of clinical outcomes in SCD. Furthermore, genomic health data holds promise to improve the prediction of disease severity in SCD. Based on the integration of genomics, metabolomics and clinical data from 1000 SCD patients, to be included in 2022, GenoMED4all aims to develop Artificial Intelligence (AI) based deep learning algorithms to improve the prediction of disease severity and phenotype in SCD. This study aims to correlate non-quantitative metabolomics data obtained from dried blood spots (DBS), one of the inputs for GenoMED4all, to quantitative measurement of 2,3-DPG. Aiming to improve the potential of non-quantitative metabolomics from DBS to asses 2,3-DPG. Materials and methods: In snap frozen blood samples from 37 SCD patients and 29 healthy controls, 2,3-DPG was quantified by liquid chromatography mass spectrometry. 2,3-DPG was also detected in DBS from the same subjects by direct infusion high resolution mass spectrometry (DIHRMS). The oxygen tension at 50% Hb saturation (p50) was determined using a Hemox Analyzer (TCS). Statistical analysis were performed by Spearman’s correlation coefficients (SPSS v26.0.0.1) and Mann Whitney testing (GraphPad Prism v9.3.0). Results: After correcting for Hb, 2,3-DPG concentrations were higher in SCD patients than in controls (p<0.001) and Z-scores for 2,3-DPG, as assessed by DIHRMS, were similar in patients and controls. The Z-scores positively correlated with 2,3-DPG concentrations (Fig1A, 0.353, p=0.004). Because of the anaemia in SCD, red blood cells (RBCs) and plasma make up lower and higher volumes in the blood, respectively, compared to healthy controls. This affects the ratio of RBC and plasma metabolites on the DBS. DIHRMS detects a wide range of RBC and plasma metabolites, whereas the quantitative measurement is restricted to measuring 2,3-DPG of RBCs. To correct for those differences between methods, we applied a correction factor to the DIHRMS data using (1/Ht)*(1-Ht/1), correcting for the RBC volume (1/Ht) and the plasma volume (1-Ht/1). This resulted in a trend towards higher Z-scores in patients than controls (p=0.0597). Moreover, the positive correlation with 2,3-DPG concentrations increased to 0.526 (Fig1B, p<0.001). As 2,3-DPG affects the oxygen affinity of Hb, all measurements were correlated to p50. Expectedly, 2,3-DPG concentrations positively correlated with p50 (0.842, p<0.001). After applying the correction factor to the DIHRMS data, p50 correlations increased from 0.361 (p=0.003) to 0.529 (p<0.001). Conclusion: Strongest correlation between quantitative and non-quantitative methods for 2,3-DPG detection were observed after correcting for both RBC and plasma volumes in non-quantitative metabolomics. After correction, DIHRMS can be used to assess 2,3-DPG concentrations in DBS. This translation of non-quantitative to quantitative metabolomics for 2,3-DPG and potentially other RBC metabolites adds significant value to the use of DIHRMS, as DIHRMS is far more efficient in obtaining extensive information about the total metabolome than quantitative methods. The large population size and the AI based deep learning algorithms of GenoMED4all will enable to evaluate the potential of non-quantitative metabolomics in SCD. Funding: Horizon2020, GenoMED4all(https://genomed4all.eu/), Agios Pharmaceuticals Inc., ERN-EuroBloodNetFig 1. correlations between non-quantitative (Z-score) and quantitative 2,3-DPG detection A) non-quantitative and quantitative 2,3-DPG detection B) non-quantitative detection corrected for RBC and plasma volume and quantitative 2,3-DPG detection The authors do not declare any conflict of interest

Quantification of individual remyelination during short-term disease course by synthetic magnetic resonance imaging.

MRI is an important diagnostic tool for evaluation of myelin content in multiple sclerosis and other CNS diseases, being especially relevant for studies investigating remyelinating pharmacotherapies. In this study, we evaluated a new synthetic MRI–based myelin estimation in methylenetetrahydrofolate reductase deficiency as a treatable primary demyelinating disorder and compared this method with established diffusion tensor imaging in both methylenetetrahydrofolate reductase deficiency patients and healthy controls. This is the first synthetic MRI–based in vivo evaluation of treatment-associated remyelination. 1.5 T synthetic MRI and 3 T diffusion MRI were obtained from three methylenetetrahydrofolate reductase deficiency patients at baseline and 6 months after therapy initiation, as well as from age-matched healthy controls (diffusion tensor imaging: n = 14, synthetic MRI: n = 9). Global and regional synthetic MRI parameters (myelin volume fraction, proton density, and relaxation rates) were compared with diffusion metrics (fractional anisotropy, mean/radial/axial diffusivity) and related to healthy controls by calculating z-scores and z-deviation maps. Whole-brain myelin (% of intracranial volume) of the index patient was reduced to 6 versus 10% in healthy controls, which recovered to a nonetheless subnormal level of 6.6% following initiation of high-dosage betaine. Radial diffusivity was higher at baseline compared with healthy controls (1.34 versus 0.79 × 10−3 mm2/s), recovering at follow-up (1.19 × 10−3 mm2/s). The index patient’s lesion volume diminished by 58% under treatment. Regional analysis within lesion area and atlas-based regions revealed lower mean myelin volume fraction (12.7Baseline/14.71Follow-up%) and relaxation rates, higher proton density, as well as lower fractional anisotropy and higher radial diffusivity (1.08 × 10−3Baseline/0.94 × 10−3Follow-up) compared with healthy controls. The highest z-scores were observed for myelin volume fraction in the posterior thalamic radiation, with greater deviation from controls at baseline and reduced deviation at follow-up. Z-deviations of diffusion metrics were less pronounced for radial and mean diffusivity than for myelin volume fraction. Z-maps for myelin volume fraction of the index patient demonstrated high deviation within and beyond lesion areas, among others in the precentral and postcentral gyrus, as well as in the cerebellum, and partial remission of these alterations at follow-up, while radial diffusivity demonstrated more widespread deviations in supra- and infratentorial regions. Concordant changes of myelin volume fraction and radial diffusivity after treatment initiation, accompanied by dramatic clinical and paraclinical improvement, indicate the consistency of the methods, while myelin volume fraction seems to characterize remyelinated regions more specifically. Synthetic MRI–based myelin volume fraction provides myelin estimation consistent with changes of diffusion metrics to monitor short-term myelin changes on individual patient level.

P1500: 2,3-DIPHOSPHOGLYCERATE DETECTION VIA DIRECT INFUSION HIGH RESOLUTION MASS SPECTROMETRY CORRELATES WITH QUANTITATIVE DETECTION IN BLOOD OF PATIENTS WITH SICKLE CELL DISEASE

Background: Sickle cell disease (SCD) is a hereditary and chronic life-threatening disorder, characterized by haemolytic anaemia. Increased 2,3-diphosphoglycerate (2,3-DPG) concentrations, along with decreased oxygen affinity of hemoglobin, may be related to the variability of clinical outcomes in SCD. Furthermore, genomic health data holds promise to improve the prediction of disease severity in SCD. Based on the integration of genomics, metabolomics and clinical data from 1000 SCD patients, to be included in 2022, GenoMED4all aims to develop Artificial Intelligence (AI) based deep learning algorithms to improve the prediction of disease severity and phenotype in SCD. Aims: To correlate non-quantitative metabolomics data obtained from dried blood spots (DBS), one of the inputs for GenoMED4all, to quantitative measurement of 2,3-DPG. Aiming to improve the potential of non-quantitative metabolomics from DBS to asses 2,3-DPG. Methods: In snap frozen blood samples from 37 SCD patients and 29 healthy controls, 2,3-DPG was quantified by liquid chromatography mass spectrometry. 2,3-DPG was also detected in DBS from the same subjects by direct infusion high resolution mass spectrometry (DIHRMS). The oxygen tension at 50% Hb saturation (p50)was determined using a Hemox Analyzer (TCS). Statistical analysis were performed by Spearman’s correlation coefficients (SPSS v26.0.0.1) and Mann Whitney testing (GraphPad Prism v9.3.0). Results: After correcting for Hb, 2,3-DPG concentrations were higher in SCD patients than in controls (p<0.001) and Z-scores for 2,3-DPG, as assessed by DIHRMS, were similar in patients and controls. The Z-scores positively correlated with 2,3-DPG concentrations (Fig.1A, 0.353, p=0.004). Because of the anaemia in SCD, RBCs and plasma make up lower and higher volumes in the DBS, respectively, compared to healthy controls. DIHRMS detects a wide range of RBC and plasma metabolites, whereas the quantitative measurement is restricted to measuring 2,3-DPG of RBCs. To correct for those differences between methods, we applied a correction factor to the DIHRMS data using the formula (1/Ht)*(1-Ht/1), correcting for the RBC volume (1/Ht) and the plasma volume (1-Ht/1). This resulted in a trend towards higher Z-scores in patients than controls (p=0.0597). Moreover, the positive correlation with 2,3-DPG concentrations increased to 0.526 (Fig 1B, p<0.001). As 2,3-DPG affects the oxygen affinity of Hb, all measurements were correlated to p50. Expectedly, 2,3-DPG concentrations positively correlated with p50 (0.842, p<0.001). After applying the correction factor to the DIHRMS data, p50 correlations increased from 0.361 (p=0.003) to 0.529 (p<0.001). Image:Summary/Conclusion: Strongest correlation between quantitative and non-quantitative methods for 2,3-DPG detection were observed after correcting for both the RBC and plasma volume in non-quantitative metabolomics. After correction, DIHRMS can be used to assess 2,3-DPG concentrations in DBS. This translation of non-quantitative to quantitative metabolomics for 2,3-DPG and potentially other RBC metabolites adds significant value to the use of DIHRMS, as DIHRMS is far more efficient in obtaining extensive information about the total metabolome than quantitative methods. The large population size and the AI based deep learning algorithms of GenoMED4all will enable to evaluate the potential of non-quantitative metabolomics in SCD. Funding: Horizon2020, GenoMED4all (https://genomed4all.eu/), Agios Pharmaceuticals Inc., ERN-EuroBloodNet

Progressive medial temporal degeneration with TDP-43 pathology is associated with upper limb and bulbar onset types of amyotrophic lateral sclerosis

This study aimed to clarify the relationship between progressive medial temporal atrophy and onset subtype in patients with amyotrophic lateral sclerosis (ALS). Medial temporal atrophy, ALS functional rating scale (ALSFRS), and cognitive function were assessed in 119 patients who were grouped into three ALS subtypes: bulbar, upper limb, and lower limb onset. Medial temporal atrophy, represented by a Z-score, was determined using an analysis software of magnetic resonance images known as the voxel-based specific regional analysis system for Alzheimer's disease (VSRAD). Among 119 patients, 60 underwent follow-up VSRAD, ALSFRS, and cognitive testing. The sequential data were compared among onset subtypes. Furthermore, TDP-43 pathology was assessed in 20 autopsied patients (including seven who underwent VSRAD before death) to examine the relationships among medial temporal atrophy, onset subtypes, and severity of the hippocampal TDP-43 pathology. Multiple regression analysis revealed that the Z-score at baseline was associated with the age of onset and duration of illness. A high Z-score at baseline and the bulbar/upper limb subtypes affected the progression rate of Z-score. Pathological examination revealed increased hippocampal TDP-43 pathology score associated with bulbar and upper limb subtypes. Moreover, the Z-score before death correlated with the hippocampal TDP-43 pathology score. Medial temporal atrophy in ALS is associated with bulbar and upper limb onset subtypes. This progression may be related to the extent of TDP-43 pathology.

Construction of a Six-Gene Prognostic Risk Model Related to Hypoxia and Angiogenesis for Cervical Cancer.

Background: The prognosis of cervical cancer (CC) is poor and not accurately reflected by the primary tumor node metastasis staging system. Our study aimed to develop a novel survival-prediction model. Methods: Hallmarks of CC were quantified using single-sample gene set enrichment analysis and univariate Cox proportional hazards analysis. We linked gene expression, hypoxia, and angiogenesis using weighted gene co-expression network analysis (WGCNA). Univariate and multivariate Cox regression was combined with the random forest algorithm to construct a prognostic model. We further evaluated the survival predictive power of the gene signature using Kaplan-Meier analysis and receiver operating characteristic (ROC) curves. Results: Hypoxia and angiogenesis were the leading risk factors contributing to poor overall survival (OS) of patients with CC. We identified 109 candidate genes using WGCNA and univariate Cox regression. Our established prognostic model contained six genes (MOCSI, PPP1R14A, ESM1, DES, ITGA5, and SERPINF1). Kaplan-Meier analysis indicated that high-risk patients had worse OS (hazard ratio = 4.63, p < 0.001). Our model had high predictive power according to the ROC curve. The C-index indicated that the risk score was a better predictor of survival than other clinicopathological variables. Additionally, univariate and multivariate Cox regressions indicated that the risk score was the only independent risk factor for poor OS. The risk score was also an independent predictor in the validation set (GSE52903). Bivariate survival prediction suggested that patients exhibited poor prognosis if they had high z-scores for hypoxia or angiogenesis and high risk scores. Conclusions: We established a six-gene survival prediction model associated with hypoxia and angiogenesis. This novel model accurately predicts survival and also provides potential therapeutic targets.

PERSISTENCE OF BLOOD PRESSURE PHENOTYPES ACCORDING TO OFFICE AND 24 HOUR AMBULATORY BLOOD PRESSURE IN CHILDREN

Objective: To assess the persistence of BP phenotypes according to office and 24-h ABPM in youth over time. Design and method: Retrospective study including 582 children who underwent measurement of both office BP (OBP) and ABPM on the same day. The second office BP and ABPM was performed within 1 year apart. OBP was measured using an oscillometric device validated in children. ABPM was performed using oscillometric SpaceLabs 90207 monitors. OBP and ABPM were classified according to the criteria of the ESH (Lurbe et al J Hypertens 2016). Four phenotypes based on OBP and ABPM were defined: true normotensives, sustained hypertensives, white-coat hypertensives, and masked hypertensives. Persistence and Kappa statistic were used to evaluate the concordance of BP phenotypes. Factors related with persistence on BP phenotypes were evaluated using logistic regression models. Results: At the initial assessment, the majority of children fell within the category of true normotension (77%), followed by masked hypertension (13%), sustained hypertension (5%) and white coat hypertension (5%). The prevalence of true normotensive increased significantly in the follow-up. The flow through phenotypes is shown in the Figure. Only 38 initial true normotensive patients changed to other categories, mainly masked (12); 63 of initial masked hypertension changed, mainly to normotensive (58); 24 of white coat changed predominantly to normotension (16); finally, 25 of sustained changed, largely to normotension (14), but 9 children migrated to masked. The overall agreement was 74.2% (kappa 0.20). The grade of agreement was slightly higher for boys than for girls. In the multivariable model, higher age showed to be a protective factor, whereas increased office SBP and waist circumference were significant risk factors. The masked hypertensive phenotype carried the highest risk for lack of persistence. Conclusions: Children with hypertensive BP phenotypes should be re-evaluated because a large percentage of them will become normotensive. High BP levels and high BMI z-score or waist circumference were significant risk predictors for the lack of persistence on BP phenotypes.

Associations of body mass index and weight change with circulating levels of high-sensitivity C-reactive protein, proinflammatory cytokines, and adiponectin among breast cancer survivors.

This study examined the associations of body mass index (BMI) and weight change with inflammatory markers among breast cancer survivors in Korea. A total of 495 women were included who had been diagnosed with primary breast cancer and survived for at least 6 months since the surgery. Information on the body weight and height of the participants was collected both at the study enrollment and diagnosis. The plasma levels of inflammatory markers were measured, including high-sensitivity C-reactive protein, interleukin (IL)-6, IL-8, tumor necrosis factor-α, and adiponectin. A summary z-score was calculated by summing up the z-scores of each biomarker. The least-square means and 95% confidence intervals (CIs) were calculated using a generalized linear model and odds ratios (ORs) and 95% CIs for the elevated levels of inflammatory markers with a multivariate logistic regression model. Participants with a BMI ≥27.5kg/m2 at the study enrollment and at diagnosis were significantly associated with elevated summary z-scores compared to those with a BMI<23kg/m2 ; the ORs (95% CIs) were 5.42 (2.15-13.71) for current BMI and 3.66 (1.68-7.98) for BMI at diagnosis, respectively. Additionally, a weight loss>5% since diagnosis was associated with a lower prevalence of high summary z-scores; the OR (95% CI) was .20 (.08-.52) compared to a stable weight. A high BMI at diagnosis and current BMI with a greater degree were associated with unfavorable levels of inflammatory markers among breast cancer survivors. Additionally, weight loss since diagnosis was inversely associated with these markers.

Body Composition Is a Predictor for Postoperative Complications After Gastrectomy for Gastric Cancer: a Prospective Side Study of the LOGICA Trial

PurposeThere is a lack of prospective studies evaluating the effects of body composition on postoperative complications after gastrectomy in a Western population with predominantly advanced gastric cancer. MethodsThis is a prospective side study of the LOGICA trial, a multicenter randomized trial on laparoscopic versus open gastrectomy for gastric cancer. Trial patients who received preoperative chemotherapy followed by gastrectomy with an available preoperative restaging abdominal computed tomography (CT) scan were included. The CT scan was used to calculate the mass (M) and radiation attenuation (RA) of skeletal muscle (SM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). These variables were expressed as Z-scores, depicting how many standard deviations each patient’s CT value differs from the sex-specific study sample mean. Primary outcome was the association of each Z-score with the occurrence of a major postoperative complication (Clavien-Dindo grade ≥ 3b). ResultsFrom 2015 to 2018, a total of 112 patients were included. A major postoperative complication occurred in 9 patients (8%). A high SM-M Z-score was associated with a lower risk of major postoperative complications (RR 0.47, 95% CI 0.28–0.78, p = 0.004). Furthermore, high VAT-RA Z-scores and SAT-RA Z-scores were associated with a higher risk of major postoperative complications (RR 2.82, 95% CI 1.52–5.23, p = 0.001 and RR 1.95, 95% CI 1.14–3.34, p = 0.015, respectively). VAT-M, SAT-M, and SM-RA Z-scores showed no significant associations. ConclusionPreoperative low skeletal muscle mass and high visceral and subcutaneous adipose tissue radiation attenuation (indicating fat depleted of triglycerides) were associated with a higher risk of developing a major postoperative complication in patients treated with preoperative chemotherapy followed by gastrectomy.

Bone health and asymmetry in elite female cricketers

ABSTRACT The aim of this study is to determine if bone mineral density (BMD) and bone asymmetry differs between female cricket fast bowlers, spin bowlers and batters. BMD was determined at the total body, lumbar spine, and proximal femurs in 12 fast bowlers, 13 batters and 11 spin bowlers from pre-season DXA scans. High Z-scores at the total body, lumbar spine, and proximal femur were observed in all cricketers (mean Z-scores: +1.4 to +3.3) compared with a general age matched reference population. Fast bowlers had significantly greater BMD on the contralateral side of the lumbar spine compared with the ipsilateral side (p = 0.001, 5.9–12.1%). No asymmetry was found between hips in all groups. All cricket positions demonstrated high BMD at all measured sites. The lumbar spine of fast bowlers is asymmetric, with significantly greater BMD on the contralateral side of the spine, particularly at L4, possibly in response to the asymmetric lumbar loading patterns observed in bowling. Highlights Elite female cricketers demonstrate high BMD at total body, lumbar spine and proximal femur sites, regardless of playing position compared with a general age and ethnic group matched reference population. Fast bowlers have greater BMD on the contralateral (opposite bowling arm) side of the lumbar spine compared with the ipsilateral side, while a symmetrical pattern was observed in spin bowlers and batters. No asymmetry in BMD or section modulus between hips was observed at any proximal femur site for any cricket position.

Ketosis in Dairy Cows during Early Lactation - Detection in Pooled Blood Serum Samples

Background: Ketosis is the most important metabolic disease with prevalence from 15 to 45%. Ketosis is diagnosed using a metabolic profile. Due to the high prevalence, it is necessary to determine a large number of metabolic profiles within farm, which represents an additional cost, so the implementation of pooled serum in assessing the metabolic status of cows was examined. The aim of this study was to validate and evaluate the influence of the relative position (Z-score) of the value of pooled sample metabolic parameters within the known reference value of healthy cows in the detection of ketosis in herd during early lactation.Materials, Methods &amp; Results: The experiment has been carried out using blood samples collected by puncture of coccygeal vein from 50 ketotic and 50 healthy cows. Laboratory analysis includes determination of beta-hydroxybutyrate-BHB, non-esterified fatty acids-NEFA, cholesterol-CHOL, triglycerides-TGC, glucose-GLU, albumin-ALB, total protein-TPROT, UREA, Ca, P, total bilirubin-TBIL and aspartat aminotransferase-AST. The pooled serum was made from 10 individual samples originating from 10 different cows. A serum aliquot of 0.1 mL was taken from each sample, and a 1 mL volume of pooled serum was finally formed. Three types of serum pools were made: 1) 30 pooled sample were from ketosis; 2) 30 pooled sample were from healthy cows and 3) 60 pooled samples containing mixed sera of healthy cows and cows with ketosis were made as follows: 10 pools contain 10% to 60% of ketotic cows (1/10 to 6/10 samples). Statistical analysis includes: a) difference in metabolite concentration and Z-score in pooled sample and arithmetic mean individual sample in healthy and ketotic cow, b) correlation between Z-score of pooled sample and arithmetic mean of individual sample, c) ability of Z-score of metabolite to divide ketotic from healthy cow, d) correlation between Z-score and % of ketotic cow in pooled sample; and e) calculation of 95%CI of pooled sample Z-scores for each % of ketotic cow in pools. Z-score and all analysis were calculated for each metabolic parameter. The results of the study show that the mean values and Z-scores of the pool and the calculated average value of the individual samples participating in that pool differ significantly in healthy cows and cows in ketosis, except for TPROT and Ca. A higher value and a higher Z-score were found for BHB, NEFA, UREA, TBIL and AST, and a lower value and a lower Z-score for TGC, CHOL, GLU, ALB and P in ketotic cows compared to healthy cows. The value of the Z-score of the pooled sample and the calculated mean values of individual samples participating in the pool are highly correlated with each other (coefficient of determination over 99%). Z-score of metabolites in the pooled sample can be used to distinguish healthy from ketotic cows (ROC AUC= 0.711 to 0.989), except for TPROT and Ca. The Z-score value of the pooled sample shows a linear correlation with the percentage of ketotic cows in the pool and the reference ranges of Z-scores change significantly as a function of the percentage of ketosis cows.Discussion: Modern research on the metabolic profile in cows requires obtaining a large amount of information from as few samples as possible. The advantages of using the Z-score are reflected in the following: this score does not depend on the absolute value of the metabolite, but on the position within the known population reference value, Z-score of sample and the arithmetic mean of individual samples included in the same pool are almost identical, the Z-score of these 2 groups of results is ideally correlated, the Z-score significantly correlates with the % of ketosis samples in the pooled sample. The use of pooled sample Z-score can be a useful in a herd level assessment of metabolic status and detection of ketosis as most important metabolic disease in dairy cows.Keywords: dairy cattle, ketosis, metabolic disease, metabolic profile, pooled serum, z-score, diagnostics.

Exploring species-specific inhibitors with multiple target sites on S. aureus pyruvate kinase using a computational workflow

Experimental evidence indicated that bacterial pyruvate kinase of glycolysis can be evaluated as an alternative target to eliminate infections, while antibiotic resistance poses a global threat. Here, we use a computational workflow to reveal and investigate the potential allosteric sites of methicillin-resistant S. aureus PK, which can help in designing species-specific drugs to inhibit activity of this organism. Residue interaction networks point to a known allosteric site at the small C-C interface, a potential allosteric site near the small interface (site #1), and a second potential allosteric site at the large interface (site #2). 2 µs-long molecular dynamics (MD) simulations with AMBER16 generate different conformations of one narrow target site. Known and potential allosteric sites on the selected conformers are investigated using ensemble docking with AutoDock Vina and a library of 2447 FDA-approved drugs. We determine 18 hits, comprising ergot-alkaloids, anti-cancer-agents, antivirals, analgesics, cardiac glycosides, all with a high docking z-score for three sites. 5 selected compounds with high, average and low z-scores are subjected to 50 ns-long MD simulations for MM-GBSA calculations. ΔGbind values up to −49.3 kcal/mol at the C-C interface, up to −32.7 kcal/mol at site #1, and up to −53.3 kcal/mol at site #2 support the docking calculations. We investigate mitapivat and TT-232 as reference compounds under clinical trial, targeting human PK isomers. We suggest 18 FDA-approved hits from the docking calculations and TT-232 as potential inhibitors with multiple target sites on S. aureus PK. This study also proposes pharmacophores models for de novo drug design. Communicated by Ramaswamy H. Sarma

Body image perceptions and avoidance behaviours among a Moroccan group of adolescents

Background Adolescents are a vulnerable group to body dissatisfaction that causes unhealthy attitudes and behaviours. It has been shown that many factors affect body image dissatisfaction. Aim To describe body image size perception, degree of body dissatisfaction, avoidance behaviours, and their relationship with gender, age, and weight status, and to assess the relationship between body dissatisfaction and avoidance behaviours among a group of Moroccan adolescents. Subjects and methods This cross-sectional survey was comprised of a sample of 487 adolescents. Stunkard’s Figure Rating Scale was used to assess perceptions of current and ideal body image and body dissatisfaction. Body Image Avoidance Questionnaire was employed to assess avoidance behaviours. Results Body dissatisfaction was found to be strongly associated with weight status in both male and female adolescents. Avoidance behaviours were positively associated with gender, age, weight status, and body dissatisfaction. Indeed, avoidance behaviours were frequently reported among females, young adolescents, those with high BMI z-score, and those seeking to lose weight. Adolescents tended to behave under the influence of two factors: clothing and weighing-grooming. Conclusion Weight status is an important factor that deeply impacts adolescent body dissatisfaction. Adolescents resort to behaviour avoidance and physical appearance control to cope with body dissatisfaction.

Abstract WP21: Cognitive Improvement In Patients With Dural Arterio-venous Fistula After Endovascular Embolization: Interim Analysis Of The NAIF Study

Introduction: Dural arteriovenous fistulae (dAVF) are rare acquired intracranial vascular malformations with clinical manifestations varying from asymptomatic lesions, non-hemorrhagic neurological disorders, and intracranial hemorrhage which may be fatal. In addition, patients with dAVF often have cognitive impairments. This study assessed whether endovascular embolization improves cognitive performance in patients with dAVF. Methods: NAIF was a prospective study including all the patients with a clinical diagnosis of dAVF (excluding those with acute intracranial hemorrhage secondary to venous hypertension) who underwent successful embolization at 5 hospitals in Spain between January 4, 2018 and January 7, 2020. Patients were categorized by risk of hemorrhage (Cognard classification 1-2A and 2B-4) via angiography. A neuropsychological evaluation covering 5 domains of cognitive function (memory, attention and executive functions, language, praxis, gnosis) was completed at baseline and a 3-month follow-up. Paired sample t-tests were used to compare mean Z-scores for cognitive tests pre- and post-treatment, where higher Z-scores signify better cognitive status. Results: A preliminary group of 15 patients (mean age 60, [range 23-83 years], 4 [26.7%] female) were included. Six patients presented with low hemorrhagic risk (Cognard1-2A) and 9 with high hemorrhagic risk (Cognard 2B-4). In the post-treatment neuropsychological evaluation, patients exhibited improved performance in executive function in the Semantic and Phonetic Fluency test (-0.57 vs. 0.21; p=0.01) and increased performance in Verbal Memory Learning (-1.45 vs. -0.82; p=0.014) relative to baseline. The remaining cognitive evaluations did not show significant differences, although there was a trend of language improvement in the Boston naming test (0.95 vs. 1.12; p=0.093). Improvements were observed in both high- and low-risk patients, and no patients experienced cognitive worsening after the intervention. Conclusion: This study suggests that endovascular embolization imparts cognitive benefits for dAVF patients undergoing endovascular embolization, and may be beneficial even for patients with a low risk of hemorrhage.

A quantile regression analysis of dietary diversity and anthropometric outcomes among children and women in the rural–urban interface of Bangalore, India

Based on a primary survey conducted in the rural–urban interface of Bangalore, this study contributes to the understanding of the relationship between dietary diversity (DD) and anthropometric outcomes of young children (6 months – 5 years) (measured by weight-for-age (WAZ), weight-for-height (WHZ), and height-for-age (HAZ) z-scores), school-aged children (6–14 years) (measured by Body Mass Index (BMI) z-scores and HAZ scores), and women (15 years and above) (measured by BMI). We examine this association not just at the mean, but also at different points of the conditional distribution of anthropometric outcomes using the quantile regression (QR) method. We use six different measures of individual- and household-level DD to check whether the estimated association depends on the choice of the metric used. Our results show that increased DD is associated with higher z-scores at the lower quantiles of the WAZ distribution. In addition, we find a positive association between DD and upper quantiles of WHZ and BMI z-scores of young and school-aged children, respectively. Except for these, no other associations at any other quantile for any anthropometric outcome of young children, school-aged children, and women are consistently significant for various measures of DD. Our results suggest that policies that focus on improving DD might not be effective in improving (most) anthropometric outcomes especially in areas facing multiple burdens of malnutrition.

Association between physical fitness and depressive symptoms in university students: a cross-sectional analysis

Objective: physical fitness is one of the most relevant predictors of an individual's mental health status. However, few studies have described the relationship between physical fitness and depressive symptoms in students from Latin America. The aim of this study was to verify the association between physical fitness and self-reporting of depressive symptoms among university students. Research methods and procedures: a cross-sectional study was conducted in 344 undergraduate students (53 % women, with a median age of 20 years, ranging from 18 to 23 years), from four public and private universities in Cali, Colombia. The components of physical fitness (vertical jump, arm pushups, trunk pushups and aerobic fitness) were assessed by field tests and a global fitness z-score was calculated as the mean of the z-scores values of each fitness test. In addition, global fitness z-score was divided into tertiles (T) to obtain three balanced groups: (T1) low, (T2) medium, and (T3) high global fitness z-score. Results: twelve percent of the population suffer from mild depressive symptoms, while 10 % reported moderate/severe depression, with women showing the highest score on the Beck-II Depression inventory. In men, inverse and statistically significant correlations were observed between the depression score of the Beck-II Depression inventory and lower muscle strength-vertical jump (Z-score) r = -0.190, aerobic fitness (Z-score) r = -0,195, and global fitness z-score r = -0.189; p < 0,01. The similar findings were observed after adjusting for age, smoking, alcohol intake and physical activity levels as covariable, between (T 1) and (T3) global fitness z-score, p = 0.028 in men. Conclusion: our results indicated that lower muscle strength and global fitness z-score was inversely related to self-rate depression symptoms using the Beck II depression inventory in men group.