Interaction Test Research Articles

Association of oxidative balance score with the risk of all-cause and CVD mortality in younger US adults with diabetes

Oxidative balance score (OBS) is a composite measures that assess the balance between pro-oxidant and antioxidant factors in an individual’s diet and lifestyle, with higher scores indicating greater antioxidant exposure. Despite its potential significance, there is a limited body of research exploring the relationship between OBS and all-cause and cardiovascular disease (CVD) mortality specifically in younger patients with diabetes. We aimed to investigate the possible relationship between OBS and all-cause and CVD mortality in younger patients with diabetes. Data for this study were obtained from the 2003–2018 NHANES. This study enrolled 3501 participants. The endpoints were all-cause and CVD mortality, determined by the National Death Index (NDI). OBS, which consists of 16 dietary factors and 4 lifestyle factors, is categorized into pro-oxidants and antioxidants. The OBS was categorized into four quartiles (Q1-Q4). We used multivariable Cox proportional hazards regression models to examine the association between continuous and quartile measures of OBS, lifestyle OBS (lifestyle antioxidants such as physical activity, etc., and lifestyle pro-oxidants such as alcohol, smoking, etc.), and dietary OBS (dietary antioxidants such as fiber, β-carotene, riboflavin, etc., and dietary pro-oxidants, such as total fat, etc.) with all-cause and CVD mortality. Additionally, we explored restricted cubic spline (RCS) analysis and also performed subgroup analyses and interaction tests. The occurrence of 409 all-cause deaths (11.7%) and 108 CVD-related deaths (3.1%) was recorded during the follow-up period. Our results found that OBS, lifestyle OBS, and dietary OBS were negatively associated with patients’ all-cause and CVD mortality. The RCS analysis further validated the association of a linear negative correlation between OBS and all-cause and CVD mortality. The results of our subgroup analyses revealed that the negative association between OBS and CVD mortality may be influenced by alcohol use. In conclusion, results from a nationally representative study of younger American patients with diabetes suggest a negative association between OBS, lifestyle OBS, and dietary OBS and all-cause and CVD mortality. Antioxidant-rich diets and lifestyle improvements are essential for reducing all-cause and CVD mortality in patients.

Metabolically healthy overweight/obesity with no metabolic abnormalities and incident hyperglycaemia in Chinese adults: analysis of a retrospective cohort study

ObjectivesTo explore whether metabolically healthy overweight (MHOW) and/or metabolically healthy obesity (MHO) increase hyperglycaemia risk in a Chinese population with a broad age range.DesignRetrospective cohort study.SettingSecondary analysis of data from...

The Effect of Motivation, Competence, Compensation on Employee Performance with Organizational Culture as A Moderating Variable

Motivation, Competence, Compensation, and Organizational Culture have a great influence on the Employee Performance of PT. Adi Dharma Abadi. These four variables prove that this study aims to analyze the influence of motivation, competence, and compensation on employee performance with organizational culture as moderating variables in PT. Adi Dharma Abadi Bogor Regency. The study was conducted at PT. Adi Dharma Abadi Bogor Regency took 35 employees as the research sample, which was calculated using an equation formula through an interaction test often referred to as Moderated Regression Analysis (MRA) with a total population of 35 employees at an error margin of 2.5 %, for the data collection techniques, questionnaires, interviews, and observations. The data is processed using the SPSS version 26 application. The test data used in this research are reliability tests, validity tests, statistical tests, and classical assumption tests. The results of this study show that Motivation, Competence, Compensation, and Organizational Culture have a positive and significant influence on Performance.

Association between lipid accumulation product and the risk of colon cancer in adults: A population-based study.

The purpose of this study was to look into any potential connections between the occurrence of colon cancer and the condition of the body of lipid accumulation product (LAP) index. Using data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES), we performed a cross-sectional analysis with 24,592 individuals. Utilizing multivariate logistic regression modelling, the relationship between LAP levels and colon cancer risk was investigated. Subgroup analysis, trend test, interaction test, and stratified smoothed curve were also carried out. LAP levels and colon cancer risk were positively correlated after controlling for potential covariates (OR = 10.56, 95% CI: 2.40-46.53), the findings of trend tests are statistically significant. In particular groups, subgroup analysis revealed a positive connection between LAP levels and the risk of colon cancer. The association between LAP levels and colon cancer risk was shown to be M-shaped in the group under 60 years old, inverted V-shaped in the female and no-diabetes groups, and inverted L-shaped in the smoking and no-hypertensive groups, according to stratified smoothed curve fitting. According to our findings, there is a strong correlation between LAP levels and the risk of colon cancer.

Association Between Riboflavin Intake and Suicidal Ideation: A Nationwide Study in Korea

Background/Objectives: In recent years, there has been an increased interest in reducing suicide rates through dietary modification; however, the relationship between riboflavin intake and suicide risk remains unclear. This study aims to examine the association between dietary riboflavin and suicidal ideation. Methods: A total of 17,320 participants from the Korean National Health and Nutrition Examination Survey (KNHANES) 2014–2020 were included. Suicidal ideation was assessed using the ninth item of the Patient Health Questionnaire-9 (PHQ-9). Riboflavin intake was evaluated through dietary assessments. Multivariate logistic regression, restricted cubic spline (RCS) regression analysis, subgroup analysis, and interaction tests were conducted to explore the relationship between riboflavin intake and suicidal ideation. Results: There was a statistically significant association between riboflavin intake and suicidal ideation [OR (95%CI): 0.83 (0.77, 0.91), p < 0.001], after full adjustment for covariates. The linear trend test, using Q1 as the reference, showed ORs (95% CI) for Q2 and Q3 of 0.96 (0.81, 1.15) and 1.06 (0.80, 1.42), respectively. The RCS analysis revealed a non-linear pattern in the relationship between riboflavin intake and suicidal thoughts. This association was particularly significant among women and individuals younger than 60 years. Subgroup analyses and interaction tests indicated that the associations remained consistent across subgroups and were not influenced by factors other than anaerobic exercise. Conclusions: Our findings suggest a non-linear inverse relationship between riboflavin intake and suicidal ideation, with notable variations by sex and age. Modifying dietary riboflavin intake may be a crucial strategy for reducing suicide risk.

A Behavioral Screening Method for Predicting PTSD-like Phenotypes: Novel Application to Female Rats.

Only a small percentage of trauma-exposed subjects develop PTSD, with females being twice as likely. Most rodent models focus on males and fail to account for inter-individual variability in females. We tested a behavioral PTSD model in female rats to distinguish between susceptible and resilient individuals. In Experiment 1, female rats underwent footshocks paired with social isolation, a PTSD risk factor. They were re-exposed to the conditioned context to test memory retention, and assessed in the Elevated Plus Maze (EPM) and Social Interaction (SI) tests for anxiety and social behavior. Footshock-exposed rats showed fear memory retention up to 16 days, indicated by elevated freezing behavior during re-exposure. They also exhibited reduced exploration in the EPM and less SI time compared to controls. In Experiment 2, we classified rats into normal responders, susceptible, and resilient groups based on locomotor activity after trauma, correlating with memory retention and anxiety. Unlike existing models focused on males and lacking predictive variables before trauma, our method identifies PTSD-like susceptibility and resilience in female rats by using exploratory behavior as a predictor before trauma exposure. Exploratory activity in a novel environment after trauma and before extinction is a reliable predictor of PTSD-like phenotypes and differentiates between susceptible and resilient female rats.

Association between the hemoglobin A1c/High-density lipoprotein cholesterol ratio and stroke incidence: a prospective nationwide cohort study in China

BackgroundStroke has emerged as an escalating public health challenge among middle-aged and older individuals in China, closely linked to glycolipid metabolic abnormalities. The Hemoglobin A1c/High-Density Lipoprotein Cholesterol (HbA1c/HDL-C) ratio, an integrated marker of glycolipid homeostasis, may serve as a novel predictor of stroke risk.MethodsOur investigation utilized data from the China Health and Retirement Longitudinal Study cohort (2011–2018). Stroke cases were identified based on self-reported, physician-confirmed diagnoses. Logistic regression models were established to determine the correlation between HbA1c/HDL-C and stroke prevalence (2011) as well as between cumulative mean HbA1c/HDL-C (2011–2015) and new stroke incidence (2015–2018). Additionally, smoothed curve fitting, subgroup analyses, and interaction tests were conducted to ensure the robustness of the findings.ResultsIn the cross-sectional analysis, 8,502 participants were enrolled, of whom 189 had a history of stroke. Our findings revealed a significant positive linear relationship between HbA1c/HDL-C and stroke prevalence after adjusting for covariates (OR: 1.26, 95% CI: 1.09–1.45). When HbA1c/HDL-C was categorized into tertiles, only the highest tertile (T3) showed a significant correlation with stroke prevalence compared to the lowest tertile (T1) (OR:1.71, 95% CI: 1.05–2.77). In the longitudinal analysis of 5,165 participants, 336 cases of new-onset stroke were identified over a follow-up period of 7 years. Adjusting for confounders, individuals with higher cumulative mean HbA1c/HDL-C exhibited an increased likelihood of new stroke incidence (OR: 1.14, 95% CI: 1.01–1.29). Using the T1 of cumulative mean HbA1c/HDL-C as a reference, the fully adjusted OR for stroke was 1.65 (95% CI: 1.21–2.24) in T2 and 1.54 (95% CI: 1.08–2.19) in T3. The predictive value of the HbA1c/HDL-C in stroke risk assessment have been significantly improved compared to the traditional HDL-C and HbA1c. Consistent associations were observed across most stratified subgroups.ConclusionsElevated baseline and cumulative mean HbA1c/HDL-C levels are significantly associated with an increased risk of stroke among middle-aged and older individuals in China, underscoring the potential of HbA1c/HDL-C as a clinical marker for long-term stroke risk assessment and prevention strategies.

School performance gap between non-immigrant and second-generation immigrant children in Sweden—time trends and contributing factors

We aimed to investigate the school performance gap and its potential trend from 2010 to 2020 in non-immigrant and second-generation immigrant children in Sweden, whether parental mental disorders and low socioeconomic status contribute to this gap and its trends, and whether the effects of these factors differ by immigration status. We used multiple Swedish population registers, including 829,787 children born 1994–2004. We examined the school performance gap and its trends by the interaction between immigration status and year with linear mixed models. We assessed whether parental mental disorders and socioeconomic status contributed to this gap and its trends, and whether their effects on school performance differ by immigration status. The existing gap was explained by parental mental disorders in addition to parental education and neighborhood socioeconomic status for both males and females. The unadjusted model suggested an increasing trend of the existing gap in school performance by immigration status for both males and females. In the adjusted model, the increasing trend of the gap remained among males and was partially attributed to parental education and neighborhood socioeconomic status. The interaction tests showed that the potential effects of these factors on school performance were smaller among second-generation immigrant children. Efforts to reduce the effects of socioeconomic inequalities and parental mental disorders are warranted in addition to extra support for second-generation immigrant children at schools.

Associations between oxidative balance scores and heart failure among americans: NHANES (2007–2018)

BackgroundThe relationship between oxidative balance score (OBS) and heart failure (HF) is controversial. The OBS was used to assess systemic oxidative stress status, with higher OBS scores implying exposure to more antioxidants. This study aimed to explore whether OBS is associated with heart failure in US adults.MethodsA cross-sectional investigation was carried out using information from the National Health and Nutrition Examination Survey 2007–2018. The linear link between OBS and HF in adults aged ≥ 45 years was investigated using multivariate linear regression models. Interaction tests and subgroup analysis were also conducted.ResultsThe prevalence of HF was 3.84%. There was a significant negative relationship between OBS (OR: 0.96 ,95%CI: 0.95–0.98, P < 0.0001) and HF. In the fully adjusted model, compared to the lowest quartile of OBS, subjects in the highest quartile had a 45% lower likelihood of developing HF (OR: 0.55, 95% CI: 0.41–0.74, p < 0.0001). In stratified analysis, OBS and HF showed no obvious negative correlation.ConclusionOBS was strongly negatively associated with heart failure. The findings underline the significance of adhering to an antioxidant diet and lifestyle, which helps prevent heart failure.

Adjuvant Chemotherapy After Resection of Localized Pancreatic Adenocarcinoma Following Preoperative FOLFIRINOX

The effect of adjuvant chemotherapy following resection of pancreatic adenocarcinoma after preoperative (m)FOLFIRINOX (combination leucovorin calcium [folinic acid], fluorouracil, irinotecan hydrochloride, and oxaliplatin in full or modified dosing) chemotherapy on overall survival (OS) is unclear because current studies do not account for the number of cycles of preoperative chemotherapy and adjuvant chemotherapy regimen. To investigate the association of adjuvant chemotherapy following resection of pancreatic adenocarcinoma after preoperative (m)FOLFIRINOX with OS, taking into account the number of cycles of preoperative chemotherapy and adjuvant chemotherapy regimen. This retrospective cohort study included patients with localized pancreatic adenocarcinoma treated with 2 to 11 cycles of preoperative (m)FOLFIRINOX followed by resection across 48 centers in 20 countries from 2010 to 2018. Patients who died within 3 months after surgery were excluded (landmark). Data were analyzed from February 1 to December 31, 2023. Preoperative (m)FOLFIRINOX chemotherapy followed by resection and eventually followed by adjuvant chemotherapy. The primary outcome was OS, calculated from the 3-month landmark. Cox regression analysis, including interaction analyses, was performed to investigate the association of adjuvant chemotherapy with OS. Overall, 767 patients were included after resection of pancreatic adenocarcinoma (median [IQR] age, 62 [55-67] years; 404 [52.7%] male). Adjuvant chemotherapy was independently associated with prolonged OS (hazard ratio [HR], 0.66; 95% CI, 0.49-0.87), confirmed by adjusted OS curves. The interaction analysis to assess estimated treatment effect across subgroups was not statistically significant. The forest plot and interaction test suggest that the association of adjuvant chemotherapy was lower among patients receiving 8 or more cycles of preoperative (m)FOLFIRINOX, those who had radiological response, and those with ypN0 disease. Compared to no adjuvant chemotherapy, both adjuvant (m)FOLFIRINOX (HR, 0.57; 95% CI, 0.40-0.80) and other multiagent adjuvant regimens (HR, 0.61; 95% CI, 0.41-0.92) were associated with prolonged OS, whereas single-agent adjuvant chemotherapy was not (HR, 0.75; 95% CI, 0.55-1.03). In this cohort study, adjuvant (m)FOLFIRINOX and other multiagent chemotherapy regimens were associated with improved OS following resection of localized pancreatic adenocarcinoma after preoperative (m)FOLFIRINOX, whereas single-agent adjuvant chemotherapy was not. The impact of adjuvant chemotherapy on OS may be lower in subgroups such as patients with 8 or more preoperative cycles of (m)FOLFIRINOX, those having radiological response, and those with ypN0.

The effects of early-life whisker deprivation on adolescent behavior in C57BL/6J mice.

Whisker deprivation at different stages of early development results in varied behavioral outcomes. However, there is a notable lack of systematic studies evaluating the specific effects of whisker deprivation from postnatal day 0 (P0) to P14 on adolescent behavioral performance in mice. To investigate these effects, C57BL/6J mice underwent whisker deprivation from P0 to P14 and were subsequently assessed at 5 weeks of age using a battery of tests: motor skills were evaluated using open field test; emotional behavior was evaluated using a series of anxiety- and depression-related behavioral tests; cognitive function was examined via novel location and object recognition tests; and social interactions were analyzed using three-chamber social interaction test. Results show that early-life whisker deprivation impairs social discrimination, as evidenced by reduced interaction preference for novel mice, while not impacting general motor abilities, cognitive performance in novel object and location recognition, or anxiety- and depression-related behaviors during adolescence. The treatment effects were consistent across sexes, with no significant differences observed between control and experimental groups within each sex. These findings contribute to a comprehensive understanding of the behavioral impacts during adolescence resulting from early-life whisker deprivation and provide valuable criteria for selecting appropriate whisker deprivation models in future research.

Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis

The impact of diabetes on incident cardiovascular disease in relation to the extent of atherosclerotic disease remains unclear. We aimed to investigate major adverse cardiovascular events (MACE) in patients with or without type 2 diabetes (T2DM) presenting with two extremes of atherosclerotic disease, those with angiographically documented minor coronary atherosclerotic lesions and those with symptomatic peripheral artery disease. We included 1238 patients from two prospective, long-term cohort studies. Patients underwent coronary angiography and/or sonography in order to assess the grade of atherosclerosis and were defined as having no signs of Atherosclerosis (n = 332; Group I), minor atherosclerosis (n = 425; Group II) and major atherosclerosis (n = 481; Group III). Cardiovascular events were recorded over a median follow-up period of 7.1 years (Q1 = 3.6 years, Q2 = 7.1 years, Q3 = 11.3 years), covering a total of 9533 patient years. We tested the hypothesis that T2DM infers the same relative risk increase irrespective of the atherosclerosis stage, considering 3-point MACE as the primary endpoint. Incident MACE was reported in 681 patients (51%). MACE occurred more frequently in patients with T2DM than in patients without T2DM (p < 0.001). Further, MACE occurred more frequently in group III (58.1%), than group II (34.1%) or group I (19.1%) (group I vs. group II vs. group III, p < 0.001). In a cox-regression-model, T2DM was a significant predictor of MACE in univariate analyses (HR = 2.43 [1.88–3.14], p < 0.001) and after multivariate adjustment for cardiovascular risk factors, as well as the different grades of atherosclerosis (HR = 1.37 [1.02–1.84], p = 0.034). Also, atherosclerosis grades predicted MACE (HR = 3.19 [2.75–3.70], p < 0.001) in univariate analyses, and also after multivariate adjustment for known cardiovascular risk factors, including T2DM (HR = 1.61 [1.31–1.98], p < 0.001). Finally, when testing for interactions between T2DM and stages of atherosclerosis on MACE we could not find any significant interaction (HR = 1.14 [0.86–1.52], p = 0.364). We conclude that T2DM infers an increased risk for MACE across anatomically and morphologically distinct stages of atherosclerosis.

Association between a body shape index and bone mineral density in US adults based on NHANES data

The relationship between a body shape index (ABSI) and bone mineral density (BMD) remains uncertain, prompting further investigation. This study aims to elucidate the association between ABSI and BMD using data from the 2011–2018 National Health and Nutrition Examination Survey (NHANES), involving participants aged 20–60. ABSI was calculated using the formula: ABSI = 1000 × waist circumference (m)×weight (kg)−2/3×height (m)5/6. The analysis employed weighted multiple linear regression, smooth curve fitting, stratified analysis, and interaction tests to explore the relationship between ABSI and total BMD. The study included 10,291 participants, with a mean age of 39.11 ± 10.77 years, and 49.20% were women. The average ABSI was 80.21 ± 1.50. Total BMD, thoracic spine BMD, lumbar spine BMD, and pelvis BMD were measured, with mean values of 0.82 ± 0.11 g/cm², 1.03 ± 0.15 g/cm², and 1.24 ± 0.16 g/cm2, respectively. A negative correlation between ABSI and total BMD was observed. In the fully adjusted model, individuals in the highest ABSI quartile had total BMD levels 0.045 g/cm² lower than those in the lowest quartile. Interaction tests showed a consistent association between ABSI and total BMD across subgroups, with variations in sex and BMI. This analysis of NHANES data confirms a persistent negative association between ABSI and BMD, suggesting that ABSI could be useful in osteoporosis prevention and diagnosis.

Association of the triglyceride glucose index with all cause and CVD mortality in the adults with diabetes aged < 65 years without cardiovascular disease

Although the triglyceride-glucose (TyG) index has been established as a valuable predictor for cardiovascular disease (CVD) and cardiovascular mortality, there is limited research exploring its association with all-cause or CVD mortality specifically in adults with diabetes aged < 65 years without cardiovascular disease. This study aimed to investigate the relationship between the TyG index and both all-cause and CVD mortality in this population within the United States. Our study recruited 1778 adults with diabetes aged < 65 years without cardiovascular disease from the National Health and Nutrition Examination Survey (NHANES) 2003–2018. Mortality outcomes were determined by linking to National Death Index (NDI) records up to December 31, 2019. Cox regression modeling was employed to examine the association between the TyG index and mortality in this population. The nonlinear relationship between the TyG index and mortality was assessed using restricted cubic splines (RCS). Additionally, subgroup analyses and interaction tests were conducted to explore potential effect modifiers. A total of 1788 participants were included in the final cohort, with an average age of 49.61 ± 0.32 years. During a median follow-up of 7.92 years, the occurrence of 150 all-cause deaths and 33 CVD-related deaths were recorded. To investigate the independent association between the TyG index and the risks of all-cause and CVD mortality, three Cox regression models were developed. In Model 1, a significant positive association was observed between the TyG index and the risk of all-cause mortality (HR 1.38, 95% CI 1.09–1.74). This association persisted in the minimally adjusted model (HR 1.44, 95% CI 1.13–1.83), which was adjusted for age, gender and race. Even after full adjustment, this positive association remained significant (HR 1.91, 95% CI 1.36–2.70). We also found that the relationship between the TyG index and all-cause mortality was linear. Subgroup analyses revealed no significant interactions between the TyG index and the stratification variables. However, we did not observe a significant association between the TyG index and CVD mortality in this population. Our results suggested that a significantly positive association between the TyG index and all-cause mortality. The positive association between the TyG index and all-cause mortality was linear. We did not observe a significant association between the TyG index and CVD mortality.

Low emotional contagious behavior induces PTSD susceptibility in observers and is related to the regulation of oxytocin receptor in mice.

Post-traumatic stress disorder (PTSD) is a serious psychiatric disorder that occurs after an individual has witnessed or experienced a major traumatic event. Emotional contagion seems to play an important role in witnessing trauma, highlighting the importance of understanding the neurobiological consequences of psychological or emotional stress and its impact on the individual's mental health. Therefore, understanding the relationship between emotional contagion and PTSD susceptibility and the abnormal neurobiological and behavioral changes behind it could help find effective molecular treatment targets. The formalin pain test was used to distinguish the level of emotional contagion in observer mice, dividing them into quartiles according to their pain response. The upper and lower quartiles were the emotional contagion-prone (ECP) and -resistant (ECR) groups, respectively. The vicarious social defeat stress (VSDS) procedure was used to establish PTSD models in mice with various emotional contagion levels when witnessing stress. Open field, elevated plus maze, social interaction test, and forced swimming test were used to examine PTSD-like symptoms. Changes in the medial prefrontal cortex (mPFC) mRNA expression of brain-derived neurotrophic factor (BDNF) and oxytocin receptor (OTR) were detected by qPCR, and their protein levels were analyzed by Western blot and immunofluorescence staining. The formalin pain test induced emotional contagion behaviors in mice between the ECP and ECR levels. The VSDS procedure resulted in PTSD symptoms in mice; mice in the lowest quartile were characterized by high levels of anxiety, depression, and social avoidance behaviors, such as decreased autonomous activity and residence time in the open field test or open arms position and increased immobility time and social avoidance behavior. These were accompanied by reduced OTR and BDNF protein expression levels and fluorescence intensity, as well as reduced OTR and BDNF mRNA levels in the mPFC. Emotional contagion can induce PTSD-like behavior in mice that witnessed stress. Low emotional contagion behavior increased PTSD susceptibility in the observer mice and might be related to the regulation of their oxytocin receptors.

Interaction Tests With Covariate‐Adaptive Randomization

Interaction Tests With Covariate‐Adaptive Randomization

Oxidative stress and retinopathy: evidence from epidemiological studies

BackgroundPrevious studies have suggested oxidative stress may play a key role in the pathogenesis of retinopathy, while evidence from observational studies directly linking oxidative biomarkers to clinically relevant outcomes has been limited. This study aims to investigate the association between oxidative balance score (OBS) and prevalence of retinopathy in a nationally representative sample of U.S. adults, including both those with and without diabetes.MethodsData were obtained from the NHANES 2005–2008, including 3,287 participants. OBS was calculated from 16 dietary and 4 lifestyle components and categorized into tertiles. Weighted logistic regression was used to assess the association between OBS and retinopathy in the overall, diabetic, and non-diabetic populations, and Cox proportional hazards models evaluated the link between OBS and all-cause mortality in those with retinopathy. Restricted cubic spline (RCS) analysis explored the dose-response relationship between OBS and retinopathy. Subgroup analyses and interaction tests were conducted based on age, sex, race, BMI, education level, and diabetes status.ResultsParticipants in the highest OBS tertile had a 28% lower risk of retinopathy compared to those in the lowest tertile (OR 0.72, 95% CI 0.54–0.95, P = 0.023). RCS analysis showed a significant overall association between higher OBS and reduced retinopathy risk, without a nonlinear pattern. In participants with retinopathy, higher OBS was linked to a 60% reduction in all-cause mortality (HR 0.40, 95% CI 0.24–0.66, P < 0.001). Subgroup analysis revealed stronger inverse associations between OBS and retinopathy in younger individuals and those with higher education, with a significant interaction between OBS and age (P for interaction < 0.05).ConclusionOur study provides evidence that higher cumulative antioxidant exposure assessed by OBS is associated with a reduced risk and severity of retinopathy and lower all-cause mortality in U.S. adults with retinopathy, highlighting the importance of maintaining a favorable oxidative balance in retinal health.

Determinants of Earnings Management: The Moderating Role of Firm Size

This study aims to provide empirical evidence on the impact of financial distress, financial ratios, and corporate governance on earnings management, using company size as a moderating variable. This study focuses on real estate, construction, and property companies listed on the Indonesia Stock Exchange (IDX) between 2020 and 2022, with a sample of 54 companies selected through purposive sampling. Data analysis was conducted using multiple linear regression to test the direct effect of independent variables on earnings management and interaction test to evaluate the moderating role of firm size. The research findings show that financial distress affects earnings management, which suggests that companies under financial stress are more likely to rely on earnings management to present favorable earnings performance. In contrast, financial ratios do not affect earnings management, which suggests that well-performing firms are less likely to engage in the practice. Good corporate governance, represented by the proportion of independent directors, audit committee and managerial ownership, also affects earnings management. In addition, firm size moderates the relationship between financial distress and earnings management, with larger firms showing a greater tendency towards earnings management when facing financial challenges. These results underscore the importance of considering financial conditions and firm size when monitoring earnings management, as larger firms may be more prone to earnings management practices under certain conditions.

Correlation Between Prognostic Nutritional Index and Heart Failure in Adults with Diabetes in the United States: Study Results from NHANES (1999-2016).

The relationship between diabetes and heart failure significantly impacts public health. This study assessed the prognostic nutritional index (PNI) as a predictor of heart failure risk in adult diabetic patients. An analysis was performed on 1823 diabetic adults using data collected from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2016. Serum albumin levels and lymphocyte counts were combined to calculate the PNI. We used descriptive statistics categorized by PNI quartiles and performed multivariate logistic regression to adjust for variables including age, gender, ethnicity, and coexisting medical conditions. The median age (mean ± SD) was 59.942 ± 12.171 years, and the mean value ± SD of the PNI was 52.412 ± 5.430. The prevalence of heart failure was 7.405%. In the fully adjusted model, for each 1-unit increase in PNI, the risk of heart failure decreased by 8.2% (odds ratio (OR), 0.918; 95% confidence interval (CI) 0.884, 0.953). Participants in the highest PNI quartile (Q4) had a 63% reduced risk of heart failure compared to those in the lowest quartile (Q1). Tests for interactions did not reveal any statistically significant differences among these stratified subgroups (p for interaction > 0.05). This study demonstrated that a higher PNI was significantly associated with a decreased prevalence of heart failure in adults with diabetes.

Repeated administration of a subanesthetic dose of ketamine results in impaired motor and cognitive behavior and differential expression of hippocampal P2X1 and P2X7 receptors in adult mice.

Ketamine hydrochloride serves multiple purposes, including its use as a general anesthetic, treatment for depression, and recreational drug. In studies involving rodents, ketamine is utilized as a model for schizophrenia. However, it is unclear whether age affects the behavioral response induced by repeated ketamine administration and if it modifies the expression levels of N-methyl-D-aspartate (NMDA) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and purinergic receptors (P2X1, P2X4, P2X7). In the present study, we evaluated the effect of intraperitoneal administration of subanesthetic ketamine dose (30mg/Kg) for fourteen days on young (35 days of age) and adult (76 days of age) mice on different behavioral tests. Nest-building behavior was evaluated during the fourteen-day treatment; short-term memory and social interaction tests were assessed twenty-four hours after the last administration of ketamine. Interestingly, only adult mice treated with ketamine showed impaired nest-building and novel object recognition tests. In the hippocampus, an area related to memory and cognition, ketamine administration showed no changes in the relative expression of GluN1, P2X4, and P2X7 while increasing GluA2 and P2X1 only in young mice. In contrast, when assessing the protein levels of P2X1 and P2X7 in the hippocampus following ketamine treatment, young mice exhibited a decrease in P2X1 levels while P2X7 levels increased. In contrast, adult mice showed the opposite pattern; P2X1 levels were higher, and P2X7 levels decreased. These results suggest that adult mice are more vulnerable to repeated ketamine administration than young mice and that a differential response of P2X1 and P2X7 might contribute to ketamine-induced behavioral changes.