Linear Mixed-effects Model Analysis Research Articles

The relationship between AutoNRT thresholds and subjective programming levels revisited

Objectives The aim of this study wasto systemically examine the relationship between AutoNRT thresholds and subjective programming levels by controlling for individual subject variation, and further, to propose an alternative way to calculate the AutoNRT threshold profile for programming purposes. Methods The study was a prospective observational study. AutoNRT thresholds, T- and C-levels were recorded at six and twelve months after activation. All subjects had received a CI24RE implant. Results Forty-one adults participated in the study. A linear mixed-effects model analysis of the relationship between the AutoNRT thresholds and the T-and C-levels resulted in a large unexplainable variation between subjects, the standard deviation was between 15.42 and 18.89 CL. However, the study showed that the profiles for the T- and C-levels could be predicted with an acceptable accuracy from AutoNRT. A model for calculating profiles from AutoNRT thresholds based on linear regression resulted in the lowest deviation from the subjective programming thresholds, with somewhat better results for C-levels than T-levels. Conclusion The results from this study showed that the predictability was reasonable when calculating the profiles for the T- and C-levels based on AutoNRT. And, further, that AutoNRT thresholds can be used when programming cochlear implants, to make global adjustments without predicting actual T- or C-levels.

Performance of spondyloarthritis-specific health utilities based on ASAS Health Index: an ancillary analysis from ASAS-HI validation study.

To compare the utility values of Spondyloarthritis (SpA)-specific ASAS Health Index (U-ASAS-HI) to generic utilities and to understand the contribution of health outcomes, personal- and country-level factors to the U-ASAS-HI. Ancillary analysis of the ASAS-HI international validation study. SpA patients who completed the ASAS-HI, 5-level EuroQol-5D (EQ-5D-5L) and Short Form-36 (SF-36) questionnaires were selected, and utilities calculated. Correlations between U-ASAS-HI and generic utility values were tested. Potential explanatory variables were evaluated in a linear multivariable mixed-effects model analysis with multilevel modeling fitted by country. 1425 patients were included, with a mean age of 42 (Standard Deviation, SD : 13.5) and 65% male. The mean utility scores were EQ-5D-5L 0.75 (SD : 0.11), SF-6D 0.72 (SD : 0.24), and U-ASAS-HI 0.42 (SD : 0.29). Correlation between U-ASAS-HI and EQ-5D-5L and SF-6D was strong (r = 0.75 and r = 0.72; p< 0.001, respectively). The linear mixed-effects model showed that worse disease activity (ASDAS) and lower physical function (BASFI) were associated with lower U-ASAS-HI. Additionally, younger age, female gender, higher comorbidity score, and symptoms of depression were associated with lower U-ASAS-HI. SpA subtype had no influence on health utility. The random effects model indicated an intercept SD : 0.045 with a 5.5% variance ratio between countries and the total U-ASAS-HI variation. The U-ASAS-HI captures the physical and mental impact of SpA, as well as personal contextual factors such as age, gender, and comorbidities. The influence of the country of residence seems negligible. The U-ASAS-HI algorithm has sufficient support to be used in health economic evaluations for SpA patients across different countries.

Association Between Patient Characteristics and the Depth of Microvascular Penetration Into the Adult Human Meniscus.

Current knowledge on the microvascular anatomy of adult human menisci is based on cadaveric studies. However, considerable interindividual variation in meniscal microvascularization has been reported in recent studies with small sample sizes. To assess the association between patient characteristics and the depth of microvascularization of the meniscus. Descriptive laboratory study. Menisci from 174 patients who received total knee replacement between March 2021 and December 2023 were collected. A total of 174 lateral and 102 medial menisci were included. Three sections were made from each meniscus: the anterior horn, midbody, and posterior horn. Immunohistochemical staining (CD-31) was used to visualize the microvasculature. The 4 primary outcome measures were the correlation between the depth of microvascular penetration into the lateral meniscus (0%-100%) and (1) age, (2) smoking, (3) degree of osteoarthritis, and (4) history of cardiovascular disease. To account for repeated measurements within each patient, a linear mixed-effects model was estimated to study the association between microvascularization and the patient's characteristics previously introduced. The depth of vascular penetration ranged from 0% to 78% into the lateral menisci and from 0% to 67% into the medial menisci. No significant correlations were found between age, smoking, degree of osteoarthritis, or history of cardiovascular disease and the degree of vascular penetration into the lateral meniscus. The linear mixed-effects model analysis, adjusted for location within the meniscus (anterior horn, midbody, or posterior horn) and meniscal side (lateral or medial), showed no significant associations between the same patient characteristics and meniscal microvascularization. The degree of microvascular penetration into the meniscus has a wide range among adults >50 years. However, the depth of microvascularization was not associated with age, smoking, degree of osteoarthritis, or history of cardiovascular disease. Because no associations were found between depth of microvascular penetration into the meniscus and patient characteristics, the latter cannot be used to estimate the vascular status of a meniscal tear in clinical practice.

Elevated Fecal Lipocalin-2 Levels During Early Life Are Associated with Maternal Inflammatory Bowel Disease Diagnosis.

Fecal lipocalin-2 (LCN2) is a biomarker of neutrophil activation, which is elevated in patients with inflammatory bowel disease (IBD); however, its dynamic changes during pregnancy and early life are largely unknown. We characterized LCN2 levels by maternal IBD diagnosis, offspring feeding behavior, and gut microbiota composition. In the prospective MECONIUM (Exploring Mechanisms of Disease Transmission In Utero through the Microbiome) study, we analyzed 559 fecal samples from 91 pregnant women with IBD, 78 healthy controls, and their 147 offspring for LCN2 levels at each trimester of pregnancy and multiple time points during early life using linear mixed-effects model and multiple logistic regression analyses. Gut microbiota community compositions were evaluated following 16S rRNA gene sequencing. IBD cases had higher LCN2 levels throughout pregnancy compared to controls. In offspring, significantly higher LCN2 was found in babies born to mothers with IBD, compared to those without IBD, at 3months, 1year, and 4years (all p < 0.03), with offspring LCN2 levels being predictive of maternal IBD case status with > 85% accuracy at ages 1 and 4. We also detected correlations between LCN2 levels and certain IBD-associated bacterial taxa in both mothers and babies. Exclusively breastfed babies had lower LCN2 in the first weeks of life compared to formula or mixed-fed counterparts. Babies born to mother with IBD had significantly higher LCN2 during early life compared to controls with exclusive breastfeeding impacting LCN2 levels early on. LCN2 levels correlated with IBD-associated microbial taxa in both mothers and babies. Future studies should identify the biological drivers and health-related consequences of elevated LCN2 during early childhood.

Stroke phase differences in the linear relationship between swimming velocity and vertical body position during front crawl

ABSTRACT We aimed to investigate whether a linear relationship exists between swimming velocity and vertical body position for each stroke phase in front crawl, and to determine whether there are differences in the velocity effect among the stroke phases. Eleven male swimmers performed a 15 m front crawl at various swimming velocities. The whole-body centre of mass (CoM) was estimated from individual digital human models using inverse kinematics. The horizontal CoM velocity and vertical CoM position from the water surface were calculated for one stroke cycle and divided into five stroke phases: entry, pull, push, release, and recovery. Linear mixed-effects model analysis revealed a positive trend between the mean swimming velocity and the mean vertical CoM position for each stroke phase (p < 0.001 for all phases). The interaction term between stroke phase and swimming velocity was significant (p < 0.001), and the slopes of the propulsive phases (pull and push) were larger than those of the non-propulsive phases (entry, release, and recovery) (p < 0.001). These findings provide practical implications that vertical body position can be evaluated independently of the stroke phase while considering velocity effects, and that focusing on propulsive phases allows easier detection of vertical body position changes.

Serum and Plasma Sphingolipids as Biomarkers of Anthracycline-Induced Cardiotoxicity.

Although effective as a chemotherapy, the utility of Doxorubicin (Dox) is hampered by cardiotoxicity. Despite this, the ability to predict and guide monitoring of patients receiving Dox or other anthracyclines is hampered by a lack of effective biomarkers to identify susceptible patients, and to detect early signs of subclinical cardiotoxicity. Based on their well-established roles in the response to Dox and other chemotherapies, we performed a retrospective analysis of serum and plasma sphingolipids (SLs) from patients undergoing anthracycline-containing therapy, correlating with cardiac parameters assessed by echocardiography. Results showed there were substantial changes in both plasma and serum SL species during therapy including ceramide (Cer), deoxydihydroCer, and dihydrosphingosine with reversion towards baseline following treatment. Linear mixed-effects model analysis revealed that at baseline, a number of SLs correlated with adverse cardiac outcomes with serum sphingosine-1-phosphate (S1P) and dihydroS1P, and plasma Cer performing comparably to the prognostic value of pro-NT-BNP, an established biomarker of cardiotoxicity. Intriguingly, while pro-NT-BNP had no predictive value at mid- and post-therapy timepoints, serum S1P and dhS1P and plasma Cer levels showed correlation with adverse outcomes, particularly at the post-therapy timepoint. Finally, analysis of plasma and serum C16:C24- Cer ratios - previously reported as predictive of adverse cardiac outcomes - showed no correlation in the context of anthracycline treatment. Taken together, this pilot study provides supporting evidence that plasma and serum SLs may have benefit as both prognostic and diagnostic biomarkers for patients undergoing anthracycline-containing therapy. This suggests that diagnostic SL measurements - recently implemented for metabolic-associated cardiac disorders - could have wider utility.

Association of Occupational Noise Exposure and Extended High-Frequency Hearing Loss in Young Workers With Normal Hearing.

Studies on the relationship between occupational noise exposure and extended high-frequency (EHF) hearing loss are limited. This study investigated the relationship between occupational noise exposure and EHF hearing loss in workers exposed to noise as measured by sound pressure level, exposure duration, and kurtosis to help provide a basis for early detection and prevention of hearing loss in noise-exposed workers. A cross-sectional survey was conducted among 602 participants with 472 noise-exposed workers and 130 non-noise-exposed controls. General demographic characteristics, noise exposure data, and hearing thresholds at conventional frequencies (0.25 to 8 kHz) and EHF (9 to 16 kHz) were collected and analyzed. Linear mixed-effects model analyses between hearing thresholds of EHF and noise exposure indicators including the 8-h equivalent continuous A-weighted sound pressure level (LAeq,8h), cumulative noise exposure (CNE), and kurtosis-adjusted CNE (CNE-K) were conducted. Among the 602 participants included in the analysis, 472 individuals (78.4%) were occupationally exposed to noise exposures ≥75 dBA. Significant differences (p < 0.05) were observed in sex, exposure duration, LAeq,8h, CNE, and CNE-K between the noise-exposed group and the nonexposed group. The mean hearing thresholds for all tested extended high frequencies ranging from 9 to 16 kHz were significantly higher in the noise-exposed group than in the nonexposed group (p < 0.05). The mean hearing thresholds of subjects in different groups of LAeq,8h exposures were generally stable with little variance in the conventional frequencies (0.25 to 8 kHz) but differed in the EHF range. Moreover, EHF hearing loss appeared to be most prominent in the subjects exposed to noise with 80 dBA < LAeq,8h ≤ 85 dBA. After the combination of the sound pressure level, exposure duration, and kurtosis by using the noise exposure indicators CNE and CNE-K, the subjects at the different noise exposures showed significant differences in hearing thresholds at EHF (p < 0.05). Linear mixed-effected model analyses showed that the CNE-K was the best to indicate noise-induced hearing loss among the three noise exposure indicators at EHF. The results indicate that the EHF hearing threshold testing is more sensitive to identifying early occupational noise-induced hearing loss than conventional audiometry. The CNE-K, an indicator combining noise energy, exposure duration, and kurtosis, is a more comprehensive and effective method for assessing the risk of EHF hearing loss due to occupational noise exposure.

Mediterranean diet, neutrophil count, and carotid intima-media thickness in secondary prevention: the CORDIOPREV study.

Several studies have supported the role of innate immune system as a key factor in the sterile inflammation underlying the pathophysiology of atherosclerosis in mice. However, its involvement in humans remains unclear. This study aimed to explore the association between neutrophil count, and the intima-media thickness of common carotid arteries (IMT-CC), as well as the potential impact of long-term dietary interventions on these associations. A comprehensive analysis was conducted within the framework of the CORDIOPREV study, a long-term secondary prevention study involving dietary interventions with either a Mediterranean or a low-fat diet. The study evaluated the relationship between absolute neutrophil count and neutrophil-related ratios with IMT-CC at baseline and after 5 and 7 years of dietary intervention. At baseline, patients in the highest tertile of neutrophil count had a higher IMT-CC and number of carotid plaques, when compared to lowest tertile (P < .01 and P < .05, respectively). Logistic regression analyses supported this association. Elevated neutrophil count, neutrophil-to-erythrocyte ratio, and neutrophil-to-HDL ratio were associated with an increased likelihood of having an IMT-CC >.9 mm {odds ratio (OR) 1.17 [95% confidence interval (CI) 1.04-1.35], OR 2.21 (95% CI 1.24-4.12), and OR 1.96 (95% CI 1.09-3.55), respectively}, after adjustment for all variables, which was corroborated by linear regression. Furthermore, a linear mixed-effect model analysis from a longitudinal analysis spanning 5 and 7 years revealed an increase in 1 unit of neutrophils/μl at these time points was associated with a mean increase of .004 (.002) mm in the IMT-CC (P = .031) after adjustment for all variables. Interestingly, in patients exhibiting regression in IMT-CC after 7 years of follow-up, those following a Mediterranean diet showed a significant decrease in neutrophil count after 5 and 7 years (both with P < .05), compared to baseline. These findings suggest that neutrophils may represent a promising target for preventing atherosclerosis. A Mediterranean diet could serve as an effective dietary strategy to reduce neutrophil levels and potentially slow the progression of atherosclerosis, offering a new neutrophil-reducing therapy concept. Further research is essential to gain deeper insights into the role of neutrophils in the pathophysiology of atherosclerotic cardiovascular disease in humans.

Association of dietary patterns with blood lipid level among the older adults over 65 years old in 9 longevity areas of China

Objective: To explore the impact of adherence to plant-based and animal-based dietary patterns on blood lipid level in Chinese older adults aged≥65. Methods: The study subjects were from the Chinese Longitudinal Health Biomarker Survey on Aging conducted between 2008 and 2018. The project carried out a baseline survey on elderly people in nine longevity areas of China from 2008 to 2009, and conducted 3 follow-up visits respectively in 2011-2012, 2014, and 2017-2018. The information about their demographic characteristics, lifestyles, physical examinations and fasting venous blood samples were collected. Food Frequency Questionnaire was used to collect data on food intake frequency. Priori plant-based and priori animal-based dietary patterns were constructed, and plant-based diet index (PDI) and animal-based diet index (ADI) were calculated in 2 011 older adults. Linear mixed-effects models were used to analyze the associations of different dietary pattern indices with blood lipid level in older adults. Results: The average age of 2 011 subjects was (83.1±11.5) years, 52.8% (1 061) of them were women. The PDI and ADI [M (Q1, Q3)] were 41.0 (38.0, 45.0) and 43.0 (39.0, 46.0), respectively. After adjusting for covariates, the results of the linear mixed effects model analysis showed that for each increment of 10-unit in PDI, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels decreased by 0.097 (95%CI:-0.151--0.042) mmol/L and 0.078 (95%CI:-0.118--0.038) mmol/L, respectively. For each increment of 10-unit in ADI, TC and LDL-C levels increased by 0.096 (95%CI: 0.042-0.151) mmol/L and 0.078 (95%CI: 0.038-0.118) mmol/L, respectively. Conclusions: In Chinese older adults≥65 years, higher adherence to the plant-based dietary pattern may lead to reductions in TC and LDL-C levels, while higher adherence to the animal-based dietary pattern may lead to increases in TC and LDL-C levels.

Cepstral Peak Prominence in normophonic Irish-English speaking adults: The effect of gender, age, speech task segmental composition, recording conditions and CPP extraction method

ABSTRACT This paper reports Cepstral Peak Prominence (CPP) values for normophonic English-speaking adults living in Ireland. A hundred vocally healthy adults (50 females, 50 males) aged 18–55 were audio recorded producing a series of speech tasks (sustained vowels, connected speech). Fifty-eight speakers in the 18–24 age group were recorded twice: remotely, using their mobile phones and onsite, in controlled recording setup. Forty-two speakers in the 25–55 age group were recorded only remotely, using their mobile phones. CPP values were extracted automatically, with and without voice activity detection (VAD), using a Praat plug-in. Linear mixed effect model analyses were conducted to establish the effect of speaker gender, age, speech task and recording conditions on CPP values. The results suggest strong significant effect of speech task. Sustained vowel [a] was found to have the highest CPP. In other speech tasks CPP values were found to decrease as the number of voiceless obstruents in them increases. We found moderate significant effect of gender: in sustained vowels only CPP[Male] > CPP[Female]. No effect of age was found. Recording condition had significant, but rather small effect, and its direction was different for CPPnoVAD (Onsite < Remote) and CPPVAD (Onsite > Remote). CPPVAD values are higher than CPPnoVAD ones regardless of the speaker gender. The choice of CPP extraction method affects mainly the speech tasks containing voiceless obstruents (CPPVAD > CPPnoVAD). The findings reported here contribute to the growing body of knowledge about normative CPP values and may serve as a reference in clinical voice assessment.

Lean Mass Longitudinally Confounds Sedentary Time and Physical Activity With Blood Pressure Progression in 2513 Children.

Randomized controlled trials have reported no effect of moderate-to-vigorous physical activity (MVPA) on reducing blood pressure (BP) in youth, probably due to short trial durations. This study examined the longitudinal effect of sedentary time (ST), light PA (LPA) and MVPA on BP in 11-year-old children followed up for 13 years to determine the confounding and mediating role of body composition. Data included 2513 children from the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort who had data on at least one time-point measure of accelerometer-based movement behaviour across the follow-up and complete BP measures at ages 11, 15 and 24 years. Body composition was assessed with dual-energy x-ray absorptiometry at all time points. Multivariate adjusted generalized linear mixed-effect model and structural equation causal mediation model analyses were conducted. Among 2513 participants (61% female, mean [SD] age 11.72 [0.21] years), ST steadily increased from ~6 h/day in childhood (age 11 years) to ~9 h/day in young adulthood (age 24 years), whereas LPA and MVPA decreased, but BP had an inverted U-shaped increase. In the longitudinal analysis, after full adjustment, a 1-min cumulative ST from ages 11 to 24 years was positively associated with increased systolic BP (0.009 mmHg [95% CI 0.007-0.011]; p < 0.001) and diastolic BP. A 1-min cumulative LPA was inversely associated with systolic BP (-0.007 mmHg [-0.009 to -0.004]; p < 0.001), but not diastolic BP. In isotemporal substitution analyses, longitudinal replacement of 10 min of ST with equal time in LPA during childhood, adolescence and young adulthood cumulatively decreased systolic BP by -2.63 mmHg [95% CI -3.17 to -2.08] (p < 0.0001) and diastolic BP by -1.93 mmHg [95% CI -2.36 to -1.50] (p < 0.0001). Replacing 10 min of ST with 10 min of MVPA had no statistically significant effect due to an absolute confounding effect of lean mass. The association of ST with systolic BP was fully mediated by increased lean mass (93% mediation). Increased total fat mass partially mediated (19%-27%) the inverse associations of cumulative MVPA with cumulative systolic and diastolic BP. Theoretically replacing 10 min/day spent sedentary with 10 min/day of LPA during growth from childhood through young adulthood may lower systolic BP by -3 mmHg and diastolic BP by -2 mmHg. Lean mass seems more significant than fat mass in the relations of ST and PA with BP and should be accounted for in future intervention studies in the paediatric and young adult population.

Abstract 4122763: Health Status Outcomes of Antianginal Therapies in Patients After Coronary Revascularization: Insights From the GREAT Disease Registry Study

Background: The impact of antianginal therapies on the health status of coronary artery disease (CAD) patients who have undergone coronary revascularization has not been extensively researched. This study aimed to investigate the effect of nicorandil on the health status in patients after coronary revascularization, measured by the Seattle Angina Questionnaire (SAQ). Methods: We analyzed data from 1,556 patients enrolled in the GREAT Disease Registry Study (Clinicaltrial No. NCT05050773) between September 2021 and May 2022. Changes in SAQ summary score (SAQ-SS) from baseline to 3, 6, 9, and 12 months were assessed. Statistical methods included a linear mixed-effects model and propensity score matching (PSM) for comparative analysis. Results: Among the 1,038 patients receiving revascularization analyzed (22.7% female; mean age [SD], 59.9 [10.2] years), 648 (62.4%) received nicorandil, while 390 (37.6%) did not. In the linear mixed-effects model analysis, statistically significant improvements were observed with nicorandil in SAQ-SS across all time points ( Table 1 ), indicating beneficial effects of nicorandil on health status outcomes after revascularization. Sensitive analysis was conducted using the PSM method. After PSM adjustment, both groups comprised 321 patients each. The change in SAQ-SS from baseline to 12 months was significantly greater in the nicorandil group (19.2 ± 14.06 points) compared to the non-nicorandil group (14.91 ± 12.9 points, p &lt; 0.001). Conclusions: These findings indicated that nicorandil is associated with improved health status outcomes in CAD patients who have undergone coronary revascularization.

Efficacy comparison of repeated low-level red-light therapy and orthokeratology lenses for myopia control.

This study aimed to compare and analyze the efficacy of repeated low-level red-light therapy and orthokeratology lenses for myopia control in children. Exactly 138 participants were enrolled in this retrospective study. Comprehensive eye examinations were performed prior to treatment. The repeated low-level red-light therapy and orthokeratology lenses groups comprised 67 and 71 patients, respectively. The age range was between 6 and 14 years, with myopia of ≤-0.50 D and astigmatism of ≤2.50 D after cycloplegia. Follow-up data were collected during the initial visit and the treatment period. Changes in axial length over a 2-year period and associated factors were analyzed. Over the 2-year period, the repeated low-level red-light therapy group exhibited significantly less axial length growth compared with the orthokeratology lenses group (0.17 ± 0.40 vs. 0.50 ± 0.27 mm, p<0.001). In the first year, the axial length growth in the repeated low-level red-light therapy group was significantly less than that in the orthokeratology lenses group (0.03 ± 0.22 vs. 0.28 ± 0.18 mm, p<0.001), with no significant difference observed in the second year (0.14 ± 0.29 vs. 0.21 ± 0.14 mm, p=0.06). The repeated low-level red-light therapy group showed a 55% reduction in axial length after 1 month and a 42% reduction after 1 year, compared with 4% and 3% reductions in the orthokeratology lenses group, respectively. Linear mixed-effects model analysis indicated that the annual axial length change rate in the repeated low-level red-light therapy group was 0.10 mm (95% confidence interval [CI], 0.07 to 0.14), compared with 0.25 mm in the orthokeratology lenses group (95% CI, 0.24 to 0.27), with an average difference of 0.15 mm (95% CI, -0.17 to -0.12, p<0.001). Repeated low-level red-light therapy demonstrated slightly superior efficacy in controlling myopia progression in children compared with orthokeratology lenses.

Association of cartilage [formula omitted] and [formula omitted] relaxation time measurement with hip osteoarthritis progression: A 5-year longitudinal study using voxel-based relaxometry and Z-score normalization

ObjectiveTo study the longitudinal changes of cartilage T1ρ and T2 relaxation time measurements in hip-OA patients. MethodsA calibration study compared two scanner data, Scanner-1 (GE Discovery MR750 3.0T) with unilateral acquisition protocol and Scanner-2 (GE Signa Premier 3.0T) with bilateral acquisition protocol, using nine subjects(average age ​= ​40.33 ​± ​13.53 years, 5 females), including one hip-OA subject. Quantified parameters from the Scanner-2 were adjusted using voxel-based relaxometry(VBR) and Z-score normalization to reduce the inter-scanner variability. Eighteen hip-OA Subjects (age ​= ​53.11 ​± ​14.96 years, 12 females) were recruited to the longitudinal variability study from 2016, comprising five assessments at 1-year intervals. Baseline to 3rd-year data used unilateral acquisition with Scanner-1, while 4th-year data used bilateral acquisition with Scanner-2. A linear mixed-effects model(LME) assessed trajectory analyses, with acquisition year, age, sex, body mass index(BMI), and Kellgren-Lawrence(KL) score as predictor variables and cartilage mean T1ρ and T2 values as outcomes. ResultsVBR analysis after Z-score normalization showed that only a few of the whole cartilage voxels had significant differences in T1ρ(femur-2.36 ​% and acetabular-3.23 ​%) and T2 (femur-2.30 ​% and acetabular-2.94 ​%) values between the scanners. The LME analysis showed that the BMI predictor variable was significantly correlated with the femur T1ρ (p ​< ​0.0001) and T2 (p ​< ​0.0001) and acetabular T1ρ (p ​< ​0.0001) and T2 (p ​< ​0.0001) cartilage region. ConclusionThe calibration study demonstrated the effectiveness of VBR and Z-score normalization in reducing inter-scanner variability. The longitudinal study revealed a significant correlation between T1ρ and T2 values of the cartilage and BMI; also the T1ρ and T2 values increased over time in some of the cartilage subregions.

Association of Neurogranin and BACE1 With Clinical Cognitive Decline in Individuals With Subjective Cognitive Decline.

CSF biomarkers have immense diagnostic and prognostic potential for Alzheimer disease (AD). However, AD is still diagnosed relatively late in the disease process, sometimes even years after the initial manifestation of cognitive symptoms. Thus, further identification of biomarkers is required to detect related pathology in the preclinical stage and predict cognitive decline. Our study aimed to assess the association of neurogranin and β-site amyloid precursor protein-cleaving enzyme 1 (BACE1) with cognitive decline in individuals with subjective cognitive decline (SCD). We enrolled participants with available neurogranin and BACE1 measurements in CSF from the DELCODE (DZNE-Longitudinal Cognitive Impairment and Dementia, Germany) cohort. The longitudinal change of Preclinical Alzheimer's Cognitive Composite score was assessed as the primary outcome in participants with SCD and controls. The secondary outcome was defined as conversion of SCD to mild cognitive impairment (MCI) during follow-up. Levels of neurogranin, BACE1, and neurogranin/BACE1 ratio across groups were compared by analysis of covariance after adjustment for demographics. The linear mixed-effects model and Cox regression analysis were applied to evaluate their association with cognitive decline and progression of SCD to MCI, respectively. A total of 530 participants (mean age: 70.76 ± 6.01 years, 48.7% female) were analyzed in the study. The rate of cognitive decline was faster in individuals with SCD with higher neurogranin and neurogranin/BACE1 ratio (β = -0.138, SE = 0.065, p = 0.037, and β = -0.293, SE = 0.115, p = 0.013). Higher baseline neurogranin and neurogranin/BACE1 ratio were associated with an increased rate of conversion from SCD to MCI (hazard ratio [HR] 1.35 per SD, 95% CI 1.03-1.77, p = 0.028, and HR 1.53 per SD, 95% CI 1.13-2.07, p = 0.007). In addition, the impact of higher neurogranin levels on accelerating the rate of cognitive decline was more pronounced in the SCD group than in cognitively unimpaired controls (β = -0.077, SE = 0.033, p = 0.020). Our findings suggest that CSF neurogranin and BACE1 begin to change in the preclinical stage of AD and they are associated with clinical progression in individuals with SCD.

Enhanced Recovery After Surgery Protocols in One- or Two-Level Posterior Lumbar Fusion: Improving Postoperative Outcomes.

Background/Objectives: Enhanced recovery after surgery (ERAS) protocols optimize perioperative care and improve recovery. This study evaluated the effectiveness of ERAS in one- or two-level posterior lumbar fusion surgeries, focusing on perioperative medication use, pain management, and functional outcomes. Methods: Eighty-eight patients undergoing lumbar fusion surgery between March 2021 and February 2022 were allocated into pre-ERAS (n = 41) and post-ERAS (n = 47) groups. Outcomes included opioid and antiemetic consumption, pain scores (numerical rating scale (NRS)), functional recovery (Oswestry Disability Index (ODI) and EuroQol 5 Dimension (EQ-5D)), and complication rates. Pain was assessed daily for the first four postoperative days and at 6 months. Linear Mixed Effects Model analysis evaluated pain trajectories. Results: The post-ERAS group showed significantly lower opioid (p = 0.005) and antiemetic (p < 0.001) use. No significant differences were observed in NRS pain scores in the first 4 postoperative days. At 6 months, the post-ERAS group reported significantly lower leg pain (p = 0.002). The time:group interaction was not significant for back (p = 0.848) or leg (p = 0.503) pain. Functional outcomes at 6 months, particularly ODI and EQ-5D scores, showed significant improvement in the post-ERAS group. Complication rates were lower in the post-ERAS group (4.3% vs. 19.5%, p = 0.024), while hospital stay and fusion rates remained similar. Conclusions: The ERAS protocol significantly reduced opioid and antiemetic use, improved long-term pain management and functional recovery, and lowered complication rates in lumbar fusion patients. These findings support the implementation of ERAS protocols in spinal surgery, emphasizing their role in enhancing postoperative care.

Pronunciation of Vowel Digraphs in Nonwords: A Replication and Extension.

In English, the pronunciation of a vowel digraph can vary; for example, ea is pronounced /ɛ/ in bread but /i/ in beach and /eɪ/ in break. We investigated participant-level effects on the pronunciation of ambiguous vowel digraphs in nonwords (e.g., yeath) using standardized test measures of six reading-related skills in 80 young adults. We employed both an established written task and set of nonword stimuli and a spoken version of the task with the same stimuli. We largely replicated the previously reported pattern of preferred nonword pronunciations in both the written and spoken versions of the task. Generalized linear mixed-effects model analyses revealed that individual differences in phonological memory, spelling knowledge, and word reading efficiency contributed to pronunciation choice beyond item-level effects. Overall, taken together with the results of item-level analyses, our findings are consistent with models and theories in which specific reading-related skills, intralexical context, and interlexical pronunciation knowledge influence ambiguous vowel digraph pronunciation in nonword reading in fluently reading young adults.

Effects of a food supplement containing phosphatidylserine on cognitive function in Chinese older adults with mild cognitive impairment: A randomized double-blind, placebo-controlled trial

BackgroundPhosphatidylserine (PS) and α-Linolenic acid (ALA), are positively associated with cognitive function, but their combination effects and possible mechanisms remain unclear. We aimed to explore the effects on cognition and potential mechanism of the supplements. MethodsThis randomized, double-blind, placebo-controlled trial recruited 190 MCI patients in Tianjin, China, and randomly assigned in intervention group and placebo group. Each group consumed two capsules every day for 12 months. Each capsule for intervention group contains 144 mg ALA, 31.5 mg PS and 3.6 mg Ginkgo total flavonoids as main functional components, with 0.48 mg Vitamin B1 (as thiamine hydrochloride), 0.48 mg Vitamin B6 (as pyridoxine hydrochloride) and 90 μg folic acid as supplement. Capsules for placebo group were identical but contain no active ingredients. Cognitive function, serum n-3 polyunsaturated fatty acids (PUFAs) and neurotransmitters were assessed at baseline and 12 months. Linear mixed effects model and causal mediation analysis were conducted to explore the effects and potential mechanism of the intervention. ResultsA total of 190 participants (mean [SD] age, 67.95 [5.62] years; 70 (36.8 %) male and 120 (63.2 %) female) were randomized to the placebo group (n = 95) and intervention group (n = 95). Compared with placebo group, the intervention group had statistically significant improvements in arithmetic testing (β, 0.688; 95 % CI, 0.103–1.274), the similarity test (β, 1.070; 95 % CI, 0.472–1.667) and short-term memory (β, 0.600; 95 % CI, 0.399–0.800). Besides, the intervention group had statistically significant increases in serum ALA (β, 1.620; 95 % CI, 0.967–2.265), DHA (β, 2.797; 95 % CI, 1.075–4.532), EPA (β, 1.472; 95 % CI, 0.296–2.643), acetylcholine (β, 0.441; 95 % CI, 0.415–0.468), GABA (β, 0.009; 95 % CI, 0.001–0.016) and 5-HT (β, 0.160; 95 % CI, 0.081–0.238) compared to the placebo group. And the intervention may improve short-term memory by increasing serum ALA levels (average causal mediation effect = 0.132, 95 % CI, 0.053–0.225) with 19.7 % mediation proportion. ConclusionsThis food supplement containing phosphatidylserine could improve different cognitive functions of MCI patients, especially short-term memory, and increase serum n-3 PUFAs and neurotransmitters levels. Serum ALA level might play a mediation role.

Gender Differences in the Association Between Childhood Neighborhood Quality and Depressive Symptoms Trajectory in Middle-Aged and Elderly Chinese: A Seven-Year Longitudinal Study.

This study aimed to examine the role of childhood neighborhood quality on trajectories of depressive symptoms throughout later life based on a nationally representative sample, and to explore the role of gender in the association. Linear mixed-effects model analysis was performed to investigate a longitudinal association of childhood neighborhood quality with depressive symptoms. A total of 7,016 participants aged 45 and above were included in this study. Depressive symptoms progression was significantly faster (β [95% confidence interval, CI]: 0.13 [0.01, 0.25]; P = .027) in the low childhood neighborhood quality when compared with the high childhood neighborhood quality. The quality of childhood neighborhood was significantly associated with a change in depressive symptoms over time in females (β [95% CI]: 0.19 [0.02, 0.36]; P = .029) but not in males (β [95% CI]: 0.09 [-0.06, 0.25]; P = .224). Targeted interventions should be developed to prevent depressive symptoms for those vulnerable groups.

Urinary polycyclic aromatic hydrocarbon metabolites in Chinese pregnant women: Concentrations, variability, predictors, and association with oxidative stress biomarkers

Polycyclic aromatic hydrocarbons (PAHs) are a class of pervasive contaminants having adverse health effects. Urinary monohydroxylated PAHs (OH-PAHs) are commonly employed as biomarkers to estimate PAH exposure levels in humans. However, little is understood about the variability in OH-PAHs among pregnant women across trimesters and their relationship with oxidative stress biomarkers (OSBs). Based on a prospective birth cohort study conducted in Wuhan, China, we selected 644 women who donated (spot) urine samples across different trimesters and measured the urinary concentrations of eight OH-PAHs and three selected OSBs (8-OHG, 8-OHdG, and HNEMA) to explore the relationship between the OH-PAHs and OSBs. Pregnant women were found to be ubiquitously exposed to the PAHs, with detection rates of the OH-PAHs ranging from 86.3% to 100%. 2-Hydroxynaphthalene (2-OH-Nap) had the highest urinary concentrations among the OH-PAHs during the three trimesters (specific gravity-adjusted median values for the first, second, and third trimesters: 1.86, 2.39, and 2.20 ng/mL, respectively). However, low reproducibility of the OH-PAHs was observed across the three trimesters with intraclass correlation coefficients ranged between 0.02 and 0.22. Most urinary OH-PAHs had the highest concentrations at the first trimester and the lowest at the third trimester. Some OH-PAH concentrations were higher in pregnant women with lower educational level [2-hydroxyphenanthrene (2-OH-Phen) and 3-hydroxyphenanthrene (3-OH-Phen)], those who were overweight [2-OH-Nap, 2/3-hydroxyfluorene (2/3-OH-Fluo), 2-OH-Phen, and 4-hydroxyphenanthrene (4-OH-Phen)], those who were unemployed during pregnancy [1-hydroxynaphthalene, 1/9-hydroxyphenanthrene, and 4-OH-Phen], and the samples donated in summer (most OH-PAHs, except for 2-OH-Nap). In multivariable linear mixed-effects model analyses, every OH-PAH was found to be significantly associated with increased levels of the three OSBs. For example, each interquartile range-fold increase in 2/3-OH-Fluo concentration was associated with the largest increase in 8-OHdG (65.4%) and 8-OHG (49.1%), while each interquartile range-fold increase in 3-OH-Phen concentration was associated with the largest increase in HNEMA (76.3%). Weighted quantile sum regression models, which were used to examine the joint effect of OH-PAH mixture on the OSBs, revealed positive associations between the OH-PAH mixture exposure and the OSBs. Specifically, 2/3-OH-Fluo and 2-OH-Nap were the major contributors in the association with oxidative damage of nucleic acids (8-OHdG and 8-OHG), while hydroxyphenanthrenes and 1-hydroxypyrene were the major contributors in the association with oxidative damage of lipid (HNEMA). Further work is required to examine the potential mediating role of oxidative stress in the relationship of adverse health outcomes with elevated PAH exposure among pregnant women.